impact o na sean one health - KVAC 2012 ....VET MED KKU thailand ...

KVAC 13 th 2012 

The 13 th KKU Veterinary Annual Conference 2012 

“International Conference on Transboundary Diseases: Impact on ASEAN One Health” 

7-8 June 2012 

Kosa Hotel, Khon Kaen, Thailand 

PROCEEDING 

Organized by Faculty of Veterinary Medicine, Khon Kaen University, Thailand 

Edited by Jaruwan Kampa 

Weerapol Taweenan 

Suthida Chanlun 

Tanaporn Asawapattanakul

The 13 th KKU Veterinary Annual Conference 2012 (13 th KVAC, Khon Kaen, Thailand) 

“International Conference on Transboundary Diseases: Impact on ASEAN One Health”, June 

7-8, 2012 / Organized by Faculty of Veterinary Medicine, Khon Kaen University, Thailand. 

1. Faculty of Veterinary Medicine 

2. Conference on Veterinary Medicine 

3. Human and Animal Health 

4. ASEAN 

I. Faculty of Veterinary Medicine, Khon Kaen University, Thailand 

II. Jaruwan Kampa 

III. Weerapol Taweenan 

IV. Suthida Chanlun 

V. Tanaporn Asawapattanakul 

All oral and poster presentation abstracts published in The 13 th KKU Veterinary Annual 

Conference 2012: “International Conference on Transboundary Diseases: Impact on ASEAN 

One Health proceeding pass a peer review process by the scientific committee of the 

conference. Proceeding did not require all authors of a research paper to sign the letter of 

submission, nor do they impose an order on the list of authors. Submission to the 

conference is obtained by scientific committee meaning that all the listed authors have 

agreed all of the contents. The corresponding (submitting) author is responsible for having 

ensured that this agreement has been reached, and for managing all communication 

between the committee and all co-authors, before and after publication. Each author is 

responsible for the content and accuracy of the entire manuscript. 

©2012 The Faculty of Veterinary Medicine, Khon Kaen University 

ISBN 978-616-223-189-6

Contents 

Welcome 1 

Committees 5 

General Information 8 

Scientific Program 11 

Invited Speakers 15 

Speaker’s Notes 35 

Oral Presentation 117 

Poster Presentation 129

Welcome Message from the President of Khon Kaen University 

Dear Distinguished Delegates, 

I am very pleased to warmly welcome you to Khon Kaen and to the International 

Conference on “Transboundary Disease; Impact on ASEAN One Health” being held on 7- 

8 June 2012. 

This conference is hosted by the Faculty of Veterinary Medicine, Khon Kaen University. I 

am very delightful for the breakthrough and expanding of the conference into an 

international event because presently we all need to live and join together as the 

partnerships. 

“ASEAN One Health” is major issue that needed a collaboration and cooperation 

between all 10 countries in South East Asia in all aspects of health care for humans and 

animals. Therefore, we all could build the strength of our ASEAN community by sharing 

our experience, knowledge and technology with each other during this conference. 

I would like to thank you the VMKKU, co-host organizations and all the private 

companies in making this conference successful. 

Warmest regards 

Associate Professor Dr.Kittichai Trirattanasirichai 

President of Khon Kaen University 

7 th -8 th June 2012 


Faculty of Veterinary Medicine - Khon Kaen University - Khon Kaen - Thailand - Tel. +66 43 202404 - http://vet.kku.ac.th 

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Welcome Message from the Dean, Faculty of Veterinary Medicine, KKU 

Dear Colleagues 

Thailand is known as a leading role in promoting regional partnership to control and 

prevent several diseases which harmful human and affect to animal production. Risk of 

emerging and re-emerging diseases at difference levels had been actively studied and 

research is going on. This is a time of increasing international trading and human 

mobility, therefore, update information and knowledge in trans-boundary diseases are 

important to share with scientists and veterinarians who working together for a better 

living of people in ASEAN community. 

The KVAC 2012 is generated during 7 th -8 th June 2012 at Kosa Hotel, Khon Kaen, Thailand 

with the purpose of creating a platform for the development of one health research, 

exchange and contribute our knowledge for Human and animal health as well as quality 

of animal products. The conference will give a better understanding in information, 

policy and regulation of national and international levels among the ASEAN countries 

and in the Asian region. This conference also provide a companion animal session to 

veterinarians to learn more and share knowhow with the speakers. 

I would like to express my appreciation to co-hosts, the Department of livestock 

Development (DLD) and Research and Diagnosis Center for Emerging Infectious Diseases 

(RCEID) as well as speakers, participants, organizing committee and sponsors. Welcome 

all of you to the “The International Conference on Trans-boundary Diseases: Impact on 

ASEAN One Health “ 

Best wishes, 

The 13 th KVAC International Conference on 

Transboundary Diseases: Impact on ASEAN One Health 

Associate Professor Dr.Suneerat Aiumlamai 

Dean, Faculty of Veterinary Medicine 

Khon Kaen University 

Faculty of Veterinary Medicine - Khon Kaen University - Khon Kaen - Thailand - Tel. +66 43 202404 - http://vet.kku.ac.th

Welcome Message from Chairman of the 13 th KVAC 

Dear Colleagues and Distinguished Delegates, 

It is my great honor to welcome you to the 13 th International KVAC Conference, 2012 

hosted by the Faculty of Veterinary Medicine, Khon Kaen University. I wish you enjoy 

and have a wonderful experience during staying in Khon Kaen. 

This year the conference focuses on issues involving ASEAN One Health and other 

interesting aspects of small animal medicine, exotic and wildlife medicine, and 

infectious diseases. With a cooperation of the RCEID (Research and Diagnostic Center 

for Emerging Infectious Diseases), one session has been managed for delegates who 

interested in infective endocarditis. The conference provides advance knowledge in 

diagnosis and current information and situation of the diseases both in human and 

animal. 

I would like to thank all committees, speakers, sponsors, co-host organizations and all 

delegates who support and contribute to the successful of the conference. 

Best Regards, 

Associate Professor Dr.Somboon Sangmaneedet 

Chairman of the Conference 




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Welcome Message from Chairman, Scientific Comittees 

Dear Friends and Colleagues 

Welcome to Thailand, to Khon Kaen and to the 13 th KKU Veterinary Annual Conference. 

By the year 2015, all nations in ASEAN Economic Community (AEC) shall be the regional 

economic integration which results not only on economic issue but also the health of 

ASEAN people. Therefore, we settled “Transboundary Diseases: Impact on ASEAN One 

Health” as the main theme of the 13 th KVAC. 

On behalf of Scientific Committee, we hope this conference would provide an 

impressive meeting place and pleasant atmosphere that will stimulate a lot of discussion 

and strengthening co-operation among ASEAN veterinary professions in fields of 

emerging diseases, livestock, wildlife/exotics and companion animals. 

We would like to thank for kindness of all of the invited speakers who are expertise in 

many interesting fields; Avian medicine, Food Safety, Disease Control and Epidemiology, 

Zoonoses, Epidemiology, Wildlife and Exotic, Livestock and Companion animals. Your 

contribution completes the theme of One Health. Presentations from young scientist 

also magnified the theme. We also take opportunity to thank our generous co-hosts 

and sponsors for making the meeting possible. 

Once again, it is great pleasure to welcome you to Khon Kaen! 

Assistant Professor Dr.Jaruwan Kampa 

Chairman, Scientific Committee 


The 13 th KVAC Committee 



Scientific Advisory Committee 

1. President of Khon Kaen University 

2. Director General Department of Livestock Development 

3. Dean of the Faculty of Veterinary Medicine, Khon Kean University 

4. Director of Research and Diagnostic Center for Emerging Infectious Disease (RCEID) 

Organizing Committee 

1. Assoc.Prof.Dr.Somboon Sangmaneedet Chairman 

2. Assoc.Prof.Dr.Viraphong Lulitanond 

3. Assoc.Prof.Dr.Chuchat Kamollerd 

4. Assist.Prof.Dr.Sarthorn Porntrakulpipat 

5. Assist.Prof.Dr.Ekkachai Pattarapanwichien 

6. Assist.Prof.Dr.Prapaporn Tungthanathanich 

7. Assist.Prof.Dr.Jaruwan Kampa 

8. Assist.Prof.Dr.Jatesada Jiwakanon 

9. Assist.Prof.Dr.Weerapol Taweenan 

10.Assist.Prof.Dr.Naruepon Kampa 

11.Assist.Prof.Dr.Duangdaun Kaenkangploo 

12.Miss Ancharin Ounthaisong 

13.Mrs.Sombat Saengpol 

Scientific Committee 

1. Assist.Prof.Dr.Jaruwan Kampa Chairman 

2. Prof.Dr.Ulf Magnusson 

3. Assoc.Prof.Dr.Thaweesak Songserm 

4. Assoc.Prof.Dr.Fanan Suksawat 

5. Assoc.Prof.Dr.Bongkot Noppon 

6. Assist.Prof.Dr.Sirikachorn Tangkawattana 



9. Assist.Prof.Dr.Chaiyapas Thamrongyoswittayakul 

10. Assist.Prof.Dr.Sompoth Weerakhun 

11. Prof.Dr.Orathai Pachirat 

12. Assoc.Prof.Dr.Wanlop Kaewkes 

13. Dr.Wises Namwat 

14. Dr.Kiatichai Faksri 

15. Dr.Tawatchai Pohuang 

16. Dr.Numfa Fungbun 

17. Mrs.Suthida Chanlun 

Information Committee 

1. Assist.Prof.Dr.Jatesada Jiwakanon Chairman 


3. Assist.Prof.Dr.Suchat Wattanachai 


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4. Mr.Pitakpong Maneerattanarungroj 

5. Miss Chanida Chainn 

6. Mr.Yanyong Wangprecha 

7. Miss Ratana Daosawa 

8. Mrs.Bunserm Somboon 

9. Mrs.Prayoon Khamtat 

10. Mrs.Prisna Vichatham 

11. Mrs.Wan Buajan 

12. Mrs.Prapatson Thihta 

13. Miss Ancharin Ounthaisong 

Treasurer Committee 

1. Assoc.Prof.Dr.Chuchat Kamollerd Chairman 

2. Mrs.Phatchareeya Konchan 

3. Mrs.Suthathip Wattanachai 

4. Miss Nuchanard Phonkhokkong 

5. Mr.Weera Suparuk 

Exhibition committee 

1. Assist.Prof.Dr.Naruepon Kampa Chairman 

2. Miss Supranee Stitammarat 

3. Mrs.Promporn Tongtieum 

4. Miss Rungarun Kulhintang 

5. Miss Pornthip Srichomchuen 

Banquet committee 

1. Assist.Prof.Dr.Prapaporn Tungthanathanich Chairman 

2. Assoc.Prof.Dr.Bongkot Noppon 

3. Assist.Prof.Dr.Varaporn Sukolapong 

4. Dr.Nusara Suwannachot 

5. Mrs.Yupadee Charoensawang 

Registration committee 

1. Assist.Prof.Dr.Duangdaun Kaenkangploo Chairman 

2. Assist.Prof.Dr.Arayaporn Macotpet 

3. Dr.Numfa Fungbun 

4. Dr.Suphannika Pnutthachalee 

5. Mrs.Sudarat Buatuan 

6. Mrs.Sombat Saengpol 

Ceremony and Reception committee 

1. Assist.Prof.Dr.Sirikachorn Tangkawattana Chairman 

2. Assoc.Prof.Dr.Fanan Suksawat 



5. Assist.Prof.Dr.Kochakorn Direksin 


6. Dr.Aran Chanlun 

7. Dr.Trasida Ployngam 

8. Assist.Prof.Dr.Ranee Sachder 

9. Miss Sukumal Udom 

10. Miss Anongluk Manjai 

11. Miss Paweena Sungseho 

12. Mr.Santi Kookrasang 

13. Miss Natchanok Kettongma 



Transportation committee 

1. Assist.Prof.Dr.Saijai Kongpechr Chairman 

2. Mrs.Yupadee Jaroensawang 

3. Mrs.Tanakorn Yanbuaban 

4. Mr.Amporn Krisornsri 

5. Mr.Pongpan Pongsapung 

Evaluation committee 

1. Assist.Prof.Dr.Ekkachai Pattarapanwichien Chairman 

2. Mrs.Aranya Singchomphoo 

3. Miss Nathapop Sechang 

4. Miss Aoythip Thananta 


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General Information 

Registration and Information desk- on the 2 th floor of Kosa Hotel 

Opening Hours 

Thursday 7 June 2012 07.45-16.00 

Friday 8 June 2012 07.45-12.00 

Conference Website: http://kvac.kku.ac.th 

Conference Venue 

Kosa Hotel 

250-252 Srichan Rd., Khon Kaen, 40000 

Phone: +66 (43) 320 320 

Website: http://kosahotel.com 

Program Materials 

Your conference kit provided at registration counter will contain the conference 

program and proceeding CD and souvenir. 

Identification Badges 

Please wear your identification badge at all times while you are attending the 

conference and social events. 

Official Language 



The official language of the conference is English. 


Onsite Conference Services 

Onsite internet counter and computer access will be provided as a complimentary for 

all participants. Photocopying, fax, and telephone services will be provided to participants 

on commercial basis. 

Coffee/Tea 

Coffee, tea and refreshment are included in the registration fee of participants and 

will be available throughout the conference at the assigned area during the breaks. 

Lunch 

Lunches are included in the registration fee of participants. Lunches will be served at 

12.00-13.00 

Liability and Insurance 

The Organizing Committee will not assure any responsibility for damages or injuries 

to person or property during the conference. It is recommended that participants should 

arrange their own personal travel and health insurance. 

Speaker-Ready Desk 

On 2 th floor of Kosa Hotel, we arrange a room for speakers for prepare their presentation. A 

desk for loading speaker’s presentation is in front of the room and is available from 07.45- 

16.00. 

Instruction for presenters 

Poster 

The posters are grouped by session and number. The number corresponds to the number in 

the abstract book. Poster should be displayed from Thursday 7 th June, 08.30 hours until 

Friday 8 th June, 16.00 hours. Posters should be mounted with double sided tape only which 

will be provided. Assistance and material for mounting the posters will be available, at the 

information desk. The authors of posters are expected to be available for answering 

questions during the poster session on 10.00-10.20, coffee beak time, Thursday. 

Oral presentations 



Time for your presentation is in the detailed of Oral presentation schedule in this 

proceeding. 

The conference language is English. The time schedule is tight and chairman will be strict on 

time, so please keep to the time allocated for you; 12 minutes talk and 3 minutes for 

question and discussion. If you aim at 10 minutes talk, you will be on the safe side. 


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Power point presentation should be downloaded on the computer in Speaker-Ready Desk 

from 07.45-16.00. The operative system of the computer in the lecture rooms is Window 7. 

Please make sure that your presentation is compatible. It is not allowed to use individual 

computers for presentation. 

If you wish to provide your presentation after the conference by showing it on our official 

webpage, please inform our staff at the Speaker-Ready room about your decision. And if 

you do not want to, the files of your presentation will be deleted after the conference. 

However, please let us know your decision on your presentation day. 


INTERNATIONAL CONFERENCE ON TRANSBOUNDARY DISEASES; IMPACT ON ASEAN ONE HEALTH 

07 June 2012 

Session 4 (Mongkut 

Thong): 

Oral scientific presentation 

(Eng) 

Session 3 (Mongkut Ngen): 

Zoonotic endocarditis 

(workshop) 

Session 2 (Mongkut Phet 2-3): 

Small animal, Exotic & Wildlife 

(Eng/Thai) 

Session 1 (Mongkut Phet 1): 

Infectious disease 

(Eng) 

Time 

7th-8th June 2012 

08.00-09.00 

Registration / Opening ceremony 

09.00-09.15 

Keynote Speech: Transboundary Diseases; Impact on ASEAN One Health 

09.15-10.15 

Dr.Wantanee Kalpravidh (FAO) 

Foresight of Transboundary Diseases in ASEAN community 

10.15-12.00 

Dr.Ronello C. Abila (OIE), Assoc.Prof.Kittisak Suwanyawisuth (KKU), Dr. Prapas Pinyocheep (DLD) 

Assoc.Prof.Dr.Suneerat Aiumlamai (Chairman) 

12.00-13.00 Lunch 

Rabies 

Vector-Borne Diseases in 

The Zoonotic Endocarditis Project in Vector Borne Vaccine 

Dr.Pornpitak Panlar 

Companion Animal 

Khon Kaen 

Preventable Disease 

(Bureau of Disease Control) Assoc.Prof.Dr.Fanan Suksawasdi Moderator: Dr.Pawin Padungtod Dr.Ronald Enrique Morales 

(KKU) 

Opening and Introductory Remarks Vargas (MU) 

13.00-13.45 

Dr.Virat Klungboonkrong (KKU) 

Dr.Henry (Kip) Baggett (IEIP/GDD) 

1) The Zoonotic Endocarditis Project 

in Khon Kaen - Description and 



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Scientific Presentation 

Updated Results Dr.George Watt 

(IEIP) 

2) Laboratory Aspects of Zoonotic 

Endocarditis in Khon Kaen 

Dr.Viraphong Lulitanond (KKU) 

Zoonotic Pathogens Causing Infective 

Endocarditis in Thailand 

Moderator: Dr Pawin Padungtod 

1) Current Concepts in Q Fever 

Dr.Gilbert Kersh (NCEZID) 

Lameness Examination and 

Orthopedics Assessment 

Asst.Prof.Dr. Monchanok Vijarnsorn 

(KU) 



3.45-14.30 

Scientific Presentation 

14.30-14.45 Coffee break / Poster Symposium 

Foot and Mouth Disease "Diagnosis and Treatment of Zoonotic Pathogens Causing Infective 

Dr.Sith Premasthira 

Common Orthopedic Problems" Endocarditis in Thailand 

(DLD) 

Moderator: Dr Pawin Padungtod 

and "Rehabilitation for 

2) An Overview of Streptococcus suis 

Orthopedic Patient: Tips and 

Infection in Thailand and Research 

Tricks" 

Findings 

Asst.Prof.Dr.Monchanok 

Mr.Anusak Kerdsin (NIH) 

Vijarnsorn (KU) 

3) An Overview of Bartonella Infections 

in Thailand and Research Findings 

Dr.Sumalee Boonmar (IEIP/GDD) 

Q Fever Panel Discussion: 

4.45-16.30 

One Health Approach in Action 

Moderator: Dr.Pasakorn Akarasewi 

Panelist: 

Dr.Pravit Chumkasean (BOE) 

Dr.Teerasak Chuxnum (BOE) 

Dr.Monaya Ekathat (NIAH) 

Dr.Samuel Yingst (AFRIMS) 

Dr.Chien-Chung Chao (NMRC) 


Dr.Pawin Padungtod (IEIP,GDD) 


08 June 2012 

Session 4 (Mongkut 

Thong): 

Oral scientific 

presentation 

(Eng) 

Session 3 (Mongkut Ngen): 

Zoonotic endocarditis 

(workshop) 

Session 2 (Mongkut Phet 2-3): 

Small animal, Exotic & Wildlife 

(Eng/Thai) 

Session 1 (Mongkut Phet 1): 

Infectious disease 

(Eng) 

Time 

08.00-09.00 Registration 

Cardiological Aspects of Zoonotic 

Endocarditis in Khon Kaen 

Moderator: Dr.George Watt (IEIP/GDD) 

One Health and the SEAOHUN Opening Remarks and Introduction 

09.00-09.45 

Network 

Dr.Susan Maloney (Director, IEIP/GDD) 

Prof. Dr.Stanley Fenwick (Tufts) 1) Cardiological Findings in Zoonotic 

Endocarditis: The Khon Kaen 

Experience 

Avian Influenza 

Prof.Dr.Orathai Pachirat (KKU) 

Assoc.Prof.Dr.Thaweesak 

2) Current Status of Cardiovascular 

Songserm (KU) 

Surgery in Blood Culture Negative 

Endocarditis 

Emerging Zoonotic Diseases: 

Dr.Sompop Prathanee (KKU) 

Toward a One Health Approach for 3) Pathological Findings in Zoonotic 

09.45-10.30 

Research and Intervention 

Endocarditis: the Khon Kaen 

Prof.Dr.Bruce Wilcox (Tufts) 

Experience 

Dr.Anucha Paupairoj (KKU) 




Coffee break / Poster Symposium 

10.30-10.45 

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Panel Discussion: 

Can the approach used in Khon Kaen 

be applied at other Thai sites and 

regionally to improve diagnosis, 

treatment and outcome of Infective 

Endocarditis? 

Introductory Remarks and Moderator 

Prof.Dr.Orathai Pachirat (KKU) 

Panelists: Cardiologists, Microbiologist, 

Immunologist, Pathologist 

Ophthalmic Drugs: General 

Consideration 

Assoc.Prof.Dr.Preenun 

Jitasombuti (KKU) 

"Zoonotic Helminthiases - 

Here and There -- " 

Prof.Dr.Yukifumi Nawa (KKU) 

10.45-12.15 

12.15-13.30 Lunch 

Laboratory Training: IFA Diagnosis of 

How to Manage Infectious 

Bartonella sp, Coxiella burnetii 

GMP GAP for Food Safety Diseases in Exotic pets 

13.30-14.15 

(Q Fever) and PCR identification of 

Dr.Sompiss Jullabutradee Asst.Prof.Dr.Sompoat Weerakul Streptococcus suis 

(KKU) 

Leader: Dr.Viraphong Lulitanond 

14.15-14.30 Coffee break 

Q Fever 


Acute Renal Failure: Urinary Streptococcus suis 

GMP GAP for Food Safety 

Clues to Success 

Mr.Anusak Kerdsin (NIH) 

14.30-15.15 

Dr.Sompiss Jullabutradee 

Assoc.Prof.Dr.Rosama 

Bartonella 

Pusoonthornthum (CU) 

Dr.Sumalee Boonmar (IEIP) 

Workshop Place: Faculty of Medicine, 


Current Treatment for 

Obstructed Cats 

Assoc.Prof.Dr.Rosama 

Pusoonthornthum (CU) 

Vet Public Health on Food 

Safety and Trend in the 

Future in Thailand 

Asst.Prof.Dr.Prapansak 

Chaveerach (KKU) 


15.15-16.00 

16.00-17.00 Awarding & Closing Ceremony

Invited Speaker



Dr. Wantanee Kalpravidh 

FAO Regional Coordinator, Food and Agricultural Office for Asia and the Pacific 

Keynote: Transboundary Diseases; Impact on ASEAN One Health 

Dr.Kalpravidh obtained her D.V.M. in 1986 from Faculty of Veterinary Sciences, 

Chulalongkorn University, Thailand and Ph.D. in veterinary epidemiology from College of 

Veterinary Medicine, University of Minnesota in 1993. She worked for the Thai 

Department of Livestock Development during the first ten years of her career. She then 

worked for Faculty of Veterinary Science and Chulalongkorn University and Betagro 

Holding, Ltd. before she joined the Food and Agriculture Organization of the United 

Nations in 2004 as Regional Coordinator until now. Over the years, she has been 

working on disease control planning and facilitating the coordination among sectors at 

national and international levels. 


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Dr. Ronello C. Abila 

OIE SRR SE Asia Sub-Regional Representative 


Dr.Ronello C. Abila is the Sub-Regional Representative of the OIE Sub-Regional 

Representation for South East Asia based in Bangkok and also manages the OIE South 

East Asia and China Foot and Mouth Disease (SEACFMD) Campaign. He joined the OIE in 

June 2004 as Regional Coordinator of SEACFMD, and in September 2007 he was given 

additional task to manage the OIE/AusAID Programme on Strengthening Veterinary 

Services in South East Asia until March 2009. In April 2009, he was appointed as the OIE 

Sub-Regional Representative concurrent to his position as Regional Coordinator of 

SEACFMD Campaign. 

Dr.Abila has a wide experience in managing disease control programs. Before joining the 

OIE, he handled various posts in the Philippines’ Bureau of Animal Industry as head of 

the Epidemiology Section, National Veterinary Quarantine Services and Animal Health 

Division. Dr Abila is a graduate of Doctor of Veterinary Medicine (DVM) from the 

University of the Philippines and has a Master of Science in Tropical Veterinary 

Epidemiology from Free University of Berlin, Germany. 

Dr.Prapas Pinyocheep 

Chief of Bangkok Seaport Animal Quarantine Station 

Bureau of Disease Control and Veterinary Services, Department of Livestock 

Development 



Assoc.Prof.Dr.Kittisak Sawanyawisuth 

Faculty of Medicine, Khon Kaen University 




Dr.Kittisak Sawanyawisuth is an Associate Professor in Internal Medicine, Department of 

Medicine, Faculty of Medicine, Khon Kaen University, Thailand. He received an M.D. 

from Faculty of Medicine, Khon Kaen University; M.A.S. (Clinical Research) from 

University of California, San Diego; and Ph.D. from University of Occupational and 

Environmental Health, Japan. His research focuses on Angiostrongyliasis caused by 

Angiostrongylus cantonensis. Currently, he has published more than 70 articles in 

international peer-reviewed journals including the American Journal of Medicine, the 

green journal. He has been an external peer reviewer for 17 international journals. He 

also has been is also invited to be guest speakers and presenters in several international 

conferences. 


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Assoc.Prof.Dr.Suneerat Aiumlamai 

Dean of Faculty of Veterinary Medicine, Khon Kaen University 

Chairman: Foresight of Transboundary Diseases in ASEAN community 

Assoc.Prof.Dr.Suneerat Aiumlamai graduated her Doctor of Veterinary Science degree 

from Chulalongkorn University, Thailand in 1987. Dr.Suneerat was working as Bovine 

Practitioner, Head of Semen Production and Dairy Information at Dairy Farming 

Promotion Organization of Thailand (1987-1997). During the time, she had done her 

Ph.D. in Theriogenology at the Swedish University of Agricultural Sciences (1991). At 

present Dr.Suneerat is an Associated Professor in Animal Reproduction and also Dean of 

Faculty of Veterinary Medicine, Khon Kaen University (2006-present). She also devoted 

her time on veterinary societies such as consultant of Thai Dairy Cooperative Association 

and Thai Holstein Association, Committee in Thai Veterinary Council, etc. In scientific 

part, she published many nationally and internationally papers on Dairy production, 

Ruminant reproduction, Milk quality and Mastitis. Her currently research studies focus 

on Feeding on dairy reproductive performance and milk quality and Reproductive 

diseases on dairy reproductive performance. 




Dr.Pornpitak Panlar 

Bureau of General Communicable Disease, Department of Disease Control 

Ministry of Public Health, Thailand 

Rabies 

Dr.Pornpitak Panlar is a veterinarian and the chief of public health emergency 

preparedness and response section (PHER), Department of Disease Control (DDC). He 

received his D.V.M. from Kasetsart University and M.PH. degree from Mahidol 

University . After working at DDC, he left to work as a exchange scholar at Rakuno 

Kakuen University, Japan on the veterinary Medicine Training Program by JVMA in 2002 

as well a visiting trainee in Hokkaido University on Hanta virus in 2002. On 2007, He has 

been trained in public health emergency at US CDC. He has experience in both public 

health and veterinary field in many disease control program such as Rabies, Avian 

Influenza, SARS and Pandemic Influenza. He is also participated in ASEAN + 3 Program 

on EID, RABIES. 

Currently, he is the chief of PHER, DDC. In this function he manages the department 

strategies on Public Health Emergency preparedness and Response including 

reemerging and emerging zoonotic disease from 2010 - present. 


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Dr.Sith Premashthira 

Bureau of Disease Control and Veterinary Services 

Department of Livestock Development 

Foot and Mouth Disease 

Dr.Sith Premasthira works in the position of Veterinary Officer at the Professional Level, 

Livestock Disease Control Section, Bureau of Disease Control and Veterinary Services, 

DLD. Dr. Premasthira received his education at Faculty of Veterinary Medicine, Kasetsart 

University (D.V.M.), Faculty of Tropical Medicine, Mahidol University (M.Sc.) and then 

from College of Veterinary Medicine and Biomedical Sciences, Colorado State University. 

His currently published article “Epidemiological simulation modeling and spatial analysis 

for foot-and-mouth disease control strategies: a comprehensive review” provides 

audience in depth of FMD. 


Assoc.Prof.Dr.Fanan Suksawat 

Faculty of Veterinary Medicine, Khon Kaen University 



Vector-Borne Diseases in Companion Animal 

Dr.Fanan Suksawat is an Associate Professor in the Department of Veterinary 

Medicine, Faculty of Veterinary Medicine, Khon Kaen University. Dr.Fanan received 

her D.V.M. degree from Kasetsart University in 1990 then completed her Ph.D. study 

in Comparative Biomedical Sciences from North Carolina State University, USA. At 

present, Dr.Fanan contribute her time, not only for teaching veterinary student at 

the KKU, but also on research of vector-borne disease among Thai pet owner, 

Veterinary professionals and companion animal. 


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Assist.Prof.Dr.Monchanok Vijarnsorn 

Department of Companion Animal Clinical Science, Kasetsart University, Thailand 

Lameness Examination and Orthopedics Assessment, Diagnosis and Treatment of 

Common Orthopedic Problems, and Rehabilitation for Orthopedic Patient: Tips and 

Tricks. 

Dr.Monchanok Vijarnsorn graduated with her D.V.M. degree from Kasetsart Unversity in 

the year of 1991. She received her master degree in the field of small animal 

orthopedics and her Ph.D. in the field of comparative orthopedics from Atlantic 

Veterinary College, University of Prince Edward Island, Canada. After returning from her 

study in the year of 2006, she has worked as an assistant professor in the Department of 

Companion Animal Clinical Science, Kasetsart University. Her works involve clinical 

teaching in small animal orthopedics for the veterinary student in both under and post 

graduate levels. Her research interests encompass small animal orthopedic surgery, gait 

analysis, implants and rehabilitation. She is one of the cofounder of the Center of 

Neurology, Orthopedics and Rehabilitation for Companion Animal of the Kasetsart 

University Veterinary Teaching Hospital. The center is aimed to provide an excellent 

clinical service and innovative research opportunity for the quality of life of small animal 

patients. At present Dr.Vijarnsorn is a director of the Kasetsart University Veterinary 

Teaching Hospital. 


Dr.Ronald Enrique Morales Vargas 

Faculty of Tropical Medicine, Mahidol University 



Vector Borne Vaccine Preventable Disease 

Dr.Ronald Enrique Morales Vargas is an instructor at Department of Medical 

Entomology, Faculty of Tropical Medicine, Mahidol University, Thailand. He finished his 

Ph.D. in Medical Entomology from Institute for Tropical Medicine, Nagasaki University, 

Japan in 2002. Dr.Ronald Enrique Morales Vargas interested in research area of 

Geometric Morphometric, Bio-Ecology of Mosquito Borne Diseases, Surveillance of 

Emerging and Reemerging Arboviruses and Oxidative Stress in Mosquito Vectors. He is 

now joining in research projects of Morphometrics of Aedes aegypti and Aedes 

albopictus, Taxonomic and Morphological Diversity of Mosquito Fauna of Thailand, 

Dengue Virus strains Diversity (Quasispecies) in its vector mosquitoes and Climate 

Changes Effects on the Mosquito Vectors Dynamics Populations. 

Assoc.Prof.Dr.Thaweesak Songserm 

Faculty of Veterinary Medicine, Kasetsart University 

Avian Influenza 

Associate Professor Dr.Thaweesak Songserm is an Associate Dean for Research, Head of 

the Center of Veterinary Research and Service and Head of the Center of Duck Health 

Science at the Faculty of Veterinary Medicine, Kasetsart University, Thailand where 

received his D.V.M. degree. His M.Sc. and Ph.D. degree were done at the Utrecht 

University, The Netherlands. Dr.Thaweesak produced several scientific publications in 

Avian Pathology, Duck diseases and diagnosis, emerging infectious animal diseases. 


