Clinical Assistant Professor Large Animal Internal Medicine University of Wisconsin-Madison MADISON, Wisconsin, United States
Presentation Description / Summary: Bovine respiratory disease (BRD) is a common cause of morbidity and mortality in calves worldwide. At our institution, over 100 calves per year with severe BRD, often accompanied by acute respiratory distress syndrome (ARDS), are referred for intensive treatment. This population is unique as diagnostics, therapy modality and duration are rarely complicated by financial restrictions due to the high genomic value of the dairy calves referred to us. As such, uncommon to many food animal diseases, the management of these cases is translatable to other species. Therapy is restricted largely by important regulations regarding drug usage in food animals and antimicrobial stewardship. Euthanasia is dictated by ethical considerations and prognosis, the latter of which has been informed by our evolving experience with this population over recent years. Diagnostic modalities include serial arterial blood gas analyses, thoracic ultrasonography and radiography. Selection of appropriate antimicrobials based on history, clinical signs, diagnostics and regulations will be discussed. When to instigate and withdraw adjunct therapies such as continuous oxygen, aminophylline, nebulization, non-steroidal anti-inflammatories, steroids, continuous pleural vacuum, blood and plasma transfusions will also be presented based upon our experiences. The impact of complicating factors such as abomasal ulceration, tracheal stenosis and septicemia are discussed in the context of necessary therapy. Positive and negative prognostic indicators in the face of severe ARDS will be outlined over the course of cases and management decision trees presented.
Learner Outcomes: 1. Antimicrobial choice and stewardship in cases of severe bovine respiratory disease complex due to multiple bacterial and viral pathogens. 2. Understand and build a decision tree to inform when and why to instigate adjunct therapies such as oxygen, steroids and aminophylline. 3. Positive and negative prognostic indicators in cases of severe BRD in calves to inform survival to discharge and beyond.
Learning Objectives:
Identify positive and negative prognostic indicators in cases of severe bovine respiratory disease BRD and/or ARDS in calves that may inform survival to discharge.
Know how to implement appropriate antimicrobial choice and stewardship in cases of severe bovine respiratory disease complex. Particularly when faced with positive diagnostics for multiple bacterial and viral pathogens, not all of which may be relevant, depending upon the case and context.
Build and implement a decision tree to inform when to instigate adjunct therapies for calves with ARDS such as oxygen, steroids and aminophylline and in which cases these might be beneficial.
