Understanding Tetanus and Tetany in Dogs  

An Owner’s Guide to Muscle Stiffness and Spasms 

The Most Important Difference 

Ep

Tetanus	Tetany
Caused by a bacterial toxin	Caused by excessive nerve excitability
Usually develops after contamination of a wound	Usually develops because of an underlying medical disorder
An infectious disease (although not contagious between dogs)	A clinical sign rather than a disease itself
Treatment focuses on eliminating the infection and supporting recovery	Treatment focuses on identifying and correcting the underlying cause

Although both conditions can make a dog appear stiff, they occur for entirely different reasons.

Tetany Is Not the Same as Muscle Cramp

This is one of the most important messages in this guide. 

Many people—including veterinarians in older publications—have used the word “cramp” to describe episodes of muscle stiffness in dogs. We now recognise that many of these cases are more accurately described as tetany. 

Although the two conditions may appear similar, they are fundamentally different. 

A muscle cramp is a sudden, painful contraction of a muscle or small group of muscles. It usually develops because the muscle itself contracts abnormally, often after exercise or fatigue. 

Tetany, however, occurs because the nerves supplying the muscles become abnormally excitable. Instead of the muscle being the primary problem, the abnormality lies within the electrical activity of the nervous system. This causes muscles to contract continuously or repeatedly, leading to stiffness, rigid limbs and abnormal postures. 

Pain is often considered an essential feature of muscle cramp, whereas tetany may or may not be painful. Some dogs appear uncomfortable during an episode, while others remain bright and alert but simply cannot control their muscles normally. 

This distinction is much more than a matter of terminology. Calling these episodes “cramp” may suggest a muscle disorder, whereas recognising them as tetany immediately prompts veterinarians to investigate important neurological and metabolic diseases—particularly disorders affecting calcium balance. 

For this reason, many dogs that have historically been described as having “cramping episodes” would now be more accurately described as experiencing tetany. 

Why Is Calcium So Important? 

One of the commonest causes of tetany is hypocalcaemia, meaning that the concentration of ionised calcium in the bloodstream is lower than normal. 

Calcium is essential for normal communication between nerves and muscles. When ionised calcium falls, nerves become increasingly excitable and begin to fire more easily than they should. This excessive nerve activity produces the stiffness and sustained muscle contractions characteristic of tetany. 

In dogs with obvious clinical signs of tetany, ionised calcium concentrations are often below approximately 1.2 mmol/L. However, it is important to understand that this threshold comes from dogs with clear, recognisable clinical disease that were investigated and reported in the veterinary literature. 

It is entirely possible that some dogs develop subtle neurological signs at higher ionised calcium concentrations, before reaching this level. Demonstrating this scientifically is extremely difficult because these dogs often have mild, intermittent signs that are less likely to undergo detailed investigation or be reported in published studies. Consequently, the absence of published evidence should not be taken to mean that slightly higher calcium concentrations cannot contribute to neurological dysfunction. 

For this reason, your neurologist may pay close attention to ionised calcium results even when they are only mildly reduced or sit at the lower end of the reference interval, particularly if the history and neurological examination strongly suggest tetany. 

Ionised calcium is different from the total calcium measured on many routine blood tests. Total calcium can be influenced by other factors, such as blood protein concentrations, and may occasionally appear normal despite the biologically active ionised calcium being reduced. For this reason, measuring ionised calcium is considered one of the most important tests in dogs suspected of having tetany. 

What Causes Tetany? 

Several different disorders can lead to excessive nerve excitability and tetany, but by far the most common is hypocalcaemia. 

The underlying reason for the low calcium may include: 

• Primary hypoparathyroidism  

• Protein-losing enteropathy (severe intestinal disease)  

• Certain intestinal cancers, such as lymphoma  

• Less commonly, other metabolic disorders  

Occasionally, despite extensive investigation, no underlying cause can be identified. These dogs may have an idiopathic (unknown cause) form of tetany or another rare movement disorder. 

Because treatment depends on identifying the underlying cause, dogs with suspected tetany often require blood tests, urine testing and sometimes advanced neurological investigations.  

