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The quagmire of enzootic pneumonia:  A view from the trenches James F. Lowe, DVM, MS Carthage Veterinary Service, Ltd Department of Veterinary Clinical Medicine, University of Illinois
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Bi pre aasv health seminar lowe ppt (1) dw020810

  • 1. The quagmire of enzootic pneumonia: A view from the trenches James F. Lowe, DVM, MS Carthage Veterinary Service, Ltd Department of Veterinary Clinical Medicine, University of Illinois
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Editor's Notes

  1. New diagnostics are really cool but they are “worse” than the old ones Many new tests PCR’s New Ab tests But same old challenges   Lab specific “ Exterior” pathogen in place that is hard to get to Systemic immune response is not related to protection Poor specificity and sensitivity because of nature of pathogen Clinicians struggle keeping up on test performance and it’s implications on sampling strategies and interpretation of results More tests and more results have lead to a state of confusion by creating more information but less knowledge about the clinical problem.
  2. Somewhere along the line we decided that it was all about the pathogen and not the disease Because we can “find” the pathogen now we assume that we should be working on getting rid of it. Mentality that elimination is the only path to success We start to believe our own data and don’t understand everything else that is going on   If we think about our “job” – Promoting the well being of animals and making our clients money over the long run by keeping clinical disease at bay - then there are multiple paths to success Did we really think about what the client needs? Did we think about what is possible? Did we think about all the alternatives, the probability of a “good” outcome, the magnitude and distribution of the potential outcomes and understand their impact on the financial success of the business?   What is the appropriated data?
  3. If it is not working we must need to do something new Numerous challenges with control of Enzootic pneumonia over last 10 years Lots of theories not many facts    Data is cloudy at best – lack of good controlled data that accounts for all the influences that happen in the “real world” Confused and frustrated producers have “wanted to do something”   Vets are good at doing but maybe not so good at objectively measuring We “solve” the clients problem but are not always good at the follow up necessary to understand what happened and why We often don’t want to have the hard conversation and so we avoid checking to see if the program that is in place is even being done right   We start making changes without really understanding what is happening in the system and so we miss some key fact We misinterpret what is happening in the farm and make more changes or fail to make necessary changes Timing of expected results WAY too much faith in the bottle   “ In my experience” the three most dangerous words in medicine     Listing the different theories, fashion topics in the last years.   Age at vaccine, duration of immunity,   They are proactive but not necessary have a complete knowledge – understanding of the disease.   We only take care of M.hyo program control when we have a new “sexy” concept in the industry, more marketing driven instead of science driven   Real expectation about Vx programs   What are those 3 words?
  4. One guy’s view from the front lines of how we mess it up Enzootic pneumonia costs real money but outbreaks of M. hyopneumoniae in negative herds cost a lot more Vaccine works provided they are not sick with some virus when you give it   They only thing important about timing is that they get vaccine before too many of them get infected   If you have bad vaccine crews, lots of viruses, crappy barns or really stupid pig flow then you might want to use two doses of vaccine (or maybe think about fixing the real issue)   If you think you can repeatedly eliminate the organism from a population with drugs then I want some of the drugs you use   Data on vaccine timing and time from vaccine to immunity, SIV and PRRS data on vaccine, basic facts about immunity and stress   Examples   Possible solution options for both situations   Need some data on sow herd infections and shedding besides the Carlos paper   I think this is an important approach
  5. Sow herds are the problem and that is the biggest problem   .   We STRUGGLE to understand what is happening in sow herds. On my list of people that need a good flogging. Right after the guy that thought we should shower in AND out, is the guy that thought we needed M. hyo “negative” gilts for commercial sow herds. Infected sow farms and negative gilts = pain in rear at some point Acclimation of gilts is not as easy as you think Predicting sow herd stability is the Holy Grail for this disease but right now there are major technical barriers to getting it done.
  6. Big bucket take homes for me Match the gilts to the sows and get them acclimated to the sow herd early Vaccinate the pigs – yes all the pigs regardless of what you think the status of the sow farm is and that includes all of the gilts There is no prize for being “negative” If you have issues be prepared to use antibiotics to cut economic losses.
  7. Challenges as we go forward We might not have Antibiotics to deal with outbreaks We need to understand what is happening at the level of the sow herd and how be build systems that are more robust to small changes in agent transmission rates in the sow herd. We need to keep working on the disease and the only way we will figure it out is large, blinded clinical trials that are expensive and hard to do.