Farm and Field Investigation and Case

Management Tools

Dr. Locke Karriker, DVMFood Supply Veterinary Medicine

Department of Veterinary Diagnostic and Production Animal Medicine

Iowa State University College of Veterinary Medicine

VDPAM 310

Objectives

Decrease anxietyIncrease proficiencyPositive experiences earlyGet past learning the

‘process’ and on to learning the medicine

AttitudeTeamworkInvestigativeProfessionally (and politely)

skepticalSimplifyPrioritizeConfidence

Table of Contents

ObjectivesOverviewSpecific tools

Preparation for visitMeeting the “manager”Facility evaluation

Documentation

Table of Contents

ObjectivesOverview of the processPreparation for visitMeeting the “manager”Facility evaluationDocumentation

Start as d

iscrete te

dious

steps b

ut become

compressed and

abbreviated with clinical

experience and familia

rity

with client

When you get to clinical courses:

Review the syllabus first!!

The syllabus describes course expectations that are relevant to farm visits.Note emphasis on confidentiality of

information, limitations on video and audio capture, and conduct expectations.

The WebCt module has examples (generated by your classmates in previous rotations) of the product that you will generate with your visit:a PPT presentation of case to the class and

instructorsa case reporta client communication letter

Farm Field Investigation Tree

Preparation….Step 1

Review background material (if available) Size of farmType of production systemMajor concernPrevious diagnostic reports

Preparation….Step 2

Contact the farm managerSchedule time for farm visitElicit directions to the farmDiscuss biosecurity protocols for the

farm# of visitors in group, required clothing,

shower facilities, downtime requirements

Chief complaint/concern

Preparation….Step 3

Contact the veterinarian associated with the farmAvailability during scheduled farm visitDissemination of results/reportsAsk for expansion on case details

Preparation….Step 4

Research clients chief concernUseful resources:

Pork gateway (hyperlink) Swine Disease Manual (hyperlink)Record benchmarks (hyperlink)The pig site (hyperlink)AASV Information CD (hyperlink)

Preparation….Step 5

Develop a “game plan”Locate supplies needed

Boots, coveralls, bleeding supplies (including sharps container), necropsy kit, camera (disinfect, charge battery, download previous pictures), garbage bag for dirty equipment, clean transportation, +/- ventilation equipment

Generate a check-off list of information to gather

Print off production benchmarks

Meeting the “manager”

IntroductionsDefine what position the contact holds (site

manager, field manager, hourly employee, contract operator, owner, etc.)

Define students role in the investigation

Structure of meetingOutline visit structure and report timelineOutline “manager” objectivesOutline how pigs are marketed (negotiated vs

contracted)

Meeting the “manager”

Go over production records, diagnostic reports, pigflowDiagram the layout of the farmDetail pig flow (source, number, facilities,

biosecurity, etc.)Historical disease concerns (ex. PRRSV,

Circovirus, previous respiratory outbreaks, etc.)

List any abnormalities or trends (detailed list)List “manager” concernsList things to look for/check during the walk

throughTake pictures of record boards if necessary

Facility evaluation - outside

Assess cleanliness/maintenance of facilities Weeds, junk, equipment, feed spills,

ventilation fans, feed bins, etc.

Assess biosecurity of the siteFence, signs, visitor log, parking

designation, entrance protocols, security of facility entrances

Facility evaluation - outside

Assess rodent/insect infestation and control measures

More information: NPB rodent control, NPB rodent control 2

Facility evaluation - outside

Feed storageWell maintained bins, periodically

cleaned, no moldy feed present, no feed spills present, feed is available, etc.

Facility evaluation - inside Evaluate feed, water

and airQuality of feed,

availability, maintenance of delivery equipment

Type of watering system, functionality

General comfort of air quality (high odor, stuffiness, noticeable drafts at animal level)

Facility evaluation - inside

Evaluate environmentAssess stocking density (standards)Appropriate temperatures for

production stage

Facility evaluation - inside

Assess biosecurity Boot baths, hoses, boot change, etc.

Assess overall cleanliness of facilityManure removed from aisles, AI

supplies or other trash thrown away, medicine properly stored after use

How are facilities cleaned between groups

Cleanliness of pigs

Facility evaluation - inside

Assess presence of noticeable hazards to the pigsSharp edges, exposed wires, protruding

gate rods, etc.

Assess equipmentTeeth clippers, scalpel blades, etc.Working order, cleanliness

Facility evaluation - insidePharmaceutical storage area

Are products well labeled?Are directions for use posted?Are open bottles dated and

refrigerated?Any expired antibiotics/vaccines

present?Any illegal or extra-label products

present?Are products for human consumption

stored in the same place?Is the refrigerator at an appropriate

temperature?Is there an appropriate sharps

container?