Part 2 – Understanding Tetanus 

Tetanus is one of the oldest recognised neurological diseases in both human and veterinary medicine. Although it is relatively uncommon in dogs, it remains an important condition because it can cause severe muscle stiffness and spasms that may appear frightening to witness. 

The reassuring news is that, unlike many neurological diseases, tetanus has a single identifiable cause. Once recognised, treatment is directed towards eliminating the infection, neutralising any remaining toxin and supporting the dog while the nervous system slowly recovers. 

Recovery is often gradual, taking several weeks or even months, but many dogs go on to make an excellent recovery. 

What Causes Tetanus? 

Tetanus is caused by a bacterium called Clostridium tetani. 

This bacterium is found naturally in the environment, particularly in soil, dust and animal faeces. Under normal circumstances it causes no problems. However, if it gains access to the body through a wound, particularly one where oxygen levels are low, the bacteria can multiply and begin producing a powerful toxin called tetanospasmin. 

It is this toxin—not the bacteria themselves—that causes the neurological disease. 

Once produced, the toxin enters nearby nerves and travels towards the spinal cord and brain. Here it blocks the normal nerve signals that allow muscles to relax after they contract. 

Without these inhibitory signals, muscles remain continuously active, leading to the progressive stiffness that characterises tetanus. 

How Does a Dog Become Infected? 

Unlike many bacterial infections, tetanus does not spread through the bloodstream from another infected dog. 

Instead, infection usually begins when bacterial spores enter the body through a break in the skin. 

Examples include: 

• puncture wounds  

• bite wounds  

• cuts from thorns or wire  

• contaminated surgical wounds (rare)  

• injuries to the feet  

• foreign bodies lodged beneath the skin.  

In many dogs, the original wound is extremely small and may have healed completely by the time neurological signs develop. As a result, owners are often surprised when no obvious injury can be found. 

Sometimes, despite careful examination, the original wound is never identified. 

Is Tetanus Contagious? 

No. 

This is an important point because many owners understandably worry about other pets. 

A dog with tetanus cannot pass the disease directly to another dog, cat or person through normal contact. 

The bacteria are widespread in the environment anyway, and disease only develops if bacterial spores enter an appropriate wound and produce toxin. 

There is therefore no need to isolate a dog with tetanus from other household pets. 

Why Are Dogs Less Commonly Affected Than Horses? 

Many owners have heard of tetanus in horses but are surprised to learn that dogs can also develop the disease. 

Different animal species vary considerably in their sensitivity to tetanus toxin. 

Horses are extremely susceptible and develop tetanus relatively frequently. 

Dogs and cats are naturally more resistant, meaning they require much larger amounts of toxin before neurological signs develop. 

This natural resistance explains why tetanus is relatively uncommon in small animal practice despite Clostridium tetani being present in the environment. 

What Are the Clinical Signs? 

The earliest signs are often subtle. 

Owners may initially notice that their dog seems: 

• unusually stiff  

• reluctant to walk  

• uncomfortable turning  

• hesitant to jump  

• less willing to exercise.  

Over several days, the stiffness usually becomes progressively worse. 

As more muscles become affected, dogs often develop a characteristic rigid gait, sometimes described as walking “like a wooden horse.” 

Unlike many neurological diseases, dogs with tetanus usually remain bright, alert and fully aware of their surroundings throughout the illness. 

The Characteristic Appearance of Tetanus 

As the disease progresses, several very characteristic features may develop. 

Muscle stiffness 

The muscles throughout the body become increasingly rigid. 

Unlike weakness, where muscles lose strength, tetanus causes excessive muscle contraction, making movement difficult and sometimes impossible. 

“Lockjaw” 

One of the best-known features of tetanus is difficulty opening the mouth. 

The muscles used for chewing become rigid, making it difficult for affected dogs to eat, drink or pick up toys. 

Although “lockjaw” is widely recognised, not every dog develops this sign. 

Facial changes 

Many dogs develop a very recognisable facial expression. 

Owners may notice: 

• ears held upright  

• wrinkling of the forehead  

• lips pulled backwards  

• a fixed facial expression  

• reduced blinking.  

These changes occur because the facial muscles become permanently contracted. 

Difficulty walking 

As stiffness progresses, walking becomes increasingly difficult. 

