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Topic:Antitoxin

Antitoxins in horses are antibodies that neutralize toxins produced by infectious agents. They are integral to the horse's immune response, providing passive immunity against specific toxins. Antitoxins can be naturally produced by the horse's immune system following exposure to a toxin or administered through therapeutic preparations to counteract toxin effects. Commonly used antitoxins in equine medicine include those targeting tetanus and botulism toxins. The administration of antitoxins can be a preventive measure or a treatment strategy during toxin exposure. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, applications, and efficacy of antitoxins in equine health management.
Anti-loxoscelic horse serum produced against a recombinant dermonecrotic protein of Brazilian Loxosceles intermedia spider neutralize lethal effects of Loxosceles laeta venom from Peru.
Toxicon : official journal of the International Society on Toxinology    October 30, 2014   Volume 93 37-40 doi: 10.1016/j.toxicon.2014.10.023
Duarte CG, Bonilla C, Guimarães G, Machado de Avila RA, Mendes TM, Silva W, Tintaya B, Yarleque A, Chávez-Olórtegui C.In this work, an anti-loxoscelic serum was produced by immunizing horses with a recombinant dermonecrotic protein from Loxosceles intermedia (rLiD1). Anti-rLiD1 antibodies were able to recognize different species of Loxosceles venoms by Western Blot and ELISA. The efficacy of anti-rLiD1 serum against the toxic effects of Loxosceles laeta (Peru) venom was tested, showing that anti-rLiD1 serum can neutralize those effects. This study confirms that recombinant proteins can be good candidates to replace crude venoms for antivenom production.
Mechanical ventilation and management of an adult horse with presumptive botulism.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    July 15, 2014   Volume 24, Issue 5 594-601 doi: 10.1111/vec.12196
Taylor SD, Toth B, Townsend WM, Bentley RT.To describe the clinical course, management, and outcome of a horse with a presumptive diagnosis of botulism treated with long-term mechanical ventilation. Methods: A 6-year-old Quarter Horse gelding with a history of esophageal obstruction was evaluated for progressive tetraparesis. Generalized and progressive skeletal muscle weakness characterized by recumbency, decreased tongue, tail, eyelid, and anal tone, and respiratory failure was observed. Anticholinergic signs including decreased salivation, xerophthalmia, and ileus were also noted. A presumptive diagnosis of botulism was made, althou...
[Normal immunoglobulin might replace unavailable equine diphtheria antitoxin].
Klinicka mikrobiologie a infekcni lekarstvi    July 6, 2014   Volume 20, Issue 1 27-28 
Chrdle A.No abstract available
Innovative immunization protocols using chimeric recombinant protein for the production of polyspecific loxoscelic antivenom in horses.
Toxicon : official journal of the International Society on Toxinology    May 28, 2014   Volume 86 59-67 doi: 10.1016/j.toxicon.2014.05.007
Figueiredo LF, Dias-Lopes C, Alvarenga LM, Mendes TM, Machado-de-Ávila RA, McCormack J, Minozzo JC, Kalapothakis E, Chávez-Olórtegui C.A chimeric protein (rCpLi) was constructed expressing three epitopes of rLiD1, a dermonecrotic toxin from the venom of Loxosceles intermedia spider. We have analyzed the neutralization potential of sera obtained by immunization of horses with rCpLi and rCpLi combined with initial doses of venoms and compared these with antivenom traditionally produced in horses using crude Loxosceles gaucho, Loxosceles laeta and L. intermedia venoms as antigens. We have demonstrated by ELISA that horses immunized with three initial doses of crude venom containing mixtures of L. intermedia, L. gaucho and L. lae...
Management of animal botulism outbreaks: from clinical suspicion to practical countermeasures to prevent or minimize outbreaks.
Biosecurity and bioterrorism : biodefense strategy, practice, and science    November 6, 2013   Volume 11 Suppl 1 S191-S199 doi: 10.1089/bsp.2012.0089
Anniballi F, Fiore A, Löfström C, Skarin H, Auricchio B, Woudstra C, Bano L, Segerman B, Koene M, Båverud V, Hansen T, Fach P, Tevell Aberg A....Botulism is a severe neuroparalytic disease that affects humans, all warm-blooded animals, and some fishes. The disease is caused by exposure to toxins produced by Clostridium botulinum and other botulinum toxin-producing clostridia. Botulism in animals represents a severe environmental and economic concern because of its high mortality rate. Moreover, meat or other products from affected animals entering the food chain may result in a public health problem. To this end, early diagnosis is crucial to define and apply appropriate veterinary public health measures. Clinical diagnosis is based on...
