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Ulceration of the anus
in groups of pubertal male pigs
Ulceración
de ano en grupos de machos púberes
Ulcération
anale chez des groupes de porcs mâles pubères
Steven McOrist,
BVSc, PhD; Mark Williamson, BVSc, PhD, Diplomate ACVP
SM: University of
Nottingham, School of Veterinary Medicine and Science, Sutton Bonington,
England. MW: Gribbles Pathology, Clayton, Victoria, Australia. Corresponding
author: Dr Steven McOrist, University of Nottingham, School of Veterinary
Medicine and Science, Sutton Bonington LE12 5RD, United Kingdom; Tel: +44
115 9516430; E-mail: steven.mcorist@nottingham.ac.uk.
Cite as: McOrist
S, Williamson M. Ulceration of the anus in groups of pubertal male pigs. J
Swine Health Prod. 2007;15(2):96–98.
Also
available as a PDF.
Summary
Ulceration of the anus as a specific condition has not been reported widely
in swine medicine. Sporadic occurrences were noted in groups of 40 to 200 sixteen-
to 17-week-old entire male pigs on four separate finisher facilities with similar
management. Cases on each facility rapidly rose from none to between 20% and
30% over 2 weeks, then stabilized. Gross lesions in early affected cases consisted
of deep, punched-out cavity ulcers, commencing to one side of the anal sphincter.
The ulcers initially had clean, well-circumscribed ulcer margins, with rolled
edges and minimal obvious granulation. Affected pigs had fully developed secondary
sex glands and firm dry feces. Deep ulcer tissue consisted of proliferative
fibroplasia in vascular connective tissue. Bacteriologic culture and histologic
Gram stains identified Streptococcus dysgalactiae and Clostridium
perfringens within representative ulcers. Outbreaks occurred when aggressive
and sexually active pubertal male pigs were housed in areas of poor water and
excreta drainage. Anal ulceration lesions were clearly distinguishable from
the more common conditions of anal prolapse or tail-biting lesions. Initial
trauma to the anus due to homosexual behavior with a consequent mixed infection,
including S dysgalactiae, in a softened ano-cutaneous environment, may
be the cause for these unusual lesions.
| Resumen
La ulceración del ano como una enfermedad específica no se ha
reportado ampliamente en la medicina porcina. La aparición esporádica
fue reconocida en grupos de 40 a 200 cerdos machos de 16 a 17 semanas de edad
en cuatro instalaciones de finalización separadas con un manejo similar.
Los casos en cada una de las instalaciones se elevó rápidamente
de cero a entre 20% y 30% en 2 semanas, luego se estabilizó. Las lesiones
macroscópicas en los primeros casos consistieron en profundas úlceras
de cavidad perforada, comenzando a un lado del esfínter anal. Inicialmente,
las úlceras tuvieron márgenes limpios, bien definidos, con orillas
enrolladas y granulación obvia mínima. Los cerdos afectados desarrollaron
glándulas sexuales secundarias y heces firmes y secas. El tejido ulceroso
profundo consistía de fibroplasia proliferativa en el tejido conectivo
vascular. El cultivo bacteriológico y la tinción de Gram histológicas
identificaron Streptococcus dysgalactiae y Clostridium perfringens dentro
de úlceras representativas. Los brotes ocurrieron cuando se alojó a
machos púberes agresivos y sexualmente activos y en áreas de
mal drenaje de agua y excretas. Las lesiones de ulceración anal fueron
claramente distinguibles de las enfermedades más comunes de prolapso
anal o lesiones de mordida de cola. El trauma inicial al ano debido a una conducta
homosexual con una consecuente infección mixta, incluyendo S dysgalactiae,
en un medio ambiente cutáneo suavizado del ano, pueden ser la causa
de estas raras lesiones.
| Resumé
L’ulcération de l’anus en tant que condition spécifique
n’est pas rapportée de manière généralisée
en médecine porcine. Des cas sporadiques ont été notés
dans des groupes de 40 à 200 verrats âgés de 16 à 17
semaines dans quatre
élevages distincts de finisseurs ayant des gestions similaires. Les cas à chaque
facilité ont augmenté rapidement de zéro à entre
20% et 30% sur une durée de 2 semaines, puis se sont stabilisés.
