Understanding the enteritis syndrome – a guide to diagnosis

Bacterial Enteritis

Clostridial enteritis

Necrotic enteritisCholangiohepatitis

Dysbacteriosis/non-specific bacterial

enteritis

Clostridium perfringens

The Enteritis Syndrome

cocci viruses nutrition

Enteritis is a growing problem worldwide

Particularly in flocks where:• Cocci vaccines are used• Antibiotic digestive enhancers have been removed• Medication withdrawal times have been extended• Wheat-based diets are fed

Economic and performance impact of enteritis

• Feed conversion: 4-10 point decline• Live weight: reduced 30-120g/bird• Mortality: increased 1-5%• Condemnations: increased up to 10%• The performance impact occurs at subclinical levels• The cost of enteritis is estimated at at US$0.05/bird or more

Enteritis is not a single disease

Two different causes lead to three forms:• Clostridium perfringens

– Clostridial enteritis/necrotic enteritis – Cholangiohepatitis

• Non-specific bacterial enteritis– not necessarily associated with C. perfringens– results in dysbacteriosis

Enteritis is not a single diseaseAccurate diagnosis is necessary for effective treatment, because each form requires a specific treatment protocol.

1. Clostridial enteritis/Necrotic enteritisDisease of the small intestine associated with proliferation of C. perfringens causing mortality and diarrhoea. Costly sub-clinical form often goes undiagnosed. Economic losses begin early, before mortality is seen.

Medication protocol: Strategically medicate with antibiotic effective against C. perfringens

CholangiohepatitisClostridial infection affecting the liver, leading to enlargement, fibrosis and often jaundice, with condemnations at processing.

Medication protocol: Strategically medicate with antibiotic effective against C. perfringens

DysbacteriosisPresence of abnormal flora in the small intestine that causes diarrhoea and/or malabsorption but does not increase mortality. Not usually associated with C. perfringens.

Medication protocol: Treat immediately when observed. Consider using litterbox to detect wet droppings early. Strategic preventive therapy may not work.

Intestinal bacterial overgrowth

Clostridial enteritis

Necrotic enteritis Cholangiohepatitis

Dysbacteriosis/non specific bacterialenteritis

Clostridium perfringens

Enteritis

cocci viruses nutrition

The classical signs of necrotic enteritisElevated mortality with intestinal necrosis

Wet litter, feed passage and diarrhoea: Is it enteritis?

Other possible signs

Diagnosis

You are presented with the following clinical signs• Wet litter, diarrhoea• Feed passage• Elevated mortality ?• Increased condemnations ?

Examine sacrificed and dead birds

Is it Coccidiosis?

Score 4• Eimeria acervulina

• Eimeria maxima

Use microscopic examination to confirm or eliminate Eimeria maxima infection

Is it Coccidiosis?

Score 3• Eimeria acervulina

• Eimeria maxima

Use microscopic examination to confirm or eliminate Eimeria maxima infection

Is it Coccidiosis?

Score 2• Eimeria acervulina

• Eimeria maxima

Use microscopic examination to confirm or eliminate Eimeria maxima infection

Is it Coccidiosis?

Score 1• Eimeria acervulina

• Eimeria maxima

Use microscopic examination to confirm or eliminate Eimeria maxima infection

Is it clostridial enteritis?

Score 4

Severe and extensive necrosis typical of field cases: classic necrotic enteritis

DiagnosisClostridial enteritisPost-mortem:• Intestinal necrosis

Clinical signs:

• Occurs at 15-25 days– the birds stop growing

– mortality

– diarrhoea

– huddling

– depression

– rough feathers

Is it clostridial enteritis?

Score 3Larger patches of necrosis

Is it clostridial enteritis?

Score 2Focal necrosis or ulceration

Erosions can be removed by gently scraping with a scalpel blade,This is not the case for Eimeria acervulina

What diagnosis do you give this?

Score 1Thin-walled or friable small intestine

If this is your only finding and there are no enteritis scores of 2, 3, or 4

Consider a diagnosis of Dysbacteriosis

Post mortem:

• Intestinal inflammation• Watery intestinal contents• Orange mucus in jejunum

Clinical:• Sticky droppings• Wet litter• Sometimes foamy caecal droppings• Reduced feed intake• Reduced physical activity• Normal or increased water intake• Normal mortality • Selective feeding behaviour

may be observed

Is it Dysbacteriosis?

To confirm diagnosis: • Use Plates • Treat with antibiotic, monitor results

– Does condition resolve with treatment?

Yes: Continue antibiotic treatment.

To get the best results treatment should be initiated as early as possible No: Enteritis not related to cocci or bacterial overgrowth

• Viruses• Feed issues,

e.g. mycotoxins, fat quality, biogenic amines