Topic:Botulism
Botulism in horses is a neuromuscular disorder caused by toxins produced by the bacterium Clostridium botulinum. These toxins interfere with nerve function, leading to muscle weakness and paralysis. Horses are particularly susceptible to botulism, which can occur through ingestion of contaminated feed, wound infections, or toxicoinfectious botulism in foals, also known as "shaker foal syndrome." Clinical signs include difficulty swallowing, muscle tremors, and recumbency. Early diagnosis and treatment are critical to improve outcomes. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, treatment, and prevention of botulism in equine populations.
Equine grass sickness is associated with major abnormalities in the ultrastructure of skeletal neuromuscular junctions. Equine grass sickness (EGS) is a frequently fatal multisystem neuropathy of equids. The aetiology is unknown; proposed causes include toxicoinfection with Clostridium botulinum and a mycotoxicosis. The effect of EGS on the organisation and structural integrity of the skeletal neuromuscular junction (NMJ), the target of botulinum neurotoxins (BoNTs), is unknown. Objective: To compare the organisation and structural integrity of skeletal NMJs from EGS horses, control horses and one horse with a presumptive diagnosis of botulism. Methods: Blinded, retrospective case control. Methods: NMJs in samp...
Botulinum neurotoxin type A does not exert concentration-dependent effects on equine articular cartilage in vitro. To determine whether Botulinum neurotoxin type A (BoNT-A) ameliorates the effects of interleukin 1 (IL-1) on equine articular cartilage, or exerts negative effects on normal equine articular cartilage homeostasis in vitro. Methods: Articular cartilage explants from 6 healthy femoropatellar joints of 3 adult horses. Methods: Explants were allocated to the IL-1 challenged or unchallenged group, then exposed to 1 of 6 concentrations of BoNT-A (0, 1, 10, 50, 100, or 500 pg/mL) for 96 hours. To assess BoNT-A's effects on inflammation, prostaglandin E2 (PGE2) was measured in media via ELISA. Matrix ...
Development of an Equine Antitoxin by Immunizing the Halla Horse with the Receptor-Binding Domain of Botulinum Neurotoxin Type A1. Botulinum neurotoxins (BoNTs), produced by , are the most toxic substances known. However, the number of currently approved medical countermeasures for these toxins is very limited. Therefore, studies on therapeutic antitoxins are essential to prepare for toxin-related emergencies. Currently, more than 10,000 Halla horses, a crossbreed between the native Jeju and Thoroughbred horses, are being raised in Jeju Island of Korea. They can be used for equine antitoxin experiments and production of hyperimmune serum against BoNT/A1. Instead of the inactivated BoNT/A1 toxoid, Halla horse was immunized...
Safety and Clinical Outcomes of an Equine-derived Heptavalent Botulinum Antitoxin Treatment for Confirmed or Suspected Botulism in the United States.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Botulism is a rare, life-threatening paralytic illness. Botulism Antitoxin Heptavalent (A,B,C,D,E,F,G)-(Equine) (BAT) manufactured by Emergent BioSolutions Canada Inc is an equine-derived heptavalent botulinum antitoxin product indicated for the treatment of symptomatic botulism following documented or suspected exposure to botulinum neurotoxin serotypes A-G in adults and pediatric patients. BAT product was US-licensed in 2013. In the United States, from October 2014 through July 2017, safety and clinical outcomes data were collected under a registry for patients treated with BAT product. Regi... Clinical Serum Therapy: Benefits, Cautions, and Potential Applications. Blood serum from immunized humans or animals (e.g., horses) contains relevant antibodies and has been used as serum therapy to treat many diseases or envenomation events. The effectiveness of blood serum was initially discovered in 1890 when Kitasato and von Behring observed the effectiveness of this type of therapy against diphtheria and tetanus. Serum therapies played an important role in the advancement of modern medicine prior to the development of penicillin and steroids. At present, several types of serum therapy remain in clinical use. However, some physicians have a limited understandi...
Outcome of adult horses with botulism treated at a veterinary hospital: 92 cases (1989-2013). There are no studies evaluating a large population of adult horses treated for botulism. Reported survival rates in outbreak situations are low; however, many horses in outbreaks do not receive treatment. Objective: That adult horses treated at a veterinary hospital would have improved survival compared to outbreak situations. Additional aims included identification of predictors of nonsurvival. Methods: All horses greater than 6 months of age with a final diagnosis of botulism admitted to a veterinary teaching hospital between 1989 and 2013 were included. Methods: Retrospective study. Histori...
Mechanical ventilation and management of an adult horse with presumptive botulism. 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...
