My colleague Dr Mwikali and I have in the past one month come across challenges we have never in our combined 62 years of veterinary practice.
I do not know whether it is our patients or our adversaries who are putting us to test.
In veterinary training, students go through a very systematic and comprehensive way of studying diseases. Many of them miss the cardinal point that not every patient is likely to exhibit the full complement of the documented signs of a disease.
The saving grace, however, does exist. It is called the pathognomonic sign. This means that particular sign or set of signs that are specific to a disease.
The challenge of the “peeing chickens” that I shared in the past two weeks had pathognomonic signs that only indicated I was dealing with a disease caused by bacteria, which had defied antibiotic treatment for five weeks.
Fortunately, we conquered our adversaries using a top-of-the-range broad spectrum antimicrobial drug combination.
Last week, another challenge arose and this time around, it came from pigs. Again, this was a first-time case. Juliet called and said two of her 3,000 pigs in Meru were urinating blood. A boar and a sow had been urinating blood on and off for about a month.
She could not provide sufficient information since she lives in Nairobi. She instructed her farm manager, Greg, to call me.
Juliet was very worried when she called. I understood her concern. A hog farm of 3,000 can easily be shut down if a disease is not addressed promptly. I, nonetheless, assured her the description she gave did not signal the presence of a disease that could result in farm closure.
Coincidentally, she confirmed she was well aware of the African swine fever that has been ravaging China for the past one year, killing some 100 million hogs.
By the time Greg’s call came, I had reviewed Juliet’s case with my other four colleagues and settled on some possible causes.
Greg’s details assisted us in deciding whether the disease could be treated as presented or a farm visit and laboratory investigation would be needed.
The problem had started about a month earlier, he recounted. It was first noted in the boar, which had served the sow and immediately produced bloody ejaculate and urine. The sow and boar were immediately separated and none was allowed to mate again.
The farm’s animal health service provider had treated the boar with antibiotics three times since the incident but it kept recurring three to four days later.
The sow started producing bloody urine about two weeks after the mating and behaved the same way as the boar when treated. The boar looked normal except for the bloody urine but the sow had been sickly for the previous days.
On the day of reporting, the sow preferred to stay alone and resisted moving, eating or drinking water. Both pigs had normal body temperature.
The sow had some vulva discharge tainted with blood. The other hogs appeared normal. There were no abortions, stillbirths or infertility in the herd.
I shared Greg’s report with my colleagues and we settled on one disease, Porcine cystitis-pyelonephritis complex (PCPC).
We ruled out the only other possibility, a serious bacterial disease known as Leptospirosis. The disease causes persistent fever in affected pigs. Sick herds have abortions, infertility, stillbirths and deaths.
I advised Greg to isolate the affected pigs until they recovered fully. I also gave a prescription of two antibiotics. A short-acting antibiotic was to be given into the vein immediately and repeated into the muscle once daily for five days.
A long-acting antibiotic was to be given into the muscle immediately and repeated on the fourth day of treatment to ensure the pigs had effective antibiotic concentration in their blood for at least seven days.
Greg reported on the third day of treatment the pigs had stopped voiding bloody urine and the sow behaved normally.
PCPC is a bacterial disease that involves the infection and inflammation of the urinary tract from the urethra to the bladder, the ureters and the kidneys.
The disease is caused by various bacteria that, under normal circumstances, live harmlessly in the pig’s urinary tract, below the bladder. The bacteria also reside in the preputial sheath of the boar and sows are further infected during mating.
The most common cause of the disease is poor hygiene. The bacteria multiply in the pen environment and infect the pigs when they lie down.
It may also occur when pigs have limited water intake and therefore urine is retained for long periods in bladder. This causes the bacteria to multiply, damage the bladder wall and then move up to the kidney and destroy tissues. The blood in urine comes from bleeding of the damaged tissues.
If not treated early, the disease causes death due to kidney damage and spread of bacteria and their toxins to the whole body through the blood.
PCPC can cause heavy losses on a pig farm if the disease is neglected and it heavily contaminates the pig house. This results in many pigs being infected and dying. It also becomes expensive to stamp out the disease as each pig must be treated individually for at least a week.
The disease is best prevented through high-level farm hygiene and providing pigs with quality drinking water at all times.
This minimises environmental contamination with the culprit bacteria and frequent flushing of the bacteria from the pigs’ urinary tract though urine.