The Facts about F10

THE FACTS ®
www.healthandhygiene.co.za
ISSUE 1 • 2006 FACTS IN
THIS ISSUE
RESPIRATORY DISEASE IN EXOTICS
AND SMALL MAMMALS

Reproduced with permission: Veterinary Times, Vol 35 No.38, 10 October 2005 JOHN CHITTY BVetMed, CertZooMed, MRCVS

Introduction stores. Sudden changes in husbandry, eg rapid temperature SMALL ANIMALS & EXOTICS
changes or mixing of individuals, will cause stress and
RESPIRATORY disease is a common problem in exotic therefore, affect immunity. Underlying systemic infection RESPIRATORY DISEASE IN EXOTICS
species in general practice, whether avian, reptilian or small may also play a part - the young Grey parrot with an airsac AND SMALL MAMMALS
mammal. aspergilloma may seem a clear diagnosis. However, if on
haematology there are few if any white blood cells then be
Different species have different disease susceptibilities. aware that it may be suffering from immunosuppression
These vary according to: caused by circovirus infection.

• Anatomy • Diet
The complicated sinus system of birds coupled with a Hypovitaminosis A is a well-known cause of respiratory
tendency to form solid pus means that upper respiratory disease in birds. Lack of this vitamin results in keratinisation
disease (URD) and sinusitis are common problems in many of glands in the mucous membranes with subsequent
avian species. Reptiles lack a muco-ciliary escalator abscessation and infection. Quality of overall diet should
meaning they find it hard to remove respiratory discharges. also be considered. Many seed diets for parrots are of
This is one factor contributing to lower respiratory disease extremely poor quality and often stored badly as well.
(LRD) in snakes. Rabbits suffer from compression of lungs Opening seed hulls will often reveal fungal growth within - a
and upper respiratory passages. Breeding to produce common source of Aspergillus spores. As a physical effect,
extremes of shape (especially "squashed nose" breeds) is a inhaled seeds may be a cause of tracheal blockage in
major factor in both upper and lower respiratory disease. parrots. In rabbits there is a very thin layer of bone between
tooth roots and nasal cavity - many cases of URTD result
• Immunity and "pathogens" from tooth root abscesses. (Fig. 1)
There are few primary pathogens found in respiratory
syndromes. Snake paramyxovirus may be an exception as Figure 1. Cross-section through a rabbit maxilla
may Bordetella bronciseptica in guinea-pigs. Other at the level of the molars. Note the thin section of
infectious agents may appear to act as pathogens in
stressed or immunologically naïve animals, eg Pasteurella in bone separating teeth from nasal cavity. It is
rabbits or chelonid herpesvirus in tortoises. Mixing of species easy to see how easily dental infection will
in households may, therefore, hold dangers, eg mixing
tortoise species will allow exchange of herpesviruses and penetrate the nasal cavity.
Mycoplasma spp between these species. While one tortoise
may cope with its own adapted organisms, another may not. Diagnosis
Mixing of rabbits and guinea-pigs allows rabbits (who will
often carry Bordetella as part of the normal respiratory flora) A range of causes cause a range of diseases, often with
to pass these organisms to guinea-pigs that don't. The similar symptoms.Accurate diagnosis is, therefore, essential
susceptibility of different species to different organisms is and often complicated - after all, the best therapeutic agents
amply illustrated by the incidence of aspergillosis in different in the world cannot work if used for the wrong condition! It is
bird species. Aspergillus spp spores are found in the also vital to explore the many underlying causes. As stated
environment and disease represents either lowered earlier, there are few primary pathogens and, while your
immunity to the organism or overwhelming infection. Grey diagnosis of a bacterial pneumonia in a boa constrictor may
parrots, Gyr falcons and Goshawks are some of the species be correct and you may be using an appropriate
that appear very susceptible and disease is commonly seen antibacterial, there is no chance of success unless the snake
in them. Peregrines and cockatoos are much more resistant is provided accommodation with appropriate temperature
so disease is rarely seen in these species. ranges, appropriate humidity ranges, and the ability to climb
(arboreal snakes often require this so gravity can assist in the
• Husbandry clearance of respiratory discharges). The most common
When we think of husbandry-related disease we often think
of reptile problems and this is often the case in respiratory
disease. These problems (especially URD in tortoises and
LRD in snakes) are often the results of low temperatures.
Inappropriate humidity levels will contribute to respiratory
disease in a range of species, both reptilian and avian.
Exposure to irritants, especially cigarette smoke, air
fresheners, cooking fumes, etc will often cause direct irritant
effects or predispose to infection especially aspergillosis in
birds. Some may be linked to the development of allergy
and/or asthma although this diagnosis remains controversial
in exotic animal medicine. Other irritants may include dusty
bedding in rabbit or rodent hutches/ cages. Rotting organic
matter in bird aviaries provides a direct source of Aspergillus

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question asked in exotics practice is not so much "what has it got?", but Figure 3.
"why has it got it?" Aspergilloma in the
air sacs of a grey
The following are often required as part of a comprehensive respiratory parrot. Note the
investigation: large consolidated
area. Therapy will
• History/signalment typically take six to
This often provides many of the clues as to "why". Full details of eight months using
husbandry and diet are required. a combination of
systemic anti-
• Clinical examination fungals, nebulisation
Some cases are easy to pick as respiratory problems there may be and surgery.
abscesses in the nasal area or an obvious oculo-nasal discharge (Fig 2).
Alternatively dyspnoea or cyanosis may be easily identified. However, it upper respiratory passages (via nares or choana (Fig 4)) trachea and
must be remembered that many of these species have a great syrinx a small rigid scope is vital for assessment of the lower tract by
respiratory "reserve" so advanced disease may be present without insertion into an airsac. Aside from direct visualisation, endoscopy
obvious effects on respiration. Instead, generalised signs may be allows direct sampling from lesions and is a much more sensitive
present - weight loss, malaise or simple failure to thrive may all be linked technique than radiography. Don't feel, however, that endoscopy is
to LRTD in many species. Rabbits and rodents may have very extensive restricted to avian medicine. It is an excellent technique in reptiles (direct
lung abscessation without any obvious signs at all - until you penetration and assessment of lung field in chelonia (Figs 5a & b)) or
anaesthestise them! Auscultation is, of course, essential. However, it is snakes as well as upper respiratory investigations, and small mammals
extremely hard to perform in reptiles (and impossible in chelonia!) due to where it is rhinoscopy and tracheoscopy are excellent tools. In terms of
the scales. Damping these sounds by auscultating through a damp cloth therapy this technique allows abscesses to be opened and drugs to be
applied to the skin. However, this does considerably reduce the applied directly to lesions.
sensitivity of the technique and electronic stethoscopes may be more
sensitive as scale sounds can, to some extent, be filtered out. In birds Figure 4.
auscultation should be performed over a range of sites around the body Endoscopy of the
to detect airflow through the lungs and the airsacs. It is also important in choanal slit of a
smaller species to use an appropriate size stethoscope paediatric or grey parrot.
infant scopes are invaluable!

Figure 2. Some diagnoses are easier than others. It is Figure 5a. This
plain that this lorikeet has a greatly distended sinus. Hermanns tortoise
However, underlying factors as well as infectious agents has pneumonia with
consolidated lungs. A
must be evaluated - this can be difficult to cure. hole is drilled in the
carapace over the
• Further investigation consolidated area (as
Almost always necessary and many tests may be required. The following determined by
should be considered: radiography).

Radiography Figure 5b. An endoscope can be inserted to visualise and
sample the affected areas. The hole is also useful to allow
The mainstay of respiratory diagnosis, especially for LRTD. It is entry of drugs during nebulisation. Between treatments it is
important to use at least two views at 90º to each other- in the case of covered with a wet-to-dry dressing. At the end of therapy it
reptiles this means horizontal beam lateral or cranio-caudal views of the
lung fields as well as the easier dorso-ventral views.Anaesthesia is often is covered with epoxy resin and allowed to heal.
essential to allow accurate positioning. (Fig 3).

Endoscopy

An essential in avian medicine! Aside from allowing visualisation of the

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Cytology and bacteriology/ sensitivity safe, broad-spectrum and penetrate well into the respiratory tract.
However, other anti-bacterials are also useful eg oxytetracycline or
The upper respiratory tract can be sampled directly via nares or choana potentiated sulphonamides and may be more appropriate where there is
(in birds/ reptiles) while tracheal or lung washes are very valuable tools in abscessation.
all species. Endoscopy will often allow direct sampling of lesions giving
more precise results especially for abscessated lesions. Where fungal disease is suspected, itraconazole or terbinafine are
extremely useful. It is worth remembering that some Grey parrots appear
Haematology/biochemistry very sensitive to itraconazole so it is worth avoiding this drug in this
species.
These provide little direct help in diagnosis of respiratory disease.
However, they will give an idea of systemic response to infection, Other systemic agents with potential effects on the respiratory system, eg
underlying immunosuppression or underlying disease. The latter is bronchodilators or diuretics have not been properly evaluated in exotic
important in the tortoise with URTD where respiratory symptoms are often species although in individual cases may be of some benefit to the
the result of recrudescence of infection in a run-down tortoise individual patient.
haematology will often show lowered white blood cell counts and
biochemistry may reveal signs of dehydration, follicular stasis or Corticosteroids may be extremely useful in cases of asthma or respiratory
renal/liver disease. Serology may be useful in some species, especially irritation. However, they may also cause profound immunosuppression
paramyxovirus in snakes or Encephalitozoon cuniculi in rabbits. and a diabetes mellitus-like syndrome in birds. Their use, therefore, must
be restricted to cases where it is felt there is no evidence of infectious
Newer tools disease (especially not zoonotic disease a corticosteroid dose is very
likely to induce shedding of Chlamydophila psittaci in a carrier even if it is
MRI and CT are proving to be of great value where accessible. Hopefully not the immediate cause of disease at that time) and ultra-short acting
increased availability will allow more patients to benefit.Obviously many agents only should be used.
of these investigations require general anaesthesia and this may
constitute a risk in the animal with respiratory compromise. Agents should Non-steroidal anti-inflammatory agents may be of use in reducing
be chosen that are easily reversed and cause minimal respiratory or pulmonary inflammation over the longer term in a range of species.
cardiovascular compromise. Oxygen must always be provided and
mechanical ventilation is frequently necessary. Accurate and constant Nasal/ Sinus Flushing
monitoring is vital and we have found capnography to be an excellent tool.
Nasal or sinus flushing is extremely useful in many exotic species. It
Therapy enables instillation of an antimicrobial directly into the site of infection and
will also enable physical flushing of pus and debris and the clearing of
Naturally, therapy should be based on diagnosis. However, therapy may nares that may provide a "feelgood" factor. This may be vital in rabbits that
have to be initiated before some test results are available or to stabilise a have great difficulty in mouth-breathing so may become very distressed if
patient too critical to allow full investigation at that stage. An ideal the nasal passages are blocked. Part of the flushing process involves the
preliminary therapy should have the following characteristics: physical unplugging of the nares and this in itself is often useful.
• broad-spectrum activity against a range of infectious agents;
• correction of underlying husbandry defects; Almost any non-irritant anti-microbial solution may be used. A mixture of
• provide physical relief of symptoms and support of respitory 1ml 2.5 per cent injectable enrofloxacin diluted in 20ml saline is
appropriate for a 1kg bird. In tortoise URTD 0.1ml oxytetracycline
membranes; injectable solution may be flushed into each nostril.
• removal of obstructions and relief of dyspnoea; and
• be non-irritant and non-stressful to the patient. We have now started using a new disinfectant agent from South Africa
called F10SC (Health & Hygiene Pty). This is a mixture of disinfectant
Underlying factors agents providing a very broad-spectrum of activity against a range of
potential agents. When used at a 1:250 dilution it appears to cause little or
As described earlier there are many potential underlying factors. These no irritation to the mucous membranes (it was initially used for the
will, hopefully, be identified at examination and during history-taking. sterilisation of drip lines and catheters). In our clinic we have used it in the
Stressors should be removed, as should obvious causes of respiratory following manner for URTD:
irritation. Hospitalisation should be tailored to provide correct
temperature and humidity for the species being treated. Snakes should • Sinus flush in birds
be provided with space to stretch out and, if necessary, to climb. Coupage A 1:250 dilution of F10SC is used at a rate of approximately 20ml/kg (Fig
of snakes allows for physical removal of discharges in the absence of a 6). It is drawn up into a syringe without a needle. The bird is restrained and
mucociliary escalator. held upside-down over a sink. The syringe is held flush against a nostril
and the mixture forcibly pushed into the nare. It should flow through the
Systemic sinuses exiting via the nares, choanal slit and conjunctivae.

Broad-spectrum antibiotics are frequently used, however they are rarely Figure 6. Sinus
effective on their own, especially when abscessation is present or where flush of a grey
the main infectious agent is non-bacterial. However, they may be useful parrot with upper
where there is a risk of systemic invasion of bacteria or where bacterial respiratory tract
infection may be a complicating factor of a fungal or viral infection. disease.

It may also be deemed un-necessary to use systemic antibiosis in URTD
where there are no systemic signs, especially as penetration of drugs into
the upper respiratory tract may be poor. Antibiotic choice is based ideally
on culture and sensitivity but, initially, is based on likely pathogens in that
species and tolerance of drug in that species - rabbits and rodents being
cases where antibiotic choice may be restricted. It is, of course, very
tempting to reach straight for the fluoroquinolone - they are comparatively

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• Nasal flush in tortoises A 1:250 dilution is again used and nebulisation periods of 20-45 minutes
0.1ml of a 1:250 dilution of F10SC is inserted into each nostril daily. This 2-3 times daily are used depending on species and condition.
has the effect of physically clearing discharges and, thanks to the open
palate of allowing the disinfectant with anti-viral and anti-bacterial Typical human asthmatics' nebulisers are often effective in this therapy.
properties to penetrate the oral cavity as well as respiratory passages. In While many texts advise use of ultrasonic nebulisers producing very
tortoise URTD much of the problem is, in fact, oral. small droplets however, for most situations this is un-necessary.
Aspergillosis in birds is one of the most common reasons for this type of
• Nasal flush in rabbits with URTD therapy. The spores of this fungus measure 2-5 microns in diameter.
When the nasal passages are blocked with pus it is useful to perform a Therefore it is unnecessary for the nebulisers to produce droplets
nasal flush. Again a 1:250 dilution of F10SC is used and 1ml is syringed smaller than 2 microns in order for the agents to penetrate as far as the
into each nostril. spores. Where fungal spread has entered air passages narrower than
this, there will generally be such consolidation that nebulisation alone
Nebulisation would not be effective.

This technique is useful for both upper and lower respiratory disease. It Penetration can be aided by providing direct access routes - in birds air
enables: sac cannulae can be placed (Fig 7), while in chelonia holes can be drilled
into the shell allowing opening of pulmonary abscesses and drug to enter
• Penetration of anti-microbials to the site of infection consolidated lungs (Fig 5a).
While this is probably true for URTD there is some doubt about this in
LRTD. Certainly where there is lung consolidation or abscessation, Figure 7. Air sac tube
nebulisation may have little ability to penetrate the lesions. However, inserted in a Harris hawk. In
other effects of nebulisation may still have benefits in these cases. this instance it was used to
relieve the dyspnoea in a
• Expectorant case of syringeal
Nebulisation acts as an excellent expectorant and aids greatly in the aspergilloma. It allows for
clearing of discharges. In snakes, nebulisation should be combined with anaesthetic maintenance
coupage as, in the author's experience, it makes loosening of discharges such that the head and
and tracheal blockage more likely unless aid is given in expelling these trachea are easily accessible
materials. for endoscopic removal of
the abscess. In other cases it
• Hydration of mucous membranes can be used to provide
As anyone who has suffered from a cold while flying or sitting in air access for nebulised drugs
conditioned rooms will tell you, drying of mucous membranes is to the caudal airsacs.
uncomfortable and has the effect of allowing infection to penetrate
deeper. Keeping membranes hydrated provides a "feel good" as well as A chamber is easy to construct. In the clinic, solid fronted cages or
assisting in membrane integrity. kennels can be used (Fig 8) while at home a simple front-opening cat
carrier covered in plastic is ideal. It is often apparent that patients "enjoy"
The simplest means of providing some of these aims is "steaming" and nebulisation and actively sit over the unit rather than retreat away from it.
for many rabbits or parrots with problems, being placed in a steamy In the home environment most owners find that, once the bird is used to
bathroom provides some short-term relief. This is, however, not along- the process, it becomes a simple routine rather than a fight.
term answer nor should drugs be "steamed" into patients as the heat and
uncertain delivery system will result in underdosing. Figure 8. Grey parrot in a
nebulisation chamber. The
Aromatics such as Olbas Oil should also be avoided as it is very easy to compressor is outside the
overdose these biologically active compounds in small animals. chamber while the pot of
nebulisers drug is inside
There are many drugs proposed as suitable for nebulisation. Often, in with the bird. Such a
avian medicine, this have been used as a route for systemically toxic chamber is also suitable for
drugs (eg, gentamycin or amphotericin) as absorption from the air sacs reptiles and small mammals.
is poor. While this is great for the patient it does raise huge Health and
Safety issues - someone has to get the patient out of the nebulisation Respiratory problems are often frustrating in diagnosis and therapy.
chamber! Also, it is very unwise to send home a bird on nebulisation Attention to underlying causes and multimodal therapies have greatly
therapy if the nebulised drugs could be toxic to the owner. As helped in improving treatment success rates.
aspergillosis therapy typically lasts at least six months this can mean a
very long hospitalisation period. Manufacturer of F10 Products:

We have, therefore, used F10SC in this situation as well. In South Africa Health and Hygiene (Pty) Ltd
it has good human safety trial results and appears relatively safe to P.O. Box 906, Florida Hills, 1716, South Africa
users. It is also broad-spectrum in activity and surfactant inclusion Tel: +27 11 474 1668 • Fax: +27 11 474 1670
benefits its properties as an expectorant. www.healthandhygiene.co.za • www.f10products.co.za

F10 PRODUCTS LTD
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK

Freephone: 0800 014 8803 • Fax: 01509 265777
Email: [email protected] • [email protected]

www.f10products.co.uk

THE FACTS ®
www.healthandhygiene.co.za
ISSUE 2 • 2006 FACTS IN
THIS ISSUE
CONTROL OF CIRCOVIRUS
INFECTION IN PSITTACINE BIRDS SMALL ANIMALS & EXOTICS
USING F10SC DISINFECTANT AND
CONTROL OF CIRCOVIRUS INFECTION IN PSITTACINE BIRDS
AVIAN GAMMA INTERFERON USING F10SC DISINFECTANT AND AVIAN GAMMA INTERFERON

MICHAEL STANFORD BVSc FRCVS

Summary Figure 2.
Classical
This study investigates the use of F10SC disinfectant in the appearance
control of a circovirus outbreak in a collection of aviaries of a grey
containing a mixed collection of parrots (macaws, grey parrot with
parrots and cockatoos). The disinfectant was used via circovirus
nebulisation in combination with avian gamma interferon infection.
injections to treat a group of juvenile grey parrots found to be There is loss
infected with circovirus from the aviaries. 70% of the birds of the normal
survived using this combination. It was concluded that architecture
F10SC was a useful adjunct to the treatment of circovirus of the
infection by reducing the possibility of secondary infections feathers and
such as aspergillosis. the bird has
started to
F10SC disinfectant was subsequently used to feather pick.
decontaminate the aviaries that housed the infected grey
parrots. A 1:100 dilution was sprayed onto all aviaries Damage to the horn producing cells of the beak leads to
surfaces twice daily for 3 weeks. Wall swabs submitted for chronic deformities and the birds find it painful to eat (Figure
PCR examination for circovirus were subsequently found to 3). The disease appears to be fatal but some birds will
be negative compared with an infected control aviary simply survive up to 10 years if nursed carefully and managed with
sprayed with water. The aviaries have since been analgesics.
repopulated and there have been no further cases of
circovirus infection in the last 4 years from the facility. It was
concluded that F10SC could be used to eliminate circovirus
infection from aviaries at the concentrations indicated but
care should be taken to ensure the buildings are tested
negative for the virus prior to repopulation.

Introduction SMALL ANIMALS & EXOTICS

Psittacine Beak and Feather Disease (PBFD) is caused by a USE OF F10SC DISINFECTANT TO
circovirus and is known to infect most species of psittacine DECONTAMINATE AVIARIES
birds. The virus affects rapidly growing cells in young birds.
The disease can present in either acute or chronic forms. In
the chronic form birds are seen with both feather loss and
malformed feathers. Birds produce feathers with unusual
colouring (Figures 1 & 2).