Identification of a human monoclonal antibody to replace equine diphtheria antitoxin for treatment of diphtheria intoxication.
Infection and immunity    August 12, 2013   Volume 81, Issue 11 3992-4000 doi: 10.1128/IAI.00462-13
Sevigny LM, Booth BJ, Rowley KJ, Leav BA, Cheslock PS, Garrity KA, Sloan SE, Thomas W, Babcock GJ, Wang Y.Diphtheria antitoxin (DAT) has been the cornerstone of the treatment of Corynebacterium diphtheriae infection for more than 100 years. Although the global incidence of diphtheria has declined steadily over the last quarter of the 20th century, the disease remains endemic in many parts of the world, and significant outbreaks still occur. DAT is an equine polyclonal antibody that is not commercially available in the United States and is in short supply globally. A safer, more readily available alternative to DAT would be desirable. In the current study, we obtained human monoclonal antibodies (h...
Preclinical assessment of a polyspecific antivenom against the venoms of Cerrophidion sasai, Porthidium nasutum and Porthidium ophryomegas: Insights from combined antivenomics and neutralization assays.
Toxicon : official journal of the International Society on Toxinology    January 10, 2013   Volume 64 60-69 doi: 10.1016/j.toxicon.2012.12.024
Gutiérrez JM, Tsai WC, Pla D, Solano G, Lomonte B, Sanz L, Angulo Y, Calvete JJ.A polyspecific antivenom is used in Central America for the treatment of envenomings by viperid snakes. This antivenom is generated in horses hyperimmunized with a mixture of venoms from Bothrops asper, Crotalus simus and Lachesis stenophrys. The present study analyzed the ability of this antivenom to neutralize the venoms of three Central American viperid species of the 'Porthidium group', i.e. Porthidium nasutum, Porthidium ophryomegas and Cerrophidion sasai, formerly classified as Cerrophidion godmani. In addition, the immunorecognition of the components of these venoms was assessed by immu...
Snake venomics and antivenomics of Protobothrops mucrosquamatus and Viridovipera stejnegeri from Taiwan: keys to understand the variable immune response in horses.
Journal of proteomics    August 18, 2012   Volume 75, Issue 18 5628-5645 doi: 10.1016/j.jprot.2012.08.008
Villalta M, Pla D, Yang SL, Sanz L, Segura A, Vargas M, Chen PY, Herrera M, Estrada R, Cheng YF, Lee CD, Cerdas M, Chiang JR, Angulo Y, León G....The proteomes of the venoms of the snakes Viridovipera stejnegeri and Protobothrops mucrosquamatus from Taiwan were characterized by N-terminal sequencing, MALDI-TOF mass fingerprinting, and collision-induced dissociation tandem mass spectrometry of in-gel generated tryptic peptides. Proteins belonging to the following toxin classes were identified: metalloproteinase, phospholipase A(2) (PLA(2)), serine proteinase, C-type lectin-like, CRISP, l-amino acid oxidase, disintegrin, and peptides (vasoactive and inhibitors of SVMPs). Nine horses were immunized with a mixture of these venoms. All horse...
New equine antitoxins to botulinum neurotoxins serotypes A and B.
Biologicals : journal of the International Association of Biological Standardization    May 5, 2012   Volume 40, Issue 4 240-246 doi: 10.1016/j.biologicals.2012.03.004
Li D, Mattoo P, Keller JE.Hyperimmune monovalent antitoxins to botulinum neurotoxin serotypes A and B have been produced by immunizing horses with newly developed formalin toxoids. After primary immunization, horses developed acceptable prophylactic antibody titers (1-5 IU/mL). Three horses received additional toxoid booster injections to induce hyperimmune antibody titers with antitoxin-A and antitoxin-B titers reaching peaks of approximately 2000 IU/mL and 150-625 IU/mL, respectively. Titers were quantified throughout the process by antigen-capture ELISA and by in-vivo neutralization. ELISA titers and neutralization ...
