Volume 51 | Issue 2 Article 15

1989 Urogentital Infections in Sows and Gilts; Differential Diagnosis, Diagnostic Techniques and Control D. W. Farnum Iowa State University

R. L. Riese Iowa State University

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Recommended Citation Farnum, D. W. and Riese, R. L. (1989) "Urogentital Infections in Sows and Gilts; Differential Diagnosis, Diagnostic Techniques and Control," Iowa State University Veterinarian: Vol. 51 : Iss. 2 , Article 15. Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol51/iss2/15

This Article is brought to you for free and open access by the Journals at Iowa State University Digital Repository. It has been accepted for inclusion in Iowa State University Veterinarian by an authorized editor of Iowa State University Digital Repository. For more information, please contact [email protected]. Urogentital Infections in Sows and Gilts; Differential Diagnosis, Diagnostic Techniques and Control

D.W. Farnum BS, DVM* R.L. Riese DVM, DACT**

Introduction

Urogenital infections and vaginal discharge The clients complaint may be reproductive are common complaints ofswine producers and manifestations of urogenital infections espe­ breeding herd managers. This is an area of cially if accurate records are kept within the great concern, not only for producers but also unit. Increased numbers ofrepeat breeders, an for swine veterinarians. This syndrome has increase in the weaning to estrus interval, an been on the increase in recent years and is increase in the number of abortions, or an associatedwithintensivemanagementofswine. increase inthe numbers ofnotin pig#and fail to Some of the manifestations of this syndrome farro'.v## sows are all possible,l The ultimate are reproductive failure, poor performance, reproductive manifestations ofthese problen1s inappetence, and underconditioned sows.2 This are an increased farrowing interval, prolonged is a sourceofgreateconomicloss to the producer farrowings and a decrease in the number of as reproductive efficiency is one of the most litters per sow per year.ll These reproductive accurate predictors ofswine enterprise profita­ problems have a direct influence onthe number bility. Even so published information on this ofpigs per sow per year and the profitability of syndrome has only been available in recent the swine unit. years and is anything but plentiful. In one study of endometritis in a group of gilts, the economic aspects ofthis infectionwere Clinical Signs assessed.9 In this study, 13.8% ofthe gilts were affected. This infection rate is severe but not Because urogenital infections may involve uncommon in herds with a problem. Only 55% one or more of several different organs the ofthe affectedgilts became pregnantwhile gilts presentation may be quite variable. However that were unaffected had a conception rate of the usual client complaintis vaginal discharge. 90%. The affected gilts that did settle required The discharge is usually seen as a dried deposit anaverage of1.85 services perconceptionwhile inthe perinealregionoras a puddleonthe floor. gilts on the same farm that showed no signs of Discharges may be noted post-breeding, post­ infection required only 1.12 services per con­ parturient, or unassociated with a stage of ception. The cost of this infection at various reproduction. The nature, volume, and fre­ levels of production and the break-even treat­ quency of the discharge may be important in ment cost are summarized in the following determining the source of the infection. M­ table. For instance ifa producer farrowed 2.05 fected sows will often have a low grade fever, be times per year,selected 60 replacement gilts, inappetent and may even lose condition if the andhad a tenpercentinfectionrate, the costper infection is severe and oflong duration. gilt would be $87.00 with a total cost for sixty gilts being $522.00. #Not in pig are those animals which are diag­ nosed nonpregnant early in the gestation pe­ Predisposing Factors riod. ## Fail to farrow are those animals diagnosed There are at least ten different factors that pregnant early in gestation but never pig predispose sows to urogenital infections. These factors can be classified as relating to environ­ *Dr. Farnum is a 1989 graduate from the Col­ ment, management, or the animal itself. Con­ lege ofVeterinary Medicine. siderationofa discharge probleminthese three **Dr. Riese is an assistant professor ofclinical categories may help the practitioner locate the sciences in the College ofVeterinary Medicine problem and make recommendations to solve at Iowa State University.

