Swine Disease Diagnostics and Economics Considerations - Dr. James Kober, Swine Veterinary Services of MI, LLC/Partner-4 Star Veterinary Services, LLC, from the 2013 Allen D. Leman Swine Conference, September 14-17, 2013, St. Paul, Minnesota, USA. More presentations at http://www.swinecast.com/2013-leman-swine-conference-material

1. James A. Kober, DVM, MS
Diplomate ABVP-SHM
Swine Veterinary Services of MI, LLC/
Partner-4 Star Veterinary Services, LLC

3. 
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Pythagorean theorem: 24 words
The Lord’s prayer: 66 words
Archimede’s principle: 67 words
The ten commandments: 179 words
The Gettysburg address: 286 words
The Declaration of Independence: 1300 words
Constitution of the United States: 4543
Health care regulations from President Obama:

4. 
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Pythagorean theorem: 24 words
The Lord’s prayer: 66 words
Archimede’s principle: 67 words
The ten commandments: 179 words
The Gettysburg address: 286 words
The Declaration of Independence: 1300 words
Constitution of the United States: 4543
Health care regulations from President Obama:
2,163,744

5. Sick pig testing: tissues, oral
fluids, serum
 Surveillance testing: oral fluids,
serum
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6. 
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What are the costs? Per case? Per year?
What are the benefits?
What are you going to do with the results?
How much is the right amount to spend on
diagnostics and/or surveillance?
The decisions on how much to spend will vary
significantly from producer to producer.

7. 
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They want to know why the pig died, regardless of
the cost.
Diagnostic costs are spread over a small number of
pigs.
This group may ask that you to run more tests
than necessary.
“test for everything” Doc
Little or no surveillance.
Often need the most help, because they make bad
health related decisions.
More individual animal care; surgeries.

8. 
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Toughest group
May wait until problem is well advanced
Costs are extremely important as there are a
small number of pigs to spread the costs
More important to rely on the veterinarians
practice experience or best judgment.
May forego actually sending tissues to the lab.
Treatment is more of a shotgun approach.
Surveillance unlikely.

9. 
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May or may not have budget
More pigs to spread costs over
Often conducts surveillance in addition to “sick
pig” diagnostics.
Need to know exactly what is at fault so
treatment can be correct and precise.
Start answering to administrators who don’t
know production.

10. 
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Often have some sort of budget.
Most will track “sick pig” diagnostics vs.
surveillance.
Will vary if multiplier vs. commercial herds.
Informal survey of colleagues working in this
type of production system:

11. 
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$0.35-$0.40 per pig marketed (commercial)
Budget determined by type of site, threat of
area spread, # samples, frequency of testing;
then looked at the system wide level (sow
units, boar studs, growing pigs, GDU).
Historical costs come into play
New breaks or emerging disease are not
restricted by budgets.

12. 
Budget includes diagnostics (including
surveillance), medicine, and vaccines into one
figure.

$45.91 per sow per year
 @ 28 PW/S/Y=$1.64 per pig weaned.
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$1.60 pig marketed
Total: $3.24 per pig marketed (diagnostics,
surveillance, medicine, vaccine).

13. 
It is very difficult to compare
company or system diagnostic
budgets. They use vastly different
ways to track the diagnostic and
surveillance costs.

14. 
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Sick pig cases
ISU only
12 months: June 1, 2012-May 31, 2013
308 tissue cases
Cost: $56,020 total
Average: $182/case.

15. 
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As farms have become more sparse (rural
areas), it may be difficult to pay for a
veterinarian to come out to post a pig.
More farms have people who are willing to do
this. With some training, they can harvest and
send tissues/oral fluids on their own.
It is becoming more common for veterinarians
to interpret lab results only.

16. 
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US Government has 15 definitions of “rural”
11 are used by the USDA
The biggest definition of rural is less than
50,000 residents (county)
The smallest definition is less than 2,500.
This creates problems when someone applies
for a “rural development grant”
Source: Michigan Farm Bureau News via The
Washington Post

17. If the veterinarian can’t be there, perhaps a
manager, intern, or student can be.
They are not diagnosticians, but can be trained in
broad categories.
As they post more pigs, more categories can be
added.
Use of a flow chart to categorize is helpful.

