210 East Wood Road Rensselaer, in 47978

210 East Wood Road Rensselaer, IN 47978

(219) 866-6465 Fax (219) 866-3431 www.rssvet.com

Thomas G. Gillespie, DVM, Diplomate, ABVP

Swine Health Management Specialty

Amy L. Woods, DVM

Vet to Vet Form

Requesting Farm: ______Date: ______

Reason for request: ______

Source Information

Farm Name:
Farm Location:
Herd Vet:
Farm Type: / F-F / 3 site / 2 site / Last Herd Visit:
Farm Size:
Current Source:
Shower Entrance:
Farm History:
Quarantine Used: / Y / N / If yes: / Onsite / Offsite
Quarantine Testing: / Y / N
If yes, describe protocol?
Quarantine Period:
Frequency of Vet Visits:
Distance to closest pig farm:
Semen Source:
Transportation:
HEALTH STATUS
Condition / Status / Comment
Actinobacillus suis
APP 1,5,7
Atrophic rhinitis (toxigenic PMD)
Circovirus (PCV II)/PCVAD
Coccidiosis
E coli (K88/F18)
Haemophilus parasuis (Glasser’s)
Ileitis
Internal parasites
Mange/Lice
PRRS
Salmonella choleraesuis
Salmonella typhimurium
Strep suis (meningitis)
TGE
Other:
NEGATIVE (N) / Disease never diagnosed, and based on history, are considered not present in the herd
NOT EVIDENT (NE) / Diseases may be present in the herd but not evident at the time of visit
POSITIVE (P) / Disease that is evident at the time of the visit

Serology Testing Dates

Disease / Date
PRRS (ELISA)
Mycoplasma (DAKO)
SIV (H1N1)
SIV (H3N2)

Health History:

Any ongoing health concerns recorded and summary of post mortems based on date:

VACCINATION SUMMARY

Breeding Herd / Yes / No / Breeding cont’d / Yes / No / N/G/F / Yes / No
P/L/E / Clostridium C / Erysipelas
PRRS / SIV (H1N1) / M. hyo
M. hyo / Ileitis / H. parasuis
E. coli / ______/ PRRS
H. parasuis / ______/ Ileitis
Rotavirus / ______/ ______

Comments/Recommendations:

Nursery vaccinations:
Selection:
Pre Dispatch:

Customer Information:

Visit Frequency:

Current genetic supplier:

Quarantine Used Y / N Onsite / Offsite

Testing:

Quarantine Period:

Customer Health Status:

1.  PRRS -

2.  Mycoplasma –

3.  Swine Influenza (H1N1) -

4.  Swine Influenza (H3N2) -

Specific Health Concerns:

Customer Vaccination Requests:

Routine Gilt Vaccinations On Arrival:

1.  PLE -

2.  PRRS -

3.  Mycoplasma -

4.  H. parasuis -

5.  Swine Influenza (H1N1) -

6.  Swine Influenza (H3N2) -

7.  Ileitis -

Customer Vet Accepted Health Status: Yes or No

Veterinarian: ______Date Approved: ______