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Prof.Dr.Yukifumi Nawa 

Faculty of Medicine, Khon Kaen University 

Zoonotic Helminthiases -Here and There 

Prof.Nawa graduated from, Faculty of Medicine, Kyoto University in 1970. He 

continued his Ph.D. at the Dept. of Immunology, John Curtin School of Medical 

Research, Australian National University, Canberra, Australia where got a Ph.D. 

degree awarded in 1978. After Ph.D. study, Prof.Nawa got a Postdoctoral Fellow, 

Department of Cell Biology, Faculty of Science, Auckland University, New Zealand. He 

was the Head of the department of Parasitology, Miyazaki Medical College, where he 

became the Professor. During the 2003-2007 he was the Director/Vice-President 

(Research & Planning), University of Miyazaki. After that Prof. Nawa hold a position 

of Invited Professor at the Faculty of Biochemical Sciences,Universitad Autonoma de 

Sinaloa, Culiacan, Mexico. He was also an Invited Professor/Consultant for the 

Faculty of Tropical Medicine, Mahidol University, Thailand. From the 2011 up to 

present, Prof.Nawa is an Invited Professor/Consultant at the Faculty of Medicine, 

Khon Kaen University, Thailand. Prof.Nawa has several publications in fields of 

Mucosal Immunology, Immunodiagnosis for Parasitic Diseases and Food-borne 

parasitic zoonoses-seroepidemiology, molecular epidemiology. In the year 2002 and 

2009, Prof.Nawa received Koizumi Prize from Japanese Society of Parasitology and 

Katsurada Prize from Japan Association of Parasite Control, respectively. He has been 

Editor-in-Chief of Parasitology International Journal and also editorial board 

members many international scientific journals. 


Dr.Sompiss Jullabutradee 

Managing Director of G&S Agri Consultant Co., Ltd, 



GMP GAP for Food Safety 

Dr.Sompiss Jullabutradee recieved D.V.M. degree from the Faculty of Khon Kaen 

University, Thailand in 1993 and, then, in 2001 Executive M.BA. (Marketing and 

Financing) from Sripatum University. Dr.Sompiss finished her MSc in Veterinary Public 

Health, Joint program of VET-Chiang Mai University & Freie University. With high 

experience in the profession, she was the FAO national consultant on “Opportunities 

and constraints in implementing Good Hygiene Practices (GHP) and Good 

Manufacturing Practices (GMP) in abattoirs and meat processing enterprises” project 

and FAO International consultant “Biosecurity Auditing training”, Dhaka and have been 

invited to present her fruitful knowledge in veterinary schools, many scientific meetings 

and conferences. At present, Dr.Sompiss work at SGS (Thailand) Co., Ltd as the subcontracted 

auditor, at the G&S Agriconsultants Co., Ltd as the MD (pre-auditing and 

customer audit for buyer from UK and EU (shrimp and meat producs) on BRC, IFS and 

other food safety standards) and TML Food and FACS as representative agent of NSF- 

CMi (UK certification body) (auditor certifying Red Tractor Assurance (ACP), Food safety 

training for poultry integrations and food processers). 


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Assist.Prof.Dr.Prapansak Chaveerach 


Vet Public Health on Food Safety and Trend in the Future in Thailand 

In 1993, Dr.Prapansak Chaveerach got his D.V.M. from the Faculty of Khon Kaen 

University and then finished the Ph.D. in Veterinary Public Health from the faculty of 

Veterinary Medicine, University of Utrecht, The Netherland, in 2002. In administrative 

tasks, Dr.Prapansak is the Assistant to the President of Khon Kaen university for 

Academic Affairs and also the Director of Master of Science program in Veterinary Public 

Health. His interesting research fields are Veterinary Epidemiology, Microbial control in 

Animal and Meat product (especially Campylobacter and Salmonella), Zoonosis and Risk 

analysis on Food of animal origin. 


Prof.Dr.Stan Fenwick 

Regional Technical Director, RESPOND Bangkok 



One Health and the SEAOHUN Network 

Prof.Dr.Stan Fenwick is B.V.MS. graduated from Glasgow University 1978 and received 

Masters in Aquatic Veterinary Studies and Masters in Tropical Veterinary Medicine form 

Stirling University (1980) and Edinburgh University (1981), respectively. During 1978- 

1980, he worked in a Dairy cattle practice in Somerset, UK then had been working as 

Senior Veterinary Field Officer, Yemen Arab Republic from 1982-1986. During 1986- 

2001, he was an Associate Professor, Microbiology and finished his PhD (1997) at 

Massey University and during 2001-2010, Professor, Veterinary Public Health, Murdoch 

University. From 2010-present he is the Regional Technical Director, RESPOND Bangkok, 

Thailand. 


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Prof.Dr.Bruce A. Wilcox 

Department of Biomedical Sciences, Tufts University Cummings School of Veterinary 

Medicine 

Emerging Zoonotic Diseases: Toward a One Health Approach for Research and 

Intervention 

Bruce A. Wilcox currently holds the positions of Research Professor, Department of 

Biomedical Sciences, Tufts University Cummings School of Veterinary Medicine and 

Director of Integrative Health Research Programme at Mahidol University, Faculty of 

Public Health. Dr.Wilcox received his education at University of California at San Diego 

(A.B. and Ph.D.), Yale University (M.S.) and Stanford University (Post-Doctoral) earning 

degrees in biology, evolutionary ecology and population biology. Dr. Wilcox has held 

faculty positions and taught global health and disease ecology in the Departments of 

Public Health and Tropical Medicine at University of Hawaii, and environmental science 

and conservation biology in the Human Biology Program at Stanford University. He is a 

co-founder of the fields of conservation biology and of ecology & health, and is the first 

person to hold the position of Professor of Ecology and Health in a school of medicine in 

the United States. He is the founding Editor-in-Chief of the international Journal 

EcoHealth, led the establishment of the International Association for Ecology and Health 

and served as its President at its establishment in 2004. His current research and 

educations interest is integrative health research methods and education, including, 

systems-based approaches for research and intervention for the control and prevention 

of emerging infectious diseases. 


Assoc.Prof.Dr.Preenun Jitasombuti 




Assoc.Prof.Dr.Preenun Jitasombuti graduated from Faculty of Veterinary Science 

Medicine, Chulaongkorn University in 1992. Then recieved MSc degree in veterinary 

Surgery in 1998. By experience and continuing educations aim at ophthalmology of 

companion animals, Dr.Preenun is the outstanding veterinary ophthalmologist in 

Thailand. He contributes time on educate veterinary students and veterinary 

practitioners not only in the field of ophthalmology but also how professional 

veterinarian to be. At present, Dr.Preenun is an Associate Professor at the Department 

of Surgery and Theriogenology, Khon Kaen University and also the President of the Thai 

Society of Veterinary Ophthalmology Practitioners. 


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Assist.Prof.Dr.Sompoth Weerakhun 


How to Manage Infectious Diseases in Exotic pets 

After graduation of DVM degree from Khon Kaen University (KKU), 

Assist.Prof.Dr.Sompoth Weerakhun has been a lecturer for wildlife, exotic and aquatic 

medicine for veterinary student at KKU. He was an Associate dean of student affairs 

(1996-2002). He also worked as an instructor for zoo and wildlife veterinarians of 

Thailand by Smithsonian Institution Program (Annual Training course) during 1996-2000. 

In year 2008, he received his PhD degree from Nippon Veterinary and Life Science 

University, Japan. His present research is aimed at diseases; pathogen-host interaction 

and treatment; of fish, rabbit, sea-turtles, elephant, macaques and many wildlife and 

zoo animals. 


Assoc.Prof.Dr.Rosama Pusoonthornthum 

Faculty of Veterinary Sciences, Chulalongkorn University 



Acute Renal Failure: Urinary Clues to Success, Current Treatment for 

Obstructed Cats 

Dr.Pusoonthornthum received her D.V.M. (First-class honor) from the Faculty of 

Veterinary Science, Chulalongkorn University in 1987. She completed her Master of 

Science Degree in Physiology from the Faculty of Science, Mahidol University in 

1989. She became instructor of small animal medicine at the Faculty of Veterinary 

Science, Chulalongkorn University in 1990. In 1991, she went to further her study for 

her Ph.D. in Veterinary Medicine (Urology) at the University of Minnesota, USA 

under the supervision of Dr. Carl A. Osborne. She received Ph.D. in Veterinary 

Medicine from the University of Minnesota in January, 1996. Her thesis entitiled” 

Epizootic Evaluation of Feline Urolithiasis” was on the epidemiologic study for the 

cats’ uroliths in the United States. She is the member of Psi Zeta, the Fraternity of 

the Veterinary Medicine in the USA. After returning to Thailand, Dr. 

Pusoonthornthum became the director of the Small Animal Hospital, Faculty of 

Veterinary Science, Chulalongkorn University. She was active in both the clinical 

works and research in small animals. In 1996, she set up the special clinic for 

nephrology and urology at the Small Animal Hospital. Her research interest is on 

renal failure of dogs and cats, feline lower urinary tract diseases and feline 

immunodeficiency virus infection. In 2003, she recieved “The Jaratsubsang 

Veterinary Practitioner of the Year Award” from the Veterinary Practitioner 

Association of Thailand (VPAT). Dr. Pusoonthornthum has published more than 70 

peer-reviewed papers, two books, book-chapters, and present papers in various 

international meeting. She is the member of the American Veterinary Medical 

Association, the American Association of Feline Practitioner and Vice-President of 

the Thai Society of Feline Practitioners (TSOFP). 


33

Speaker’s Notes



Foresight of Transboundary Diseases in ASEAN Community: 

A Clinician Perspective 

Kittisak Sawanyawisuth, MD, MAS, Ph.D. 

Department of Medicine, Faculty of Medicine 


Email: kittisak@kku.ac.th 

Even though ASEAN countries are located in the same tropical area, there are so 

many different aspects such as gross domestic product (GDP), religions, cultures, or 

healthcare services. Both local people and visitors are needed to change living 

patterns when the merging of ASEAN countries occurs. People moving from their 

own country to another country need to change their life styles and learn how to live 

in the new environment. While, local people need to interact with visitors who are 

from different cultures and languages. Healthcare systems are also different among 

ASEAN countries and may need universal insurance coverage for all countries in the 

future. In addition, physicians in ASEAN countries may need to learn more regards of 

imported diseases from other countries. Conferences or travel medicine may need to 

be emphasized or established. 

Life expectancy in ASEAN countriesis quite comparable except Singapore, while GDPs 

are wide-range varied (1). Singaporeans have the longest life expectancy (78 years 

for male and 83 years for female), whereas Thai, Vietnamese, and Malaysian people 

have average life expectancy about 70 years for male and 75 years for female. 

Among ASEAN countries, Singapore has the highest GDP at 43,300 USD in 2006. The 

expenditure on health was high in Vietname at 6.6%, while other countries such as 

Thailand, Singapore, or Malaysia spent about 3-4% of country’s GDP. Below is basic 

healthcare system in Thailand. 

In Thailand, the health insurance comprised of three systems; universal coverage, 

government coverage, and social security system. The majority of population have 

universal coverage which is the free and basic health insurance system. In 2010, 

there were 22,019 physicians in Thailand. The total number of Thai population in 

2010 was 63,701,703 people. The overall physician: population ratio was 1:2,893. 

This ratio was lowest in Bangkok (1:1,052) and one physician took care 4,947 people 

in the Northeastern part of Thailand. 

Top five causes of death in Thailand were cancer, accidents, heart disease, 

hypertension and stroke, and pneumonia, respectively (3). Generally, top five 

diseases may not be different among ASEAN countries. In Singapore, cancer is the 

leading cause of death (37%) in 2009, while heart disease, accident and stroke were 

the following orders (4). Infectious agents or sites of cancer may be different among 

countries. 

Cancer was the leading cause of death in 2009 in Thailand and the most common 

cancer is liver and bile duct liver. These two cancers are related to hepatitis B or C 

infection and liver fluke infection, respectively. Khon Kaen was renowned and 

crowned as the capital of cholangiocarcinoma or bile duct cancer. People get 


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38 



infected with liver fluke by eating raw freshwater fish (Figure 1) are at risk for 

cholangiocarcinoma. The prevalence of hepatitis B or C infection in Thailand was 

5.69% and 1.34% in 2011, respectively (3). There are other infectious diseases that 

may prevalent in Thailand such as parasitic infections, rabies, leptospirosis, and 

melioidosis. People who plan to work in specific area should get advice from travel 

medicine specialist. 

Some diseases may be exported to other countries for example eosinophilic 

meningitis or sudden cardiac death of Thai patients. Seventeen Thai labors were 

reported to have eosinophilic meningitis in Taiwan (5). They got infected by eating 

raw freshwater snails. The leading symptom is acute severe headache and physicians 

may misdiagnose as functional headache or migraine if they are not familiar of this 

disease. A total of 235 Thai male workers developed sudden unexpected death 

syndrome in Singapore between 1982 and 1990 (6). Most subjects were found death 

during the sleep. The cause of death is still unclear. Local people believe that a man’s 

life is taken by the female divorce ghost. 

Some diseases may also be imported from other countries. Malaria particularly in 

border of Thailand, Myanmar, and Cambodia is reported to have drug resistant (7). 

The rate of artemisinin-resistant malaria seems to be increasing along Thailand- 

Myanmar border (8). Therefore, public health policy may be needed to prevent the 

spreading of resistant Malaria. In addition, collaboration of ASEAN countries in 

healthcare should be emphasized to prevent the spreading of resistant Malaria. 

In conclusion, physicians in ASEAN countries should be alert for imported diseases 

from other ASEAN countries. Conferences, education, and collaboration in 

healthcare or travel medicine are crucial. National policy in healthcare should also be 

discussed. 

Figure 1. Dish made of raw fish (Koi) the local food in the Northeastern part of 

Thailand. This dish is a common source of liver fluke 

(source: http://en.wikipedia.org/wiki/Opisthorchis_viverrini) 




References 

http://www.thaiwebsites.com/healthcare(2).asp 

http://bps.ops.moph.go.th/Statistic/2.3.4-52.pdf 

http://www.boe.moph.go.th/boedb/surdata/index.php 

http://www.moh.gov.sg/content/moh_web/home/Publications/information_papers 

/2010/trend_in_adult_mortalityinsingapore.html 

Tsai, H.C., Liu, Y.C., Kunin, C.M., Lee, S.S., Chen, Y.S., Lin, H.H., Tsai, T.H., Lin, W.R., 

Huang, C.K., Yen, M.Y., and Yen, C.M. 2001. Eosinophilic meningitis caused 

by Angiostrongylus cantonensis: report of 17 cases. Am J Med, 111: 109-114. 

Goh, K.T., Chao, T.C., Heng, B.H., Koo, C.C., Poh, S.C. 1993. Epidemiology 

of sudden unexpected death syndrome among Thai migrant workers 

in Singapore. Int J Epidemiol, 22: 88-95. 

http://www.who.int/csr/resources/publications/drugresist/malaria.pdf 

Phyo, A.P., Nkhoma, S., Stepniewska, K., Ashley, E.A., Nair, S., McGready, R., Ler 

Moo, C., Al-Saai, S., Dondorp, A.M., Lwin, K.M., Singhasivanon, P., Day, N.P., 

White, N.J., Anderson, T.J., Nosten, F. 2012. Emergence of artemisinin- 

resistant malaria on the western border of Thailand: a longitudinal study. 

Lancet [Epub ahead of print] 


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Towards the Elimination of Rabies in the ASEAN Member States: 

what THAILAND forward step 

Pornpitak Panlar D.V.M., M.PH. 

Chief of Public Health Emergency Preparedness and Response 

Department of Disease Control 

Ministry of Public Health 

E-mail: ppanlar@yahoo.com 

Rabies is one of the oldest zoonotic diseases in medical history. Rabies is usually 

transmitted by bites of rabid animals mainly domestic dogs. However more than 95% 

of the 55,000 human rabies deaths estimated to occur annually in the world follow a 

rabid dog bite and are originating from Africa and Asia. In Asia (OIE, 2011), more 

than 2.5 billion people are potentially exposed to rabies infection; each year, had 

estimated 8 million people receive treatment after being exposed to animals that are 

suspected of rabies. The dog remains the most important vector and reservoir of the 

disease and is responsible for almost all the reported human cases. The elimination 

of dog rabies is the most cost-effective solution to eliminate the rabies threat in Asia. 

The well - established dog registration and mass vaccination coverage program of at 

least 70% to 75% of the dog population in a country should be in place with 

vaccination of companion dogs in urban districts, gradual implementation of mass 

vaccination of rural dog, control measures consist of compulsory registration and, 

increased post-exposure treatment of dog-injured people and awareness education 

implementing will decrease the number of humans contacting the disease 

exponentially. 

Rabies remains a low priority for the global public health community. The burden of 

rabies falls mostly on poor rural communities and children in particular.Children in 

the 5-15 year age-group represent about 40% of people exposed to dog bites in 

rabies endemic areas (Gongal et al., 2011). The majority of bites that occur in 

children go unrecognized and unreported and, consequently, exposed children do 

not receive the benefit of timely and complete courses of post exposure prophylactic 

treatment. 

Epidemiological situation 

In Thailand, the number of deaths due to rabies decreased steadily, from 370 in 1980 

(0.78 per 100,000) to 185 in 1990 (0.33 per 100,000) 57 in 1998 (0.1 per 100,000) 

and 9 (0.027 per 100000 population) in 2008. Because of the public awareness, safe 

and potent vaccines for the protection in dog as well as for thepost-exposure 

prophylaxis (PEP) in human being and health care facilities are widely considered as 

the main factors leading to this decline. 

A total 23 human rabies cases were reported in 2009. The main route of 

transmission is through the bite of rabid dogs. Dogs are the primary source of human 

infection. Cats are an alternate host and a secondary source of human exposure. The 

dog population in Thailand can be categorized into three groups: owned dogs; 

community dogs (living in public areas and fed by the population) which can be 




reached by control measures under certain conditions; and ownerless strays which 

usually escape control programs. According to a dog population survey carried out in 

1999 in Bangkok, Thailand, there were approximately 650,000 dogs living in the area, 

20% of which were ownerless. The total estimated dog population was 6.7 million in 

Thailand in 1995. Stray or community dogs and unvaccinated pet dogs are 

responsible for sustaining endemic rabies in Thailand. 

Burden of disease 

Thailand is moving towards low endemic status, Rabies is still a public health 

problem in Thailand. The number of people exposed to animal bites varies from 

300,000 - 400,000 per year and it were estimated that 17,000 - 25,000 patients need 

application of rabies immunoglobulin due to third-degree exposure. 

Although the number of human rabies deaths is decreasing, an increase in the 

number of patients receiving post-exposure prophylaxis (PEP) has been observed in 

the past decade. As many as 400 000 patients received vaccination due to dog-bites. 

Dog-bites represent a huge financial burden to the government that must provide 

PEP to those who have been bitten. The Thai private and public sectors spend at 

least US$ 10 million per year on post exposure rabies prophylaxis. (WHO-SEARO, 

2011) 

Thailand have registered a decline in the number of human rabies deaths through 

implementation of outstanding management of dog bite victims by post-exposure 

prophylaxis (PEP) with modern cell-culture vaccines, and effective vaccine delivery 

systems.The reduction of human rabies deaths from 171 in 1991 to 22 in 2003 

seemed to reflect progress but 400,000 human required rabies PEP in 2003 and 

situation still remain in Thailand as 500,000 bite victims still required rabies PEP in 

2008 (Hemachud ha, 2005) . 

However, rabies is not yet controlled in the dog population and one of the major 

challenges is to enforce the Rabies Control Act and to achieve 70% of dog 

vaccination coverage to cut the transmission cycle of dog-to-dog rabies. A new 

strategic approach has been formulated to eliminate human rabies which includes 

integrated rabies control at Sub-district level in dog population control with ensuring 

animal welfare, public awareness, especially of high risk groups, law enforcement for 

dog rabies control, community involvement in dog vaccination and dog-bite 

prevention campaigns and establishment of rabies-free areas (WHO, 2009). 

Elimination of rabies is not possible without regional cooperation; no single country 

can maintain rabies-free status unless it is brought under control in neighboring 

countries.The ASEAN countries adopted the resolution to prevent and control rabies, 

with the goal of rabies elimination by year 2020. There is also a growing concern and 

commitment for elimination of human rabies by a number of national governments 

in the SE Asia Region. Regional Strategic set up agreement between ASEAN 

Secretariat and WHO/OIE for supply sufficient human and animal vaccines, 

immunoglobulin and other related supplies needed for prevention and control 

including facilitate sharing of legislation, good practices/ success stories, technical 


41

42 



guidelines/ SOPs, national strategies, IEC materials on rabies control and prevention 

(ASEAN, 2008). Surveillance activities including laboratory diagnosis and disease 

surveillance for both human and animal health agencies still on focus, and dog 

population management, identify the laboratory needs and conduct training needs 

assessment of the countries (animal health and human health) for rabies. Advocate 

at regional level for allocation of budget to ensure sufficient supply of human and 

animal vaccines and immunoglobulin at national level. 

Evaluate on Surveillance Capacity and research on surveillance 

The lack of awareness and the lack of priority of rabies programs could represent 

barriers to the successful implementation of effective control measures. A “one 

health” approach for controlling rabies, combining increased public awareness and 

World Rabies Day have brought this neglected disease to the attention of the 

scientific community, government authorities, the media and the public (AREB, 

2007). It is hoped that this will result in an increased collaboration between 

veterinary and human health authorities, and an involvement at all levels necessary 

for the control and elimination of rabies in dogs. 

Combining activities both of human and animal health services in most developing 

countries, community representatives and other interested third parties involved in 

running a program must all agree on objectives, conditions and plans of action aimed 

at eliminating the disease and monitoring rabies safe areas. Community committees 

would play a crucial role in epidemic rabies control and prevention by providing 

more community participation, rather than depending on outside helps with an 

improved responsible dog ownership, are also key components for disease control 

(Sintunawa et al., 2004). Human and animal vaccination services feasible and 

conserves financial resources when compared to single sector campaigns. 

The best practice among ASEAN country have been recognize such as The Bohol 

rabies prevention and eradication program in the Philippines with increasing 

awareness and education by involving the Ministry of Education of their country in 

every major rabies event or program (AREB, 2009) . 

We strongly recommend to establish the national rabies control program in every 

enzootic country in the world to ensure the continued political commitment, to 

active community participation with tailoring interventions of collaboration with 

national/ international organizations and especially to ensured the Alliance for 

Rabies control and Pre-exposure prophylaxis; WHO recommends that pre-exposure 

vaccination using for persons at increased risk of exposure to rabies virus, either by 

nature of their residence, travel plans, or occupation, recognizing that in enzootic 

areas rabies should be consider.Lastly integration of rabies vaccine into the 

Expanded Program of Immunization (EPI) would facilitate access to the targeted 

population and minimize operation costs in future. 




Reference 

ASEAN. 2008. Strenthening Cooperation and Information Sharing on Rabies among 

ASEAN plus Three Countries: Call for Action. Ha Long Viet Nam. 

Dodet, B. ARAB. 2007. Meeting report. Vaccine. 10:8647-8650. 

Dodet, B. ARAB. 2009. Report of the sixth AREB meeting,Manila, The Philippine, 

10-12 November 2009. Vaccine. 28:3265-3268. 

Gongal, G. and Wright, A.E. 2011. Human Rabies in the WHO Southeast Asia Region 

: Forward Steps for Elimination. Advances in Preventive Medicine. Vol. 2011. 

1-5. 

Hemachudha, T. 2005. Rabies and dog population control in Thailand: Success or 

Failure. J Med Assoc Thai, 88 no.1 :120-123. 

OIE. 2011. Global Conference on Rabies Control :Towards Sustainable Prevention at 

the Source (abstract book). pp. 40 ,42 ,50. Incheon, Republic of Korea. 

Sintunawa, C., Wacharapluesadee, S., Wilde H. and Hemachudha, T. 2004. Paradigm 

Shief in Rabies Control: A System Approach. J Med Assoc Thai, 

87 no.2 :1530-1533. 

WHO. 2009. Rabies in the South-East Asia Region.Report. 


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Foot and Mouth Disease and ASEAN One Health 

Sith Premashthira, D.V.M., M.Sc., Ph.D. 

Bureau of Disease Control and Veterinary Services, 

Department of Livestock Development 

Ministry of Agriculture and Cooperatives 

E-mail: sith.prem@gmail.com 

Livestock animal diseases are a major constraint on economic growth, poverty 

reduction, and food security. Among the most important diseases that can damage 

the national economy and trade is Foot and mouth disease (FMD). FMD is a highly 

contagious viral disease in cloven-hoofed animals that may rapidly and unexpectedly 

spread in a country or across national boundaries. FMD control in South East Asia 

has been formally collaborated among member countries since 1994 with the 

establishment of the OIE Sub-commission for South-East Asia FMD campaign 

(SEAFMD). The regional coordination unit for SEAFMD was established in Bangkok in 

1997 to manage the related activities and coordination among 8 member countries. 

In 2010, supported by OIE and ASEAN, the remaining ASEAN countries and China 

were participated in this collaboration that was renamed to the South-East Asia and 

China Foot and Mouth Disease campaign (SEACFMD). After phase 1-3 (1997-2011) of 

the campaign (establishment, revision on strategic directions, and improvement on 

coordination and partnership efforts), phase 4 (2011-2015) includes the lesson 

learned from previous phases, scientific developments, and socio-economic study in 

the disease control activities. In addition, the campaign includes other emerging 

infectious disease and zoonoses into the activities, since experience on FMD control 

in ASEAN serves as a model for regional coordination. The SEACFMD 2020 roadmap 

to prevent, control and eradicate FMD was produced to provide a framework and 

direction to achieve FMD freedom with vaccination by 2020 and maintain FMD 

freedom in countries and zones that have attained FMD-free status. The roadmap 

context is composed of changing dynamics, key lessons, political support, animal 

movements, vaccination, zoning, biosecurity and traders, investment in maintain 

freedom, stakeholder engagement, legislation and expertise, research and 

development, and global disease control issues. The OIE/FAO progressive control 

pathway for FMD free zones or countries was initiated to be a procedure to control 

and eradicate FMD. SEACFMD strategic directions are compatible with the global 

strategy because they have sought to ensure the consistency of regional with the 

global level. 




Companion Animal Vector-Borne Diseases 

in One Health Concept 

Fanan Suksawat, D.V.M., M.S. , Ph.D. 

Faculty of Veterinary Medicine, 


e-mail: jsvetmed@yahoo.com 

Abstract 

This lecture aims to promote awareness in recognizing vector borne diseases by 

human and veterinary medical professions. The major vector-borne diseases that are 

shared by man, domesticated companion animals in term of one health concept in 

Southeast Asia will be addressed. Recent investigations indicating various arthropod 

ectoparasitic vector-borne diseases caused by bacteria, protozoa, filariae, and 

rickettsiae including bartonellosis, rickettsiosis, ehrlichiosis, anaplasmosis, 

borreliosis, leishmaniosis, trypanosomiasis, dirofilariasis, lymphaticfilariasis, are 

prevalent in this region. Several arthropods have been known or suspected in the 

disease transmission, including flies, ticks, lice, sandflies and mosquitoes. The actual 

emergence of vector-borne diseases is possibly under estimated because stray dogs 

and cats are highly populated, and the popularity of pet ownership and popularity of 

pet importation are increasing. Up-to-date knowledge on vector-borne diseases in 

humans and animals and their public health implications will be reviewed. 

Companion animals in one health 

Close physical association between human and animal diseases is a part of one 

health concept. Lifestyle and environmental alterations including the rising in global 

human and animal movement play the major impact. Potential role of companion 

animals, and particularly domesticated dogs and cats, in one health remain relatively 

less taken into account in Southeast Asia. The majority of these animals may receive 

little veterinary attention and remain substantial reservoirs of zoonotic infection. 

Tropical climate, large populations of stray dogs and cats, and increasing popularity 

of pet ownership provide an ultimate environment for vector-borne disease 

transmission in this region. 

Companion animal vector-borne diseases in one health 

The major vector-borne infectious diseases of dogs and cats that also infect man are 

several including, bartonellosis, rickettsiosis, ehrlichiosis, anaplasmosis, borreliosis, 

leishmaniosis, trypanosomiasis, dirofilariasis and lymphaticfilariasis. Transmission of 

the diseases varies on the pet lifestyle and several factors such as vaccination and 

parasite control, exposure to other domestic animals or wildlife. Only significant 

diseases are discussed as following: 

Bartonellosis 

Numerous Bartonella species are newly worldwide emerging pathogens. Clinical 

manifestations in human beings and a variety of animals associated with Bartonella 

spp. are Carrion's disease, trench fever, cat scratch disease, bacillary 


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angiomatosis, peliosishepatis, chronic bacteremia, endocarditis, pericarditis, 

adenitis, lymphadenopathy and neurological disorders. Over 30 described species 

belong to the genus Bartonella. Seventeen of these are currently considered as 

human pathogens. Seven zoonotic potential species have been isolated from dogs 

and cats. At least 5 species of Bartonella are associated with human illnesses in 

Thailand: B. henselae, B. tamiae, B. tribocorum, B. elizabethae, and B. 

vinsoniiarupensis. Endocarditis and most other diseases are mostly reported from 

immunocompetent people. Ticks, fleas, lice, and mites are confirmed or proposed as 

transmission vectors. A variety of mammals, including rodents, ruminants, 

carnivores, reptiles, marine mammals and bats; represent as potential reservoir 

hosts for Bartonella spp. Several arthropods have been known or suspected in 

Bartonella transmission, including flies, ticks, lice, sandflies and mosquitoes. 

Rickettsiosis 

In Southeast Asia, scrub typhus caused by Orientia tsutsugamushi is medically 

significant, while spotted fever group (the flea-transmitted rickettsioses) caused by 

Rickettsia typhi, R. felis is not yet known. The role of dogs in these human infections 

is transporting infected ticks into the domestic environment and the risk to owners 

of removing infected ticks from their pets. The reservoir potential for domestic pets 

for R. typhi is not proven, but there is much recent interest in the emergence of R. 

felis which is found in dogs, cats and cat fleas. 

Ehrlichiosis and anaplasmosis 

A number of ehrlichiosis and anaplasmosis infections are shared by man and 

companion animals. From a public health standpoint, Ehrlichia canis, E. chaffeensis, 

Anaplasma cytophagophila and E. ewingii have emerged as pathogens for both dogs 

and human beings. E. canis is not considered as significant zoonotic potential 

organism although human cases of infection are reported in Venezuela in 1996. 

Recent research indicates that dogs may serve as sentinels for human exposure to 

Ehrlichia species. Ehrlichia chaffeensis causes human monocytic ehrlichiosis and 

reports indicate simultaneous infection in dogs and humans. An Ehrlichia sp. closely 

related to or identical to A. phagocytophila can cause human granulocytic 

ehrlichiosis in humans and cause granulocytic ehrlichiosis in cats, dogsand horses. In 

many instances, however, identification of infection in domestic animals preceded 

recognition in humans. 

Borreliosis 

In Asia, borreliosis has a wider range of reservoirs, including lizards, birds, and 

mammals particularly rodents. It has been diagnosed throughout North America, 

Europe, and Asia and it may exist undiagnosed elsewhere. 

Leishmaniosis 

Leishmaniosis caused by Leishmania infantum and dogs are the major reservoir for 

human infection transmitted by sandflies. The disease is endemic in 88 countries on 

5 continents: Africa, Asia, Europe, North America and South America with a total of 

350 million people at risk. However, it is sporadic-Southeast Asia. L. tropica has been 




reported in Southeast Asia. Borrelia burgdorferi (strain B. afzelii) antibodies were 

reported from Malaysian blood donors and patients in 2002. 

Conclusion 

Many countries in Southeast Asia are classified as tropical climate; rainy, warm, 

cloudy southwest monsoon (mid-May to September); dry, cool northeast monsoon 

(November to mid-March); and always hot and humid. Ecosystems are conducive for 

vector survival. One health challenge for vector-borne diseases is to collaborate 

partnership among health professions to develop strategies for management and 

elimination of the diseases. To assess the diversity of potential vector-borne diseases 

along with the zoonotic significances, further international collaboration for 

zoonoses surveillance is crucial. 

References 

Day MJ. One health: the importance of companion animal vector-borne diseases. 

Parasit Vectors. 2011 Apr 13;4:49. 

Heppner DG, Wongsrichanalai C, Walsh DS, McDaniel P, Eamsila C,Hanson B,Paxton 

H.Human ehrlichiosis in Thailand. Lancet. 1997 Sep 13;350(9080):785-6. 

Hulinska D, Kurzova D, Drevova H, Votypka J. First detection of Ehrlichiosis 

detectedserologically and with the polymerase chain reaction in patients with 

borreliosis inthe Czech Republic. CasLekCesk. 2001 Mar 29;140(6):181-4. 

