Ileitis treatment options and resulting correlation on average daily gain

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you want . Joining our Ann Hess on this episode of Feedstuffs in Focus to talk about ileitis and what producers can do to minimize its impact is Dr Nate Winkleman , co -owner and veterinarian at Swine Services Unlimited .

But our primary focus is doing research with swine diseases for vaccine and pharmaceutical companies and some just nutraceutical studies as well . We research all swine diseases Since about mid-95 , I've developed a mucosal homogenate Lassoni intracellularis challenge model that was recognized pivotal for the FDA to approve antibiotics .

So I've been still focusing on Lassoni intracellularis and continue that work .

I think it's a lot of money still left on the table because subclinical and clinical ileitis is underdiagnosed and undertreated . Diagnosed and undertreated Daryl Holdkamp did a really good literature review a few years ago showing the cost of both subclinical and clinical ileitis to be anywhere from $6 to $16 per pig if it's identified in your system .

So it's a very significant and common enteric problem in North America .

quite significant . You recently shared new research at the American Association of Swine Veterinarians Conference in San Francisco on ileitis and finishing pigs . Can you explain more about that study and the top level findings ?

I've tested both lincomycin and avilacin , or tilvalocin or tilvalocin however you want to pronounce it many times individually , both in the feed and the water , and lincol has an injectable as well . But this is the first time I had the opportunity to test both of them side by side in an ileitis challenge model and this was in older pigs .

It was in a 10-week-old pig when we challenged the pig and the trial lasted for 35 days . So it was a 10 to a 15-week-old pig . So it was a 10 to a 15-week-old pig . The trial design basically is we had three treatment groups . We had 170 pigs total . The challenge control group there were 50 pigs in the challenge control group that received a very high .

All the pigs received a high 10 to the 10th Lawsonia challenge . The second group was the Abelson group . There are 60 pigs in the Abelson group . The third group was the lincomycin water medicated group . That had 60 pigs in it , also the pigs .

We waited until we saw clinical signs but because of the very long incubation period of a Lawsonia to cellularis we didn't see clinical signs . We saw on day 13 post-challenge . 10% of the pigs had clinical signs . So that's when we started the five-day treatment . Pigs were treated from day 13 to day 18 . We measured many parameters .

We measured clinical parameters of fecal diarrhea scores , fecal color scores , body condition or abdominal appearance scores . Obviously we measured performance parameters of average daily gain , average daily feed intake and feed conversion rate . It was a terminal study .

So 35 days after the pigs were challenged with Lawsonia , all the pigs were euthanized and we measured gross PPE or PIA as porcine intestinal adenomatosis . That's the underlying lesion of ileitis . You can actually see that grossly on the intestine . We measured a severity index on day 35 when we euthanized all the pigs .

At the end , basically , under the constraints of this trial , ablac or tibulocin performed better in all the parameters that we measured compared to lincomycin . However , both of the antibiotics were effective in controlling the disease compared to the controls . So that's the bottom line summary .

The older the pig is , the more bacteria you have to give , because the pig has an amazing ability to hide this disease . Diarrhea is not a common clinical sign by the time you see diarrhea in ileitis-challenged pigs . All the pigs are subclinically affected and some are clinically affected .

This was a good challenge because we had mortality from ileitis in the grower pig . Two pigs died in the control group , one from acute PHE or porcine hemorrhagic enteropathy on day 18 , and then one chronic pig died on day 28 in the control group .

One pig died from the PHE acute bloody form of biliitis on day 22 in the lancomyosin group and there was not any mortality in the ableson group . To answer your question on average daily gain , there was just dramatic differences between the treatments and the controls the control group .

When we measure average daily gain from day 13 , when we started treatment until day 35 at the end of the study , the average daily gain in the control was 1.75 pounds per day and in tilvalocin it was 2.26 . So that's almost 50 points . That's amazing .

Lincomycin was at 2.07 , and both lincomycin and the tilvalocin were statistically significant compared to the controls for average daily gain . Feed conversion is also an important parameter . This intestinal disease causes a hyperplasia or a thickening of the mucosa of the small intestine . So you can't normally assimilate nutrients . So both they go off feed .