Dogs often take: 

• short, stiff steps  

• slow movements  

• exaggerated extension of the limbs  

• difficulty turning.  

In severe cases, dogs may become unable to stand without assistance. 

Hypersensitivity 

Many affected dogs become unusually sensitive to external stimuli. 

Bright lights, sudden noises or gentle handling may trigger exaggerated muscle spasms. 

For this reason, dogs with tetanus are often nursed in a quiet, dimly lit environment to minimise unnecessary stimulation. 

Difficulty swallowing 

If the muscles involved in swallowing become affected, eating and drinking may become difficult. 

Some dogs require temporary assisted feeding while the nervous system recovers. 

Does Tetanus Affect the Brain? 

This is a common question. 

Although tetanus is a neurological disease, the toxin does not affect consciousness. 

Most dogs remain fully aware throughout the illness. 

They recognise their owners, respond normally to voices and remain mentally bright despite being unable to move comfortably. 

This can make the disease particularly distressing for owners because their dog appears mentally normal while physically unable to relax its muscles. 

How Is Tetanus Diagnosed? 

There is no single blood test that confirms tetanus in most dogs. 

Instead, diagnosis is usually based on: 

• the history  

• the pattern of clinical signs  

• neurological examination  

• exclusion of other diseases.  

The characteristic combination of progressive muscle stiffness, normal mental status and the classic facial appearance is often highly suggestive. 

Your veterinarian will also carefully examine your dog for evidence of wounds that may have allowed infection to occur. 

Additional investigations may be recommended to exclude other conditions that can produce muscle stiffness, particularly when the diagnosis is less straightforward. 

How Is Tetanus Treated? 

Treatment has several goals. 

1. Eliminate the infection 

If a wound can be identified, it is cleaned thoroughly and any damaged tissue removed where necessary. 

Appropriate antibiotics are then prescribed to eliminate the bacteria and prevent further toxin production. 

2. Control muscle spasms 

Muscle rigidity can be extremely exhausting. 

Medications may be used to reduce muscle spasms and improve comfort while the nervous system gradually recovers. 

These drugs do not cure tetanus but make recovery considerably more comfortable. 

3. Intensive nursing care 

Good nursing care is one of the most important parts of treatment. 

Depending on the severity of the disease, this may include: 

• soft bedding  

• regular turning to prevent pressure sores  

• assistance with eating and drinking  

• bladder management if required  

• physiotherapy during recovery  

• nursing in a quiet, low-stimulation environment.  

Dogs requiring hospitalisation are monitored closely until they can eat, drink and move safely on their own. 

How Long Does Recovery Take? 

Recovery from tetanus is usually slow. 

Although antibiotics stop further toxin production, they cannot remove toxin that has already attached to nerves. 

The nervous system therefore needs time to repair itself by forming new nerve connections. 

Most dogs improve gradually over several weeks, although complete recovery may take two to three months, and occasionally longer in more severely affected patients. 

Patience is often one of the most important aspects of treatment. 

What Is the Prognosis? 

The prognosis depends largely on: 

• how severely affected the dog is  

• whether treatment is started promptly  

• whether complications develop during recovery.  

Fortunately, many dogs survive and regain a good quality of life. 

Once recovery is complete, the toxin has been eliminated and the nervous system has repaired itself, most dogs do not experience recurring episodes. 

Part 3 – Understanding Tetany 

Unlike tetanus, which is a specific infectious disease, tetany is not a disease in itself. Instead, it is a clinical sign that tells your veterinarian that the nerves supplying the muscles have become abnormally excitable. 

This distinction is extremely important. 

When a veterinary neurologist diagnoses tetany, the next question is not “How do we treat the tetany?” but rather “Why has this dog developed tetany?” 

Finding the answer to that question is the key to successful treatment. 

What Is Tetany? 

Tetany is a neurological condition in which the nerves supplying the muscles become excessively excitable. 

Normally, nerves send carefully controlled electrical signals that tell muscles when to contract and when to relax. 

In tetany, this control is lost. 

The nerves begin firing too easily and too frequently, causing muscles to contract involuntarily. Rather than relaxing normally, the muscles remain stiff or undergo repeated sustained contractions. 