98 Iowa State University Veterinarian it. boars.14 The reproductive state ofthe female is In the area of housing and environment important as well. Infections are common in there are two basic areas that need to be ass­ post-weaning, post-farrowing, and cyclic gilts essed. The first is restricted movement which and rare in prepubertal gilts, lactating sows, results in decreased water intake and less fre­ and pregnant sows.2 Advanced parity sows quent urination. This would indicate that sows have more problems with urogenital infections housedintetherbarns orgestation stallswould than lower parity animals.3 Prolonged or diffi­ have anincreased rate ofurogenital infections.l2 cult farrowing will tend to cause an increase in This is,in fact, the case. Sows housed in tether the number of infections.2 In abortion due to barns have the highest rates of infection fol­ placentatropic or feticidal agents the autolyz­ lowed by sows in gestation stalls and sows in ing fetus or placenta provides an excellent pens with solid floors and gutters have higher growth media for the bacteria that cause uro­ rates ofinfectionthan sows housedin pens with genital infections.2,12 slattedfloors. 2 The second basic area ofhousing and environment that predispose sows to uro­ Pathogenesis genital infections is humidity. High humidity in a building results in accumulation of urine Most urogenital infections ascend from the and moisture on the floor. This brings about a vagina. Noncycling, nonpregnant animals are higherrate ofurogenital infections than is seen relatively resistant to infection due to a tightly in buildings with acceptable humidity levels.2 closed cervix.2 The uterus of the so,x/ is rela­ The humidity in a swine facility is controlled by tively resistant to infection at the time ofestrus the ventilation system and the design and due to increased levels of IgG and IgA and maintenance ofthe ventilation system are just increased activity ofphagocytic cells under the is important as the ventilation rate in the con­ influence of estrogen.2 The cervix is, however, trol ofhumidity . open at this tinle and may allow a large bacte­ The management of a breeding herd can rial load access to the uterus. Natural resis­ have a large role inthe prevalence ofurogenital tance to infectionis decreased during the luteal infections in the sow. Poor hygiene is probably phase whenthe uterus is underthe influence of the most important factor that predispose sows progesterone andbacteria often colonize at this to these infections. The floors of the breeding time. The urinary tract is also relatively resis­ area and farrowing stalls should be clean. tant to infection but trauma during mating, Perinealcontaminationbyfecal materialcauses artificial insemination, or parturition may al­ moreurogenitalinfectionsthananyothersingle Iowan infection to begin.17 Urine stasis will also factor.3 This accumulation of manure may be reduce the resistance ofthe urinary tract. related to the design ofthe floor but more often is due to inadequate waste removal and im­ Differential Diagnosis proper cleaning of the perineum before breed­ ing and farrowing. The second management The first major consideration in the differen­ related problem is assistance, by farm person­ tialdiagnosis ofurogenitalinfections ofswineis nel, during farrowing and breeding.2 Swine the determinationofthe originofthe discharge. unit workers often have fecally contaminated Discharges may result from the vulva, vagina, hands. When they assist the boar, perform cervix, uterus, bladder, or renal pelvis.3 Loca­ artificial insemination, or intervene in the far­ tion can often be determined by observing the rowing house this contamination can easily nature, amount and frequency of discharge, find its way into the genital tract of the sow. and stage of reproductive cycle. Washing hands, use of gloves, and cleaning The second major consideration in the dif­ artificialinseminationequipmentbetweensows ferential diagnosis of urogenital infections in will reduce this problem. swine is the agent or agents that are involved. There are multiple factors associated with A number of bacteria have been isolated from the animals themselves predisposing them to urogenital infections. Some of these bacteria urogenital infections. The boar may mechani­ are prinlary pathogens but a large number are cally carryorganisms from one sow to the next.12 opportunists. Apathogenic bacteria that have Some organisms such as Corynebacterium suis been isolated from the urogenital tract ofsows will colonize the preputial diverticulum of and gilts include: Streptococcus spp., Citro-