So average daily gain is affected . But the feed conversion rate is also significantly affected . In this trial it was a dramatic difference as well . The Avilacin group had a 1.81 feed conversion rate compared to a 2.69 feed conversion rate over that day 13 to 35-day period . The lincomycin group was intermediate . It had a 2.16 feed conversion rate .

It wasn't statistically significant at a PO5 level for this study . It probably would have been if we would have had more than 60 pigs , because the differences were still quite high numerically . And then , lastly , I might as well mention the PPE severity score differences also .

We look at the ilium first , the jejunum , the cecum and the colon for these PIA lesions and we can see and measure those . So we measure those in centimeters and we have a scale of zero being normal , one mild , two moderate and three severe .

So we take the lesion length times the lesion score and add that together throughout the intestine to get a lesion severity index . Severity index the lesion scores were the lowest in the alicin treated group . It was statistically better than the controls .

That severity index of the 25 was the mean score on those 60 pigs and it was 75 was the lesion severity score in the controls . And then lincomycin was intermediate at 33 and was not statistically better than the controls . And I should say ablacin wasn't statistically better than the lincomycin in these parameters either , just numerically better .

is to always be on the lookout . The key is to always be on the lookout . Be on the lookout visually for clinical ileitis Whenever you see abnormal diarrhea . Our first diarrhea score is a one and that's just a soft cow , pie-like diarrhea . It's not normal diarrhea .

My producers will tell me that , doc , that's just normal diarrhea and no , there's no such thing as normal diarrhea . That's my favorite saying and you've probably heard me say that before , but so you walk by it .

If you see clinical diarrhea in a pig that's in a grow finish pig , especially a pig that's in a grow finish pig , especially a pig that's over 100 pounds or the fecal color score is also a really good thing to look at visually .

If you see blood in feces , we we score our fecal color score on a mild , moderate , severe score as as as well severe is a classic black , tarry , red , black or-black or black-red melana . Two-color scora is just some blood in it . It might be dark , brown or orange , but there aren't too many things that are going to cause bloody diarrhea .

We don't bloody diarrhea is brachyspira , hyaluronic acid or hamsonia . We don't have that in very many of our farms , although it might be on the increase . But if you see blood , something's wrong and then get a diagnosis , don't walk by anything clinical without knowing what it is .

Fecal PCRs are the gold standard anti-mortem test , whether they're taken with a direct fecal sample or you take fresh fecal samples and pool up to three to five at the most , or if you take oral fluid samples .

Don't walk by clinical diarrhea without knowing what it is , because my rule of thumb , if it's clinical in a grow-finish pig , you've got the rest of the population . That's subclinical or clinical and they need to be treated with water medications .

It's very , very cost-effective to treat with water medications , as I can talk about in a benefit-cost analysis that we did on this study . So that's number one . Look at it visually . Number two is monitor it . So that's number one . Look at it visually . Number two is monitor it .

Use the fecal PCR with the oral fluids and take fecal samples and routinely monitor your finishing barns , at least once or twice a year , so you aren't walking by it . Iliitis only lasts in an individual pig . Iliitis will probably only last for 35 to 42 days .

In some bad situations they might shed for out to 70 days and the population might only have ileitis in that grow-finish barn for six weeks or two months , months . So it's your job to find it and take action if you have a clinical diarrhea to water medicate .

And then what we also learned from this trial is the correlation between fecal shedding and average daily gain . So there was a moderate correlation of 0.51 in this trial , showing that as fecal shedding decreased , that average daily gain dramatically decreased also , and it had a high P value .

So my rule of thumb is whenever you have fecal PCRs or oral fluid samples approaching 30 , a CT value of 30 at the University of Minnesota they're in the diagnostic lab you better take action because that means there's lots of fecal shedding . And we also showed that there's a moderate correlation between fecal shedding and lesion scores .

So the more lesions you have , the more fecal shedding and lesion scores . So the more lesions you have , the more fecal shedding you have and the more average daily gain and feed conversion loss you have . So when your CT values get down around 30 , take action and water medicate .

Or if you see clinical diarrhea with blood or just diarrhea consistency scores , then treat with water medication because it's very , very cost effective .

of clinical diarrhea . You talked about water-soluble treatment being an effective delivery method and looking at some costs too with this trial . Won't you dive into that more for us and explain why that is such an effective delivery method ?