These episodes can affect: 

• one limb  

• multiple limbs  

• the neck  

• the face  

• the whole body.  

Importantly, the muscles themselves are usually healthy. The problem lies in the abnormal electrical behaviour of the nerves. 

What Does Tetany Look Like? 

The appearance varies between dogs. 

Some develop intermittent episodes lasting only a few seconds. 

Others remain stiff for several minutes. 

Typical features include: 

• rigid extension of one or more limbs  

• difficulty bending the legs  

• an arched back  

• neck extension  

• stiff, stilted walking  

• difficulty standing normally  

• muscles that feel unusually firm during an episode.  

Unlike many neurological disorders, affected dogs usually remain fully conscious and aware. 

Many owners report that their dog continues looking at them throughout the episode but simply cannot control its muscles properly. 

Between episodes, some dogs return completely to normal, while others retain a mild degree of stiffness. 

Are Tetany Episodes Painful? 

This is one of the commonest questions owners ask. 

The answer is sometimes—but not always. 

Some dogs appear distressed during an episode and may vocalise or become anxious. 

Others remain remarkably calm despite obvious muscle stiffness. 

This is another important reason why tetany should not automatically be described as “cramp.” 

Pain is generally considered one of the defining features of muscle cramp. Tetany, however, is primarily a disorder of nerve hyperexcitability, and pain may or may not be present. 

Your veterinarian will assess your dog’s comfort carefully during the neurological examination. 

Tetany Is Not the Same as Cramp 

This is perhaps the single most important concept in understanding tetany. 

For many years, dogs experiencing episodes of muscle stiffness were frequently described as suffering from cramping syndrome. 

Today we know that this terminology can be misleading. 

A true muscle cramp is a problem of the muscle itself. It is usually a painful, involuntary contraction affecting a single muscle or a small group of muscles. 

Tetany is different. 

In tetany, the primary problem lies within the peripheral nerves, not the muscles. 

The nerves become excessively excitable and continuously stimulate otherwise normal muscles to contract. 

Although the end result—a stiff limb—may look similar, the underlying disease process is completely different. 

Recognising this distinction is clinically important because it changes how veterinarians investigate affected dogs. 

A dog thought to have “muscle cramps” might receive pain relief alone. 

A dog recognised as having tetany immediately prompts investigation for disorders affecting calcium regulation and nerve function—conditions that are often treatable. 

For this reason, many veterinary neurologists now prefer the term tetany whenever the clinical signs are consistent with peripheral nerve hyperexcitability. 

Why Does Tetany Occur? 

The most common reason is that the nerves become unstable because the concentration of ionised calcium in the bloodstream falls below normal. 

Calcium plays a critical role in regulating how easily nerves generate electrical impulses. 

When ionised calcium falls, the threshold required to activate a nerve becomes lower. 

In simple terms, the nerves begin firing far too easily. 

Instead of responding only when they should, they become overactive, repeatedly stimulating muscles and producing stiffness and sustained contractions. 

This process is known as peripheral nerve hyperexcitability, and it forms the basis of tetany. 

Why Do Neurologists Measure Ionised Calcium? 

If a dog develops signs suggestive of tetany, one of the most important investigations is measurement of ionised calcium. 

Ionised calcium is the biologically active form of calcium circulating in the blood. 

It is this fraction—not the total calcium—that directly influences nerve function. 

Routine blood tests often measure total calcium, but this can sometimes appear normal even when ionised calcium is reduced. 

For this reason, a dog with suspected tetany should ideally have ionised calcium measured specifically. 

This is one of the most valuable tests your veterinarian can perform. 

How Low Does Calcium Have to Be? 

Published studies describing dogs with obvious tetany have generally involved patients whose ionised calcium concentration is below approximately 1.2 mmol/L. 

However, this should not be interpreted as a strict threshold below which signs suddenly appear. 

The dogs reported in the veterinary literature are naturally those with sufficiently obvious clinical signs to prompt investigation and publication. 

It is entirely possible that some dogs develop more subtle neurological abnormalities at higher ionised calcium concentrations, but proving this scientifically is extremely difficult. 

Mild or intermittent episodes are less likely to be recognised, investigated or reported, making them largely invisible in published studies. 

