1. VDPAM 445 Swine Topics Enteric Disease Control
Dr. Alex Ramirez
Veterinary Diagnostic and Production Animal Medicine
Iowa State University

2. Neonatal Diarrhea

3. Neonatal Immunity Age of immunocompetency Colostral immunity
Around day 70 of gestation
Antigen dependent
Colostral immunity
IgG primarily  systemic antibodies
Acquisition stops: no more produced, no more absorbed
Titer in sow at farrowing = titer of pig at 4 weeks of age
Lactogenic immunity
IgA  local antibodies in the gut
Milk origin

4. Neonatal Diarrhea Differential diagnosis E. coli Viral Coccidiosis
K88, K99, F41, 987, etc.
Viral
Rota
TGE
Coccidiosis
Clostrium spp
Clostridium perfringes type C & A
Clostridium difficlile

5. Coccidiosis

6. Coccidiosis Usually only a problem in farrowing or early nursery
Isospora suis
Minimum age = 5 days
No approved treatments
Marquis (15% w/w ponazuril) Antiprotozoal Oral Paste by Bayer

7. Clostridiums

8. Clostridiums Clostridium perfringens – Rot gut Toxin driven
C = traditional more common
A = “newer”
Acute: blood
Chronic: rope gut
DDx = coccidiosis
Prevention
Vaccination Pre-farrow
Feed sows BMD 14 days pre-farrow & lactation

9. Clostridium perfringens

10. Clostridiums Clostridium difficile Incidence Antibiotic use
Discontinue antibiotics
Re-establish normal microbial flora

11. Neonatal Diarrhea Treat baby pigs Environment Prevention  Sows
Treat whole litter
Be aggressive – dehydration
Environment
Temperature
Moisture
Prevention  Sows
Vaccination
Oral feedback

12. Post-Weaning Diarrhea (PWD)

13. Post Weaning Diarrhea- PWD
Classic PWD caused by E. coli
Often hemolytic
F18 pillus antigen type is most common
Pigs can be bred to be resistant: gene probe selection
TGE after an outbreak can persist in the nursery and will mimic PWD
Historically right after weaning, now 2-3 weeks into nursery (withdrawal of animal proteins?)
SBM hypersensitivity
Transition diets especially pellet  ground

14. Post Weaning Diarrhea- PWD
Classic PWD caused by E. coli
Can also have acute septicemic disease resulting in sudden death in nursery and suckling pigs
Edema disease: shiga-like toxins
Vascular effects
CNS signs: focal encephalomalacia
Acute deaths
Poor doers
PCR organism to check for genetic codes
Pilli
F18, K88, K99, 987, F41
Toxins
Sta, Stb, LT, Stx2e

15. Post Weaning Diarrhea- PWD

16. Post Weaning Diarrhea- PWD
Pre-disposers
Chilling: cold floors, drafts
Poor diet quality
Ingredient quality: fish meal
Pellet integrity
Least cost formulations
Feed changes, medication changes, simultaneous feed and medication changes
Poor sanitation between groups: some plastic floors are hard to clean
Feeding mats moving to disposable/biodegradable
Major problem in some large systems

17. PWD: Therapy Enteric infection  oral medication
“Nutritional” prevention via diet or water
Plasma proteins (7.5% of diet) until 15#’s
May break upon withdrawal; continual at lower level until 25#’s
Plasma proteins in water (Solutein- APC)
Zinc oxide
<15# - 3,000 ppm
15-30# - 2,000 ppm
Citric acid (1# per gallon of stock solution) or other organic acids
Vitamins and electrolytes in water: supportive

18. PWD: Therapy Antibiotic therapy in feed for prevention
Apralan (150 gram per ton)
Mecadox (50 gram per ton)
Denagard (35 gram per ton) Plus (400 grams CTC)
Antibiotics in water for prevention or treatment
4-5 day treatment
Spectinomycin (5 mg/#)
Gentamycin (1-2 mg/#)
Neomycin (2-10 mg/#)
Amoxicillin, Ampicillin
Antibiotics – “red butt” condition

19. PWD Rule-outs Carryover from farrowing Endemic TGE Coccidiosis
Rotavirus
Endemic TGE
Plus or minus carryover from farrowing
Loss of lactogenic immunity at weaning plus environmental exposure  TGE