Figure 1. Abnormal colouring in a grey parrot Figure 3. A Senegal parrot with chronic circovirus infection.
with circovirus infection. The normal architecture of the beak has been lost making it
painful for the bird to eat without adequate analgesia. The

normal development of the feathers has also been lost.

In all birds the bone marrow is infected leading to
immunosuppressive actions. This is seen more dramatically
in young Grey parrots that frequently present with the more
acute forms of the disease rather than the chronic (Figure 4).

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Figure 4. Young grey Figure 7. Grey parrots are
parrots are extremely frequently handreared in
susceptible to acute the UK due to their
circovirus infection. The popularity as pets.
increase in the popularity Unfortunately they
of captive breeding and produce vast amounts of
hand rearing has led to a feather down which can
dramatic increase in the become infected with
spread of circovirus circovirus and
infection throughout the subsequently rapidly
UK breeding population. spread through hand
rearing establishments.
A classical haematology profile will reveal severe leucopaenia
(especially heteropenia) with signs of anaemia. These birds rapidly attack by suppressing cell proliferation, inhibiting viral replication and
succumb to secondary invaders such as Aspergillus fumigatus (Figure augmenting the activity of macrophages and T lymphocytes. There are
5). The disease is invariably rapidly fatal with few Grey parrots appearing type 1 and type 2 interferons. Type 1 interferons are essentially antiviral
to develop the chronic form of the disease. and antiproliferative in their effects. Recently an interferon omega (type
1 interferon) has been produced commercially for the treatment of
Figure 5. Aspergillus in the canine parvovirus and feline leukaemia virus in Europe (Virbagen
lung of a young grey parrot Omega, Virbac Animal Health Animal Health, Carros, France). Type 2
secondary to circovirus interferons have a more immunomodulatory effect. Initially the use of
infection. The fungal interferon was limited due to the difficulty in manufacturing the protein in
hyphae rapidly spread large enough quantities but the recent development of recombinant DNA
through the technologies has made interferon economic and easy to produce. The
immunosuppressed birds use of interferons in humans for the treatment of chronic hepatitis B and
leading to death from an various malignancies has transformed treatment success rates with
overwhelming infection. these difficult diseases. The use of interferons and other cytokines has
been well researched in the poultry industry in a bid to reduce the use of
Figure 6. Biopsy of the vaccines and in feed antibiotics with significant success. Interferons are
bursa in a young Grey regarded as being species specific and interferon from one species
parrot infected with would not normally function in another. Despite this interferon of feline
circovirus. The bursa has origin has been found to be affective for the treatment of canine
numerous inclusion bodies diseases. The omega interferon has been found to bind with cells from
caused by the virus. different species in vitro although there is no data available for avian
cells. The commercially available omega alpha 2 interferon exerts its
It is felt that birds are only able to contract the virus whilst they have a effects by preventing viral replication.
cloacal bursa present (normally the bursa is present up to 16 weeks of
age, Figure 6). PBFD virus is best diagnosed by a PCR test normally The use of F10 Super Concentrate (F10SC, Health and Hygiene Ltd,
using either blood and feather pulp samples in the live bird. Recently is South Africa) administered by fogging systems as a preventative
has been noticed that the PCR test is potentially unreliable and positive treatment for respiratory diseases in poultry in particular aspergillosis is
birds can be missed. Whether this is due to a problem with the test documented. The disinfectant has been shown to dramatically reduce
protocol or that there are two forms of the virus is debated and a breeder Aspergillus fumigatus spore counts in hatcheries so it is felt that it would
could certainly not depend on the test to produce a disease free unit potentially be the best method of preventing secondary infection in these
when buying in young birds unless repeat testing is performed. The immune suppressed circovirus positive birds. Most of the young
author finds that bone marrow from the tibiotarsus in addition to blood circovirus positive chicks appear to die from secondary Aspergillus
and feather samples give the operator the best chance of finding the fumigatus infections. It has the advantage of appearing to be safe for use
virus but avoiding false negatives. on both eggs and chicks whilst being effective against many pathogens.
Recently F10 has been used by many Veterinary surgeons for the
The virus is spread mainly by contact with highly infective feather dust in treatment of exotics in particular aspergillosis in avian cases with good
young birds. Grey parrots tend to produce large quantities of powder results (Figure 8). The 1:125 dilution of F10 has also been shown to be
down and if the bird is infected there is a high risk of dust being passed effective against Chicken Anaemia Virus a common circovirus affecting
between birds. This means that young birds in breeding establishments poultry.
are particularly at risk (Figure 7). The virus is highly infectious and stable
in the environment so once premises are infected it is difficult to ensure Figure 8. F10SC disinfectant has become a
that the virus has been eliminated from the environment. This is a big popular non-specific treatment for respiratory
concern in nurseries and hand rearing rooms. It is vital to practice disease amongst avian veterinary surgeons. It is
excellent biosecurity in aviaries and to use an "all in-all out" system in the normal applied by nebulisation or fogging
nurseries to avoid introducing the virus to buildings. sytems. It was used in this study in an attempt to
decontaminate a commercial breeding aviary
The interferons are a group of small protein and glycoprotein cytokines from circovirus in the environment.
naturally produced by the avian immune system following natural
infection or vaccination. Interferons protect the bird from biological

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The disinfectant has also been used successfully for the treatment of Total Leucocyte Count circovirus by PCR test in all 7 birds. The birds were still alive and not
respiratory conditions in psittacines and many other pet species. Total Leukocyte Countsexhibiting any clinical signs of circovirus infection, either chronic or
acute, 9 months post diagnosis.
Use of F10 disinfectant and gamma
interferons to treat acute circovirus Total Leukocyte Counts in Surviving Birds Treated
infection in grey parrots With Avian Gamma Interferon

Once the outbreak had been detected in the aviary facility large numbers 8
of hand reared grey parrot chicks succumbed to the virus. They
presented with anorexia, depression and rapid death usually from the 7
secondary infection Aspergillosis fumigatus. It was decided to use
interferon as a potential treatment for the young greys due to its 6 Bird 1
theoretical immune stimulatory activity. A small amount of avian gamma Bird 2
interferon was obtained from Dr Peter Kaiser (Compton Laboratories
UK) in addition to the mammalian interferon of feline origin available 5
commercially in the UK (Virbagen Omega Interferon Virbac, UK). A Bird 3
group of 22 juvenile grey parrots testing positively for circovirus by PCR
test were randomly split into two groups. 4 Bird 4
Bird 5
All 22 birds exhibited profound leucopaenia with total leukocyte counts
below 1 × 109 (normal range 3-15 × 109) in all cases. Each bird was 3 Bird 6
injected daily with one million international units of an alpha type 1 2 Bird 7
interferon of feline origin intramuscularly for 90 days. Additional
measures involved fogging the birds for 15 minutes twice daily with 1
F10SC at a dilution of 1:125. The fogger produced a droplet size of 6um.
The birds were monitored by determination of serial total leukocyte cell 0
counts at intervals. Only 2 birds were surviving at week 30. Both Day Day Day Day Day Day Day Day
surviving birds were still leucopenic and found to be PCR positive for 1 7 30 60 120 150 180 210
circovirus on samples obtained in week 30. The birds were euthanased Day After Diagnosis
(Figure 9).
Figure 10. Graph demonstrating the improvement in leucocyte counts in
Total Leukocyte Counts in surviving birds the birds treated with avian interferon. After 60 days there was a steady
treated with Virbagen Omega Interferon improvement in the total white blood cell count. After 6 months the birds
5
was negative by PCR for circovirus.
4
On the basis of this study interferon gamma of poultry origin would
3 Bird 1 appear to have a potential use in the treatment of circovirus infection in
2 Bird 2 young grey parrots. Despite the costs involved in daily injections and
quarantining the birds this treatment was considered cost effective due
1 to the high cost of baby psittacines. Mammalian interferon was not
satisfactory. Interferons are considered species specific and a
0 mammalian interferon would not be expected to have a significant action
0 30 60 90 120 150 180 210 in avian patients but cross-species reactivity has been reported in birds.
Time After Diagnosis (Days) No side effects were seen from the repeated interferon injections in any
bird. The results are encouraging and a double blind placebo trial would
Figure 9. Demonstration of leukocyte counts in Grey parrots treated with be indicated in the future.
mammalian interferon. There was no improvement in the condition of the
By this stage it was felt that although the protocol appeared potentially
birds and a decision was made to euthanase them. effective for a previously untreatable disease the cost was potentially
prohiberative for most clients given the low success rate. It would be
A second group consisted of 10 grey parrots that had been presented expected that interferon would have to be administered until the PBFD
with clinical signs of circovirus, which were confirmed by PCR test. All 10 virus had been eliminated which in theory meant 90 days treatment in the
birds were found to be severely leucopaenic. These birds were treated average case. It was; however, felt that interferon would be potentially far
using an avian gamma interferon derived from poultry cell culture. The more useful in combination with F10 preventing initial infection. In poultry
birds were injected once daily using one million units of avian interferon the administration of interferon has been found to improve growth rates
gamma intramuscularly for 90 days. The birds were fogged with F10SC and prevent common infections without the need to vaccinate. The
as with the initial group. Seven of the 10 birds were alive at week 30. The interferon is applied by a fogging system and has been found to be more
increase in total leukocyte counts in these birds over the time period is economic than the use of antibiotics and vaccines in commercial poultry
shown in figure 10. By day 180 all 7 birds were exhibiting normal total systems.
white blood cell counts. Using a t2 comparisons of means test there was
a statistical difference between the total leukocyte count in the same Use of F10 disinfectant to decontaminate
birds between day 210 and day 1 (with 95% confidence limits). Samples the aviaries
of blood and feather pulp taken in week 30 were found to be negative for
Due to the resistant nature of circo viruses in outbreaks of PBFD
identification of infected birds and subsequent treatment or euthanasia
of birds testing positive is only the starting point. The environment that

®

housed the infected birds should be considered infected with circovirus from the aviaries were all found to be negative for PBFDV by PCR test.
for a long period of time (years rather than months) unless completely The control aviary was still positive at this time. The control aviary was
decontaminated. In reality this leads to any new stock purchased by the sprayed for 3 weeks with F10SC and demonstrated to be negative for
owner having the risk of being exposed to the virus for many years from PBFDV on 3 wall swabs after this time. Four months later all the aviaries
the date of the initial infection unless a thorough clean up operation has were re swabbed for PBFDV and all were found to be negative. At this
been performed and the buildings have been demonstrated to be free stage the aviaries were repopulated with psittacine birds. There have
from the virus by PCR testing. This explains why many pet shops, been no further cases of Psittacine Beak and Feather Disease at the
breeders and hand rearing facilities act as reservoirs for the disease. premises since the initial outbreak in 2001.All young stock released from
the aviary is tested for circovirus at point of sale with no positive results
In this case the owners had 7 aviaries containing a variety of psittacine found.
birds (Figure 11). They were all of traditional wood and galvanised wire
construction making disinfection difficult. Unfortunately the aviaries Conclusions
were also all linked together by covered walkways so any infection could
spread through the premises relatively easily. Once the infection had 1) Avian gamma interferon in combination with F10SC nebulisation was
been detected in the grey parrots all the birds at the premises were found to be a potential treatment for Psittacine Beak and Feather
tested by PCR test. All positive adult birds were euthanased after 2 Disease. No apparent side effect was seen with either the interferon
positive test results. In reality this was limited to the cockatoos. All the or F10SC use at the concentrations described. Avian Gamma
parrots that tested negative for PBFDV were placed in quarantine. In Interferon is now being used in Europe in many outbreaks of PBFD
addition swabs were taken from the environment and tested for PBFDV including more recently chronic cases and the research into its
from all 7 aviaries. Each aviary was found to be positive on 2 or more wall effectiveness continues.
swabs.
2) The use of interferon as an immune enhancer prior to PBFD virus
Figure 11. Typical infection would also appear to be a useful future use of this new
construction of the technology. Combining this treatment with the constant application of
aviaries involved in the F10 by nebulisation to reduce circovirus contamination and prevent
study. The wood and secondary infections would be a useful protocol in most bird
galvanised wire establishments involved in buying birds in or allowing members of
construction made the public to handle babies.
disinfectant application
difficult. 3) F10SC was demonstrated to assist in the decontamination of
aviaries infected with PBFD virus at the dilution 1:100. Despite the
The aviaries were thoroughly sprayed twice daily with F10SC (1:100 encouraging results it should be noted that aggressive spraying was
dilution) for one week by the same individual. Care was taken to ensure required to eliminate the disease from the aviaries demonstrating the
that the spray covered all surfaces including throughout the covered residence of the virus. Prior to introducing new stock to the aviary
walkways (Figure 12). One aviary was kept as a control and sprayed best practice would indicate that all surfaces should be swabbed for
twice daily with water. After 7 days the aviaries were swabbed for the virus and submitted for a PCR test. Preventing potential owners
circovirus infection a second time (3 swabs per aviary). The control handling young chicks would be useful (Figure 13)
aviary was still positive for PBFD virus in addition to three of the other 6
aviaries on one or more wall swabs. Three aviaries were negative to Figure 13. In an ideal world
PBFD virus on all three swabs. young birds should be kept
behind glass to prevent the
Figure 12. Fogger used spread of circovirus from
to spray contaminated feather dust.
aviaries.
4) F10SC should also prevent other avian pathogens when used in this
The results were encouraging but demonstrated the resistant nature of way such as polyoma virus and papilloma virus. As it appears safe in
the virus but it was decided to continue with the trial. After three weeks of contact with birds at the recommended doses F10SC has an
spraying twice daily with F10SC (1:100 dilution) further swabs taken important role to play in the bio security of any aviary facility.

Acknowledgements
The author would like to thank Philippe Mahl (Virbac Animal Health) for demystifying
interferon, Dr Peter Kaiser for supplying avian interferon and John Temperley (Health and
Hygiene) for his help with the F10SC fogging system. Thank you to Michael Waters (Royal
Veterinary College) for the assistance with the pathology images. Health and Hygiene and
Birch Heath Veterinary Clinic jointly funded the PBFD PCR tests.

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THE FACTS ®
www.healthandhygiene.co.za
ISSUE 3 • 2007 FACTS IN
THIS ISSUE
MINIMUM INHIBITORY
CONCENTRATION (MIC) AND ZONE MICROBIOLOGY GENERAL
MINIMUM INHIBITORY CONCENTRATION (MIC)
OF INHIBITION DETERMINATION
METHODS TO BE USED WHEN
TESTING F10SC DISINFECTANTS

Neil Forbes BVetMed Dip ECAMS FRCVS, Elize Lloyd BSc Hons Microbiology

Summary  To compare the sensitivity or resistance of the eight test SMALL ANIMALS & EXOTICS

F10 Super Concentrate Disinfectant (F10SC) is a quaternary organisms to commercially available susceptibility discs
ammonium and biguanidine compound based disinfectant. gentamicin 10µg and Enrofloxacin 5µg on two different
Independent tests have shown it to be effective against types of agar.
bacteria, fungi, viruses and spores (bacterial and fungal
spores). It had been reported that when using the  To establish the MIC values of the agent against a number
sensitivity/resistance zone of inhibition test method on
bacterial isolates that inconsistent results occur.Astudy1 was of commonly occurring bacterial pathogens, these
initiated to determine the most appropriate laboratory included known ATCC strains, local isolates and avian
method to be used for evaluation of F10SC when using zone pathogens.
of inhibition test methods using commercially available
susceptibility dics of 10µg Gentamicin and 5 µg Enrofloxacin The Study
as controls.
Test organisms
In 1036 readings all eight organisms tested were sensitive to The following organisms were used:
F10SC disinfectant in a dilution of 1/250 in broth and
complete visual inhibition was observed at this and much Pseudomonas aeruginosa ATCC 27853 ZONE OF INHIBITION TEST METHOD FOR F10SC GENERAL
lower levels. The more resistant organisms, for example Escherichia coli
Pseudomonas aeruginosa and Escherichia coli, produced Staphylococcus aureus ATCC 25922
small inhibition zones on agar at a concentration equal to a Klebsiella pneumoniae
1/250 dilution, but were still completely inhibited by 1/1000 Staphylococcus aureus MRSA ATCC 25923
and 1/4000 dilutions of F10SC in broth respectively. The
more sensitive organisms, for example Staphylococcus Pasteurella multocida ATCC 10031
aureus, produced large inhibition zones on agar at a Local Isolate supplied by:
concentration equal to a 1/250 dilution of the product and H F Verwoerd Hospital 3/1995
were completely inhibited in broth by dilutions as low as 1/16 000. B/N 177/6
A total of 146 readings were taken of each of the Gentamicin Local Avian Isolate supplied by:
and Enrofloxacin controls. Veterinary Faculty Onderstepoort

However the study did show that this type of test must be Enterococcus faecalis ATCC 29212
carried out within strict parameters otherwise inconsistent
and misleading results would be obtained. Salmonella choleraesuis serotype typhimurium ATCC 13311

Introduction Preparation of bacterial suspensions MICROBIOLOGY SMALL ANIMALS & EXOTICS

The study was conducted with the following objectives : According to NCCLS guidelines4 the direct colony
suspension method was selected.
 To investigate an agar disc diffusion zone of inhibition test
The cultures were grown on non selective agar ( nutrient
method for evaluating the susceptibility of aerobic and agar slopes) for 16 - 18 hours at 35°C (± 2°C) and growth
facultative anaerobic bacteria against F10SC. was re-suspended with sterile 0,85 % saline. The
concentrated suspensions obtained were diluted with sterile
 To compare zone inhibition results over a range of four to 0,85 % saline to match the turbidity of a 0,5 McFarland
standard (approximately 70 - 75 %T at 600 nm). The
six different concentrations of F10SC on two different resulting bacterial suspensions contained approximately 1,5
types of agar normally used for susceptibility testing i.e. x 108cfu/ml .
Mueller Hinton agar (supplier Merck) and Iso-Sensitest
Agar (Oxoid) (supplier C.A. Milsch). Macro-broth dilution MIC determination

Broth dilution MIC determination was performed in
accordance with the guidelines as described by the NCCLS4.

Mueller-Hinton broth (pH 7,2 - 7,4) supplied by Merck. The
broth was prepared and sterilized according to the
manufacturer's instructions. The cation concentration of the
broth was not adjusted and the broth was used “as is”.