For this reason, many veterinary neurologists interpret ionised calcium results alongside the individual dog’s history and neurological examination, rather than relying on a single numerical cut-off. 

In other words, a mildly reduced ionised calcium concentration may still be clinically important if the history strongly supports tetany. 

What Causes Low Calcium? 

Several different diseases can reduce ionised calcium. 

The most common recognised causes include: 

Primary hypoparathyroidism 

This is one of the commonest causes of tetany in dogs. 

The parathyroid glands normally regulate calcium levels through production of parathyroid hormone (PTH). 

If insufficient PTH is produced, calcium concentrations fall, allowing tetany to develop. 

Protein-losing enteropathy 

Some severe intestinal diseases cause excessive loss of proteins and disturbances in calcium regulation. 

Although less common than hypoparathyroidism, they are an important cause of hypocalcaemia. 

Intestinal lymphoma 

Certain cancers affecting the intestines can also interfere with calcium regulation and occasionally present with tetany. 

Other causes 

Less commonly, other metabolic disorders may alter calcium balance. 

Occasionally, despite extensive investigation, no underlying cause can be identified. These cases may be classified as idiopathic, although this appears to be uncommon. 

Is Tetany the Same as a Seizure? 

No. 

This distinction is extremely important. 

During tetany, dogs usually: 

• remain conscious  

• recognise their owners  

• respond to voices  

• remain aware of their surroundings.  

In contrast, dogs experiencing a generalised epileptic seizure usually lose awareness and cannot respond normally. 

Although both conditions involve abnormal muscle activity, the underlying neurological mechanisms are completely different. 

Tetany results from excessive activity of the peripheral nerves, whereas epileptic seizures arise from abnormal electrical activity within the brain. 

Can Tetany Be Mistaken for Other Conditions? 

Yes. 

Tetany can resemble several different disorders, including: 

• muscle cramps  

• orthopaedic pain  

• movement disorders  

• seizures  

• tetanus.  

This is why a detailed history, careful neurological examination and, ideally, videos recorded at home are so valuable. 

Subtle differences in posture, awareness and muscle activity often allow an experienced neurologist to distinguish between these conditions. 

Part 4 – How Is Tetany Investigated and Treated? 

One of the most encouraging aspects of tetany is that, unlike many neurological disorders, the underlying cause is often identifiable and treatable. 

For this reason, the aim of investigation is not simply to confirm that tetany is present. Instead, it is to answer the much more important question: 

Why has this dog developed tetany? 

Once the underlying cause has been identified, treatment can often result in complete resolution of the neurological signs. 

Step 1 – A Detailed History 

The investigation begins with a careful discussion of your dog’s episodes. 

Your veterinary neurologist will ask questions such as: 

• When were the episodes first noticed?  

• How long do they last?  

• Do they affect one limb or several limbs?  

• Does your dog remain conscious?  

• Are the episodes painful?  

• Are they triggered by exercise, excitement or stress?  

• Do they improve with rest?  

• Are they becoming more frequent?  

• Has your dog been ill in any other way?  

Although these questions may seem straightforward, they provide valuable clues about whether your dog is experiencing tetany or another neurological disorder. 

Videos Are Often One of the Most Important Tests 

Because tetany is usually intermittent, many dogs appear completely normal during their consultation. 

For this reason, videos recorded at home are often one of the most valuable diagnostic tools available. 

A short video showing the beginning, middle and end of an episode frequently provides far more information than a verbal description alone. 

Ideally, the video should show: 

• the whole body  

• your dog’s face  

• all four limbs  

• your dog attempting to walk if it is safe to do so.  

If possible, avoid holding or supporting your dog during filming, as this can alter the appearance of the movement. 

Step 2 – Neurological Examination 

Many owners are surprised to learn that the neurological examination is often completely normal between episodes. 

This is actually reassuring. 

Most dogs with tetany have normal: 

• strength  

• balance  

• spinal reflexes  

• cranial nerve function  

• sensation  

once an episode has resolved. 

During an episode, however, your neurologist may observe: 

• sustained muscle contraction  

• limb rigidity  

• difficulty initiating movement  

• abnormal posture  

• increased muscle tone.  

Importantly, dogs with tetany remain mentally normal throughout the episode, helping distinguish tetany from many forms of epilepsy. 