Lerdthusnee K, Nigro J, Monkanna T, Leepitakrat W, Leepitakrat S, Insuan 

S, Charoensongsermkit W, Khlaimanee N, Akkagraisee W, Chayapum K, Jones 

JW.Surveys of rodent-borne disease in Thailand with a focus on scrub typhus 

assessment.Integr Zool. 2008 Dec;3(4):267-73. 

Parola P,Cornet JP,SanogoYO,Miller RS,et al.Detection of Ehrlichia spp., Anaplasma 

spp., Rickettsia spp., and other eubacteria in ticks from the Thai-Myanmar 

border and Vietnam. J Clin Microbiol. 2003 Apr;41(4):1600-8. 

Perez M, Rikihisa Y and Wen B. Ehrlichia canis-like agent isolated from a man in 

Venezuela: antigenic and genetic characterization. J Clin Microbiol. 

1996;34(9):2133-2139. 

Suksawat J, Xuejie Y, Hancock SI, Hegarty BC, Nilkumhang P, BreitschwerdtEB. 

Serologic and molecular evidence of coinfection with multiple vectorbornepathogens 

in dogs from Thailand. J Vet Intern Med. 2001 Sep- 

Oct;15(5):453-62. 

Suksawat J, Pitulle C, Arraga-Avarado Magrogal K, Hancock SI, Nilkumhang P, 

Breitschwerdt EB. Coinfection with three Ehrlichia spp. in dogs from Thailand 

andVenezuela with emphasis on consideration of 16 Sribosomal DNA. J Clin 

Microbiol. 2001 Jan;39(1):90-3 

Tay ST, Kamalanathan M, Rohani MY. Borreliaburgdorferi (strain B. afzelii) antibodies 

among Malaysian blood donors and patients. Southeast Asian. J Trop Med 

Public Health. 2002 Dec;33(4):787-93. 


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Diagnosis and Treatment of Common Orthopedic Problems 

Monchanok Vijarnsorn, D.V.M., M.Sc., Ph.D. 

Department of Companion Animal clinical Sciences 


e-mail: mvijarnsorn@yahoo.com 

Hip luxation 

Hip luxation is an acquired condition commonly found in small animal practice. Most of 

the hip luxations are traumatic origins (Schulz, 2007). The concurrent conditions, types 

of displacement, duration of luxation and extent of tissue damage should be taken into 

consideration when establishing a treatment plan. The possibly concurrent conditions 

include osteoarthritis of the hip, avulsion fracture of the femoral head and fractures 

involving acetabulum, epiphysis of femoral head, femoral neck and greater trochanter 

(Bordelon et al., 2005).The displacement incranio-dorsaldirection is the type of 

displacement that commonly occurs in small animal population. The ventral luxation 

ranks the second most common type of hip displacement. The patient’s weight bearing 

ability may be range from non-to minimal weight bearing. Weight bearing ability may be 

improved with chronicity. Inadequate treatment will result in osteoarthritis of the hip. 

The integrity of the hip can be achieved by functions of various tissue structures include 

the round ligament of the head of the femur, the joint capsule, the dorsal acetabular rim 

and the muscles supporting the hip (Bordelon et al., 2005) . The tearing of round 

ligament and joint capsule permit the luxation of femoral head. The extent of capsular 

tissue damage can be range from small rent to complete fraying of whole capsule 

(Schulz, 2007). The infolding capsular tissue may prevent repositioning the femoral head 

into acetabulum during closed reduction. 

Diagnosis of hip luxation relies on history, orthopedic and radiographic examinations. 

The lost of inverted triangle formed by 3 typical landmarks including iliac crest, greater 

trochanter and ischiatic tuberosity indicates the displacement of the hip. The thumb test 

is a specific maneuver for detection of hip luxation. The radiographs of the ventro-dorsal 

and lateral views are crucial for verifying hip luxation and other concurrent pathology 

(Piermattei et al., 2006). The closed reduction should be attempted in all cases prior 

surgical treatment if no concurrent condition exists (Bordelon et al., 2005). The closed 

reduction has to be performed under anesthesia. The epidural analgesia and pain 

medication may facilitate the reduction procedure. Generally, hip luxation should be 

corrected within 4-5 days post injury (Bordelon et al., 2005). After cranio-dorsal hip 

reduction, the Ehmer sling should be applied for a period of 7-10 days. The hobble sling 

is a method of choice to provide stabilization after the ventral hip reduction. The chance 

of success when using closed reduction technique is approximately 35-50% (Bordelon et 

al., 2005). The rate of success will be even lower in patient with poor conformation of 

the hip. 




The open reduction of the hip is indicated when the closed reduction failed. The joint 

reconstruction techniques should be selected base on the extent of soft tissue damage. 

Those reconstructions include capsulorrhaphy and synthetic capsular techniques.The 

toggle pin placement is to construct the neoligament to replace the round ligament 

function. Either synthetic capsular reconstruction or toggle pin placement is very useful 

for the hip luxation with severe degree of capsular damage (Schulz, 2007). The 

translocation of greater trochanter in caudo-distal position may provide an additional 

stability for the hip. However the long term stability can be achieved through 

periarticular fibrosis.The excision arthoplasty is to remove the head and neck of the 

femur. The technique is more appropriate for the management of hip luxation with 

other pathologic conditions or the situation that the stability of the hip cannot be 

sustained. The success rate of open reduction is varied from 85-90% regardless of the 

reconstruction technique (Bordelon et al., 2005). The post operative management 

should be selected based on the stability achieved after repair and compliances of the 

owner and patient. The management after treatment using cage confinement with or 

without sling placement should be continued for 3-8 weeks. 

Legg-Calve-Perthes diseases 

Legg-Clave-Perthes disease is a developmental condition primarily found in miniature or 

toy breed dogs. This pathologic condition has also been known as Osteochondritis 

juvenilis or avascular necrosis of the femoral head. The disease process results in aseptic 

necrosis of the femoral head due to the interruption of blood supply to the femoral 

epiphysis (Gambardella, 1993). The condition mostly occurs at 4-11 months of ages 

before the closure of the proximal femoral physis. There was no gender predilection 

reported in canine population. The bilateral occurrences of 12-16% have been 

diagnosed in affected canine population (Demko and McLaughlin, 2005). 

The epiphyseal vascular system is a solely vascular architecture supplying the femoral 

epiphysis. These vessels enter the femoral head near insertion of the joint capsule. The 

disturbance of the femoral head vascularity may lead to osteonecrosis of the femoral 

head. The underlying causesof the disease are still unknown however an autosomal 

recessive gene has been thought to be one of the predisposing factors of the disorder. It 

has been reported to be inherited disease in the Manchester Terriers (Vasseur et al., 

1989). Other risk factors include hormonal and metabolic imbalance, vascular 

abnormalities, trauma, and conformation abnormalities (Demko and McLaughlin, 2005). 

Synovitis or abnormal conformation of the limb may lead to the increase in intraarticular 

pressure. The intraarticular tamponade cause the vein to collapse which in turn can 

compromise blood supply. In the early phase of osteonecrosis, the subchondral bone 

may still be able to support the articular cartilage without any presenting sign. When 

there is a progression of ischemic subchondral bone plate, the articular surface will 

collapse and the congruity between the femoral head and acetabular surface will be 

lost. The patients will demonstrate the signs of pain and lameness then the 

osteoarthritis will be subsequently developed (Schulz, 2007). 


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The diagnosis of avascular necrosis of the femoral head is based on history, orthopedic 

and radiographic examinations. The manipulations of the affected hip will aggravate the 

painful response. The limited range of motion and joint crepitation can be detected 

upon joint manipulation. In chronic case, muscle atrophy may be observed. The 

radiographic examination reveals the osteolytic foci associated with bone resorption at 

the femoral neck. The deformities including flattening of the femoral head and the 

collapse of the femoral neck are the appearances found in later stage of the disease 

process (Demko and McLaughlin, 2005). 

The conservative treatment using anti-inflammatory medication and exercise restriction 

may be successful treatment in small proportion of the cases. Most of the patients 

require surgical treatment. The excision arthroplasty of the femoral head and neck is the 

method of choice. The fragmentation, if presents should be removed. Thejoint capsule 

should be carefully preserved and reconstructed to ensure the stability of the joint 

(Schulz, 2007). After surgery, the patients should be encouraged to use their limbs. Nonsteroidal 

antiinflammatory medication should be prescribed for controlling pain and 

allowing the early limb function. Various rehabilitation modalities are recommended for 

management of pain, improvement of joint range of motion and restoration of overall 

limb function. The timely surgical intervention and appropriate rehabilitation protocol 

will yield a good to excellent prognosis (Demko and McLaughlin, 2005). 

Hip Dysplasia 

Canine hip dysplasia is a developmental disorder characterized by the laxity, subluxation 

and incongruity of the immature hip. The poor congruence leads to abnormal pressure 

distribution on the articular surface during gait cycle. This effect can mechanically 

induce cartilage damage and subchondral bone remodeling. If the condition sustains, 

the osteoarthritis of the hip will subsequently develop at varying degree of severity 

(Demko and McLaughlin, 2005). Most of the affected dogs elicit clinical signs of pain and 

lameness at the age of 4-10 months old. The disorder is mostly found in large breed 

dogs however, small breed dogs may also be affected. The etiology of canine hip 

dysplasia is multifactorial. Genetic predisposition, high nutritional plane, rapid growing 

and poor conformation of pelvic muscle mass are among the most important risk factors 

(Demko and McLaughlin, 2005). 

The patients maybe presented with the signs of lameness, morning stiffness, and 

reluctance to perform daily activities including running, climbing stair and jumping 

(Schulz, 2007). The typical bunny hopping and swaying gaits can be detected during 

lameness examination (Piermattei at al., 2006). Joint crepitation, pain and limited range 

of motion can be detected upon joint manipulation. Atrophic muscle of the hind limb 

and hypertrophic muscle of the forelimb may be associated with weight shifting from 

hind to fore quarter. In skeletally immature patients, hip laxity can be assessed using the 

Ortolani and Barden tests (Piermattei et al., 2006). In older patients the laxity may no 

longer be a presenting sign owing to the development of periarticular fibrosis in the 




later stage of the disease. The clinical signs of osteoarthritis will be prominent in chronic 

cases (Demko and McLaughlin, 2005). Radiographic examination is a primary tool to 

evaluate the degenerative changes within the hip joint. The incongruity, subluxation and 

luxation can be revealed and the semi-objective measurement can be employed to 

gauge the varying degree of hip laxity including the measurements of Norberg angle and 

distraction index (Schulz, 2007). The radiographic appearances of the dysplastic hip can 

be characterized by the shallowness of acetabulum, the remodeling of femoral head and 

neck, the subchondral bone sclerosis and the formation of osteophyte at the joint 

margin (Demko and McLaughlin, 2005). 

The effective management of hip dysplasia can be achieved through pharmacological, 

non-pharmacological and surgical treatments. The conservative management is a 

combination of pharmacological and non-pharmacological modalities including nonsteroidal 

antiinflammatory medication, the use of disease modifying agents, weight 

controlling program, and physical therapy (Schulz, 2007). The physical rehabilitation is 

very useful to decrease pain and increase muscle strength. The surgical interventions 

are selected based on the size and age of the patients, the progression of degenerative 

changes, the compliance of the owner and patients and the preference of the surgeon 

(Demko and McLaughlin, 2005). Juvenile pubic symphysiodesis is a procedure 

recommended to perform in young dogs at 3-4 months of age. The electrocauterization 

technique is directly employed on the pubic symphysis of immature patients causing the 

premature closure of pubic symphysis (Demko and McLaughlin, 2005). The procedure 

results in increased acetabular ventroversion which improve the coverage of the 

femoral head (Dueland et al., 2010). The application of juvenile pubic symphysiodesis is 

not beneficial for the canine patients over 6 months of age. The narrowing of pelvic 

canal is the complication of this technique (Demko and McLaughlin, 2005). The triple 

pelvic osteotomy is a surgical procedure to reorient the pelvic conformation. The 

femoral head coverage is increased and the stability of the hip is regained (Schulz, 

2007). Good candidates for this procedure are the patients less than 10 months of age 

with a radiographic sign of hip laxity. The presence of osteoarthritic changes is a 

contraindication that preventsthe patient to become a candidate of this technique 

(Demko and McLaughlin, 2005). The study comparing the long-term effects of the 

juvenile pubic symphysiodesis and the triple pelvic osteotomy suggested the similar 

effects on hip joint conformation for both interventions. However neither procedure 

eliminates the laxity characteristic of hip dysplasia or the progression of degenerative 

joint disease (Manley et al., 2007). 

The total hip replacement is recommended when the patients reach the stage of severe 

osteoarthritis unresponsive to medical treatment. The procedure is to replace the hip 

with components of prosthetic implants. The cemented system was primarily developed 

and used for many decades (Schulz, 2007). The cementless canine modular prostheses 

have recently invented. The stabilization of the new implants relied on the biological 

osteointegration between prosthesis and bone (Bragdon et al., 2004). The procedure 

should be performed in skeletally mature dogs. The goals are to eliminate pain and to 


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restore the overall limb function (Schulz, 2007). The other alternative procedure is 

excision arthroplasty or femoral head and neck ostectomy. The development of the 

pseudoarthrosis supported by a strong fibrous joint capsule will allow the pain free 

ambulation. However the result from excision arthroplasty is favorable in smaller dogs 

weighing less than 20 kg (Demko and McLaughlin, 2005). The long-term study reported 

postoperative complications including limb shortening, muscle atrophy, reduced rangeof-motion, 

painful response upon passive movement of the hip, and joint crepitation 

(Off and Matis, 2010). The kinetic and kinematic gait analyses have revealedfunctional 

deficits that cannot be easily recognized by visualization (Off and Matis, 2010). The small 

dogs had better compensations of limb function when comparing to larger dogs. 

Nonetheless, the excision arthroplasty offers a practical and economical treatment to 

restore limb function and good quality of life. The prognosis after surgical treatment is 

generally good if the surgical technique and postoperative management are properly 

prescribed (Schulz, 2007). 

References 

Bordelon, JT. Reaugh, HF and Rochat, MC. (2005). Traumatic luxations of the appendicular 

skeletal.Veterinary Clinics of North America: Small Animal Practice, 35: 1169-1194. 

Bragdon, CR., Jasty, M., Greene, M., Rubash, HE.and Harris, WH. (2004). Biologic fixation of total 

hip implants: insights gained from a series of canine studies. Journal of Bone and Joint 

Surgery (American volume), 86: 105-117. 

Demko J. and McLaughlin R. (2005). Developmental orthopedic disease.Veterinary Clinics of 

North America: Small Animal Practice, 35: 1111-1135. 

Dueland, RT., Adams WM., Patricelli, AJ., Linn KA. and Crump PM. (2010). Dueland RT, Adams 

WM, Patricelli AJ, Linn KA, Crump PM. Canine hip dysplasia treated by juvenile pubic 

symphysiodesis.part I: two year results of computed tomography and distraction index. 

Veterinary and Comparative Orthopaedics and Traumatology, 23: 306-317. 

Gambardella PC. 1993. Legg-Calve´-Perthes disease in dogs.In Disease mechanisms in small 

animal surgery. pp 804-807. Philadelphia, Pennsylvania USA, Lippincott Williams & 

Wilkins. 

Manley PA, Adams WM, Danielson KC, Dueland RT, Linn KA. 2007. Long-term outcome of 

juvenile pubic symphysiodesis and triple pelvic osteotomy in dogs with hip dysplasia. 

Journal of American Veterinary Medical Association, 230: 206-210. 

Off, W. and Matis, U. 2010. Excision arthroplasty of the hip joint in dogs and cats. Clinical, 

radiographic, and gait analysis findings from the Department of Surgery, Veterinary 

Faculty of the Ludwig-Maximilians-University of Munich, Germany. Veterinary and 

Comparative Orthopaedics and Traumatology, 23: 297-305. 

Piermattei, DL.,Flo,GL. and Decamp, CE. 2006. Orthopedic examination and diagnostic tools. In 

Handbook of small animal orthopedics and fracture repair. pp 3-24. St. Louis, Missouri, 

USA, Saunders Elsevier. 

Schoulz, K. 2007. Diseases of the joints.In Small animal surgery. Pp 1143-1315. St. Louis, 

Missouri, USA, Mosby-Elsevier. 

Vasseur PB, Foley P, Stevenson S, Heitter D. 1989. Mode of inheritance of Perthes'disease in 

Manchester terriers. ClincalOrthopaedics and Related Research. 244:281-92. 




Lameness Examination and Orthopedic Assessment 





Lameness examination and orthopedic assessment are the essential parts in diagnosis of 

musculoskeletal disorders. To achieve a good diagnostic accuracy, full and relevant 

history has to be obtained and general physical examination has to be carried out 

(Piermattei et al., 2006). History taking may start with general questions that encourage 

the owners to describe the lameness characteristics, conditions and duration. Specific 

questions may be useful to rule in some particular diseases (Arthurs, 2011). The 

sequence of lameness examination consists of 1) inspection, 2) palpation, 3) 

manipulation, 4) conduction of specific maneuvers, 5) formulating a differential 

diagnostic list and 6) arrangement of further investigations including diagnostic imaging, 

arthroscopy and laboratory tests (Piermattei et al., 2006). Management of orthopedic 

disorders is to understand the abnormality and to provide the treatment or advice 

necessary to restore the functional capacity of the musculoskeletal system. Such 

functional capacity may be subjectively or objectively evaluated (Hesbach, 2007) using 

several orthopedic assessment methods. The outcomes from appropriate orthopedic 

assessments will be helpful in establishing and refining an effective treatment plan 

(Hesbach, 2007). 

Pain is a crucial response that protects the body system. It is a signal that limits activities 

which will be potentially harmful to the components of the musculoskeletal system such 

as muscle, nerve, blood vessels, tendon, ligament, bone and articular cartilage. On the 

other hand, it is a practical tool for diagnosis and a good parameter for orthopedic 

assessment. Pain provides a starting point for the orthopedic examination both by 

history and clinical finding. Pain results in decreased weight bearing ability of the limb 

and limited range of motion of the joints (McLaughlin, 2001). Although pain behaviors 

are complex, a behavior-based assessment tool for evaluating the severity of painand 

subjective pain scales in dog have been developed and validated for clinical evaluation 

(Brown et al., 2007 and Hesbach, 2007). The decrease in pain level is an important 

indicator to prove the efficacy of treatment intervention including rehabilitation 

protocol (Hesbach, 2007). Muscle strength may be impaired by pain or denervation. Gait 

will eventually altered due to abnormality of overall function in the affected limb. 

Lameness is the result from the alteration in gait pattern.The examiners should make a 

conscious effort to include gait observation in the lameness examination (Arthurs, 

2011). 


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Inspection is to visualize the body structure and conformation for visible deformities or 

abnormalities in shape, posture and movement. Inspection should be performed either 

in standing position or during motion. The examiners can observe alignment and 

symmetry of the body segment in standing posture. Some clinical evidences including 

swelling and edema, bruise, muscle atrophy may be detected (Arthurs, 2011). Swelling 

that confined to the joint may indicate distension due to joint effusion, haemarthrosis or 

pyarthrosis. Localized area of swelling may suggests an obstruction of lymphatic or 

venous drainage, severe trauma, bone fracture, neoplastic condition or infection. 

Weight shifting from the affected limb to the contralateral or ipsilateral limb, or nonweight 

bearingposture may be observed at standing. Limb mala ligament such as genu 

varum, genu valgum, hyperextension or hyper flexion are deformities that commonly 

found in canine population. Reluctance to stand up or limb trembling may suggest 

weakness or pain conditions (Arthurs, 2011). The limb circumference can be measured 

using measure tape or tension-controlled measuring device. A significant difference in 

limb circumference between the affected limb comparing to the contralateral one 

indicates muscle atrophy (Hesbach, 2007). 

Gait observation can be carried out at indoor corridoror outdoorsettings. The 

examination should take place on the smooth and non-slippery floor which islong and 

wide enough for multiple stride analysis. Home videos taken by owner may be helpful to 

demonstrate the gait abnormalities that occur in familiar and comfortable environment 

(Arthurs, 2011). The gait observation usually employs at walking and trotting which 

represent the standard three- and two-beat gaits. The examiners should observe the 

gait abnormality and active range of motion of the joints. The affected limb(s) should be 

identified and severity of lameness should be determined. The examiners should 

subjectively assess weight bearing ability of the limbs and symmetry between the left 

and right limb pair. Some abnormal posture and movement including head bobbing, hip 

hiking, paddling or bunny hopping may be recognized during the gait observation. The 

head bobbing is consistent with the forelimb lameness while the hip hiking and bunny 

hopping are more likely to be associated with the hind limb lameness (Arthurs, 2011). 

The head bobbing is characterized by upward movement of the head when the affected 

or painful limb strikes the ground. The hip hiking is an upward motion ofthe hip to 

compensate weight bearing force when the affected hind limb strikes the ground and 

can be seen from the posterior position. The paddling movement of the forelimb can be 

detected during stair climbing. This paddling pattern is more consistent with the 

contracture of the infraspinatous muscle (Piermattei et al., 2006). 

Gait observation can be objectively evaluated by using a more sophisticated system, the 

computer assisted kinetic or kinematic gait analysis (McLaughlin, 2001). Multiple gait 

variables can be obtained for quantitatively analysis of the abnormal gait pattern. The 

kinetic gait analysis measures variables derived from the limb when striking the ground. 

These variables include the 3 orthogonal ground reaction forces and their associates 

such as limb loading rate, stance time and impulse (Evans et al., 2005). The kinematic 

gait analysis is the measurement of gait variables during the swing phase when the limb 




lifting up from ground. The angular variables including angular velocity and acceleration 

will be quantitatively assessed by computer assisted video analysis (Torres et al., 2010). 

Both methods yield valuable and descriptive information for orthopedic research. In 

practice, the vertical ground reaction force is more relevant to weight bearing capacity. 

The practical method using force mapping platform is commercially available. This 

platform contains several force sensors that independently measure the weight bearing 

force of each limb (Lascelles et al., 2006). The changes of weight bearing force in 

respond to the injury or treatment can be objectively evaluated by stepping over the 

platform surface. 

Palpation is next important step that should be performed thoroughly on every limb. It 

is a process to examine the body by touching or pressing on the body area. The 

examination should be carried out using a systematic approach (Piermattei et al., 2006). 

The sequence of examination may start from the limb which is not likely to be 

unaffected and the affected limb is the last one to evaluate (Arthurs, 2011). The initial 

palpation to identify the specific and recognizable structure or landmark will help 

determining the location of some structure that is not easy to identify. For example, the 

anatomic landmarks of the hip are the ischial tuberosity, the greater trochanter of the 

femur and the dorsal iliac crest. These landmarks form the inverted triangular shape 

(Piermattei et al., 2006). This triangular shape will be lost in the hip dislocation cases. 

During palpation, the patients’ painful response when compressing the affected area 

(tenderness) should be recognized. The detection of the point of tenderness is very 

useful for localizing the lesion. One of important purposes of the palpation is to verify 

the continuity of anatomic structures such as bone and tendon. The changes in 

temperature including increase in heat due to inflammation or asymmetrical coldness of 

the limb due to impaired circulation should be recognized during palpation.The 

palpation can be performed in standing posture. Joint effusion and asymmetric muscle 

mass may be easily detected. Bone prominence will be obviously seen when muscle 

becomes atrophy. The deep palpation and assessment of flexibilities and tenderness of 

the vertebral column and paravertebral muscle should be performed from cervical to 

sacral spine (Arthurs, 2011). It is important to evaluate the neurological function by 

performing basic neurological examination when conducting lameness examination and 

orthopedic assessment (Piermattei et al., 2006). Generally, palpation and manipulation 

process can be carried out simultaneously. Both examination processes should start 

from distal to proximal extremity (Arthurs, 2011). Some patients feel comfortable in 

lying position. The lateral recumbency would be more suitable position in those cases 

especially when performing joint manipulation and some specific test or maneuvers. 

The manipulation is aimed to detect the abnormalities of the joint during movement. 

Range of motion is amount of motion possible in each joint. The range of motion can be 

evaluated within 3 planes of movement: flexion/extension, abduction/adduction, 

internal/external rotation (Hesbach, 2007). In normal condition, it is assumed to have 

pain free movement throughout the full range of motion. Irregular articular surface will 

produce grating sensation so called crepitation during the joint movement (Piermattei 


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56 



et al., 2006). The crepitation or click sound may also be produced by tissue moving over 

the bony prominence as found in the displacement of menisci (meniscal click). 

Assessment of the range of motion is essential part of orthopedic evaluation. The 

passive range of motion of the joint can be measured by using goniometer. Although the 

reference range of motion is documented for some certain breeds, but the data 

comparisons among different breed may not be appropriate due to the variations of 

body conformation within small animal population (Hesbach, 2007). It is more sensible 

to compare the values from those of contralateral limbs with the affected ones or the 

values from pre with post treatments. Restricted range of motion in a joint is nearly 

always due to mechanical causes including periarticular fibrosis or the contracture of 

musculotendinous unit (Piermattei et al., 2006). The decrease in range of motion may 

be an indicator of pain. The strength of muscle can be indirectly evaluated using 

morphometric measurement of the muscle mass. Other techniques such as 

ultrasonography, magnetic resonance image and computer tomography may be helpful 

in the estimation of the size of muscle. However those assessments are neither practical 

nor economical methods for routine work (Hesbach, 2007). The attempt to evaluate the 

range of motion and stability of the joint is not advisable if the broken bone is 

diagnosed. 

The stability of periarticular tissue, tendon and intra-articular ligament can be assessed 

using special tests which are the sets of maneuvers together with some knowledge of 

the anatomy involved (Piermattei et al., 2006). Specific maneuvers for the examination 

of the fore limb include drawer tests for detection of canio-caudal and medio-lateral 

instabilities of the carpal and shoulder joints (Arthurs, 2011). Initial diagnosis of the 

bicipital tendinitis can be made by perception of the pain in response to digital pressure 

applying on the bicipital tendon (Piermattei et al., 2006). This test may be facilitated by 

shoulder flexion and elbow extension maneuvers. The specific maneuvers for diagnosis 

of the stifle problems are the test for stability of patellar, cruciate and collateral 

ligament deficits. The cranial cruciate ligament rupture can be diagnosed using either 

cranial drawer test ortibial compression test. The test for medio-lateral stability of the 

stifle can be employed to confirm the collateral ligament rupture (Piermattei et al., 

2006). The Barden hip lift and Ortolani tests are useful for detecting hip laxity in 

immature patients (Arthurs, 2011). The thumb test is to confirm luxation of the hip 

(Piermattei et al., 2006). Some of these tests may potentially induce pain response. It is 

highly recommended to perform those tests under sedation or light anesthesia. The 

information derived from thorough lameness examination and orthopedic assessment 

will help identifying the affected limb and localizing the lesion(s). At the end of the 

examinationprocess, the examiners should be able to formulate a list of differential 

diagnosis (Arthurs, 2011). The radiographic examination is required in most cases. At 

least two standard antero-posterior and lateral projections must be employed for 

diagnosis of the orthopedic disorders. Theoblique projections may be useful if standard 

viewsgive rise to confusion owing to the superimposition of several bone structures 

(Piermattei et al., 2006). The coned-down localized view help focusing the x-ray beam 

within a narrow window. This technique yield sufficient resolution so that the details of 




structure and pathology such as joint effusion and hairline fracture can be observed. 

The stress radiographic technique is very useful to verify the tear of major ligament that 

supports and stabilizes the joint. The radiograph taken from the contralateral limb is 

very useful for comparison. It is indicated when there is some difficulty in interpreting 

the radiographs (Piermattei et al., 2006). 

Occasionally, additional tests may be required to confirm a strong impression 

demonstrating in the radiograph. These tests will allow a firm diagnosis to be concluded. 

In some situations when the lameness examination fails to clarify the problem and 

localize the lesion, some additional tests may help identifying the area that should be 

concentrated upon (Samoy et al., 2008). These further investigation methods offer 

noninvasive diagnoses for the safety of the patients. Computer tomography (CT scan) 

can show the image of tissue slices in the median sagittal, parasagittal, coronal 

andthetransverse planes. The CT scan also provides a greater range ofgrey-scale 

separation, thus allowing a greater differentiation of tissue types. Magnetic resonance 

image (MRI) is another tomographic imaging system that possessesa better ability to 

distinguish between different types of soft tissues (Marinoet al., 2010). They are of 

particular value in assessing neurological structures such as brain, spinal cord, meniscal 

and ligamentous structures within joints. Scintigraphy is a functional imaging technique 

that involves intravenous injection of radionuclide such as technetium-99m tracer 

(Samoy et al., 2008). The technique is to evaluate uptake of technetium-99m by body 

tissue.The emission of gamma radiation from technetium-99m tracer in the body will be 

captured by a gamma camera system. The camera system connects to the computer 

work station that contains the software to generate the image representing the 

mapping of technetium-99m uptake amount and anatomical position. It is very useful 

for identification of the inflammation site within the body including arthritis, hairline 

fracture and fragmented coronoid process (van Bruggen et al., 2010). Arthroscopic 

examination is a direct visualization of the articular cartilage and intra-articular 

structures by endoscopic technique (Martini, 2003). The diagnosis of the lesion and 

treatment can be performed simultaneously. The laboratory test may be helpful in some 

cases especially in diagnoses of joint diseases. The routine synovial fluid analysis and the 

detection of biomarkers that indicate the presence of joint diseases are widely used in 

both human and veterinary medicine (Swan et al., 2002). 

References 

Arthurs G. (2011). Orthopedic examination in dog 1.Thoracic limb.In practice, 33: 126- 

133. 

Arthurs G. (2011). Orthopedic examination in dog 2.Pelvic limb.In practice, 33: 172-179. 

Brown DC., Boston RC., Coyne JC. and Farrar JT. (2007). Development and psychometric 

testing of an instrument designed to measure chronic pain in dogs with 

osteoarthritis. American Journal of Veterinary Research, 68: 631-7. 

Evans, R., Horstman, C. and Conzemius, M. (2005). Accuracy and optimization of force 

platform gait analysis in labradors with cranial cruciate disease evaluated at a 

walking gait.Veterinary Surgery,34: 445–449. 


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Hesbach, AL. (2007). Techniques for objective outcome assessment. Clinical Techniques in 

Small Animal Practice, 22: 146-154. 

Lascelles, BDX., Roe, SC., Smith E., Reynolds, L., Markham, J., Marcellin-Little, D., Bergh, 

SM. and Budsberg, SC.(2006). Evaluation of a pressure walkway system for 

measurement of vertical limb forces in clinically normal dogs. American Journal 

of Veterinary Research, 67: 277–282. 

McLaughlin, RM. (2001). Kinetic and kinematic gait analysis in dogs. The Veterinary 

Clinics of North America.Small Animal Practice, 31: 193-201. 

Marino, DJ.andLoughin, CA. (2010). Diagnostic imaging of the canine stifle: a review. 

Veterinary Surgery, 39: 284–295. 

Martini, FM. (2003). Arthroscopy in the dog.Veterinary Research Communications, 27 

Suppl.1: 85–91. 

Piermattei, DL.,Flo,GL. and Decamp, CE. (2006) Orthopedic examination and diagnostic 

tools. In Handbook of small animal orthopedics and fracture repair.pp 3-24. St. 

Louis, Missouri, USA, Saunders Elsevier. 

Samoy Y., Van Ryssen B., Van Caelenberg A., Gielen I., Van Vynckt D., Van Bree H., De 

Bacquer D. and Peremans K. (2008). Single-phase bone scintigraphy in dogs with 

obscure lameness.Jounal of Small Animal Practice, 49: 444-50. 

Swan, A., Amer, H. and Dieppe, P. (2002). The value of synovial fluid assays in the 

diagnosis of joint disease: a literature survey.Annals of the Rheumatic Diseases, 

61:493–498. 

Torres, BT.,Punke, JP., Fu, YC., Navik, JA.,Speas,AL., Sornborger, A. and Budsberg, SC. 

(2010). Comparison of canine stifle kinematic data collected with three different 

targeting models.Veterinary Surgery, 39: 504–512. 

vanBruggen LW., Hazewinkel HA., Wolschrijn CF., Voorhout G., Pollak YW. andBarthez 

PY. (2010) Bone scintigraphy for the diagnosis of an abnormal medial coronoid 

process in dogs. Veterinary Radiology & Ultrasound, 51: 344-348. 