An outbreak of equine botulism type A associated with feeding grass clippings. Ostrowski SR, Kubiski SV, Palmero J, Reilly CM, Higgins JK, Cook-Cronin S, Tawde SN, Crossley BM, Yant P, Cazarez R, Uzal FA.In September 2010, an outbreak of type A botulism involved 4 horses in northern California that were fed grass clippings obtained from a nearby park. All 4 animals developed a progressive flaccid paralysis syndrome clinically consistent with exposure to preformed Clostridium botulinum neurotoxin (BoNT). Within 48 hr of consuming the grass clippings, all 4 horses showed marked cervical weakness (inability to raise their heads to a normal position) and died or were euthanized within 96 hr. One horse was submitted for diagnostic examination and subsequent necropsy. At necropsy, extensive edema wa...
Generalised tetanus in a 2-week-old foal: use of physiotherapy to aid recovery.
Australian veterinary journal    October 20, 2011   Volume 89, Issue 11 447-451 doi: 10.1111/j.1751-0813.2011.00845.x
Mykkänen AK, Hyytiäinen HK, McGowan CM.A 2-week-old Estonian Draft foal presented with signs of severe generalised tetanus, recumbency and inability to drink. The suspected source of infection was the umbilicus. Medical treatment was administered, including tetanus antitoxin, antimicrobial therapy and phenobarbital to control tetanic spasms. In addition, an intensive physiotherapy program was carried out during the recovery period. Techniques designed for syndromes involving upper motor neuron spasticity in humans were applied. Exercises aimed at weight-bearing and mobility were executed with the help of a walking-frame. The foal m...
[Comparative efficacy of homologous and heterologous biologicals against diphtheria].
Zhurnal mikrobiologii, epidemiologii i immunobiologii    May 15, 2010   Issue 2 94-96 
Kapustian VA, Matokhina AG, Perelygina OV.Comparative assessment of efficacy of homologous and heterologous diphtheria antitoxins on the example of diphtheria intoxication. Methods: Homologous hyperimmune sera were obtained through immunization of rabbits and guinea-pigs with diphtheria toxoid according to schedule. Immune rabbit sera contained 70 - 100 IU/mL of antitoxin antibodies and guinea-pig sera contained 60 - 80 IU/mL. Equine diphtheria antitoxin was used as a heterologous one. Measurement of antitoxin level using experimental animals is based on quantitative assessment of ability of studied sera to neutralize specific dermone...
Lethal toxin of Clostridium sordellii is associated with fatal equine atypical myopathy.
Veterinary microbiology    February 1, 2010   Volume 144, Issue 3-4 487-492 doi: 10.1016/j.vetmic.2010.01.024
Unger-Torroledo L, Straub R, Lehmann AD, Graber F, Stahl C, Frey J, Gerber V, Hoppeler H, Baum O.The lethal toxin of Clostridium sordellii (TcsL) evokes severe, mostly fatal disease patterns like toxic shock syndrome in humans and animals. Since this large clostridial toxin-induced severe muscle damaging when injected intramuscularly into mice, we hypothesized that TcsL is also associated with equine atypical myopathy (EAM), a fatal myodystrophy of hitherto unknown etiology. Transmission electron microscopy revealed skeletal and heart muscles of EAM-affected horses to undergo degeneration ultrastructurally similar to the damage found in TcsL-treated mice. Performing immunohistochemistry, ...
[Two horses with neurological symptoms: could this be equine botulism?].
Tijdschrift voor diergeneeskunde    November 7, 2009   Volume 134, Issue 19 790-795 
Roest HI, de Bruijn CM, Picavet MT, Prins B, Parmentier D, de Zwart GM, Dijkstra YE, van Zijderveld FG.Symptoms, diagnosis and therapy of equine botulism are discussed by the presentation of two detailed reports of horses with neurological symptoms and the results of laboratory investigations over the period 2003-2008 in the Netherlands. In addition a brief summary of the available literature is presented. Prevailing symptoms of botulism in horses include paralysis of the tongue, salvation, dysphagia and paresis and paralysis of the skeletal muscles, as well as signs of colic. Symptoms and prognosis vary with the amount of botulinum neurotoxin (BoNT) involved. For early clinical diagnosis of bo...
Stability of equine IgG antivenoms obtained by caprylic acid precipitation: towards a liquid formulation stable at tropical room temperature.
