dabvp (food animal) ruminant extension university of ...dehydration loss of fluid in feces &...

33
Dr. Michelle Arnold, DVM DABVP (Food Animal) Ruminant Extension Veterinarian University of Kentucky Veterinary Diagnostic Laboratory

Upload: others

Post on 22-Jan-2020

2 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Dr. Michelle Arnold, DVMDABVP (Food Animal)Ruminant Extension Veterinarian

University of Kentucky Veterinary Diagnostic Laboratory

Page 2: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

.

Neonatal Calf DiarrheaDr. Michelle Arnold- Ruminant Veterinarian, Associate Professor,

Clinical Title Serieshttp://

Page 3: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Esophageal Feeder

http://www.youtube.com/watch?v=tL0k398r2j4

Page 4: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Dehydration

Loss of fluid in feces & decreased fluid intake (depend on milk intake)

Decrease in plasma volume and extracellular fluid volume

This causes a decrease in cardiac output, oxygen delivery->hypovolemic shock

Page 5: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Assess Hydration Status

% Dehydration Demeanor Eyeball Recession *Skin Tent

(seconds)

<5 Normal None <1

6-8 (mild) Slightly depressed 2-4 mm (.1”) 1-2

8-10 (moderate) Depressed 4-6 mm (.2”) 2-5

10-12 (severe) Comatose 6-8 mm (.3”) 5-10

>12 Comatose/Dead 8-12 mm (.4”) >10

*Skin tent: Pinch skin on side of neck and twist 90 degrees; count when it disappearsEyeball recession-may be inaccurate if no body fat stores (chronic cachexia)

Lab testing: plasma protein concentration is best

Page 6: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Calf on the left ( A ) has a normal hydration status. There is no space

between the eyelid and the eyeball. The calf on the right ( B ) is severely

dehydrated. The eye is sunken at least 7 to 8 mm into the orbit.

Geof W. Smith

Treatment of Calf Diarrhea: Oral Fluid Therapy

Veterinary Clinics of North America: Food Animal Practice, Volume 25, Issue 1, 2009, 55 - 72

http://dx.doi.org/10.1016/j.cvfa.2008.10.006

Page 7: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular
Page 8: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Metabolic Acidosis in Calves

Acidosis is not correlated with degree of dehydration (D-Lactate concentration is very important); more severe in older calves (>7 days of age)

CNS depression

Decreased suckle response

Weakness/Inability to stand

Cold oral mucosa

Page 9: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Estimate Degree of Metabolic Acidosis

Calf Demeanor Base Deficit ≤8 days of

age

Base Deficit > 8 days of

age

Standing , strong

suckle reflex, warm

oral cavity, alert

0 (Oral fluids ) 5 (Oral Fluids)

Standing, weak suckle

reflex, cool oral cavity,

lethargic

5 mmol/L 10 mmol/L

Sternal recumbency,

weak to no suckle

reflex, cool oral cavity

10-12 mmol/L 15 mmol/L

Lateral recumbency, no

suckle reflex, cold oral

cavity

13 mmol/L 20 mmol/L

Page 10: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

If calf is standing

And has a suckle reflex, can treat with oral rehydrationproducts

Page 11: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Oral electrolytes

Quick and easy-no catheter

A calf with any suckle reflex should tolerate oral fluids.

Often used to replace fluid loss, correct acid-base and electrolyte abnormalities, and to provide nutritional support

Big differences in products available

Page 12: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Diaque (BIVI)

Na+=90mM/L; K+=25mM/L; Cl-=55mM/L

Amino Acid-glycine (7mM/L)

Osmolality=377 mOsm/L

Alkalinizing Agent-bicarbonate (25mM/L) & Acetate (12mM/L)

SID=65

Glucose:Sodium=1.8:1

Psyllium-No

Good oral electrolyte product for calves

Page 13: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Agri-Labs Hydra-Lyte

Na+=90 mM/L; K+=30mM/L; Cl-=45mM/L

Amino Acid=glycine (16mM/L)

Osmolality=614 mOsm/L

Alkalinizing Agent-Acetate (60mM/L)

SID=75

Glucose:Sodium=3.3:1

Psyllium-No

Good oral electrolyte product for calves

Page 14: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Oral Electrolyte Feeding

Do not withhold milk feeding for prolonged periods of time-milk has never been proven to exacerbate diarrhea

Add electrolytes as an extra meal(dairy)

Beef calves-avoid high bicarbonate (may inhibit milk clot formation if bicarb>40)

Acetate products can be fed with milk

Page 15: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

IV therapy is indicated in calves 8% dehydrated and/or if:

Signs of severe CNS depression or coma

Unable to stand, wobbly or recumbent

Absent or weak suckle reflex

Anorexia for more than 24 hours

Rectal temperature < 100° F

Cold oral mucosa

Rapidly progressing dehydration and consistent, profuse watery diarrhea

Page 16: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

WHY IV and Not Oral?