Rehabilitation for Orthopedic Patients: Tips and Tricks 





In the year of 2008, the recommendations for management of hip and knee 

osteoarthritis have been developed and published by the Osteoarthritis Research 

Society International (OARSI). Twenty-five recommendations have been generated 

based on a critical appraisal of new research evidences, guidelines, and the consensus 

opinions of multidisciplinary group of experts (Zhang et al., 2008). The OARSI 

recommendations for the treatment of hip and knee osteoarthritis consist of 

pharmacological, non-pharmacological and surgical modalities. Among those 25 

recommendations, rehabilitation regimen including appropriate muscle strengthening, 

range of motion exercises, aquatic therapy, thermal modalities, transcutaneous 

electrical neuromuscular stimulation (TENS) and acupuncture have been proposed with 

varying degrees of the strength of recommendation (Zhang et al., 2008).Not only 

patients with osteoarthritis but also the patients with fracture or patients with a high 

risk of fracture due to osteoporosis also benefit from effective rehabilitation program 

(Pfeifer et al., 2004). It has been known for a decade that the sense of propioception will 

decrease post surgically or post injury. Therefore the sensory ability should be 

reeducated to improve balance and strength (Edge-Hughes, 2007). The ultimate goals 

are to regain the normal function and to prevent the recurrence of injury. 

The physical rehabilitation relies on the accurate diagnosis and proper patient 

evaluationto establish an appropriate treatment plan. An effective team of small animal 

rehabilitation should consist of the rehabilitation-trained veterinarian, the physical 

therapist, the veterinary technician or nurse, the client and the most important part of 

the team, the patient. The intervention should clearly demonstrate a patient-focused 

care. Establishment of therapeutic plan should emphasize on an outcome-oriented 

approach derives from an appropriate clinical judgment (Hesbach, 2007). The 

veterinarian will perform most of the traditional diagnoses. When the traditional 

diagnoses have been made, the impairment or functional limitation should be focused. 

A good example among those circumstances is osteoarthritis of the hip. The 

impairments or functional limitations that should be taken into consideration are limited 

range of motion of the affected joint, painful response upon joint manipulation, 

decreased weight bearing capacity (of the affected limb) and diminished ability to 

perform daily life activities. The treatment protocol should be established in order to 

treat or meliorate those impairments. The relevant outcome measures have to be 

gauged regularly to ensure the effectiveness of the treatment protocol. The 

rehabilitation protocol may need to be adjusted according to the patient outcomes. 


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The understandings of tissue inflammation and healing are crucial for treatments of 

tissue injury. Some rehabilitation techniques are beneficial for managing inflammation 

and pain during the early phase of injury (Shumway 2007). Generally, during the first 24- 

48 hours after injury or post surgically, application of ice will help minimizing the 

inflammation responses thereby facilitating vasoconstriction. Cold application with or 

without pressure will reduce pain and control for swelling at the injured site. Physical 

modalities including low level laser therapy may be useful in the late stage of 

inflammation (day 3-5). The reparative phase will take place around day 5-21 and may 

occur for 15 weeks. The aims of rehabilitation at this phase are to promote the 

regeneration of connective tissue and vascular system. The architecture of newly 

formed fiber should be aligned in the direction that enhances the strength and flexibility 

of the musculoskeletal tissue (Edge-Hughes, 2007). The sense of propioception and body 

awareness should be restored. The co-ordination of locomotor system has to be 

retrained to gain functional mobility of the whole body. The physical modalities for 

regeneration of the tissue encompass therapeutic exercises and some selected physical 

modalities such as therapeutic ultrasound, neuromuscular electrical stimulation (NMES), 

and low level laser therapy (Edge-Hughes, 2007). The targets of treatment of this phase 

can be extended to the last stage of healing process, the remodeling phase. The 

therapeutic exercises play their important roles in the latest phase to build up the 

strength, to enhance joint range of motion and to regain the propioception. 

The traditional modalities that have been used for centuries are cryotherapy and 

superficial heat therapy. The cryotherapy mainly exerts its effects via vasoconstriction 

which diminish blood flow to the injured area, decrease vascular permeability and 

minimize the cellular metabolism in response to acute inflammation (Heinrichs, 2004). 

The cryotherapy also provides analgesic effect by decreasing the sensory and motor 

nerve conduction velocity. Analgesic effect of cold application can also be explained by 

gate control theory which the transmission of pain can be prevented at the spinal cord 

level to the higher position by overstimulation of cold receptor. The simplest way to 

apply cryotherapy is the use of ice pack or cold pack. However the cold compression 

units are commercially available. Care should be taken when performing the cold 

application on sensitive skin to avoid cold-induced injury. The cryotherapy is more 

suitable to apply during the acute inflammatory phase of tissue healing for the 

reductions of edema and pain. The treatment time of 30-45 minutes and administration 

of 3-6 times a day to the injured part may be sufficient to provide therapeutic effects. 

The heat application is recommended to use when the inflammation subsides. The heat 

can induce the release of chemical mediators that may lead to vasodilation and 

relaxation of the smooth muscle (Heinrichs, 2004). The thermal effect from hot pack or 

thermal gel can cause vasodilation at superficial skin level. The therapeutic ultrasound 

may be more appropriate if deep thermal effect is required. Enzyme activities increase 

at the temperature of 45 degree Celsius. The oxygen-hemoglobin dissociation curve will 

shift to the right creating an optimum environment for tissue repair since oxygen is 

more available. Treatment duration and administration are similar to the cold 

application (Heinrichs, 2004). 




Therapeutic ultrasound is a method usedfor promoting the healing of musculoskeletal 

tissue. The effects of this method can be described in 2 perspectives, thermal and nonthermal 

therapeutic ultrasound. The thermal mechanism is to generate heat that will 

increase cellular metabolic rate, enzyme activity, blood flow to the injured site, and 

viscoelasticity of the tissue. The non-thermal therapeutic ultrasound provides biological 

effects to stimulate cellular protein synthesis, to enhance regeneration and to reduce 

pain sensation. These effects are beneficial for reparative phase of the tissue healing if 

used properly. The ultrasound wave can penetrate into the tissue at varying degrees of 

depth depending on the frequency of the wave. Three MHz is rather superficial with the 

penetration depth of 0.5-2.0 cm. One MHz provides a better penetration as deep as 2-5 

cm. Some machine can generate the frequency of 2 MHz which is able to penetrate into 

tissue at the depth of 1-3 cm.In practice; 3-MHz setting is recommended for the 

treatment of superficial lesion while 1-MHz setting is more suitable for deeper lesion 

(Canapp, 2007). The other parameter setting is intensity which is a rate of energy 

delivered per area (Watt/cm 2 ). The high intensity means the temperature of the tissue 

will be increased faster. Generally coupling agents or ultrasound gel is required for a 

better contact between ultrasonic probe and skin. The movement of probe in figure 8 or 

circular manners at the speed of 4 cm per second is recommended. Stationary 

placement of the probe over the skin can induce hot spot or tissue damage therefore 

movement of probe is to prevent those complications. Contraindications of therapeutic 

ultrasound include the application overacute inflammation area of the incision or injury 

sites, neoplasia, pregnant uterus, eye, etc. The therapeutic ultrasound may be used to 

treatmuscle and ligament sprain, synovitis, tendinitis, bursitis, adhesion, scar formation 

and contracture (Canapp, 2007). 

Low level laser used in rehabilitation belongs to class 3 with the wavelength range 

varied from 600-1000 nm. It is believed that the energy derived from low level laser will 

be absorbed into the cells being treated and will stored as ATP. The cells utilize ATP for 

protein synthesis in tissue regeneration and repair. The biological effects of low level 

laser have been reported to stimulate collagen synthesis, angiogenesis, cartilage and 

bone healing. The uses for reduction of inflammation and pain have also reported 

(Canapp, 2007). The power of energy delivered by low level laser equipment is 

expressed in a term of milliwatts of power. The equipment with high milliwatt capacity 

will takes less time to generate energy amount. The setting parameter for low level laser 

therapy is amount of energy delivered to an area unit or joule per square centimeter 

(J/cm 2 ). The varying therapeutic dosages have been documented for different purposes. 

The parameter settings for acute (24-72 hours post injury or surgery), subacute (more 

than 72 hours post injury or surgery) and chronic injury are recommended at the level 

less than 2, 3-4, and 5-8 J/cm 2 , respectively (Canapp, 2007). The indications for low level 

laser therapy include treatments of bursitis, tendinitis, capsulitis, arthritic conditions, 

tendon and ligament injury, muscle sprain and strain, and chronic wound. The 

applications of low laser therapy should be avoided in the neoplastic condition and 


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pregnancy. The other contraindications include applications near eye, thyroid and 

growth plate. 

The methods of electrical stimulation arewidely used in the rehabilitation for orthopedic 

or neurological patients. Transcutaneous electrical neuromuscular stimulation (TENS) is 

to pass low level electrical current transcutaneously via surface electrode to stimulate 

the nerve. The main purposes of TENS are to modify pain and inflammation. By this 

method, the pain threshold or pain pathway can be altered. The electrical currents can 

be optimized for each individual to alleviate acute pain and inflammation by delivering a 

high frequency of 80-150 Hz (Canapp, 2007). However a low frequency less than 10 Hz 

setting is more appropriate for chronic pain. The size of electrical stimulation padneeds 

to be selected based on the area treated and size of patient. Adequate amount of gel is 

required for conductance of electricity without any need for shaving the area of 

application.The concept of neuromuscular electrical stimulation (NMES) is to use the 

electrical current to sensitize the motor end plates and to allow nerve depolarization 

followed by muscle fiber activation and contraction. The aim is to enhance the ability of 

muscle contraction in order to regain muscle strength after injury. Multiple parameters 

may need to be adjusted including frequency, amplitude, pulse duration, ramp, 

waveform, on/off time and polarity of electrode. These parameter settings need to be 

modified for each patient to ensure the smooth, strong and comfortable contraction of 

muscle. One electrode should be placed at the point of insertion of the target muscle 

and the other electrode should be placed on motor pointof the muscle which usually 

situates at mid belly (Canapp, 2007). The beneficial effects of NMES have been studied. 

The NMES demonstrated its effects on skeletal muscle by increasing of the aerobicoxidative 

potential, augmentation of muscle fiber and enhance capillary perfusion. 

These effects will improve the performance of muscle in terms of increasing strength, 

muscle mass and oxidative activities. 

Therapeutic exercise is considered a crucial part of rehabilitation to improve function 

and performance of the locomotor system. It should be incorporated into rehabilitation 

program to restore the strength, endurance, balance, propioception, and flexibility of 

the patient after injury or post surgery. Not only the locomotor system will benefit from 

the exercise, the cardiovascular and pulmonary functions will be improved as well. At 

the early phase of the rehabilitation program, the protocol may consist of physical 

modalities such as cryotherapy, heat application, low level laser therapy, therapeutic 

ultrasound or electrical stimulator. When pain subsides, range of motion exercise may 

be started in order to restore the range of motion of the joint. Later on the other 

therapeutic exercises should be included in the treatment protocol. The prescription of 

appropriate type and duration of exercises should be varied according to the condition 

treated, age and health status of the patient. Each type of the therapeutic exercise has 

its specific goal of treatment. Range of motion exercises either passive or active ones 

will help improving the movement of the joints. Joint manipulation from flexion to 

extension in passive range of motion exercise should be performed gently and slowly. 

The pattern should mimic the natural gait pattern which will be helpful in reeducating 




neuromuscular function (Saunders, 2007). The therapist should observe any signs of 

discomfort and pain such as turning the head toward the therapist, moving the leg away 

or vocalization. The number of repetition and the frequency can be adjusted according 

to the condition of patient and affected joint. In general 15-20 repetitions per a set of 

exercise and 2-4 sets of exercise per day are considered to be sufficient (Millis et al., 

2004). Stretching technique can be applied at the position of full flexion or extension 

when performing passive range of motion exercise. The aim of this technique is to 

stretch the connective tissue structures including muscle, musculotendinous unit and 

periarticular tissue to regain flexibility and extensibility. This will eventually allow a 

greater range of motion of the joint. Fibrotic adhesion, myostatic contracture and scar 

formation can be prevented and managed by appropriate stretching exercise if timely 

prescribed. To perform static stretching technique, a therapist holds the joint in static 

manner for 15-30 seconds at the joint position that the target muscle and connective 

tissue are stretched. Balance exercise may start at the early stage when the patients can 

ambulate (Millis et al., 2004). At the initial phase of recovery, patients may be assisted 

to stand as long as their muscle can support. Once the strength is regained, 3-leg 

standing by holding one leg at a time for 10 seconds may enhance the strength of 

muscle (Saunders, 2007). Some devices may be useful for balance training such as 

rehabilitation disc which is unstable surface for balance training. The stabilization 

exercise can be performed through standing on a rehabilitation ball. The patient has to 

stabilize whole body on the ball while the therapist slowly and gently rocks the ball side 

to side or forward and backward. Several groups of muscles will be utilized during this 

activity. Not only the strength will be regained but also balance and propioception will 

be retrained as well. Weight bearing exercise can be done through many activities such 

as leash walking, land tread mill exercise and standing on rocking platform or 

rehabilitation ball. By using these devices, the strength of the affected limb will be 

augmented due to weight shifting between the affected and unaffected limb 

(contralateral limb). Aquatic therapy or hydrotherapy is one of the most useful and 

enjoyable rehabilitation activities for most canine patients. Buoyancy of the water is the 

force that supports the body making less weight bearing force on the limbs. Hydrostatic 

pressure from the water helps reducing edema. Movement in the water will enhance 

muscle strength and range of motion of the joints. Several orthopedic conditions are 

benefit from swimming including osteoarthritis, fracture (with internal fixation), muscle 

sprain, tendon or ligament strain (Millis et al., 2004). The swimming duration need to be 

adjusted according to the orthopedic condition and cardiovascular status of the 

patients. A set 2-5 minutes swimming can be performed several times a day in 

swimming pool or natural lake or stream (Levine et al., 2004). However safety issues 

should be concerned. The patient should not be left unattended in water alone. Some 

dogs are reluctant to swim therefore more appropriate type of aquatic therapy should 

be selected. Walking on underwater treadmill is one of the best choices. The patients 

will gain muscle strength, better range of motion, cardiovascular endurance, 

propioceptive ability and weight bearing capacity from this activity. The depth of water 

can be adjusted to yield different amount of upward force derived from buoyancy effect 

of the water to support weight bearing. Standing in water at the level of the hock, the 


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stifle and the hip weigh 91, 85 and 73% of the body weight respectively (Saunders, 

2007). The speed of the treadmill and walking time can be adjusted to control the 

intensity of exercise. Some underwater treadmills are equipped with jet stream which 

provides water current flow in the direction to resist the body movement. This 

resistance facilitates the strength and endurance training. When the locomotor function 

of the patient improves, the water level can be decreased and the speed can be 

increased to enhance weight bearing capacity, strength and endurance. 

In conclusion, the treatment protocol is the most important part of rehabilitation 

program. Understandings of the nature of injury, wound healing and tissue repair, type 

of surgical treatment, anticipated result and prognosis, rehabilitation techniques and 

compliance of the client and patient are crucial factors to consider in establishment of 

an effective protocol (Adamson, 2004). The standard process of patient management 

consists of 5 elements including examination, evaluation, diagnosis and prognosis. These 

5 elements should be performed thoroughly prior the development of specific 

rehabilitation protocol.Appropriate physical modalities and therapeutic exercises should 

be selected and incorporated into the treatment protocol based on the functional 

deficits and rehabilitation needs of the patient. 

References 

Adamson, CP., Levine, D., Millis DL. and Taylor RA. Putting it all together: principle of 

protocol development. In Canine rehabilitation and physical therapy. pp 426- 

432. St. Louis, Missouri, USA, Saunders. 

Canapp, DA. (2007). Select modalities. Clinical Techniques in Small Animal Practice, 22: 

160-165. 

Edge-Hughes, L. (2007). Hip and sacroiliac disease: selected disorders and their 

management in physical therapy. Clinical Techniques in Small Animal Practice, 

22: 183-194. 

Hesbach, AL. (2007) Techniques for objective outcome assessment. Clinical Techniques 

in Small Animal Practice, 22: 146-154. 

Levine, D., Rittenberry L. and Millis DL.(2004) Aquatic therapy.In Canine rehabilitation 

and physical therapy. pp 264-288. St. Louis, Missouri, USA, Saunders. 

Millis DL., Lewelling, A. and Hamilton S. (2004) Range-of-Motion and stretching exercise. 

In Canine rehabilitation and physical therapy. pp 228-243. St. Louis, Missouri, 

USA, Saunders. 

Pfeifer, M., Sanaki, M., Geusens, P., Boonen, S., Preisinger, E. and Minne, HW. (2004). 

Musculoskeletal rehabilitation in osteoporosis: a review. Journal of Bone and 

Mineral Research, 19: 1208-1214. 

Saunders, DG. (2007). Therapeutic exercise. Clinical Techniques in Small Animal Practice, 

22: 155-159. 

Shumway R. (2007). Rehabilitation in the first hours after surgery.Clinical Techniques in 

Small Animal Practice, 22: 166-170. 




Lohmander, LS. and Tugwell, P. (2008). OARSI recommendations for the management of 

hip and kneeosteoarthritis, Part II: OARSI evidence-based, expert consensus 

guidelines.Osteoarthritis Cartilage. 16:137-162. 


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Zoonotic helminthiases -- here and there -- " 

Yukifumi Nawa, MD, Ph.D. 

Professor-emeritus, University of Miyazaki, Japan 

Invited Professor/Consultant 

Research Affairs Division, Faculty of Medicine, Khon Kaen University 

E-mail: yukinawa@kku.ac.th, yukifuminawa@gmail.com 

Introduction 

Many parasitic diseases are zoonotic in nature. While some zoonotic helminthes are 

cosmopolitan parasite distributing worldwide, some others are living in a limited narrow 

areas. In addition, even if the distribution of a parasite is comparable in the natural life, 

the prevalence of human cases might be quite different due to the different behavior of 

the residents in relation to their socio-economical, cultural and educational status. 

Moreover, due to globalization, the increase in number of travelers/immigrants has 

been causing global dissemination of zoonotic helminthiases. Nowadays zoonotic 

helminthiases are emerging here, there and everywhere. Under such a situation, 

medicals and veterinarians should share their knowledge and collaborate together to 

develop new cutting edges for prevention, control andtreatment of the disease.In this 

review, I would like to show just some examples of the emerging tasks of zoonotic 

helminthiases to be solved by Thai scientists. A few representative zoonotic 

helminthiases are listed and discussed in the alphabetical order. 

Angiostrongyliasis 

Angostrongyliasis can be seen where people prefer to eat freshwater snails. Taiwan and 

some Pacific islands including Hawaii have long been known endemic areas. Recently 

this disease is, emerging the coastal areas of mainland China with several large 

outbreaks (Wang et al., 2002). This emergence is considered to be due to the recent 

introduction of HongKonese, Taiwanese or even Japanese dishes, which occasionally use 

raw snail meats. May be along with the global warming and the expansion of cargo 

shipping, both the intermediate snail hosts and the rodent final hosts carrying this 

parasite are spreading from subtropical to climate zone. The mainland Japan used to be 

a non-endemic area of A. cantonensis, this parasite can be seen in many cites in Japan. 

Recently Tokiwa et al. (2012) reported that, using small subunit (SSU) ribosomal (r) RNA 

and mitochondrial cytochrome c oxidase subunit I (coxI) gene sequences as molecular 

markers, they identified 2 distinct SSU genotypes (G1 and G2) and 8 distinct coxI 

haplotypes (ac1 to ac8). By phylogenetic analysis for coxI sequences, some isolates in 

Japan were related to Pacific isolates, and some related to those of mainland China. 

Interestingly, some haplotypes found in Japan were not able to correlate to other Asian 

populations. International collaboration is necessary to elucidate such orphan isolates. 

Moreover, Thailand has some minor and rare Angiostrongylus spp., A. siamensis and A. 

malaysiensis in wildlife. Their relation to other Angiostrongylus spp. and their 

pathogenicity to humans should be explored in future. 




Dilofilariasis 

Dilofilariasis is an accidental infection with the larval stage of Dilofilaria spp., which is 

transmitted by mosquitoes. Two species, D. immitis and D. repens are known as the 

major human pathogen. While D. immitis infection is common in Asia and North America, 

D. repens infection is common in Europe and South Asia. As its common name “dog 

heart worm, Dirofilaria adult worms lodge in the pulmonary artery to the right ventricle 

of dogs. In humans, D. immitis larvae also mainly found in the pulmonary artery. 

However, D. repens is found mainly in the subcutaneous connective tissue of humans. 

Including both species, the infection rate in dogs is estimated to be 5-30% in dogs with 

the predominance in developing countries. In Thailand, recently Boonyapakorn et al. 

(2008) reported that the estimated prevalence of dirofilariasis in dogs in Chiang Mai is 

18.2% (15-21%; 95% CI). When we looked at the global prevalence of human pulmonary 

dirofilariasis, the results is astonishing with the extreme predominance in Japan and US 

compared to the other countries. In Thailand, only few human cases (including 

cutaneous dirofilariasis by D. repens) have been reported. The situation is much the 

same in other Asian countries. 

Diphylobothriasis 

Diphylobothriasis is an infection with a fish tapeworm, Diphylobothriumlatum (in 

Europe) or D. nihonkaiense (in Japan) by eating uncooked/semi-cooked fillet of 

salmonoid fishes as “Sushi” or “Sashimi”. Infective stage of the parasites, prelocercoids, 

reside in the muscles of the intermediate host salmonoid fishes and, once they were 

ingested by humans or some mammals like bears, they become adult worms of 4-5 m 

length in the intestine of the hosts. Because of the distribution of the intermediate host 

fish, diphylobothriasis is primarily a disease of cold climate areas. However, along with 

the popularization of “Sushi” and “Sashimi” and the development of cold chain 

transportations, diphylobothriasis is no longer a disease of north, because, sporadic 

cases have been found recently in India, Malaysia, Indonesia and Taiwan. Even a 

possible case of a Japanese boy infected with D. nihonkaiense in Switzerland was 

reported (Shimizu et al. 2008). Since the importation and consumption of raw salmon 

dishes is increasing in Thailand, it is not surprising that diphylobothriasis case(s) could 

happen right now in this country. 

Gnathostomiasis 

This disease is primarily known as the representative of cutaneous larva migrans (CLM) 

caused by several species of genus Gnathostoma. In Asia, G. spinigerum is the major 

pathogen to cause human diseases. Although this species distributed widely in Asia, 

patients have been found mainly in Thailand and Japan where people prefer to eat 

freshwater fish in raw. In addition, G. hispidum, G. doloresi and G. nipponicum are 

distributed in Asian countries and are proven to be pathogenic to humans to cause larva 

migrans. However, human infections with those 3 species were only found in Japan, but 

nowhere else (Nawa 1995). In Thailand, G. hispidum and G. doloresi were proven to 

distribute in the wildlife, but the confirmed human cases of infection with those species 

have never been reported. Moreover, in Thailand, two rare Gnathostoma species, G. 


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malayanum and G. vietnamicumwere recorded in the past. Neither their pathogenicity 

to humans nor their molecular phylogenetic status among genus Gnathostoma remains 

to be solved. 

In terms of clinical aspects, over 100 cases of CNS involvement have been recorded in 

Thailand, but the CNS gnathostomiasis is extremely rare in other countries albeit 

gnathostomiasis is endemic in many countries (Katchanov et al. 2011). In contrast, ocular 

gnathostomiasis have been reported from several countries like Japan, Mexico and India 

with the almost comparable numbers of cases seen in Thailand (Nawa et al. 2010). The 

discrepancy of the epidemiology of CNS and ocular gnathostomiasis needs some 

explanation. 

Sparganosis 

Sparganosis is one of the unique and common zoonotic helminthiasis in Asia. The 

patients are mainly found in China, Japan, Korea and Thailand. In Thailand, over 50 

cumulative cases have been reported (Anantaphruti et al. 2011). In terms of the clinical 

manifestations, subcutaneous tissues are the preferential sites affected. However, due 

to the nature of larva migrans, varous organs/tissues can be affected. Interestingly, 

ocular sparganosis is prominent in China and Thailand, whereas cutaneous cases are 

predominant in Japan and Korea. One important reason for this is that as a part of 

traditional medicine, frog muscles have been commonly used as the poultice in China as 

well as Thailand. In these countries, direct invasion of the parasite through 

ocular/periocular soft tissue is the major cause of infection. In Vietnam, large numbers 

of such cases have been reported in the 1930s but none in the recent years. Whether 

this is a true figure or just a lack of statistical data should be checked carefully. 

Toxocariasis 

This is the most representative zoonotic helminthiasis to create keywords of ocular larva 

migrans (OLM) and visceral larva migrans (VLM). Infection occurs by ingesting eggs or 

larvae of dog and/or cat ascarids, Toxocaracanis or T. cati. Infection rates in dogs/cats 

are still high even in the developed countries because of the difficulties of control of this 

parasite due to their unique lifecycle of transplacental and/or colostrum infections. 

Generally, toxocariasis is considered as the disease of children infected by pet puppies. 

However, the situation in Japan is quite different from other countries where the peak 

prevalence was seen at the middle age people (Akao et al., 2007). By retrospective study, 

the majority of those Japanese toxocariasis cases were supposed to be infected by 

eating raw chicken/bovine liver as “Sashimi”. In Thailand, the prevalence of Toxocara in 

dogs is much higher than Japan with the prevalence of 3.4% in adult dogs and 37.5 % in 

puppies (Rojekittikhun et al., 1998). Nevertheless, human toxocariasis cases are only 

rarely reported in this country, in spite that human cases of dog hookworm infection 

have been more frequently reported (Inpankaew et al., 2007). 




Conclusion 

This is just a quick glance of zoonotic helminthiasis in and outside of Thailand. 

Nevertheless, you will be able to see some key issues to develop new cutting edge for 

further research work. Epidemiological studies often reveal the significant difference of 

the prevalence of human cases in spite of equally high endemic areas. The factors affect 

such variance is quite variable from disease to disease. From the access to the 

diagnostic systems to the human behavior, we should examine carefully with the 

multidisciplinary collaboration. In particular, close collaboration between medicals and 

veterinarians are necessary for elucidate the real figures of zoonotic helminthiasis. 

References 

Akao, N. and Ohta, N. (2007) Toxocariasis in Japan. ParasitolInt 56: 87-93. 

Anantaphruti, M.T., Nawa, Y. and Vanvanitchai, Y. (2011) Human sparganosis in 

Thailand: An overview. Acta Trop. 118:171–176. 

Boonyapakorn, C., Srikitjakarn, L., Morakote, N., Hoerchner, F. (2008) The epidemiology 

of Dirofilaria immitis infection in outpatient dogs at Chiang Mai University 

Small Animal Hospital, Thailand. Southeast Asian J Trop Med Publ Health. 

39(1): 33-8. 

Inpankaew, T., Traub, R., Thompson, R.C., Sukthana, Y. (2007) Canine parasitic zoonoses 

in Bangkok temples. Southeast Asian J Trop Med Publ Health. 38: 247-55. 

Katchanov, J., Sawanyawisuth, K., Chotmongkol, V. andNawa, Y. (2011) 

Neurognathostomiasis:a neglected parasitosis of nervous system. Emerg Infect 

Dis 17(7):1174-80. 

Nawa, Y., Katchanov, J., Yoshikawa, M., Rojekittikhun, W., Dekumyoy, P., Kusolusuk, T. 

andWattanakulpanich, D. (2010) Ocular Gnathostomiasis: A comprehensive 

review. J Trop Med Parasitol 33: 77-86. 

Nawa Y. (1991) Historical review and current status of gnathostomiasis in Asia.Southeast 

Asian J Trop Med Public Health. 1991 Dec;22 Suppl:217-9. Review. 

Rojekittikhun, W., Nuamtanong, S., Anantaphruti, M.T., Pubampen, S., Maipanich, W., 

Visedsuk, K. (1998) Toxocara and Gnathostoma among stray canines in 

Bangkok.Southeast Asian J Trop Med Publ Health. 29: 744-7. 

Shimizu, H., Kawakatsu, H., Shimizu, T., et al. (2008) Diphyllobothriasis nihonkaiense: 

Possibly acquired in Switzerland from imported Pacific salmon. Internal 

Medicine 47: 1359-1362. 

Tokiwa, T., Harunari, T., Tanikawa, T.et al., (2012) Phylogenetic relationships of rat 

lungworm, Angiostrongylus cantonensis, isolated from different geographical 

regions revealed widespread multiple lineages. ParasitolInt (in press, 

E-pubaheaddoi : 10.1016/j.parint.2012.02.005). 

Wang, X-T., Huang H-J., Dong Q-Q., Lin Y., Wang Z-M., Li, F-Q., Nawa Y. and Yoshimura, K. 

(2002) A clinical study of Eosinophilic meningoencephalitis caused by 

angiostrongyliasis. Chin Med J 115: 1312-1315. 


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Food Safety as EssentialVeterinary Practice next decade 

Prapansak Chaveerach, D.V.M., Ph.D. 

Faculty of Veterinary Medicine 


e-mail: chaveerach@kku.ac.th 

Increasing food consumption number has been demonstrated for all countries. Due 

to the increasing number of people in the world, it is more urgent task on the 

livestock production to serve the need. While the veterinary task on the safe food is 

very important to certify, inspection and assessment of risk at farm level untilfinal 

products. Meat is an important nutrition of diet of many people and is responsible 

for a significant number of foodborne disease outbreaks in developed and 

developing counties. Residues of all used drugs in the livestock and farm are 

responsible to cause health concern due to food contaminant. It is well known that 

food of animal origin is served for all. At the beginning, livestock farming is taken 

care by veterinary profession to make sure that the healthy animal has been reared 

and send to the slaughtering until becoming the safety food products for 

consumption. From farm to table concept is important to prevent the hazard 

substance or agents contaminated into the food. From the meaning given by WHO, 

veterinary public health is a component of public health activity devoted to the 

application of professional veterinary skill, knowledge and resources for the 

protection and improvement of human health (WHO/FAO, 1975).It is obvious that 

food of animal origin is closely related to veterinary task. 

Development of Veterinary Public Health (Van Knapen F, 2002). 

In the phase 1, the beginning of 1900 the need of food and transportation was need 

obviously. Then veterinary job could focus on the cure or eliminate a particular 

disease like Rinderpest and Anthrax. Food of animal origin produced by farmer was 

objective to security for the country and utilization benefit of transportation. Most of 

the time drugs were used to cure and treat the diseases. The agriculture pattern was 

found in small scale using self-resources. This phase may be called Food security 

because the food particularly served for man, energy and power mainly. 

Then, in the phase 2, around the mid of 1900, meat inspection has been implement 

to control zoono-parasitic disease like Trichinellosis, Echinoccosis and so on. The 

zoonotic disease outbreak came across the particular countries, so it has been 

revealed that the traditional meat inspection and the quality inspection of carcass 

and product and was huge pronounced in developed countries. The regulation and 

law in many developed countries has been started at the early 1950 and implement 

on the food chain effectively. Veterinary intervention methods, aim to control and 

prevention disease at farm, have been intensively focused to use ofdrug and 

vaccination regime. The result has been demonstrated that the risk of particular 

disease has been decrease significantly. However, the emerging disease like 

Campylobacter, Salmonella, bird flu, BSE has recently been making people fear and 

very concern at the national and global level. Also biotechnology on health science 

has been developed to allow on the veterinary diagnosis and control the disease has 




been done successfully. It has been called in the term of Food safety. What kind of 

food that the people need to consume during this period of time? The food could be 

safe in principle, looking good, healthy and finally feel wealthy. The quality 

guarantee process on the food chain has been developed such as HACCP, GAP, GMP 

and risk assessment. So, in the food chain as veterinary task, a local veterinary, 

veterinary diagnosis at farm and animal hospital or meat inspection, veterinary 

clinical pathology on diagnosis has been concern. People in developed countries 

reveal trend to accept the consumption of safe food under the certain measurement 

previously. Food safety campaigns from government authority in many countries 

have been doing to push and implementation eventually in the national and 

international trade market. 

