Osteomyelitis is a significant cause of total carcass condemnation in pigs at the slaughterhouse. The decision for total condemnation of a pig carcass for osteomyelitis is often based on traditional perceptions of the risk of pyaemia, leading to controversy among Official Veterinarians (OV) in the industry. This review aims to provide a more comprehensive understanding of the etiopathogenesis of osteomyelitis in pigs, the microorganisms involved, and the risk factors. It also highlights the urgent need for a more uniform method to evaluate osteomyelitis cases, which could significantly reduce economic losses in the industry. Lesions originating from tail-biting, tail docking, castration, teeth resection, and raw management are described as risk factors for osteomyelitis. Osteomyelitis is caused by the entry of pathogens into the animal’s bloodstream through an open wound. Trueperella monocytogenes, Staphylococcus aureus, and Streptococcus spp. are the most described pathogens. At slaughter, OVs condemn carcasses with osteomyelitis due to pyaemia. Signs of acute disease are essential to identify pyaemia cases. In chronic cases, total carcass condemnation can be avoided depending on the number of lesions and vertebrae affected. A clear overall image of the problem would help authorities in various countries adopt a more homogenous approach.
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