Good evening everyone and welcome to today's webinar on bovine respiratory disease. As you'll be well aware, BRD remains one of the biggest health challenges affecting young stock with a significant impact on calf health, performance, and farm productivity. Tonight we'll be looking at the latest developments in BRD management and prevention, including the emergence emerging evidence around bovine coronavirus, the role of thoracic ultrasound scanning, and how vaccination fits into a wider prevention strategy.
We're joined. Joined by 3 fantastic speakers this evening, Doctor Kat Baxter Smith from MSD Animal Health, tonight's webinar sponsors, who will set the scene and look at BRD in practise. Ben Struggnell from Farm Postmortems will share what he's seen through his diagnostic work, including the involving evidence around bovine coronavirus, and Will Bauer from Fossway Farm Vets will explain how he's using thoracic ultrasound scanning on clients' farms and how this can be developed as a chargeable veterinary service.
We'll have a round. An hour together with 15 minutes at the end for questions. If anyone has any questions for our speakers, please put them in the dedicated Q&A box, and we'll come to them during the, at the end of the session.
For comments or other queries, there's also a chat box, so please put anything related to that in there. Just before I hand over to Kat, you might just see a quick poll pop up on your screens right now, asking whether you're more beef or dairy focused. If you could just answer that now, that would be great.
I'll just give you a few seconds to answer that. I think you, they're all coming in. So yeah, basically, I hope you have a really good session tonight.
Enjoy, enjoy the webinar, and now I'm going to hand over to Kat Baxter Smith. Thank you, Sarah. Hopefully you can hear me OK.
Yeah, thank you for filling in the poll. It just gives us all, the speakers, a bit of an idea of the sort of vets that we're speaking to and, and hopefully means we can tailor the webinar a bit better for you. So, I'm certainly happy to see who that will be.
I can't see the results currently, but I'm hoping that once the poll is closed, I will be able to. Oh, here we go. So, we have 21% mainly dairy, 9% mainly suckler beef, no mainly calf rearers, 38%.
Mix of dairy, beef, even 32% of are not applicable. So I'm not sure who you, who you lot are. Hopefully, interested parties.
Anyway, let's crack on. So, yeah, I'm gonna sort of set the scene and talk a bit about the impact of BRD. The vaccination strategies and how we can help our farmers to prevent it.
We know it's common. I think all vets know this and all farmers do know this. This is from our young stock survey we did in 2020, which I think had around 30 to 400 farmers respond, which were a good mixture of beef, dairy, and calf rear as well.
So common, very common on farm, and also common to cause mortality, which, you know, is really not good, and we really should be trying to avoid. Here we have, some nice postmortem lesions. There's a lot more gory ones to come from Ben, so we're looking forward to those.
But certainly, the impact in dairy and beef is significant. And, this one on dairy on the left, so even it's, even just a small lesion of like, 1 to 2 centimetres, causes a significant impact in, future milk production. Production and beef even, again, even a small lesion, this is not like a full lobe lesion, this is like a tiny small lesion, like a few centimetres, causes a significant amount of decrease in growth rates.
So, yeah, Will's gonna talk a bit more about thoracic ultrasound and how it can be quite useful to see the impact of, the underlying pneumonia that, pretty much is present on all farms. In this study, they scanned calves from one week of age and looked at proportion of animals with lung consolidation. These were dairy calves, and you can see it's present from 2 weeks of age.
So in really young animals we are, we are seeing lung lesions. So this just demonstrates how young they are starting to become infected, you know, affected by it. Unsurprisingly, the kind of most common time to see lung lesions is in that kind of weaning period.
The calves are stressed and undergoing lots of changes at that time. Also, their maternal antibody is waning, so it does, it does sort of, it's quite obvious really why they would be suffering from, from lung lesions at that point. So, BRD is, is generally subclinical.
This graphic kind of represents the green animals being the healthy animals, the pink animals being the subclinical cases, and the red being the clinical cases. By clinical, we mean they are showing clinical signs such as coughing or, fever. And yeah, we've got this variation here, but even on very good farms, when I'm sure will agree with me, but when we go and do scanning of the lungs, you have a certain proportion of animals that look perfectly healthy on the outside, but when you scan the lungs, they, they do have lung lesions, and thoracic ultrasound is very sensitive for detecting these, and it's these subclinical animals that are really causing the problem because they're often not treated or noticed, but they are impacting on the bottom line.
