The user submitted the following data:

Fram Type: Open

Breed: Ross 308

Bedding Status: Dry

Age: 20

Feed Intake: 100

Here is how the farmer described the situation:

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Disease Diagnosis Based on User Input:

Propable Diseases

• - Infectious Bursal Disease (IBD, Gumboro): Age 20 days is the classic window for clinical IBD in broilers; Pakistan (Sindh) is endemic for vvIBDV. Moderate increase in daily mortality is typical and may be followed by secondary bacterial/adenoviral problems.
• - Coccidiosis (Eimeria spp.), often complicated by Necrotic Enteritis (Clostridium perfringens): Peak risk 18–28 days. Even with dry litter, anticoccidial failure or vaccine reaction can trigger intestinal damage and sudden, moderate mortality. NE frequently follows subclinical coccidiosis.
• - Colibacillosis (Avian Pathogenic E. coli) secondary to immunosuppression or respiratory/enteric insults: Common in broilers around 2–4 weeks, often after IBD, IBV, or coccidiosis. Manifests as increased mortality with airsacculitis, pericarditis, perihepatitis.
• - Inclusion Body Hepatitis (Fowl Adenovirus): Typically 2–5 weeks, presents as a spike in mortality with pale, enlarged, friable liver. Frequently associated with prior immunosuppression (IBD/CIAV).
• - Infectious Bronchitis (nephropathogenic strains): Endemic in the region; nephropathogenic IBV at ~2–4 weeks can cause increased mortality, wet litter (polyuria), swollen kidneys with urate deposition; sets the stage for E. coli.
• - Environmental/heat stress (management differential): Hyderabad can be hot; at 20 days, heat/ventilation issues can raise mortality modestly, especially in the afternoon. Needs house climate data to confirm.

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Recommended Treatment

• Toltrazuril (for coccidiosis): 7 mg/kg body weight per day in drinking water for 2 consecutive days; repeat once after 5 days if needed
  If using 2.5% solution, this equals ~0.28 mL/kg BW/day. Adjust for actual water intake. Do not combine with sulfonamides during the same period. Observe label withdrawal (commonly 5–7 days).
• Amprolium (alternative for coccidiosis): 120–240 mg/L drinking water for 3–5 days, then 60 mg/L for 1–2 days
  Dose as amprolium base. If using 20% powder, 0.6–1.2 g/L for 3–5 days then 0.3 g/L for 1–2 days. Do not give vitamin B1 during treatment; resume vitamins after.
• Lincomycin (for necrotic enteritis) ± Spectinomycin: Lincomycin 16.5–20 mg/kg BW/day in drinking water for 5 days
  Combination products (linco-spectin) may be used per label. Effective against C. perfringens. Consider in-feed bacitracin where permitted for 5–7 days as adjunct.
• Amoxicillin (for colibacillosis/enteritis): 15–20 mg/kg BW/day in drinking water for 3–5 days
  Useful for E. coli and mixed bacterial complications. Base choice on culture/sensitivity when available. Observe withdrawal (commonly 2–3 days, check label).
• Trimethoprim–Sulfonamide (for E. coli and secondary bacterial infections): Total combination dose ~30 mg/kg BW/day in drinking water for 3–5 days
  Ensure good hydration; monitor for kidney stress. Observe withdrawal (often 5–10 days; check label).
• Enrofloxacin (reserve; for severe colibacillosis where permitted): 10 mg/kg BW/day in drinking water for 3–5 days
  Use only if legally allowed and culture supports need; stewardship is critical. Observe withdrawal (often 7–14 days).

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Supportive Therapy

• - Balanced electrolytes in water for 3–5 days; include vitamin C 200–300 mg/L during heat or stress.
• - If nephritis suspected (IBV): use electrolytes containing potassium citrate (1–2 g/L) for 3–5 days, ensure abundant cool water, and temporarily reduce dietary protein 1–2%.
• - Multivitamins after anticoccidial course; Vitamin E (100–200 IU/L) + Selenium (~0.3 mg/L) for 3–5 days to support liver/immune function.
• - Probiotics (Bacillus/Enterococcus) for 3–5 days to stabilize gut flora; consider yeast cell wall/MOS in feed.
• - Mycotoxin binder in feed (e.g., 1–2 kg/ton) if feed quality is uncertain.
• - Organic acidification of drinking water to pH 5.5–6.0 (formic/propionic blends) to suppress enteric pathogens; maintain 2–3 ppm free chlorine at drinker when not acidifying.
• - Ensure easy access to cool water (flush lines before peak heat); raise drinkers to shoulder height to reduce spillage.

