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Table of Contents
Coliform Diseases
Viral Diarrhea
Clostridium perfringens - related diseases
Cryptosporidiosis
Coccidiosis
Salmonellosis
Giardiosis
Dietary Causes
General Management
Young Ruminant Diarrhea AQS Session
Diarrhea is a common complaint in calves and other young ruminants, particularly in the
first few months of life. Many of the pathogens and management practices that cause
diarrhea in calves also affect lambs, goats and modified ruminants such as llamas. Most
herds have been exposed to diarrhea-causing pathogens, and management practices will
largely determine the health impact that those pathogens will have on the youngstock. In
"real life", most young ruminant diarrheas are caused by more than one factor or
pathologic agent. It is important to be able to correctly diagnose and appropriately treat
diarrhea in livestock, and to be able to suggest management strategies that will prevent
further outbreaks of disease. Several pathogens are zoonotic agents (Salmonella spp.,
Cryptosporidium spp., Giardia spp., and certain types of enteropathogenic E. coli) so
great care must be taken when handling diarrheic animals, contaminated bedding, and
fecal samples to avoid contaminating yourself and others.
Coliform Diseases
1. septicemic colibacillosis
2. enteric colibacillosis
Septicemic colibacillosis
Clinical signs. Disease most commonly occurs in the first 2 weeks of life. Neonates show
sign of progressive depression and inappetence, followed by watery diarrhea. Signs of
sepsis such as fever (more protracted cases), hypothermia (peracute and terminal cases),
scleral injection, mucous membrane abnormalities, and tachycardia occur commonly.
Disease progression depends on the virulence of the E. coli serotype and the vulnerability
of the patient. For example, calves with complete failure of passive transfer can develop
coma and death within 6 hours of the onset of clinical signs. In more slowly progressing
cases, bacteremia can result in signs of meningitis, physitis and synovitis. Prognosis is
guarded to poor for survival.
Pathogenesis. Opportunistic E. coli organisms invade through umbilical (most common),
nasal, or oropharyngeal routes. Clinical signs develop approximately 24 hour after
inoculation. Risk factors: (1) complete or partial failure of passive transfer, and (2)
exposure to a serotype of E. coli that is able to invade into the bloodstream and rapidly
multiply.
Diagnosis. Suspect this disease whenever a neonate presents with prominent signs of
sepsis, particularly if these signs precede the onset of diarrhea. The organism can often be
cultured from blood, and from affected synovial and cerebrospinal fluid.
Treatment. Therapy is costly and time-consuming, and prognosis for survival is guarded.
These factors, and the chance of joint and physeal complications, should be discussed
with owner prior to embarking on therapy. Results are best when aggressive treatment is
started early in the course of the disease. The patient's serum IgG status and blood
glucose can be assessed on the farm. Samples should be taken prior to antibiotic therapy
for microbiological analysis (blood, synovial fluid), and ideally, blood should be obtained
for complete blood count and select chemistries (e.g. total protein, creatinine and
electrolyte concentrations).
B. Continued fluid therapy (2.5 - 5 ml/kg/hr) is recommended for critically ill neonates
until rehydrated and stabilized. Oral rehydration can then be used.
E. Other supportive therapy: minimize environmental stress; keep patient warm and dry.
Insure adequate nutrition.
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Enteric Colibacillosis
Clinical signs. Diarrhea typically occurs in the first 7 days of life. The feces are fluid or
pasty in consistency, and are typically white-to-pale yellow in color. Hence the layperson
description, "white scours". The tail and hindquarters are heavily soiled with feces.
Affected calves become weak, depressed, and anorectic as their fluid deficits and
electrolyte/ acid-base disturbances worsen. Affected animals either recover or die within
5 days.
Pathogenesis. Calves and lambs that fail to ingest adequate amounts of colostrum are
most at risk. Chilling, crowding, and dirty, pathogen-rich environments increase
susceptibility to disease. Enteric colibacillosis is caused by strains of E. coli that are
enterotoxigenic. Enterotoxigenic E. coli (ETEC) have 2 pathogenic weapons: (1)
attachment factors (pili) that allow them to attach to the small intestinal brush border, and
(2): an enterotoxin that causes crypt cells to hypersecrete fluids and electrolytes.