Again, not many farmers are actually using temperatures. So, most farmers, I would say, are just looking at the animals, and if they're coughing, they're like, oh, maybe I'll take the temperature, maybe I'll just jab it. So, I think having protocols on, on farms for, particularly with the kind of turnover of farm staff that we can see, so that they know when to treat and how to treat and what to treat with, I think this is really one of the critical parts of management of BRD is that early treatment, understanding when animals need treating.
And, and what with, and, and actually being able to recognise and, and I think taking temperatures can be very useful, although time consuming. Certainly if they're coughing, to be honest, if they're coughing, you don't almost need to take a temperature because you, you know there's something wrong, you know, they need treating. So, yeah, I, I know there are people like Bart Pardon who don't really even see the value in taking the temperature.
They just say if they're coughing, then they need treating. So, as I said, most of lung damage is not visible, and using thoracic ultrasound can help to understand the true extent of the issue, as in what is the prevalence on farm, like how many animals are actually, you know, have got a problem, even if they do look healthy on the surface. And if you were to weigh these animals, you would see that impact in growth rates.
I always think it's a shame that more farmers don't routinely weigh their calves. Treating animals earlier, so using actually less antibiotics because you're not getting these chronic cases. These are the ones that just keep going, coming back and needing treating and treating because they, they have lung lesions that are too severe really to be treated now, and they've become chronic and, and they are just going to keep relapsing.
Oh, there's an arrow, so you can see it. So, we did, as I said, some survey work where we asked farmers about their kind of management of BRD and, 80% did treat the calf pretty quickly. That, well, ASEP is what they said.
Although there have been studies to show that when they look at temperature bolus in the stomach versus the timed treatment, it, it can be up to sort of 4 days later. So, a farmer might think they're treating ASAP when actually the calf has been sick for several days. They do like to have a farm protocol or, their own habit that they normally do use.
They think treatment is effective, so farmers don't necessarily understand that that treatment isn't a cure. So they think, oh, I've just jabbed it, so it'll, it'll get better now, it's fine, it won't affect my productivity. So I think it's trying to change that mindset of actually, yeah, you've treated it, but it doesn't mean the lesion's gone, and it's, the animal is still going to be affected in the long run.
They generally only ring the vet when they feel out of control, so it tends to be when you get that tipping point when lots of animals are coming down with the problem and, and they're treating them and they're not getting better. So unfortunately, the vet comes in as a firefighting, in a sort of firefighting situation when things have often spiralled and it's almost too late. We asked them how do they prevent BRD on their farm, and these were the top, 5 that they said.
So, hygiene, I mean, sure, that's good. Ventilation, I think, for me, super important, and, and there's so many, so many bad buildings out there and, and not necessarily the confidence from, from vets to advise on this. But it is, for me, one of the, the main things or the main thing that will make a big difference.
Colossum feeding, of course, which is really the cornerstone of good calf management. Vaccination. Obviously we're glad that's there being MSD, but, I think it's very, you know, we have a lot of really good vaccines out there that cover most of the diseases that we see, and they certainly should be utilised, as part of a good BRD prevention protocol.
Isolation of new animals, you know, I mean, it depends on the farm system. I think it's interesting they've put that there because I don't see many farmers isolating new animals. Yeah, so farmers are keen for help.
This is what I think was quite useful from this survey. They really want help from their vets, and, and the top two were disease prevention and cholostrum and nutrition management. So, I think this is nice for vets or for us because we can see they want help, and we can see the areas that they want help in, and, maybe it's down to the interests of the individual.
Vet that goes on that farm. Some vets are certainly more interested in young stock than others, and I think this is a service that we should be offering our farmers. Just because it's not an interest for us, it doesn't mean we should be ignoring it.
So, there's normally somebody in the practise who is interested, and maybe they should be the one to be advising if, if, if the current vet is, is, is more of a sort of adult cattle person. I think it's, it's critical for these farmers to be getting this right. So, in terms of like, where do we start, the farmers have got a problem, and how do we help them?
