farm and field investigation and case management tools

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Farm and Field Investigation and Case Management Tools Dr. Locke Karriker, DVM Food Supply Veterinary Medicine Department of Veterinary Diagnostic and Production Animal Medicine Iowa State University College of Veterinary Medicine VDPAM 310

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Farm and Field Investigation and Case Management Tools. VDPAM 310. Dr. Locke Karriker, DVM Food Supply Veterinary Medicine Department of Veterinary Diagnostic and Production Animal Medicine Iowa State University College of Veterinary Medicine. Objectives. Decrease anxiety - PowerPoint PPT Presentation

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Page 1: Farm and Field Investigation and Case Management Tools

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

Page 2: Farm and Field Investigation and Case Management Tools

Objectives

Decrease anxietyIncrease proficiencyPositive experiences earlyGet past learning the

‘process’ and on to learning the medicine

Page 3: Farm and Field Investigation and Case Management Tools

AttitudeTeamworkInvestigativeProfessionally (and politely)

skepticalSimplifyPrioritizeConfidence

Page 4: Farm and Field Investigation and Case Management Tools

Table of ContentsObjectivesOverviewSpecific tools

Preparation for visitMeeting the “manager”Facility evaluation

Documentation

Page 5: Farm and Field Investigation and Case Management Tools

Table of ContentsObjectivesOverview of the processPreparation for visitMeeting the “manager”Facility evaluationDocumentation

Start as discrete tedious

steps but become

compressed and

abbreviated with clinical

experience and familiarity

with client

Page 6: Farm and Field Investigation and Case Management Tools

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

Page 7: Farm and Field Investigation and Case Management Tools

Farm Field Investigation Tree

Page 8: Farm and Field Investigation and Case Management Tools

Preparation….Step 1Review background material (if

available) Size of farmType of production systemMajor concernPrevious diagnostic reports

Page 9: Farm and Field Investigation and Case Management Tools

Preparation….Step 2Contact the farm manager

Schedule time for farm visitElicit directions to the farmDiscuss biosecurity protocols for the

farm# of visitors in group, required clothing,

shower facilities, downtime requirementsChief complaint/concern

Page 10: Farm and Field Investigation and Case Management Tools

Preparation….Step 3Contact the veterinarian associated

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

Page 11: Farm and Field Investigation and Case Management Tools

Preparation….Step 4Research clients chief concernUseful resources:

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

Page 12: Farm and Field Investigation and Case Management Tools

Preparation….Step 5Develop a “game plan”

Locate supplies neededBoots, 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

Page 13: Farm and Field Investigation and Case Management Tools

Meeting the “manager”Introductions

Define what position the contact holds (site manager, field manager, hourly employee, contract operator, owner, etc.)

Define students role in the investigationStructure of meeting

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

contracted)

Page 14: Farm and Field Investigation and Case Management Tools

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

Page 15: Farm and Field Investigation and Case Management Tools

Facility evaluation - outside

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

ventilation fans, feed bins, etc.Assess biosecurity of the site

Fence, signs, visitor log, parking designation, entrance protocols, security of facility entrances

Page 16: Farm and Field Investigation and Case Management Tools

Facility evaluation - outside

Assess rodent/insect infestation and control measures

More information: NPB rodent control, NPB rodent control 2

Page 17: Farm and Field Investigation and Case Management Tools

Facility evaluation - outside

Feed storageWell maintained bins, periodically

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

Page 18: Farm and Field Investigation and Case Management Tools

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)

Page 19: Farm and Field Investigation and Case Management Tools

Facility evaluation - insideEvaluate environment

Assess stocking density (standards)Appropriate temperatures for

production stage

Page 20: Farm and Field Investigation and Case Management Tools

Facility evaluation - insideAssess biosecurity

Boot baths, hoses, boot change, etc.Assess overall cleanliness of facility

Manure removed from aisles, AI supplies or other trash thrown away, medicine properly stored after use

How are facilities cleaned between groups

Cleanliness of pigs

Page 21: Farm and Field Investigation and Case Management Tools

Facility evaluation - insideAssess presence of noticeable

hazards to the pigsSharp edges, exposed wires, protruding

gate rods, etc.Assess equipment

Teeth clippers, scalpel blades, etc.Working order, cleanliness

Page 22: Farm and Field Investigation and Case Management Tools

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?

Page 23: Farm and Field Investigation and Case Management Tools

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

Page 24: Farm and Field Investigation and Case Management Tools

Facility evaluation - Personnel

“Show me how” versus “Explain how”

Open ended questions – NOT “yes/no”

Page 25: Farm and Field Investigation and Case Management Tools

Facility evaluation - PigsAssess 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.

Page 26: Farm and Field Investigation and Case Management Tools

Facility evaluation - PigsDiagnostic testing

Collect blood samples

Perform necropsies on mortalities – assess trends

Find acute clinical pigs for dx work

Page 27: Farm and Field Investigation and Case Management Tools

Follow-up

Summarize findings and generate report

Submit report to both producer and owner/veterinarian

Page 28: Farm and Field Investigation and Case Management Tools

Specific Examples

Page 29: Farm and Field Investigation and Case Management Tools

Marco Case Report

Page 30: Farm and Field Investigation and Case Management Tools

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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HBS HeatStroke

Cardiac Fighting GastricUlcer

Ileitis Other Pleuro-pneum.

Pneum. Septicem. Tail bite Unkn. Volvul.

Cause and sex

Mor

talit

ies

Page 31: Farm and Field Investigation and Case Management Tools

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

Page 32: Farm and Field Investigation and Case Management Tools

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

$

$

Page 33: Farm and Field Investigation and Case Management Tools

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 alChapter 7 Measures of Association and Effect p.95

Page 34: Farm and Field Investigation and Case Management Tools

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/HyperkeratosisLu

ng L

esio

n

Odds Ratio2.23

Relative Risk

Page 35: Farm and Field Investigation and Case Management Tools

PCV2 Associated Finisher Mortality

October 1, 2005

Page 36: Farm and Field Investigation and Case Management Tools

Iowa State University College of Veterinary MedicineFood Supply Veterinary Services

Nursery and finisher mortality uncoupled….

Page 37: Farm and Field Investigation and Case Management Tools

0%

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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.

Page 38: Farm and Field Investigation and Case Management Tools

Mature gilts in acclimation barn

Very little coughing

Very lethargic

Anorexic

No coughing

No vomiting

Many with fevers

Page 39: Farm and Field Investigation and Case Management Tools

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

Page 40: Farm and Field Investigation and Case Management Tools
Page 41: Farm and Field Investigation and Case Management Tools
Page 42: Farm and Field Investigation and Case Management Tools

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

Page 43: Farm and Field Investigation and Case Management Tools

Sow lactation triage plan

Page 44: Farm and Field Investigation and Case Management Tools

Necropsy Checklist

Page 45: Farm and Field Investigation and Case Management Tools

QUESTIONS???