Farm and Field Investigation and Case Management Tools Dr. Locke Karriker, DVM Food Supply...
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Transcript of Farm and Field Investigation and Case Management Tools Dr. Locke Karriker, DVM Food Supply...
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
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
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
More barrows died than gilts for every cause except:Heat Stroke/Stress, Ileitis, and Fighting
Primary Cause of Death by Sex
0
20
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Mal
e
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ale
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e
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Fem
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Fem
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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
Iowa State University College of Veterinary MedicineFood Supply Veterinary Services
Nursery and finisher mortality uncoupled….
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
1/4/
03
3/4/
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5/4/
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7/4/
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7/4/
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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