18. Finisher Mortality
Classification Flowchart
C
Death
Was this a
“sudden”
death?
“ACUTE”
A
N
“UNKNOWN”
1
Y
“BRAINER”
2
Y
“POLYSEROSITIS”
3
Y
“RESPIRATORY”
4
Y
“ULCER”
5
Blood in
intestines?
N
Y
Blood in
stomach?
“CHRONIC”
Y
“HBS”
6
Record and continue
A “sudden death” is a pig that is found
dead in the home pen with no previous
treatment.
Perform
Necropsy?
Y
E
“EUTHANIZED”
Record reason:
-“junk”
-“downer”
-“lame”
-“rupture”
Y
Euthanized?
N
CNS observed
before death?
N
All organs
stuck together?
N
Lung Lesions?
N
N
N
“OTHER”
Locke Karriker, DVM, MS, DACVPM
John T. Waddell, DVM, MBA
Revised: October 22, 2006
7

19. 
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Summer of 2011, large client (6600 sows farrow
to finish, multiple sites)
Post weaning death loss too high.
Why? Unknown.
Two veterinary students from MSU worked for
10 weeks; posted every post weaning pigs they
could find.
(Thanks to Novartis and Pfizer/Zoetis)

20. 
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W/M flow: total 215 pigs posted.
Top 6 reasons are:
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Bacterial pneumonia/A. suis-17%
Unknown:
-16%
Polyserositis
-16% Causes: H. parasuis or
M.
hyorhinis
HBS
-10% twisted gut
Meningitis
-7% H. parasuis, Strep suis,
hem. E. coli
Vitamin E/Se
-7%
Total, top 6
-73%
Two distinct peaks at 6-8 weeks in and 13-15 weeks in

21. 
Nurs and Finisher: 208 pigs posted. Top 7
reasons:
Polyserositis
-30%,
 Unknown
-17%
 Bact pneumonia
-14%
 Vit E/Se
-5%
 Meningitis
-5%
 HBS
-4%
 Rectal prolapse
-6.5%
 Total, 7 reasons
-81.5%
 Three peaks (4-6, 7-9, 10-12 weeks post weaning)


23. 
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Monitoring the health of the herd.
To be sure herds negative for certain agents
remain negative (PRRS primarily).
To monitor when stable herds become
unstable.
To monitor when unstable herds become
stable.
To monitor if exposure to subclinical agents has
taken place (PED, PRRS, ileitis)

24. 
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Much easier to budget; routine
Have a plan if results don’t come out like you
would like.
“Monitoring for the sake of doing something
does not justify itself in all but the highest
health system” (Hansen, et al).

25. 
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Load, close, homogenize
Vaccinate
Weaned pigs to a different site
Institute McREBEL
Dump isolation to slaughter
Wait until shedding is complete
Put into sow herd “cause we really need the
gilts, doc”

26. 
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SPF slaughter checks
10 pigs quarterly; looking for lesions of
Mycoplasma hyopneumoniae
Pass/fail
Problems:
If failed, just brought 10 more pigs
 Some farms raised pigs outdoors specifically for slaughter
checks.
 Small sample, but most farms were small, continuous
flow, single site farms.
 Likely would find at least one set of lungs with lesions if
Mycoplasma was present.
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27. 
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Specific, routine tests
Frequency can be altered to fit exact agent(s) or
likelihood of exposure.

28. Age
Timing Frequency Sample type Test Cost per test # samp/pl/rp # smplgs / yr Seq /smplng
Sows
Baseline
Due to be weaned pigs
Baseline
Nursery (4 weeks post wean) Baseline
Finishing (4 weeks post-place) Baseline
Gilts (GDU)
Baseline
Sows
Continuos
Due to be weaned pigs Continuos
Nursery (4 weeks post wean) Continuos
Finishing (4 weeks post-place) Continuos
Gilts (GDU)
Continuos
TOTAL
Once
Once
Once
Once
Once
No
Monthly
Quarterly
Quarterly
Quarterly
Serum
Serum
Oral fluid
Oral fluid
Oral fluid
Serum
Serum
Oral fluid
Oral fluid
Oral fluid
ELISA
PCR
PCR
PCR
PCR
ELISA
PCR
PCR
PCR
PCR
$4.00
$25.00
$25.00
$25.00
$25.00
$4.00
$25.00
$25.00
$25.00
$25.00
20
12
4
4
8
0
6
2
2
4
1
1
1
1
1
0
12
4
4
4
0
2
1
1
1
0
0.5
0.5
0.5
0.5
Program can be modified according to goal of production, status of herds, risk of infection and pig flow
This plan = baseline sampling/testing (20 sows, 60 DTW piglets, 4 ropes in Nursery, 4 in Finishing and 8 in gilt flow)
+ continous testing (30 DTW, 2 ropes in Nur, 2 in Gfin and 4 in GDU / quarter)
Seq cost
120
120
120
120
120
120
120
120
120
120
Cost per sampling Cost per year
$80.00
$540.00
$220.00
$220.00
$320.00
$0.00
$210.00
$110.00
$110.00
$160.00
$80.00
$540.00
$220.00
$220.00
$320.00
$0.00
$2,520.00
$440.00
$440.00
$640.00
$5,420.00

29. 
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PRRS area regional control projects
Monitor the status of a region instead of a
single farm or site.
Can use to monitor active infections vs stable
vs. negative farms
Can watch and predict an infection moving
across the area.