®

Eleven tubes were prepared in duplicate for each test organism starting Preparation of Petri dishes
with a 1/125 dilution of F10SC (0,8%) made directly in Mueller-Hinton
broth. Tube 1 contained 1 ml of this solution. Sterile Mueller-Hinton broth Sterile blank discs (Mast) 6,5 mm in diameter of were obtained from
(1 ml) was put into tubes 2 - 11 and the starting concentration of 1/125 Davies Diagnostics.
was diluted 1:1 with the sterile broth in tube 2, resulting in a concentration Approximately 130 plates each of Mueller-Hinton agar and Iso-Sensitest
of 0,4% or a dilution of 1/250 in tube 2. Further serial dilutions were done agar were used for the tests. Tests at all levels of F10SC were done on
in the same way up to tube number 9 covering a range of dilutions from duplicate plates for each type of agar. An average of six discs were used
1/125 to 1/32 000. Tube 10 contained inoculated broth and served as a over two pates for each F10SC dilution.
positive control. Tube 11 contained uninoculated broth and served as a
negative control. Both tubes 10 and 11 contained no anti microbial All agar plates were inoculated with bacterial suspensions prepared
agents.All tubes contained 1 ml of Mueller-Hinton broth. according to the direct colony suspension method as previously
described.
The bacterial suspensions obtained with the direct colony suspension
method contained approximately 1,5 x 108 cfu/ml. These suspensions Plates at room temperature were streaked 3 times with cotton swabs
were further diluted 2 ml in a total of 10 ml with sterile saline to give an dipped into the suspension over the entire agar surface, rotating the
approximate count of 3 x 107 cfu/ml. Each tube containing a total plates approximately 60° to ensure an even distribution of the test
volume of 1 ml broth (except the negative control tube) was inoculated organism. Excessive moisture was avoided.
with 10 µl (0,01 ml) of this diluted organism suspension resulting in an
approximate count of 3 x 105 cfu/ml or per tube. Plates were left 3-5 minutes to dry. Blank discs were put onto the
inoculated surfaces of the Mueller-Hinton and Iso-Sensitest agar plates
Total counts were done (serial dilutions) on plate count agar to confirm using sterile forceps. Approximately three discs per 90 mm plate were
the viable number of organisms that were present in the test used. Gentle pressure was applied with sterile forceps to ensure
suspensions. complete contact of discs with agar. Oxoid gentamicin 10µg and
Enrofloxacin 5µg reference discs were also applied to both types of
Tubes were incubated 16 - 20 hours at 35°C. The MIC value obtained is inoculated agar.
interpreted as the concentration of the anti microbial agent, contained in
the first tube in the series, that inhibits visible growth of the test organism. A micro pipette (Eppendorff pipette) was used to drip 10 µl discs of
the various stock solutions of F10SC onto the discs.
Agar disc-diffusion zone of inhibition
determination. Plates were not inverted and were incubated within 15 minutes of disc
application for 16 - 18 hours at 35ºC (± 2ºC). All testing was done in
The Kirby Bauer method of agar disc-diffusion zone of inhibition duplicate and total counts of all the bacterial suspensions were done.
determination as described by Koneman et al3 was used.
Quality Control of media
Mueller-Hinton agar (pH 7,2 7,4) supplied by Merck. The agar was
prepared and sterilized according to the manufacturer's instructions. Three ATCC reference strains of test organisms were used for the
(± 25 ml was poured into 90 mm Petri dishes. Agar thickness quality control of the Mueller-Hinton agar and broth:
approximately 4 mm.)
Pseudomonas aeruginosa ATCC 27853
Oxoid Iso-Sensitest agar supplied by C A Milsch. The agar was prepared Escherichia coli ATCC 25922
and sterilized according to the manufacturer's instructions. (± 25 ml was Staphylococcus aureus ATCC 25923
poured into 90 mm Petri dishes.Agar thickness approximately 4 mm.)
Mueller-Hinton agar: All three organisms were used. The agar depth
Preparation of discs and F10SC stock solutions was controlled at approximately 4 mm to minimize variability in zone
sizes. Commercially available Oxoid susceptibility discs gentamicin
To achieve the same levels of active ingredients present in 1 ml of a 10µg were put on Mueller-Hinton plates used for the testing of
specific broth dilution of F10SC on discs containing a volume not F10SC. The average inhibition zone sizes obtained for gentamicin
exceeding 10 µl (0,01 ml), it was necessary to prepare stock solutions of were well within the stated acceptable ranges for each specific
F10SC: reference organism as indicated by the NCCLS4.
For example:
Mueller-Hinton broth: Pseudomonas aeruginosa ATCC 27853, and
Desired disc content: Escherichia coli ATCC 25922 were used for the quality control of the
0,4 % F10SC (a dilution of 1/250 of F10SC is equal to 0,4 % of F10SC). broth. SABS could not supply the Staphylococcus aureus ATCC 29213
reference strain suggested by the NCCLS4 for the testing of Mueller-
Desiredd disc contenntt:: 0,44 % F10SC Hinton broth. The use of Pseudomonas aeruginosa ATCC 27853 and
AAmmoouunntt ddeelliivveerreeddttoo ddiisscc ((00,,0011 mmll)) ==cocnocnencetrnattiroantioofnsotofcsktoscoklustioolnut(i4o0n%) Escherichia coli ATCC 25922 for quality control purposes was
considered sufficient to validate the results. Serial dilutions were
Thus 0,01 ml of a 40 % solution on a disc contained the same amount of prepared in Mueller-Hinton broth containing gentamicin ranging from 10 -
active ingredients as 1 ml of a 0,4 % solution of F10SC. Stock solutions 0,078 µg/ml. MIC values observed for both organisms were well within
ranging from 40 % to 1,25 % were prepared and used on the discs. the acceptable ranges as specified by the NCCLS4
These represented 1 ml broth dilutions of F10SC ranging from 1/250 to
1/8000.

In previous tests 20 µl of less concentrated stock solutions were used on
the discs with poor results. Volumes in excess of 10 µl cause distortion of
the inhibition zones because of the limited ability of the discs to fully
absorb such volumes.

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Positive controls: Sterile Mueller-Hinton broth, Mueller-Hinton agar Diffusion susceptibility results
plates and Iso-Sensitest agar plates were inoculated with the test
organism suspensions used for the relevant tests and good growth was All the organisms tested were sensitive to F10SC in a dilution of 1/250 in
observed after 16-20 hours incubation. broth and complete visual inhibition was observed at this and much
lower levels. The more resistant organisms, for example Pseudomonas
Negative controls: Sterile Mueller-Hinton broth, Mueller-Hinton agar aeruginosa and Escherichia coli , produced small inhibition zones on
plates and Iso-Sensitest agar plates were incubated under the same agar at a concentration equal to a 1/250 dilution, but were still completely
conditions as the rest of the test tubes and plates to confirm sterility. inhibited by 1/1000 and 1/4000 dilutions of F10SC in broth respectively.
The more sensitive organisms, for example Staphylococcus aureus,
RESULTS produced large inhibition zones on agar at a concentration equal to a
1/250 dilution of the product and were completely inhibited in broth by
MIC values in Mueller-Hinton broth dilutions as low as 1/16 000.

Average result of both tubes tested for each organism indicated as one The effect of F10SC concentrations on eight different test organisms
result only where results were the same. Both results indicated where was measured. Average inhibition zone sizes were noted in mm. (An
differences between the duplicate test results were observed. average of 6 discs were used for each F10SC dilution over two plates)

Table 1 Zone measurements

Tube number 10 11 The effect of F10SC concentrations on eight different test organisms.
1 2 3 4 5 6 7 8 9 Negative Positive Inhibition zone measurements in mm. (± 6 discs per F10SC dilution over
Concentration of F10SC two plates.
Dilution of F10SC Control Control
0,8% 0,4% 0,2% 0,1% 0,05% 0,025% 0,0125% 0,00625% 0,0031% Table 2 - using Mueller-Hinton Agar.

1/125 1/250 1/500 1/1000 1/2000 1/4000 1/8000 1/16000 1/32000 Dilution of F10SC
1/500 1/1000
Pseudomonas aeruginosa - - - - +++ +++ +++ +++ +++ - +++ Dilution 1/250 0,2% 0,1% 1/2000 1/4000 1/8000
ATCC 27853 0,4% 0,05% 0,025% 0,0125%
%F10SC (1ml/100ml) on
Escherichia coli - - - - - - ++ +++ +++ - +++ discs containing 10µl 40%
ATCC 25922 of stock solution
9,7
Staphylococcus aureus - - - - - - - - -/+ - +++ F10SC stock solution 16,7
ATCC 25923 used for the disc 23,7
preparation 21,7
Klebsiella pneumoniae - - - - - - -/+ ++ +++ - +++ 23,3 20% 10% 5% 2,5% 1.25%
ATCC 10031 Pseudomonas aeruginosa 19,9
ATCC 27853 23,0
Staphylococcus aureus - - - - - - - - ++ - +++ 17,7 9,4 9,1 8,8 8,6 Not tested
MRSA Local isolate Escherichia coli
ATCC 25922
Pasteurella multocida - - - - - - - - +++ - +++ 15,1 13,9 12,0 11,2 Not tested
Local isolate Staphylococcus aureus
ATCC 25923
Enterococcus faecalis - - - - - - - - ++ - ++ 22,3 20,6 17,6 15,9 14,9
ATCC 29212 Klebsiella pneumoniae distortion distortion
ATCC 10031
Salmonella choleraesuis 20,6 19,2 17,8 15,5 14,4
Serotype typhimurium - - - - - - - +++ +++ - +++ Staphylococcus aureus
ATCC 13311 MRSA Local isolate

+++ indicated good visible growth of the test organism Pasteurella multocida 23,9 21,3 20,6 16,5 12,6
- indicated the absence of visible growth of the test organism Local isolate
17,4 15,3 13,5 Not tested Not tested
Enterococcus faecalis
The F10SC MIC values ATCC 29212 22,3 19,1 18,2 16,1 13,3
Figure A
Salmonella choleraesuis 16,2 13,1 11,6 Not tested Not tested
Serotype typhimurium
ATCC 13311

Test organism: Concentration of F10SC (dilution) that Table 3 - Iso-Sensitest Agar
resulted in complete visual inhibition of the
Pseudomonas aeruginosa test organism = MIC value Dilution of F10SC
ATCC27853 Adilutionof 1/1000or 0,1% F10SC
Escherichia coli A dilutionof 1/4000or 0,025% F10SC Dilution 1/250 1/500 1/1000 1/2000 1/4000 1/8000
ATCC 25922 A dilutionof 1/16 000 or 0,00625% F10SC
Staphylococcus aureus A dilutionof 1/4000or 0,025% F10SC %F10SC (1ml/100ml) on 0,4% 0,2% 0,1% 0,05% 0,025% 0,0125%
ATCC 25923 A dilutionof 1/16 000 or 0,00625% F10SC discs containing 10µl
Klebsiella pneumoniae A dilutionof 1/16 000 or 0,00625% F10SC of stock solution 40% 20% 10% 5% 2,5% 1.25%
ATCC 10031 A dilutionof 1/16 000 or 0,00625% F10SC
Staphylococcus aureus F10SC stock solution 10,1 9,5 9,5 9,3 8,9 Not tested
MRSA Local isolate A dilution of 1/8000 or 0,0125 % F10SC used for the disc 15,6 14,4 12,9 11,0 10,4 Not tested
Pasteurella multocida preparation Distortion Distortion Distortion Distortion 15,6
Local isolate Severe Severe Severe Severe Distortion 13,6
Enterococcus faecalis Pseudomonas aeruginosa overlapping overlapping overlapping overlapping overlapping Distortion
ATCC29212 ATCC 27853 Distortion 21,1 19,7 16,1 No Result overlapping
Salmonella choleraesuis Severe Distortion Distortion Distortion Distortion
Serotype typhimurium Escherichia coli overlapping overlapping overlapping overlapping overlapping 16,6
ATCC 13311 ATCC 25922 23,3 No Result Severe 20,7 21,2 Distortion
Distortion Severe overlapping Distortion Not tested overlapping
Repeatability of results: The values obtained for Pseudomonas Staphylococcus aureus 17,9 overlapping 14,3 overlapping 14,5
ATCC 25923 19,8 15,6 17,4 12,5 16,7
aeruginosa ATCC 27853, Escherichia coli ATCC 25922 and 18,7 15,9 Not tested Not tested
Klebsiella pneumoniae 17,2 14,4
Staphylococcus aureus ATCC 25923 were the same as obtained in ATCC 10031 16,1 12,3 13,0
previous tests under the same conditions2.
Staphylococcus aureus Not tested
MRSA Local isolate

Pasteurella multocida
Local isolate

Enterococcus faecalis
ATCC 29212

Salmonella choleraesuis
Serotype typhimurium
ATCC 13311

®

Mueller-Hinton Agar Iso-Sensitest Agar

Pasteurella multocida Klebsiella pneumoniae Staphylococcus
aureus MRSA

Conclusions

Staphylococcus Staphylococcus 1) Good growth of all the test organisms was observed on both types of
aureus MRSA aureus
test media. However the final diluted bacterial suspension applied to

the plates must be controlled to give counts equal to 0,5 McFarland
Standard of approximately 1,5 log8 cfu/ml in order that the bacterial

load is within the capacity of the antimicrobial solution on the disc.

2) Inhibition zones of Gram positive and negative test organisms on
Mueller-Hinton agar were in general clear and well defined with very
little distortion, even at very high concentrations of F10SC. However
the thickness of the agar must be approximately 4mm and placed on a
levelled surface.

Escherichia coli Pseudomonas 3) On Iso-Sensitest agar plates a problem was observed with some of
aeruginosa the test organisms when F10SC was tested in high concentrations.
Severe distortion and overlapping of inhibition zones occurred on
plates inoculated with Staphylococcus aureus, Staphylococcus
aureus MRSAand Klebsiella pneumoniae. Discs containing F10SC in
concentrations of 1/250; 1/500; 1/1000 and 1/2000 cannot be used for
the susceptibility testing of these organisms on Iso-Sensitest agar.
Only when the concentration of F10SC was reduced equivalent to
1/4000 and 1/8000 were the zones less distorted and could be
measured.

4) It is recommended that Mueller-Hinton agar be used when carrying
out susceptibility test with F10SC.

5) Volumes in excess of 10 µl cause distortion of the inhibition zones
because of the limited ability of the discs to fully absorb such volumes.

6) In this study only one isolate of a specific species was examined.

Because of intra species variation it is currently not possible

to establish zone diameter limits for resistant, intermediate and

Enterococcus Salmonella choleraesuis susceptible isolates within a group. The Proposed Agar
faecalis Serotype typhimurium
Diffusion Method for use with F10SC4 can be used to

screen as many isolates of a specific species to establish zone

diameter limits for isolates considered to be resistant

References

1. SABS report No. 2570437/1936/Y64427
2. SABS report No. 7218/2547288/1317/Y59521
3. Koneman ,E.W. Editor: Colour atlas and textbook of Diagnostic Microbiology, 5th edition.

Lippincott Williams &Wilkins, Maryland.
4.National Committee for Clinical Laboratory Standards. Performance standards for

antimicrobial susceptibility testing; Supplement 1. National Committee for Clinical
Laboratory Standards, Wayne, Pa

F10 PRODUCTS LTD Manufacturer of F10 Products:
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK
Health and Hygiene (Pty) Ltd
Freephone: 0800 014 8803 • Fax: 01509 265777 P.O. Box 906, Florida Hills, 1716, South Africa
Email: [email protected] • [email protected] Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za
www.f10products.co.uk

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ISSUE 4 • 2007 www.healthandhygiene.co.za

Determination of disinfectant FACTS IN
residues in tissue after oral THIS ISSUE
supplementation of drinking
water with F10SC disinfectant POULTRY OSTRICH SMALL ANIMALS & EXOTICS

Michael Stanford FRCVS Dirk Verwoerd MRCVS TISSUE RESIDUES
Dawie Malan MSc Thea Coetzee M Tech ORAL SUPPLEMENTATION

Summary fumigatus spores. F10SC disinfectant has also been utilized POULTRY OSTRICH SMALL ANIMALS & EXOTICS
to treat respiratory infections in both captive exotic birds,
F10 Super Concentrate disinfectant (F10SC) was birds of prey, and reptiles by nebulisation. It has been used in AIRBORNE DECONTAMINATION
administered to poultry continuously in the drinking water at the reduction of Psittacine Beak and Feather Disease NEBULISING
two dilution rates (1:1000 and 1:250). Tissue samples were infection in African Grey parrots by reducing contamination
examined for disinfectant residues using a biological disc of the environment with Circo Virus spp. In addition it has
inhibition assay at day 35 of the study. No significant residues been used in the treatment of circovirus infection in
(P>.0.05) were detected in liver, muscle or kidney tissues at combination with avian gamma interferons. Due to the
either dilution rate compared with a control group. There was increasing alternative uses of F10SC in the prevention and
no significant increase in mortality (P>0.05) in the F10SC treatment of disease there is a need to rule out the possibility
disinfectant treatment groups over the control group. It is of tissue residues from continuous oral treatment. The aim of
concluded that F10SC disinfectant can be added to the water this study therefore was to investigate whether F10SC
supplies of poultry and other avian species or by nebulising disinfectant could be safely administered orally to birds over
in an attempt to reduce disease or improve water quality a period of time without side effects or detectable tissue
without the risk of producing tissue residues. residues.

Introduction Fogger used to overspray in aviaries
and poultry houses in the presence of the birds.
F10 Super Concentrate disinfectant (F10SC) is a novel
quaternary ammonia and biguanide compound based Material and Methods
disinfectant which by independent tests and trials has been
shown to be effective against gram negative and gram- The trial was conducted under the auspices of the Republic
positive bacteria, enveloped and non-enveloped viruses in of SouthAfrica'sAgricultural Research Council (ARC) at their
addition to fungal spores. Similarly the disinfectant has been Animal Nutrition and Animal Products Institute facility at
shown to be non-toxic, non-irritant, non-corrosive and Irene, Gauteng Province. Subsequent sensitivity and tissue
biodegradable . Due to both its safety and efficacy F10SC analysis testing was carried out at the ARC's Onderstepoort
disinfectant has been increasingly used in applications Veterinary Institute's (OVI) Residue Laboratory (South
where the diluted solution is inhaled through nebulisation or African National Accreditation Service (SANAS) accredited
as an aerosol over-spray (fogging) rather than just as a laboratory).
surface disinfectant. It has been administered through the
drinking water to improve the water quality in automatic
drinking systems in both broiler and layer operations thereby
reducing bacterial challenges during production. It has been
used as therapy during outbreaks against infective agents
such as Avian Influenza Virus, Newcastle Disease Virus and
Infectious Bursal Disease Virus.

Fogging the enclosed air space in commercial poultry
houses as well as in setters and hatchers regularly with
F10SC disinfectant has been demonstrated to significantly
reduce environmental contamination with Aspergillus

®

The trial was conducted using 153 as hatched Ross 788 day-old broilers Broilers were selected randomly from each group (16 broiler chickens
obtained commercially. The birds were placed randomly into a small from the control treatment and 30 broiler chickens each from both the
broiler experimental house. The facility consisted of 9 pens with each F10SC treatments). After the birds had been killed humanely tissue
pen containing 17 chickens. This study was run in the form of a 3 x 1 samples (158) where initial taken from across the 3 groups consisting of
block design with each treatment replicated 3 times. breast meat and liver and a further (14) confirmation samples of thigh
meat and kidney. Feed and water samples were also submitted to the
During the period no additives, growth stimulants, coccidiostats or ARC-OVI Laboratories for residue detection. A biological assay based
medicines were included in the feed. on disc inhibition zones in cultures of Bacilis subtilis were used to detect
disinfectant residues. A sensitivity evaluation test determined that
Upon arrival at the research site, the chickens were examined and any F10SC disinfectant would be detected at concentrations of 1:9000 and
obviously sick or dehydrated birds were culled. Standard management greater using the indicator microorganisms (Bacilis subtilis)
techniques were followed as described by the suppliers of the Ross
chickens (Ross Broiler Management Manual, 2002) and the same care Results
and management was provided to all the birds used in the study. All birds
were housed in wire pens with the floor covered with approximately 5cm Statistical analysis of the performance data utilised a procedure test with
wood shavings. Each pen was equipped with a 10-liter fountain drinker significance reported with 95% confidence limits.
and a plastic tube feeder. The house temperature at the start of the study
was kept as close as possible to 32 °C whereafter it was decreased with Detection of F10SC residues in tissue residues at
a gradient as the chickens grew older. All the broilers received broiler day 35
starter and finisher diets formulated to commercial specifications that
contained no additional medication or supplementation. The feed was A summary of the feed and water samples and the tissue sample residue
formulated and mixed at the ARC Poultry Nutrition facilities at Irene. The tests are given in Table 1 below.
birds received no vaccines.
Table 1
The experimental house was divided into two areas. The control group of
chickens was placed and reared in the one side of the house. The two
treatment groups that were supplemented with F10SC via the drinking
water with respectively 1:1000 and 1:250 concentrations (10ml and
40ml/ 10-l drinking water) were placed opposite each other on the other
side of the house. Footbaths containing F10SC in the water were placed
on both sides of the control and treatment pens respectively for the
personnel to walk through in the broiler house. The F10SC was prepared
fresh on a daily basis and placed into the footbaths and drinkers.
Chickens were weighed weekly, and their feed intake recorded. The
water consumption was recorded throughout the study.

The water treatments were administered to each Liver samples (Table 1) from individuals in the control group and 1:1000
group as follows: F10SC dilution group indicated evidence of F10SC disinfectant residue
despite the muscle samples producing negative results. Accumulation of
Control (Pens 1,2,3): Broilers that received only clean drinking water chemical substances in the liver would most probably be expected to
also occur in kidney tissue but this was not detected. Further tests on
containing no F10SC disinfectant. these 6 chickens on further muscle and kidney samples were negative
for residues of F10SC. The disc diffusion based assay is regarded as
Dilution (Pens 4,5,6): Broilers that received drinking water highly sensitive but with lower specificity. The results on the liver
samples were therefore considered to be “false positives” due to
containing 1:1000 F10SC imperfect specificity of the disc diffusion assay. It was therefore
concluded there was no accumulation of F10SC residues in the tissue
 Dilution (Pens 7,8,9): Broilers that received drinking water samples.

containing 1:250 F10SC .

®

Effect of F10SC disinfectant supplementation on
mortality

Mortalities encountered over the 35 day test period are shown in Table 2.