In the phase 3, since now, increasing population, economics, education and high 

demandof safe meat makes change of the pattern of animal husbandry and behavior 

of meat consumer. However, in this period the use of drug and chemical in the 

agriculture or livestock in order to prophylaxis and prevent the disease has been 

intensively operation. However, the demand of people really needs to have healthy 

food, happy animal, friendly environment. By the results of researching, 

biotechnology on molecular and detection method has been developed so fast. Also 

the environment protection and animal welfare is very concern in the modern 

livestock. So, safe food is not enough for the consumer. From now on, trust, 

confidential and guarantee on the food products is strongly committed for 

communication. In many countries, the control system and prevention caution such 

HACCP, GMP, GAP and risk assessment plays an important role on the primary 

production level throughout the global trade market.This phase 3 is leading the 

modern animal husbandry, innovation of food production process, legislation and 

identification of animals at farm, good farming practice, good veterinary practice, 

monitoring and surveillance and certification system. These results effect on human 

health directly. Therefore, veterinary education curriculum has been focus more on 

public health of veterinary school in Europe (Lipman LJ and van Knapen F., 2009). 

With intensive husbandry and high demand quality and quantity of meat, veterinary 

task on this phase has been slightly change into global work skill as epidemiologist, 

risk analyst and cooperate with health scientist but the veterinary task in phase 2, 

slaughterhouse unit, pathologist, meat inspection and so on is still need to be 

completed the certification. Adaptation of governance authority has been set in 

order to meet the international standard. However, the cultural practice influenced 

by multidisciplinary, lifestyle, the way of eating, behaviors, education, career and 

economics plays an importance role to select the food of consumer.Recently, food is 

not only nourishment but also does traditional cuisine and social occasion. These 

influence on people behavior to accept or choose the variety of food, not only a safe 

food. It was found that consumer perception on food risk is difference from food 

authority and stakeholder (Ellen van Kleef et al., 2006). Food acceptance may be 

activity of the commitment between consumer and stakeholders. However, it may 

be also become argumenton the trade barrier at international level, if it has not been 

clearly understood and well preparation. By general veterinary task on food safety is 

empower to responsibility of human health. Therefore, the certain veterinary 

profession in the food process should present the transparency, honest and ethical. 


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Moreover, there has been concern about the transgenic food, GMO, residues 

toxicant food and risk of hazard the bacteria. Hence, in veterinary school, specific 

topic on epidemiology, meat inspection and risk assessment on food chain should be 

emphasis on the veterinary curriculum. 

Challenge on Public Health 

Foodborne disease by contamination of Salmonella, Campylobacter, Listeria and 

others (viral and parasitic protozoa) is global human health problem causing illness 

and economics loss. Increasing of number of illness in developed and developing 

countries is found.WHO estimated the mortality of foodborne disease, killed 2.2 

million people annually, most of them were children. A huge international trade and 

tourist is risk of distribution of the disease. Experienced of BSE (mad cow disease) 

and dioxin in Europe has been demonstrated that the disease could be easily spread 

and caused panic atmosphere. Drug and chemical used in the livestock that could 

release to environment around the farm and may expose into food chain. Surface 

water and waste product from farm is harbor to be the source of contamination. 

Veterinary Public Health Task 

Foodborne pathogen commonly comes from animal origin and environment which is 

easily contaminated into the food. Salmonella, Campylobacter, Shigella, 

Staphylococus, Vibrio, Listeria, E. coli O157:H7 are caused human diarrhea showing 

severe clinical sign particularly in young, elderly and immunosuppressive people. 

Most bacteria have been found in environment and non-clinical sing animal. For 

example, Salmonella and Campylobacter are the important pathogen on food chain 

causing human diarrhea, typhoid fever, severe gastroenteritis after consumption of 

the contaminated food. It is known that poultry is heavily contaminated with 

pathogen bacteria like Salmonella and Campylobacter while chicken show no clinical 

sign. It is assume that progeny could then pass the pathogen into young broilers via 

eggs. The bacteria stay in the broiler and be shed in to the environment. There are 

full of the bacteria in their gut after the transmission in the flock. The prevalence of 

Salmonella and Campylobacter in chickens is high in industry purpose. From the 

point of view veterinary intervention, without using antibiotic in feed, the strict 

biosecurity measurement on farm, it is opportunity to discover the best of choice to 

concern. The study showed that high biosecurity on farm could reduce the 

prevalence of Salmonella or Campylobacter in broiler farm. Moreover, freepathogen 

chicken breeder has also been practiced in many countries. Alternative 

measurement such as probiotic, prebiotic, vaccination and bacteriocin use to avoid 

residues and unwanted substanceare onward to be developed in the field. There is 

demonstrated that hygiene management and prevention method of farm level is 

current veterinary administration to cove with the pathogen bacteria. 

The purpose of the use of chemical, antibiotic, hormone and artificial substance, in 

farm animal is to prophylaxis and growth promoter. A ton of intensive drug use, 

penicillin and tetracycline in feed animal in pig or chicken every year is found. It may 

cause residues in meat if withdrawal time before slaughterhouse is not meet. It also 

created a breeding ground for multidrug resistant bacteria, superbug. However, non 

contaminant chemical in meat is indeed preferable for consumer. The regulation on 




the control of these forbidden substances in the Europe Union to monitor certain 

substance in live animal and animal products is compulsory (MilagroReig and Fidel 

Toldrá, 2007). In practicing, veterinary authority needs a responsible farmer or 

industrial part, feed and food technologist to work closely in operating under the 

strict regulation and law. To prohibit using of veterinary drug, it may cause low 

productivity and disease outbreak in animal but itis challenge veterinary professional 

to look for the possible intervention and control regime at farm. Analytical measure 

for residue analysis of veterinary drugs and growth promoting agents in food 

product process is valuable for the control as well. New test technology should be 

developed on accuracy in order toavoid the dispute on the trade. Instruments 

method as HPLC, GC, or bioassay and the combine of bioassay and immunoassay 

demonstrating high sensitivity and specificity result have been recognized to be the 

high standard detection method of the veterinary drug and other toxicant from 

environment samples (Codex). However, resulting new toxicant has been recognized, 

the consequence in food on human health is nation and international implication. 

In phase 3, by economics status, fear of residues in meat, new concept of 

consumption concerning about safe food of animal origin is spread globally by 

increasing number of travelling and international trade. On the other hand, if 

contaminated food with harmful virus or bacteria has been distributed to other 

counties, the public health could be consequence worst. Obviously, local livestock 

with specific disease somewhere could have been caused disease outbreak across 

the world. For example, bird flu, H5N1, is mortal virus, carried by broiler chicken 

could be spread rapidly form the curtain country to others. Therefore, the animal 

should have been reared under hygiene circumstance at the farm at all time. To 

achieve the goal, the good cooperation among professional is need. Industry sector, 

veterinary profession, farmer, medical, epidemiologist and food technologist are 

responsible of food safety. 

Also, the use of antibiotic or anabolic substance in feed of animal husbandry is 

prohibited though industrial and developing countries by laws and regulations. 

Under intensive livestock, animal can produces cortisol hormone accumulated in 

meat or other organs which could be harmful after the human consumption for a 

period of time. Then, a good management on husbandry following the role of animal 

welfare could reduce the stress of the animal given low level of the cortisol 

hormone. The role of animal welfare has been focus on companion and livestock 

animal to give animal free of 5 domains, freedom from discomfort, hunger and 

thirst, fear and distress, pain and injury and natural behavior. In many counties, the 

ethical husbandry has been announce and accomplished. There may be on the trade 

argument in near future. Moreover, becoming equality international standard there 

will strongly change a veterinary profession direction on the way of veterinary 

practice. 

For epidemiological purpose, to control and prevention the disease on current 

veterinary practice of a large scale and intensive husbandry makes it complication. 

Consumer demand next decade, food acceptance not only safe food but also worth 

nutrient of healthy (food is wealthy), will help a veterinary, producer agricultural 


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industry and farmer to response of guarantee and certify the quality food product. 

The whole process of food will be monitored and surveillance. Many quality certified 

systems have been experienced such as GAP, GMP, HACCP, ISO and so on, 

internationally. The argument of these resulting regulations on international trade 

may occur. This quality assurance may be inter-trade barrier near future. Although 

the diversity of location, business scale, plan pattern the safe food is the equal 

opportunity for individual consumer, generally risk assessment basedon scientific 

evidence of specific topic will be widely acceptable. 

Thailand Condition 

By diversity of biological, suitable climate, managed land, Thailand is potential 

harbor for agriculture. High technology on animal husbandry and disease control, 

reliability slaughter unit and potential labor is globally accounted for the exported 

food country. In particular poultry exporter, Thailand is the one producing chicken 

meat for world consumption. Under the quality base, Thai food producerhas been 

obligatory followed by the regulations. Veterinary task on epidemiology should 

pursue on the quantitative method to prevent and control the disease successfully. 

For example, guarantee system need to be good preparing managed data in the food 

process correctly and veterinary intervention need to use of free antibiotic and 

unwanted chemical in animal feed. It is challenge to discover a new strategy to 

control the disease, in particular burden disease like Salmonella and Campylobacter 

causing human health and economics. Using epidemiological study based on risk 

assessment result, if the prevalence of Salmonella in chicken is completed lower 

than 1 percentage, it could adequately control by other methods. In contrary, 

Campylobacter presents in the chicken cecum in high number but not yet such as 

method could control the bacteria successfully. New strategy focusing on the 

combination of high biosecurity and other potential methods may cove with the 

bacteria. In spite of no currently success method to control the bacteria, risk analyst 

could have been in process to conduct the possible risk on the consumption of the 

poultry for the trade. 

However, social and behavior factor has been influence on the way of lifestyle 

regards to foodborne disease. By general people of western countries, rich people 

are risk of mild intestinal disease because of their lifestyle, show to prefer to have 

raw food or mishandling of food while poverty experience with serious condition 

causing life-threatening such as infant diarrhea, typhoid fever, fluke infection and 

finally high mortalityin young people, elderly, immunosuppressive people is indeed 

found. In Thailand, the data on rich and poor people related to foodborne disease is 

unknown. It is possible that privileged have trended to buy a safer food. 

Organic livestock under natural environment, animal welfare regime and free from 

the use of chemical in animal feedcould create the food of animal origin for 

consumption safer. These husbandry farms have been increased in number of 

Europe and somewhere of USA area. However, when animal get back on ground 

during rearing period, it is a high opportunity to get the disease and dangerous 

parasitic pathogens from the environment as well. Therefore, the cure using drug 

and chemical direct to the animal may be unavoidable although the vaccination has 




been done. Clearly, the safe food of organic animal should be similar to the animal 

reared by the intensive husbandry. So, many regulations and laws as above should 

be followed rigorously. 

Conclusion 

Development of veterinary task is demonstrated in 3 phases followed by the purpose 

of food production as food security, food safety and food acceptance. Decision 

making of people on consumption of food of animal origin is bear to have safe food, 

healthy animal and friendly environment. The quality assurance is very important to 

communication. Certification and risk assessment will play a role on the food process 

in order to trade globally. Concerning practice of veterinary profession is needed to 

focus on the quantitative epidemiology, risk analysis and multidisciplinary work. 

References 

Codex Alimentarius Commission. Joint FAO/WHO Food Standards Programme, 

Residues of veterinary drugs in food, Volume 3. 

Ellen van Kleef, Lynn J. Frewer, George M. Chryssochoidis, Julie R. Houghton, Sara 

Korzen-Bohr, Thanassis Krystallis, Jesper Lassen, UwePfenning and Gene 

Rowe. 2006. Perceptions of food risk management among key stakeholders: 

Results from a cross-European study. Appetite. 47(1); 46-63. 

Lipman LJ, van Knapen F. 2009. Integrating the issues of global and public health into 

the veterinary education curriculum: a European perspective. Rev Sci Tech. 

Aug;28(2):745-51. 

MilagroReig and Fidel Toldrá. 2007 Veterinary drug residues in meat: Concerns and 

rapid methods for detection. 

http://dx.doi.org/10.1016/j.meatsci.2007.07.029 

Van Knapen F. 2002. Veterinary public health: past, present, and future. Vet Q. Apr; 

22(2):61-2. 


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Emerging and Reemerging Infectious Diseases: Biocomplexity as an 

Interdisciplinary Paradigm 

(EcoHealth Journal 2005,p244-257) 

Bruce A. Wilcox 1 and Rita R. Colwell 2 

1 Division of Ecology and Health, Department of Tropical Medicine, Medical Microbiology, and 

Pharmacology, John A. Burns School of Medicine,University of Hawaii, Honolulu, HI 96826 

2 Institute for Advanced Computer Studies, College of Computer, Mathematical and Physical 

Sciences, University of Maryland, College Park, MD 20742 

e-mail: wilcox.bruce@gmail.com 

Abstract 

Understanding factors responsible for reemergence of diseases believed to have 

been controlled and outbreaks of previously unknown infectious diseases is one of 

the most difficult scientific problems facing society today. Significant knowledge gaps 

exist for even the most studied emerging infectious diseases. Coupled with failures in 

the response to the resurgence of infectious diseases, this lack of information is 

embedded in a simplistic view of pathogens and disconnected from a social and 

ecological context, and assumes a linear response of pathogens to environmental 

change. In fact, the natural reservoirs and transmission rates of most emerging 

infectious diseases primarily are affected by environmental factors, such as 

seasonality or meteorological events, typically producing nonlinear responses that 

are inherently unpredictable. A more realistic view of emerging infectious diseases 

requires a holistic perspective that incorporates social as well as physical, chemical, 

and biological dimensions of our planet’s systems. The notion of biocomplexity 

captures this depth and richness, and most importantly, the interactions of human 

and natural systems. This article provides a brief review and a synthesis of 

interdisciplinary approaches and insights employing the biocomplexity paradigm and 

offers a social–ecological approach for addressing and garnering an improved 

understanding of emerging infectious diseases. Drawing on findings from studies of 

cholera and other examples of emerging waterborne, zoonotic, and vectorborne 

diseases, a ‘‘blueprint’’ for the proposed interdisciplinary research framework is 

offered which integrates biological processes from the molecular level to that of 

communities and regional systems, incorporating public health infrastructure and 

climate aspects. 

Keywords: emerging infectious diseases, complexity, disease ecology, 

global environmental change, climate variability 

Introduction 

Understanding the mechanisms that underlie newly emerging and reemerging 

infectious diseases (EID) is one of the most difficult scientific problems facing society 

today. EIDs are diseases that have recently increased in incidence or in geographic or 

host range (e.g., tuberculosis, cholera, malaria, dengue fever, Japanese encephalitis, 

West Nile fever, and yellow fever), diseases caused by new variants assigned to 




known pathogens (e.g., HIV, new strains of influenza virus, SARS, drug resistant 

strains of bacteria, Nipah virus, Ebola virus, hantavirus pulmonary syndrome, and 

avian influenza virus), and bacteria newly resistant to antibiotics, notably the 

multiple resistant strains that render the armamentarium of antibiotics useless 

(Smolinski et al., 2003). 

Fundamental questions persist concerning molecular mechanisms and specific 

cellular processes involved in pathogenesis, as well as transmission dynamics and 

epidemiology, of pathogens that cause some of the most studied of the reemerging 

infectious diseases, such as tuberculosis, malaria, and cholera. Newly emerging 

diseases caused by entirely novel or previously unrecognized pathogens, such as 

HIV/AIDS, SARS, and hantavirus, or those whose modes of transmission are currently 

under study, as in the case of Ebola and Nipah, represent yet another significant 

challenge. Certainly the mechanisms or processes of disease emergence involve 

factors in addition to those at molecular and cellular levels. These include climate, 

rainfall, ocean and air circulation patterns, and extreme weather events, as well as 

the ecology of the pathogens’ reservoirs and vectors, namely those factors 

associated with larger-scale mechanisms and the dynamic behavior of ecosystems in 

which parasite (pathogen) and host relationships are embedded (Horwitz and 

Wilcox, 2005). Still other factors are involved, and must be identified, if a truly 

holistic framework is to be constructed that incorporates factors related to human 

and societal mechanisms. 

Demographic and social changes, along with associated environmental alterations, 

and even the efforts to control disease, have contributed to the severity of the 

problem of EIDs (Wilcox and Gubler, 2005). The use of antimicrobials, pesticides, and 

biological controls predictably are effecting changes in pathogens, hosts, and 

ecological systems, and often unwittingly facilitating disease emergence or 

reemergence (Lederberg et al., 1992; Gubler, 1998; Burroughs et al., 2003; Knobler 

et al., 2003; Smolinski et al., 2003). Antibiotic resistant Strepococcus A and E. coli 

0:157 are prime examples. Pathogens and their hosts, including humans, reproduce, 

grow, and adapt in an environmental context, devastatingly exemplified by the avian 

influenza threat (chickens, ducks, pigs, and humans in close confines). This context is 

most accurately captured using a holistic or systems perspective, considering subsystems 

at different levels of organization—those at lower levels embedded within 

those at successively higher levels — including social as well as physical, chemical, 

and biological components. 

This view, applied to the extraordinary depth and richness of living systems, 

spanning the scale of microbial genomes to the regional ecosystems populated by 

humans and reservoir species, evoked the term biocomplexity (Colwell, 1998). 

Several investigators, including social scientists, conceived and elaborated on similar 

themes using different terminology. Ecological and social scientists working on 

ecosystem and natural resources management challenges refer to ‘‘social–ecological 

systems’’ (Berkes and Folke, 1998; Berkes et al., 2003) or ‘‘human and natural 

systems’’ (Gunderson and Holling, 2002). The contraction of social–ecological 

systems, ‘‘socioecological systems,’’ has been used to describe this same systems 


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perspective, stressing coupled human–natural systems and complexity theory, in the 

context of health and emerging infectious diseases (Waltner-Toews, 2001). The 

hyphenated or contracted terms share with biocomplexity an emphasis on the 

interaction of humans and nature as a complex system, and arguably embrace what 

is fundamentally the same paradigm. For convenience in this article, we will refer to 

‘‘human–natural systems perspective’’ as synonymous with ‘‘biocomplexity.’’ We 

also note these ideas, including those associated with ‘‘eco-epidemiology’’ 

expressing the need for a broadened concept of causality in epidemiology (Kaufman 

and Poole, 2000), are part of a larger emerging paradigm called ‘‘post-normal 

science’’ by some investigators (Ravetz, 1999). 

In this article, we draw from our own research and the results of a recent meeting 

entitled Social–Ecological Systems and Emerging Infectious Diseases, that was part of 

the National Institutes of Health Roadmap initiative, Research Teams of the Future, 

the purpose of which was to examine EIDs through the lens of this new paradigm. 

The objective of this meeting was to facilitate interdisciplinary research on the 

problem of emerging and reemerging infectious diseases. Our aim here is to provide 

a short review and synthesis of these interdisciplinary approaches and insights 

emerging from the meeting and reported in the recent literature. We use the case of 

cholera, the current scientific understanding of which currently provides a basis for 

the most complete human–natural systems model of any EID, and a complementary 

model based on zoonotic and vectorborne EIDs in general. Together, with two 

published EID case studies from this meeting, a framework is developing that has 

significant potential for explaining the phenomenon of global infectious disease 

emergence. We believe the approach has significant bearing on the interdisciplinary 

methodology of emerging infectious disease research, and suggests future research 

directions, as well as prospects for managing infectious disease emergence. 

New EID Research Paradigm 

Two complementary views or general models of emerging infectious disease have 

developed, based on the human natural systems perspective: one centered on and 

illustrated by the case of cholera and the other which builds on the accumulating 

cases of mainly reemerging zoonotic and vectorborne diseases. Cholera is historically 

the most studied infectious disease, since the discovery of its etiology established 

the theory of communicable diseases and the field of epidemiology (Snow, 1855). 

The relatively recent discovery (Huq et al., 1983; Colwell, 1996) of the connection of 

cholera with the natural environment and ecological processes has dramatically 

broadened the scope of cholera research. With a few exceptions, zoonotic and 

vectorborne diseases are, in general, readily understood as having links with the 

natural environment. However, the connection between their epidemiology and 

ecosystem dynamics or processes, not to mention coupled human–natural system 

behavior, is only now beginning to be appreciated. Some EIDs like SARS, Ebola, even 

HIV/AIDS, and the more recent and disturbingly potentially disastrous avian 

influenza (Aldhous and Tomlin, 2005; Osterholm, 2005) are diseases that effectively 

originate as zoonotic parasites or pathogens whose transmission cycles can become 

completely uncoupled from their animal reservoirs. 




Biocomplexity and the case of cholera 

The most significant challenge in what has come to be called sustainability science 

(Kates et al., 2001), is reaching across and connecting disciplines toward 

understanding the complex chemical, biological, and social interactions in the 

systems comprising our planet. In pointing this out, the term ‘‘biocomplexity’’ was 

introduced to capture the depth and richness and interaction of society and natural 

systems (Colwell, 1998). The coining of this term embraces a wide variety of goals 

and phenomena that Pickett et al. (2005) summarized to include: 

(a) links across the sciences; 

(b) the linkage of biological and physical processes; 

(c) the wide scope of various methodological approaches; 

(d) the inherent complexity of the Earth, including global scales and the 

human components of systems; 

(e) environmental problem solving; 

(f) a foundation in systems and chaos theories; and 

(g) the creation of order in nature. 

The imperative for such a paradigm can be described in terms of the global context 

that now frames all health issues, and specifically in the case of one infectious 

disease, namely cholera, and the environment (Colwell, 2004). The world has 

become so integrated and global (with international arrivals per year in the U.S. 

alone in the hundreds of millions), that the notion that a disease can be completely 

eradicated has become simplistic. Infectious disease is a moving target, and as the 

climate, as well as other sources of natural or anthropogenic environmental 

variation changes, any disease that has an environmentally sensitive stage, reservoir, 

or vector will be affected. Thus, the simplistic view must be expanded to recognize 

that neither ecosystems nor the pathogens that live in them respond linearly to 

environmental changes. Moreover, many environmental events such as climate 

change and seasonality, but particularly associated meteorological and 

oceanographic events, are inherently unpredictable by present models. The 

expanding field of global climate research must include the human dimension, i.e., 

infectious diseases. Incorporating a prediction based on signals from climate models 

into health measures can thereby provide new opportunities for proactive, rather 

than reactive, approaches to public health. 

Cholera provides possibly the best example of how our understanding of an 

emerging infectious disease has evolved from a linear reductionist model focused on 

oral– fecal transmission of a waterborne bacterium and a human host, to a vastly 

more complex, yet accurate ecological model of an infectious disease. This model 

includes global weather patterns, aquatic reservoirs, bacteriophages, zooplankton, 

the collective behavior of surface attached cells, an adaptable genome, and the deep 

sea, together with the bacterium and its host (Huq et al., 1983; Colwell, 1996; 

Faruque and Nair, 2002; Merrell et al., 2002; Huq et al., 2003; Lipp et al., 2003; Louis 

et al., 2003; Zampini et al., 2003; Espeland et al., 2004; Gil et al., 2004; Huq et al., 

2005). 


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A study of the coast of Peru has provided new insights in this regard. Here, cholera 

surfaced in 1991 after a century of absence in Latin America. Cholera has recurred in 

Peru since then, following a seasonal pattern, with the greatest number of cases in 

summer (June–March) in Lima and other major cities along the coast. The detection 

of V. cholerae followed both ambient and sea surface temperature increases and 

coincided with, or preceded, annual outbreaks of cholera in summer (Huq and 

Colwell, 2003; Lipp et al., 2003). Off the Peruvian coast, there was a significant 

correlation between cholera incidence and elevated sea surface temperature from 

October 1997–June 2000, which included the 1997–1998 El NinÕ event (Gil et al., 

2004). This link suggests that an early-warning system for cholera risk could be 

established for Peru and neighboring countries. Although not related directly, both El 

NinÕ events and cholera outbreaks have increased since the 1970s. This pattern has 

emerged in both Peruvian waters and the Bay of Bengal. Sea surface temperature 

and height, as well as plankton blooms, can be remotely sensed and thus used to 

forecast outbreaks of cholera (Colwell, 1996). 

In addition to laboratory and satellite studies, social science has contributed to our 

understanding of cholera. Sari cloth, available even in the poorest household, was 

found to be useful for removing the cholera bacteria attached to particulates and 

plankton from water for households, including drinking water, in Bangladesh. 

Laboratory studies showed that old sari cloth folded at least four times filtered out 

more than 99% of the V. cholera attached to plankton. A 3-year study in 65 villages 

in Matlab, Bangladesh, demonstrated the incidence of cholera was roughly half 

among those who used sari filters compared to the control (Colwell et al., 2003). 

The full picture of cholera from a human–natural systems perspective has clearly 

come together recently, based on the sea surface temperature (SST) and sea surface 

height (SSH) correlations with disease outbreaks (Colwell, 1996; Lobitz et al., 2000; 

Pascual et al., 2000). The linkage of disease cycles over a four decade time series 

with regional climate, rainfall, river discharge, and flooding has now been 

demonstrated (Koelle et al., 2005). This body of research establishes the linkages 

across time and space scales in the dynamics of the regional system, the pathogen, 

and nonlinear human susceptibility levels. The picture that has emerged is that of a 

causal chain involving regional climatic patterns, river basin rainfall variability, river 

discharge and flooding, and transmission variability. The interannual variability 

shows a strong correspondence to climate patterns at long periods (for over 7 years 

for monsoon rains and Brahmaputra river discharge) and at shorter periods (under 7 

years for flood extent in Bangladesh, sea surface temperatures in the Bay of Bengal, 

and the El NinÕ Southern Oscillation). Calkin and Colwell [unpublisheddata] have 

developed a predictive model that has provenuncannily accurate (Fig. 1). 




Figure 1.Time series comparison of predicted and observed cholera incidence in 

Matlab, Bangladesh, 1998–2002. Predicted Cholera Rate is calculated based on sea 

surface temperature and sea surface height data measured by satellite remote 

sensing data, and chlorophyll. Cholera Incidence Rate is actual incidence. Based on 

Calkin and Colwell [unpublished data]. 

Comparison with leptospirosis and other waterborne EIDS 

Another globally reemerging waterborne disease, leptospirosis, the subject of one of 

three methodological case studies during in the recent Social–Ecological Systems and 

Emerging Infectious Diseases meeting (Lewis, 2005; Vinetz et al., 2005), could not be 

more dissimilar to cholera in its biology and in the epidemiological and basic 

research attention received. Yet striking similarities with cholera are surfacing that 

suggest its emergence follows a similar pattern of coupled human–natural system 

dynamics. Outbreaks commonly are associated with seasonal rainfall and floods, and 

like cholera, according to local knowledge held by taro farmers (Vinetz et al., 2005), 

with drought conditions. If confirmed, this would lend further support to a disease 

emergence model incorporating the effects of anthropogenic environmental change 

on the hydroecology of natural drainage basins (local watersheds or river basins), 

contributing to decreased ecological resilience and, thereby, an increased frequency 

of extreme floods and droughts (Kaneshiro et al., 2005; [Wilcox et al., unpublished 

data]). Even without an increase in climate variability predicted to occur with 

anthropogenic global climate change, the interaction of natural rainfall variability 

with land use changes (e.g., increasing impervious surface area associated with 

urbanization) can explain, and is predicted to contribute to, both increased flood and 

drought conditions. Either appears to promote pathogen spread and survival in the 

environment, host–host transmission, higher prevalence in host reservoirs, increased 

environmental contamination by pathogenic bacteria shed by hosts, and the 

increased risk of human exposure as a causal chain. 

This explanation of how climate patterns and rainfall variability interact with land 

and ocean processes to increase both the pathogen reservoir ‘‘pool’’ and the 

frequency of human contact with pathogens, may be generally applicable to other 

emerging infectious diseases caused by waterborne pathogens (Campylobacter, 

Cryptosporidium, Cyclosporidium, norovirus, rotavirus, and even Escherichia coli). 

Human activity contributes through mechanisms linked across vastly different time 

and space scales: human behavior and exposure to contaminated water in the 

household, village, or city; river basin, drainage basin, or catchment managementespecially 

related to agriculture-affecting water quality, pathogen survival, and 

transport; and global climate change potentially causing more extreme weather 

conditions, including storm and rainfall variability in general (Curriero et al., 2001). 


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Human mediated transport of these pathogens and their variants can be added as a 

global scale mechanism. Expressing these relationships, which produce nonlinear 

behavior, including the abrupt and as yet unpredictable changes in microorganisms, 

their ecology, and the infectious diseases they cause, is very difficult. However, a 

human–natural systems perspective has begun to provide some insights into how to 

approach the problem of at least predicting the circumstances that facilitate disease 

emergence. Combining what cholera has taught us with the model of reemerging 

zoonotic and vectorborne diseases described below may provide the basis for a 

general theory of infectious disease emergence. 

Model of zoonotic and vectorborne EIDS 

A human–natural systems perspective also has been used to explain zoonotic and 

vectorborne EIDs (Wilcox and Gubler, 2005). A theoretical framework or ‘‘blueprint’’ 

depicted in Figure 2, describes disease emergence as involving biological processes 

operating on the scale of molecules and cells to that of coupled, regional-scale, 

human–natural systems. Yet it stresses the demographic and social drivers of 

regional environmental change spreading geographically across the globe, as well as 

the failure of disease control and public health policy. Urbanization, agricultural 

intensification, and habitat loss and alteration, in particular, driven by population 

growth and consumption, characterize the model. In general, this blueprint stresses 

the role of regional environmental change described by land use transformations 

and their drivers (population, technological capacity, and sociocultural organization). 

These transformations have acted in concert with inadequate or inappropriate 

policies or methods of vector control and disease prevention that have unwittingly 

promoted disease emergence. The changes taking place (at the second and third 

levels in Fig. 2) affecting pathogen and host ecology and evolution (e.g., selection for 

insecticide and antimicrobial resistance) include public health agencies’ actions, or 

inaction. These ecological-evolutionary dynamics are micro-scale in time and space. 

However, the cumulative effect of these microscale processes involving pathogen 

and host adaptation, and range expansion (or reexpansion), ultimately can produce 

regional and even global consequences. 

This blueprint places more of an equal emphasis on human and natural system 

behavior. In particular, it emphasizes the interaction of regional environmental 

change and declining public health infrastructure that has occurred on a dramatic 

scale in tropical developing regions in recent decades. Thus, in the same period and 

places in which the most significant human–environmental transformations have 

been taking place in recent history, divestment in public health infrastructure, 

including in effective hygiene and disease control measures, has also been occurring. 

This is an elaboration on the argument that institutional factors, combined with 

dramatic changes in demographic and social conditions, including an exponential 

increase in global transport, are responsible for much of the global emerging 

infectious disease problem (Gubler, 1989; 1998; 2002a,b). In fact, this view is 

complementary with that described for cholera and leptospirosis above. But it 

emphasizes more strongly the role of regional environmental change largely 

associated with urbanization, agricultural intensification, and natural habitat 

alteration, rather than the role of climate variability (presently observed or that 




predicted due to anthropogenic global climate change). Geographic shifts in vectors, 

effects of temperature change on pathogens and transmission rates, and other 

factors predicted by global climate change models (including increased climate 

variability) potentially will magnify disease emergence already caused by these 

human–natural system dynamics, again an argument for the holistic perspective. 

Figure 2. Blueprint illustrating environmental factors associated with emergence of 

disease. Regional environmental change, which is influenced significantly by 

population growth, resource consumption, and waste generation, plays an important 

role in the emergence of infectious disease, especially in tropical developing regions. 

Associated land use and transformation of resource production (urbanization, 

agricultural expansion and intensification, and natural habitat alteration), have 

produced changes in ecological systems, notably in landscapes and, in turn, their 

natural communities and ultimately in their pathogen, animal host, and human 

populations. Thus, the altered ‘‘host-pathogen’’ dynamics facilitate novelty, 

including exchange of genetic material among pathogens, resulting in rapid 

adaptations by the pathogens and more frequent generation of novel pathogen 

variants. Some will be more virulent, infective, and/or capable of enhanced 

transmission, contributing to disease reemergence or emergence. Factors related to 

public health infrastructure and climate variability, and their interactions with 

regional environmental change, also contribute significantly to disease emergence. 

In addition to natural climate variability and climate shifts, the climate change 

contribution of global warming may well contribute further to disease emergence. 