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Recommended Management

• - Do immediate necropsies on 5–10 fresh mortalities: check bursa (size/hemorrhage), kidneys (swollen/urates), intestines (lesion scoring for coccidia, NE ‘Turkish towel’ mucosa), liver (pale, friable), heart/liver for fibrin. Use findings to prioritize therapy.
• - Verify and optimize house climate: target 24–26°C at 20 days; RH 50–70%; maintain adequate air exchange to keep ammonia <20 ppm and CO2 <3000 ppm. Provide extra ventilation and cooling during hot hours.
• - Review vaccination history (IBD, IBV, NDV). Do NOT vaccinate with ‘hot’ IBD vaccines during an active outbreak. For ND/IB, consider only if clear field challenge and per veterinarian guidance.
• - Assess anticoccidial program (vaccine/shuttle/rotation). If breakthrough suspected, switch to a different class immediately and review future rotation strategy.
• - Improve water hygiene: flush lines daily, maintain 2–3 ppm free chlorine at the drinker (or stabilized H2O2 as per label), check water pH/hardness and biofilm.
• - Litter management: keep dry (<25% moisture), fix leaks, increase ventilation over litter; spot-replace caked areas. Adjust drinker height and flow to minimize spillage.
• - Prompt removal of dead birds at least 3 times daily; segregate culls; restrict movement between houses and use dedicated footwear/clothing per house.
• - Strengthen biosecurity: controlled entry, footbaths (refresh daily), vehicle and equipment disinfection, rodent/insect/wild-bird control, all-in/all-out with adequate downtime and thorough cleaning/disinfection between flocks.
• - Nutrition check: verify feed quality and particle size; avoid sudden diet changes; consider reducing crude protein slightly and adding enzymes during enteric disease; confirm inclusion of toxin binder.
• - Record-keeping: log hourly temps during hottest periods, daily water/feed intake, and mortality by time-of-day to detect heat-related patterns.

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Lab Tests

• - Post-mortem examination with lesion scoring: bursa index (bursa:body weight ratio), Johnson & Reid coccidiosis score, NE lesions.
• - PCR: IBDV (bursa), IBV (trachea/kidney), NDV (trachea/cloacal swabs) from fresh dead birds.
• - Bacterial culture and sensitivity: liver, heart blood, air sacs for E. coli and Clostridium perfringens.
• - Histopathology: bursa (lymphoid depletion for IBD), liver (intranuclear inclusions for IBH), intestine (NE).
• - Fecal/intestinal scrapings: coccidia oocyst identification and counts.
• - Serology (paired sera, 10–14 days apart): ELISA for IBD/IBV and HI for NDV to assess recent exposure/immune response.
• - Feed and water quality: mycotoxin screen (aflatoxin, DON, T-2), water bacteriology and residual chlorine at drinkers.

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Missing Information

• - Exact age unit (assumed 20 days) and daily mortality trend by day (onset, peak, time-of-day).
• - Clinical signs: diarrhea/wet or bloody droppings, depression, ruffled feathers, respiratory signs (cough/sneeze/rales), neurologic signs, sudden deaths, wet litter/urates.
• - Necropsy findings: bursal size/hemorrhages, kidney swelling/urate deposition, intestinal lesions (location/severity), liver color/fragility, fibrin on heart/liver, cecal cores.
• - Vaccination program with dates and products (IBD, IBV, NDV) and breeder MDA information if available.
• - Current anticoccidial program (drug/vaccine, rotation), feed formulation (CP, energy), recent feed or ingredient changes, and whether a mycotoxin binder is used.
• - Environmental data: house temperatures (min/max), humidity, ventilation rates, ammonia levels, stocking density units (m²/bird or ft²/bird), air speed over birds.
• - Water program: source, chlorination level, pH, hardness, flushing routine, any recent changes.
• - Any treatments already given (drug, dose, duration) and response.
• - Body weight and uniformity at 20 days; feed and water intake patterns.