Table 2.

The incidence of 3% mortality was low. There was no significant
difference (P>.0.05) in mortality or incidence of disease between the
control group and F10SC treatment groups.
Effect of F10SC disinfectant supplementation on water
and feed intake.
Although the sole purpose of the study was to determine F10SC
residues in the tissue samples taken a note was nevertheless made of
water and feed intake over the 35 day period. It should be noted that the
manufacturers recommended concentrations of F10SC for continuous
supplementation of drinking water to improve water quality are from
1:20,000 to 1:40,000 and from 1:2500 to 1:10,000 when used to reduce
bacterial infections in poultry dependant upon the type of micro-
organism contamination.
Cumulative water intake (g) up to 35 days of age.

In general, the cumulative water consumption values were respectively Open misting/fogging system used in a nebulising therapy
88% and 56% lower for the 1:1000 F10SC and 1:250 F10SC groups to treat airsaccullitis in adult ostriches
compared to the control over the 5-weeks rearing period.

At higher concentrations drinking water treated with F10SC has an
increasingly bitter taste. Taste tests have shown that at concentrations
of 1:2000 and above no chemical taste is observed.

®

Conclusions Chitty JR: 2002 Use of a new disinfectant agent in the management of
upper respiratory tract disease in chelonia. Proc 45th Ann. Congr. Br.
This study was not designed to evaluate the disinfectant F10SC in an SmallAnim. Vet.Assoc.: 634
application in a commercial broiler production unit as other studies have Van Wyk W: 2002 The use of F10 in treating avian respiratory disease
demonstrated potential uses and effectiveness of the disinfectant in Van der Spuy S: 2002 Aspergillosis in the pet bird, Veterinary and
disease control. The sole purpose of this study was to prepare chickens Paraveterinary Congress,
over a rearing period of 35 days to determine whether F10SC has any Temperley JP, Limper L, Horner RF, Odendaal M, Verwoerd DJ: 2003
residual effect in broiler tissue that could be detected in an accredited Novel Disinfectant for Aspergillus Control. International Hatchery
inhibitory substances laboratory test. Practice, Vol 17 nbr 6
Stanford M: 2004 Recombinant Omega Interferon in combination with
Although the concentrations used in the study of 1:1000 and 1:250 of F10 Nebulisation for the treatment and prevention of Circovirus Infection
F10SC far exceed the manufacturer's recommendations for continuous inAfrican Grey Parrots Veterinary Record 154, 435-436
long-term use in drinking water the results showed there was no Le Roux L: 2004 F10 an alternative localized therapy with extended
indication of residues in chicken meat (breast and thigh) or organs (liver clinical applications, SAVAConfernece, Cape Town
and kidneys). The results suggest that the manufacturer's Evans I: 2004 To determine the threshold taste limit for F10SC in tap
recommended concentrations of F10SC for improving water quality to water
reduce microbiological contamination of 1:20,000 to 1:40,000 and from SABS Microbiology: 2004 F10 DisinfectantAerosol, Test the efficiency of
1:2500 to 1:10,000 when used to reduce bacterial infections will not an aerosol fogging application, Report No. X34736/40
result in any inhibitory substances residues. Chitty J: 2005 Respiratory Disease in Exotic and Small Mammals,
Veterinary Times Vol 35 No.38 10 October
Alternatively the addition of F10SC to the drinking water of poultry to Stanford M: 2006 Control of Circovirus Infection in psittacine birds using
reduce the occurrence of bacterial, Salmonella or E.coli, infections and F10SC Disinfectant andAvian Gamma Interferon
mycotic disease in poultry would be potentially very useful.
Related Tests
Similarly the use of F10SC as a long-term treatment in exotic birds might
also be considered to be a safe option in refractory cases of aspergillosis Airspace Decontamination using F10SC
where F10SC disinfectant is used by nebulisation as therapy for the Disinfectant
treatment of Aspergillus fumigatus in exotic avian species or by over- Tests were conducted by The SABS Microbiology Dept to determine the
spraying (fogging) in the presence of birds to reduce surface and effectiveness of F10SC Disinfectant to eliminate airborne micro-
airborne microbiological contamination at the higher recommended organisms.
concentrations of 1:250; F10SC is unlikely to result in a build-up of
chemical residues or side effects sometimes associated with systemic Manufacturer of F10 Products:
treatments.
Health and Hygiene (Pty) Ltd
REFERENCES P.O. Box 906, Florida Hills, 1716, South Africa
Tel: +27 11 474 1668 • Fax: +27 11 474 1670
Forbes NA: 1996 Respiratory Problems. In: Beynon PH, Forbes NA, www.healthandhygiene.co.za • www.f10products.co.za
Lawton MPC. Shurdington, UK. BSAVA.: 147-157

Verwoerd DJ: 2001 Aerosol use of a novel disinfectant as part of an
integrated approach to preventing and treating aspergillosis in falcons in
the UAE. Falco. 17:15-18

Bosman H: 2001 Use of F10 Super Concentrate in Broilers. Summary
report of commercial trial on day-old chicks

Forbes NA: 2001Aspergillosis, International Falconer, May

Bailey T, & Sulivan T: 2001 Aerosol therapy in birds using a novel
disinfectant Exotic DVM, Vol. 3.4Aug/Sept

Stanford M: 2001 Use of F10 in Psittacines. Exotic DVM, vol 3.4
Aug/Sept

Verwoerd DJ: 2002 F10: Clinical uses in an Avian Model with individual
[Aspergillosis in Gyrfalcons] & population [Fungal & Bacterial
airsaccullitis in ostriches] examples/case studies. Br. Vet. Zool. Soc.
Ann. Conf. Edinburgh

Chitty JR: 2002 A novel disinfectant in psittacine respiratory disease.
Proc 23rdAnn. Conf. Expo.Assoc.Avian Vet: 25-28

F10 PRODUCTS LTD
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK

Freephone: 0800 014 8803 • Fax: 01509 265777
Email: [email protected] • [email protected]

www.f10products.co.uk

®

ISSUE 5 • 2007 www.healthandhygiene.co.za

THE NEED FOR BIOSECURITY IN FACTS IN
A VETERINARY PRACTICE TODAY THIS ISSUE

Linda Muller, BA (UP), DipCurAnim (UP), John Temperley, FCMI. GENERAL VETERINARY PRACTICE

SUMMARY Respiratory equipment can easily BIOSECURITY AND
Veterinary facilities are not excluded from the risk of hospital- become sources of infection INFECTION CONTROL
acquired infections and these occur more often than we
would care to admit. In order to provide the best veterinary THE HUMAN HEALTH SERVICES SITUATION
care possible, veterinarians and their staff have an According to figures released by the Centre for Disease
underlying responsibility to minimize the risk of additional Control and Prevention (CDC) in March 2005, 90,000
harm that might befall a patient because of their Americans die each year due to nosocomial infections and
interventions. This includes minimizing the risk of exposing another 1.9 million suffer needlessly from infection related
patients to infectious agents. It is therefore incumbent upon illnesses. These patients spend up to 30 more days in
vets to actively manage the risk of nosocomial infections. hospital and together with the additional treatment it adds a
These infections in veterinary facilities are not solely a considerable amount to the nation's health care bill - as much
patient-care concern; as in human health the spread of as $5 billion dollars annually.
infectious agents can also significantly impact on normal
daily operations, revenue, client satisfaction, client In the UK hospital acquired infections strike about 100,000
confidence, public image and can even affect the morale of people a year, costing £1 billion and resulting in about 5,000
staff. The most important factor in preventing these deaths. (Weekly Telegraph 24 March 2004). A recent report
infections is improving the hygiene practices of health care in the same newspaper indicates that the situation has
providers. All staff members associated with animal care worsened dramatically over the past two years. The reasons
must be educated in proper hand-washing procedures, given for the increase is that the hospitals are too full at 85%
aseptic technique, basic hygiene principles and the capacity. The initiative taken to get staff to wash their hands
appropriate use of disinfectants. or use an alcohol hand gel has not had any significant effect
on reducing hospital acquired infections. (Weekly Telegraph
The aim of this article is to highlight the need for proper 14 March 2007).
infection control programmes in veterinary practices.
“South Africa is on the verge of a massive increase in the
INTRODUCTION outbreak of infectious diseases in our hospitals with very few
Nosocomial or hospital-acquired infections are an inherent measures to control it” (Sunday Tribune 24 July 2005). “We
risk of hospitalization and are undesirable, costly, can be life- suspect that in South Africa a conservative estimate of
threatening and can usually be prevented. Sources of such hospital acquired infections is about 15% of admissions. I
infections can be either endogenous (e.g. from the patient's would not be surprised if in some institutions this figure is
own flora) or exogenous (e.g. from a source other than the even more horrific” (Prof Sam Mhlongo, Medunsa, The Star
patient). Most nosocomial infections are endemic, occur with 24 December 2004).
predictable frequency, are endogenous in origin and occur
among immunocompromised, severely ill, or elderly Unfortunately infection control and more particularly
patients. Epidemic infections are less common and imply a disinfection are too often seen as a cost to be minimized
common source (exogenous), vector transmission and are rather than a Quality Assurance issue to be properly dealt
often associated with specific procedures or devices. with in the delivery of the medical care to the patient.
Factors that predispose patients to nosocomial infections
can be classified as intrinsic (e.g. age, sex, breed, immune A VETERINARY PERSPECTIVE: THE NEED FOR
status of patient) or extrinsic (e.g. surgical procedures, BEST PRACTICE
diagnostic or therapeutic interventions, staff exposures). The responsible use of antibiotics in veterinary medicine to
Although many factors affect the risk of virtually all safeguard the efficacy of antibiotic therapy in animals and
nosocomial infections, such as severity of underlying illness,
advanced age, immunosuppression and surgical
procedures, others affect the risk of a specific infection. For
example, mechanical ventilation specifically increases the
risk of nosocomial pneumonia and indwelling urinary
catheters are associated with urinary tract infections.

The prevention of nosocomial infections by the identification
of risk factors and the development, i.e, introduction and
monitoring the effectiveness and efficiency of preventative
measures, is the principle objective of hospital biosecurity.

®

minimize possible public health risks is currently a worldwide concern. The resistance rates of penicillin (84%), ampicillin (82%), and ampicillin
Everything possible must be done to prevent the emergence of combined with clavulanic acid (78%) and a member of the first
resistance and the spread of resistant bacteria. Such measures include generation of cephalosporins, cephaloridine (78%) are also given as a
individual preventative practices, improvement in hygiene and nursing comparison.
practices, control of antibiotic use and shortening hospitalization
periods. “Samples received at a diagnostic laboratory are of course not
representative of all the strains causing disease, but only reflect initial
“Hospital acquired infections are particularly difficult to control in a busy treatment failures.
veterinary practice. Biosecurity measures that can be implemented on a It is nevertheless an indication of a worrying trend and a forecast of
farm, or at boarding kennels, are far easier to put into place, and monitor, severe problems in the future.” Dr Marijke Henton, Golden Vet Lab.
than what is possible in a practice. Referral practices are especially at
risk, as they regularly admit animals that have already been treated, and A SOUTH AFRICAN INITIATIVE
therefore are more likely to be carrying resistant bacteria.” - Dr Marijke In 2000 the SAVC launched a pilot project where veterinary practices
Henton, Golden Vet Labs. could voluntarily opt to be inspected by inspectors appointed by Council.
The aim was for the practices to obtain accreditation through meeting set
WHAT ARE THE RISKS? standards pertaining to amongst others; facilities, diagnostic imaging,
We just never know what will be walking or carried in through the door!An recordkeeping, hygiene and infection control. Feedback indicated a
example of a nosocomial infection that occurred a number of years ago need for guidance at both a policy and practical level. The Council
was a series of Klebsiella pneumoniae infections in animals being subsequently circulated a guideline document “Disinfectants and
examined for infertility. The initial strain was isolated from a mare, where Antiseptics in Veterinary Practice” to assist practice management
Klebsiella is a recognized pathogen. Alarm bells only rang 9 months develop, implement and evaluate an infection control and hygiene policy
later, after 9 cows and 4 bitches had yielded exactly the same capsular best suited for their particular applications.
type in the interim. Whereas Klebsiella is regarded as a common cause
of infertility in mares, it is seldom found associated with infertility in dogs Legislation pertaining to the new regulations for the veterinary
and cows. A search for the source of the infection located it in a tub of profession is pending, but compulsory inspections for accreditation
lubricant gel that was used to introduce the speculum into the animals. purposes will soon be a reality for every practice.
The rare strain of Klebsiella had probably been introduced into the gel
from the mare, and it had survived for nine months in the gel.

Recently, two trans-tracheal aspirates, received on the same day from FORMULATING AND IMPLEMENTING A POLICY
the same veterinary diagnostic hospital, yielded Pseudomonas stutzeri. Step 1 - Identify the risks!
The two isolates were identical and the antibiograms were also the The first step in formulating a biosecurity policy is to identify where
same. The sampling apparatus had not been properly disinfected after cleaning, disinfection or sterilization is required.
the first aspirate had been taken.
FIG. B - RISK IDENTIFICATION IN MODERN VETERINARY
Another example, Haemophilus parasuis was isolated from samples PRACTICE
from a sheep as well as a pig, sent on the same day, from the same
practice. Haemophilus parasuis is not found in sheep at all, and there INTENDED USE USAGE/RISK
had been cross-contamination from the pig samples.
HIGH MEDIUM

RESISTANT STRAINS Surgical instruments X X
Case studies and lab results indicate that the threat of emerging Intravenous catheters X X
diseases due to resistant strains like MRSA infections in veterinary Hypodermic needles X X
practice is very real, e.g. 50 samples received by a veterinary diagnostic Anaestehesia equipment X
laboratory in just a 30 day period presented the following: - Endotrachael tubes X X
Laryngoscopes X
An analysis of the Staphylococcus strains isolated from dogs during Urinary catheters X
January and February 2007, from samples received showed that 38% of Rectal thermometers
the strains were resistant to methicillin. Most of the isolates (78%) were Otoscope attachments X
S. intermedius and 22% were S. aureus. There was no real difference in Stethoscopes X
the resistance rates between the two species, and they are therefore Endoscopes X
combined in the FigA. Diagnostic imaging probes X
Razor blades X
FIG. A Bedding X
Food and drink bowls X
Staphylococcus methicillin resistance Kitchen utensils X
Brushes and toys X
Percentage 90 Scale X
80 Door knobs, light switches X
70 Methicillin Ampicillin Ampicillin/ Cephaloridine Staff clothing X
60 Resistant Clavulanic Nail brushes X
50 Soap containers X
40 Sensitive Cages X
30 Litter trays X
20 Basins X
10 Drains
Waste bins
0 Cleaning equipment
Penicillin

High=Sterilization essential
Medium=Sterilization / High level disinfection

®

The nature of instrument/equipment disinfection or sterilization can be Biofilm removal
understood more readily if these items are divided into categories based Biofilm is a complex aggregation of micro-organisms marked by the
on the known risk of infection involved in their use. This classification excretion of a protective and adhesive matrix. There is an increasing
scheme was first suggested by Dr. E.H. Spaulding in 1972 and provides awareness in health environments of the need to deal more effectively
a good base. Unfortunately this assessment was based upon the need to with this very difficult problem.
deal with surface cross-contamination whereas now we know that a
significant risk of infection arises from airborne contamination as well, Surfaces in the animal production environment (poultry & pig houses,
commonly via the air conditioning system or simply from dust carried milking machines & bulk tanks etc. etc.) as well as clinics and keeping
from surface to surface by air movement. cages, kennels and catteries - often develop a microfilm fatty layer within
The simpler the programme the less confusing to the staff and the more which pathogenic micro-organisms escape general surface
cost-effective it will be. washing/disinfection due to the use if ineffective products and or
procedures and therefore act as a reservoir population to infect the next
Semi-critical devices that pose a medium risk of transmitting batch of animals/ patients. Biofilm can coat the inside surfaces of water
an infection and require high level disinfection reticulation pipes used in intensive animal production or, as has been
found, the inside surfaces of catheters. Such situations demand periodic
Step 2 - Reduce the risks! deep cleans with a product formulated to remove natural fats and oils
The aim is always to reduce the microbe level to the lowest possible level (F919SC Degreaser/Cleaner has proved to be very effective in such
in the most practical and cost-effective way. Basic hygiene principles and applications) and the daily use of effective disinfectant/cleanser
good housekeeping will go a long way. Surfaces that look clean, dry and products such as F10SCXD Veterinary Disinfectant/Cleanser.
shiny are probably safe and good for staff morale.
Staff should be aware and well trained in basic hygiene principles and Air quality
routine cleaning procedures. Good practices such as damp dusting, Airborne contamination can be a significant source of contamination
vacuuming and fogging should be the norm. particularly in buildings that are more than 4 years old. Sick buildings are
Vacuum cleaning not limited to office buildings.
Vacuum cleaning is an efficient and effective method collecting dust and
hair in veterinary settings. The cleaning and disinfection of primary and secondary filters in central
Fogging air conditioning systems and the ducts themselves need to be regularly
This is a novel way of applying a disinfectant in the form of aerosol micro monitored in terms of pressure drops at the filters as well as settle plate
droplets and can be extremely effective and economic if done correctly. sampling at individual diffuser outlets. Products such as the F10 HVAC
The disinfectant can reach onto surfaces otherwise difficult to reach and range of cleaners and disinfectants for central systems and F10HVAC
if used with a safe disinfectant (product specific toxicological data must aerosols for individual units have achieved exceptional reductions in
be available for a fogging application), it can be used in the presence of micro-organism counts. They are a significant step forward in making
staff and patients. Foggers that produce different droplet sizes (average these tasks more effective and efficient because in most situations they
12 - 22 microns) are commercially available. can be used whilst the building is occupied.

Fogging with a safe product can be done Step 3 - Manage the risks
in the presence of staff and patients There is little point in going to all the trouble of identifying and reducing
infection risks if measures are not in place to maintain the achievements.

Monitoring of physical standards can be done using a simple inspection
sheet and performing a physical inspection on a weekly/monthly basis
involving the staff responsible for each area. Results should be
compared to standards that have bet set and used to motivate staff by
recognising good results and re-training where poor results are found.
Microbiological surveys should be carried out at least quarterly.

PRODUCT SELECTION
New, exciting and often useless products are presented in all shapes
and sizes with weird and wonderful claims being made about efficacy,
dilutions, contact times and residual effect. If you accept that the risks
are increasing then product selection is a critical decision and cannot be
left to uninformed persons. This in turn means efficacy test reports,
toxicity reports, MSDS, must be checked for relevance and adequacy.
Are they registered by an appropriate Authority, e.g. in South Africa there
is a Compulsory (general) Standard Act 29 for disinfectants but only
products registered under the Dept ofAgriculture Stock RemediesAct 36
are assessed for their efficacy against animal diseases. Look at the
depth of a product's performance. A product that can just manage a log3
challenge is not suitable for the varying demands to be found in a
veterinary practice. Products should be capable of dealing with at least
log5 as required by the EU, EN Standards, or better still the US, AOAC
Standards that require a log6 kill for hospital applications. Mutations
resulting in resistance micro-organisms only occur when the challenge is
not totally eliminated. If the product is not up to the challenge, what
relevance has cost, fragrance or staff satisfaction?