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Pathology of Disease Control 

The emphasis on inadequate or inappropriate institutional actions (or inactions) 

coupled with the response of vectors, pathogens, and ecological systems (which in 

many cases are believed to provide natural control mechanisms), is particularly well 

suited to the application of the body of theory derived from the social ecological 

systems and resilience literature, developed mainly to explain failures in natural 

resource management systems. This theory, centered on the so-called adaptive cycle 

has been used to help explain why, in most cases, such management efforts have 

failed (e.g., most managed fisheries have either collapsed or have been over-fished, 

and efforts to control floods or pests frequently have resulted in worse floods or 

pest outbreaks). It also has been applied, in a very limited but promising degree, to 

the problem of infectious disease emergence (Holling, 1986;Holling et al., 2002). 

Other investigators (Waltner-Toews, 2001) have also described the imperative to 

consider EIDsfrom a complex, coupled human–natural systems perspective. 

In fact, a ‘‘syndrome’’ has been described, called the‘‘pathology of regional 

development and ecosystem management,’’in which a causal chain of events is 

precipitated by human action, followed by natural system reaction, etc. (Gunderson 

et al., 1995). This could be extended to emerging infectious diseases and be termed 

‘‘the pathology of infectious disease control.’’ The basic features of the new 

synthesis by Holling (2001) and Holling et al. (2002) aremost readily explained in 

terms of the definitions of the core concepts involved (Table 1). A remarkable 

feature ofthis ‘‘model’’ is its demonstration of how disease emergence results from 

the interaction of variables on vastly different time and space scales, as alluded to 

above (Fig. 2). While pathogen life cycles and human infection events, for example, 

act as ‘‘fast variables’’ with periodicities on the scale of days, weeks, or less, regional 

environmental and global climate change represent ‘‘slow variables’’ with 

periodicities on the scale of decades or longer. These variables interact through the 

mediation of cross-scale influences, for example, floods or drought, and their 

increased severity because of the loss of ecological resilience arising from 

anthropogenic land use change. The regional environmental change model of 

disease emergence and the ecological resilience model noted above, that 

incorporates the role of extreme weather events, readily integrate into a single 

general model that largely explains the current global EID phenomenon. It may 

provide a basis for developing future scenarios, including those incorporating an 

increased frequency of extreme meteorological events predictable from 

anthropogenic global temperature increase. 




EIDs, emerging infectious diseases; SES, social–ecological systems. 

Holling (1986), and subsequently Holling et al. (2002), used this theoretical 

framework to explain the resurgence of malaria in Africa. Janssen and Martens 

(1997) took a similar approach, developing a model simulating malaria prevalence, 

taking into account adaptation of the vector and parasite and adaptive management 

in the application of insecticide according to mosquito abundance. However, the 

‘‘adaptive cycle’’ of Holling et al. (2002) reflects the lack of adaptive management. It 

metaphorically describes a chain of events characteristic of coupled human–natural 

systems whereby the social and economic environment changed (more development 

became possible in areas protected from malaria by vector control programs), 

followed by a narrowing of the agencies’ goal (socioeconomic initially), from the 

agencies’ objective to spray insects and reduce mosquito populations and treat the 

human population, to that of distributing insecticide or antimalarial drugs. However, 

the persistent reduction in mosquitoes led to gradual increases in the number of 

people susceptible to malaria and mosquitoes resistant to insecticide. The objective 


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to control the vector and disease succeeded, until the system itself evolved to a less 

resilient state producing, paradoxically, less control of the vector and disease, ending 

up with a return of episodic outbreaks of malaria. 

Reemergence of Dengue as a Human–Natural System Phenomenon 

The subject of case study during the recent Social–Ecological Systems and Emerging 

Infectious Diseases meeting, dengue is a classic reemerging infectious disease from 

which much can be learned by using a human–natural systems perspective. Although 

new infections are reported annually on a lesser scale (approximately 50 million) 

than cholera and malaria, dengue has become one of the most troubling global 

infectious diseases, because it is reemerging at a faster rate, with a more severe 

form (dengue hemorrhagic fever), than perhaps any other. As summarized by Spiegel 

et al. (2005) and described previously (Gubler, 1997; Pinheiro and Corber, 1997), 

dengue fever and dengue hemorrhagic fever (DF/DHF) has gone from being an 

insignificant health problem 20 years ago to one of the world’s most important 

global public health problems today. Clearly, the interaction of key policy changes in 

vector control strategy with dramatic changes in demographic and social conditions 

accompanying unplanned urbanization can be concluded to be responsible for 

reemergence of DF/ DHF in the Americas (Gubler, 2002a). 

An arboviral (arthropod transmitted) virus, transmission of dengue is dependent 

entirely on the mosquito Aedes egypti; herein lies the fundamental biological factor 

contributing to this pathogen’s success. Outside its native range in Africa from which 

it spread (and ultimately the dengue virus with it) centuries ago, A. egypti’s 

adaptability to domestic environments, including its capability of readily breeding 

inside dwellings, makes the disease difficult to control in the absence of integrated 

‘‘top-down’’ and ‘‘bottom-up’’ vector control programs, beginning virtually at the 

neighborhood level. A. egypti had been, in fact, all but eliminated from Latin America 

by the 1970s, but its geographic distribution has since re-expanded and now extends 

from Paraguay to the U.S.–Mexico border. While many governments and agencies 

carried out ineffective, if any, vector control programs, the mosquito’s habitat 

(human settlements) and the virus’ host population (humans) grew exponentially. 

Ironically, reducing dengue to its pre-1970’s level will require a vastly greater effort 

than before. This time, not only will it require a much higher level of planning and 

coordination of vector control efforts, but many of the same challenges facing global 

sustainability: increased rates of human migration, driven by poverty and political 

instability, and sprawling and overcrowded cities, where unscreened housing, dense 

residential areas with large numbers of household breeding sites (e.g., nonbiodegradable 

containers), and absence of waste management, sewer and water 

systems, produce ideal conditions for mosquito breeding. 

Examining the history of DF/DHF and a number of country-level programs in the 

Americas and Asia and using Biocomplexity and Emerging Infectious Disease 251a 

social-ecological system perspective, Spiegel et al. (2005) identified a number of 

important elements of successful control programs. Without going into detail, but 

relevant to this discussion, is the fact that the elements identified, using this 

approach, largely reflect what would have been required to avoid the system failure 




that is suggested by‘‘pathology of disease control.’’ That is, adaptability, both of 

programs to control the mosquito vector’s changing behavior and to educate the 

public, addressing local toregional scale in the control efforts and the capacity to 

learn from experience, were found to be critical elements absent from the failed 

programs and key in the successful programs. Barriers (defined in Table 1) to their 

development and sustainable implementation include lack of interdisciplinary 

cooperation, reinforced by differences in valuesheld by the different players and the 

failure to take into account the complexities of coupled ecological and socialsystems. 

Toward a general theory 

The case of cholera, along with the preliminary studies of the disease ecology of 

leptospirosis, and the cases of malaria and dengue fever, all share a number of 

features. First, their resurgence generally was not predicted, and can be 

characterized by what social-ecological systems theory calls ‘‘surprise’’ the 

unexpected result (Table 1) of the abrupt, nonlinear or discontinuous behavior 

characteristic of ecosystems arising, for example, from interaction between key 

variables that operate at distinctly different scales-a faster variable interacting with 

slower variables. Spatially contagious processes, such as epidemics that spread 

geographically, occur only when there is an interaction among a trigger, a pathogen 

jumping to a new intermediate host, or a human infection event (a fast variable), 

and a sufficiently large and connected population of susceptible hosts or humans (a 

slow variable). Thus, demographic, social, and landscape transformations occurring 

on the scale of a regional system over a period of decades or more, interact with 

changes in host–parasite/pathogen dynamics that occur on the scale of a single 

watershed or catchment area, with a periodicity of days or months. 

How these cross-scale mechanisms produce regional or global-scale disease 

emergence patterns is outside the realm of conventional epidemiology or analytical 

approaches generally. Such cross-scale processes are, however, characteristic of 

ecosystems (Holling, 1992) and coupled human–natural systems (Gunderson and 

Holling, 2002; Berkes et al., 2003), whose dynamics are influenced by the interaction 

of variables and dynamics operating on vastly different time and space scales that 

involve natural processes discontinuously distributed, as shown in Figure 3. An 

essential component of this dynamic, not easily conveyed visually (at least within the 

graphical representation of time and space scales), is that of resilience as a variable, 

both in the human and natural sub-systems comprising the human–natural 

environment (or social–ecological system) as a whole. This can be envisioned as the 

increased or diminished capacity of the system to absorb impacts of periodic events, 

whose timing and location is inherently unpredictable, at least at the level of current 

scientific understanding and available models. For example, deforestation lessens 

the capacity of a watershed or river basin to absorb storm events and prevent 

excessive runoff that is laden with nutrients and/or pathogens contributing to 

disease emergence. Similarly, narrowly focused and inflexible bureaucracies are 

unable to detect and learn from such events, so as to be able to respond with 

appropriate measures that either address the problem of lost resilience in the 

natural environment or increased vulnerability of human populations to infections, 

outbreaks, or epidemics-as the pathogen expands from a local toward a global scale, 


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via cross-scale influences. The spread of waterborne pathogens by flooding and 

other pathogens by human migration, transport, or other spreading modalities, is 

illustrated by the widening plume in the center of the space-time graph (Fig. 3). 

Figure 3.Time and space scales of demographic units, disease processes, and 

environmental events. Climate variability and meteorological events, with distinct 

periodicities and occurring on specific geographic scales, interact with the dynamics 

of the pathogen–host (human populations in this example) that occur on similar 

scales. For example, a local windstorm or rainstorm can disperse mosquitoes or 

waterborne pathogens within a locality. Factors, such as social behavior and specific 

environmental conditions that are characteristic for a given human population, can 

determine whether or not a disease agent will flourish in an environment and be 

transmitted among hosts, including humans, in a particular settlement. 

Meteorological events that affect the environment, such as seasonal monsoon rains 

or the El NinÕ Southern Oscillation (ENSO), which occur on a larger scale in time and 

space, can induce drought or flood conditions. The result can be the spread of a 

disease agent(s), setting the stage for epidemics, the occurrence of which will, in 

turn, depend on human population factors, such as human behavior and the level of 

herd immunity. Additional variables can facilitate disease emergence, i.e., increased 

connectivity created by urbanization, increased rate of regional migration, and global 

transport; and/or decreased social and ecological system resilience, resulting, for 

example, in more severe and larger scale impacts of the meteorological event. 

Connecting climate change and the effects on human health 

The complexity and uncertainty associated with global climate change and its effect 

on disease incidence and distribution have proven challenging from both the 

research and policy standpoints. As a public health issue this can, unfortunately, be 

misconstrued as suggesting a lack of consensus among experts that the potential 

human health consequences-though as yet not clearly demonstrated-are of 

significant concern (Colwell et al., 1998). Uncertainty, due both to an incomplete 

picture of how climate and pathogens interact as well as the complexity inherent in 

human–natural systems, has been a major factor. Moreover, few longitudinal 

disease databases are long enough in time to study long-term trends required to 




monitor health effects of climate change. However, the progress made in 

understanding cholera’s reemergence and that of zoonotic and vectorborne EIDs 

generally, has been significant and has, to some extent, begun to reduce uncertainty. 

Most modeling of the effects of climate change have been done with the focus on 

malaria (e.g., Martens et al., 1999; Rogers and Randolf, 2000), the only zoonotic and 

vectorborne EID for which adequate climate change or variability models and 

surveillance data of sufficient resolution were available (van Lieshout et al., 2004), at 

least until recently (e.g., Hales et al., 2002; Brownstein et al., 2005). Though at first 

considered too simplistic (Rogers and Randolph, 2000), the malaria models have 

attempted to incorporate an increasing realism, taking into account altitudinal 

instead of latitudinal shifts alone, and the adaptive capacity of public health 

infrastructure, in addition to socioeconomic conditions (Haines and Patz, 2004; van 

Lieshout et al., 2004). The MARA (Mapping Malaria Risk in Africa) project is one such 

example. Derived maps of malaria suitability (based on climate) were compared with 

previously collected, independent data including surveys, site visits, parasite rates, 

and spleen rates gathered in several East African countries and providing a more 

thorough validation than past climate-malaria modeling (MARA/AMRA, 1998). 

Excluding any increase in population, an increase of 16%–28% in person-month 

exposure to malaria risk by year 2100 was determined (Tanser et al., 2003). In spite 

of these improvements and the availability of increasingly high resolution geographic 

data, the reliability of projections for vectorborne diseases, in general, has been 

hampered by the complex and nonlinear dynamics of the relationship between the 

vector population and disease prevalence. This is a result of the interactions 

between transmission rates, the rate of development and duration of temporary 

acquired immunity, and the age structure of the population, for which the field data 

are too limited to resolve (Rogers et al., 2002). 

However, even with such data, the inability of present modeling approaches to 

capture the uncertainty, nonlinearity, and the cross-scale nature of pathogen– 

vector– human host relationships—and the ecosystems in which they are 

embedded—represents a major challenge. Nor can current modeling approaches 

account for locally or regionally abrupt climatic shifts that have proven societally 

disruptive in the past (Alley et al., 2003). Predicting the timing, spatial scale, and 

intensity of such shifts and their effects on transmission rates, host susceptibility, 

socioeconomic conditions, and public health infrastructure defies conventional 

analytical modeling. However, some projections for malaria have incorporated 

measures of ‘‘adapative capacity’’ based on expert opinion (van Lieshout et al., 

2004). This notion has received recent attention, due to the coastal disasters in 

South Asia and the U.S., producing qualitative indicators of resilience (Adger et al., 

2005). These potentially are quantifiable and could at least provide a basis for 

assessment and predictions of local- and regional- scale social–ecological resilience 

in response to the effects of abrupt change. 

Although progress awaits better and more field surveillance data and modeling 

methods that combine the power of multivariate statistical analysis with the realism 

of complex systems thinking, a significant amount of ecological theory and empirical 


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data exists that link anthropogenic environmental change and pathogen emergence. 

Moreover, the validity and robustness of some of the key relationships, including the 

quantitative expressions describing them, are beyond dispute. For example, the 

mechanisms involved and the relationship of species extinction to habitat loss, in 

general (Rosenzweig, 1995), and the case of tropical forest, in particular (Laurence 

and Bierregaard, 1997), are relatively well understood, empirically demonstrated, 

and follow quantitative rules that are among the most thoroughly documented in 

ecology. The effect of climate change on habitat in terms of latitudinal and 

altitudinal shifts resulting in the contraction in the areal extent of many types of 

habitat is virtually certain. So, too, is the corresponding reduction in the sizes of local 

and regional populations of vulnerable wildlife species. These direct impacts on 

natural ecological communities, along with the effects of urbanization and 

agricultural intensification shown in Figure 2, undoubtedly will affect pathogen 

emergence in ecosystems through multiple feedback loops linking ecosystem 

disturbance, local extinction, and disease (Harvell et al., 2002). Ecosystem-focused 

infectious disease research will require monitoring and surveillance that integrate 

wildlife and human disease (Deem et al., 2005). 

The decline or local extinction of species also diminishes ecosystem resilience 

(Chapin et al., 1997; 2005;Elmqvist et al., 2003), thus adding to their vulnerability to 

climate variability. A causal link between the present global warming trend and more 

extreme meteorological events remains to be established statistically. However, the 

interactionof the increased number and intensity of tropical storms that has been 

recently demonstrated (Webster et al.,2005), with the increased vulnerability of 

developed landscapes to floods and drought, has undeniably contributed to disease 

emergence. 

Conclusions: the challenge of forging a new paradigm 

The metaphor of biocomplexity was inspired by the interdisciplinary imperative, not 

only to integrate more completely the natural sciences, but also to understand the 

role that natural and social system interactions play in the dynamics of our planet’s 

systems and how these influence sustainability. The coupled human-natural systems 

perspective embodied in these ideas is fundamental to the development of a science 

of sustainability. As described by Kates et al. (2001), it requires addressing core 

questions, such as how these interactions can be incorporated into emerging models 

and conceptualizations of long-term trends in environment and development. What 

determines the vulnerability or resilience for particular types of ecosystems and 

human livelihoods? How can meaningful ‘‘limits’’ or ‘‘boundaries’’ be defined to 

provide effective warning of conditions beyond which nature–society systems incur 

significantly increased risk? 

No issue could be a more fundamental measure of sustainability than public health, 

and the increasing emergence and reemergence of infectious diseases globally is 

possibly the world’s most challenging public health problem today. Yet this problem 

is incomprehensible without a vastly broadened research perspective, if not an 

entirely new paradigm—one that is encompassed by biocomplexity and new 

conceptual frameworks provoking new theories and models. The body of theory 




associated with newliterature on social–ecological systems and resilience, as well as 

other schools of thought employing a human–natural system perspective show 

promise for advancing interdisciplinary agenda for research and practice aimed at 

controlling infectious diseases. 

This noble goal will not be reached easily and will require science and education 

initiatives that cross disciplinary as well as institutional, societal, and cultural 

boundaries (e.g. Kaneshiro et al., 2005), much like the case of HIV/AIDS. Clearly, 

without appreciating the complex dynamic between social and ecological processes 

so readily apparent for the diseases discussed here, and employing the related 

frameworks and perspectives, we will forego the ability to gain insights into the 

underlying causes of the recent historical upsurge in emerging infectious diseases. 

Acknowledgments 

This work was supported by conference grants from the U.S. Public Health Service, 

R13TW007300 NIH Roadmap initiative ‘‘Research Teams of the Future’’ and the 

Henry M. Jackson Foundation for the Advancement of Military Medicine 

Telemedicine and Advanced Technology Research Center (TATRC) (USAMRAA 

Emerging Infectious Disease Conference-05357001) (Principal Investigator, B.A.W.). 

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• Administration routes 

• Topical 

• Systemic 

• Injection 

• Factor considerations 

• Location of lesion 

• Owner compliance 

• Semipermeable barriers 

• Properties of drug 

Ophthalmic Drugs: General Considerations 

Preenun Jitasombuti, D.V.M., M.Sc. 

Department of Surgery and Theriogenology 


e-mail: preenun@kku.ac.th 

• Location of the lesion 

• Anterior segment: cornea, conjunctiva, ant.Chamber, iris, Post.Chamber 

and lens 

• Posterior segment: vitreous, ciliary body, choroid, retina, sclera 

• Orbit area: zygomatic salivary gr., extraocular muscle, cranial nerve, 

lacrimal gr., vascular system 

• Owner compliance 

• Time & ability 

• Manageable pet? 

• Painful condition 

• Treatment instruction*** 

• Semipermeable barrier 

• Cornea barrier 

• Conjunctiva barrier 

• Sclera barrier 

• Blood-ocular barrier 

• Ophthalmic drugs 

•Antimicrobial drugs 

• Antibiotics 

- Topical 

- Systemic 

- Subconjunctival 

• Antiviral drugs 

- Topical 

- Systemic 


• Antifungal agents 

- Topical 

- Systemic 

- Subconjunctival 



•Anti-inflammatory and immunosuppressive 

• Topical anti-inflammatory agents 

• Systemic anti-inflammatory agents 

• Subconjunctival anti-inflammatory agents 

•Glaucoma medication 

• Topical 

- Parasympatomimetics 

- Adrenergics 

- Adrenergics antagonists 

- Carbonic anhydrase inhibitors 

- Prostaglandin agonists 

• Systemic ocular hypotensive medications 


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•Cataract medication 

• N-Acetyl-L- Carnosine 

•Lacrimomimetic agents and artificial tears 

• Artificial tear 

• Cyclosporine 

• Tacrolimus 

•Sedative drug 

• Dogs 

- Diazepam 0.28 mg/kg + KETAMINE 5.5 mg/kg 

- Tiletamine/Zolazepam 6.6-9.9 mg/kg 

• Cats 

- Diazepam 0.22-0.44 mg/kg + KETAMINE 1-5 mg/kg 

- Tiletamine/Zolazepam 6 mg/kg 

•Mydriatics 

•Topical anesthetics 

“USE MEDICATIONS RESPONSIBLY” 




Acute Renal Injury: Urinary Clues to Success 

Rosama Pusoonthornthum, D.V.M., M.Sc., Ph.D. 

Department of Veterinary Medicine, 

Faculty of Veterinary Science, Chulalongkorn University 

e-mail: trosama71@hotmail.com 

Acute renal injury (ARI) or acute renal failure (ARF) is defined as a severe and sudden 

decline in glomerular filtration rate (GFR) usually with signs of uremia. ARI can be 

due to pre-renal, renal, and post-renal causes. Pre-renal ARI is a result of 

hypovolemia and decreased renal perfusion, which is usually reversible but can lead 

to irreversible renal failure. Post-renal ARI is a result of bilateral ureteral obstruction 

or urethral obstruction, which is also usually reversible but can lead to irreversible 

renal failure. Intrinsic ARI is a primary insult to or a failure of nephrons caused by 

toxins, ischemia, infectious agents, or acute on chronic failure. Animals experiencing 

ARI, except for those that have pre-existing chronic renal failure, are usually of 

normal body weight and condition and clinical signs of uremia are severe. Often 

animals in ARI are oliguric or anuric, but polyuric ARI does occur. Kidneys may be 

normal or enlarged and painful. Laboratory evaluation usually reveals a normal 

hematocrit, azotemia, hyperphosphatemia, acidosis, hyperkalemia, and 

inappropriately dilutes urine. Active sediment may be found on microscopic 

examination of urine. 

The abrupt decline in renal function occurs because of several mechanisms including 

1) afferent arteriolar vasoconstriction in response to decreased circulating volume; 

2) damaged glomerular surface area and filtration properties; 3) vasodilatation of 

efferent arteriole; 4) tubular back leak of luminal substances; and 5) tubular 

obstruction due to cell swelling, crystals, casts, and/or cellular debris. 

Causes of ARF include: 

Nephrotoxicants Substances associated with ARI include aminoglycosides, 

angiotensin-converting enzyme inhibitors, NSAID's, cis-platinum, amphotericin B, 

and ethylene glycol. These result in altered renal hemodynamics or in direct 

nephrotoxicity, which causes ARI. 

Hypercalcemia Hypercalcemia may cause or be a result of renal failure. ARI is caused 

by renal vasoconstriction, tubular dysfunction, and nephrocalcinosis. Causes should 

be explored in an animal with hypercalcemia and ARI. Treatment involves 

management of ARI and lowering of serum calcium concentration with saline 

diuresis and furosemide. 

Pyelonephritis Acute pyelonephritis may cause ARI if the bacterial infection is 

bilateral. It is usually characterized by acute febrile illness associated with large 

painful kidneys. In addition to management of ARI, antimicrobials should be 

administered for 4-6 weeks. 


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Leptospirosis ARI may occur in animals with leptospirosis without hepatic 

involvement. The organism induces acute interstitial nephritis. Treatment involves 

managing ARI and treating with penicillin followed by doxycycline for the carrier 

state. 

Neoplasia Lymphoma is the most common cause of neoplastic associated ARI, 

especially in cats. For neoplasia to cause ARI, it must involve both kidneys. 

Approximately 50% of cats are FeLV positive. Treatment involves managing ARI and 

chemotherapy; however, the prognosis is guarded and survival is shorter in cats that 

are FeLV positive. 

Urinalysis 

Apart from its potential to aid discovery of non-urinary disease (e.g., diabetes 

mellitus), a complete urinalysis is needed to screen for evidence of subclinical 

excretory pathway disorders (e.g., bacterial urinary tract infection, urolithiasis), as 

well as to provide the necessary context for proper interpretation of the results of 

tests (e.g., indices of proteinuria and azotemia) that will be used to screen for early 

renal disease or failure. Subclinical excretory pathway disorders not only occur with 

sufficient frequency to warrant efforts to detect and treat them in their own right, 

they can incite renal disease and lead to renal failure. 

Urine sediment evaluation can alert the clinician to importantproblems while the 

patient is still asymptomatic (i.e., ammonium biurate crystals, pyuria in a diabetic 

patient). Also, there are some diseases for which early detection may lead to better 

survival (ie, protein losing nephropathy). 

When collecting a free-catch urine sample, a mid-stream sample is preferred. The 

initial urine that is voided will contain cells, bacteria, and debris from the urethra 

and vulva or prepuce, and may not be a representative sample. Because female dogs 

are usually positioned with the vulva close to the ground when urinating, a shallow 

container (such as a piepan) may be helpful. The sample container should be 

cleanand free of detergent to avoid interference with the biochemical analysis. 

Samples collected from midstream into a sterile container may have false positive 

urine culture results from external contaminants (i.e., hair on prepuce or 

hindquarters). Urine samples brought in by owners are rarely suitable for urine 

culture. Quantitative analysis should be performed on all free-catch samples 

submitted for bacterial culture. 

Obtaining a free-catch midstream urine sample from a cat can be a difficult task. 

Removing the litter from the litter boxor replacing it with nonabsorbent material 

[NoSorb beads(Catco, Inc. Cape Coral, FL), plastic packing material, unpopped 

popcorn, etc.] may allow collection of a suitablesample. 

Manual expression of the bladder to facilitate obtaining a free-catch sample is rarely 

successful in awake animals and may induce vesiculoureteral reflux at pressures 

necessary to induce voiding. If the urine is infected, this introduces the risk of 

causing ascending pyelonephritis. 




Urinary Catheterization 

Male dogs are placed in lateral recumbency for catheterization. The penis is 

extruded from the prepuce, and the tip cleaned with dilute chlorhexiderm solution 

to remove any debris or discharge. Sterile lubricant is placed on the tip of the urinary 

catheter, which is then placed in the urethral orifice and the catheter advanced into 

the bladder. 

Most female dogs need chemical restraint to allow urinary catheterization. Lidocaine 

gel can be placed in the vaginal vault by syringe (without needle) to facilitate 

catheter placement without chemical restraint in some dogs. The urethral papilla is 

located on the floor of the vagina canal, and is recognizable as a subtle deviation on 

the floor. The lubricated urinary catheter is passed just under the finger on the 

urethral papilla, which helps direct the catheter down and into the urethra (Fig 2). 

Both male and female cats usually need chemical restraint to allow urinary 

catheterization. A 3.5 to 6 French catheter can be used in most female cats. After 

passing a urinary catheter to obtain a urine sample, the first few milliliters of urine 

should be discarded, as that is the portion most likely to have debris from the 

urethra. A second aliquot can then be obtained for urinalysis and quantitative 

culture if desired. The risk of creating a urinary tract infection from catheterization is 

higher in female dogs compared with males. 

Cystocentesis 

Cystocentesis is the best method for obtaining urine samples for bacterial culture 

and can be performed on awake animals. A 1 inch, 22-gauge needle is preferred, and 

for very large or obese dogs, a 1.5 to2-inch needle may be required.Iatrogenic 

hematuria can occur if the need is in contact with the opposite bladder wall. If the 

UA is being performed to monitor hematuria, a free catch sample may be preferable 

to cystocentesis or catheterization. 

Urine Color 

Normal urine is typically transparent and yellow on visual inspection. Concentrated 

urine samples may appear amber colored and dilute urine may be a lighter yellow 

color. However, urine color should NEVER be used to replace USG assessment. 

When a patient has abnormal urine color, a thorough investigation into diet, 

medications, and environment should be undertaken. The most commonly observed 

abnormal urine colors in dogs and cats are red, brown, and black with hematuria, 

hemoglobinuria, myoglobinuria and bilirubinuria being the most common causes. 

The serum color may provide information about the cause of alterations in the urine 

color. Patients with bilirubinuria will typically have hyperbilirubinemia, although 

bilirubinuria without hyperbilirubinemia can occur in normal male dogs. Cats with 

bilirubinuria in absence of hyperbilirubinemia should have serial urine and 

biochemical assessment to monitor for the development of icterus. If normal serum 

color is present, an ammonium sulfate test should be performed for myoglobin. 


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Like color, clarity of urine can be affected by urine concentration. A wellconcentrated 

urine sample is more likely to be turbid than a dilute sample. Other 

things that can increase turbidity include white blood cells (WBC), red blood cells 

(RBC), crystals, bacteria, mucus, lipid, and contaminating materials. 

Urine Volume 

The daily volume of urination reported by an owner is an important determinant of 

which portion of the urinary tract should be investigated. A patient that has disease 

limited to the lower urinary tract will present with signs of stranguria (difficult 

urination) or pollakiuria (abnormally frequent urination) that could easily be 

mistaken for polyuria (excessive volume of urine) by an owner. Diseases of the 

urinary bladder or urethra alone do not cause polyuria. The presence of polyuria 

would imply that either the upper urinary tract is thesource of the problem (ie, 

kidneys) or there is another metabolic problem causing the excessive urination (ie, 

diabetes mellitus, Cushing’s disease, etc.). It is often difficult for owners to discern 

between pollakiuria and polyuria. The easiest way to get around this would be to 

have the owner quantitate water consumption for a few days. A normal dog should 

drink 1 oz per pound per day. 

Urine specific gravity 

Specific gravity is defined as the ratio of the weight of a volume of liquid to the 

weight of an equal volume of distilled water. Recent studies have documented that 

specific gravity is not affected by storage.It is accepted that a dog with normal renal 

function will have a USG > 1.030 and a cat > 1.035. 

Hyposthenuria is defined as a USG



Biochemical Analysis 

Urine dipstick analysis is a convenient method of assessing several biochemical 

aspects of urine. Urine pH can give an indication about renal disease (ie, tubular 

acidosis) or systemic acid-base status, and urine pH affects the solubility of several 

types of urinary crystals. 

Blood, Hemoglobin Myoglobin 

The heme portion of hemoglobin and myoglobin acts as a peroxidase and can cause 

a color change on a reagent test strip. Most test strips candetect 5 to 20 RBC/mL or 

0.015 to 0.062 mg/dL of free hemoglobin (equivalent to 5-20 RBC/mL). About 0.5 mL 

blood per liter of urine (approx. 2500 RBC/mL) is necessary for visual detection of 

hematuria. Up to 5 RBC/mL of urine is considered normal in people. False positive 

reactions may occur if the sample is contaminated with oxidizing agents in 

disinfectants. False negative reactions may occur if RBCs have settled to the bottom 

of the sample, leading to a disparity between the dipstick and sediment evaluation. 

RBCs will lyse in dilute (USG

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tubular disorders, such as acute tubular necrosis, pyelonephritis, Fanconi’s 

syndrome, or primary renal glucosuria, can lead to normoglycemic glucosuria. 

Ketone 

The primary ketones encountered in small animals are acetoacetic acid, acetone, and 

ß-hydroxybutyric acid. There agents are sensitive to the effects of moisture, heat, 

and light, so the container should be kept closed when not in use. Ketones are 

produced from fatty acid metabolism. Poorly controlled diabetes mellitus is the most 

common reason for their development, but starvation, a high protein and low 

carbohydrate diet, and some drugs can also cause ketonuria. 

Bilirubin 

When hemoglobin is degraded, the heme portion is converted to bilirubin, which is 

conjugated in the liver and excreted in the bile. Some conjugated bilirubin escapes to 

the circulation and is filtered by the glomerulus and appears in the urine. The kidney 

can metabolize hemoglobin to bilirubin and secrete it in dogs but not in cats. The 

practical sensitivity of bilirubin reagent sticks is reported to be 0.4 to 0.8 mg/dL. 

Small amounts of bilirubin are normal in dogs, but bilirubinuria is never normal in 

cats. Bilirubinuria tends to be higher with extrahepatic biliary obstruction compared 

with intrahepatic disease. 

Urobilinogen 

Conjugated bilirubin is excreted into bile then degraded by intestinal bacteria into 

urobilinogen. Most of the urobilinogen is then oxidized to urobilin, but a small 

amount is reabsorbed and excreted in the urine. Urobilinogen is unstable and stored 

urine samples yield inaccurate results. Urobilinogen is a normal finding. 

Nitrite 

Nitrite is not a reliable marker of bacteriuria in small animals. 

Leukocytes 

In dogs, the test is specific, but not sensitive, meaning the test fails to detect many 

cases of pyuria, but a positive test is an indicative of pyuria. WBCs may be present 

from infection or inflammation. Because of the high false positive rate in cats, this 

test is not useful in this species. 

Protein 

The tests that detect excess amounts of protein in the urine do not in themselves 

provide information about where in the urinary tract or how the protein entered the 

urinary space. Lesions that generate hemorrhage or exudation into the urine may 

cause plasma proteins, including albumin, to be found in the urine regardless of 

whether the lesions are located in the kidneys or the excretory pathway. The 

hallmark of such sources of proteinuria is that the hemorrhage, inflammation, or 

both, cause a coincident finding of sufficient hematuria, pyuria, or both, to account 

for the proteinuria. Consequently, the first step in interpreting any positive test for 

albuminuria or proteinuria needs to be evaluation of the results of a sediment 




examination, preferably of the same urine specimen. Similarly, evaluation of the 

coincident urine specific gravity is a crucial first step in determining whether any 

increase in serum creatinine concentration that is observed might have an entirely 

prerenal cause. 

