A 4-year-old standardbred gelding presented to Cornell’s Equine Hospital in August 2013 with a chief complaint of dysphagia. The horse had a history of recent travel in Pennsylvania and was reported to have difficulty swallowing food for the past two days. At the time of presentation, the patient was weak in all four limbs with a short, choppy stride. The patient’s initial physical exam findings showed dehydration, a toxic line on his gums, poor tongue tone, and harsh cranioventral lung sounds. On endoscopy, pharyngeal paralysis was noted, and the soft palate was dorsally displaced over the epiglottis. The patient was hospitalized for supportive therapy and treatment of presumed botulism intoxication. Botulism type B antitoxin was given intravenously to bind and inactivate free toxin in the bloodstream. This paper will discuss initial diagnostics, as well as the supportive nursing care and weeks of rehabilitation afterwards.