**4.1 General symptoms**

*Animal Reproduction in Veterinary Medicine*

**3.4 Assessment of colostrum uptake**

suggest looking at them every 30 min during parturition.

skin temperature [53]. If skin temperature drops below 30o

**3.5 Assistance of colostrum uptake**

own mother or other sows.

still unable to successfully suckle.

successful [53] and needs to be assisted to suckle and ingest colostrum.

than 37o

Certain behavioral and physiological indicators can be used to identify piglets with low vitality and low colostrum uptake [72]. Piglets with low vitality may need assistance with colostrum uptake in order to prevent starvation, hypothermia, and crushing by the sow [2]. **Table 5** provides an overview of these indicators. Besides birth weight and crown-rump length, piglet's survival chance correlates with body temperature, vitality score, rooting response, and latency to teat and suckle [72]. Whenever the following criteria are met, the piglet needs assistance with colostrum uptake: vitality score of less than two (no movements within 15 s of birth), latency to teat and therefore to suckle of more than 30 min, and a body temperature of less

C during the first hour after birth. In order to spot these piglets in time, we

C, the piglet has not been

However, this may be difficult to implement into practice. It may be helpful to make use of thermal images to overcome these difficulties [53]. Similar to body temperature, skin temperature is linked to birth weight, vitality, and colostrum ingestion and can be used to see whether a piglet has reached the teat and suckled and ingested colostrum within 30 min of birth [73, 74]. As a piglet begins to suck and ingest colostrum, energy and warmth are produced, increasing body and therefore

It is important to ensure that each piglet in the whole litter has a sufficient intake of good quality colostrum (more than 200 g) within 12–16 h from the beginning of parturition [14, 75]. When possible, piglets with low colostrum uptake should be assisted to suckle, by helping them to attach to the smallest functioning teats. This procedure should be repeated three to four times within the first few hours. Additionally, weakly piglets can be hand-fed with colostrum collected from their

Assisted suckling and hand-feeding are appropriate in small or normal size litters where only one or two piglets require help. In large litters or when more piglets require assistance, split suckling is more effective. In order to minimize the sibling competition for colostrum intake, the litter is split into two groups. The heavier and stronger piglets are kept in the creep area or in a separate box, allowing the smaller piglets to suckle for 60–90 min, and then the groups are switched. When separating the piglets, both groups should always have free access to a warm creep area. This can be easily achieved by using a box with an additional heat lamp for the separated group, which leaves the creep area accessible for the remaining group to suckle. Assisted suckling should be combined with split suckling if some small piglets are

Another strategy is to prolong the colostral phase. Piglets ingest colostrum usually until 24 h after the onset of parturition [75]. The composition of colostrum is affected by the status of tight junctions between mammary epithelial cells, and the ability to manipulate mammary tight junctions in the late colostral phase could allow Ig concentrations to be maintained at higher levels for a longer period. Injecting a supraphysiological dose of oxytocin to sows on day 2 of lactation (i.e., between 12 and 20 h after birth of the last piglet) increased the concentrations of IGF-I, IgG, and IgA in milk collected 8h after the injection [76]. The injection of oxytocin in the early postpartum period therefore delayed the occurrence of tightening of mammary tight junctions and prolonged the colostral phase, thereby

having beneficial effects on the composition of early milk.

**98**

General symptoms include fever, reduced appetite, lethargy, and vaginal discharge [41]. Body temperature is the most frequently used to evaluate the health status of a sow in the puerperal period [78]. Reference values range from 39 [24] to 40°C [38]. Though body temperature is a sign of inflammation, it can also be affected by several other parameters such as the circadian rhythm [79], parity [79], variation in repeated measurements [80], and positioning of the thermometer in the rectum [81]. Vulvar discharge occurs also in healthy and diseased animals [82, 83] with the highest incidence between days 2 and 4 postpartum [78, 84]. Further, the color, consistency, and quantity of vaginal discharge vary regardless of whether the vaginal discharge is physiological or pathological [85]. The color can vary from clear, whitish, yellowish to reddish (**Figure 3**). The consistency varies from watery to creamy with lumps, and the amount can be up to 500 ml [85, 86]. Increased volumes of vaginal discharge are associated with endometritis, but otherwise there does not seem to be strong correlations between other characteristics of vaginal discharge and PDS [86].


**Table 6.**

*Indicators, based on clinical history and clinical symptoms, for postpartum dysgalactia syndrome.*

#### **Figure 3.**

*Puerperal vaginal discharge with different colors. 0 = clear, 1 = reddish, 2 = yellowish, and 3 = whitish. The color of vaginal discharge varies regardless of whether the vaginal discharge is physiological or pathological [85]. Increased volumes of vaginal discharge are associated with endometritis. Images taken by Alexander Grahofer.*

In conclusion, body temperature, especially under 40.0°C; appetite; and vaginal discharge cannot be used alone and as the single criterion for PDS. Still, body temperature of more than 40.0°C together with other clinical symptoms such as general behavior and feed intake are associated with PDS and require further diagnostics [78, 79]. These symptoms can be normal or associated with an infection of the urogenital tract or the mammary gland and constipation.

