CSI Kentucky: Foal Diarrhea

Dr. Nathan Slovis of the Hagyard Equine Medical Institute in Kentucky is investigating "something different" in foal diarrheas veterinarians are seeing this spring.

When about a month ago there were some foal diarrhea cases at three or four big Thoroughbred boarding facilities that didn’t respond to the normal course of treatment, Dr. Nathan Slovis in his typical investigative fashion began to look for something different that might be causing this lack of normal response to treatment. iStock/Dan Brandenburg

So, what does Crime Scene Investigation (CSI) have to do with foal diarrhea issues in Kentucky? Both use science to solve “mysteries” and address problems. On television, these mysteries can be solved in about 54 minutes (depending on commercial breaks). In real life, it can take longer.

Nathan M. Slovis, DVM, DACVIM, CHT, is the director of the McGee Medical Center at the Hagyard Equine Medical Institute in Lexington, Kentucky. He is known for not accepting the status quo when it comes to diagnosing horse problems.

When about a month ago there were some foal diarrhea cases at three or four big Thoroughbred boarding facilities that didn’t respond to the normal course of treatment, Slovis in his typical investigative fashion began to look for something different that might be causing this lack of normal response to treatment.

“This is not an ‘outbreak,’ ” Slovis said. “This isn’t an MRLS-type of situation. The death rate is not higher” than in a normal foaling year.

While foal diarrhea is common in most breeding areas, with the extraordinary number of Thoroughbreds produced in a condensed timeframe in Kentucky, when an issue arises, it can seem larger than life.

“We’re finding the usual Clostridium perfringins type A (in the foals with diarrhea), but the conventional treatments are not working,” said Slovis. “In the past, we would have said this is a ‘resistant’ Clostridium, but I think this is a marker for something else going on.”

Having more than one disease process going on at the same time is nothing unusual in human or animal medicine, and Slovis said this situation calls for using technology instead of just “blowing it off” due to a cause that isn’t yet known.

“I’m working with my colleagues, farm managers and owners, the Gluck Center, the Kentucky Diagnostic Lab and researchers from other institutions to see if we can find out what else is there,” said Slovis. “I want to put a name to it.”

A few years ago, Slovis and his team did this same thing to determine that there was an issue with Enterococcus durans in a group of mares and foals on one farm. He presented his findings on this at the 2018 ACVIM Forum in a talk titled, “Identification of Enterococcus durans as a Cause of Neonatal Diarrhea on a Thoroughbred Breeding Farm.”

Another such investigation happened with a group of yearlings that had joint infections. He used next-gen sequencing to determine the rare cause was the bacteria Kingella kingae.

Another incidence of researching something that was not normal was identifying a previously unknown toxin associated with Clostridium perfringens. (Read about that discovery in the EquiManagement article “Hagyard Veterinarians Identify Toxin Associated With Clostridium perfringens.”)

Slovis said with the current foal diarrhea problems, he is not sitting back. He has spent quite a bit of time sampling feces and the environment at facilities. Some of those samples are undergoing culture exams and next-gen screening, and some samples are being archived for future research.

Slovis also has been working with Dr. Feng Li, the William Robert Mills Chair in Equine Infectious Disease at the University of Kentucky’s Gluck Equine Research Center. Li was formerly a professor of biology and microbiology in the Veterinary and Biomedical Sciences Departments at South Dakota State University, and some samples have been sent to Li’s former lab in South Dakota.

“The main thing is to do what is right for the horse,” said Slovis. 

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