But by on day seven , none of those pigs were shedding . Um , by day 13 , 100 of those pigs were shedding . By day 13 , 100% of those pigs were shedding and the fecal PCRs were down in that 25 to 27 CT value at the University of Minnesota . I keep saying at the University of Minnesota , because the PCR CTs , pcrs aren't standardized across labs .

So , for example , at Iowa State they only go through 35 cycles to identify their Lawsonia PCRs , where at the University of Minnesota they go through 40 cycles . So the numbers are going to be a little bit different .

But at the University of Minnesota , for example , when you get down to around 30 that I just mentioned 30 is when you do a qPCR that's about five times 10 to the fourth .

So that means there's 50,000 Lassonia bacteria per gram of feces and it only takes somewhere between a hundred and a thousand bacteria to infect a pig and start the whole disease process in that population . So you know you've got a lot of bacteria that the pig is spreading fecal to oral throughout that , throughout that population .

So you know you've got a lot of bacteria that the pig is spreading fecal to oral throughout that population . Regarding the cost-benefit analysis that you asked about , I just used some basic assumptions from today's markets $67 per 100-weight live , $300 per ton of feed .

The cost of ablison in our study was 63 cents per pig for that five-day period and the cost for lincomycin was 32 cents per pig over that five-day period . So ablison was a more expensive treatment . However , the benefits of Abelson outweighed those of lincomycin and both of them were much , much better than the controls .

For example , the extra body weight on day 35 . For Abelson the pigs averaged 11.4 more pounds heavier on day 35 . The lincomycin pigs were seven pounds heavier . You put that $67 per 100-weight live and put a value on that , that's $7.50 for Abelson and $4.50 more value for the poundage on that pig . The feed savings and feed conversion rate for Abelson was $3.24 .

The feed savings for linchomycin , compared to the controls , was $1.25 . So the total benefit just in performance . I didn't look at mortality here but there's benefit in mortality as well . The total benefit for Abelson was $10.73 just in this trial by treating with Abelson , and it was $5.83 for the lincomycin water medication . So the benefit-cost ratio .

When you divide that by the cost of the antibiotics , the benefit-cost ratio turned out to be about the same . It was 17 to 1 for alicin and 18 to 1 for lincomycin . But the bottom line here is that you spend 31 more cents for antibiotic costs for alicin and it pays you back $4.90 in performance improvement with average daily gain and feed conversion rate .

So under the constraints of this trial , alicin was the better antibiotic in this ileitis challenge .

the subclinical . It looks like 80% of those pigs are just fine but they're shedding More than likely they're shedding . Some might be normal . It depends upon where in the course of the disease they are when you're taking these PCRs . But water medication is the best treatment for population .

But still , if you have pigs that have bloody diarrhea or a PHE , you need to inject those pigs . The best thing for that individual pig is an injectable antibiotic . For Lawsonia , lincomycin and Tylen are common ones . Also , if there was enough disease in this trial , if this were a field outbreak , we would have followed up with feed medication .

Also , because you medicate in the water for five days , you still have to follow up with feed medication for another couple weeks after that because the water medication doesn't completely stop all shedding . It reduces shedding . Actually the Avilacin reduced shedding 8.3 times more than the lincomycin on day 21 after the water medication was taken out .

But still , if it was a field outbreak , you use all methods of delivery . Water medication is the best . If they're really sick pigs you want to inject them and you want to follow up in the population , depending upon how much clinical signs you see and if you have mortality or not with feed medication as well . So I guess hopefully that answered the question .

If you think clinical diarrhea is normal diarrhea , you're walking by it and leaving money on the table , so monitor it , get in there and hang some . It's easy to hang oral fluids . Easy to hang oral fluids . It's easy to take some fecal samples from suspect feces and pool them for PCRs . Know where you are and catch it .

Catch it early so you can treat it with water medication and save your producer a lot of money .

so much for joining us today .

By offering multiple options for active ingredients , concentrations and administration routes , farmgate provides you with choices to fit your needs and get you the results that you want . I'm Sarah Muirhead and you have been listening to Feedstuffs In Focus .

If you would like to hear more conversations about some of the big issues affecting the livestock , poultry , grain and animal feed industries , subscribe to this podcast on your favorite podcast channel . Until next time , have a great day and thank you for listening .