Historically, botulism has usually been seen as a fatal problem for the young foal. However, Pamela Wilkins, DVM, PhD, of the Graham French Neonatal Intensive Care Unit at the University of Pennsylvania’s New Bolton Center, said that she has had a positive experience in treating affected foals. In her AAEP Convention presentation “Botulism in Foals: A Survivable Disease,” she said that botulism in foals less than six months of age is readily treated, with a survival rate of more than 95% in appropriately treated foals. Treatment can include nursing care, intravenous fluid support, nasogastric or nasoesophageal tube feeding, broad-spectrum antimicrobials (excluding aminoglycoside and tetracycline classes), oxygen therapy, and the administration of botulism antitoxin. Approximately 33% of affected foals might require positive pressure mechanical ventilation, she said.

Wilkins and her colleagues did a retrospective study in which they examined data from 28 botulism-affected foals under the age of six months treated at the Graham French Neonatal Intensive Care Unit from 1989 to 2001. Of the 28 foals, 25 survived with no reported long-term or career-limiting problems.  All surviving foals were treated with botulism antitoxin shortly after arrival at the clinic. One foal died from respiratory failure and cardiac arrest, while two foals were euthanized for economic reasons