Historically, the main pilar antigen found in calf and lamb ETEC infections was
designated as K99. Because the K designation is also used to name capsular antigens, the
K99 antigens are now called F5 in some diagnostic centers. An F41 pilar antigen is also
detected in some calf and lamb ETEC diarrheas.
Clin path findings. Calves with diarrhea (regardless of the etiologic agent) lose large
quantities of water, potassium, sodium, chloride, and bicarbonate, and develop a
metabolic acidosis. The loss of bicarbonate coupled with lactic acid production and
decreased renal perfusion cause the metabolic acidosis. Although total body potassium
levels are decreased, hyperkalemia is often noted in diarrheic calves (secondary to the
acidosis). Hyperkalemia is cardiotoxic, particularly if in combination with hyponatremia,
acidosis, and hypocalcemia. Bradycardia, decreased p wave amplitude and increased t
wave amplitude on ECG, and cardiac standstill are signs associated with serum potassium
concentrations of over 7 meq/l. Hypoglycemia is also a common finding because
neonates lack adequate energy reserves to sustain them during periods of inappetence.
Diagnosis. Observe clinical signs consistent with the disease in the appropriate age group.
Postmortem exam reveals fluid-filled loops of small intestines. Since the bacteria does
not invade into the mucosa, there are no gross or histopathologic lesions. Feces can be
submitted to a diagnostic center for an ELISA test to detect the pilar antigens (K99, F41).
In a pure ETEC infection, fecal pH is alkaline secondary to loss of bicarbonate. However,
it is not unusual for several pathogens to team up to make calves sick (mixed infections
with ETEC and viral agents), so the fecal pH test might not be very revealing in all cases.
Treatment.
A. Fluid therapy is the most important treatment! Severe dehydration: treat with IV
fluids. In calves that are mildly to moderately dehydrated (8% or less), oral fluid therapy
is an effective route. Alternate oral electrolyte solutions every 6 hours with whole cow's
milk (or high quality milk replacer) via a nurse bottle or esophageal feeder. Do not mix
the electrolyte solutions with the milk because it will interfere with development of the
casein clot, thereby causing a nutritional diarrhea. Continued feeding of milk sustains the
growth of diarrheic calves and promotes regeneration of damaged mucosa (Can J Vet Res
1989;53:477).
(1 liter = 2 pints)
Prevention. Insure that calf receives colostral immunity. In problem herds, cows can be
vaccinated with a K99 bacterin in the prepartum period. The calf ingests protective
antibody in the colostrum. Alternatively, calves can be inoculated orally right after birth
with a K99 monoclonal antibody preparation. The antibody prevents binding of the K99-
associated ETEC to the small intestinal epithelium. A vaccine for the F41 ETEC is not
available.
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Viral Diarrhea
Rotaviruses and coronaviruses are the most common causes of viral diarrhea in calves.
Rotavirus infections occur earlier in life and produce milder lesions than do coronaviral
infections. Both viruses cause varying degrees of dehydration, acidosis, and electrolyte
derangements (hyponatremia, hypochloremia, hyperkalemia).
Rotavirus infection
Clinical signs. Rapid onset of diarrhea in calves from 1 day of age up to about 3 weeks of
age; most cases occur in the first week of life. The clinical signs mimic enteric
colibacillosis: yellow watery diarrhea, mild depression (worsens as fluid, acid-base and
electrolyte disturbances worsen), inappetence, and reluctance to stand. Uncomplicated
cases are self-limiting and symptomatic for only 1-2 days. However, secondary infections
occur commonly, and will influence the ultimate clinical course of the illness.
Pathogenesis. Calves are mainly infected through an orofecal route. The organism is very
hardy in the environment, and is resistant to inactivation by most disinfectants. The
presence of colostral antibodies in the bowel lumen is protective initially, but once the
antibody level in the milk declines in a few days, the calf is susceptible to infection.
Rotaviruses invade the tall columnar cells at the tips of the small intestinal villi. The
infected cells are desquamated, and the villar tip atrophies. The absorptive and digestive
functions (lactase secretion, etc.) of the villar tips are impaired, yet secretion by the crypt
cells continues in an uninterrupted fashion. Bacterial fermentation renders undigested,
unabsorbed nutrients into osmotically active small acids that draw more fluid into the
digestive tract. As a result, the feces from animals with pure rotaviral infections will be
acidic.