Toxicon : official journal of the International Society on Toxinology    August 13, 2009   Volume 53, Issue 6 609-615 doi: 10.1016/j.toxicon.2009.01.012
Segura A, Herrera M, González E, Vargas M, Solano G, Gutiérrez JM, León G.Liquid formulations of antivenom require a cold chain for their distribution and storage, especially in tropical countries characterized by high temperature and humidity (climatic zone IV). Since cold chain is often deficient in many regions, there is a need to develop novel formulations of liquid antivenoms of higher stability at room temperatures. The effect of addition of the polyols mannitol and sorbitol on the thermal stability of caprylic acid-fractionated equine whole IgG antivenoms was assessed in preparations having different concentrations of protein and phenol. Results evidenced tha...
Standardization and validation of Vero cell assay for potency estimation of diphtheria antitoxin serum.
Biologicals : journal of the International Association of Biological Standardization    June 18, 2009   Volume 37, Issue 5 297-305 doi: 10.1016/j.biologicals.2009.05.002
Kumar S, Kanwar S, Bansal V, Sehgal R.Diphtheria toxin has the capacity to block protein synthesis in cultured mammalian cells, and thus causing cell death. This capacity of diphtheria toxin was utilized for in-vitro neutralization test to determine antibody titer, using Vero cells, which have been found to be susceptible to diphtheria toxin. In the present study, a Vero cell assay was standardized and validated for potency estimation of diphtheria antitoxin serum (DATS). The results obtained by Vero cell assay were compared with in-vivo biological assay. High degree of correlation (+0.98) was found between in-vivo biological assa...
Fine and domain-level epitope mapping of botulinum neurotoxin type A neutralizing antibodies by yeast surface display.
Journal of molecular biology    October 3, 2006   Volume 365, Issue 1 196-210 doi: 10.1016/j.jmb.2006.09.084
Levy R, Forsyth CM, LaPorte SL, Geren IN, Smith LA, Marks JD.Botulinum neurotoxin (BoNT), the most poisonous substance known, causes naturally occurring human disease (botulism) and is one of the top six biothreat agents. Botulism is treated with polyclonal antibodies produced in horses that are associated with a high incidence of systemic reactions. Human monoclonal antibodies (mAbs) are under development as a safer therapy. Identifying neutralizing epitopes on BoNTs is an important step in generating neutralizing mAbs, and has implications for vaccine development. Here, we show that the three domains of BoNT serotype A (BoNT/A) can be displayed on the...
Efficacy demonstration of tetanus vaccines by double antigen ELISA.
Pharmeuropa bio    December 13, 2005   Volume 2005, Issue 1 31-52 
Rosskopf U, Noeske K, Werner E.This paper describes a double antigen ELISA (DAE) for rapid, specific and reliable assessment of the antitetanus immune status of horses and sheep. Compared with the indirect ELISA, the double antigen ELISA has the advantage of species-independent testing of sera. Thanks to its test design, it is more specific since the detected antibodies are forced to bind tetanus toxoid twice. In addition, it is very sensitive to tetanus antibodies, enabling the detection of low antibody titres, in range which is relevant for the assessment of the protective status (tetanus toxin neutralising antibodies). T...
Replacement of the in vivo neutralisation test for efficacy demonstration of tetanus vaccines ad us. vet.
ALTEX    September 28, 2005   Volume 22, Issue 3 169-174 
Rosskopf U, Noeske K, Werner E.The bacterium Clostridium (C.) tetani is an ubiquitous pathogen. This anaerobic, gram-positive bacterium can form spores and can be found in the whole environment. It enters the body via injuries of the skin and wounds where it releases the neurotoxin "tetanospasmin" (= tetanus toxin). The animals most susceptible to tetanus infection are horses and sheep. Only active immunisation by tetanus vaccine provides effective protection against tetanus intoxication. The marketing authorisation requirements stipulate that efficacy of tetanus vaccines ad us. vet. must be demonstrated in all target anima...
The improvement of the therapeutic anti-Lachesis muta serum production in horses.
