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Not everyone may recognize ileitis. As antibiotic usage drops, it's hitting younger and younger pigs, says Monte Fuhrman, a veterinarian with Sioux Nation Ag Center in South Dakota. He has seen ileitis in pigs at 70-80 lb.

Most producers are familiar with the signs: loose stools, blood flecks in the stool, weight variation, gaunt pigs and mortality. The hard part is differentiating ileitis from other diseases at necropsy. Circovirus, or PCV2, for instance, looks almost exactly like ileitis at posting. Therefore, getting laboratory confirmation of Lawsonia is critical to implementing a proper treatment program.

Once the signs are there however, it's too late for vaccination and Denagard^® becomes Fuhrman's product of choice. If the outbreak is acute, he turns to Denagard Liquid Concentrate.

“Many farms are reducing the use of feed-grade antibiotics,” Fuhrman says. “Water medications are becoming more important and water-soluble Denagard, when prescribed in a veterinary/client relationship, has been a highly effective treatment.”

Sioux Nation clients do use Denagard with chlortetracycline — Denagard Plus — in the feed at weaning. It's commonly the first combination antibiotic in place, primarily for respiratory disease, says Fuhrman, who is director of swine veterinary services for the Sioux Falls, S.D., ag service company and one of 10 staff veterinarians.

Denagard also plays a role as part of an ileitis control program. Administered before and after the required non-medicated vaccination window, it keeps infection pushed back so the vaccine has time to stimulate immunity, notes Don Walter, senior technical manager for enteric products at Boehringer Ingelheim Vetmedica, Inc.

If pigs already have been exposed to the ileitis organism, on the other hand, they will not benefit from vaccination and in those cases, Denagard is a good choice in an ileitis control program, he adds.

The oral, avirulent live Enterisol^® Ileitis vaccine must be administered three to four weeks prior to the beginning of any exposure to infection. Blood sampling shows many of Fuhrman's client herds seroconvert (show antibody titers to Lawsonia, the organism that causes ileitis) at 12 to 16 weeks. “That means those pigs were exposed around eight to 12 weeks of age. Time of exposure is not the time pigs seroconvert,” Fuhrman says. “Pigs need to be vaccinated eight weeks before seroconversion. If you're already seeing clinical signs, often observed around 20 weeks of age, it's too late. Work with your veterinarian to determine the best time to vaccinate.”

Enterisol Ileitis is not difficult to use, but there have been issues with incorrect storage, administration and human errors, notes Fuhrman. “The quality control effort as far as manufacturing and distribution of the vaccine, however, has been very impressive,” he adds. “Making sure the appropriate amount of dry ice is used according to weather conditions ensure the vaccine is viable when it arrives at the farm.

“The company has really put together a nice cookbook approach that allows us to do a good job with the Enterisol Ileitis vaccine,” states Fuhrman. “The process is to obtain blood samples, have them tested, look at the results and eight weeks ahead of serologic conversion place the vaccine with no antibiotics on either side. It should work.”