20. PWD Treatments Prevention Environment Sanitation Vaccination Feed
Oral F18
Feed
Antibiotics
Water

21. Ileitis (PPE, PIA)

22. Ileitis Caused by Lawsonia intracellularis
Porcine Proliferative Enteropathy (PPE)
Three main forms
PIA: porcine intestinal adenomatosis
Ileal villi develop secondary and tertiary branches  thickening of the ileal mucosa
Necrotic form: fibrinonecrotic membrane forms on ileal mucosa, may extend to colon
Acute hemorrhagic form  sudden death
Most common in gilts and sows

23. Ileitis Clinical signs Poor doing pig Mal-absorption
Protein losing enteropathy
Diarrhea: orange tinge suggestive of partially digested blood, over blood with acute hemorrhagic form
Many times soft or loose stools are over interpreted
Increase number of cull or light weight pigs

24. Ileitis Lesions

25. Ileitis: Treatment
Antibiotics that work: Tylan, CTC, Lincomycin, Denagard (Tiamulin), Mecadox
Acute hemorrhagic form in older finishers/gilts/sows
Inject with Tylan (10 mg/# SID)
Inject with Lincomycin (5 mg/# SID)
Follow-up with 100 gram/ton Tylan in the feed for 2-3 weeks
Outbreak in growing pigs
Inject severe cases with Tylan (dose as above)
Water soluble Tylan
Water soluble Denegard

26. Ileitis Control MLV product from BI
Timing and handling of vaccine is critical
Oral administration via medicator
Administer vaccine over 4 hour period
No feed medication for 3 days prior to vaccination
Starter pack - binds chlorine in water and colors water blue
Monitoring stools is commonly done to “titrate” antibiotic control programs

27. Ileitis Treatment Vaccination Prevention though antibiotics
Feed
Water
Don’t forget market-ready pigs!

28. Don’t
Forget
PCV2 
Diarrhea
similar
to Ileitis

29. Swine Dysentery

30. Swine Dysentery Brachyspira hyodysenteriae Characteristics
Mucohemorrhagic diarrhea
Marked inflammation
Large intestine only (cecum and/or colon)
Grow finishing pigs (usually >50 lbs)
Spirochetal colitis  B. pilosicoli

31. Swine Dysentary Prevention Treatment Negative replacement stock
Wean < 21 days
Rodent control
Treatment
Medication
Feed: Mecadox, Lincocin, Denegard
Sanitation

32. Salmonellosis

33. Salmonellosis Primarily Salmonella cholerasuis
Salmonella typhimurium can cause diarrhea
Wide variety of organisms can be food borne pathogens
Often stress/environment induced
Clinical signs
Severe lethargy (very sick): +/- fever
Purple discoloration of ears and belly = septicemia
Diarrhea: +/- blood
Pneumonia

34. Salmonellosis Lesions Diagnosis via culture Splenomegaly
Inflamed intestine
Pneumonia – interstitial (wet lungs)
Button ulcers on mucosal surface: primarily in colon
Hemorrhagic lymph nodes
Especially gastro-hepatic
Other signs of septicemia
Diagnosis via culture

35. Salmonellosis

36. Salmonellosis: Treatment
Injectables
Naxcel (per label), Spectinomycin (ELU), Nuflor (ELU)
Water medication
Neomycin, Gentamycin, Spectinomycin (ELU)
Respiratory - Nuflor
Feed medication
Mecadox (50 gram/ton)
Neomycin and Terramycin (200 gram/ton of each)
Many other options in foreign countries including quinolones

37. Salmonellosis Control
Vaccination
S. cholerasuis +/- S. typhimurium
MLV’s are effective
Oral IN IM
Killed vaccines have poor efficacy
Environment is the primary focus: sanitation

38. Salmonellosis Treatment
Vaccination
Antibiotics
Prevention – Feed
Treatment
Water
Injectable
Feed
Sanitation

39. Hemorrhagic Bowel Syndrome (HBS)

40. Hemorrhagic Bowel Syndrome
Definition of syndrome: consistent clinical signs and/or lesions but cause unknown
Older (>150#) finishing pigs found dead
+/- bloated abdomen
Post-mortem lesions
Uniform hemorrhagic appearance of entire gut or small intestines only
Lumen content hemorrhagic and not clotting
No palpable volvulus of the mesenteric root

41. Hemorrhagic Bowel Syndrome

42. Hemorrhagic Bowel Syndrome
Current thinking is that torsion or volvulus is primary problem: resolve in agonal state
More common in deep bellied pigs?
Control via feed grade medication?
100 grams per ton of tetracycline with or without 30 grams per ton of BMD (Bacitracin Methylene Disalicylate)
Added fiber to the diet
Usually sporadic incidence (<1%) so hard to justify therapy costs