Les lésions macroscopiques observées lors des premiers cas se présentaient
sous forme de cavités ulcéreuses profondes débutant d’un
côté du sphincter anal. Initialement, les ulcères avaient
des bordures nettes et bien délimitées, avec des bords roulés
et un minimum de granulation. Les porcs affectés avaient des glandes sexuelles
secondaires complètement développées et des fèces
sèches et fermes. Des ulcères profonds étaient constitués
de fibroplasie proliférative dans du tissu conjonctif vasculaire. Les
cultures bactériennes et des colorations de Gram de lames histologiques
ont permis d’identifier Streptococcus dysgalactiae et Clostridium
perfringens à partir d’ulcères représentatifs.
Des poussées de cas se sont produites lorsque des porcs mâles pubères
agressifs et sexuellement actifs étaient logés dans des endroits
où le drainage de l’eau et des déjections étaient
déficients. Les lésions d’ulcération anale étaient
clairement distinguables des lésions plus communes comme le prolapsus
anal ou le mordillage de queue. Un trauma anal initial associé à un
comportement homosexuel avec une infection mixte subséquente, incluant S
dysgalactiae, dans un environnement ano-cutané ramolli, pourrait être
la cause de ces lésions inhabituelles.
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Keywords: swine, anus,
ulceration, Streptococcus dysgalactiae
Search the AASV web site
for pages with similar keywords.
Received: July
14, 2006
Accepted: September
7, 2006
Ulceration of the anus as a specific condition has not been
reported widely in swine medicine or indeed in other species. In
humans, deep ulceration of the anal area has been reported in some
AIDS patients as a feature of the condition in homosexual
males.1 It has also been linked to an adverse reaction
to nicorandil, a potassium channel activator drug, in non-AIDS
patients.2 This report describes an unexplained and
severe ulceration of the anal area in groups of pubertal male pigs.
The syndrome occurred over several batches and locations of a
linked farm system over a period of 3 years.
Case description
The case-study farm system consisted of three separate breeding
farms sourced by a single nucleus herd. These breeding farms were
stocked with specific lines of Large White × Landrace, with a Large
White (Yorkshire) terminal sire line supplied by semen from a
separate boar stud. These breeding farms supplied weaned pigs to
separate on-site or off-site production nursery facilities, which
then supplied grower pigs to on-site or off-site finisher
facilities. Pigs were not neutered on any farm and were sorted and
held after weaning in separate male and female groups. All pigs
were sent for slaughter at 20 to 22 weeks old. The rations for all
facilities were supplied by a central feed mill operation and
consisted of a fully formulated wheat cereal and canola base
diet.
Sporadic occurrences of the anal ulceration condition were noted
over a 3-year period on four of 15 separate grower-finisher
facilities within this farm system. The syndrome occurred only in
groups of male pigs; the age of onset was 16 to 17 weeks. At this
age, male pigs were kept in large-pen groups or whole-barn groups
of 40 to 200. Affected groups usually occurred in approximately 50%
of pens per barn, but sometimes involved all pens in the barn.
Sporadically, affected groups were found among normal groups which
were located on the same site and which had been sourced and housed
in the same way. The percentage of pigs within an affected group
appeared to rise rapidly from none to 20% to 30% over a 2-week
period. Therefore, in a typically affected group of 180 male pigs,
cases would rise in an outbreak from 0 to 20 to 40 in a 2
week-period, starting at 16 weeks of age, then stabilize. Attempts
were made to investigate the case environment and early cases in
pigs at 16 weeks of age. Gross study of the lesions was performed
on affected individuals. Tissue samples were collected for routine
histology. Anaerobic and aerobic cultures were performed on 13
affected pigs in the early stages of the condition (Days 1 to 3).
Once affected pigs were 18 weeks old (Days 10 to 14), many had
progressive deep perineal ulcers, centered on the anus, which were
more difficult to characterize. Affected pigs appeared to have
normal appetites and growth rates and were sent for treatment,
slaughter, or euthanasia on an individual basis. In many affected
groups, addition of amoxicillin to the diet to deliver a dose rate
of 5 mg per kg of body weight caused a noticeable reduction in the
incidence and severity of cases within the outbreak, but did not
appear to fully eliminate the syndrome.