Toxicon : official journal of the International Society on Toxinology    March 1, 2005   Volume 45, Issue 4 467-473 doi: 10.1016/j.toxicon.2004.12.006
Stephano MA, Guidolin R, Higashi HG, Tambourgi DV, Sant'Anna OA.The main features associated with pit viper envenomations include the intense local lesions such as oedema, necrosis, acute renal failure and other effects. The severity of these reactions to snakebite depends on the degree of envenomation. Lachesis muta venom (LMV) has weak lethal activity, but due to the large amount often inoculated, the effects are extremely severe and demand anti-venom with a high neutralizing capacity. LMV had the lowest neutralizing antibody induction capacity in horses when compared with that of other venoms. For example, Bothrops anti-venom serum neutralizes 180 times...
Anticomplementary activity of equine whole IgG antivenoms: comparison of three fractionation protocols.
Toxicon : official journal of the International Society on Toxinology    December 8, 2004   Volume 45, Issue 1 123-128 doi: 10.1016/j.toxicon.2004.07.025
León G, Lomonte B, Gutiérrez JM.Early adverse reactions occur in a number of patients treated with heterologous antivenoms and have been associated with anticomplementary activity (ACA). In order to reduce the ACA of equine whole IgG antivenoms produced by caprylic acid fractionation, three different fractionation protocols were compared: (a) routine caprylic acid fractionation; (b) caprylic acid fractionation followed by beta-propiolactone treatment; and (c) caprylic acid fractionation followed by ion-exchange chromatography using a quaternary ammonium membrane. The three protocols yielded products with similar physicochemi...
Clostridium perfringens type A myonecrosis in a horse in Korea.
The Journal of veterinary medical science    December 11, 2003   Volume 65, Issue 11 1245-1247 doi: 10.1292/jvms.65.1245
Choi YK, Kang MS, Yoo HS, Lee DY, Lee HC, Kim DY.Acute hemorrhagic myonecrosis accompanied by severe inter- and intrafascicular edema and hemorrhage of the right gluteal area was diagnosed in a 13-year-old male thoroughbred horse. Once the muscular and fascicular changes were subsided, the horse then developed acute respiratory problem. Histologically, the lung had diffuse severe hemorrhage with mild neutrophilic infiltration. The cause of death was acute respiratory failure that is believed to occur secondary to toxaemic event. Alpha and beta2 toxin secreting Clostiridum perfringens type A was isolated from the muscle and lung. The diagnosi...
Mechanical ventilation in foals with botulism: 9 cases (1989-2002).
Journal of veterinary internal medicine    October 8, 2003   Volume 17, Issue 5 708-712 
Wilkins PA, Palmer JE."Shaker foal" disease, toxicoinfectious botulism of foals, was 1st described as a clinical entity in 1967. The reported mortality rate was 90%, with death occurring within 24-72 hours of the onset of the characteristic clinical signs. The mortality rate decreased when equine-origin botulism antitoxin became available; however, a certain percentage of foals continued to die of respiratory failure. Mechanical ventilation is an important part of the treatment of infant botulism and is essential to the survival of many affected infants. We report a retrospective study of 9 foals with toxicoinfecti...
Botulism in foals less than 6 months of age: 30 cases (1989-2002).
Journal of veterinary internal medicine    October 8, 2003   Volume 17, Issue 5 702-707 doi: 10.1111/j.1939-1676.2003.tb02503.x
Wilkins PA, Palmer JE.Botulism has been recognized as a clinical entity in foals since the 1960s. Also known as "Shaker foal" disease, the toxicoinfectious form of botulism affects foals, with the highest incidence in the United States seen in Kentucky and the mid-Atlantic region. The disease is characterized by progressive muscular weakness caused by the action of botulism neurotoxin at cholinergic neuromuscular junctions. Increased number of episodes and duration of recumbency, muscular trembling, and dysphagia are seen in affected foals. Left untreated, the disease can be rapidly fatal, with death occuring secon...
Collaborative study for the establishment of two European Pharmacopoeia Biological Reference Preparations for serological potency testing of tetanus vaccines for veterinary use.
Developments in biologicals    April 8, 2003   Volume 111 69-76 
Lensing HH, Behr-Gross ME, Daas A, Spieser JM.The European Directorate for the Quality of Medicines (EDQM) has organised an international collaborative study, divided into two phases, aimed at producing and establishing two suitable reference sera for serological potency testing of tetanus vaccines for veterinary use for batch consistency demonstration. In phase I pools of sera were produced by immunising guinea pigs and rabbits with tetanus toxoid using the immunisation schedule prescribed by the European Pharmacopoeia (Ph. Eur.) for potency testing of tenanus vaccines for veterinary use. Following aliquoting and freeze-drying, character...