®

SAVA Medico Committee recommendations issued in 2001 and CONCLUSION
endorsed by the SAVC set out a product selection model Fig C below. Hospital-acquired infections may not be an everyday occurrence in
F10SC Veterinary Disinfectant has been used as an example of your facility, you may even not be aware that such an infection ever
compliance evaluation. occurred, but the threat is real.
Why compromise your patient's well-being, your practice image, and
PRODUCT SELECTION CRITERIA your client's trust in you or your own health when an effective policy
backed up by Best Practices Processes will ensure a good standard is
EVALUATION OF DISINFECTANTS FOR USE IN THE maintained?
VETERINARY PRACTICE Is a clean and safe environment not the very least your clients and
patients can expect from you?
(Extract from DISINFECTANTS AND ANTISEPTICS IN VETERINARY PRACTICE a document prepared by SAVA MEDCO 2001)
ACKNOWLEDGEMENTS
A Hard Surfaces with animals present D Instruments without rinsing before use 1. Dr Marijke Henton MMedVet(Bact), Veterinary Specialist, Idexx
B Air Spaceswith animals present E Skin and Mucous Membranes
C Cage Kennels with animals present F Laundry pre-soak. Golden Vetpath Lab, [email protected]
REFERENCES
APPLICATION ABCDE F 1. Ayliffe GAJ Control of Hospital Infection Third Edition. Chapman

1 = Recommended standard 121212121212 & Hall Medical. 1992
2 = F10 being evaluated 2. Bland vd Berg P, Muller L, Verwoerd DJ, Temperley JP, BurgerAP,
N = NON COMPLIANT
Y = YES IT COMPLIES SABS,SAVA MEDCO “Disinfectants and Antiseptics in Veterinary
EFFICACY Y YY YYYYYYYYY Practice” 2001
Y YY YYYYYYYYY 3. Block SS Disinfection, Sterilization and Preservation. Fourth
• Gram positive bacteria Y YY YYYYYYYYY Edition Lea & Febiger 1991
• Gram negative bacteria Y YY YYYYYYYYY 4. Centres for Disease Control (CDC) Guidelines for the Prevention
• Enveloped viruses Y YY YYYYYYYYY and Control of Nosocomial Infections.Atlanta 1986a
• Non enveloped viruses Y YY YYYYYYY Sr Linda Muller is the Companion Animal Business Manager and
• Yeasts and moulds John Temperley the Managing Director of Health and Hygiene (Pty)
• Fungi YY YYYYYY Ltd, the manufacturers of F10 disinfectants and F919 products.
• Fungal spores YY YYYYYY
• Bacteria spores
• Protozoa, including cysts YN
• Other specifics
• Are relevant claims included on the Act 36 label Y YY YYYYYYYYY
• Were tests carried out on the finished product Y YY YYYYYYYYY
• Were the tests carried out by an accredited laboratory Y YY YYYYYYYYY

SIDE EFFECTS

• Oral toxicity > 3000g/kg YY Y Y Y YYYYY

• Dermal toxicity > 4000g/kg YY Y Y Y YYYYY

• Inhalation toxicity is non toxic YY Y Y Y YYYYY

• Ocular irritation - draize score not more than 2 after 24 HrsYY Y Y Y Y Y Y Y Y

• Skin irritation - intact skin score < 4 (SABS 671) YY Y Y Y YYYYY

• Skin irritation - abraded skin < 4 (SABS 671) YY Y Y Y YYYYY

• Tissue compatibility substantiated YYYY

• Non corrosive to all metals YY Y Y Y YYYYYY Y

• Can it be used without the use of safety equipment/

protective clothing YYYYYY YYYY

• Can it be used in the presence of animals/Humans Y Y Y Y Y Y Y Y

• Unrestricted use in terms of the Act 36 label (1) YYYYYY YY

• Were tests carried out on the finished product YY Y Y Y YYYYYY Y

• Were the tests carried out by an accredited laboratory Y Y Y Y Y Y Y Y Y Y Y Y

ACCREDITATION AND REGISTRATION

Registered in terms Act 36 of 1947 (1) YY Y YY Y Y YY YY Y

Compulsory Registration of Disinfectants Act 29 (2) Y Y Y Y Y Y Y Y Y Y Y Y

• Other 3

QUALITY ASSURANCE

• SABS Approval Marks (Efficacy and QA process) 4

• SABS Compliance Marks (Safety and QA process) 5

• Other 6

APPROVALS SUCH AS EQUIPMENT MANUFACTURERS

• Equipment manufacturers - Endoscopes Y7

• Other

(1) Disinfectant products claiming to control or eliminate specific animal pathogen must be
registered under Act 36/1947 Stock Remedies

(2) Disinfectant products registered under Act 29 do not cover specific animal pathogens
3 Other registrations in countries in addition to SA
4 SABS Approval Marks
5 SABS Compliance Marks
6 Quality Assurance Other, GMP approved byAPVMAto manufacture veterinary medicines
7 Manufacturer's Approval, Olympus, Flexible Endoscopes

F10 PRODUCTS LTD Manufacturer of F10 Products:
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK
Health and Hygiene (Pty) Ltd
Freephone: 0800 014 8803 • Fax: 01509 265777 P.O. Box 906, Florida Hills, 1716, South Africa
Email: [email protected] • [email protected] Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za
www.f10products.co.uk

®

ISSUE 6 • 2007 www.healthandhygiene.co.za

FACTS IN
THIS ISSUE

INTRODUCTION birds, bacterial and fungal air sacculitis and acute
pneumonia, including aspiration pneumonia in neonatal
The core actives of the F10 Veterinary Disinfectant product mammals.
range are quaternary ammonium and biguanidine
compounds which act synergistically to kill a wide range of FLUSHING
viruses, bacteria, fungi and spores. It is available as a
concentrated disinfectant for dilution with water (F10SC The nasal flush is a useful technique for management of
Veterinary Disinfectant), a combined disinfectant and upper respiratory tract infections in avian and reptilian
cleanser (F10SCXD Disinfectant/Cleanser), a germicidal patients (Chitty J 2002; Chitty J, 2004). The animal is
treatment shampoo (F10 Germicidal Treatment Shampoo), restrained with its head downwards to avoid aspiration and
a germicidal barrier ointment (F10 Germicidal Barrier F10SC, again at a concentration of 1:250 in saline is forcibly
Ointment) with or without cypermethrin as an insecticide and syringed into the external nares so that it exits through the
as a new wound spray which also contains cypermethrin choana and drains out of the oral cavity. Although the
(F10 Germicidal Wound Spray with Insecticide). The F10 anatomy varies with species, this usually allows the flushing
product range is manufactured by Health and Hygiene (Pty) solution to pass over the surface of the nasal conchae and
Ltd in South Africa. These products have been used on a parts of the infraorbital sinus such as the preorbital
wide variety of vertebrates, including mammals, birds, diverticulum. This technique can be carried out easily and
reptiles and amphibians and show efficacy at low safely in most small to medium sized birds as well as lizards
concentrations, with short contact times and with minimal and chelonians and allows daily removal of accumulated
tissue irritation. mucus and inflammatory material as well as direct
application of the medication to mucous membranes.
Zoological medicine is characterized by the large variety of F10SC is also suitable for sinus flushing directly into the
animal species that may be dealt with on a regular basis and preorbital diverticulum in birds. Again the head is held below
products effective against a wide variety of pathogens and the body to avoid aspiration and the needle is inserted
with low toxicity across taxa are useful and cost-effective
additions to the zoo veterinarian's armoury. This paper
discusses a range of applications for the F10 products which
the author has found useful in clinical zoo practice.

NEBULISATION

Nebulisation involves the aerosolisation of a liquid
therapeutic agent so as to allow its direct application into the
upper and/or lower respiratory tract. It allows instantaneous
drug delivery to the required site without the potential lag
time which many systemic drugs take to achieve therapeutic
tissue concentrations. It also allows drugs with systemic side
effects such as aminoglycosides to be given safely, since the
respiratory epithelium is relatively impermeable and it is also
a good method of rehydrating small animals, especially
birds. Nebulisation is a particularly useful adjunct treatment
in cases of fungal or bacterial upper and lower respiratory
disease including rhinitis, sinusitis, tracheitis, bronchitis, air
sacculitis and pneumonia. In avian species if air sac or lung
disease is present, an ultrasonic nebuliser capable of
producing a particle size of less than 5µm is preferable, since
the diameter of the air capillaries ranges from 3-10µm. If
upper respiratory tract disease is present, cheaper
compressor nebulisers can be used, which produce a larger
particle size. Typically animals are nebulised for 15-20
minutes two to three times a day with F10SC diluted 1:250
with saline. This has been found to be an effective adjunct
therapy in many cases of rhinitis and sinusitis in birds,
reptiles and small mammals, respiratory aspergillosis in

®

perpendicularly through the skin at the commisure of the beak, under the the site to abscess formation and may be counterproductive (Myers,
zygomatic bone. The flushing solution should exit via the choana. Care 2006). Since dead space increases the risk of infection, if this cannot be
must be taken to avoid the globe. easily eliminated eg by drainage or sutures then wounds in this category
should also be left open. Soft tissue loss or lack of available skin may
also prevent primary closure. Examination, diagnosis and treatment
may involve anaesthetising the animal first and the risk of multiple
anaesthetics needed for repeated debridement for example may
outweigh the benefits of primary closure. Difficulty in returning an animal
safely to its social group after surgery is another common reason for
electing minimally invasive second intention healing as a method of
wound management.

FOGGING Superficial first degree burns and some second degree burns heal well
by second intention and traumatic wounds with compromised perfusion
F10SC diluted at 1:250 with saline can also be used for fogging entire and ongoing tissue necrosis are also more successfully managed at
rooms as part of routine biosecurity measures. In the author's institution least initially as open wounds. Disadvantages to second intention
it is used for hospital wards, brooder room incubation and chick rearing healing include the increased likelihood of fly strike or myiasis, exposure
facilities and quarantine units, particularly where groups of birds are of important underlying structures and problems associated with
housed together. Fogging with F10 may be done in the presence of the contraction and epithelialisation for example the production of a fragile
animals, since it is safe and non-irritant if inhaled either by them or by epithelialised surface which is continually retraumatised.
hospital staff.
Initial wound management after restraint, assessment and stabilization
WOUND MANAGEMENT of the patient usually involves debridement and wound lavage. Choice of
irrigation solution depends on factors such as availability, tissue toxicity
Trauma is one of the most common health problems seen in almost all
zoo animals. Inter or intra-specific trauma may result from competition
for space/territory, food, shelter or nesting sites and materials. It may be
precipitated by abnormal behaviour for example in socially inept hand-
reared individuals, animals suffering from concurrent disease or in birds
unable to fly due to wing-clipping or pinioning. Self trauma is also
common, either for behavioural reasons or due to animals injuring
themselves on fences, the glass sides of vivaria or other inanimate
objects in their environment.

Bite or claw wounds, horn injuries, blunt trauma, lacerations, abrasions,
punctures and chronic wounds such as pododermatitis due to
inappropriate husbandry or underlying disease are all common. While
the principles are the same as in domestic species, wound management
can prove challenging to deal with in zoo animals, especially in species
that are not easily handled or observed. Primary or immediate closure is
often only feasible for surgical wounds or sharp lacerations that are
presented at a very early stage and many zoo mammals for example
primates are adept at removing even buried sutures unless precautions
are taken to prevent this. Delayed primary closure before granulation
tissue appears and secondary closure when granulation tissue is
already present can be useful but usually involve prior repeated
debridement and lavage. Second intention healing where an open
wound heals by granulation tissue formation, epithelialisation and
contraction is the most commonly used method of dealing with minor and
moderate wounds in zoo species.

The most common reason for choosing to allow wounds to heal by
second intention is contamination of the wound, the degree of which is
directly correlated to the time since injury and is also related to
environmental factors such as enclosure substrate and hygiene. Bite
wounds where the skin has been punctured and underlying tissues
damaged are always heavily contaminated. Late presentation of
wounds is much more common than in domestic species as many zoo
species cannot easily be observed at close range and actively mask
signs of illness or injury as a predation avoidance mechanism. Closure of
a wound that has not been adequately cleaned or debrided predisposes

®

and detrimental effects on wound healing. Povidone iodine, Severe pododermatitis in birds often necessitates surgical debridement
chlorhexidine, saline and lactated Ringers solution are all commonly of the lesion which may then be managed as an open wound (Burke et al,
used. F10SC at a dilution of 1:250 in saline provides a useful alternative 2002). F10 Barrier Ointment may be used topically on the defect, in
which is non-irritant, non-toxic, has a broad spectrum of antimicrobial conjunction with appropriate systemic antibiotics until healing occurs.
activity and retains this in the presence of moderate organic material. It
can also be used for irrigation of larger body cavities such as the crop in An F10 Germicidal Wound Spray with Insecticide is also available which
cases of impaction or yeast infection, uterine lavage in cases of metritis is useful for applying from a short distance to animals that cannot be
and the abdominal cavity in cases of peritonitis in mammals. easily restrained for more proactive wound care. It has a duration of
activity of several days but is water soluble and so may need to be
Wounds that are to be allowed to heal by second intention may then be applied more frequently under certain weather conditions or in semi-
managed by the application of topical medications with or without aquatic species. If primary closure is used in zoo species, then often
dressings and bandages to provide an optimal wound healing wounds are closed with absorbable sutures to avoid the need to
environment and prevent further secondary infection (Liptak, 1997; anaesthetize an animal subsequently for suture removal. Since sutures
Krahwinkel & Boothe, 2006). Again various topical products are can act as a nidus for infection and tracking of bacteria into a wound, this
commonly used including triple antibiotic ointments and silver increases the likelihood of post surgical infection and an antimicrobial
sulfadiazine cream (Swaim, 1990). F10 Germicicdal Barrier Ointment, spray applied to the suture line can reduce this risk. This author also
routinely applies F10 Germicial Wound Spray with Insecticide to
hoofstock and other large mammals that have been anaesthetized with
remote injection techniques since the darting procedure itself can result
in infection at the dart site due to drawing of hair and skin into the wound
and discharge or bleeding from the wound can increase the possibility of
myiasis. The bright pink colouration of the wound spray is useful to mark
the site of the dart wound, especially if dangerous opioids such as
etorphine have been used, however the product is also available in a
colourless formulation. As with the insecticidal barrier ointment, the

based on quaternary ammonium and biguanidine compounds with
glycerin and lanolin has been used by the author in many classes of
vertebrate with no adverse side effects, even in amphibia where
systemic absorption of topical medications is a particular concern. It has
no apparent negative effects on epithelialisation or wound contraction
and is also available with cypermethrin as an insecticide. This latter
formulation is not recommended in amphibians or felids. It has also been
applied by the author around external fixator pins after fracture repair in
both birds and mammals.

Abscesses in reptiles and birds often consist of encapsulated caseous
material that can be removed in one discrete piece, leaving a cavity
which should be liberally lavaged with an appropriate antimicrobial agent
such as F10SC diluted as stated above. After flushing, the abscess
cavity is packed with F10 Germicidal Barrier Ointment and left to heal by
secondary intention.

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wound spray is also contraindicated in felids due to the cypermethrin Batrachochytrium dendrobatis zoosporangia in vitro and is therefore a
component, although it has been used by the author with no ill effects on potential therapeutic agent for amphibians infected with this important
large cats including lions, tigers and a snow leopard with fly strike. pathogen (Webb et al, 2007).

DERMATOMYCOSES HOSPITAL HYGIENE

F10 Treatment Shampoo has been used to treat fungal tail alopecia in an Finally F10 products are routinely used at the author's zoo hospital for
8 year old red panda where culture isolated Microsporum gypseum. The disinfection and sterilisation purposes. Surfaces are disinfected with
tail was treated topically for two months, initially at intervals of 2-3 days F10SC diluted 1:250 in water. If resistant viral contamination is
and then at weekly intervals. No systemic treatment was given and after suspected however, for example after housing a parrot positive for
two months the hair had regrown and fungal culture was negative. psittacine beak and feather disease, the concentration is increased to
F10SC diluted 1:3000 with RO water is also used as a prophylactic 1:125. This higher concentration is also used for footbaths placed at the
treatment for amphibians during their quarantine period. Wild caught entrance to quarantine units. Where development of a biofilm is likely
amphibians in particular are prone to secondary bacterial and fungal skin such as in the post mortem room and hospital cages, F919 SC
infections, particularly when undergoing the stress of adjusting to a life in Degreaser/cleanser (a sodium and silicate compound) is used at a
captivity. Bathing of new frogs and toads once weekly for 5 minutes at the dilution of 1:50 with hot water.
above dilution is carried out with the aim of reducing this risk. F10 at the
above dilution has recently been shown to be 100% effective in killing Endotracheal tubes, feeding/crop tubes, and bottles for feeding
neonates are washed in a 1:250 dilution of F10SCXD then rinsed with
water before submersing them in a 1:250 dilution of F10SC. For cold
sterilization of endoscopes and surgical instruments the concentration is
increased to a 1:100 of F10SC.

Health and Hygiene have developed a comprehensive set of advisory
guidelines covering the use of the F10 and F919 products in veterinary
hospitals which are available on their internet web site
www.healthandhygiene.net .

CONCLUSION

In conclusion, use of the various F10 products mentioned above has
proven safe, effective and non-toxic to a variety of species even when
inhaled or applied directly to open wounds. The author has used these
products with success in amphibians, reptiles, birds and the following
groups of mammals: insectivores, procyonidae, primates, edentates,
rodents, felids, rhinos, hippos, equids, bears, camelids and bovids.

References:

Burke HF, Swaim SF & Amalsadvala T (2002) Review of Wound Managament in Raptors.
Journal ofAvian Medicine and Surgery 16(3): 180-191.

Chitty J (2002) A novel disinfectant in psittacine respiratoy disease. Proceedings of the
Association ofAvian Veterinarians, Monterey. 25-27.

Chitty J (2004) Respiratory System. In Manual of Reptiles, eds SJ Girling & P Raiti : 230-242.
BSAVA, Gloucester.

Krahwinkel DJ & Boothe HW (2006) Topical and systemic medications for wounds. Veterinary
Clinics of NorthAmerica SmallAnimal Practice 36(4): 739-57.

Liptak JM (1997) An overview of the topical management of wounds. Australian Veterinary
Journal 75(6): 408-13.

Myers DA (2006) Common Procedures and Concerns with Wildlife. Veterinary Clinics of
NorthAmerica ExoticAnimal Practice 9: 437-460.

Swaim SF (1990) Bandages and topical agents. Veterinary Clinics of North America Small
Animal Practice 20(1): 47-65.

Webb R, Mendez D, Berger L & Speare R (2007) Additional disinfectants effective against the
amphibian chytrid fungus Batrachochytrium dendrobatis. Diseases of Aquatic Organisms 74:
13-16.

F10 PRODUCTS LTD Manufacturer of F10 Products:
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK
Health and Hygiene (Pty) Ltd
Freephone: 0800 014 8803 • Fax: 01509 265777 P.O. Box 906, Florida Hills, 1716, South Africa
Email: [email protected] • [email protected] Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za
www.f10products.co.uk

®

ISSUE 7 • 2007 www.healthandhygiene.co.za

SOME EXPERIENCES IN THE USE OF FACTS IN
F10 IN THE TREATMENT OF REPTILES THIS ISSUE

Dr. Dorianne Elliot, Bird and Exotic Animal Hospital,Onderstepoort. SMALL ANIMALS & EXOTICS

Introduction Daily room fogging for 10-15 minutes with 1:250 F10SC in a BIOSECURITY, NEBULISING, NASAL FLUSHING, WOUND IRRIGATION, ZOOLOGICAL MEDICINE
For the past several years we have been using a variety of commercial fogger unit was performed for 6 weeks. No SOAK THERAPY, WOUND MANAGEMENT, FUNGAL DERMATITIS
the F10 products in our clinic. The BEAH is a private, special reptiles showed discomfort or respiratory distress during the REPTILES
interest clinic based on the premises of the Onderstepoort fogging.
VeterinaryAcademic Hospital.
No new infections were noted after the strict hygiene protocol
The case load of the BEAH consists entirely of birds and was begun although several individuals continued to
exotic animals including reptiles. Both first opinion and demonstrate dysecdysis and increased levels of aggression.
referral cases are seen.
Nebulising cases with bacterial
Biosecurity in the hospital pneumonia
We use the F10SC Veterinary Disinfectant (F10SC) and Bacterial pneumonia is an extremely common condition of
F10SCXD Veterinary Disinfectant/Cleanser (F10SCXD) tropical snakes such as Burmese Pythons. Most cases are
products for general biosecurity in the clinic. F10SC is used precipitated by incorrect husbandry including inadequate
at a 1:250 concentration to clean all cages, bowls and cage warmth and humidity. Commonly isolated bacteria include
equipment. We have found this product to be safe and non- Proteus mirabilis, Pseudomonas aeruginosa and
irritant when used in reptile enclosures. Although we have Aeromonas spp.
not undertaken any formal testing ourselves we are kept
informed of the ongoing testing regimen carried out by Nebulisation is a valuable adjunctive therapy in these cases
Health and Hygiene and we are aware that the OVAH where and F10SC at a 1:250 concentration is used along with
F10 products are used throughout carry out regular antibiotics and mucolytics for twice daily treatment. Each
microbiological surveys. Since using F10 products we have nebulisation session lasts for 10-15 minutes.
not had a cross infection incident in our reptile unit. F10SC is
also used regularly in a commercial fogger to minimise Burmese Python
airborne contamination and to penetrate small areas hard to with purulent nasal
hand clean. All hospital rooms are fogged weekly while 1:250 discharge.
F10SCXD is used on our floors daily. Bacterial pneumonia,
severe
Viral challenges
A daily cleaning and fogging protocol as recommended by Nebulising a
the Health and Hygeine personnel was used in a closed Burmese
collection of indigenous reptiles where there had been a Python
reovirus outbreak. The diagnosis was made on Post Mortem
including Electron Microscopy. Soak therapy in exudative dermatitis
Scale rot or “Blister disease” is an exudative dermatitis of the
Very little was known about this specific virus except that it ventral body scales associated with septicaemia and/or
affected vipers and colubrids severely while boids housed in filthy, damp caging. We use topically 1:500 F10SC as a
the same facility never showed any signs of illness. The 30min soak before dressing replacement in these cases. No
clinical signs varied from acute pneumonia, lung adverse effects have been seen even when therapy was
haemorrhage and death to dysecdysis, regurgitation, extended to twice weekly soaks for 5-6 weeks. Severe cases
weightloss and increased levels of aggression. are treated with systemic antibiotics.