I think we have to look at, we have to, you know, ask some questions, speak to them, find out what their true objectives are, because this is different from farm to farm. You know, maybe they, oh, I want to make lots of money, or do I want my calves to look really healthy and be happy and live a lovely life. And, and that does vary according to who you're going to speak to and what farms you're going to be on.
Then it's worth looking at the calf journey on the farm and where the pinch points are, where can you make, changes and see the most difference, and then we can put into strate like our prevention plan and strategy into place. I felt like I show this slide a lot, but I do quite like it. So it's a study done, she had not referenced it properly, which is very naughty.
This is a study done. By, I think it was the University of Nottingham, but a few years ago where they asked vets and farmers of recurring topics of discussion during a visit, and they asked them separately, you know, what do you discuss, and there was actually quite a strong disconcordance in calf mortality with the vets feeling like they, they discussed this quite frequently, whereas the farmers not feeling that vets talked about calf mortality with them. So either we as vets are not discussing it but thinking we are, or we are discussing it, but the farmers are not hearing what we're saying.
So I think that's, a particular thing to think about if you're going on a farm regularly and you think you are talking about young stock, are you actually getting the message across? Because in many cases, the farmers are not hearing it. I've just put the dairy heifer down as an example.
We've got a lot of you doing dairy, so that's good. These animals go through a lot of changes in their lifetime, and each time we do this to them, it's hitting their immune system pretty hard. Yeah, it's almost amazing that we do manage to rear animals with what we put them through, I think sometimes.
So, you know, they're born in the calving pen, then they're moved to another pen, then they're weaned and maybe moved to another pen, then they're moved again. And you know, these are all pinch points where we can see disease come in. And I think the good thing about using thoracic ultrasound, and we will probably say this too, you can actually pinpoint exactly when you start seeing lesions.
So you can say, well, when, when is this problem starting to happen and why is that? So are you seeing lesions here or are you seeing them here? And if so, let's put in our interventions before that.
So, I've just put in some of the pinch points so we can see, and, you know, there's things we can do and things that are out of our control. But like ventilation, again, I, as I said, it's one of the critical things for me, other diseases that we could be managing, Stocking density, again, I just see so many farms where, Their animals are crowded and they're wondering why they get disease. I know it's difficult for farmers because of, TB and various other things, but when animals are crowded, it is so difficult to, to have good hygiene and it's so difficult to have good ventilation.
And there was, there is no vaccine or antibiotic that will get them out of this if the stocking density is too high. And again, hygiene, using the correct disinfectants and particularly for scour as well, and things that we can help with, you know, to help improve their immunity and bring, bring that up, vaccination, good cholesterol management, and the innate immunity that they're born with. I'm not going to do much on housing, although I could talk about this all day.
I think it's very important that vets understand like good housing and can advise farmers on this. There's some really good information on the AHDB website and Like, even thinking about inlets and outlets, you know, small calves will not produce enough air for it to raise and go out the top. One of my colleagues was talking about a visit they went on yesterday, and they said the ventilation was really poor.
They put, they let off a smoke bomb and the smoke just went up and then back down again. So that's exactly what the pathogens are going to be doing. So I think there's really nothing that can compensate for poor, poor, housing, and it's not like they need to buy new housing.
I think there's a lot that can be done to housing that they're already in to improve it. I mean, when they're young and baby calves as well, we have to think about their, their, their core temperature and if they're cold, because, you know, being cold is almost just as bad as having no ventilation. So it's certainly a fine line in these young calves.
These are just the, the regulations for space available. And again thinking about our hygiene and biosecurity. So diagnosis, I think, yeah, in the survey they said around 60% of farmers had not diagnosed the cause of the problem, and there's plenty of supported diagnostics out there, not just by us, by plenty of other companies.
So there's not really any excuse for saying they're too expensive. I think from our perspective we have serology, so blood testing, and this is best used after the outbreak, though. Say you've had the housing season, you know, you've had an outbreak in a group of young animals, we recommend they're around 3 to 6 months of age, so their, MDA has waned by that point.
