Diabetic autonomic neuropathy is probably the most undiagnosed but serious complication of diabetes. The main objectives were to assess the prevalence of peripheral and autonomic neuropathy in a population of diabetic patients, analyze it in a real-life outpatient unit scenario and determine the feasibility of performing SUDOSCAN tests together with widely used tests for neuropathy. A total of 33 patients were included in the study. Different scoring systems (the Toronto Clinical Neuropathy Score—TCNS; the Neuropathy Disability Score—NDS; and the Neuropathy Symptom Score—NSS) were applied to record diabetic neuropathy (DN), while the SUDOSCAN medical device was used to assess sudomotor function, detect diabetic autonomic neuropathy and screen for cardiac autonomic neuropathy (CAN). Fifteen (45.5%) patients had sudomotor dysfunction. The SUDOSCAN CAN risk score was positively correlated with the hands’ electrochemical sweat conductance (ESC), diastolic blood pressure (DBP), the level of the glycated hemoglobin, as well as with the TCNS, NDS and NSS. Performing SUDOSCAN tests together with other tests for DN proved to be a feasible approach that could be used in daily clinical practice in order to screen for DN, as well as for the early screening of CAN, before more complex and time-consuming tests.

Tetanus is uncommon in dogs, which are considered relatively resistant to tetanospasmin, and detailed descriptions of the diagnostic evaluation of severe generalized cases remain limited. A 5.5-month-old intact male Miniature Schnauzer was presented four days after a puncture wound to the right pelvic limb. On admission the dog was alert but non-ambulatory, with generalized muscle rigidity, tremors, marked cervical hyperextension, hyperactive spinal reflexes, facial muscle spasms and dysphagia. Together with the wound history and rapid progression, these findings supported a presumptive diagnosis of generalized tetanus, clinically classified as Grade III. Serum collected before tetanus antitoxin administration contained no detectable antibodies against Clostridium tetani neurotoxin. Treatment comprised equine tetanus antitoxin, antimicrobials, multimodal sedation and muscle relaxation, enteral nutrition, intensive nursing and physiotherapy. Needle electromyography on day 10 showed increased insertional activity, positive sharp waves and fibrillation potentials, and continuous spontaneous motor unit activity. Despite patient young age and rapid disease progression, clinical improvement was evident from day 10, and the dog was discharged on day 16, ambulatory and eating voluntarily. This case highlights that severe generalized canine tetanus remains principally a clinical diagnosis, while serial neurological examination, clinicopathological monitoring and electromyography can strengthen diagnostic confidence, characterize disease progression and support clinical management.