The recommended routine included washing of all cage Daily soaks for up to two weeks have been used in patients
furniture in 1:250 F10SC initially and weekly thereafter. Cage with large, superficial lesions.
furniture was labelled and used strictly in its own cage (ie no
bowls/hides were moved from one cage to another).

All handling equipment including hook and grab sticks were
wiped down and dipped into a 1:250 F10SC solution and
allowed to air dry. This cleaning protocol was followed each
time the equipment was used. The handling equipment was
manufactured from anodised aluminium and no staining of
the metal was noted.

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Albino Burmese Python with Bite wounds
reddening and blistering of The feeding of live prey rodents to snakes should be prevented at all
the ventral and lateral body costs. Rats and mice can inflict severe, even fatal wounds on reptiles if
wall scales left in the cage with the snake. Once again. F10 Germicidal Barrier
Ointment has been used successfully to protect and prevent secondary
Daily F10 soaks for infections of these wounds.
Burmese Python
F10SC is regularly used as a general wound irrigation solution. The
Burn wounds 1:250 concentration can easily be drawn into a 20ml syringe. An
Burn wounds caused by contact with overheated cage warming intravenous catheter, generally 20g is then attached to the syringe for
equipment are unfortunately a common injury in captive reptiles. Mild irrigation. This small bore catheter allows sufficient pressure to be
burn wounds as well as superficial traumatic injuries can be treated with generated to flush off superficial wound contaminants. By the time of
F10 Germicidal Barrier Ointment. presentation, most reptile wounds are grossly contaminated and a
prolongued debridement phase can be expected.
Corn Snake 2 weeks into
treatment for severe ventral The wounds will often develop a dark, leatherynecrotic surface layer
burn wounds caused by under which granulation is occurring. At this stage we find the F10
malfunctioning heating pad. Germicidal Barrier Ointment more suitable.

Corn Snake 8 weeks Rat bite wound in a Boa
into treatment Constrictor, ribs and
vertebrae are exposed
Fungal dermatitis
Fungal dermatitis is occasionally seen in reptiles. Although we have Nasal flushing
found it necessary to use systemic antifungals in severe cases, F10 Nasal flushing has been performed in a Boa Constrictor with purulent
Germicidal Barrier Ointment can be effective in early cases of this exudate blocking the external nares after resolution of a purulent
condition. bacterial pneumonia. The visible exudate was manually removed and a
1:500 F10SC solution used to gently flush from the nares to the mouth.
Severe fungal dermatitis in No adverse reaction was seen and the condition did not recur once the
a juvenile iguana dried exudate was removed.

A new combination
F10 Germicidal Wound Spray with Insecticide is a product we have just
started using. This product has been successfully used on tortoises
suffering from dog bite wounds. Secondary fly strike is always a risk with
these cases as the injuries are often extensive and the patients need
outdoor time to encourage feeding behaviour and general health.

This F10 product has been used on superficial wounds as well as on the
dressings covering the severe wounds. To date the use of this product
seems encouraging.

Conclusion
In conclusion, we find F10 products to be an invaluable addition to our
biosecurity and treatment arsenal. The safety and ease of use of these
products make them easy to use in multiple situations.

F10 PRODUCTS LTD Manufacturer of F10 Products:
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK
Health and Hygiene (Pty) Ltd
Freephone: 0800 014 8803 • Fax: 01509 265777 P.O. Box 906, Florida Hills, 1716, South Africa
Email: [email protected] • [email protected] Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za
www.f10products.co.uk

®

ISSUE 8 • 2008 www.healthandhygiene.co.za

THE USE OF F10 IN FALCON MEDICINE: FACTS IN
PRACTICAL APPLICATIONS THIS ISSUE

Jaime Samour MVZ, PhD, Dip ECAMS and Jesus Naldo DVM BIOSECURITY, FOGGING, NEBULISING, FLUSHING, BUMBLE FOOT, INCUBATION BIRDS OF PREY

Wildlife Division, Wrsan, Abu Dhabi, United Arab Emirates

Introduction fibreglass or plastic trays. Very often a pad of plastic matting WILDLIFE MEDICINE
Falcons and falconry have formed an integral part of life of (Astroturf™) is placed within the tray in order to help cleaning
the deserts of the Arabian Peninsula for thousands of years. the sole of soiled protective shoes. It is highly recommended SMALL ANIMALS & EXOTICS
In the past, Bedouin tribesmen, during the winter months, to clean the tray and replace the solution everyday if the use
used to trap, train and hunt with migratory falcons in order to is intensive. During the summer months, it is recommended
supplement their basic diet. The falcons were subsequently to place the footbaths within the facilities to avoid
released in the spring, as the caring of these falcons evaporation due to prevalent hot and dry weather conditions.
throughout the year could strain their already limited
resources. Today, after the hunting season, Arab falconers Fogging medical facilities/falcon wards
keep their falcons in air-conditioned rooms or aviaries during All rooms within a
the long moulting months so they can be used again for the clinic or a hospital
following season. As a byproduct of this change of attitude, a facility should be
substantially large population of hunting falcons are kept in disinfected using a
captivity every year throughout the Gulf countries. The need commercially
for professional health care to such a large captive available fogging
population of falcons prompted the creation of modern falcon unit two or three
hospitals in most countries of the region. times a week or
daily as required.
Biosecurity programme The objective is to
Falcon hospitals in the Gulf, in common with other medical eliminate or
facilities dedicated to the exclusive care and treatment of drastically reduced
avian species somewhere else, are exposed to a wide range
of pathogens from incoming out-patients. The need of Fogging air spaceswith F10SC airborne pathogens
designing and implementing a biosecurity programme that and to disinfect all
could prevent propagation and the spread of pathogens
throughout the facility cannot be underestimated. contact surfaces and inaccessible or difficult to reach areas.
Fogging has been particularly important in clinical
Housing a large number of falcons (e.g. falcon hospital, examination and post-mortem room facilities during the
moulting facility and breeding programme) within the same handling of suspected cases of Newcastle disease and avian
facility could represent a potential risk of infection if a influenza. The recommended dilution commonly used for
comprehensive biosecurity programme is not implemented. fogging is 1:250 using either F10SC for post-cleansing
disinfection or F10CXD for a more comprehensive cleansing
One of the main pillars of any biosecurity programme is and disinfection procedure.
disinfection which could be defined as a procedure intended
to eliminate, from a particular defined area, any pathogenic Surface disinfection - medical facilities/
organism or to render them inert with one or a combination of
chemicals. There are many products available in the market falcon wards
that could be used within a biosecurity programme.
However, the authors have found F10 disinfectant products During the falconry season, hundreds of falcons are
to be ideal for such undertaking due to its safety and non-
corrosive properties and the unique synergic activity of its admitted in falcon specialist hospitals in the Middle East for
quaternary ammonium and biguanadine compounds acting
against a wide range of viruses, bacteria, fungi and spores. clinical examination or for treatment. In the course of a

The following is an account of the uses of F10 products in our normal day, it is not uncommon to handle 20 to 40 or more
biosecurity programme used in our falcon medical facility.
falcons undergoing a diverse array of clinical conditions
Footbath access/exit quarantine/hospital
wards including trichomonosis, aspergillosis, Newcastle disease
Footbaths should be installed in all entrance/exits of the
quarantine station and isolation and hospital wards. F10SC and avian pox. The need of implementing an adequate
is normally used diluted 1:250 and placed in shallow
disinfection protocol

of work tops, tables,

door handles, sink

and others cannot be

overemphasized.

Adequate disinfection

can be carried out

using a hand spray

using F10SC or

High level surface F10CXD in a dilution
disinfection using F10SC 1:250 and disposable
paper towels.

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Surface disinfection incubation, hatching and chamber is provided with an observation window covered with Plexiglas
rearing rooms, egg disinfection.
Falcon captive breeding programmes have become very popular in to allow observation of the falcon during nebulisation. The chamber is
some countries in the Middle East, but in particular in the United Arab
Emirates due to a ban on the use of wild-caught falcons in the sport of connected to a nebulising unit capable of producing a particle size
falconry. This is in agreement with the legislation of the Convention on
International Trade in Endangered Species of Wild Fauna and Flora smaller than 5µm. A solution
(CITES). At our facility we use F10 products in the general disinfection of
incubation, hatching and rearing rooms and for the sanitation of eggs. of F10SC in saline 1:250 is
Prior to the breeding season the rooms are thoroughly cleaned and
disinfected including fogging and spraying of worktops. Similarly, the used once or twice a day for
equipment is cleaned and sprayed using a solution of F10SC at the
dilution 1:250. Eggs are usually sprayed with the same solution and up to 6 to 8 weeks depending
allowed to dry on racks prior placement within incubators.
on the severity of the case.
Therapy
Food retention in the crop
Nasal and sinal flushing in the therapeutic
management of upper respiratory disease has been reported if the
Nasal and sinus flushing are an integral part of the therapeutic
management of clinical conditions affecting the upper respiratory falcons are immediately fed
system in falcons. The flushing solution is commonly prepared using
F10SC diluted 1:250 with saline. A 20 ml syringe is filled up with the after nebulisation. It is
flushing solution. A modified rubber cup is placed on the tip of the syringe
before applying this to the opening of the nares. The solution is gently recommended to nebulise
injected in the nares and exists through the choana. The procedure is
repeated on the contralateral side if the medical condition is bilateral. It is falcons in the morning and at
usually recommended to repeat the same procedure twice a day for 5 to
7 days depending on the severity of the infection. Surgical debridement midday and to allow a
to remove caseous masses within the different diverticula of the
Purpose built chamber to minimum of 4 hours rest
infraorbital sinuses is nebulise using F10SC period before offering any
very often required in food to the falcons.
falcons as part of the
post-operative Foot baths in the therapeutic management of
treatment of infections
with T. gallinae. After bumblefoot
the surgical removal
of caseous masses Bumblefoot is the single most important medical condition affecting
and seropurulent
exudates, the flushing hunting falcons in the Middle East. Predisposing factors include lack or
of the sinus with the
same solution and sudden cessation of exercise,
F10SC solution administered through the nares using a cannula is
highly recommended. nutritional deficiencies and

Nebulisation in the therapeutic management of inadequate perches. At our facility
lower respiratory diseases
Air sacculitis of fungal and bacterial origin is very common in falcons in we use disinfectant footbaths as
the Middle East. The diagnosis is commonly made through a
combination of survey radiographs, haematology analyses and part of the therapeutic
endoscopy. The collection of biopsies and microbiology swabs during
endoscopy examinations are indispensable in the differential diagnosis. management of bumblefoot. A
The therapeutic management depends largely on the results of the
examination of the samples collected. Nebulisation is commonly used in plastic tray, firmly attached to a
the therapeutic management of lower respiratory system in falcons. At
our facility we use a custom-made chamber constructed out of laminated falcon stand is filled out with a
plywood to ease the cleansing and disinfecting procedures. The
warm (41°C) solution of F10SC

diluted 1:250 with saline. A cut out

piece of plastic matting

(Astroturf™) is placed at the

bottom of the tray to avoid further

pressure sore injuries. The falcon

is allowed into the bath for periods

of up to 30 min twice a day.

Supervision by a veterinary

technician during this period is

essential. Early bumblefoot

Purpose built foot bath stages benefit by applying F10
containing F10SC solution Germicidal Barrier Ointment after

the bath.

Conclusion
F10 disinfectant products have formed an integral part of our biosecurity
programme at our falcon facilities for many years. All of the F10 products
use the same active ingredients, but due to the complex interaction of the
different components resistance or residual build-up is very unlikely to
occur. The F10 disinfectant products have also proved useful as adjunt
components in the therapy of several medical conditions and it has been
invaluable for general use around the practice. The versatility of F10SC
Veterinary Disinfectant, in particular, in worth highlighting since,
although a high performance product, it is safe and therefore easy to use
in a wide range of applications and procedures at the multi-purpose
concentration of 1:250.

F10 PRODUCTS LTD Manufacturer of F10 Products:
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK
Health and Hygiene (Pty) Ltd
Freephone: 0800 014 8803 • Fax: 01509 265777 P.O. Box 906, Florida Hills, 1716, South Africa
Email: [email protected] • [email protected] Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za
www.f10products.co.uk

®

ISSUE 9 • 2008 www.healthandhygiene.co.za

THE ROLE OF F10 PRODUCTS IN THE FACTS IN
AVICULTURE HEALTH AND HYGIENE STRATEGY THIS ISSUE

AT THE NEW INTERNATIONAL CENTRE FOR BIOSECURITY, FOGGING, NEBULISING, FLUSHING, BUMBLE FOOT, INCUBATION BIRDS OF PREY
BIRDS OF PREY

JEMIMA PARRY-JONES MBE, Aviculturist

Introduction of prey centre. Sadly it failed, and so I was forced to move the WILDLIFE MEDICINE
Keeping large numbers of birds has always been a task with collection back from the US to the UK. Both of these moves
concerns about hygiene. Now with the changes in climate were incredibly stressful for the birds (and me!). SMALL ANIMALS & EXOTICS
and new viruses moving around the world at scary speeds, it We used F10 (F10SC Veterinary Disinfectant) for much of
is an even more important part of caring for captive birds. the travel arrangements. The transit boxes, were the same
ones used for both trips, and indeed we keep enough boxes
Having said that I feel very strongly that one can also over do in each barn corridor to safely box the birds in emergencies.
things. Recently I was trying to work with someone who These boxes were cleaned and then sprayed with F10 prior
wanted outside enclosures to be hospital clean, or at least to to boxing up the birds, and we clean them before and after
aim for it. I actually feel this is very bad for the birds because I every use.
think what it does is remove their ability to deal with diseases
that will without doubt come their way, whilst they are living Travelling boxes
outside.
Unloading at the airport
I think there is a happy medium, where the birds live a fairly
natural life and are able to cope with the normal run of the mill
problems that affect many living things in their daily life, but
are kept at a good level of cleanliness. I think there is an
absolute parallel with what is happening to humans today.
The more we try to keep children away from anything that
might affect them and clean to the point of ridiculousness, the
less we allow them to build up a natural immunity to life's
infections and problems.

When we were children I can remember that we frequently
used to get mosquito larvae out of the taps, and on one
occasion a live tadpole! And yet I rarely get ill and even more
rarely get stomach infections. It is a proven fact that children
brought up with animals in the house are less likely to
develop allergies.And to make a final point, my Grandmother
always told us that we should eat a peck of dirt before we die.
Looking up a peck is bloody difficult because a peck is, I
think, a measurement of volume and therefore it depends on
what you are measuring as to what it weighs. But I am told it is
9 litres or 56 lbs, but I have to say I am not sure about that,
what I do know is that, it's a lot of dirt!!!

So with that in mind, keeping captive birds and their housing
clean is really important, but for more than one reason is it
best not to go over the top when birds are in enclosures.
Incidentally one of the other reasons is to reduce the stress
caused by constantly going in and out with untrained birds. I
also believe that there is a huge amount we do not know
about stress, and we have much to learn so wherever
possible avoid causing it.

Traveling boxes
I have in the last four years moved the bulk of my collection,
189 birds, from the UK to the US, supposedly to merge with
another group in South Carolina and start the definitive bird

®

Fogging Treating a yeast infection

During the quarantine periods at both ends of the two trips to avoid some On the trip home, it became apparent that Mozart my very elderly

of the known problems arising from stress we used F10 (F10SC Eurasian Eagle Owl had lost so much of his vision through cataracts that

Veterinary Disinfectant) through electric atomisers/foggers twice daily to he needed an operation to

fog the quarantine quarters for periods of 35 minutes each time. The treat the worst of them to

foggers are a great give him the chance of a

way to apply F10 to reasonable life. After the

a large number of very successful operation

birds in an indoor he had a few problems

space and they mainly due to his age he

worked very well. was 34 at the time. One of

During both the problems was a yeast

periods we lost infection in the operated

only one bird to upon eye. There is no

Aspergillosis, and treatment for this in birds,

that was an owl and yeast infections are

from the far north notoriously difficult to get

and an imprint rid of. So Neil Forbes, my

which are more consultant vet said we

highly susceptible know F10 (F10SC

Fogger used to spray aviaries than wild or parent Veterinary Disinfectant)

reared birds. will kill yeast, we know its

Food containers pretty safe so at a 1:1000
Probably the most important area to keep clean is where the birds pick
up food and sometimes eat. Putting food, particularly in our case meat dilution, put drops in
onto existing dirty surfaces is a recipe for disaster. With the exception of
the large vultures, we put the food for all our birds onto a drawer that Mozart's eye twice a day. I
slides into the back of the aviary from the service corridor. The drawer
has a plastic or similar type material base. We feed the diurnal birds in am very glad to say that it
the morning and the owls in the evening. In the morning we open the owl
feed drawers, pick up any left over's, wipe or scrape the drawer clean Mozart fully recovered worked and Mozart is now
and then spray with F10 (F10SC Veterinary Disinfectant), close the
drawer and leave to dry. We do the same thing in the evening for the 35 and doing very well.
diurnal birds. So every drawer is cleaned every day and sprayed with
F10 every day. Once a week the enclosure is cleaned and so at that point Water baths
the drawer is washed even more thoroughly and sprayed with F10. All Water baths are another potential source of problems. We do not clean
the dilutions are 1:250. I have been doing this for 4 years now and I our hawk baths daily. It is done depending on the weather and the
believe that it has had a noticeable decrease in the number of sick birds individual birds, once or twice a week, occasionally more if they need it.
that we have had. The baths are removed from the enclosure, we have them at the front so
they can be removed without entering the enclosure and causing stress.
They are scrubbed clean, and then sprayed with F10 (F10SC Veterinary
Disinfectant) and left for at least ten minutes before putting them back in
and refilling them. If we are getting very sunny weather we will put a drop
of F10 into the drinking water.

Food preparations Bumble foot
The surfaces where the food is thawed are cleaned and sprayed with A couple of birds in the US, and one during the long stay in the
F10 (F10SC Veterinary Disinfectant) daily. All the feed buckets are warehouse in Hereford developed mild bumble-foot, and several had the
cleaned once they are emptied and then sprayed with F10 and left with potential to develop it. In all cases we cleaned the feet, cleared any dead
dry. All surfaces, such as our particularly nice chopping board are material and then spread on F10 Oinment (F10 Germicidal Barrier
sprayed at least twice a day and often more. Ointment) bandaged well with pads and vet wrap and sticky fabric tape.
We changed the bandages about every 10 days, and very soon the F10
Falconry bags had done the trick and cleared up the problems. It is important to watch
We are advised by our vet to spray our gloves with F10 (F10SC that the bandages do not cause any sores themselves. And to change
Veterinary Disinfectant) after each bird, so as to prevent any potential any problem perching immediately
spread of disease. Similarly, we spray with F10 our falconry bags once a
day after emptying. The small plastic liners of the bags are cleaned and Conclusion
sprayed daily. F10 products used as we use them as daily requirements for all our
health and hygiene procedures are easy to use, safe, and the results
All of this may seem extreme, but with a sprayer handy at all times, it is speak for themselves.
the job of a moment and well worth the effort.