Treatment. Fluid therapy (as described under enteric colibacillosis section) is the most
important aspect of treatment. Commercial lactase supplementation (LactaidTM) in milk
is beneficial with rotaviral/coronaviral infections because it aids in digestion of lactose.
Provide good nursing care. Antibiotic therapy is reserved for cases of diarrhea where a
bacterial component is suspected.
Control.
1. Vaccines are available to give to prepartum cows to boost colostral immunity, and to
give to neonatal calves orally. These products have historically yielded poor results.
2. Follow recommendations under management considerations section.
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Coronavirus infection
Clinical signs. Coronarius infections occur most commonly in calves that are 7-10 days
old, but can occur up to 3 weeks of age. Clinical sign are similar to but more severe than
a pure rotaviral infection because both small and large bowel is affected.
Pathogenesis. The virus (Coronaviridae family) gains entrance through an orofecal route
of exposure. Both colonic and small intestinal columnar epithelium cells on the villi are
infected. As a result, more severe fluid and electrolyte losses occur and recovery from a
pure coronavirus infection takes longer than recovery from a pure rotavirus infection. The
mechanism for the diarrhea is similar for coronaviral and rotaviral infections: loss of the
villar digestive and absorptive function leads to an osmotic diarrhea. As in the case of
rotaviral infections, pure coronaviral infections result in acidic feces.
Diagnosis. The distinct halo (corona) that surrounds the organism is visualized by
electron microscopy using a negative staining procedure. ELISA tests are NOT available
to detect coronavirus. Histopathology of the intestine allows visualization of the villar
damage. Fluorescent antibody staining of frozen sections of intestine will demonstrate
presence of the virus.
Treatment and control. Same as for rotaviral infections. Vaccines available are of limited
efficacy.
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Calves that are born with a persistent BVD infection as a result of exposure to the virus in
the first 4 months of gestation are particularly vulnerable to other infections. These
persistently infected calves often present with a complaint of chronic unthriftiness,
intermittent diarrhea, and failure to grow normally. The vast majority of these calves die
in the first year of life as a result of a disease from which an immunocompetent calf
would have easily recovered.
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C. perfringens type C
Pathogenesis. C. perfringens type C produces beta toxin, a potent cytotoxic agent. The
beta toxin causes mucosal cell inflammation and destruction in the small intestines.
Normally the beta toxin is destroyed by proteolytic enzymes (trypsin) in the digestive
tract. Neonates are more susceptible to disease than adult animals because they have less
proteolytic enzymes in their digestive tract than adults. Furthermore, a factor in colostrum
inhibits trypin's proteolytic activity, so colostrum ingestion might actually increase the
animal's vulnerability to the beta toxin.
Diagnosis. Disease is rapidly fatal once clinical signs are noted so diagnosis is often
made postmortem. Necropsy findings: extensive hemorrhage in the distal small intestinal
tract and mesenteric lymph nodes. Isolation of C. perfringens from intestinal contents is
not conclusive because some types are commensal (normally found in the G.I. track).
Observation of large numbers of Gram positive rods on a fecal smear supports a
diagnosis, but definitive diagnosis is made with an ELISA test that detects the beta toxin.
Treatment and prevention. Given the fulminant, fatal nature of the disease, treatment is
rarely successful. Aggressive intravenous fluid therapy, penicillin therapy, and
nonsteroidal anti-inflammatory therapy should be initiated in valuable animals.
Administer C and D antitoxin subcutaneously to all neonates at risk. Prevent the disease
through vaccination of pregnant animals in the final 4-6 weeks of pregnancy.
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Clinical signs. Diarrhea, convulsions and sudden death in a rapidly growing, well-fed
animal is a common presentation. The disease is seen most frequently in lambs
(particularly in single lambs less than 12 weeks old nursing a high producing ewe), and to
a lesser extent in kids, 1-3 month old calves, and feedlot cattle. Hyperglycemia and
glucosuria are common clinical features in sheep. Death can occur within 30 to 60
minutes after showing signs. Neurologic signs such as ataxia, trembling, opisthotonis,
head-pressing, vocalization, convulsions, and coma are prominent in calves and lambs.