Taking blood samples to look for antibodies to those pathogens can be really helpful to find out what's going on. And then nasal swabs, which I tend to recommend in the face of an outbreak. So, Yeah, you know, they will, they will pick up also probably a lot of general bacteria that are there, but they are a quick and generally easy way, particularly if you do the pooled PCR of finding out if there is something like IVR or RSVPI3 type of thing.
So this is some data that we just recently published at the World Biatrics, comparing, so we have serology, our serology data, and we also have our PCR data from, I think it was the last few years. So, and we tested for, we didn't test consistently for all pathogens. So on the serology, we don't test for, I'm gonna say IBR and Pasorella mortoscia, but you can see here, there's a high level of positivity and, quite a good correlation as well, except for the PI3, which seems to come out much, much more in the serology.
I do, we do see that, the bacteria is obviously diagnosed more in later disease, and, the viruses are diagnosed more in early disease, and it's certainly much more useful to, do, nasal swabs in very, sort of early infected animals, so when they're first infected, rather than when they've been coughing for weeks, whereby you're just gonna get Pasarella altoscia, my, you know, Mannheimer hemolytica. We, we see those all the time. So, and bovine coronavirus is something that we're sort of looking at more.
Obviously, we have a vaccine, so we have a reason to do this, but, it has been recognised by plenty of, research to be a significant pathogen in the respiratory complex. In our testing, it was actually the only virus that detected in around 60% of serology. And in about 25% of PCR, it is a sort of opening the door type pathogen.
So, I think Ben's going to talk more about it, but it allows the other, the other pathogens to come in and the severity of the disease is then worse, and we see it interestingly a lot with Mycoplasma bovis, so the two seem to be quite synergistic. Right. Whizzing on through, yeah, farmers want to prevent, and actually, I think the key thing from this slide is 79% highlighted that seeing lung damage would engage them.
So, when I do thoracic ultrasound, I like to have a screen with me rather than just the bugs, because then the farmer can see the image, and it really engages them in, in what's happening. Because if you're just sat there with goggles on and they don't know what you're looking at, they, they get bored. So, I think having a screen really helps, particularly when you first start doing it.
Choosing a vaccine, it's, it is a minefield, I know this. We make obviously these ones, then there are other companies that make loads of other, and which ones to use and when, it's, it's, it is difficult. I, I completely appreciate that.
I think, one of us is generally always around on the phone if you want to talk through, vaccine strategies. We, we have quite a lot of, tools to help you, such as protocols. Certainly I wouldn't put in a vaccine onto a farm without doing some testing first to find out that.
What what you've got is what you're going to vaccinate for. I think the good thing about having lots of vaccines means you can be quite specific and tailored. There's not any one size fits all, I would say for any farm.
I think it's a matter of actually doing some testing, understanding what's there, when is the disease happening, and making a vaccine protocol accordingly. So this is just an example, like of a protocol that we could put together for some dairy heifers. We can vaccinate them from birth if needed for coronavirus and RSVPI free.
Then we can go in with injectable vaccines and IVR if we want to cover those things as well. So as vets, I think it's a shame if we're just attending farms because we're being called on the back of an outbreak. I think there's a lot of opportunities to be proactive now.
And, yes, you know, the back of an outbreak is when probably the farmer is most motivated to do something. But also we have, I think I would like to get to the point where we're getting regular, we're having regular young stock visits on farms in the same way we have fertility visits. I think this is such a good opportunity for practises and, many farmers are really happy to pay for them once they realise and understand the value that they bring.
So, you know, we, we can't be just making our profit off the back of drugs anymore. I think we need to be spending time on farm helping them raise healthy animals, and this is a good way to do it. Again, MSD, they have a lot.
There's a lot of things here to support you. Calf health checklists, which is a calf, dairy calf audit tool. Same for suckler herds that you can go on farm, spend an hour interrogating every part of the system, and this, this is just a kind of a checklist to help you do that.
We have training on thoracic ultrasound practises, and we have these, these, protocols. So there's plenty of help out there if you wanted to get started on this sort of thing. So I can see there's some questions come in, which is thrill, but I'm gonna hand over to Ben, and then at the end we'll come back and do all of the questions.