Vol, 51 No.2 99 bacter, Escherichia coli, Corynebacterium spp. , rowed. The normal vagina has a decreasing and Staphylococcus Spp·24 bacterial gradient from caudad to craniad.24 Pathogenic isolates include: Proteus, Esch­ The pathological appearance of vaginitis is a erichia coli, Klebsiella, Streptococci, Coryne­ purulent exudate with fibrin tags and hemor­ bacterium pyogenes, Corynebacterium suis, rhage.25 The organisms that are associated Pseudomonas aeruginosa, Pasteurella mul­ with vaginitis are many and mixed infections tocida, Staphylococcus aureus, Actinobacillus, are common. Vaginitis alone will usually not Mycobacterium avium, and Ureaplasma. 24 interfere with the fertility of the sow, but the Other agents may cause a vaginal discharge infection may ascend into the uterus where the in swine. These may be viral, fungal, or para­ potential for infertility is much higher. sitic. Pseudorabies virus will cause an ulcera­ Cystitis and pyelonephritis are usually as­ tive endometritis when inoculated into the sociated with an ascending infection and urine uterus ofsows.24 This often results in a purulent stasis. The appearance ofcystitis usually con­ discharge and is probably responsible for the sists of hyperemia, mucosal ulceration, and decreasedfertilitythatis observed duringacute fibrinopurulent exudate.25 As the cystitis be­ pseudorabies outbreaks.24 Stephanurus den­ comes morechronica thickenedfibrotic bladder tatus, the swine kidney worm, is a fairly com­ wall is a common pathological finding.25 The Il10n problerninthesoutheasternUnitedStates. bladder infection may then ascend causing Estrogenic mycotoxins such as, zearalanone, ureteritisandpyelonephritis. Pyelonephritisis have the potential to cause vulvar swelling and characterized by wedge shaped yellow tracts vaginal discharge. thatextendfrom thekidneypelvis to the cortex, and by fibrinopurulent exudate.25 Organisms Pathology that have been associated with pyelonephritis andcystitisinclude: Streptococcus spp., Proteus Some important pathological findings asso­ spp., Corynebacterium suis. and coliforms.24 ciated with these diseases. Pyogenic oophoritis may on very rare occasions result in a vaginal Diagnostic Technigues discharge. This is usually an ascending infec­ tion and Corynebacterium Pyogenes is a com­ Because urogenital infections are a complex mon isolate.24 Adhesions are quite common and herd problem and more of a syndrome rather may result in permanent infertility.1 than a specific disease, a thorough diagnostic Endometritis is a much more common cause workup is essential. of vaginal discharge and usually results from First the diagnostician must get a complete an ascendingbacterial infection. Virtually any history and review herd records. These records of the bacteria mentioned in the previous sec­ will help determine where in the reproductive tion canbe isolatedfrom a case ofendometritis. cycle the disease is occurring, which building is Endometritis usually occurs in cycling sows or involved, whethercertainboars areconsistently gilts or in postpartum sows. In acute cases of involved, whethercertain attendants (either at endometritis, the most striking pathological mating or farrowing) are consistently involved, findingis the accumulationofpurulentexudate the age ofthe animals involved, andthegeneral in the lumen of the uterus.25 As the infection health ofthe animals on the farm. becomes more chronic, fibrosis, ulceration, and An antemortem examination ofalldischarg­ abscessation are common pathological find­ ing animals should then be completed. This ings.25 There may also be an associated perito­ examination should include both a general nitis as the infection ascends through the ovi­ physical examination and a detailed examina­ ducts.25 The fertility of sows with an acute tion of the reproductive tract. Attitude, appe­ endometritis may return if the infection is tite, and body condition should be evaluated resolved. As theinfectionbecomesmorechronic, and the perineal region examined for exudate. however, the sows fertility may be seriously Examination of the reproductive tract should compromised. include vaginoscopy, urinalysis, transvaginal Vaginitis and cervicitis are also associated swabs, and pregnancy determination. Boars with a vaginal discharge. This is usually due to ought to be examined and a preputial swab an ascending infection and is common in ani­ taken. mals that have been recently mated or far- A postmortem examination or slaughter

100 Iowa State University Veterinarian check may also be useful in the diagnosis of a breedingandearlygestationareas once a week, urogenital infection problem. Gross examina­ increase lactation length if possible to allow tion of the bladder, renal pelvis, uterus, and postpartuminfections to clear, and additions to vagina is important. The ovaries should also be the breeding herd should be obtained from examined to determine ifthe sow is cyclic and herds with no history ofurogenital infections.3 what stage ofthe cycle she is in. Specimens for bacteriological culture and histopathology can Summary also be obtained at this time. Urogenital infections are one ofthe nagging Treatment and Control problems that the swine producer and veteri­ narian must deal with. It is a complex problem Important factors for the practitioner to with no easy answers about cause or control. It consider when presented with a herd problem is a problem that gains severity as more sows ofvaginal dischargeisherdincidence andwhen are put into controlled housing. Prevention to intervene. As a rule vaginal discharge will rather than treatment is the key. Communica­ present as a sporadic problem in individual tion between the veterinarian and unit person­ sows.2 In some herds vaginal discharge is a nelis thekeyto prevention. As withmanyofthe significantproblemthatwill requireveterinary confinement associated diseases ofswine, uro­ intervention. A discharge rate ofless than 2% genital infections are diseases of man that should be expected in both pregnant and day 5 manifest themselves in the pig. postpartum sows.2 A discharge rate of 3% or greater should be considered abnormal and veterinary intervention is probably justified.19 Once the veterinarian and producer decide to proceed with treatment the results are usu­ allyfrustratingatbest. Becauseofthe anatomy Bibliography ofthe sow's cervix and the limitations ofrectal nlanipulation intrauterine therapy is not prac­ tical. The exception to this might be in the 1. Clark LK, D'Allaire S, LemanAD: Reproduc­ estrous sow. Parenteral and oral antibiotics tive System in: Diseases of Swine. Sixth can be used, but this is expensive and not al­ Edition.pp. 101-143. ways efficacious. Some of the antimicrobials that have been used include penicillin, tetracy­ 2. Dial GD, MacLachion NJ: Urogenital Infec­ cline, sulfonamides, and potentiated sul­ tions of Swine Part I: Clinical Manifestations fonamides.15 The use of antimicrobials in the and Pathogenesis. Compendium ofContinuing feed as a prophylactic measure may decrease Education for the Practicing Veterinarian. Vol. the incidence of infection, but could present 10 No.1. pp. 63-70. 1988. residue problems in culled sows. Another pos­ sibility is antimicrobial infusions into the pre­ 3. LemanAD: Vaginal Discharges. Proceedings puce of boars.24 Commercially available in­ AASP. pp. 585-589. 1986. tramammary infusion syringes work well for this and boars should be treated quarterly.24 4. Clark LK: Troubleshooting Reproductive Preventionratherthantreatmentis the control Problems.ProceedingsAASP pp. 535-543.1986. method ofchoice. In order to prevent urogenital infections in 5. Miller DM: An Investigation ofVaginal Dis­ sows a thorough review of management prac­ charge in Swine. Proceedings AASP.pp. 71-74. tices on the farm should be obtained. Obvious 1986. managerial problems can then be pointed out and eliminated. Other recommendations that 6. Walton JR: Pyelonephritis - Cystitis in the the veterinarian might want to make include: Sow. Proceedings AASP pp.169-171. 1985. cull all dischargingsows thatreturnto estrusor are nonpregnant and any sows that are 6-7 7. Stein TE: Epidemiology ofReturn to Estrus parity or more, mate each sow to only one boar, in Weaned Sows. Proceedings AASP pp.172­ use only clean boars on gilts, clean the entire 176.1985.