Collapsed, dehydrated calves in severe shock can’t rapidly resorb sufficient amounts of oral or SQ fluids.

IV fluid therapy restores oxygen delivery and removes metabolic products of poorly perfused tissue.

Severely depressed calves that are not dehydrated need IV alkalinizing fluid

Page 17: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Neonatal Calf Diarrhea

Rotavirus/Coronavirus

E. coli K99

Salmonella spp.

Cryptosporidia

Clostridium perfringens type C

Septicemia

Page 18: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Rotavirus pathogenesis

Healthy villi

Stunted villi

Page 19: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Mechanism of Diarrhea

Secretory Diarrhea-net secretion of chloride, sodium, and water into the intestinal lumen

Malabsorptive Diarrhea-Damage to the small intestinal villi results in failure to absorb electrolytes and water

Page 20: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Diarrhea results in:

Dehydration

Metabolic acidosis

Electrolyte abnormalities

Negative energy balance

Overgrowth of small intestine with Gram (-) bacteria

Page 21: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Antimicrobial Use

Calves with diarrhea have an increased number of coliform bacteria in the small intestine

This occurs independent of cause

Overgrowth associated with energy malabsorption

Overgrowth persists after primary pathogen has been expelled

Page 22: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Antibiotics

Specific antibiotics are effective in decreasing mortality and increasing growth rate when administered to calves with diarrhea

Calves with simple diarrhea recover faster with antibiotics

Page 23: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Appropriate Antibiotics

Target coliform bacteria and coliform must be susceptible to it

Minimize risk of antibiotic resistance

Must reach suitable concentration in small intestine

Page 24: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Antibiotics in Calf Diarrhea

Bacteremia

Ceftiofur 1.1-2.2 mg/kg, IM/SC, q 12 h

Ampicillin (Polyflex) 10mg/kg, IM, q 12 h

Small Intestine

Polyflex 10 mg/kg, q 12 h

Amoxicillin trihydrate-clavulanate potassium (5:1, 12.5 mg/kg, q 12 h

Use antibiotics for 3-5 days.

If concurent pneumonia-Baytril is good choice

Page 25: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Ancillary Treatments

Acute diarrhea- Banamine

Chronic Diarrhea- B vitamins

Not recommended

-Intestinal protectants and motility modifiers (psyllium)

-Probiotics-may increase days of diarrhea

Page 26: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Scours Vaccine

Scours vaccine for E. coli, rota and corona viruses, Clostridium perfringens Type C

• usually given 1-2 months before calving

• Vaccine is expensive and has a short shelf life

Page 27: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Scours Vaccines

Scour Bos 9Initial: 5-7 mos;Booster at 8 mos;Annual: 6.5-7 mos

GuardianInitial: 7 mos; booster at 8Annual: 7.5-8 mos

Scour Guard 4KCInitial: 7 mos; booster at 8Annual: 8 months

Page 28: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular
Page 29: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Lower the Scours Challenge in the Environment by….

Providing cows and calves plenty of space during the calving season

Keeping calving areas, facilities and equipment as clean as possible

Separating scouring calves and their mothers from the rest of the herd

Using geotextile and rock to minimize mud

Goal: Clean Teats

Page 30: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Raise resistance to scours...keeping cows healthy

Manage pregnant females so that they are :

• A Body Condition Score of 5-6

• Not mineral deficient

• Free of internal and external parasites

• Vaccinated-Immune systems not compromised by viruses such as BVD

• Bred to calving-ease bulls so calves are born quickly

Page 31: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Raise resistance to scours... Vaccinate all healthy, pregnant females with the broad

spectrum scours preventive

Ensure each new calf ingests 2-3 quarts of high-quality, antibody-bolstered colostrum 2 hours after birth and another 2 quarts within 6 hours of birth

Page 32: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

Sandhills Calving System: Move pregnant cattle to a new and distant site from the problem area

1 week old

pairs

Calving

Pasture

2-3 week old

pairs

Page 33: DABVP (Food Animal) Ruminant Extension University of ...Dehydration Loss of fluid in feces & decreased fluid intake (depend on milk intake) Decrease in plasma volume and extracellular

An Important Concept

“The dumbest kidney is smarter than the smartest veterinarian”