So if you have questions, please put them in the Q&A, and or the chat, and, and we will come back to them for sure. Thank you for having me. My job is to explain diagnostics and recent trends in the p.m.
Room, so I will tell you what I see in my PM. Room and how I approach, my cases of BRD with the caveat that I always have a dead one and you don't always have a dead one. A dead one is always, always, always useful.
Never ever waste a dead one, I would say that, wouldn't I, but I think it's really important to know what's really going on. You need a dead one, you need histopathology, I'll repeat that a lot, a lot in this talk. I would remind you of two things.
One is the cattle respiratory tract involves. What you breathe in and what you breathe out, so the, the, the thing that gets damaged most of all is this green line which is the mucocili escalator, and this gets damaged by all the viruses, PI3RSV and coronavirus and Mycoplasma bovis, and this mucocili escalator I think is absolutely critical to our understanding of BRD because this is where the whole thing falls down often, . I want to remind you that the different pathogens live in different parts of the respiratory tree, so RS IBR lives here right at the top.
My experience of IBR, as I'll tell you in a minute, is acute, tracheitis, runny eyes, all that stuff, high mortality, acute acute on, acute off. You vaccinate in the face of the outbreak, normally it goes away. I'm not saying you can't have rolling IBR in dairy herds, but normally what I see is acute on and acute off and the.
Are easy to see as I'll show you. Mycoplasma bovis lives a little bit further down in the ciliated respiratory epithelium. PI3 and, bovine coronavirus live in airways a little bit further down.
RSV lives right in the terminal bronchiole just before the alveoli, and the bacteria live, in the alveoli, and that's important and what keeps the histopathology is so important to get you to understand what exactly is going on in each of these stages of the lung. But also make the point that cattle are not like sheep when it comes to BRD. If a, if a lamb gets pneumonia.
It, it dies, you know, it gets pneumonia, it's, its lungs fill up with mycoplasma with Mannheimer hemolytica like this, like a bath, and then 24, 36 hours that lamb is dead. Fine, then dead. Simple.
That is not the case in cattle, most of the time. In cattle, you get an insult, you survive with a bit of damage to your mucoceli escalator, you get another insult, you survive, you get another insult, you survive, and so it goes on and so it goes on and you. Die, you know, 5678 weeks later, possibly longer, and that's why I think that ultrasound is so important because it captures you early.
It is a chronic, most of the calves on my PM room table have died of chronic, chronic disease, with some exceptions, so I'll just get the acute ones out of the way now. Here is IBR, diphtheritic, . Purulent, necrotic material all the way up from the top of the trachea right down to the bottom, all the way from the top all the way down to the bottom.
If you want to make confirm the diagnosis, which you probably don't need to because you've got two eyes that work, you just need to send a bit of trachea in for PCR. Vaccinate in the face of an outbreak, jobs are good and goes away. I don't know as much about the rolling disease on dairy farms, but this is how I see IBR, mainly in strong stores, and I really only see IBR in cattle above 6 months old.
I think it's a disease of, older cattle, not of younger cattle, and if you're wondering, is it IBR or isn't it, it probably isn't because the disease in the lesions in the trachea are very striking, normally. That's acute. Another example of acute bacterial pneumonia is occasionally cattle can get acute bacterial pneumonia like sheep do, just where the alveoli fill up with Mannheimia hemolytica, Histophius somni, Pasorella maltoida, something like that.
Normally in those cases the mucocili escalator is intact, right? And also normally in those cases because. The bacteria are right down in the bottoms of the alveoli, they're close to the blood vessels, you get vascular injury and when you get vascular injury, you get fibrin leaking out of the blood vessels, so you have fibrin fibrinous pleurisy like that and because you've got vascular injury, you also get thrombosis, so you get tissue loss, so you get this sort of marbling pattern sometimes with black, purple and red lesions.
Because of thrombosis, because of a vascular injury, because of all the endotoxin and fibrin leaking out of the blood vessels so I'm just trying to relate what you see here with your own two eyes to what's going on ultrastructurally in the bottoms of the lungs. Here you can see the bacteria are that close to the blood vessels that a major part of the pathology involves vascular injury, which here you've got dark dead tissue and fibrin coming out of the blood vessels and histologically you see . Lots and lots of vascular injury, lots and lots of neutrophils, lots and lots of bacteria, streaming out cells, all that sort of stuff, no damage to the mucoceli escalator, that tells you it's acute.