F10 PRODUCTS LTD Manufacturer of F10 Products:
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK
Health and Hygiene (Pty) Ltd
Freephone: 0800 014 8803 • Fax: 01509 265777 P.O. Box 906, Florida Hills, 1716, South Africa
Email: [email protected] • [email protected] Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za
www.f10products.co.uk

®

ISSUE 10 • 2008 www.healthandhygiene.co.za

SOME EXPERIENCES AND SUCCESSES WITH FACTS IN
F10 PRODUCTS IN EQUINE PRACTICE THIS ISSUE

Dr Marisa Slabber, BVSc

Introduction bandage. The bandages were initially changed every other EQUINE
I have had great success with the use of F10 products at an day and flushed with 1:250 of F10SC. The horse became
equestrian facility which has over 500 horses. The most sound within two days without painkillers or any antibiotics WOUND MANAGEMENT, WOUND IRRIGATION, NASAL FLUSHING, UTERINE FLUSING, RINGWORM,
effective way in which I can share my experiences with being given. Foot pads were applied and he was rested until VENERAL INFECTION, INFECTION CONTROL
colleagues is to select and describe a variety of cases which his soles had grown over the defects.
show the versatility and effectiveness of this novel product
range. Case 3

All F10 products include the core actives of a compound of A young X breed mare from the veld was admitted with a puff
quaternary ammonium and biguanidine which together with adder bite to the facial area. Her nostrils were almost swollen
other components act synergistically to kill a broad spectrum shut.
of bacteria, fungi, viruses and spores.
A tracheostomy was performed. A 1:250 of F10SC solution
Wound Management was used to sterilize the wound as well as the instruments
used in the procedure. The wound was cleaned daily with
Case 1 1:250 of F10SC. After two days the tracheostomy tube was
removed and the mare made an uneventful recovery with the
A thoroughbred gelding from the veld came in with a cut wound closing over the next two weeks
involving the medial bulb of his near fore, approximately 12
hours after the injury occurred. Initial prognosis was very Case 4
poor as the cut went right down into the medial wall of the
hoof. A Friesian mare was admitted with a grossly contaminated
wound to the right rear hindquarter. The wound was
As presented After recovery approximately 15cm long and 6cm deep.

The wound was copiously flushed with a 1:250 F10SC
solution before and after surgical debridement. It was
stitched and a drain put into place and was flushed every day
with a 1:250 F10SC solution for 2 weeks. The swelling and
discharge was minimal over the first three days after which it
subsided completely and the mare made an uneventful
recovery.

Copious amounts of a 1:250 solution of F10SC Veterinary As presented After recovery
Disinfectant was used to flush the wound every other day
which was then bandaged with Flamazine. The horse was Case 5
also put onto painkillers and Penicillin for 10 days. The
exposed laminae in the hoof wall, was also flushed through A Friesian gelding was admitted with a large soft swelling
the crack with 1:250 F10SC solution. At no time was site between his front legs in his pectoral region.
inflamed. After day 13 the wound did not debride anymore
and was starting to contract. Although the coronary band is The seroma was drained and flushed every day with a 1:300
slightly misformed, the hoof wall is growing down at a fast F10SC solution until the discharged stopped after six days.
rate. The horse was discharged to normal work and The hole was left to close and he was discharged. No
completely sound. antibiotic treatment was given.

Case 2 Case 6

X Breed gelding that came from the veld walking lame on A young Friesian cross was admitted with a swollen near
right front was admitted. On closer inspection I saw that both hind limb. One week later a 1.2cm long and 0.7cm thick stick
front feet had an area of 2cm diameter of sensitive laminae was removed through the hoof wall. It still had hair and a lot of
exposed on both sides of the frog, due to a severe case of mud attached to it and the prognosis was poor.
foot rot.

The farriers proceeded to cut away dead material to better
expose the involved areas in the clefts of the frog. The site
was flushed with copious amounts of a 1:250 solution of
F10SC and both front feet were bandaged with a Limacine

®

Nasal flushing

Case 10

The site was flushed copiously with a 1:250 F10SC solution every other A TB cross gelding was admitted with a fracture and a supurating
day and a flamazine bandage applied. Painkillers and antibiotics were fistulous tract to the right dorsal frontal sinus. The wound was shaved
also given. Two weeks later all treatment was stopped and the protruding and cleaned and since there was no sequestrum visible on radiographs,
laminae were covered with Equilox. The mare is sound and was the wound was penetrated with a large bore jelco and flushed with a
discharged under supervision for the Equilox to be maintained in place. 1:250 F10SC solution every day for two weeks until the discharge was
clear, during which time appropriate antibiotics were given. The wound
Case 7 closed by itself in two weeks and the horse was discharged with an
uneventful recovery. No surgery was necessary.
A cross breed gelding was admitted on with grossly enlarged
melanomas on right hind semimembranous semitendinous region. Case 11
Three large 6-7cm growths were removed and could only be partially
closed due to the tension on the surrounding skin. The open wounds A young Irish Draught mare was brought in from the veld, with a draining
were flushed every day with a 1:500 F10SC solution. They closed within fistulous tract from the dorsal frontal sinus and a purulent nasal
two weeks by second intention without infection or inflammation. discharge. On x-ray examination there was a sequestrum 3 x 2.8cm in
diameter, in the dorsal frontal sinus, that was removed surgically.
Case 8 Because of the purulent exudate from that sinus, a drain was placed
surgically into the sinus cavity. The sinus cavity was flushed every day
Old thoroughbred broodmare was admitted once a day with a 1:250 F10SC solution. The discharge decreased
with a swollen right front knee. She was put dramatically over the next 2 weeks and the drain was taken out and the
onto antibiotic treatment and a drain was put nasal cavity still flushed with 1:500 F10SC solution until the wound
in surgically under local sedation. Her knee closed by second intention.
was flushed every other day with a 1:250
F10SC solution and kept bandaged. After Uterine flushing
ten days the swelling and heat and
discharge was gone. The hole closed and Case 12
she was discharged and is still carrying a
foal. Three mares with retained placentas (>12 hrs duration) were admitted. A
slow IV infusion of Fentocin was administered and the placentas
Case 9 removed using rectal massage. The uterus was flushed with a 3 litre
solution of sterile saline mixed with 1:300 F10SC in 2 of the mares and a
In the midst of a severe Rhodococcus outbreak a periosteal elevation 1:250 F10SC in the third. Excess solution was "massaged out" rectally.
was performed on a young foal on the lawn outside the hospital. A 1:250
F10SC solution was used in and around the periosteal as well as on the All three mares subsequently conceived and one was confirmed
instruments. pregnant after her foal heat covering.

The foal recovered without complications or secondary infections. Rhodecoccus

Infection control Case 13

When attending to wound management cases it is routine practice to A severe outbreak of Rhodococcus equine was successfully managed
keep instruments and suture material in a 1:250 F10SC solution until by applying a 1:250 solution of F10SC on a daily basis in an aerosol mist
needed. spray/fog using an electrically operated atomizer to cover all stable walls
and create a standing fog. In addition a solution of 1:250 F10SC was
F10 Germicidal Wound Spray with Insecticide was routinely applied post used to wash clean water troughs and feed buckets daily.
operatively to all wound sites and for the treatment of large open wounds
closing by second intention. In addition to providing an effective No new cases were reported after Fogger used to spray stables.
antiseptic barrier and fly repellant it seems to prevent or significantly the fogging and disinfection
decrease the amount of proud flesh formation. routines were implemented even
although during this time the
F10 PRODUCTS LTD horses were kept mixed in both
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK stables and paddocks and
randomly rotated in the stables
Freephone: 0800 014 8803 • Fax: 01509 265777 each night.
Email: [email protected] • [email protected]
Conclusion
www.f10products.co.uk
The F10 products mentioned above are effective, non toxic on open
wounds and because of their versatility I will continue not only to use
them but I believe will continue to find more and more applications for
their use.

Manufacturer of F10 Products:

Health and Hygiene (Pty) Ltd
P.O. Box 906, Florida Hills, 1716, South Africa
Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za

anti-Pseudomonas antibodies cannot penetrate the exopolysaccharide Wound Management
matrix of the microcolonies of Pseudomonas cells in the alveoli of the Few if any wounds seen by veterinarians can be regarded as “clean”,
lung. But they can and do react with their specific antigens at the surface and even if they start off clean has to heal under essentially dirty,
of these cryptic microcolonies to form immune complexes. Immune recontamination prone environments often complicated by blowfly
complexes cause severe collateral damage to surrounding tissue, in the strike. Specific challenges include superficial damage to the distal
cystic fibrosis lung and in other biofilm infected organs, and some extremities of equines, where the tensions involved plus constant
clinicians have now turned to the use of prednisone to reduce the exposure to environmental microorganisms (even under bandages)
immune response and thus to minimize collateral tissue damage in often delay wound healing out of all proportion to the size of the defect.
cystic fibrosis and other biofilm infections. The new perception that Common complications include sepsis, cellulitis and excessive
device-related and other chronic bacterial infections are caused by granulation (proudflesh). Other situations with traditionally very poor
bacteria growing in biofilms has encouraged clinicians to use higher prognoses include extensive burn wounds, dog bites accompanied by
doses of antibiotics, to remove devices early when antibiotic therapy major areas of skin loss, extensive tissue necrosis due to (cytotoxic)
fails, and to use immune suppression when immune complexes threaten snake bites etc. These are often infected by environmental opportunists
to cause tissue damage. such as staphs, streps and pseudomonas, all with extremely well
developed biofilm formation characteristics that remain refractory to
Multiple drug resistance conventional treatments.
Antimicrobial resistance is often transferred horizontally between
related bacteria and this happens with remarkable ease within a biofilm F10 in various formats is highly effective as part of an integrated
community. Thus biofilms in pipes (from endotracheal tubes to treatment protocol; F10 SC Veterinary Disinfectant / F10 Antiseptic
reticulation systems) form part of the range of mechanisms whereby Solution (1:250 dilution) as a irrigation solution, F10 Germicidal Barrier
multiple drug resistance is cultured, retained and transferred in both Ointment and F10 Germicidal Wound Spray plus Insecticide. The latter
human and veterinary hospital settings as well as in production animal is particularly effective in the (sheep) farm treatment of trauma and other
environments such as dairies and poultry & pig production systems. The superficial wounds and cuts as well as after tail docking and castration
complex overlapping chemical structure of F10 to inhibit microbial procedures where its long residual effect protects the wound against re-
resistance build-up is confirmed by its continued effectiveness in daily infection and repels insects (this product is also effective in the
use over a period of 14 years in hygiene applications in a major elimination of infestations due to blow fly strikes).
veterinary hospital.
Conclusion
Examples of antibiotic resistance in veterinary pathogens and Veterinary and medical practitioners have largely been unaware of the
conditions where biofilm formation is an important contributor to rapid increase in our understanding of interactions within intricate
the problem: microbial ecosystems, especially where these have a major impact on
the therapeutic outcome of challenging, refractory disease complexes.
Bacterial organism Animal Disease/ Antibiotic Reference An appreciation and understanding of the pivotal role that biofilms play in
species infection resistance the progression of such syndromes will greatly aid in the design of
effective, integrated preventative and treatment protocols where surface
Acinetobacter Horse Jugular catheter Amoxicillin / Vaneechoutte disinfection (inert & biological) combine with systemic antimicrobials
baumannii Infection clavulanic acid et al. (2000) plus supportive agents. This combined approach has radically changed
the success: failure ratio in a large number of veterinary / medical
Actinobacillus spp. Horse Post-operative Penicillin Smith and applications and promises to open up new possibilities to all who have
wound infection Ross (2002) the imagination and drive to pursue this.

Klebsiella Horse Musculoskeletal Ampicillin, Moore et al. Further reading:
infection amoxicillin / (1992) 1. Biofilms and their relevance to veterinary medicine A.L. Clutterbuck, E.J. Woods, D.C.
clavulanic acid
Knottenbelt, P.D. Clegg, C.A. Cochrane and S.L. Perciva.
Pseudomonas Dog Otitis Amoxicillin / Hariharan Veterinary Microbiology Volume 121, Issues 1-2, 31 March 2007, Pages 1-17
aeruginosa 2. Biofilm formation as microbial development George O'Toole,¬ Heidi B. Kaplan and ¬
clavulanic acid et al. (1995) Roberto Kolter. ¬
Staphylococcus Annual Review of Microbiology Vol. 54: 49-79 (Volume publication date October 2000)
aureus Cow Mastitis Amoxicillin, San Martin 3. Bacterial biofilm in upper respiratory tract infections. Morris DP.
ampicillin, et al. (2003) Curr Infect Dis Rep. 2007 May;9(3):186-92
lincomycin, 4. Biofilm formation by mycoplasma species and its role in environmental persistence and
penicillin survival.
Laura McAuliffe, Richard J. Ellis, Katie Miles, Roger D.Ayling and RobinA. J. Nicholas
Staphylococcus Horse Post-operative Methicillin Trostle et al. Microbiology 152 (2006), 913-922
epidermiss wound infection (2001) 5. Anovel disinfectant in psittacine respiratory disease. Chitty J (2002)
Proceedings of theAssociation ofAvian Veterinarians, Monterey.25-27
Staphylococcus Dog Pyoderma Ciprofloxacin Lloyd et al.
intermedius (1999) Manufacturer of F10 Products:

Health and Hygiene (Pty) Ltd
PO Box 906, Florida Hills 1716, South Africa
Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za

THE FACTS
www.healthandhygiene.co.za
ISSUE 12 • 2009

BIOFILMS: IMPORTANCE AND FACTS IN
CONTROL IN BIOSECURITY AND THIS ISSUE
DISEASE MANAGEMENT FROM A

VETERINARY PERSPECTIVE

Dr Dirk J Verwoerd BSc.Agric BVSc MRCVS

Executive Summary antimicrobials by bacteria in the biofilm growth phase, BIOFILM (INERT & BIOLOGICAL), BIOSECURITY, WOUND MANAGEMENT GENERAL
Biofilms are simple to complex microbial ecosystems on compared to the same isolate in the planctonic (free floating)
surfaces. The study of Biofilms combine expertise from a form. SMALL ANIMALS & EXOTICS
wide variety of scientific disciplines such as Engineering
(components, alloys, non-corrosive paints, etc), Physics Some of these aspects have major practical implications
(surfaces, flow dynamics etc), Veterinary / Medical (micro- regarding recurrent / reservoir infections, horizontal spread
biology, pharmacology and therapeutics), and Food of resistance, nosocomial complications during longterm
Hygiene. hospital and intensive care situations to individual patients
and populations. Effective strategies against biofilms consist
These surfaces can be inert and thus indirectly linked to of an integrated approach where appropriate antibiotics /
diseases in animal populations and patients, such as plastic antifungals are combined with surface cleaning and
water pipes in a reticulation system, air conditioning disinfection using a compound chosen for its detergent plus
humidification and filtration systems, intravenous catheters, disinfectant plus tissue friendly properties, such as the broad
prosthetic devices or they can be biological and thus more spectrum F10SC Veterinary Disinfectant / F10 Antiseptic
directly associated with animal health such as Solution. Biofilm found on hard surfaces and the insides of
granulomatous wound healing tissue, respiratory epithelium pipes can be effectively removed by the combined use of a
and epithelial to glandular mucosae in the udder. The purpose built cleaner such as F919 Biofilm Remover
ecosystems can consist of bacteria, fungi and / or yeasts that followed by the application of the F10 disinfectant.
communicate with each other in various ways. The microbial
organisms build a framework of an extracellular poly- The formation of the microcolony
saccharide matrix (slime) that prevent the effective action of The formation of bacterial biofilms begin with the adhesion of
simple disinfectants / antimicrobials. Several studies have a small number of bacterial cells to a surface (making the
indicated a 10 -1000 fold higher resistance to certain selection of effective biocidal disinfectants / antiseptics and

The 5 classic stages of WILDLIFE MEDICINE
biofilm formation; from
initial colonization of
surfaces by planctonic
bacteria (1-3) to growth
into mushroom shaped

“adolescent”
microcolonies (4) to
“seeding” via the aquous
medium from mature

microcolonies to
establish secondary

foci (5).

Microbial Biofilms:

Sticking together for success

Single celled microbes readily form communities
in resistant structures that provide advantages
of multicellular organisation

Waiting to grow Meeting the challenge Going with the flow

Bacteria can shrink to a While antimicrobial damage Propelled by shear forces,aggregated
spore-like state to wait alter cell layers, the biofilm cells can break loose, roll,or ripple
in water, soil even rock or community can survive along a surface in sheets and remain
tissue- until conditions are in their protected biofilm state
right for active growth Finding a niche

Chemical gradients create

micro-environments for

different microbial species

or levels of activity

Changing their spots

Active bacteria will attach to virtually
any surface, within minutes, changes in
gene expression transform "swimmers"

to "stickers"

Getting breakfast in bed Sending the right signals

Nutrients diffuse into the Close proximity of cells
matrix as they flow by facilitates the exchange of
molecular signals that

Building houses of slime regulate behaviour

Attached bacteria multiply and

encase their colonies with a Dividing the labour
slimy matrix
Genetic regulation may allow
a degree of differentiation
among cells of a single species
To serve the community as a whole

Summary of characteristics of biofilm growth.

use of fogging applications to access difficult to reach surfaces of critical surfaces operates in all ecosystems. The same mechanisms that protect
importance). After a planktonic bacterial cell has sensed and ‘explored’ a biofilm bacteria in lakes and streams from predatory amoeba, also
surface, the cell may commit to the active process of adhesion and protect bacteria in animal systems from phagocytosis by white blood
biofilm formation through the upregulation of a large variety of genes. cells. Similarly, the same mechanisms that protect environmental
Amongst these are the genes that rapidly stimulate the formation of an biofilms from bacteriophage and chemical antagonists in streams and
Exopolysaccharide material (EPS) framework, also known as “bacterial lakes also protect biofilms in animal bodies from antibodies and
slime”. Studies of the basic architecture of biofilms have shown that the antibiotics. The survival value of biofilm formation inside the animal body
microcolony is the basic structural unit of the biofilm. Bacterial cells is probably even higher than it is in most environmental systems,
within the matrix are characterized by their lack of Brownian motility because the body is so relentless and implacable in its coordinated
(movement). immunological attack on the ‘foreign’ materials that enters it.

Careful structural analysis of the shape of many microcolonies often Bacterial biofilms in medical systems are virtually identical with biofilms
reveals a mushroom-like shape, most of the cells are found in the ‘crown’ in any other aquatic ecosystem. This fundamental understanding is very
of the mushroom and very few are in the ‘stalk’. Microcolonies are valuable, because it allowed important advances in other areas of biofilm
arranged in a horizontal array in thin biofilms, but they may also form research.
vertical arrays in very thick sessile communities. Flow of water or blood
through these biofilms occur through discrete channels, restricting the It follows logically from the above that only an integrated approach;
exposure of these bacteria to antimicrobials/disinfectants. where surface (mucosal) disinfection/antiseptics PLUS systemic
antimicrobials and other supportive substances where appropriate, such
The biofilm mechanisms as Cortisones , will have a good prognosis in these medical conditions.
These bacterial biofilms form on the surfaces of medical devices and on Such a disinfectant/antiseptic has to combine biocidal efficacy with
tissue surfaces within compromised organs, and they grow in exactly the safety (tissue friendliness) and a detergent effect to break up the EPS
same way that biofilms grow in environmental and industrial systems. slime; which are exactly the unique characteristic combination of F10
The natural laws that causes bacteria to grow preferentially in biofilms on disinfectants. The elimination of biofilms from hard surfaces and the

inside of pipes is made easier with the use of a product such as F919
Biofilm Remover. The mechanism of action of F919 is not reliant upon a
mechanical brushing action or HP washer jet but interacts chemically
with the organic film to release it from the surface and take it up into
suspension where is can be washed away. Such an application is always
followed by an application of F10 disinfectants.

Fogger used to overspray in aviaries
and poultry houses in the presence of the birds.

Biofilm buildup has been detected in catheters Here in particular an integrated approach where systemic antimicrobials
plus surface disinfection via fogging with F10 (with the animals present)
Respiratory and Nosocomial Infections: has proven itself both in pig and poultry production systems as well as
Complicated Bovine Respiratory Disease, a complex comparable in (nebulising) in individual avian (and other species) patients. Similar
many respects to “Community Aquired Pneumonia” in humans, is the complicated respiratory conditions often occur in Zoo and other
result of the interaction between stressed / compromised hosts and a collections of exotic mammals, avians, reptiles and amphibia where F10
variety of microorganisms that include various viruses, bacteria and fogging and irrigation (wound irrigation and nasal/sinus flushing) has
Mycoplasmas. Recent studies have indicated that the refractory and proven to be the crucial difference between success and failure during
recurrent nature of these conditions can often be explained through the particular treatment regimes.
role of Mycoplasma biofilms. Bacterial biofilms often complicated by
Mycoplasma spp and fungal elements are common as part of the
airsacculitis syndrome in avians.