Collaborative study for the establishment of a European Pharmacopoeia Biological Reference Preparation for Clostridia antiserum for serological potency testing of veterinary clostridial vaccines.
Developments in biologicals    April 8, 2003   Volume 111 171-180 
Lucken R, Daas A, Behr-Gross ME.The European Directorate for the Quality of Medicines (EDQM) has organised an international collaborative study, divided in two phases, aimed at producing and establishing a suitable reference serum for serological potency testing of clostridial vaccines for batch consistency demonstration. In phase 1 a series of pools produced from sera provided by each manufacturer and raised against the broadest range of antigens possible were blended to obtain TN titres which were representative of the range normally elicited by the vaccines under test. Detailed statistical analysis of the data was not pos...
Inhibition of collagenase breakdown of equine corneas by tetanus antitoxin, equine serum and acetylcysteine.
Veterinary ophthalmology    March 19, 2003   Volume 6, Issue 1 67-72 doi: 10.1046/j.1463-5224.2003.00271.x
Haffner JC, Fecteau KA, Eiler H.To determine whether tetanus antitoxin, equine serum, and acetylcysteine, which are currently used in the treatment of equine corneal ulcer, inhibit the digestion of equine corneal collagen when exposed to collagenase in vitro. Methods: Corneas from 40 adult horses. Methods: Sections of equine corneas were incubated with saline, a solution of bacterial collagenase in saline, bacterial collagenase in saline plus equine tetanus antitoxin, bacterial collagenase in saline plus equine serum, or bacterial collagenase in saline plus acetylcysteine. Each one of the collagenase inhibitors was tested at...
The impact of a low dose, low volume, multi-site immunization on the production of therapeutic antivenoms in Thailand.
Toxicon : official journal of the International Society on Toxinology    December 7, 2002   Volume 41, Issue 1 57-64 doi: 10.1016/s0041-0101(02)00209-x
Sriprapat S, Aeksowan S, Sapsutthipas S, Chotwiwatthanakun C, Suttijitpaisal P, Pratanaphon R, Khow O, Sitprija V, Ratanabanangkoon K.Therapeutic antivenom against snakes was first produced by Albert Calmette in 1894. Since then antivenoms have saved the life of countless snakebite victims. However, there are still many problems associated with antivenom production, for example variable percentage of responder horses, low neutralizing potency of antivenom, the large amount of snake venom needed for immunization and the difficulties encountered in producing potent polyvalent antivenoms. These problems have led to shortage and high cost of antivenom and, in some cases, failure of treatment. In 1997, a new immunization protocol...
Inactivation of West-Nile virus during peptic cleavage of horse plasma IgG.
Biologicals : journal of the International Association of Biological Standardization    July 20, 2002   Volume 30, Issue 2 163-165 doi: 10.1006/biol.2002.0335
Lazar A, Epstein E, Lustig S, Barnea A, Silberstein L, Reuveny S.Peptic cleavage of horse plasma IgG is a common procedure for the preparation of F(ab)(2) products for human use, such as antivenin and antitoxin. The removal of the Fc fragment from the IgG molecule by enzymatic cleavage at low pH, ensures fewer side-effects of the F(ab)(2) product for passive immunotherapy compared with the whole IgG molecule. Since the starting material may be contaminated by zoonotic horse viruses, it is necessary to demonstrate the removal or inactivation of possible viral contaminants. Guidelines for performing such studies were published by the Commission for Plasma-Der...
Botulism in the horse.
The Veterinary clinics of North America. Equine practice    January 10, 2002   Volume 17, Issue 3 579-588 doi: 10.1016/s0749-0739(17)30053-6
Galey FD.Botulism should be considered in cases where weakness, paralysis, or intolerance to exercise might be seen in the horse. Dysphagia may also be present, although it is not a consistent finding. Potential sources include carrion in hay, moldy or otherwise rotted vegetation or forage, birds carrying material from animal burial or other similar sites, and contaminated carcasses on-site. Horses, especially foals, may also suffer from toxicoinfectious botulism, a condition where the C. botulinum might colonize and produce toxin within the gastrointestinal tract. Wounds also may harbor the organism a...