Title Page
-
Version # 2: November 13, 2019
-
Doc ID: 4.a.ii.2.a
-
Notify Veterinarian of an initiated OHC
-
Farm Name
-
House Number
-
Age of Bird (In Days)
-
Date Placed
-
Date RCA Completed
-
Date Mortality Increased
-
Requirements Statement:
-For week 1 (0-7 days of age) action threshold is >5/1000/day for more than 2 consecutive days.
-For week 2-harvest (8 days-harvest) action threshold is >3/1000/day for more than 2 consecutive days, or > 5/1000 for 1 day.
Investigation Background
Requirements Statement: -For week 1 (0-7 days of age) action threshold is >5/1000/day for more than 2 consecutive days. -For week 2-harvest (8 days-harvest) action threshold is >3/1000/day for more than 2 consecutive days, or > 5/1000 for 1 day.
Chick Health
-
Is This First Week Mortality?
-
Chick Quality (0-7 Days)
Select One Of The Following: -
Infectious Disease (Omphalitis, Asper, etc...)
-
Non-Infectious Disease (Dehydration, Red Hocks, Navel)
-
Mixed
-
Other
-
Describe:
Mortality (Dead + Culls) as x/1000
-
Increments of "0.1" - round to the tenth decimal place, are only accepted. (As Needed)
-
EX: 2.3 is okay, but 2.28 is NOT accepted.
-
Today
-
Yesterday
-
2 Days Before
Method by which notified of mortality increase
-
Through visitation
-
Through communication with grower
-
Date Notified
-
Was notification immediate as required in contract?
-
Grower was retrained on mortality reporting requirements
-
Other corrective action was implemented, please describe
-
Are birds greater than 21 days of age?
-
Is the mortality (deads, NOT culls) greater than 3/1000 for 2 consecutive days or 5/1000 for 1 day?
-
Will or have birds or AI swabs been submitted to the lab in response?
-
Comments (If Applicable)
Flock Supervisor Investigation
On-Farm Issues
-
Water
-
Describe Issue:
-
Temperature Extremes
-
Describe The Issue:
-
Air Quality
-
Describe The Issue:
-
Feed
-
Describe The Issue:
-
Lights
-
Describe The Issue:
-
Other
-
Describe The Issue:
Correction
-
Describe The Correction:
Infectious Disease
-
Respiratory
-
Select One Of The Following:
-
Airsac
-
Vaccine Reaction
-
Other
-
Describe The Issue:
Guts
-
Select One Of The Following:
-
Necrotic Enteritis
-
Cocci
-
Other
-
Describe The Issue:
Lameness
-
Select One Of The Following:
-
Bacteria (FHN) (Synovitis)
-
Reovirus
-
Kinky Back
-
Kick Stand
-
Other
-
Describe The Issue:
Other
-
Dermatitis
-
Mixed
-
Uneven
-
Spike
-
Feed Knockdown
-
Unknown
-
Describe:
On Farm Necropsy
Submitted to Laboratory?
AI Swabs Submitted
Was a Feed Sample Submitted
Script Request
-
Script Request Submitted?
-
Tack A Picture Of Your Script Request Form
-
Has a written and/or verbal instruction on administering medication occurred?
-
Date communicated
-
Was This house Treated last flock?
-
Is This The Second Flock In This House Being Treated?
-
Is This The Third Flock In This House Being Treated?
-
Is This The Fourth Flock In This House Being Treated?
-
Is This The Fifth Flock In This House Being Treated?
-
Is This More Than The Fifth Flock Being Treated In This House?
Flock Supervisor Sign-off and Date
-
Enter Name:
-
Enter Date & Time:
Veterinary Review Plan
Antibiotic Treatment (Details in Prescription)
-
Penicillin
-
Tetracycline
-
Lincomycin
-
Tylosin
-
BMD
-
SULFA
-
Other
-
Describe Treatment:
Non-Antibiotic Treatment (Run According to Label Directions Unless Instructed Otherwise By Vet)
-
Amprol
-
Copper Sulfate
-
Manage
-
Other
-
Describe The Treatment
Management
-
Cull Affected Birds
-
Describe Alternative Management:
-
Further Actions:
Reviewing Veterinarian Signature
-
For VET use ONLY.
-
Select VET
-
Vet Review Date:
Prescription
-
For Vet Use ONLY.
-
Prescription Number
-
Add media