The effect of Clostridium botulinum toxin type A injections on motor unit activity of the deep digital flexor muscle in healthy sound Royal Dutch sport horses. Therapeutic reduction of the activity of the deep digital flexor (DDF) muscle may play a role in treatment of laminitic horses. Clostridium botulinum toxin type A induces reduced muscle activity and has a spasmolytic effect in horses. In this study, the effectiveness of 200 IU C. botulinum toxin type A on reduction of DDF muscle activity was measured in seven healthy, sound, adult Royal Dutch sport horses. C. botulinum toxin type A was injected using ultrasound and electromyographic (EMG) guidance. The effectiveness was assessed by interference pattern analysis (IPA) and motor unit action pote...
New equine antitoxins to botulinum neurotoxins serotypes A and B. 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. 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...
Repetitive stimulation of the common peroneal nerve as a diagnostic aid for botulism in foals. Botulism is a potentially fatal paralytic disorder for which definitive diagnosis is difficult. Objective: To determine if repetitive stimulation of the common peroneal nerve will aid in the diagnosis of botulism in foals. Methods: Four control and 3 affected foals. Methods: Validation of the test in healthy foals for its comparison in foals with suspected botulism. Controls were anesthetized and affected foals were sedated to avoid risks of anesthesia. The common peroneal nerve was chosen for its superficial location and easy access. Stimulating electrodes were placed along the common peronea...
Edaphic and Phytochemical Factors as Predictors of Equine Grass Sickness Cases in the UK. Equine dysautonomia or equine grass sickness (EGS), as it is more commonly known, is a usually fatal disease of equids of uncertain etiology, although associated with grazing, that affects the autonomic and enteric nervous system. Lowered gastrointestinal motility, leading to paralysis of the gut, is one of the main symptoms of EGS. Previous studies have implicated anaerobic bacteria, notably Clostridium botulinum, but what triggers the severe bacterial infestations remains enigmatic. We hypothesized that a detailed comparison of soil mineral and botanical composition of EGS and control sites ...
Type A botulism in horses in the United States: a review of the past ten years (1998-2008). The objective of the current retrospective study was to describe naturally occurring type A botulism in horses in the United States. In the past 10 years, the Botulism Laboratory at the University of Pennsylvania's School of Veterinary Medicine has identified 3 isolated cases and 8 outbreaks of type A botulism in horses via samples positive for Clostridium botulinum type A toxin or spores using the mouse bioassay test. Additional information was obtained by review of submission forms and by telephone or email interviews. Almost all type A cases and outbreaks occurred in the western United Stat...
[Two horses with neurological symptoms: could this be equine botulism?]. 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...
Seroprevalence of antibotulinum neurotoxin type C antibodies in horses in Israel. Clostridium botulinum type C is prevalent in Israel and outbreaks recorded in many species, other than horses. Association between levels of anti-BoNT/C antibodies and equine grass sickness (EGS) have been demonstrated but seroprevalence of anti-BoNT/C antibodies in horses has not been reported nor has EGS been reported in Israel. Objective: To determine the seroprevalence of specific anti-BoNT/C antibodies in horses in Israel and to determine whether age, breed and gender, or geographical region of farms are potential risk factors for exposure to BoNT/C. Objective: Anti-BoNT/C antibodies are ...
Comparison of IgG antibody levels to Clostridium botulinum antigens between euthanased and surviving cases of chronic grass sickness. Serum from 12 horses suffering from chronic grass sickness (CGS) were assayed for IgG antibodies against botulinum neurotoxins C and D (BoNT/C and BoNT/D) and to a surface antigen extract of a neurotoxin negative strain of Clostridium botulinum type C. Collectively, the six surviving CGS cases demonstrated significantly higher initial IgG levels (P=0.05) against surface antigens than the six that were subsequently euthanased. The surviving animals also demonstrated higher initial IgG levels against the BoNT/C but not reaching significance (P=0.06). The two groups demonstrated no difference bet...
Equine botulism and acute pasture myodystrophy: new soil-borne emerging diseases in Switzerland? In Switzerland, the incidence of equine botulism and acute pasture myodystrophy have remarkably increased in the last five years. Equine fodder-borne botulism in Europe is most likely caused by Clostridium botulinum types C and D that produce the toxins BoNT/C and BoNT/D. Horses showing signs suggestive of botulism (muscle weakness and tremors, reduced tongue tone, slow chewing, salivation and difficulties swallowing, drooping eyelids, mydriasis), especially patients that have fed on suspect fodder (mostly haylage), must be treated with anti-serum as soon as possible. They also need intensive ...
