The degree of disease is related to the degree of infection, the quantity of toxin produced, and the immediacy of therapeutic treatment. By and large, the therapy is supportive once the diagnosis is made. Sometimes the site cannot be located or easily attended without causing extreme distress to the horse. The use of sedatives and muscle relaxants can give some relief to these signs, and placing cotton in the ears also can help with respect to sound-induced spasms. Stabling or hospitalization in a dark, quiet stall with as little handling and disturbance as possible is desirable.
Good footing is very important.
If the diagnosis is made early, a commercially manufactured antitoxin can be administered, but remember that once the toxin is bound to the nervous system, the antitoxin will have no effect. The antitoxin does serve to neutralize any toxin that is still circulating in the bloodstream at the time of its administration. Another important aspect of therapy is to maintain hydration and nutritional needs. Depending on how seriously affected, these horses might need intravenous fluid therapy and a nasogastric feeding tube. It can take up to two weeks to see any improvement, and clinical signs can persist for a month or more.