Gross lesions in early affected cases consisted of deep
punched-out cavity ulcers commencing to one side of the anal
sphincter region (Figure 1). The ulcers had clean,
well-circumscribed margins, with rolled edges and minimal obvious
granulation. The ulcer floor consisted of a thin necrotic surface
and deeper inflammatory reaction. No obvious fistula, abscess,
foreign body, tail-biting lesion, prolapse, or other trigger
factors were evident in any of the dozens of affected pigs closely
examined grossly. The affected pigs (16 to 18 weeks old) were
consistently at pubertal onset with fully developed testicles and
internal secondary sex glands (eg, seminal vesicles within the
lower abdomen). The rectal and colonic feces were regularly of a
firm to constipated consistency, with dry matter of 20% to 25%. In
over 50% of untreated cases, this initial punched-out ulcer
progressed to affect wider and deeper tissues, with evident
purulent ulceration and associated inflammation extending across
the perineum.
| Figure 1: Punched-out cavity ulcer in a 16-week-old
intact male pig, commencing to one side of the anal sphincter region.

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All biopsies and autopsy tissue samples at the early stage of
ulcerative lesions revealed that deep ulcer tissue consisted of
proliferative fibroplasia in a vascular connective tissue
collagenous stroma, with scattered neutrophils and macrophages.
Histologic Gram stains of tissue samples revealed numerous
tissue-located bacteria, predominantly gram-positive coccal forms
scattered within the inflammatory stroma. Bacteriologic culture of
early cases revealed consistent growth of Streptococcus
species, identified as S dysgalactiae by routine API 20
Strep identification system (bio Merieux, Hazelwood, Missouri) in
Lancefield Group C, identified by latex bead agglutination
reactions using a Streptex kit (Remel Inc, Lenexa, Kansas). This
bacteriologic identification was consistent across samples from
several groups. Anaerobic cultures also revealed growth of
Clostridium perfringens in several cases.
The most consistent features of the outbreaks were the age,
origin, and sex of the pigs over numerous pens and barns over a
3-year period. Cases primarily occurred in pigs housed on organic
bedding (rice hull and wheat straw combinations), but were
occasionally noted in pigs housed on concrete slatted floors. In
all forms of housing, however, the onset of outbreaks occurred when
pigs were housed in areas of poor water and excreta drainage, with
standing fecal-soiled water on the organic or concrete flooring.
Concurrently, the pubertal male pigs within affected pig groups
were also aggressive and sexually active among their cohorts, and
hyperactive when approached.
Discussion
These novel lesions of anal ulceration were clearly
distinguishable from the more common conditions of anal prolapse or
tail-biting lesions by ourselves and attendant farm staff. The tail
itself appeared normal and the anal mucosa showed no noticeable
protrusion throughout individual cases. We suggest that the
proximate cause of the cases was initial trauma to the anus due to
pubertal homosexual behavior with consequent mixed infection,
including
S dysgalactiae and C perfringens, in a water-softened
ano-cutaneous environment. Streptococcus dysgalactiae is
probably a relatively common opportunistic pathogen within
cutaneous ulceration lesions.3 This organism and closely
related organisms are known commensals of the external sexual
organs of pigs.4 Thus, S dysgalactiae may
have been directly introduced into the initial lesion sites from
infected penetrative male genitalia. Whether the particular
isolates of S dysgalactiae in these unusual cases had
altered virulence factors compared to commensal isolates was not
clear from our study.
A number of factors other than the proximate causes may have
been involved in these outbreaks. It is possible that the bedding,
feces, and urine of these growing pigs may have had the potential
to scald the ano-perineum, perhaps due to alterations in pH or
cereal content within the diet, allied to poor environmental
control of water within pens and barns. However, we also considered
an important factor to be the single-source genetic supply of
entire and pubertal male pigs of Large White heritage, which showed
agitated behavior patterns. Swine veterinary consultants are
alerted to this novel and highly deleterious problem in
non-castrated male pigs housed on wet organic or other bedding.
References
1. Wilcox CM, Schwartz DA. Idiopathic anorectal ulceration in
patients with human immunodeficiency virus infection Am J
Gastroenterol. 1994;89:599–604.
2. Toquero L, Briggs CD, Bassuini MM, Rochester JR. Anal
ulceration associated with Nicorandil: case series and review of
the literature. Colorectal Dis. 2000;8:712–720.
3. Davies CE, Hill KE, Wilson MJ, Stephens P, Hill CM, Harding
KG, Thomas DW. Use of 16S ribosomal DNA PCR and denaturing gradient
gel electrophoresis for analysis of the microfloras of healing and
nonhealing chronic venous leg ulcers. J Clin Microbiol.
2004;42:3549–3557.
4. Bara MR, McGowan MR, O’Boyle D, Cameron RD. A study of
the microbial flora of the anterior vagina of normal sows during
the different stages of the reproductive cycle. Aust Vet J.
1993;70:256–259.
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