Step 3 – Blood Tests 

Blood testing is the cornerstone of investigating tetany. 

Routine blood tests provide valuable information about your dog’s overall health and help identify diseases that may be responsible for the neurological signs. 

However, one blood test is particularly important. 

Measuring Ionised Calcium 

If tetany is suspected, ionised calcium should always be measured. 

This is one of the most important messages in this guide. 

Many routine laboratory profiles only measure total calcium. 

Unfortunately, total calcium does not always reflect the amount of biologically active calcium available to nerves and muscles. 

Ionised calcium represents the active form of calcium within the bloodstream and is therefore the measurement that matters most when investigating tetany. 

A normal total calcium concentration does not necessarily exclude clinically important abnormalities of ionised calcium. 

For this reason, your veterinarian may recommend a specific ionised calcium measurement even if previous blood tests have appeared normal. 

Looking for the Cause of Low Calcium 

If ionised calcium is reduced, the next step is to determine why. 

Further investigations may include: 

Parathyroid hormone (PTH) 

The parathyroid glands regulate calcium concentrations. 

If these glands fail to produce enough parathyroid hormone, calcium levels fall, resulting in primary hypoparathyroidism, one of the commonest causes of tetany. 

Measuring PTH alongside ionised calcium often allows this diagnosis to be confirmed. 

Additional blood tests 

Depending on the individual patient, your veterinarian may also assess: 

• kidney function  

• liver function  

• protein concentrations  

• phosphate  

• magnesium  

• vitamin D metabolism where appropriate.  

These tests help identify less common causes of hypocalcaemia. 

Investigating intestinal disease 

Some dogs develop low calcium because of severe intestinal disease. 

If blood tests suggest this possibility, additional investigations such as abdominal ultrasound, intestinal biopsies or other gastrointestinal tests may be recommended. 

Does Every Dog Need an MRI? 

No. 

Unlike many neurological diseases, tetany is usually diagnosed without brain imaging. 

If the history, neurological examination and blood tests clearly indicate hypocalcaemia, an MRI is often unnecessary. 

However, MRI may be recommended if: 

• the diagnosis remains uncertain  

• the neurological examination is abnormal between episodes  

• seizures are suspected instead of tetany  

• another neurological disease cannot be excluded.  

Your neurologist will recommend MRI only if it is likely to answer an important clinical question. 

Could It Be Something Else? 

Tetany can resemble several other disorders. 

These include: 

• epileptic seizures  

• paroxysmal dyskinesia  

• orthopaedic disease  

• spinal disease  

• muscle disorders  

• tetanus.  

Fortunately, combining the history, neurological examination, home videos and blood tests usually allows these conditions to be distinguished. 

How Is Tetany Treated? 

Treatment depends entirely on the underlying cause. 

Unlike tetanus, there is no single treatment for tetany itself. 

Instead, treatment is directed at correcting whatever has caused the nerves to become overexcitable. 

Emergency Treatment 

Dogs with severe hypocalcaemia may require hospitalisation. 

If muscle spasms are severe or prolonged, calcium can be administered slowly into a vein under careful monitoring. 

Intravenous calcium acts rapidly and often produces dramatic improvement. 

However, this is only a temporary treatment. 

The underlying calcium disorder must still be corrected. 

Long-Term Treatment 

Many dogs require medication to maintain normal calcium concentrations. 

This commonly includes: 

• calcitriol, the active form of vitamin D  

• oral calcium supplementation where required.  

These medications help restore and maintain normal calcium balance, preventing further episodes of tetany. 

The exact treatment depends on the underlying diagnosis and is tailored to each individual dog. 

Why Does My Dog Need Repeat Blood Tests? 

Owners often ask why blood tests need repeating if their dog appears much better. 

The answer is that calcium regulation is a careful balancing act. 

Too little calcium can lead to recurrent tetany. 

Too much calcium can also cause significant health problems, including damage to the kidneys. 

For this reason, dogs receiving treatment for hypocalcaemia require regular monitoring, particularly during the first few weeks after diagnosis. 

Your veterinarian will usually measure ionised calcium repeatedly while adjusting medication until the concentration remains stable. 