#### **4.2 Endometritis**

Besides prolonged parturition, obstetrical intervention, and the birth of more than one dead piglet, also retained placentae is a risk factor for endometritis [3]. For both, endometritis and retained placentae, ultrasonography is considered the best tool for diagnosis [3, 59, 78, 87]. Examination of uterine structures currently utilizes three criteria: fluid echogenicity, echotexture, and size [59, 87]. Changes in echotexture are a reflection of changes in the endometrial edema. Increased echotexture and any fluid echogenicity must be considered abnormal and indicative of an exudative inflammation of an acute or acute-chronic type [59, 87]. Fluid echogenicity is often associated with uterine edema and therefore increased echotexture and size of uterine cross-sections [3]. Thus, all criteria, enlarged uterine size, hyperechoic fluid accumulation, and heterogeneous uterine wall, are interconnected and can be used as ultrasonographic parameters to ascertain uterine disorders (**Figure 4**) [3, 87, 88].

In contrast, chronic endometritis, representing the most common type of uterine inflammation in pigs and most common cause of reproductive failure, cannot be definitively diagnosed by ultrasonography or by any other tool [59, 87]. Therefore, it is essential to recognize acute endometritis in time. This can be done based on the

**101**

**4.3 Cystitis**

**Figure 4.**

*steps. Images taken by Stefan Björkman.*

*Tools and Protocols for Managing Hyperprolific Sows at Parturition: Optimizing Piglet Survival…*

criteria mentioned above, but it must be considered that fluid echogenicity, uterine edema, and increased uterine size during the first few days after parturition may be normal [3, 78, 88]. Furthermore, when interpreting uterine size, the age and parity of the sow as well as the number of postpartum days need to be considered [3, 59, 87].

*Transabdominal ultrasonographic images of uterine cross-sections (X, Y) of sows assessed 3 days after parturition with enlarged and heterogeneous uterine wall (A) and hyperechoic fluid accumulation (B). Uterine vessels are prominently enlarged (examples marked with arrows). Scale bars on right margins in 1 cm* 

Ultrasonography can also be used for the diagnosis of cystitis [89, 90]. Still, it is not as reliable as in the diagnosis of acute endometritis. Clear changes in the wall thickness and regularity and the mucosal wall surface are volume dependent [89, 90]. Overall, these measurements seem to be unreliable for diagnosis of cystitis. On the other hand, animals with cystitis have moderate to high amounts of sediment [89, 90]. Unfortunately, half of the sows without cystitis also show moderate to high amounts of sediment, which is mainly caused by the diet [89, 90]. Nevertheless, when none to mild amounts is present, the probability that the sow is suffering from no cystitis is high. When moderate to high amounts of sediment are present,

Another diagnostic test is urinalysis. It is preferred to collect spontaneous midstream urine in a transparent tube. The best time for collection is in the morning before feeding. On-farm urinalysis includes macroscopic urine evaluation and urine stix testing. During the macroscopic urine evaluation, the color, odor, and turbidity are evaluated [91, 92]. The color can vary between light yellow and dark yellow, depending on urinary concentration. The color should not be red or brown which indicates hematuria or myoglobinuria. The turbidity of the urine should be clear. Cloudy or turbid appearance indicates the presence of bacteria. The presence of bacteria can also increase ammonia in the urine and cause a putrid odor. Urine turbidity has a sensitivity of 0.74–0.80 and a specificity of 0.50–0.92 and 0.50 [93, 94]. Nevertheless, if urine is physiological, the probability that the sow is suffering from no cystitis is 0.85 [95]. Thus, because of low sensitivities of certain single markers, several markers need to be evaluated together. A macroscopic evaluation should always be combined with urine sticks testing. Urine sticks allow testing for protein, pH, nitrite, blood, and leukocytes. Parameters with low sensitivity are leukocytes, pH, and nitrite [93, 94]. Parameters with good sensitivity are blood and protein [95]. The normal pH is between 5.5 and 8, and an increase above 8 is indicative for the presence of bacteria. On the other hand, many other factors can increase the pH such as feeding, other diseases, and medication. Whenever the majority of these mark-

ers indicate cystitis, a urine sample should be sent for bacterial investigation.

*DOI: http://dx.doi.org/10.5772/intechopen.91337*

other diagnostic tests need to be applied.