Purpose built chamber to nebulise using F10SC Open misting/fogging system used in a nebulising therapy
to treat airsaccullitis in adult ostriches

Immune complexes in biofilm affected organs
Many challenges remain, particularly in chronic infections with a
prominent immunological component and / or resistant (“hospital”)
bacteria. These aspects combine in cystic fibrosis patients and thus
illustrate the principles involved. One of the invidious characteristics of
chronic P. aeruginosa pulmonary infections in cystic fibrosis patients is
the formation of large amounts of immune complexes in the lung.
Because individual cystic fibrosis patients may be infected with P.
aeruginosa for two to three decades, these patients form huge amounts
of antibodies against the antigens of this persistent pathogen. These

ISSUE 13 • 2009 www.healthandhygiene.co.za

F10 USED TO TREAT ABSCESSES IN TWO FACTS IN
AFRICAN ELEPHANTS THIS ISSUE

Brett Gardner, BVSc and Céline Le Rochais, DVM

Introduction Thokwe prior to surgery. WILD LIFE
African elephants are exceptionally thick skinned animals Case 2: ABSCESSES, FLUSHING, WOUND MANAGEMENT, WOUND IRRIGATION
that rely on this barrier of thick hide to prevent penetrating Thokwe an adult cow approximately 24 years of age had a
injuries in the often harsh environments they inhabit. The chronic non-healing abscess that had ruptured at its dorsal
literal meaning of the name Pachyderm means thick skin. border and started dissecting underneath the skin on the
Their skin thickness varies from 1.0 – 3.2cm, with the skin right shoulder, also in the region of the triceps muscle. It had
over the triceps being about 2.5cm thick. been treated with oral trimethoprim sulphonamides and with
the same wound lavage solutions as Joe had been for
Once penetrated their skin forms a very thick capsule that approximately four months prior to our involvement. Due to
often hinders drainage and rupture of abscesses. It allows its rapid spread and poor drainage it was decided to
purulent material to accumulate and dissect underneath the anaesthetize her with etorphine and azaperone.
skin and these abscesses often take an extensive amount of
time to drain spontaneously if at all. Trauma is a fairly Breaking up abscess compartments: With a long artery
commonly presented problem in elephants used for elephant forceps the inside partitions of the abscess were bluntly
back safari enterprises. Wound management in non-trained
elephants or other large wild species is exceptionally broken down to facilitate drainage and flushing.
challenging. Often abscesses in elephants are lanced and
allowed to heal by second intention. The placement of
surgical drains would be counter productive in animals
trekking approximately 12km daily through thick vegetation.
The late presentation of these cases also made primary
closure an unsuitable method of treatment.

Case 1:
Joe an adult male elephant of approximately 26 years of age
had a chronic non-healing draining abscess below the left
shoulder, in the region of the triceps muscle. It was about ten
by eight centimetres in size with thick encapsulation. It had
been treated with oral trimethoprim sulphonamides on and
off over six months. It had also been treated with various
wound lavage solutions including diluted iodine and
chlorhexidine for approximately two to three years prior to
our involvement. Due to the elephant being a trained
elephant the examination and treatment of the wound was
greatly facilitated.

Examination of the wound didn’t reveal any foreign matter
but large amounts of thick pus were present. It was
extensively flushed after breaking down the fibrous inner
bands with artery forceps. F10SC Veterinary Disinfectant
was diluted to a ratio of 1:250 with clean water. Twice daily
the wound was flushed using a 50ml catheter tipped syringe
and a feeding tube under pressure. It was flushed with 300ml
diluted F10SC per session. It had a natural ventral facing
opening that facilitated drainage. Once daily the entire cavity
was filled with F10 Germicidal Barrier Ointment that
remained inside until the afternoon flushing. Within seven
days there was almost no discharge and flushing was
decreased to once daily. F10 ointment was then only instilled
once every two days for a week.

Thereafter the F10 ointment was discontinued and flushing
was only carried out once every four to seven days. Within
three months the abscess had become unnoticeable and
was no longer producing any discharge.

Under anaesthesia an incision was made at the most ventral aspect of
the abscess and with artery forceps all the internal septae and
compartments were broken down. It was vigorously flushed with F10SC,
diluted 1:250 with clean water. Gentamycin antibiotic beads were
prepared from a Demotec® hoof repair kit (similar to polymethyl-
methacrylate) and injectable gentamicin (50mg/ml) as a string on
surgical nylon and were then subsequently sterilized with formalin gas.

Flush F10SC: F10SC diluted 1:250 with clean water is used to flush the Products used during Thokwe’s treatment.
lanced abscess under pressure with a 50ml catheter-tipped syringe.
In both these cases the original inciting cause of the abscesses is
The string was sutured into the draining tract. Otherwise the abscess unknown. Both these elephants were trained elephants that were
was treated the same as the other case. Within two days the drainage accustomed to daily handling and this allowed for easy administration of
from the abscess had dramatically decreased. Within a week of placing the F10 products. The failure of the earlier treatments might have been
the beads, combined with the flushing and F10 ointment, the abscess due to retained foreign material or necrotic sequestra, possibly
was only discharging small volumes intermittently. The beads were inactivation of the compounds by means of purulent material and lack of
removed after seven days. By two months after treatment the abscess adequate drainage.
had nearly resolved completely.
No bacterial cultures or antibiograms were ever conducted. The most
Instilling the ointment: A 50ml catheter-tipped syringe is filled with common bacteria isolated from abscesses in elephants tend to be
F10 Germicidal Barrier Ointment and then injected into the abscess cavity. Staphylococcus sp and Streptococcus sp. Other bacteria such as
Corynebacterium pyogenes and Pasteurella multocida have also been
isolated from African elephants. Even so, the efficacy of F10 products in
these two cases cannot be contested.

The combination of F10SC flushes and the instillation of F10 ointment
into two properly drained elephant abscesses delivered both excellent
and affordable results.

We would like to sincerely thank Mr Paul Coetsee for his exceptional
skill at handling elephants and for sharing his knowledge with us.
Without his assistance the treatment of these elephants wouldn’t have
been possible.

Manufacturer of F10 Products:

Health and Hygiene (Pty) Ltd
P.O. Box 906, Florida Hills, 1716, South Africa
Tel: +27 11 474 1668 ³Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za

®

ISSUE 14 • 2011 www.healthandhygiene.co.za

F10 USED IN THE PROCESS OF ENUCLEATION FACTS IN
AND EXENTERATION IN EXOTIC ANIMALS THIS ISSUE

Brett Richard Gardner BVSc and
Katja Natalie Koeppel BVMS, MRCVS, MSc (wildlife), CertZooMed

Introduction eye removal was deemed appropriate as it was established SMALL ANIMAL & EXOTICS
Enucleation is the process of removing the globe when that there was very limited vision in the eye and the
there is pathology strictly limited to the globe itself. exophthalmos was progressing irrespective of treatment. ZOOLOGICAL MEDICINE
Exenteration is the process of removing the globe and the No further diagnostic modalities were employed to WOUND MANAGEMENT
orbital contents when these tissues are also involved. Both determine the extent or exact origin of the exophthalmos.
procedures are reserved for serious ocular conditions which The palpebral fissure was enlarged surgically and the
are untreatable, or where the globe and its surrounding vitreous aspirated from the globe. After following the
tissues are non-viable. The typical mammalian eye has standard surgical procedure for removal of the globe, F10
seven ocular muscles grouped into the rectus, oblique and barrier ointment (kept at a cool temperature to maintain it
the retrobulbar muscles. The upper eyelid is the larger and as a semi-firm gel), was aspirated in a sterile syringe and
more mobile of the two eyelids. In birds and reptiles there instilled into the empty socket. This allows for the
are many individual variations to the musculature of the eye elimination of dead space in the socket with the delivery of
and the presence and function of the eyelids. In contrast to locally acting antimicrobials. In this case it may also have
mammals, birds and reptiles have a larger and more mobile assisted with stopping the mild seepage of blood from the
lower eyelid. In birds the eye socket is dramatically medial vascular plexus. The eyelid margins were removed
enlarged with a very large posterior segment to the eye. and a tarsorrhaphy performed. The bird was placed onto
Especially in small species of birds care should be taken oral clindamycin at 100mg/kg, twice daily for five days post
not to damage the contralateral optic nerve through the thin surgery and carprofen at 5mg/kg intra-muscularly once
interorbital septum. In mammals the eyelids are sutured to daily for three days. It recovered uneventfully. Post surgery
one another after removing the globe in a process called a large dark mass was located within the iris and posterior
tarsorrhaphy. This isn't always possible in reptiles as only chamber of the eye. Cytology revealed round cells that
certain species have functional eyelids with a normal resembled melanoma cells. A month after surgery there
palpebral fissure. The process of enucleation involves was no sign of any recurrence and the bird was doing well.
retracting the eyelids, clamping the optic nerve, taking care
not to twist it, and then severing the optic musculature to Case 2
allow removal of the globe. In some smaller exotic species A geriatric adult female white-faced whistling duck
it is necessary to collapse the globe through aspiration of its (Dendrocygna viduata) presented with severe, sub-acute
contents to allow proper visualization of the posterior trauma to the right eye socket with the globe absent at the
segment of the globe. Great care must be taken not to time of presentation. It was anaesthetized with isoflurane
damage the medial vascular plexus along the wall of the and the socket was curetted carefully to avoid damaging
globe as profuse bleeding may occur. the contralateral optic nerve and all foreign material and
devitalized tissue removed. The remnants of the third eyelid
Case 1 were removed and the socket was filled with F10 barrier
A 23g, adult female blue-crowned hanging parrot (Loriculus ointment. The wound was treated as an open wound for
galgulu) presented with a corneal opacity of the right eye two weeks with twice daily topical F10 barrier ointment. The
that did not stain with fluorescein. There was considerable bird was also placed onto seven days of amoxicillin/
exophthalmos but minimal involvement of the surrounding clavulanic acid as an intramuscular injection at a dose of
soft tissue. It was treated for three days with intramuscular 35mg/kg once daily and carprofen at 5mg/kg once daily for
carprofen injections at 5mg/kg once daily and for six days three days. The cause of the trauma is unknown. Once the
with topical chloramphenicol ointment applied three times socket had shown considerable granulation, the tissue
daily.. At the end of the treatment regimen however, there
was no response and it was elected to remove the eye. The REPTILES

Removing a neoplastic globe from a blue-crowned hanging parrot. Sterile aspiration of F10 barrier ointment for
placement into the open eye socket.

®

surrounding the injury was bluntly dissected and sutured over. The Black-necked spitting cobra post-spectacle removal with
defect was filled with F10 barrier ointment in a sterile fashion prior to
closure. Due to this species being aquatic, it had to be hospitalized F10 barrier ointment applied to the infected spectacle.
throughout the granulation process until the closed wound was water
tight. Four months after treatment it was still doing well. incision was made ventrally on the spectacle in an attempt to flush and
drain the sub-spectacular space as there was no response to
Case 3 treatment and a sub-spectacular infection was suspected. A swab of
A spayed, four year old, adult female green iguana (Iguana iguana) the contents of the sub-spectacular space was submitted for bacterial
presented with anorexia, serous discharge from the right eye, peri- culture and resulted in the culture of Staphylococcus epidermis. The
orbital caking of the right eye with dried exudate and severe snake was treated with chloramphenicol eye ointment and ceftazidime
blepharospasm. On examination of the eye a large superficial central at 20mg/kg injected intramuscularly every 72 hours for ten days. A soft
corneal ulcer was noted that was strongly positive on a fluorescein test. contact lens was also placed on the cornea. This is not normally
There was a moderate degree of conjunctivitis with markedly visible performed but by removing the infected material the adherent
vasculature. It was treated with chloramphenicol eye ointment twice spectacle was damaged and removed, thus exposing the globe itself. It
daily for five days, enrofloxacin injected intramuscularly every other day was changed every three days when the snake was injected. Two
at a dose of 5.5mg/kg and a single vitamin B-complex injection at a weeks later the eye flared up again and was put on a similar treatment
dose of 5mg/kg intramuscularly. The blepharospasm ceased and the regime but without a contact lens this time. It responded to treatment
fluorescein test came up negative. Three weeks later there was acute but flared up again approximately a month later. It was decided to
exophathalmus with blepharedema and superficial bleeding from the perform an enucleation. Anaesthesia was induced and maintained as
conjunctiva. The fluorescein test was repeated and came up negative. before and the eye was carefully examined again. Several layered
No intra-ocular abnormalities were noted. It was treated with topical eye retained spectacles were removed, covered by a mucopurulent
drops, containing chloramphenicol, neomycin and naphazoline HCL discharge. After removal the new spectacle and eye underneath
three times daily for six days and once daily injections of carprofen at appeared healthy. It was decided not to remove the eye and to treat it
4mg/kg for three days. A small central fluorescein positive corneal ulcer with topical F10 barrier ointment once daily for seven days. The
appeared again seven days after the retrobulbar swelling was noted. spectacle was sent for fungal culture which resulted in the growth of
Paeciliomyces spp. This is a common skin commensal in reptiles but
Fluorescein positive corneal ulcer on an iguana's eye. has from time to time been implicated in cutaneous and disseminated
mycoses. It was found to be resistant against Nystatin, Clotrimazole,
Using ultrasonography, no intra-ocular masses, retrobulbar masses, Ketoconazole, Itraconazole and Fluconazole but sensitive to F10,
haematomas or abscesses could be found to account for the swelling. Hibitane, Virkon ® and Microcidal (griseofulvin). Of these products few
A severe retrobulbar cellulitis was diagnosed. The iguana was then are safe for use in the eye or available in a suitable formulation. It has
treated with moxifloxacin eye drops three times daily and oral shed a new spectacle normally and no abnormalities of the spectacle
meloxicam at a dosage of 0.1mg/kg once daily but failed to respond. It have been noticed for eight months after, at the time of publishing this
was elected to perform an exenteration due to the unresponsive nature article. A new spectacle was shed normally during those eight months.
of the lesions. The curetted socket was filled in a sterile fashion with In snakes the majority of retained spectacles associated with fungal
F10 barrier ointment and the iguana placed onto enrofloxacin every infections are the result of poor hygiene and management. The
other day as before. The wound healed very well over two and a half infection very often involves the surrounding tissues as well.
weeks. However a serosanguinous discharge was then noted. A small
catheter was inserted through the discharge opening and it was Conclusion
flushed with F10 SC diluted 1:250. The discharge cleared up and the F10 barrier ointment appears to be an ideal product to use as an
patient eventually healed. adjuvant treatment in the surgical processes of enucleation and
exenteration. It acts directly on a wide range of pathogens that might
Case 4 be present prior to or post surgery. Thus far we have seen no side
A nine year old, male black-necked spitting cobra (Naja nigricollis) effects from instilling the product into the empty socket. It also
presented with a cloudy opacity of the right eye. It was treated with facilitates the elimination of surgical dead space.
systemic antibiotics and topical treatment for some time before the
decision was made to anaesthetise the snake. It was treated with Acknowledgements
ceftazidime at a dose of 20m/kg im once every 72 hours. The snake We would like to sincerely thank Dr Venter from the Johannesburg
was induced with propofol IV and maintained on isoflurane Animal Eye Hospital for performing the ocular ultrasonography on the
anaesthesia via intermittent positive pressure ventilation. A wedge green iguana.

References: Reptile medicine and surgery, 2nd edition, D.R. Mader, Saunders Elsevier 2006.
Avian Medicine, 2nd edition, J. Samour, Mosby 2003.

F10 PRODUCTS LTD Manufacturer of F10 Products:
Unit 7, Windmill Road, Loughborough, LE11 1RA, UK
Health and Hygiene (Pty) Ltd
Freephone: 0800 014 8803 • Fax: 01509 265777 P.O. Box 906, Florida Hills, 1716, South Africa
Email: [email protected] • [email protected] Tel: +27 11 474 1668 • Fax: +27 11 474 1670
www.healthandhygiene.co.za • www.f10products.co.za
www.f10products.co.uk





ISSUE 17 2016

THE USE OF F10 AS A TREATMENT FOR
BACTERIAL AND FUNGAL DISEASE IN

ANURANS

Michelle Barrows, BSc,BVMS,CertZooMed1* Katja Koeppel, BVMS, Msc, CertZooMed1
and Gabby Drake, BSc, BVSc2

**First published in Proceedings of Association of Reptilian and Amphibian Veterinarians, 2010**

ABSTRACT guttural toads with suspected bacterial Treatment of Bacterial and Fungal Disease in Amphibians
F10 is a veterinary disinfectant which contains dermatitis were treated for 9 days with F10SC
quaternary ammonium and biguanidine diluted 1:250 in reverse osmosis (RO) water
compounds which act synergistically to kill a applied by daily fogging using a nebuliser for
wide range of viruses, bacteria, fungi and 15-20 min. A mixed growth of contaminants
spores. It is available in various formulations, was cultured. Systemic enrofloxacin at 5mg/kg
including a concentrated disinfectant for s.i.d. i.m. was also given and the toads made a
dilution with water (F10SC; Health and full recovery.
Hygiene) and an ointment (F10 Germicidal A Natal ghost frog was fogged with F10SC in
Barrier ointment; Health and Hygiene). These the same way after a skin colour change of
products have been used by the authors and unknown cause. Treatment was discontinued
others on a wide variety of vertebrates and after 5 days when normal skin colour returned.
show efficacy at low concentrations, with short F10SC diluted 1:2000 in RO water was also
contact times and with minimal tissue used to bathe two painted reed frogs after
irritation.1-4 In amphibians the systemic routine PCR tests for Batrachochrytrium
absorption of topical medications is a particular dendrobatidis were positive. The frogs were
concern, however there is one report of the bathed daily for 5 min for 12 days and
topical use of F10SC to treat ulcerative skin subsequently tested negative for B
disease in 21 Tomato Frogs Dyscophus dendrobatidis. Another painted reed frog
guinetti.5 Here we report the use of F10 diagnosed by histopathology with cutaneous
Products in other anurans, including painted phaeohyphomycosis was bathed daily for 5
red frogs Hyperolius marmoratus, guttural min with F10SC diluted 1:3000 with RO water
toads, Amietophrynus gutturalis and a Natal for 30 days. There was no apparent resolution
ghost frog, Helophryne natalensi. of lesions and the frog was then euthanised
Two guttural toads presented with skin due to an outbreak of mycobacteriosis in the
discolouration, vesicles and ulcers of the group.
rostrum and plantar surfaces of the distal limbs. These cases show that F10 Products can be
Inappropriate substrate was thought to be the useful for the treatment of bacterial and fungal
underlying cause with bacteria and yeasts skin disease in anurans including the important
cultured as secondary contaminants pathogen B dendrobatidis. F10 at a
(Acienetobacter sp. Cryptococcus laurentii and concentration of 1:3000 has been shown to be
Candida tropicalis). Daily application of F10 100% effective in killing B dendrobatidis
Germicidal Barrier Ointment in combination zoosporangia in vitro6 and the authors are
with systemic enrofloxacin 5mg/kg s.i.d. i.m. currently carrying out an in vitro trial using
(Baytril 5%; Bayer) and husbandry changes guttural toads.
resulted in resolution of the lesions. Four

ACKNOWLEDGMENTS
The authors would like to acknowledge the diagnostic work of Dr Emily Land and Dr Desiree Dalton
(National Zoological Gardens) and Dr Maryke Henton (IDEXX Laboratories Ltd).

LITERATURE CITED
1. Bailey T, Sullivan T. 2001. Aerosol therapy in birds using a novel disinfectant. Exotic DVM 3.4:17.
2. Chitty J. 2002. A novel disinfectant in psittacine respiratory disease. Proceedings of the Association

of Avian Veterinarians, Monterey: 25-27.
3. Chitty J. 2004. Respiratory System. In Girling SJ, Raiti P (eds) BSAVA Manual of Reptiles 2nd

Edition. British Small Animal Veterinary Association, Gloucester, UK:230-242.
4. Girling SJ. 2005. Respiratory Disease. In Harcourt-Brown N, Chitty J (eds) BSAVA Manual of

Psittacine Birds 2nd Edition. British Small Animal Veterinary Association, Gloucester, UK:170-179.
5. Drake GJ, Koeppel K, Barrows M. 2010. F10SC nebulisation in the treatment of ‘red leg syndrome’

in amphibians, Veterinary Record 166:593-594.
6. Webb R, Mendez D, Berger L, Speare R. 2007. Additional disinfectants effective against the

amphibian chytrid fungas Batrachochytrium dendrobatis. Diseases of Aquatic Organisms 74:13-16.