Adventures of the Vet: Equine Food Poisoning

The toxicity of equine botulism was a grim prognosis. Cathy and I tried to reassure each other as Hans was given an expensive antivenom at the veterinary hospital. Equine botulism toxin works in a very specific way, binding to proteins between nerves and muscles, and causing general weakness and sometimes complete paralysis. Hans’s only hope was an antidote to the poison and a long hospital stay. This was it, if he survived.

When food poisoning goes down and can’t go up, the outlook is grave, even with intensive care. Photo by Dusty Perrin

I have only seen two cases of equine food poisoning in my career, and they are both horrifying. Horses are highly sensitive to toxins – it takes more to kill a mouse than it does a horse, so even a few mouthfuls of contaminated feed can be fatal.

Doctors at the hospital stressed that while the source was most likely his straw, there was no way to be sure. And they still couldn’t completely rule out rabies, so everyone who came into contact with Hans had to be considered at risk.

In the thick of equine food poisoning

Hans remained stable for the next few days, even though he wasn’t producing much manure, and his bowels were still very slow. His risk of aspiration pneumonia was high, so he was receiving regular fluids and foods through a stomach tube. An intravenous drip containing essential electrolytes works around the clock.

Doctors reported that he lay down about every 20 minutes to rest, but the important thing was that Hans always got up. Every time I spoke to a member of Hans’ team, it was the first thing they described—the great ability of a great horse to always be on its feet.

Progress was slow over the next week, and the team was concerned that Hans was not getting enough calories, so they increased his feeding. The bill increased day by day.

Cathy wasn’t making money, but she was determined to save her horse, and if the hospital recommended something, she agreed to it without a doubt. Due to the COVID pandemic, she couldn’t even visit Hans, and the kind doctors often made video calls from Hans’ booth so Cathy could see and talk to her beloved horse.

The entire hospital seemed to be involved in Hans’ affair, and he was soon developing a fan club. Veterinary students would stop by all day to check on and care for him, and there was always a technician around monitoring his fluids, administering medications and recording his lying and standing patterns.

Hans did not falter once. When he wanted to stand up, the mattress would fly around him as he swayed gallantly to his feet, his IV fluid sacs swinging violently from their top hook. But he was always getting up.

Angle shift in food poisoning of surviving horses

When the status of equine food poisoning goes down and can’t go up, the outlook is grave, even with intensive care. The horse should be kept on a special air bed and rotated from side to side and supported in the clipping position periodically.

Pressure sores develop, and colic and pneumonia are constant risks. It’s a long waiting game to see if a patient can rebuild the damaged nerve-muscle connections. Full recovery may take months.

But Hans did not completely fall. I was impressed with how cool and collected Cathy was. A lot of the owners were upset about the increasing bill, but Cathy was always so grateful and kind.

Hans is eventually able to eat a slurry of pills and water on his own, though he still cannot chew normally. Crews began taking him on short walks to the end of the trail and back, meticulously surrounded by an army of supporters in case he lost his balance. Hans quickly got tired, and after a walk he always lay down and slept deeply, but soundly, standing on his feet when he got up.

On Day 26, the doctors thought Hans was finally strong enough to go home. It was a celebratory occasion, and there were dozens of socially distanced hospital staff, doctors, and vet students hugging Hans and wiping their eyes.

His thickly bedded trailer waited in the parking lot. Cathy Hanes bought her a sweet new blanket and matching cargo shoes. Pinned to his clothes, the staff cheered as he climbed into the trailer and drove off. Cathy was still waving as they rounded the corner and disappeared from sight.

With gratitude

Cleaning the booth is always bittersweet after a long patient has gone home. A thermometer, stethoscope, and charts for Hans hang from the door, and empty fluid bags and a coiled IV line hang from the top hook. There was a trash can full of examination gloves and plastic gowns in the corridor, and a bleach foot bath was nearby.

There was a bucket of brush with Hans’ tail hair tangled through the bristles, half-eaten grain slurry still in the feeder. The technicians and barn crew sadly stripped his stall and scrubbed and disinfected the floor and walls, and soon there was no sign he was ever there.

Hans moved to a small pen with a large booth and continued his recovery. It was a year before he was allowed to ride, and even then Cathy kept him out for a walk on easy trails.

When I paid the huge bill, I attached a note to the hospital staff.

“I’ve suffered from depression for the past year, and it was at its worst when I thought we were going to lose Hans to horse food poisoning. But every time you gave me encouraging news and told me what a fighter he was, I fought really hard too. Every time you told me Hans always stood his ground. Feet, it encouraged me to get up too, both of them out of the woods now, thank you and your staff of angels. Love forever, Cathy and Hans.”

This Vet Adventures column about equine food poisoning appeared in the June 2021 issue of Vet Adventures Illustrated horse magazine. Click here to subscribe!

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