Persistent renal proteinuria is an important marker of CKD in dogs and cats. Because 

of its importance, the ACVIM has published a consensus statement about the 

assessment and management of proteinuria in dogs and cats. Several different 

methods to detect proteinuria are useful. These include semiquantitative tests 

performed by conventional urinalysis, determination of UPC ratio, and assay of urine 

albumin concentration. Each of these methods has its place in veterinary practice, 

none of these methods entirely replaces the others, and they can be used in a 

complementary fashion. 

Because proteinuria and albuminuria have numerous possible causes, they must be 

assessed appropriately to determine their implications in affected animals. This 

assessment involves localization of the origin of the proteinuria as well as 

determination of its persistence and magnitude. Because persistent renal proteinuria 

usually indicates presence of CKD, which sometimes is a progressive disorder, its 

detection identifies dogs and cats that have increased risk for adverse health 

outcomes. At a minimum, urine tests for proteinuria should consist of a complete 

urinalysis that includes conventional semiquantitative evaluations of protein 

concentration. Because false-positive dipstick colorimetric test reactions commonly 

occur in highly concentrated or highly alkaline (pH > 7.5) dog and cat urine 

specimens, satisfactory test methods are either a dipstick colorimetric test, with 

positive reactions confirmed by a sulfosalicylic acid (SSA) turbidometric test, or a SSA 

turbidometric test alone. Alternatively, a species-specific, point-of-care test (i.e., 

Heska E.R.D. Test) or a quantitative ELISA assay could be used to confirm the 

presence of albuminuria in the face of a positive dipstick result. All positive 

reactions, regardless of urine specific gravity, should prompt a follow-up evaluation 

of some kind. Reliance on dipstick tests alone is not recommended due to the low 

specificity of positive reactions (i.e., high frequency of false-positive results). 

For animals with a true-positive semiquantitative test for protein in a complete 

urinalysis that does not reflect concomitant urinary hemorrhage or inflammation, 

evaluation of the UPC is the most logical next step. Usually the UPC confirms the 

proteinuria and provides an index of the magnitude of proteinuria for comparison 

with subsequent values as monitoring continues. 

Urine dipsticks can give a semiquantitative estimate of proteinuria. The color 

indicator (tetrabromophenol blue) is more sensitive to albumin than to globulins, 

and most urine protein is albumin. Results are reported as trace (10 mg/dL),1 + (30 

mg/dL), 2 + (100 mg/dL), 3+ (300 mg/dL), or 4+ (1000 mg/dL). Very alkaline or highly 

concentrated urine may cause false positive results. The sulfosalicylic acid 

turbidimetric test precipitates protein and can be used to confirm positive dipstick 

results. 


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Because of minor species differences in albumin, there are different kits for dogs and 

cats. In people, the gold standard is the 24-hour protein excretion, calculated by 

analyzing an aliquot of all urine produced over a 24-hour period. Collecting a 

complete 24-hour urine sample is cumber some in animals. The urine 

protein:creatinine ratio (UPC) accounts for the variations in urine volume throughout 

the day by means of the creatinine concentration. UPC values correlate well to 24 

hour urine protein excretion in dogs and cats. Values below 0.5 are considered 

normal in nonazotemic dogs and cats, and values above 0.5 in azotemic dogs and 0.4 

in azotemic cats should prompt intervention. Glomerular proteinuria is caused by 

damage to the glomerular filtration barrier and is the most common and most 

serious type of proteinuria. 

Summary 

The urinalysis may help to differentiate ischemia, toxic, and infective causes 

of acute renal injury, thereby guiding the therapeutic approach. Early diagnosis of 

acute renal injury is critical to success in its management. The presence of a urine 

low specific gravity or abnormal materials in the urine may be suggestive of the 

presence of acute renal injury. In particular, proteinuria (including 

microalbuminuria), glucosuria, cylinduria, and enzymuria are useful diagnosis tests. 


Table 1.Renal failure due to primary renal causes. 

Ischemia 

Severe pre-renal causes 

Renal vascular thrombosis 

Renal parenchymal injury 

Nephroliths 

Immune-mediated 

Glomerulonephritis 

Interstitial nephritis 

Systemic lupus glomerulonephritis 

Neoplastic 

Lymphoma 

Hemangiosarcoma 

Polycystic 

Toxins 

Aminoglycoside antibiotics 

Polymyxin B 

Sulfonamides 

Cephaloridine 

Tetracyclines 

Amphotericin B 

Thiacetarsamide 

Non-steroidal anti-inflammatory drugs 

Methoxyflurane 

Carbon tetrachloride 

Ethylene glycol 

Heavy metals 

Myoglobin 

Hemoglobin and red cell stroma 

Compost ingestion 



References 

Bartges, J.W. (2006).There’s Nothing Cute about Acute Renal Failure. Proceedings of 

Atlantic Coast Veterinary Conference. 

Reine, N.J, Langston, C.E. (2004).Urinalysis Interpretation: How to Squeeze Out the 

Maximum Information from a Small Sample. Clinical Technique in Small 

Animal Practice. 56:2-9. 

Rieser, T.M. (2005). Monitoring For and Prevention of Acute Renal Failure in the 

Critically Ill. Proceedings of International Veterinary Emergency and Critical 

Care Symposium. 


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Current Treatment for Obstructed Cats 

Rosama Pusoonthornthum, D.V.M., M.Sc., Ph.D. 

Department of Veterinary Medicine, 

Faculty of Veterinary Science, Chulalongkorn University 

e-mail: trosama71@hotmail.com 

A blocked cat is a cat with urethral obstruction, most often a male due to the 

tapered distal urethra. The most commonly seen cause of urethral obstruction are 

plugs that form secondary to underlying feline interstitial cystitis (FIC; one of the 

causes of feline lower urinary tract disease; FLUTD); calculi and tumors are also seen 

but less commonly. The clinical signs of obstruction are very similar to the signs seen 

with unobstructed cystitis, so checking whether the bladder is full or empty should 

be a priority on examination. If a female presents obstructed, the possibility of 

neoplasia rises sharply. 

Blocked cats are the most common condition seen in practice that is life threatening. 

Success rates for unblocking and survival can and should approach 100%. This 

depends upon prompt and accurate assessment of each case, careful stabilization 

and optimal treatment. Nevertheless, the majority can survive and go on to a full 

and happy life. 

Unfortunately the optimal management of the cat with urethral obstruction is not 

treating properly by certain problems and popular misconceptions. The most 

important things to consider optimizing success rates for the treatment of 

obstructed cats are: 

• An immediate and accurate assessment of the major body system 

abnormalities of the cat 

• Measurement of electrolyte and acid base status 

• Electrocardiographic monitoring 

• Optimal initial stabilization prior to unblocking: 

� Aggressive fluid therapy is necessary and can be administered safely 

despite the obstruction 

� Use any isotonic crystalloid fluid 

� Calcium gluconate is an extremely useful drug and should be used in 

preference to insulin/dextrose or bicarbonate for hyperkalaemia 

• Perform cystocentesis to decompress urinary bladder. 

• Optimise your technique for urethral catheterization to increase success 

rates and avoid urethral trauma. 

• Don't use baseline azotemia as a prognostic indicator. Cats with high 

creatinine that return to normal within 12-36 hours 

• Place intravenous catheter and commence intravenous fluid therapy (0.9% 

NaCl as hyperkalaemia is common, but Lactate Ringer solution is acceptable). 

• More specific treatments for hyperkalaemia (such as soluble insulin and 

glucose) are not always necessary, and very careful monitoring is required if 

they are used. 




• Relieve bladder distension - this can be done by catheterization if the cat is 

stable enough for anesthesia (rare at the time of initial presentation). More 

prolonged stabilization over a period of a couple of hours is more commonly 

required; in this circumstance the bladder should be decompressed by 

percutaneous aspiration (60 ml syringe, extension set, three-way tap and 22gauge 

intravenous catheter; the stylet is withdrawn as soon as the catheter 

enters the bladder). 

• Carefully monitor response to treatment. 

Technique for Catheterization 

1. 3 to 4 Fr cat catheter is selected (a new type with end holes rather than side 

holes is being developed and will make unblocking easier) and lubricated with 

sterile water-soluble jelly (K-Y jelly). 

2. Perineal area and penile tip cleaned with very dilute chlorhexidine solution 

(clipped beforehand if required). 

3. Assistant extrudes penis from prepuce and catheter is introduced. Gentle 

intermittent flushing with sterile saline solution may help alleviate the 

obstruction. 

4. In some cases the tip is so obstructed that the catheter cannot be introduced 

into the urethra at all. In these cases, a sterile lacrimal catheter or small 

intravenous catheter (with the stylet removed!) can be used, and is advanced 

into the urethral orifice and then withdrawn and flushed. This is repeated; 

each time a small amount of plug is removed, until the catheter can then be 

introduced freely. 

5. Massage of the penile tip and/or urethral massage per rectum can help 

alleviate the obstruction. 

6. As the catheter is advanced, care is taken to keep advancing along the 

midline. Once the catheter has passed 2–3 cm in, the penis is allowed back 

into the prepuce. The prepuce is then grasped, and pulled caudally and 

dorsally. This helps to straighten out the urethra and makes iatrogenic 

damage less likely. Repeated flushing with sterile saline may be required. 

7. Once the catheter is in the bladder, the bladder is emptied and urine 

collected for bacteriology, specific gravity and sediment examination. 

8. The bladder is then repeatedly flushed with sterile saline to remove as much 

of the debris as possible. 

9. Debate exists about whether to suture the catheter in for 24–36 hours to 

allow ongoing drainage. 

10. Ongoing intravenous fluid therapy and monitoring are then required, along 

with analgesia and spasmolytic medication to encourage voluntary urination. 

In recurrent cases, further bladder and urethral imaging, with ultrasonography and 

contrast radiography, is indicated to rule out other causes of obstruction. 

Ongoing treatment for underlying FIC must be addressed, as treatment for this will 

reduce the chance of recurrent episodes. 


109

110 



Aftercare 

After re-establishing urinary output diagnostic investigations can be undertaken to 

determine the cause of the obstruction. The volume of the urine output should be 

closely monitored and the urine sediment should be examined daily for evidence of 

infection. If the urine output fails to rise, or falls to



How to Manage Infectious Diseases in Exotic Pets 

Sompoth Weerakhun, D.V.M., Ph.D. 

Department of Medicine, Faculty of Veterinary Medicine 


e-mail: somwee@kku.ac.th 

Update infectious disease in exotic pets 

Recently, Thailand has a trend of large increasing exotic pets.The most common 

exotic pets are rabbit. The numerous of pet rabbits like the third companion 

compared dog and cat, followed by other small pocket pets, birds, reptiles and 

ornamental fish. These animals almost are imported, farmed and some wild-caught 

(Weerakhun, 2011). The retrospective studies in animal clinics in central Bangkok 

and Khon Kaen province suspected infectious disease of bacteria, virus, fungus and 

parasites. The most of cases of showed diarrhea from bacterial and protozoan 

gastrointestinal tract infections, such as Escherichia coli, Campylobacter, Giardia, 

Spironucleus, Spirochetes and Eimeria (Weerakhun, 2011). In current year, diseased 

rabbits due to infectious disease were retrospective studied (N=2877) that they were 

divided to healthy, surgical requested, skin diseases, gastrointestinal tract infection, 

respiratory tract infection and other unidentified as 22.38% (N=624), 12.45% 

(N=347), 9.29% (N=259), 35.4% (N=987), 15.64% (N=436) and 4.84% (N=135), 

respectively (Woralar, unpublished data). 

Rabbit gastrointestinal syndromes (RGIS) was investigated that 48% of pet rabbits 

were gastrointestinal diseases compared with other diseases. Dysbiosis was highly 

detected for more than 25% of all RGIS.Young rabbit (

112 



infected by Bordetella bronchiseptica, Salmonellosis was common in reptiles and also 

dermatophytosis and external parasites infestation were common in rabbit and 

other small mammals (Weerakhun, 2011). Toxoplasma and hookworm infested in 

non-human primates and rodents. Internal parasites and external parasites always 

harmfully damage in wildlife-caught (Weerakhun, 2011). These example data show 

that infectious diseases are common diseases in exotic pets, harmfully damage and 

they are also reservoir hosts. 

So, how we manage infectious diseases of these animals, such as imported pets, 

farmed or wildlife-caught. 

Management infectious disease: Aim to manage risk associated with infectious 

disease. 

Procedure detail: Adapted from DECS, (2011) 

1. Identified potential sources of infection. The practitioners must know well 

about the pathogens or diseases which be studying: 

a. Definition of the causative agents: Clostridium spp. is an obligate 

anaerobic, spore-forming, gram-positive and rod shape. Clostridium 

piliforme and C. spiroforme cause acute hemorrhagic typhlocolitis due 

to dysbiosis condition in rabbit and rodents (Jepson, 2009: Meredith 

and Crossley, 2002) 

b. Incidence and prevalence: Prevalence rate of Pasteurella multocida 

caused diseased rabbits of respiratory tract and was 33.3%. 

Incidence of Pseudomonas aeruginosa pneumonitis among patient 

rabbits about 178 cases per 1000 rabbits. Mortality rate of respiratory 

infectious disease in rabbit was 43% (Woralar, unpublished data). 

c. Microbiology: P. multocida remains the most commonly pathogen of 

respiratory infection in rabbit and other small mammals. Other 

pathogens, such as P. aeruginosa and Staphylococcus aureus have 

been reported to cause pneumonitis in the same patient with high 

incidence rate. 

d. Transmission mode and pathophysiology: Pathogenetic mechanism in 

the disease could help us to observe risk factor, for example, 

inhalation of pathogen agents is probably the most important 

transmission mode of pneumonia whereas direct inoculation rare 

frequency occurs. Also, history of animal feeding could help to check 

risk factors, such as the low fiber-diet induces gastrointestinal 

hypomotility and dysbiosis in rabbit (Weerakhun, 2011). 

e. History and clinical signs: Complete history taking and physical 

examination, for example, Guiney pig who kept with rabbit is risk to 

Bordetella bronchiseptica (Jepson, 2009). Non-human primates 

expose to birds is risk for Chlamydophilla infection (Weerakhun, 

2011). History of the animals is importance to investigate the 

diseases, for example, practitioners should know how the owners 

keep its; where, with other animals, feeding, sanitation. Where the 

pet were bought, farm, wild-caught, market or pet shops. Who are 

the owners’ contacts after buy animals or find the problem of it, such 




as vet, seller, farmer or nothing that help to evaluate the education 

level for well keep animals (Weerakhun, 2012). 

f. Diagnostic testing for infectious diseases of exotic pets: Large diversity 

of exotic pets is also large details for diagnostic protocols; for 

example, all birds with suspected infectious diseases must observed in 

O2 cage for clinical signs and abnormal behavior, then coprology 

studied and fecal smear for gram stain. Radiography, complete blood 

count, serum chemistry profiles must take when patients are not 

severe. Severely ill will be cloanal or cloacal swabbed for bacterial or 

fungal culture, also viral identification technique. Radiographic finding 

and pattern could tentative identified the group of pathogens, 

military always caused by acid-fast bacilli and fungi, whereas 

interstitial pattern might be viruses, Chlamydia or Mycoplasma. So, 

practitioners should know for addition routine check for the diseases 

of special pets. 

g. Study through clinical research, record, consultation, review 

literatures and case reports, etc. 

2. Risk assessment; evaluate the risk of infection from above (1), such as 

transmission modes, consider risk factors, frequency of exposure, experience 

of the owners, kinds of pet shop and markets, environment factors and 

seasonal risk. 

a. For example, young rabbits opportunist dysbiosis with high incidence 

on some month as when Kaset’s Fairs provided. Young rabbit (

114 



3. Risk control; to eliminate or minimize the risk of infectious diseases. 

a. Treatment base on the pathogens, pathophysiology and clinical signs, 

drug susceptibility, severity index and support needs. 

b. Prevention; 

i. Good hygiene and reduce contamination 

ii. Eliminate risk factors or avoid to contact the carrier 

iii. Vaccination, determine the need for vaccination and 

availability of vaccine 

iv. Education pet owners, related staffs and veterinarians, some 

training for them in risk area and seasonal 

v. Safe work practices to diminish environment contaminated 

and spread of the diseases 

vi. Standard protocols providing and confidentiality recording 

vii. Quarantined new coming pets, wildlife-caught and patient in 

house or safe area 

viii. Severely patient or contact by harmful pathogens might need 

to hospital admission and observe 

ix. Survey the infectious disease and provide risk assessment 

form if need 

x. Introduce policies if need 

4. Monitoring, evaluation and review: 

a. Network or consultative system providing 

b. Conference and seminar attend and also individual review, case 

research and report 

c. Recording 

d. Staff training 

e. Surveying or monitoring by diagnostic tools and statistics 

For successfully manage for infectious diseases of exotic pets, practitioners need to 

prepare your facilities for special pets, such as special outpatient department, 

inpatient ward with large diversity of animals, knowledge on biology and veterinary 

sciences for each pets that you observe, some equipments for them, special 

nutrition and recovery formula, special drugs, well physical examine and laboratory 

testing and well treatment (Weerakhun, 2012). Moreover, history and medical 

recording and clinical researching are importance for well risk control. 

References 

Butsurin, A., Weerakhun, S., Limaroon, S., Watanawongwiboon, P., Woralar, R., 

Roungreungkolkit, J.,Siriporn, D. and Sang a-roon, S. (2012). Diagnosis and 

treatment of rabbit gastrointestinal syndrome.pp 38-40. VPAT Regional 

Veterinary Congress 2012 (VRVC 2012): Towards one health, one standard. 

Impact Muang Thong Thani, Thailand. 

DECS; Department of Education and Children’s Service.(2011). Infectious disease 

control procedure.pp 4-13.Government of South Australia. 

Jepson, L. (2009). Exotic Animal Medicine: A Quick Reference Guide. p 578.Saunders 

Elsevier, Philadelphia, USA. 




Keeble, E. (2011). Encephalitozoonosis in rabbits – what we do and don’t know.In 

practice. 33:426-435. 

Meredith, A. and Crossley, D.A. (2002).Rabbit.In BSAVA Manual of Exotic Pets 4 th 

edition. (ed. By A. Meredith and S. Redrobe). pp 76-92.BSAVA, Gloucester, 

UK. 

Sikong, N., Singsena, K., Pakpiboon, P., Yinhanmingmongkol, C and Arya, N. 

(2012).Serological survey of Encephalitozooncuniculi in pet rabbits in 

Thailand. pp 50-52. VPAT Regional Veterinary Congress 2012 (VRVC 2012): 

Towards one health, one standard. Impact Muang Thong Thani, Thailand. 

Weerakhun, S. (2011).Infectious diseases of exotic pets. pp. 153-158. The 12 th KKU 

Veterinary Annual Conference 2011:The international conference on global 

issues influencing human and animal health for ASEAN. Faculty of Veterinary 

Medicine, Khon Kaen University, Thailand. 

Weerakhun, S. (2012). How to set up ward for rabbit and rodents: tricks and tips. pp 

135-140. VPAT Regional Veterinary Congress 2012 (VRVC 2012): Towards one 

health, one standard. Impact Muang Thong Thani, Thailand. 

Woralar, R., Weerakhun, S., Chukanhom, K., Tangkhawattana, S., Suwannachot, N. 

and Kaenjumpa, P. (2011). Preliminary study of Pasteurella multocida 

infection of respiratory tract system in rabbits.pp. 228.The 12 th KKU 

Veterinary Annual Conference 2011:The international conference on global 

issues influencing human and animal health for ASEAN. Faculty of Veterinary 

Medicine, Khon Kaen University, Thailand. 

Woralar, R., Weerakhun, S., Juruwattanadilok, P., Churuwattanadilok., P and 

Kaenchampa, P. (2012). Nasal flora of healthy rabbits and drugs sensitivity. 

pp 70-73. VPAT Regional Veterinary Congress 2012 (VRVC 2012): Towards one 

health, one standard. Impact Muang Thong Thani, Thailand. 


115

Oral presentation



Oral presentation 

Detection of Toxoplasma gondii with the New Limit Detection 

by Quantitative Polymerase Chain Reaction 

Chavaphat Suviriyapaisal 1,3,4 , Yaowaluk Sukthana 2 , Aongart Mahittikorn 2 , 

Ruenruthai Udonsom 2 and Suvit Limawongpranee 1,4 * 

1 Department of Parasitology, Faculty of Medicine Siriraj Hospital, 

2 Department of Protozoology, Faculty of Tropical Medicine, 

3 Department of Immunology, Faculty of Medicine Siriraj Hospital, 

4 Faculty of Graduate Studies, Mahidol University, Bangkok, Thailand 10700 

ABSTRACT 

Toxoplasmosis is one of widespread zoonotic protozoa disease that occurs in both 

animals and humans. It is leading cause of abortion in newborn and blindness and 

brain abscess in immunodeficiency patient. Traditional molecular assays are often 

difficult to perform, especially for the early diagnosis of Toxoplasma gondii (T. 

gondii) infections. The objective of this present study develop and evaluate lower 

limit detection, sensitivity and specificity of Quantitative Polymerase Chain Reaction 

(qPCR) technique with a new set of primers targeting the B1 gene to reproducibly 

detect T. gondii. The result showed that, the detection of T. gondii DNA by qPCR 

with a detection limit at 0.01 tachyzoite/µl or 10 ag/µl and qPCR were 100% both 

sensitivity and specificity. The specificity of the qPCR was confirmed by using 

genomic DNA from related parasites, including genomic DNA of Entamoeba 

histolytica, Escherichia coli, Neospora caninum, Cryptosporidium spp. Cryptococcus 

neoforman, Giardia duodenalis, Klebsiella spp., Mycobacterium tuberculosis, Feline 

DNA, Canine DNA, Swine DNA, Bovine DNA and Human DNA. Our result 

demonstrated increased sensitivity and lower limit detection of the B1 gene in qPCR 

assay are highlighted. 

Keywords: Lower limit detection, Toxoplasma gondii, Quantitative polymerase chain 

reaction 

*Corresponding author e-mail: Suvit.lim@mahidol.ac.th 


119

120 




Serological and Molecular Survey on Bartonella spp. 

among Veterinary Professionals 

Nathatai Wanachalerm 1 *, Fanan Suksawat 2 , Orathai Pachirat 3 , 

M.Y. Kosoy 4 , Soawalak Sripakdee 5 , Anusak Serdsin 5 , 

Surang Dejsirilerk 5 , Pithai Kanbutra 6 and Pitaya Papirom 7 

1 Graduate student, 2 Department of Medicine, Faculty of Veterinary Medicine, 

3 Department of Cardiology Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 

Thailand, 40002, 4 Centers for Disease Control and Prevention, Fort Collins, Colorado, USA, 

5 Department of Medical Sciences, Ministry of Public Health, Nontaburi, 

Thailand, 6 Department of Veterinary Teaching Hospital, 7 Department of Pathobiology, 

Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand 40002 

ABSTRACT 

Bartonella spp., the causative agents of bartonellosis, is Gram-negative bacteria that 

periodically infect erythrocytes. Human bartonellosis is mostly zoonotic. At least 5 

species of Bartonella are associated with human illnesses in Thailand: B. henselae, B. 

tamiae, B. tribocorum, B. elizabethae, and B. vinsoniiarupensis. Endocarditis, 

parinaud occuloglandula syndrome, bacillary angiomatosis, peliosishepatis, 

septicemia, neuropathy and lymphadenopathy are mostly reported from 

immunocompromise people. Ticks, fleas, lice, and mites are confirmed or proposed 

as transmission vectors. Veterinary professionals are at risk due to the regularity in 

contact with Bartonella spp. reservoirs. Therefore, objectives of this study were to 

investigate Bartonella spp. in human volunteers who work at veterinary clinics and 

to evaluate risk of Bartonella spp. for veterinary professionals based on analysis of 

their samples. Blood samples from 63 volunteers, 28 men and 35 women were 

collected. Indirect fluorescent assay (IFA) was used for detection of specific 

antibodies and polymerase chain reaction (PCR) was used for Bartonella DNA 

detection. None of serum samples was reactive to B. henselae, B. quintana, B. 

clarridgeiae, and B. vinsoniiarupensis antigens and all samples were PCR negative. 

Negative result may be inappropriate sampling time, unresponsive immune systems 

in the studied group and/or good practice and hygiene in Thai veterinary 

professionals. Actual infection should be further determined to estimate the 

professional prevalence among veterinarians in different parts of Thailand. 

Keywords: Bartonella spp., Indirect fluorescent assay, Polymerase chain reaction, 

Veterinary professional 

*Corresponding author e-mail: wanachalerm@yahoo.com 





Detection and Characterization of Bartonella species 

in Western Australia 

Gunn Kaewmongkol 1,2 *, Sarawan Kaewmongkol 3,4 , Halina Burmej 1 , 

Mark D. Bennetta 1 , Patricia A. Fleming 1 , Peter J. Adams 1 , 

Adrian F. Wayne 5 , Una Ryan 1 , Peter J. Irwin 1 and Stanley G. Fenwick 1 

1 School of Veterinary and Biomedical Sciences, Murdoch University, South Street, 

Murdoch 6150, Western Australia, Australia, 2 Faculty of Veterinary Medicine, 3 Faculty of 

Veterinary Technology, Kasetsart University, Bangkok, Thailand, 

4 Center for Agricultural Biotechnology (AG-BIO/PEDRO-CHE), Thailand, 

5 Science Division, Department of Environment and Conservation, Manjimup, 

Western Australia 6258, Australia 

ABSTRACT 

Previous studies on Bartonella species in Australia have been confined to mammalian hosts, 

including humans, cats, native rodents and eastern grey kangaroos. However, little is known 

about the status of bartonellae in arthropod vectors, which is essential in understanding the 

transmission dynamics of the organisms. Ticks and fleas were collected from both wild and 

domestic animals from various locations in Australia. All ectoparasites were screened for 

Bartonella species using newly designed nested-PCRs targeting the gltA gene and the ITS 

region. Multilocus sequence analysis (MLSA) of the 16SrRNA, gltA, ftsZ and rpoB genes and 

the ITS region was applied to identify and confirm the status of all Bartonella species 

identified in this study. The MLSA of the COI and 18S rRNA genes of flea vectors harbouring a 

diversity of Bartonella species were analysed to characterize the genetic diversity in the flea 

vectors and to elucidate vector-parasite associations. A phylogenetic analysis of the 5 

concatenated loci identified 3 novel Bartonella species in flea vectors from marsupials in 

Western Australia. Candidatus Bartonella antechini was detected in fleas (Acanthopsylla 

jordani) from mardos (Antechinus flavipes; yellow-footed antechinus). Candidatus Bartonella 

woyliei was detected in fleas (Pygiopsylla hilli), from brush-tailed bettongs (Bettongia 

penicillata; woylies), and Candidatus Bartonella bandicootii was detected in Pygiopsylla 

tunneyi fleas from western barred bandicoots (Perameles bougainville). The grouping of 

marsupial-derived Bartonella species confirmed the existence of a marsupial cluster of 

Bartonella species in Australia, which appears to have evolved separately to Bartonella 

species in other mammals. The detection of the zoonotic B. henselae and B. clarridgeiae in 

red foxes and their fleas (Ctenocephalides felis), indicated that red foxes could be an 

important reservoir of Bartonella infections for other animals and humans in the same 

location. Bartonella henselae and B. clarridgeiae DNA were also detected from fleas 

collected from pet cats in the same area. The genetic association of these zoonotic 

Bartonella species detected in wildlife and pet animals has demonstrated and confirmed the 

distribution of zoonotic Bartonella species in fleas from both wild and domestic animals in 

this region. The genetic clustering of Bartonella species and flea vectors with their Australian 

fauna hosts suggests co-evolution of hosts, fleas and Bartonella species in Australia. In 

conclusion, the close association between Australian fauna, Australian fleas and Bartonella 

species suggests adaptation by Bartonella species to a specific ecological niche, comprised of 

specific mammalian hosts and specific flea vectors in particular environments. 

Keywords: Australia, Bartonella species, Co-evolution, Fleas, Native animals 

*Corresponding author e-mail: gunn_kaew@yahoo.com 


121

122 




Microbiological Quality of Farm Waters in View of Indicator Organisms 

Sirinya Weruwanarak 1* , Pairat Sornphlaeng 2 and Bongkot Noppon 2 

1 Master student for Veterinary Public Health program, 

2 Department of Veterinary Public Health, Faculty of Veterinary Medicine, 

Khon Kaen University, Khon Kaen, Thailand 40002 

ABSTRACT 

The study aimed at examining the microbiological quality of water at the broiler farm 

with regards to Escherichia coli and fecal coliform contamination. These bacteria are 

normally used as indicator for the safety evaluation of waters and foods. In total, 360 

water samples were collected from main tank, drinking lines, pond and water from 

evaporative systems during 3 consecutive seasons in September, 2011 to April, 2012. 

The AOAC approved method i.e. 3M Petrifilm TM E. coli/Coliform Count Plates, was 

used for E. coli, fecal coliform and total coliform isolation and enumeration. Results 

showed that the highest detection of E. coli was found in rainy season (45.00%, 

54/120) and the lowest detection was encountered in winter (31.66%, 38/120). 

However, it was not the case for fecal coliform where the highest detection was 

found in summer (70.83%, 85/120) and the lowest detection was in winter (44.16%, 

53/120). In addition, the highest contamination of total coliform was noted in rainy 

season (45.00%, 54/120) while the lowest contamination was found in winter 

(29.17%, 35/120). In summary, the range of E. coli, fecal coliform and total coliform 

contamination was between 31.66-45.00%, 44.16-70.83%, and 29.17-45.00%, 

respectively. This study indicated that water at broiler farms are possibly acted as a 

mean to distribute the hazardous organism to enter the live birds and may be 

transferred to human after consumption of improperly cooked broiler meats. 

Keywords: Escherichia coli, Fecal coliform, Total coliform, Petrifilm 

*Corresponding author e-mail: wanarak_si@yahoo.co.th 





Surveillance of Salmonella Contamination in Water and Litter Samples 

at Broiler Farms, Khon Kaen Province of Thailand 

Parichat Kubkaew 1 *, Kwankate Kanistanon 2 and Bongkot Noppon 3 

1 2 

Ph.D. candidate, Graduate school, Department of Veterinary Physiology, 

3 Oral presentation 

Surveillance of Salmonella Contamination in Water and Litter Samples 

at Broiler Farms, Khon Kaen Province of Thailand 

Parichat Kubkaew 

Department of Veterinary Public Health, Faculty of Veterinary Medicine, 


ABSTRACT 

Surveillance of salmonellosis has been conducted in many parts of Thailand. Reports 

have shown the relationship between Salmonella spp. in broilers farms and public 

health. Limited studies were conducted for monitoring the farm water quality. This 

study therefore aimed at monitoring water quality at farm level. Water samples 

were collected from main tank, drinking lines, waste or pond water and water from 

evaporation systems. Samplings were also extended to litter samples at the broiler 

farm. Sample collections were conducted during 3 consecutive seasons in 

September, 2011 to April, 2012. Ten broiler farms located in Khon Kaen were 

included in this study. Each sample was taken when birds are at their 1-15 and 16-35 

days of age starting up on their arrival. A total of 400 samples were processed. 

Salmonella spp. were isolated and identified following the ISO 6579:2002 guideline. 

Results showed that Salmonella spp. contamination was found at 1.66% (1/60) in 

main tank water, 7.22% (13/180) in drinking water, 6.66% (4/60) in pond or waste 

water and 16.66% (10/60) in evaporation system water. In addition, litter samples 

were 32.50% (13/40) contaminated with Salmonella spp. in both age ranges. The 

overall contamination was 10.25% (41/400) from all sample types. Contamination of 

Salmonella in all sample types showed that broilers aged 16-35 days are more 

pruned to have high detection rate (13.00%, 26/200) compared with younger birds 

(7.50%,15/200). This study indicated the improper management of water supply at 

farm level. This finding noted that the present of Salmonella spp. in water and litter 

samples may also be transferrable to individual broiler, and eventually consumers. 