Vol, 51 No.2 101 8. Leman AD: Methods for Diagnosis of Swine Proceedings. Ch.. 4. 1984. Reproductive Failure. Proceedings AASP pp. 17.Bollwahn W., Vopelium AV, Arnhofer G.: 295-301. 1985. The ClinicalValue ofBacteriuriainSows. IPVS Proceeding. Ch. 4. 1984. 9. Parsons TE, Marsh WE, Dial, G: Vulvar Discharge in the Gilt: An Economic Assess­ 18.MadecF, David F: Urinary Problems in Sow ment. Proceedings AASP. pp. 403-406. 1987. Herds. IPVS Proceedings. Ch. 4. 1984.

10. Dial G: Optimizing Reproductive Perform­ 19. Muirhead MR: Vaginal Discharge Signals ance and Establishing New Horizons for Sow Reproductive Woes. Pigletter. Vol 2. no.7. Productivity. Proceedings AASP pp.149-168. 1987. 20. Dial G: Urogenital Infections ofSwine with Special Emphasis on the Clinical Management 11. Muirhead MR: Constraints on Productivity of Endometritis. Proceedings AASP. pp. 286­ in the Pig Herd. Veterinary Record Vol. 102 pp. 291. 1987. 228-231. 1978. 21. Wrathal AE: Reproductive Failure in the 12. Muirhead MR: Epidemiology and Control of Pig: Diagnosis and Control. Veterinary Record. Vaginal Discharge in the Sow Mter Service. Vol 100: Page 230-237. March 1977. Veterinary Record Vol. 119 pp. 233-235. 1986. 22. Stein T: Economics ofSwine Reproduction. 13. Larsen JL, Hogh P, Hovind-Hougen K: Proceedings AASP. pp. 236-239. 1982. Studies on the Adhesive Properties ofCoryne­ bacterium suis. IPVSproceedings. Ch. 4. 1984. 23. AndersonJH, Reproductive Efficiency: Pigs per Sow per Year. Proceedings AASP. pp. 241­ 14. Walton JR: Pyelonephritis - Cystitis in the 244.1982. Sow: Possible Methods ofControlin Intensively Housed Pigs. IPVS Proceedings. Ch. 4. 1984 . 24. Dial, GD, MacLachan, NJ: Urogenital Infec­ tions in Swine Part II; Pathology and Medical 15. Taylor DJ: The Clinical and Bacteriological Management. Compendium on Continuing Effects of Antimicrobial Therapy of Naturally Education for the Practicing Veterinarian. Vol. Occurring Postpartum Vulval Discharge in 10 No.2. pp. 529-538ApriI1988. Sows. IPVS Proceedings. Ch. 4. 1984. 25. Jubb, K, Kennedy, P, Palmer, N: The female 16. Hogh P, Blom, E, Larsen, JL: Coryne Genital Tract in Pathology of Domestic Ani­ bacterium suis Infections in Danish Pigs. IPVS mals. 3rd Edition. pp. 314. 1985.

Mike Slawienski

102 Iowa State University Veterinarian