Neurological syndromes among horses in The Netherlands. A 5 year retrospective survey (1999-2004). The presence of toxins or infectious agents combined with environmental factors in combination with a susceptible host can be the cause for neurological disease in groups of horses. During a 5 year observational period outbreaks of neurological diseases among horses were evaluated. Causes of occurring neurological diseases were equine botulism, lolitrem intoxications, equine herpesvirus type 1-associated myelo(encephalo)pathy, and encephalitis caused by (disseminated) Streptococcus equi subspecies equi infection. This article focuses on the first three syndromes because of their predominant in...
Effects of injection of botulinum toxin type B into the external anal sphincter on anal pressure of horses. To determine effects on anal pressure of horses after local injection of the external anal sphincter with Clostridium botulinum toxin type B. Methods: 11 healthy adult horses. Methods: Peak and resting anal sphincter pressures were measured with a custom-made rectal probe that was connected to a pressure transducer. Pressures were measured before treatment and after injection with botulinum toxin type B (BTB) or saline (0.9% NaCl) solution. Dose titration with 500, 1,000, 1,500, and 2,500 U of BTB was completed. Physical changes, behavior, and anal pressure were recorded for each horse. Result...
Mechanical ventilation in foals with botulism: 9 cases (1989-2002). "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...
Two cases of equine grass sickness with evidence for soil-borne origin involving botulinum neurotoxin. Botulism is caused by different types of Clostridium botulinum, a soil bacterium. Equine grass sickness (equine dysautonomia) is suspected of being a clinical form of this disease. On a stud where this disease occurred twice within 8 months, grass and soil samples and necropsy specimens of one horse were tested for the presence of bacterial forms and toxin of C. botulinum. Different types and type mixtures (A-E) of C. botulinum and botulinum neurotoxin were found. For the first time, it has been shown that green grass blades contain botulinum toxin. The results support the hypothesis that equi...
Therapeutics of musculoskeletal disease in the horse. Therapeutic medications play a crucial role in the successful therapy of many musculoskeletal diseases that occur in horses. For example, appropriate antibiotic therapy is extremely important in the treatment of diseases caused by infections with microorganisms such as botulism, tetanus, osteomyelitis, and muscle abscesses. In addition, numerous prescription medications and nutritional supplements are available for the treatment of osteoarthritis in horses. Many of these agents currently on the market fall into a new class of drugs called SADMO agents. Unfortunately, the efficacy and mechanism...
[Botulism–a forgotten disease?]. The laboratory diagnosis of C. botulinum is described for cattle and horses in the years 1995-1998. Out of 122 cases 66 were positive. All types of toxins were identified; in cattle mainly types C and D. In 9 cases typing was not conclusive. The results of an enquiry of afflicated animal owners showed, that modern agricultural technology has an important impact on toxinogenesis in feed stuff. Possibilities to prevent the disease and to reduce economic losses are discussed; a solution cannot be presented.
Application of PCR to a clinical and environmental investigation of a case of equine botulism. PCR for the detection of botulinum neurotoxin gene types A to E was used in the investigation of a case of equine botulism. Samples from a foal diagnosed with toxicoinfectious botulism in 1985 were reanalyzed by PCR and the mouse bioassay in conjunction with an environmental survey. Neurotoxin B was detected by mouse bioassay in culture enrichments of serum, spleen, feces, and intestinal contents. PCR results compared well with mouse bioassay results, detecting type B neurotoxin genes in these samples and also in a liver sample. Other neurotoxin types were not detected by either test. Clostrid...
Clostridium botulinum type-C intoxication associated with consumption of processed alfalfa hay cubes in horses. An episode of nervous system dysfunction was observed in horses on 17 premises in 4 counties of southern California. Thirty-eight horses were affected, and 31 of those died. The common clinical signs of disease in the affected horses were: increased appetite; anxious attitude; rythmic, intermittent muscle tremors in the area of the tricep muscles; decreased palpebral tone; mydriasis; small hard fecal balls; and tendency to become sternally recumbent with the neck extended. The temporal distribution of cases on all 17 premises suggested a relationship between exposure to a common batch of alfal...
Cerebrospinal fluid creatine kinase activity in horses with central nervous system disease: 69 cases (1984-1989). The CSF creatine kinase (CK) activity was determined in 70 CSF samples from 69 horses with CNS disease. Abnormal values (greater than or equal to 1 IU/L) were determined from 32 CSF samples, and normal values (less than 1 IU/L) were found in 38 samples. Increased CK activity was most frequently associated with a diagnosis of equine protozoal myelitis; CK activity was not increased in 11 horses with cervical compressive myelopathy. Other diagnoses, in which CSF CK activity was increased included trauma (n = 1), idiopathic epilepsy (n = 2), botulism (n = 2), articular facet fracture (n = 1), int...