30. 
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110 sites
Thoroughly tested 2009, 2011, and 2013.
Mapped, dendogram created
2009-all serum; 2011-part serum, part oral fluids;
2013- mostly oral fluids.
Plan of action introduced to all producers in the
area.
Taught to look for sick pigs.
Collect oral fluid samples and submit to laboratory
Results to ARC leader; notify producers in the area what
was going on.
 Goal is to warn area producers if something new is
happening.
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32. 11.11.23_20 11038377
13.4.4_2013 012822
13.3.13_201 3009550_1
13.3.13_201 3009550_3
11.11.30_20 11038888
13.4.3_PP
13.2.12_201 3006011
11.9.20_201 1030312
13.3.13_201 3009550_2
12.3.16_121 512
12.5.1_1222 42
13.3.14_201 3010367_2
13.3.14_201 3010367_3
11.3.16_201 1008397
11.10.25_20 11034389
09.8.18_200 9023368
11.11.17_20 11036300_2
11.11.17_20 11036300_3
11.11.30_20 11037451
09.9.25_D09-048096
09.10.29_D09-053722
09.5.28_D09-026622
11.8.18_201 1026699
09.5.28_D09-026618
11.12.8_119 779
13.1.2_1268 11
09.6.26_D09-032003
11.8.24_201 1027304
11.9.29_201 1031458
09.8.13_D09-040733
09.7.31_D09-038228_1
09.7.31_D09-038228_3
09.7.16_D09-035282
09.8.4_D09-038894_2
Res pPRRS 2-5-2 ORF5
11.11.15_20 11036186
13.3.14_201 3010367_1
09.10.19_D09-051843
09.8.4_D09-038894_1
09.8.13_D09-040732
09.10.29_D09-053724
09.11.18_D09-056753
09.7.31_D09-038228_2
09.7.1_2009 019123_1
09.7.1_2009 019123_3
09.7.1_2009 019123_2
09.12.4_200 9034224_2
09.7.1_2009 019123_4
09.7.1_2009 019123_5
09.12.4_200 9034224_1
09.5.12_D09-023830
09.7.2_D09-032898
09.10.2_D09-049195
09.10.30_D09-053958
09.7.16_D09-035284
09.7.28_D09-037475
13.3.22_201 3011055_1
13.3.22_201 3011055_2
11.11.17_20 11037560
13.4.4_2013 012894
11.11.17_20 11036300_1
ATP-PRRS 1-4-2 ORF5
13.2.26_201 3007331
19.3
18
16
14
12
10
8
6
Nucleotide Subs titutio n per 100 res idues
4
2
0

33. 
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Previously used IFA, SN, CF, virus isolation
Now immunohistochemistry, PCR, sequencing
PCR/molecular is now the most requested test
at the ISU diagnostic lab.
Very specific and very sensitive

34. ISU VDL FY 2013
Pharmacology
Bacteriology
Tox/Nutrition
Histology
Virology
Res/Dev
Molecular
2,750
<1%
180,784
36%
10,167
2%
87,650
17%
5,339
1%
6,115
1%
210,348
42%
503,153
100%
Total # tests done on 55926 submissions
Molecular includes PCR tests, including sequences

35. 
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Oral fluids and PCR testing has revolutionized
the world of diagnostic testing
Can be used for both sick pig diagnostics as
well as surveillance.
Oral fluids now allow lay people collect and
submit the samples.
2010: 10,000; 2011: 30,000; 2012: 50,000

36. 
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PCR tests for new agents can be developed
quickly (PED)
As of Sept 1, appox. 6000 tests for PED
conducted at ISU @ $30 each
100 IHC tests for PED @ $13 each.
What about new tests?
FAD
Other viruses

38. 
Tissue diagnostics:
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Lay people posting and submitting
Flowchart to guide decisions
 Students/interns to post large numbers to make findings
significant
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Oral fluids easily collectable
PCR very sensitive and specific
Surveillance:
Combination of oral fluids and serum to precisely
monitor individual herds as needed.
 Regional projects should help areas deal with disease
instead of individual farms.
 Diagnostic Labs continue to do a great job improving
existing tests and developing new ones.


39. 
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Lemen Conference organizers.
Iowa State Veterinary Diagnostic Laboratory
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Rodger Main
BIVM (surveillance spreadsheet)
Dr. Karriker and Dr. Waddell
Novartis and Zoetis
Friends and colleagues who completed the
survey