Animals that recover can have residual neurologic deficits (focal symmetric
encephalomalacia). Diarrhea characterized by dark, loose feces is noted if the animal
survives for more than a day.
Goats can also present with peracute bloody diarrhea and CNS malacia. However,
chronic sublethal diarrhea has been reported in a few adult goats as the only presenting
sign (JAVMA 1992;200:2,p214). In our practice area, we have seen adult goats die from
enterotoxemia within 48 hours of showing signs of depression and diarrhea. The affected
goats were on a high concentrate diet.
Treatment. Treatment of severe, rapidly progressing cases of enterotoxemia are not very
rewarding because the effects of the epsilon toxin are not reversible. Treatment of the
chronic form seen in adult goats is more amenable to therapy.
Treatment consists of the administration of antitoxin, parenteral penicillin, and
intravenous fluid therapy. Central nervous system anti-edema drugs (nonsteroidals,
DMSO IV at 1 g/kg) are indicated if severe neurologic signs are noted. Parenteral
thiamine supplementation is recommended whenever a ruminant shows signs of cerebral
and digestive disorders; polioencephalomalacia (PEM) also can develop secondary to a
carbohydrate overload. Enterotoxemia and PEM can occur concomitantly.
Prevention
These comments pertain to C. perfringens type C and D:
Vaccination: A vaccination program for ruminants should include C and D toxoid. The
initial vaccination protocol consists of 2 injections subcutaneously one month apart.
Calves, lambs kids, and young llamas are vaccinated at least 2 times (30 days apart)
between 1 and 4 months of age. Use C/DT (C.perfringens type C and D, tetanus toxoid)
in small ruminants. When vaccinating goats, be sure to use a C/DT product specifically
labeled for goats. After the initial vaccination series, annual boosters are recommended.
The vaccines are very irritating at the site of injection, and can incite a granuloma that
will persist for a month or more. Warn clients of this effect, particularly in show animals!
Vaccinate show animals in the axilla or any location where the lump would not be
visible. Do not give IM in food animals even though label says this is an acceptable
route; the resultant muscle damage significantly decreases carcass value.
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Cryptosporidiosis
Clinical signs. The causative organism, Cryptosporidium parvum, causes diarrhea in 1-4
week old calves, lambs, and kids. They are susceptible until they become functional
ruminants. The diarrhea is diffuse, watery and yellowish in color. The feces can contain
undigested milk, blood, fibrin, and mucus. Moderate dehydration, mild-to-moderate
depression, tenesmus, and low-grade fever are common signs. Chronically affected
animals become emaciated. The disease typically causes high morbidity and low
mortality. Most uncomplicated cases will recover in 6 to 10 days Relapses are fairly
common, and can occur from auto-reexposure.
Note: This organism is a potent zoonotic agent: it readily affects people (especially fourth
year veterinary students) and produces painful diarrhea and influenza-like symptoms. It
causes a persistent and often fatal diarrhea in immunosuppressed animals and people.
Pathogenesis. The protozoan organism infects the brush border (microvilli) of the
intestinal cells; it does not invade into the cytoplasm. A membrane developed by the host
surrounds the organism, thereby protecting it from antimicrobial agents. Unlike coccidial
oocysts, C. parvum oocysts are already sporulated as soon as they pass in the feces, and
therefore are immediately infectious.
Transmission occurs when an animal ingests the sporulated oocysts. The infection leads
to villus atrophy and to crypt cell hyperplasia. Diarrhea results from malabsorption and
maldigestion, and increased secretory activity.
Treatment and control. Currently there are no effective drugs labeled for elimination of
the parasite. However, decoquinate (deccox) administered orally at 4.5x the label dosage
for 1-3 weeks is showing promising results in affected calves. Fluid therapy, nonsteroidal
anti-inflammatory drugs (flunixin meglumine), lactase treatment of the milk, and good
nursing care are important mainstays of therapy. Good hygiene decreases the likelihood
of disease and helps prevent reinfection. The oocysts are resistant to most disinfectants.
They are most effectively destroyed by fumigation of contaminated areas and utensils
with 5% ammonia solution, or 10% formalin solution.