43. Gastric Ulcers

44. Gastric Ulcers
Pigs will start to develop erosions of the non-glandular portion of the stomach within hours of feed removal
Out of feed
Sick due to something else: pneumonia
Erosion can vary from superficial to complete penetrating
Acute cases
Pig found dead with large blood clot in stomach
Anemia – very pale

45. Gastric Ulcers Subacute cases Chronic cases Lesion
Pig found dead or live but very sick with blood in small intestine but no inflammation of intestine
Chronic cases
Gaunt pig with black, tarry looking stool
Pale appearance - Anemia
Lesion
Non-glandular portion of stomach where esophagus enters is eroded (pitted, indented)
Normally this surface is slightly elevated from rest of stomach mucosa

46. Gastric Ulcers

47. Gastric Ulcers Peritonitis with perforation Pre-disposers
Local or generalized
Pre-disposers
Other diseases that caused reduced appetite: mainly respiratory
Feed not available: plugged feeder, late deliveries
Fine grind to corn (< microns)
Pellet diets
Common end stage cause of finisher mortality

48. Other Diseases

49. Additional Information:
Whipworms – outdoor production, pet pigs
Ascarids – outdoor production, pet pigs
Rectal stricture – congenital, 2ndary to salmonellosis
Rectal prolapse – several techniques to repair but not a high yield procedure

50. Whipworms Trichuris suis Antihelminitcs – NOT Ivomec!
Worms are visible in large intestine and cecum
Must look closely or use a magnifying lens
Ileal-cecal junction if good are to look
Clinical signs
Diarrhea +/- blood
Poor doing pigs
Pre-disposers
Dirt lot environment
Low protein diets
Antihelminitcs – NOT Ivomec!

51. Whipworms

52. Ascarids: Roundworms Ascaris suum
Little or no consequence in confined pigs
Lack of exposure to feces
Sows in gestation stalls and farrowing crates
Pigs on wire and cement slat floors
Continuous problem in pasture raised pigs
21 cycle
Clinical signs and lesions
Poor doing pigs
Liver scars (milk spots)
Petechia on lungs in acute cases (larval migration)

53. Ascarids: Roundworms

54. Ascarids: Roundworms Pigs will develop immunity Common scenario
Liver scars will resolve in 4-8 weeks
Common scenario
Replacement gilts raised in confinement have no immunity
Moved to heavily contaminated, outside dirt lots to kept them cycling
Larva start marching through the lung 7-10 days later  acute outbreak of respiratory disease

55. Internal Parasite Treatment
Mandatory?
Many confinement herds only deworm sows 3-4 weeks pre-farrowing or at farrowing
Many herds deworm young pigs that have had no chance for exposure to roundworms: wire flooring
Avermectins at weaning (okay for mange)
Banminth (pyrantel) continuously in the nursery diets
With outdoor pigs, recognize risk for whipworm infestation
Deworm pigs several times with fenbendazol (Safe-Guard) in the feed: 9-10 and weeks of age
Double strength levamisole in water

56. Rectal Stricture Sequelae to: Clinical appearance Lesions
Salmonellosis
Rectal prolapse
Clinical appearance
“Air belly”; severe distension of abdomen
Cachexia
Lesions
Stricture in rectum
Enlarged spiral colon (megacolon); +/- peritonitis

57. Rectal Stricture

58. Rectal Prolapse Primarily prolapse of mucosa Pre-disposers
Variable degrees
Polyp on one side
Complete circle
Pre-disposers
Genetics
Increased abdominal pressure
Coughing
Chilling  piling

59. Rectal Prolapse

60. Rectal Prolapse Repair
Purse string: tissue still fresh, sows
Replace prolapse, suture around the anus, leave an approximately ¾ inch (one finger width) opening to enable defecation
Rectal ring: tissue already necrotic
Various sizes, choose largest that will fit
Hold ring with clamp and position so that the “slot” in the ring is at the anus
Use elastrator band or umbilical tape to secure the ring
Trim excess tissue so that pen mates don’t bother

61. Rectal Prolapse Repair

62. Acknowledgements
I would like to recognize others for their significant contributions to this presentation:
Dr. Brad Thacker
Dr. Locke Karriker
Dr. Pat Halbur
Dr. Butch Baker

63. Questions ?