Facility evaluation - Personnel

While inspecting the facility, evaluate the manager and/or employees capabilitiesKnowledge of protocolsTrainingKnowledge of equipment (ventilation

system especially)How well does employee information

match what you see

Facility evaluation - Personnel

“Show me how” versus “Explain how”

Open ended questions – NOT “yes/no”

Facility evaluation - Pigs

Assess sick pens and pulling “accuracy” How many sick pigs/pen are present (pigs that

should have been pulled prior to visit)How many pigs/pen pulled dailyAre pigs treated when they are pulledIs supplemental feeding utilized

Note abnormal characteristics Rough hair, gaunt pigs, tail biting, thumpers,

skin lesions, joint problems, neurologic signs, etc.

Facility evaluation - Pigs

Diagnostic testingCollect blood samples

Perform necropsies on mortalities – assess trends

Find acute clinical pigs for dx work

Follow-up

Summarize findings and generate report

Submit report to both producer and owner/veterinarian

Specific Examples

Marco Case Report

More barrows died than gilts for every cause except:Heat Stroke/Stress, Ileitis, and Fighting

Primary Cause of Death by Sex

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HBS HeatStroke

Cardiac Fighting GastricUlcer

Ileitis Other Pleuro-pneum.

Pneum. Septicem. Tail bite Unkn. Volvul.

Cause and sex

Mo

rta

litie

s

Primary Cause Avg Of Weight (lbs) St Dev Of Weight (lbs) CountHeat Stroke/Stress 194.09 59.81 187

Ileitis 191.18 61.12 17HBS 167.60 48.27 269

Pleuropneumonia 152.96 64.90 49Fighting 148.77 47.26 61Tail Bite 144.06 53.92 32

Pneumonia 143.87 60.15 53Gastric Ulcer 136.75 47.47 100

Unknown 129.82 47.54 55Other 124.18 52.50 92

Septicemia 116.48 50.82 61Volvulous 110.00 14.14 2Cardiac 99.77 45.07 86

Primary Cause Avg Of Weight (lbs) St Dev Of Weight (lbs) CountHeat Stroke/Stress 194.09 59.81 187

Ileitis 191.18 61.12 17HBS 167.60 48.27 269

Pleuropneumonia 152.96 64.90 49Fighting 148.77 47.26 61Tail Bite 144.06 53.92 32

Pneumonia 143.87 60.15 53Gastric Ulcer 136.75 47.47 100

Unknown 129.82 47.54 55Other 124.18 52.50 92

Septicemia 116.48 50.82 61Volvulous 110.00 14.14 2Cardiac 99.77 45.07 86

GF-Study: Weight Data by cause

$

$

Relative Risk

• Risk in the exposed group versus the risk in the unexposed group:

RR = (a/a+b)/(c/c+d)

Introduction to Veterinary Epidemiology, Houe et al

Chapter 7 Measures of Association and Effect p.95

Pigs with any lung lesion were 2.23 times as likely to have an ulcer or hyperkeratosis as pigs that did not have any lung lesions.

**LUNG EDEMA PIGS WERE EXCLUDED REGARDLESS OF ULCER STATUS

Relationship of lung lesions to hyperkeratosis or ulcers**

Y N

Y 290 310 600

N 46 166 212

336 476 812

Ulcer/Hyperkeratosis

Lu

ng

Les

ion

Odds Ratio2.23

Relative Risk

PCV2 Associated Finisher Mortality

October 1, 2005

Iowa State University College of Veterinary MedicineFood Supply Veterinary Services

Nursery and finisher mortality uncoupled….

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Placement Week 2 Week % 6 Week % 10 Week % 14 Week % Total %

Data represents cumulative mortality by week of placement for an average of 67,814 pigs placed per week (a total of

12,681,394 pigs on the graph) through peak of outbreak in southeastern U.S.

Mature gilts in acclimation barn

Very little coughing

Very lethargic

Anorexic

No coughing

No vomiting

Many with fevers

Rectal temps (24 Gilts)105.7105.3105.2104.6104.5103.7103.6103.3103.3103.2102.9102.8102.7102.6102.5102.4102.3102.3102.2101.9101.8101.4100.8100.7Mature gilts in acclimation barn

Diagnostic Results

• 30/30 sows positive for PRRS on ELISA

• 0/30 sows positive for TGEv on differential ELISA, no piglet tissues positive– 22/30 sows positive for PRCV

• 24/24 gilt nasal swabs positive for influenza – H3 strain

Sow lactation triage plan

Necropsy Checklist

QUESTIONS???