*Tools and Protocols for Managing Hyperprolific Sows at Parturition: Optimizing Piglet Survival… DOI: http://dx.doi.org/10.5772/intechopen.91337*

#### **Figure 4.**

*Animal Reproduction in Veterinary Medicine*

In conclusion, body temperature, especially under 40.0°C; appetite; and vaginal discharge cannot be used alone and as the single criterion for PDS. Still, body temperature of more than 40.0°C together with other clinical symptoms such as general behavior and feed intake are associated with PDS and require further diagnostics [78, 79]. These symptoms can be normal or associated with an infection of the

*Puerperal vaginal discharge with different colors. 0 = clear, 1 = reddish, 2 = yellowish, and 3 = whitish. The color of vaginal discharge varies regardless of whether the vaginal discharge is physiological or pathological [85]. Increased volumes of vaginal discharge are associated with endometritis. Images taken by Alexander* 

Besides prolonged parturition, obstetrical intervention, and the birth of more than one dead piglet, also retained placentae is a risk factor for endometritis [3]. For both, endometritis and retained placentae, ultrasonography is considered the best tool for diagnosis [3, 59, 78, 87]. Examination of uterine structures currently utilizes three criteria: fluid echogenicity, echotexture, and size [59, 87]. Changes in echotexture are a reflection of changes in the endometrial edema. Increased echotexture and any fluid echogenicity must be considered abnormal and indicative of an exudative inflammation of an acute or acute-chronic type [59, 87]. Fluid echogenicity is often associated with uterine edema and therefore increased echotexture and size of uterine cross-sections [3]. Thus, all criteria, enlarged uterine size, hyperechoic fluid accumulation, and heterogeneous uterine wall, are interconnected and can be used as ultrasonographic parameters to ascertain uterine disorders (**Figure 4**) [3, 87, 88]. In contrast, chronic endometritis, representing the most common type of uterine inflammation in pigs and most common cause of reproductive failure, cannot be definitively diagnosed by ultrasonography or by any other tool [59, 87]. Therefore, it is essential to recognize acute endometritis in time. This can be done based on the

urogenital tract or the mammary gland and constipation.

**100**

**4.2 Endometritis**

**Figure 3.**

*Grahofer.*

*Transabdominal ultrasonographic images of uterine cross-sections (X, Y) of sows assessed 3 days after parturition with enlarged and heterogeneous uterine wall (A) and hyperechoic fluid accumulation (B). Uterine vessels are prominently enlarged (examples marked with arrows). Scale bars on right margins in 1 cm steps. Images taken by Stefan Björkman.*

criteria mentioned above, but it must be considered that fluid echogenicity, uterine edema, and increased uterine size during the first few days after parturition may be normal [3, 78, 88]. Furthermore, when interpreting uterine size, the age and parity of the sow as well as the number of postpartum days need to be considered [3, 59, 87].

#### **4.3 Cystitis**

Ultrasonography can also be used for the diagnosis of cystitis [89, 90]. Still, it is not as reliable as in the diagnosis of acute endometritis. Clear changes in the wall thickness and regularity and the mucosal wall surface are volume dependent [89, 90]. Overall, these measurements seem to be unreliable for diagnosis of cystitis. On the other hand, animals with cystitis have moderate to high amounts of sediment [89, 90]. Unfortunately, half of the sows without cystitis also show moderate to high amounts of sediment, which is mainly caused by the diet [89, 90]. Nevertheless, when none to mild amounts is present, the probability that the sow is suffering from no cystitis is high. When moderate to high amounts of sediment are present, other diagnostic tests need to be applied.

Another diagnostic test is urinalysis. It is preferred to collect spontaneous midstream urine in a transparent tube. The best time for collection is in the morning before feeding. On-farm urinalysis includes macroscopic urine evaluation and urine stix testing. During the macroscopic urine evaluation, the color, odor, and turbidity are evaluated [91, 92]. The color can vary between light yellow and dark yellow, depending on urinary concentration. The color should not be red or brown which indicates hematuria or myoglobinuria. The turbidity of the urine should be clear. Cloudy or turbid appearance indicates the presence of bacteria. The presence of bacteria can also increase ammonia in the urine and cause a putrid odor. Urine turbidity has a sensitivity of 0.74–0.80 and a specificity of 0.50–0.92 and 0.50 [93, 94]. Nevertheless, if urine is physiological, the probability that the sow is suffering from no cystitis is 0.85 [95]. Thus, because of low sensitivities of certain single markers, several markers need to be evaluated together. A macroscopic evaluation should always be combined with urine sticks testing. Urine sticks allow testing for protein, pH, nitrite, blood, and leukocytes. Parameters with low sensitivity are leukocytes, pH, and nitrite [93, 94]. Parameters with good sensitivity are blood and protein [95]. The normal pH is between 5.5 and 8, and an increase above 8 is indicative for the presence of bacteria. On the other hand, many other factors can increase the pH such as feeding, other diseases, and medication. Whenever the majority of these markers indicate cystitis, a urine sample should be sent for bacterial investigation.