Once good control has been achieved, monitoring becomes much less frequent. 

What Is the Prognosis? 

The outlook depends almost entirely on the underlying cause. 

Primary hypoparathyroidism 

This generally carries an excellent prognosis. 

Although lifelong medication is often required, most dogs live completely normal lives once calcium concentrations have been stabilised. 

Protein-losing enteropathy and intestinal disease 

The prognosis depends upon successful treatment of the underlying intestinal disorder. 

As calcium concentrations improve, tetany usually resolves. 

Idiopathic cases 

Occasionally no cause can be identified. 

Fortunately, some of these dogs experience spontaneous resolution of their episodes, while others remain stable with infrequent signs. 

Can Tetany Return? 

Yes. 

If calcium concentrations fall again, tetany can recur. 

This is why regular monitoring and careful adjustment of medication are so important. 

Owners should also contact their veterinarian promptly if they notice any recurrence of stiffness, muscle spasms or unusual episodes. 

Early intervention often prevents more severe clinical signs from developing. 

Part 5 – Living with a Dog Recovering from Tetanus or Tetany 

Receiving a diagnosis of tetanus or tetany can be overwhelming. Both conditions often develop suddenly, and the muscle stiffness and abnormal posture can be alarming to witness. 

Fortunately, the long-term outlook for many dogs is much better than owners initially expect. 

Although recovery from tetanus may take several weeks, and some causes of tetany require lifelong medication, many affected dogs go on to enjoy an excellent quality of life. 

Understanding what to expect during recovery can help you support your dog and recognise when veterinary advice is needed. 

Caring for a Dog Recovering from Tetanus 

Recovery from tetanus is rarely immediate. 

Although the bacteria can be eliminated with antibiotics, the toxin that has already attached to the nervous system cannot simply be removed. Instead, the body must gradually repair the affected nerve endings, a process that takes time. 

During recovery, your dog may continue to appear stiff for several weeks. 

Some dogs improve steadily every day, while others seem to plateau for a short period before making another noticeable improvement. 

This is entirely normal. 

The most important aspect of recovery is patience. 

Nursing at Home 

Your veterinary team will advise you when your dog is ready to continue recovering at home. 

Simple measures can make recovery much easier, including: 

• providing soft, well-padded bedding  

• helping your dog stand if necessary  

• preventing slipping by using rugs or non-slip flooring  

• keeping food and water easily accessible  

• encouraging gentle movement as advised by your veterinarian  

• avoiding excitement and stressful situations until recovery is well established.  

Many dogs also tire easily during the early stages of recovery, so allowing plenty of opportunities to rest is important. 

Living with Hypoparathyroidism 

Many dogs with tetany are eventually diagnosed with primary hypoparathyroidism. 

Although this sounds worrying, it is generally a condition that can be managed very successfully. 

Most affected dogs require lifelong medication to maintain normal calcium concentrations, but once the correct dose has been established they usually return to a completely normal lifestyle. 

Many owners report that, after treatment begins, their dog behaves exactly as they did before becoming ill. 

Giving Medication 

If your dog has hypocalcaemia, treatment commonly includes calcitriol (the active form of vitamin D), sometimes together with oral calcium supplements. 

These medications work by helping the body maintain normal calcium concentrations. 

It is important to: 

• give medication exactly as prescribed  

• avoid changing the dose without veterinary advice  

• attend scheduled blood tests  

• contact your veterinarian if episodes begin to recur.  

Because every dog regulates calcium slightly differently, medication often requires careful adjustment during the first few weeks or months. 

Why Monitoring Matters 

Many owners understandably wonder why blood tests are still necessary when their dog appears completely normal. 

The answer is that calcium concentrations can change long before obvious neurological signs develop. 

Regular monitoring allows your veterinarian to identify these changes early and adjust medication before tetany returns. 

Monitoring also helps avoid calcium concentrations becoming too high, which can cause its own health problems. 

Once your dog’s calcium concentration has remained stable for some time, monitoring usually becomes much less frequent. 

Can My Dog Exercise Normally? 

In most cases, yes. 

Once calcium concentrations have been stabilised and your veterinarian is happy with your dog’s progress, normal exercise can usually be resumed gradually. 

