Breakthrough treatment saves horse at Mizzou

When Aliva Jones from Butler, Missouri, first saw Cardi, a young quarter horse, she did not expect the journey that they would embark on. A few weeks after Jones brought Cardi home, she began to notice that something was off with her horse during routine wound care.

“Cardi was stiff and couldn’t really walk, she had a prolapsed eyelid, and her face just didn’t look right,” Jones explained.1 “I was almost 100% sure it was tetanus. I had given her the first dose of the vaccine, but she wasn’t yet due for the second, so she wasn’t fully protected.”

Jones brought Cardi 3 hours away to the University of Missouri’s Veterinary Health Center (VHC), where the team confirmed she had tetanus. Lynn Martin, DVM, MPH, DACVI (LAIM), noticed the severity of her condition and a team of equine experts began treatment to help save Cardi. Martin noted that she presented with classic neurologic signs of the disease, moved with a rigid and uneasy gait, a sardonic grin, and a protruding third eye. If a horse presents like this, they normally do not survive, according to Martin.

Cardi was treated with standard supportive care to start, including wound management, intramuscular antitoxin injections, antimicrobials, tranquilizers, and supportive measures such as housing Cardi in a dark quiet stall. However, Martin began to realize that this was not enough, plus a nationwide shortage of the antitoxin made things more complicated for Cardi’s team.

The VHC team was able to secure multiple doses of the antitoxin and quickly began treatment, but by this point the toxin had reached Cardi’s central nervous system. However, in severe cases of tetanus, the intramuscular administration of the antitoxin is not very effective, which led Martin to propose a more aggressive approach: intrathecal injection. After the first dose, Cardi collapsed.

“For a second, I thought we lost her,” Martin said. “But we gave her fluids and kept monitoring everything. And then … she got back up.”

In order to keep Cardi moving in the right direction, Marin proposed a novel approach to improve the treatment, placing an indwelling intrathecal catheter to deliver the antitoxin in a safer, slower, and smaller repeated doses. In collaboration with John Dodam, DVM, MS, PhD, DACVAA, the team at VHC performed the delicate procedure. This innovative procedure was the key to Cardi’s lifesaving treatment because administering the antitoxin in smaller more controlled doses can help avoid severe reactions that are noted with the initial large injection, allowing treatment to go on without complications.1

Over 6 treatments her stiffness eased, the tension left her face, and she began to walk, eat, and trot again. She was able to eventually return home to continue her recovery journey.

“It was incredible,” Martin explained. “In all my years, I’ve never seen a horse come back from Tetanus like this. Cardi beat the odds because everyone — faculty, interns, students, residents and the anesthesia team — came together for a total team effort.”

“As far as I know, this is the first time this procedure has ever been done,” Martin said. “It’s rare to encounter something entirely new in practice, and moments like this remind me why I became a veterinarian,” Martin concluded.1

Reference

1. Childress N. Breakthrough care at Mizzou’s Veterinary Health Center gives horse a second chance at life. Show Me Mizzou. June 23, 2025. Accessed June 24, 2025. https://showme.missouri.edu/2025/breakthrough-care-at-mizzous-veterinary-health-center-gives-horse-a-second-chance-at-life/