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Coccidiosis
Clinical signs. Most ruminants are exposed to low levels of coccidial organisms early in
their life, resulting in subclinical infections and development of immunity. Interestingly,
the immunity is not sterile, and many clinically normal ruminants shed low levels of
oocysts in their feces. Clinical coccidiosis is a manmade problem that occurs primarily in
nonimmune, stressed animals that are crowded together in lots or stables that are heavily
contaminated by oocysts. Clinical signs are noted in animals over 3 weeks of age. The
most common sign of coccidiosis (and the main economic impact of the disease) is
failure of youngstock to grow and gain weight to their full potential. Severely affected
animals will pass watery feces that might contain fresh blood. Tenesmus, when present,
can lead to rectal prolapse. In some cases, the feces can look like pure unclotted blood,
and can contain mucus, fibrin casts, and mucosal strands. Anemia, hypoproteinemia and
dehydration can develop as a result of massive destruction and loss of the intestinal
epithelium. Although most animals recover after a mild bout of coccidiosis, gut function
and appetite do not return to normal for many weeks. Recovering animal remain unthrifty
and fail to gain weight compared to unaffected contemporaries; the difference in body
weights are still appreciable 10 months after the disease outbreak. Nervous signs that
resemble hypomagnesemia are occasionally noted in young cattle with coccidiosis.
Pathogenesis. Coccidiosis is caused by an intracellular protozoan parasite. Eimeria
species cause all the known coccidial infections in domestic ruminants. Unsporulated
single cell oocysts are passed in the feces. It takes at least 48 hours for them to sporulate
in the environment into an infective stage. After ingestion, released sporozoites invade
into the intestinal epithelial cells and begin reproductive stages. Clinical signs develop
approximately 2 weeks after the infective oocysts are ingested. The developing parasites
rupture intestinal epithelial cells and invade new cells several times before the infection
becomes patent (oocysts in the feces). Widespread loss of intestinal mucosa allows loss
of fluid, plasma proteins (albumin), and blood into the bowel lumen. Surviving animals
have severe villous atrophy that results in signs of maldigestion and malabsorption.
Treatment. Supportive therapy consists of fluids, nutritional support, blood transfusion (if
PCV 1500 mg/dl+++
7. Calves that are being raised on commercial milk replacers need high quality milk
replacers that use real milk proteins (more digestible than vegetable proteins). When
available, real milk is the best food! Feed calves, lambs etc at least every 12 hours and
preferably at the same time every day. To maintain optimal growth, calves need to be fed
replacer (or milk) at the rate of 12-15 % of their body weight per 24 hours (divided into at
least 2 feedings).
8. Get a diagnosis: in herds with an outbreak of diarrhea that is causing significant
morbidity and mortality, postmortem examination of a freshly dead animal is the most
expedient and cost-efficient way to get a diagnosis. Your Georgia State Diagnostic Lab
provides an invaluable and incredibly inexpensive service. If harvesting diagnostic
samples from a dead animal on the farm, submit chilled (not frozen) segments of small
intestine for microbiology, and segments in formalin for histopathological studies. Fecal
samples should be collected and submitted to a diagnostic facility as soon as possible
after signs of diarrhea develop.
The owners of a 5 day old Angus heifer calf telephone your office secretary. They noted
that the calf was depressed and unwilling to stand and nurse her dam this morning. Fresh
blood was seen on the calf's perineal area. The owners said the calf appeared normal the
previous evening. As you drive up the drive, you see an elderly couple hovering
anxiously over the recumbent calf. Physical examination reveals moderate depression.
She is too weak to stand for more than a few seconds. Her temperature is 103.8 degrees
F, pulse is 120 BPM, and respiratory rate is 44 BPM. The nasal mucosa is dark pink, and
the plantum is completely dry. The capillary refill time is 2.5-3 seconds. The eyes are
sunken and skin turgor reduced. The calf's ears and limbs are cool to the touch. The sclera
are 3+ injected. No crackles or wheezes are ausculted in the thorax. The abdomen is
tucked up and the calf appears gaunt. Her estimated body weight is 45 pounds (20 kg).
Dried feces with blood in them are present on the calf's tail and buttocks. The umbilicus
is slightly swollen. A visual blood glucose test indicates the calf's blood glucose is
approximately 40%.