Immediately after diagnosis, however, vigorous exercise may occasionally trigger episodes in dogs whose calcium concentrations are not yet fully controlled. 

For this reason, exercise should be increased gradually and in accordance with your veterinarian’s advice.

When Should I Contact My Vet? 

You should contact your veterinary surgeon promptly if your dog develops: 

• new episodes of muscle stiffness  

• repeated muscle spasms  

• difficulty walking  

• reluctance to exercise  

• difficulty eating or swallowing  

• unusual weakness  

• any signs similar to those seen before diagnosis.  

Dogs recovering from tetanus should also be reassessed if they appear to become stiffer after initially improving or if they develop coughing, breathing difficulties or marked lethargy. 

Frequently Asked Questions 

Is tetanus contagious? 

No. 

Dogs cannot catch tetanus directly from another dog. Infection occurs when Clostridium tetani spores contaminate a suitable wound. 

Will my dog recover from tetanus? 

Many dogs make an excellent recovery. 

Recovery is often slow because nerves require time to repair after toxin exposure, but patience and good nursing care are usually rewarded. 

Is tetany permanent? 

Tetany itself is a clinical sign rather than a disease. 

If the underlying cause can be corrected, the tetany often resolves completely. 

Will my dog need lifelong treatment? 

This depends on the cause. 

Dogs with primary hypoparathyroidism usually require lifelong treatment with calcitriol, with or without calcium supplementation. 

Dogs whose hypocalcaemia develops secondary to another disease may only require treatment until that underlying disorder has been successfully managed. 

Could my dog have another episode? 

Yes. 

If calcium concentrations fall again, tetany may recur. 

This is why regular monitoring and adherence to treatment are so important. 

Fortunately, once calcium concentrations have been stabilised, most dogs remain free from further episodes.

Can tetany be mistaken for epilepsy? 

Yes. 

Because tetany can produce sudden episodes of abnormal movement, it is sometimes mistaken for epileptic seizures. 

However, most dogs with tetany remain fully conscious and aware throughout the episode, which helps distinguish the two conditions.   

Could it simply be muscle cramps? 

Although the word “cramp” is commonly used, many dogs referred for “cramping episodes” are actually experiencing tetany. 

Recognising this distinction is important because tetany often has an identifiable—and frequently treatable—underlying cause. 

Key Messages 

• Tetanus and tetany are completely different conditions despite their similar names.  

• Tetanus is caused by a bacterial toxin affecting the nervous system.  

• Tetany is a clinical sign caused by excessive nerve excitability and is often associated with low ionised calcium.  

• Tetany is not simply another name for muscle cramp.  

• Measuring ionised calcium is one of the most important investigations in dogs with suspected tetany.  

• Many dogs with hypocalcaemia have an underlying disorder that can be successfully treated.  

• Dogs with primary hypoparathyroidism generally have an excellent long-term prognosis with appropriate lifelong management.  

• Recovery from tetanus may take weeks, but many dogs ultimately return to an excellent quality of life.  

• Regular follow-up appointments and blood tests are essential to maintain long-term control and prevent recurrence.  

Final Thoughts 

Watching your dog experience severe muscle stiffness or spasms can be frightening, but it is important to remember that these clinical signs do not all have the same cause. 

One of the greatest advances in veterinary neurology has been recognising that many dogs once described as having “cramping syndromes” are actually experiencing tetany caused by peripheral nerve hyperexcitability. This distinction matters because it directs veterinarians towards investigating ionised calcium and other potentially treatable metabolic disorders, rather than simply describing the movement itself. 

Similarly, although tetanus can appear dramatic, it is a well-recognised condition with an identifiable cause, and many affected dogs recover well with appropriate treatment and supportive nursing. 

Whether your dog has tetanus or tetany, the aim is not simply to treat the muscle stiffness, but to understand why it has developed. Once the underlying cause has been identified, treatment can be tailored to your dog’s individual needs, giving them the best possible chance of making a full recovery and returning to a happy, active life. 

If you have any concerns about your dog’s progress or notice any recurrence of stiffness, abnormal posture or muscle spasms, contact your veterinary surgeon or veterinary neurologist promptly. Early recognition and treatment remain the keys to achieving the best possible outcome.