NC State Veterinary Team Guides Miniature Horse Through Rare Bout of Botulism
When Raleigh attorney Emily Haas adopted a miniature horse despite a lifelong fear of equines, she never imagined the journey would test both science and faith.
Mocha, the waist-high companion Haas describes as her “soul mate who dines on hay,” became part of a small herd outside Raleigh that included a mule and a hinny. Life was peaceful — until late December, when Mocha stopped eating.
Haas noticed feed slipping from Mocha’s mouth. The normally bright miniature horse grew listless and lay apart from the others. An initial farm call ruled out esophageal obstruction (“choke”), but the examining veterinarian raised a more concerning possibility: botulism.
A Rare and Dangerous Diagnosis
Mocha was transported to the NC State Veterinary Hospital, where clinicians routinely treat miniature horses and stock botulism antitoxin for emergencies.
Botulism in horses is uncommon in North Carolina, according to Dr. Erin Pearson, one of the veterinarians involved in Mocha’s care. The disease is caused by toxins produced by Clostridium botulinum, which interfere with neuromuscular transmission, leading to progressive weakness and paralysis. Risk factors often include contaminated or moldy hay, particularly round bales, though exposure sources are not always clear.
Between Dr. Pearson and Dr. Elizabeth Treece, the hospital had managed fewer than a dozen botulism cases — none of which had survived. Haas was told Mocha’s chance of survival was approximately 50%, with uncertainty about the degree of recovery even if she lived.
Early Intervention Makes the Difference
Mocha’s case was identified early, which proved critical. Although weak and reluctant to move, she was still able to stand at admission. Her tongue function was severely compromised — a hallmark of botulism — making swallowing nearly impossible.
The veterinary team administered botulism antitoxin immediately to neutralize circulating toxin before it could bind irreversibly to nerve endings. Supportive care followed, including placement of a feeding tube to maintain nutrition while damaged nerves regenerated.
Clinicians also pursued additional diagnostics and precautionary treatments. They addressed the possibility of equine protozoal encephalitis (EPM), monitored for aspiration pneumonia, and treated a developing corneal ulcer. Throughout her hospitalization, Mocha required intensive monitoring and nursing care.
A Two-Week Turning Point
It took approximately two weeks before Mocha regained the ability to swallow independently. After 16 days in the hospital, she was discharged.
Recovery was gradual. Mocha lost weight and required dietary adjustments. Her activity level was limited, and she was unable to immediately rejoin herd play. But she survived — an outcome that had not previously occurred in the clinicians’ collective experience with equine botulism.
Haas credits the veterinary team’s rapid response and scientific expertise for the result. While the exact source of toxin exposure remains uncertain, soil ingestion — a habit Mocha reportedly had — is considered a possible route. As a preventive measure, Mocha has since been vaccinated against botulism.
A Case That Highlights Preparedness
Equine botulism remains rare in North Carolina, but the case underscores the importance of early recognition, access to antitoxin, and intensive supportive care. Teaching hospitals such as NC State are uniquely positioned to manage such cases due to available resources and multidisciplinary expertise.
For Haas, the experience reinforced her appreciation for veterinary medicine.
“We talk about miracles like there’s some mystical thing,” she said. “Miracles can also be having the right people who understand science.”
Mocha is now home, grazing again — a small horse whose survival reflects both the fragility of neuromuscular health and the power of timely veterinary intervention.
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