Therefore, farmers should have a proper control of the farm water quality in order to 

prevent cross contamination which may lead to salmonellosis in human. 

1 *, Kwankate Kanistanon 2 and Bongkot Noppon 3 

1 2 

Ph.D. candidate, Graduate school, Department of Veterinary Physiology, 



ABSTRACT 

Surveillance of salmonellosis has been conducted in many parts of Thailand. Reports 

have shown the relationship between Salmonella spp. in broilers farms and public 

health. Limited studies were conducted for monitoring the farm water quality. This 

study therefore aimed at monitoring water quality at farm level. Water samples 

were collected from main tank, drinking lines, waste or pond water and water from 

evaporation systems. Samplings were also extended to litter samples at the broiler 

farm. Sample collections were conducted during 3 consecutive seasons in 

September, 2011 to April, 2012. Ten broiler farms located in Khon Kaen were 

included in this study. Each sample was taken when birds are at their 1-15 and 16-35 

days of age starting up on their arrival. A total of 400 samples were processed. 

Salmonella spp. were isolated and identified following the ISO 6579:2002 guideline. 

Results showed that Salmonella spp. contamination was found at 1.66% (1/60) in 

main tank water, 7.22% (13/180) in drinking water, 6.66% (4/60) in pond or waste 

water and 16.66% (10/60) in evaporation system water. In addition, litter samples 

were 32.50% (13/40) contaminated with Salmonella spp. in both age ranges. The 

overall contamination was 10.25% (41/400) from all sample types. Contamination of 

Salmonella in all sample types showed that broilers aged 16-35 days are more 

pruned to have high detection rate (13.00%, 26/200) compared with younger birds 

(7.50%,15/200). This study indicated the improper management of water supply at 

farm level. This finding noted that the present of Salmonella spp. in water and litter 

samples may also be transferrable to individual broiler, and eventually consumers. 

Therefore, farmers should have a proper control of the farm water quality in order to 

prevent cross contamination which may lead to salmonellosis in human. 

Keywords: Broiler farms, Litters, Monitoring, Salmonella spp., Water 

Keywords: Broiler farms, Litters, Monitoring, Salmonella spp., Water 

*Corresponding author e-mail: botun_vet66@hotmail.com 

*Corresponding author e-mail: botun_vet66@hotmail.com 


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A Comparison of Two Lameness Detection Methods in Sows: 

A Search for the Best Method 

Nitipong Homwong 1, 2 * and John Deen 1 

1 College of Veterinary Medicine, University of Minnesota, Minnesota, USA 55108, 

2 Faculty of Agriculture at KamphaengSaen, Kasetsart University, 

NakhonPathom, Thailand 73140 

ABSTRACT 

Lameness scoring systems are based on simple numerical scales. Therefore, the 

lameness scoring relies on subjective judgment. The difficulty in observing lameness 

due to hiding behavior in sows is like to contribute to a problem of attributing 

consistent scores. As a result, they may exhibit normal behavior to disguise their 

lameness from detection. This may also apply when lameness detection tests are 

conducted. This reaction, hence, can present difficulties for diagnosticians and 

researchers in accurately detection of lameness in sows. The objective of this casecontrol 

study was to compare the agreement and reliability of two methods used in 

detecting lameness in sows. In this study, sows were observed twice. They were 

observed during one 5-AM feeding session and recorded as being lame (1) or nonlame 

(0) for total 70 sows. Forty-eight of the sows were randomly selected from this 

gestation barn. Half were lame and the other half non-lame. This chosen group was 

used as “gold standard” for lame detection in this study. They were then moved 

individually through the walkway. Another observation was held with the same 

trained person recording the lame condition as previously, blinded to ID. For the 

second observation of detecting lamness, the sensitivity was 62.5% (95%CI[43.13- 

81.86]) and the specitivity was 95.8% (95%CI[87.84-100.00]). The agreement was 

referred to as Kappa statistic (1 indicated as perfect agreement beyond the chance, 

0.8 substantial, 0.6 moderate, 0.4 fair, 0.2 slight and 0.0 poor or no agreement). 

Based on this analysis, Cohen's Kappa for 2 rating by equal weight was 0.583 (95% CI 

[0.353-0.814], s.e.=0.118, p




Prevalence of Parasitic Infections of Dairy Cattle in 

Smallholder Dairy Farms in Khon Kaen Province, Thailand 

Aran Chanlun 1 *, Chaiyapas Thamrongyoswittayakul 1 , 

Manassanan Borisutpeth 1 , Pitaya Papirom 1 , Pithai Kanbutra 1 , 

Suthida Chanlun 1 , Pranpreeya Kammee 1 and Nawapat Kaewvisethong 1 

1 Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand 40002 

ABSTRACT 

The objective of the present study was to investigate the prevalence of parasitic 

infections, i.e. intestinal parasites, blood parasites and ectoparasites, of dairy cattle 

in the smallholder farms, Khon Kaen province, Thailand. Thirteen dairy farms were 

randomly selected for investigations during March and April 2012. Two hundred and 

eighty-seven (60.2%) of 477 cattle were found ectoparasites by physical examination 

and 59.5% (284/477) were infested with lice at either the brush of the tail or the skin 

of the vulva. Lice infestations were found in most farms (12/13) while no tick was 

detected in all farms. In additions, fecal and EDTA blood samples were also collected 

from 210 cattle for examinations of the intestinal and blood parasites, respectively, 

by using the routine methods for the laboratory diagnosis. One hundred and 

nineteen (56.7%) of 210 fecal samples were found the intestinal parasites and 

strongyle nematode infections were the principal problems of cattle in all farms, 

ranging from 4.4% to 100%. Overall prevalence of blood parasite infections was 11% 

(23/210) and Anaplasma marginale, Theileria spp. and microfilaria of round worms 

were found at 4.8% (10/210), 3.8% (8/210) and 2.4% (5/210), respectively. It was 

concluded that parasitic infections were highly prevalent in dairy cattle in the 

smallholder farms. However, the distribution of infections did not vary much with 

age. The programs for controlling parasitic infections in the farms need to be revised 

and evaluated to increase the productivity of the farms. 

Keywords: Blood parasite, Dairy cattle, Ectoparasites, Prevalence, Smallholder farm 

*Corresponding author e-mail: aran_jan@kku.ac.th 


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126 




Seroprevalence of Bovine Viral Diarrhea in Cattle 

in 4 Livestock Regions 

Kriwon Hongyuntarachai 1 *, Arun Chungrachang 1 and Panpilai Sekasiddhi 2 

1 Saraburi Artificial Insemination and Biotechnology Research Center, Saraburi 18260 

2 The Bureau of Biotechnology in Livestock Production, Department of Livestock Development, 

Pathumthani, Thailand 12000 

ABSTRACT 

A prevalence study of Bovine Viral Diarrhea (BVD) by detecting BVDV antibodies and 

antigens in cattle was conducted. Blood and ear notch tissue samples were collected 

from female crossbred Holstein-Friesian in Livestock Region(LR) 1,2,3 and 7 of 

Thailand. The blood samples were screened for antibodies against BVDV using an 

ELISA test kit :PrioCHECK®BVDVAb while ear notch tissue samples were tested for 

BVDV antigens by PrioCHECK® AG PI focus. Data were analyzed and results were 

shown in 4 categories: (1.) number of farms, (2.) number of female cattle, (3.) farms 

with and without abortion history and (4.) status of female cattle (cow, heifer and 

calf). Results of BVDV antibodies prevalence showed category 1: among the 108 

farms, LR7 had highest seroprevalence of 83.9% whereas LR1,2,3 were 62.5%, 

53.6% and 72%, respectively. Category 2: the total of 3,380 cattle, LR7 also had 

highest seroprevalence of 30.21% while LR1,2,3 were 14.97%, 2.86% and 20.05%, 

respectively. Category 3: seroprevalence of all farms with history of abortion was 

71.43% while farms without abortion history was 64.44%. Category 4: 

seroprevalence of all cows, heifers and calves were 20.70%, 10.88% and 10.36%, 

respectively. Results of BVDV positive antigens prevalence showed category 1: from 

89 farms, LR1,2,3,7 were 0%, 4.5%, 5.6% and 6.9%, respectively. Category 2: from 

2,679 cattle, LR1,2,3,7 showed 0%, 0.2%, 0.2%, and 0.2%, respectively. Category 3: 

positive antigens of farms with abortion history was 6.45%. Category 4: positive 

antigens prevalence of all cows, heifers and calves were 0.11%, 0.52% and 0%, 

respectively. This study provides beneficial information for dairy cattle reproductive 

herd health management planning and BVD prevention program 

Keywords: Bovine viral diarrhea, Cattle 

*Corresponding author e-mail: khongbell@gmail.com 





Dynamic Population of Macaca fascicuaris in Kreo’s Cave, 

Semarang Residence After Developing of Jatibarang Dam 

Pudji Astuti 1,2 *, Asmarani Kusumawati 1,2 , Arif Setiawan 2 , 

Luthfiralda Sjahfirdi 3 , Hera Maheshwari 4 and FX. Wagiman 2 

1 Faculty of Veterinary Medicine, GadjahMada University, Yogyakarta, 

2 Research Center For Management of Biological Resources, GadjahMada University, 

3 Faculty of Mathematics and Natural Science, University of Indonesia, Depok, 

4 Faculty of Veterinary Medicine, Bogor Agricultural University, Bogor, Indonesia 

ABSTRACT 

Kreo cave is tourism site in Semarang which is popular for “Macaca fascicularis” as 

their icon. In the other side, Macaca is one of primate that has a potency to 

distribute of zoonotic disease. In this moment, the preservation effort of Macaca 

becomes even more intensive due to developing of Jatibarang dam. The activities of 

Jatibarang dam are believed to affect number of population, daily range and 

behavior of Macaca fascicularis. The aims of this study are to determine dynamic 

number of individual so that prediction rate of reproduction and population density 

would be known. Cencus of Macaca fascicualris has been started from April 2010 

where dam activity has been started and repeated in March 2011 and March 2012. 

In this research, method of Track and Count was used to estimated the number of 

population. During 10 days survey it has been identified two groups of Longtailed 

macaque in Kreo-Cave Tourism-site with the name of Parkiran’s and Kreo’s group. In 

the first cencus (year 2010), there were a total of 201 indiviadual which were contain 

of 134 individual from Kreo and 67 from Parkiran. In the second year, rate of 

reproduction has been increased in amount of 11% with the composition of 144 

individual for Kreo and 90 individual for Parkiran. In the third year, the number of 

Macaca fascicularis was 144 individual for Kreo and 75 individual for Parkiran so that 

the total was 219 individual. Up to now, habitat has been disappeared for 70% so 

that it would be worried if the animals will expand to the local communities, destroy 

and attack of their planting, also zoonotic disease will be spread significantly. Ten 

from 17 feeding tree has disappeared, most of sleeping tree has also gone. Rate of 

density is getting increase start from 11.48 individual/Ha in 2010 to 41.69 

individual/Ha in March 2012. It has been concluded that although animals have lost 

most of their habitat, rate reproduction of Macaca fascicularis still has been running 

well eventhough number of juvenile was getting decrease. To inhibit their expansion 

to the local communities, feeding must be given from the authorities every day and 

replanting of sleeping and feeding tree must be started from now. 

Keywords: Kreo cav, Macaca fascicularis, Population 

*Corresponding author e-mail: pastuti2@yahoo.com 


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Incomplete CIDR Device Retention During Induction of Oestrous 

in Dairy Heifers 

Suvaluk Seesupa 1 *, Nawarat Pha-obnga 1 and Suneerat Aiumlamai 2 

1 Graduate student, 2 Department of Surgery and Theriogenology, 


ABSTRACT 

CIDR is an intravaginal progesterone device, is widely used for oestrous 

synchronization in dairy cattle which occasionally pulled off from the vagina during 

the synchronization protocol. The objective of this study was to report the estrous 

synchronization outcome of an incomplete CIDR device retention in dairy heifers. 

Thirty-two cycling crossbred Holstein-Friesian dairy heifers were received a CIDR 

combined with 20 µg of GnRH agonist on day 0 and were injected with 500 µg of 

prostaglandin F2α analogue on day 7 before the CIDR was removed 24 hrs later. 

Heifers in which the device was pulled off, the sanitized device was reinserted 

immediately. Oestrous detection was performed by visual observation 4 times daily 

during 24-72 hr after CIDR was removed. Heifers with the device remaining in vagina 

for 8 days were defined as the complete retention group, while those having the 

device pulled off were defined as the incomplete retention group. Data from the 

complete and incomplete retention groups were analysed using descriptive 

statistics, Generalized Estimating Equations and Mann-Whitney U test. The result 

found that 31.25% (10/32) of heifers with incomplete retention of CIRD in which 

78.13% (25/32) of heifers showed sign of oestrous. No significant difference in age, 

body weight and body condition score between incomplete and complete retention 

groups was found. Percentage of heifers showed sign of oestrous in the incomplete 

retention group was significantly lower (p0.05) between 

these two groups and vaginitis was found only in the complete retention group 

(9.06%; 2/22). In conclusion, the results showed that this CIDR protocol was 

effectively used for estrous synchronization. However, an incomplete retention of 

CIDR in vagina could be diminished the successful estrous synchronization program. 

Keywords: CIDR, Oestrous synchronization, Dairy heifers 

*Corresponding author e-mail: suvalukse@kku.ac.th 


Poster presentation



Poster presentation 

Case study: Kidney Stones in Perineal Urethrostomy 

Red Kalahari Goat 

Sarawut Sringam 1 *, Patchanee Sringam 2 and Sirikachorn Tangkawattana 3 

1 Department of Surgery and Theriogenology, 2 Department of Physiology, 

3 Department of Pathobiology, Faculty of Veterinary Medicine, Khon Kaen University, 

Khon Kaen, Thailand 40002 

ABSTRACT 

A 65 kg-2.5-year-old male Red Kalahali goat had difficulty in urinating since last 4 

months. Urinary calculi was diagnosed and perineal urethrostomy was performed. 

The buck returned to the Veterinary Teaching Hospital, Faculty of Veterinary 

Medicine, Khon Kaen University with the clinical signs of depression, anorexia, 

abdominal pain, inability to stand and oliguria for 1 week. Urinary catheterization, 

fluid replacement, antibiotic, vitamin and antipyretic drugs were prescribed during 6 

days of treatment. His complete blood cell count indicated the presence of 

leukocytosis, neutrophilia, eosinopenia and monocytosis. The creatinine and 

aspartate aminotransferase increased. Urinary analysis revealed hematuria and 

pyuria together with bacteriuria, hyposthenuria, proteinuria and struvite crystalluria. 

The post-mortem examination revealed the hemopurulent cystitis with turbid urine, 

the multiple necrosis on the renal cortex and a plenty of various size of stones in 

renal pelvis. The findings indicated that the kidney stones and infection were the 

major causes of death. The prevention of urolithiasis should be the best choice. 

Keywords: Goat, Kidney stones, Urethrostomy 

*Corresponding author e-mail: sarsri@kku.ac.th 


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A Comparative Study on the Efficacy of Two Toltrazuril Anticoccidial 

Drugs for Coccidiosis Control in Meat Goats 

Niorn Ratanapob 1 *, Pipat Arunvipas 1 and Waraphon Phimpraphai 2 

1 Department of Large Animal and Wildlife Clinical Science, 


Kasetsart University, Kamphaengsaen Campus, Thailand 73140 

ABSTRACT 

Coccidiosis can cause the losses in goat industry. However, many coccidiostats can 

also be used to alleviate the losses from coccidial infection. Toltrazuril is one of the 

most effective coccidiostats that has been used in domestic animals, including goat. 

There are many brand names of drug which have toltrazuril as an active ingredient 

but differed in manufactured sources and prices. This study was conducted to 

compare the treatment efficacy of two brand names of toltrazuril anticoccidial drug. 

Twenty free range goats in a meat goat farm in Chainat province were systematically 

allocated into two groups. Toltrazuril A and B were used in this study as a single oral 

dose: group 1 received toltrazuril A 20 mg/kg BW and group 2 received toltrazuril B 

20 mg/kg BW. Fecal samples were collected per rectum before and after treatment 

at day 0, 7, 14, 21 and 28. Numbers of oocyst were detected by Modified Mc Master 

technique with a sensitivity of 50 oocysts per gram of feces. Student s t-test was 

conducted to compare log-transformed oocyst number between two groups at each 

time of sample collection. Means of oocysts per gram of feces in group 1 and 2 were 

76,856 and 64,835, 9,911 and 2,505, 25,344 and 16,985, 6,655 and 11,400, and 

44,127 and 12,785 at day 0, 7, 14, 21 and 28, respectively. Log-transformed means of 

oocysts per gram of feces between group 1 and 2 were not different statistically at 

all sampling times. Therefore, cost-effectiveness is a factor that should be concerned 

in choosing toltrazuril for coccidiosis control in meat goat. 

Keywords: Coccidiosis, Efficacy, Goat, Toltrazuril 

*Corresponding author e-mail: fvetnor@ku.ac.th 





Relationship between Serum Urea Nitrogen and 

Reproductive Performance in Dairy Cows 

Pachjarawan Sukteab 1 , Chalong Wachirapakorn 2 

and Suneerat Aiumlamai 3 * 

1 Graduate Student, Department of Surgery and Theriogenology, 

Faculty of Veterinary Medicine, 2 Department of Animal Science, Faculty of 

Agriculture, 3 Department of Surgery and Theriogenology, Faculty of Veterinary Medicine, 


ABSTRACT 

The current study was conducted to determine the relationship between serum urea 

nitrogen (SUN) and reproductive performance of dairy cows in smallholder dairy 

farms of Waritchaphum dairy cooperative in SakonNakhon province, Thailand. A 

total of 184 Holstein crossbred dairy cows (>75 %) from 34 randomly selected 

farms were used in this study. Feeding and reproductive management were similar 

in all herds, veterinary and insemination services were provided by the dairy 

cooperative. The diets were 10.90±3.28% crude protein, the concentrate was given 

twice daily during milking and the forages were given free choice. The average 

lactation number and days in milk of the cows were 3.05±2.12 and 170.79±84.91, 

respectively. Blood samples were collected twice from each cow in 50 days apart 

during the study period and the mean SUN from each cow was used. All breeding 

records were collected from each cow to be analyzed for the fertility indices which 

were days of calving to the first insemination interval (CFS), days of calving to 

conception interval (CC) and numbers of service per conception (SC). The results 

showed that 28.80 % and 17.93 % of the cows had SUN level 20 mg/dl, 

respectively. Although, the correlation between SUN concentration and any of the 

fertility indices were not statistically significant (p>0.05), slightly negative correlation 

of SUN and fertility indices was found. Only 8.15 % of the cows had an acceptable 

reproductive performance in which the CFS, CC and SC were less than 60, 85 and 1.5, 

respectively and the mean SUN of these cows was 13.97±6.43 mg/dl. In conclusion, 

the decrease in fertility of the cows with SUN >20 mg/dl or SUN

134 




Effect of Taxol on In Vitro Developmental Competence of 

Bovine Oocytes 

Chatree Chumnandee 1�� and Saksiri Sirisathein 2 

1 Graduate Student of PhD Program in Interdisciplinary Veterinary Science, 

2 Department of Surgery and Theriogenology, Faculty of Veterinary Medicine, 


ABSTRACT 

Taxol (paclitaxel) is a microtubule stabilizing agent, commonly used as an anti-cancer 

drug. In recent years, Taxol has been used to treat mammalian oocytes prior to 

vitrification. The preliminary study was conducted to determined effect of Taxol on 

in vitro developmental competence of bovine oocytes. The cumulus oocyte 

complexes (COCs) were divided into 2 groups; group 1; non-treated with Taxol 

(control), group 2; treated with Taxol. After follicular aspiration, the COCs was in 

vitro matured in TCM-199 with Earle s salt medium supplemented with 7.5 mM 

HEPES, 1 g/L PVA, 0.45 mM pyruvate, 5.3 mM sodium lactate, 0.2 mM cyteamine, 0.2 

mM cyteine, 0.25 mM glutamine, 25 mM NaHCO3, 1000 g/L gentamicin, 5% fetal calf 

serum and 0.025 Armour Unit/mL follicle stimulating hormone. The COCs were 

cultured at 38.6°C, 5% CO2 for 22-24 h. For Taxol treated group, COCs were 

incubated in the TCM-199 with 1 �M Taxol for 15 minutes before in vitro 

fertilization. Then, the COCs from both groups were co-incubated with spermatozoa 

at a concentration of 2�10 6 sperm/mL in the TALP medium (110 mM NaCl, 3.2 mM 

KCl, 0.4 mM NaH2PO4, 2.0 mM CaCl22H2O, 0.5 mM MgCl26H2O, 5.0 mM glucose, 

1mg/mL PVA, 3.35 mM penicillamine, 0.05 g/L gentamicin, 0.4 mM pyruvate, 13.0 

mM lactate, 5.0 mM HEPES and 25mM NaHCO3) at 38.6°C, 5% CO2 for 16-18 h. The 

presumptive zygotes were cultured at 38.6°C, 5% CO2 and 5% O2 in the SOF medium 

(103.7 mM NaCl, 7.16 mM KCl, 1.19 mM KH2PO4, 1.71 mM CaCl22H2O, 0.5 mM 

MgCl26H2O, 3 g/L PVA, 10 mM HEPES, 0.40 mM threonine, 0.1 mM NEA, 0.05 g/L 

gentamicin, 0.33 mM pyruvate, 3.33 mM lactate and 25 mM NaHCO3) with 0.05 mM 

glutamine until 72 hour post insemination (hpi). The embryos with at least 4 cells 

were cultured in the SOF medium with 1.5 mM glucose and 0.5 mM citrate until 144 

hpi, then in the TCM-199 medium with 2% FCS until day 8. The results showed that 

the percentages of fertilization and blastocyst were not different between the 

control group and the Taxol group (90.4 vs 84.9, and 34.6 vs 24.5%, respectively) 

(p>0.05), as well as the cell number of blastocyst in both groups (117.33�25.18 and 

111.50�8.42, respectively) (p>0.05). In conclusion the results indicated that Taxol 

treatment, under the above condition, had no toxicity on developmental 

competence of bovine oocytes. 

Keywords: Bovine oocyte, Taxol, Toxicity 

*Corresponding author e-mail: chatree@npu.ac.th 





The Effect of Corynebacterium cutis Lysate (Ultra-corn ® ) 

to Control Somatic Cell Count in Dairy Cows 

Kanograt Suchalerm 1 , Chadaporn Sirirungsakulwong 1 , 

Suriya Lamsida 1 and Chaiwat Jarassaeng 2 * 

1 6 th year student, 2 Department of Surgery and Theriogenology, 


ABSTRACT 

The aim of this study was to evaluate the effectiveness of repeated inoculations of a 

Corynebacterium cutis lysate (Ultra-Corn ® ) in a commercial dairy farm at Phimai 

district Nakhon Ratchasima province. The study was done in randomly selected 20 

dairy cows with SCC over 250,000 cells/ml. Cows were divided randomly into two 

groups and treated group received 3 weekly 20 mg/100 kg of Ultra-Corn ® injected 

intra-muscularly while the control group received distilled water instead. Milk was 

collected a week before first injection then followed entire period for 8 weeks of 

observation and collected milk for SCC analysis by using Fossomatic ® . The result 

showed no significant differences between the treatment and control groups of 

cows. In this study, the immuno-stimulant effect of Ultra-Corn ® , a Corynebacterium 

cutis lysate could not decreased SCC in case of infection of Streptococcus uberis. 

Keywords: Corynebacteriam cutis, Dairy cows, Somatic cell count, Subclinical mastitis 

*Corresponding author e-mail: chajar@kku.ac.th 


135

136 




Determination of Allisonella histaminiformans in Dairy Cows with 

Rumen Acidosis induced by Feeding High Protein Concentrate 

using a real-time PCR Technique 

Nirattisai Chaisaen 1 , Chaiyapas Thamrongyoswittayakul 1 *, 

Rittichai Pilachai 2 , Aran Chanlun 1 and Chalong Wachirapakorn 3 

1 Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand 40002, 

2 Faculty of Technology, UdonThani Rajabhat University, UdonThani, Thailand 

41000, 3 Faculty of Agriculture, Khon Kaen University, Khon Kaen, Thailand 40002 

ABSTRACT 

Allisonella histaminiformans, known as gram negatively and acid tolerant bacteria in 

rumen, relied solely on histidine decarboxylation for their energy derivation for 

growth, thus producing hitamine. The study was conducted to determine the A. 

histaminiformans population in dairy cows ruminal fluid in acidosis condition 

induced by feeding high protein concentrate (22.9% dry matter) using a real-time 

polymerase chain reaction approach. Six rumen-fistulated, non-pregnant, dry 

Holstein cows with an average 449.3±53.4 kg of body weight were assigned in 

completely randomized design during a 28-day period (21-day preliminary and 7-day 

experimental periods). The cows were fed twice daily by equally one halves of a 

concentrate:roughage ratio (87.5 : 12.5), subsequently measured rumen pH and 

collected rumen fluid pre-(T0) and 8-hour post-morning feeding (T8) in day 0 (D0), 3 

(D3) and 7 (D7). Ruminal population of A. histaminiformans were compared and 

specifically detected by FAM/TAM Taqman probe, which was designed according to 

a partial sequence of 16S rRNA of A. histaminiformans. Results indicated that feeding 

cows with high protein diet induced rumen acidosis with a significantly reduced 

rumen pH in T8 of D3 and D7 (4.86 and 5.16, p=0.003). The population of A. 

histaminiformans was significantly increased (p




Bulk Tank Milk Investigation of BVDV Infection 

in an Extensive Dairy Population 

Tassanee Wetchapan 1 , Watcharapon Promsut 1 , Wilasinee Chanapea 1 , 

Suneerat Aiumlamai 2 and Jaruwan Kampa 3,4 * 

1 5 th year students, 2 Department of Surgery and Theriogenology, 3 Department of 

Pathobiology, 4 Research Group for Preventive Technology in Swine and Ruminant Disease, 


ABSTRACT 

Bovine viral diarrhoea virus (BVDV) causes significant losses in reproduction and, 

subsequently, herd s production in dairy herds. Bulk tank milk of 532 dairy herds 

located in an extensive dairy raising area in the central part of Thailand, were 

investigated the virus prevalence by using an indirect ELISA kit. By detection of 

specific anti-BVDV antibodies, 25.9% of herds (138/532) had positive results. The 

prevalence was higher than the previous investigations on 1992 and 1997 which 

were 4.4% and 15.8%, respectively. Although most of the herds, 74.1%, were free- 

BVDV infection, however, those herds were at risk of losses in the near future if any 

biosecurity measures had no plan to be applied. 

Keywords: Bovine Viral Diarrhoea Virus, Dairy cattle, Prevalence 

*Corresponding author e-mail: jarpat@kku.ac.th 


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138 




Prevalence and Risk Factors of Brucellosis in Domestic Ruminants in 

Salakphra Wildlife Sanctuary, Kanchanaburi Province, Thailand 

Nantawan Yatbantoong 1 *, Pipat Arunvipas 1 , Sathaporn Jittapalapong 2 , 

Rattanawat Chaiyarat 3 , Prawut Prampree 4 and Samart Prasittiphol 5 

1 Faculty of Veterinary Medicine, Kasetsart University, Kamphaengsaen Campus, 

Nakhon Pathom, Thailand 73140, 2 Faculty of Veterinary Medicine, Kasetsart University, 

Bangkhen, Thailand 10900, 3 Faculty of Environment and Resource Studies, Mahidol 

University, NakhonPathom, Thailand 73170, 4 Salakphra Wildlife Sanctuary, Kanchanaburi, 

Thailand 71190, 5 Department of Livestock Development, Kanchanaburi, Thailand 71000 

ABSTRACT 

The number of livestock such as cattle and goat raised in the protected area in 

Thailand has increased continually. Once the livestock get diseases, the spreading of 

pathogen to wildlife in the area may occur. Brucellosis is one of a chronic infectious 

disease in domestic and wild animals. It is also a zoonotic disease which is important 

to public health. A survey of brucellosis infection and risk factors of brucella 

seropositivity in domestic ruminants was carried out in a buffer zone of Salakphra 

Wildlife Sanctuary (SLP), Kanchanaburi Province. SLP is located in the Western Forest 

Complex (WEFCOM) which is one of the largest protected forest area in Thailand. 

This study was performed between April 2009 and November 2010. Three hundred 

and thirty three blood samples from 48 herds were randomly selected. Data on 

husbandry practices were collected by questionnaires for risk factors investigation. 

Sera were screened for anti-Brucella antibodies using Rose Bengal Test (RBT) and 

ELISA technique was used as a confirmatory test. Logistic regression was used to 

analyze factors to be associated with brucellosis infection. The results showed that 

17 samples (5.11%) had antibody against Brucella abortus. Cattle over two years 

were 36.5 times more likely to be seropositive than young cattle (p=0.03). A herd 

with time of livestock raising over ten years was 38.4 times greater odds for being 

seropositive than of the herd with time of livestock raising less than ten years 

(p




Inhibitory Effect of Plant Essential Oils against Malassezia 

pachydermatis isolated from Dogs with Malassezia dermatitis 

Tanaporn Asawapattanakul 1 , Rattanaporn Leesing 2 , 

Watcharee Khunkitti 3 and Jareerat Aiemsaard 1* 

1 Faculty of Veterinary Medicine, 2 Faculty of Science , 3 Faculty of Pharmaceutical Science, 


ABSTRACT 

This study was performed to investigate the anti-Malassezia activity of betel vine 

(Piper betel Linn.), clove [Syzygiumaromaticum(L.) Merr. & Perry] and lemongrass oil 

(Cymbopogoncitratus Stapf.) against Malassezia pachydermatis isolated from dogs 

with Malassezia dermatitis. The screening of antifungal activity of the essential oils 

were evaluated using disc diffusion and broth microdilution methods. By the disc 

diffusion assay, Malassezia pachydermatis showed the most susceptibility to the 

betel vineoil (inhibition zone at 2% = 21.00±3.126 mm). In addition, the results of 

broth microdilution assay indicated that the Malassezia pachydermatis was very 

susceptible to betel vineoil, with minimum inhibitory concentrations/minimum 

fungicidal concentrations (MICs/MFCs) ranging from 0.03 to 2 µl/ml. Thus, the oil 

may be a useful alternative for treating Malassezia-associated diseases. 

Keywords: Anti-Malassezia activity, Essential oil, Malassezia pachydermatis 

*Corresponding author e-mail: Ajaree@kku.ac.th 


139

140 




Study of Gastro-intestinal Transit Time in Rabbit 

using Barium Sulphate 

Tanapol Ampratchar 1 , Nopporn Surdprakhon 1 , Machima Polyeam 1 , 

Sompoat Weerakhun 1 and Naruepon Kampa 1 * 

1 Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand 40002 

ABSTRACT 

Gastro-intestinal (GI) tract problems such as gas, stasis and obstruction are common 

problem in rabbits. The diagnosis can be sometimes made based on the physical 

examination and the symptoms of rabbits. Radiography, a useful tool for evaluating 

the GI tract problem has widely been used in exotic animals including rabbits to 

confirm the diagnosis. However, the information of GI transit time of rabbits has not 

been studied intensively. In this study, the GI transit time of normal rabbits has been 

studied using barium sulphate. Ten healthy rabbits age between 1-1.5 years were 

used. All rabbits were fed the same food and were allowed to drink water ad lib. 

Food were fasted 3 hours prior the experiment. Each rabbit was given barium 

sulphate mixed with syrup at 5 ml/kg, approximately. The rabbit was radiographed 

immediately after swallowing barium sulphate and every 15 mins (15, 30, 45, 60 and 

75 mins) and after that every 30 minute (105, 135, 165, 195, 225 and 255 mins). All 

radiographs of each rabbit were interpreted for gastrointestinal transit time analysis. 

The average of GI transit time of barium sulphate which appears to be seen in 

caecum was 1 hour and 52.5 mins ranging between 1 hour and 3.15 hour. The 

different of transit time may caused by many factors such as different volume 

content in GI tract, stress and individual variation of each rabbit. Values obtained 

from this study might be useful in helping the diagnosis of GI problem. 

Keywords: Gastro-intestinal transit time, Rabbit, Barium sulphate 

*Corresponding author e-mail: naruepon.kampa@gmail.com

impact o na sean one health - KVAC 2012 ....VET MED KKU thailand ...

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