Now here is an example of how you might get acute bacterial bronchopneumonia in cattle, where you have the stack effect as Cas Cat was saying earlier on, the stack effect working quite well up here at cow level, so cold air is coming in here, wants to sink but it doesn't because the heat of the cows is . Sending it out the ridge, but down at calf level there's not much airflow, the number of bacteria per milli up here is low, the number of bacteria per millire down here is high, especially on a humid day, especially when there's, you know, not much going on. So the, the effect is like a dwarf in a lift when someone farts.
So here's the fart down here, lots of fart particles, lots of bacteria, lots down here, not many up here. The result is you get acute bacterial bronchial pneumonia. That does happen, but it's not as common as the chronic stuff I'm going to talk about later.
The the next briefly acute one that I want to talk about is acute RSV and this is what we're all told at college, acute RSV. Gives you overinflated lungs with air bully and lots of air and, and, you know, you say, well, I died because there were too, too much air in my lungs, which sounds a bit Irish, but this is why when you've got RSV as I said, right in the bottoms of the bronchi, the last terminal bronchioles. I should have said bronchioles, not bronchi, before the alveoli, er they, that's where the virus er lands, so you get swelling in those bronchioles, you can expand those bronchioles and breathe in.
But you can't expand them and breathe out, that means that more air gets breathed in than gets breathed out, air gets trapped and and leaks into the interstitial space, which means you end up with lungs that look like that, too much air in the lungs but in the wrong place, right? So that's what happens with acute RSV and that's what they tell you at college, that's why you get those air bullied because of basically because of the bronchiolitis. Now, remember that picture cos I'll show you a similar picture later which looks a lot like RSV but isn't RV.
RSV RSV is a ubiquitous virus. I mean, most, virtually every farm in the country, I should think has RSV, and I suspect that every, every calf, by the time it gets to 6 months old, has met RSV with one of three consequences. It's either died acutely like this, it's recovered completely, or it's recovered with some damage to its mucociliary escalator, of which more later, but you can die of acute RSV and if you do that, this is what your lungs, .
Look like, I think this has become much less common since the advent of the live vaccines for RSV. Incidentally, the histopathology, if you've got acute RSV is pretty typical, bronchiolar epithelial necrosis. Bit later on, I'm going to tell you that I do histopathology first and then the PCR and this is why, because if I know that I've got a.
Acute bronchiolar epithelial necrosis. I know that there's acute, bronchiolar damage there. The virus is likely still to be present, therefore it's valid to do the PCR.
I'll tell you why later, there are some circumstances where the virus has been and gone, and there's no point doing the PCR because I'm just going to confuse myself or waste somebody's money, I think. Anyway, that's acute RSV. That's why it happens, and that's what the histopathology looks like and that's what tells me it's acute.
There it is again. The same thing to some extent can happen with coronavirus and with PI3, all these pneumotropic viruses which if we're gonna understand we have to really get to the bottom of by doing the histopath, so. Those are 3 examples of acute disease, but I don't really want to talk about acute disease because most disease, most BRD in cattle I think is chronic.
I just want to make the point that if you have acute disease, it's fine to swab noses for viruses, but if you possibly can get a dead one, if you can possibly drill into your farmers. Please get them to call you when you have a dead one, if there's an outbreak of what looks like an acute disease, and please, if you do the postmortem on the dead one, please take fixed tissue and fresh tissue for the PCR fixed tissue for histopathology and the PCR. Because histopathology is the really the only way to find out what has gone on in those lungs once you factor in the dimension of time, as in most of the lungs that land on my table, I've got old airway damage, old damage to the mucociliary escalator.
Which has happened so long ago that the virus is no longer there, so the PCRs are no good. The only thing that's going to tell you that that's what's happened is the histopathology and a good look at the airways like that, so you have things like bronchi bronchiolitis, fibrosa, obliterans and stuff like that. And very often what's happened is you're still breathing in the same number of pathogens, but your mucocelic escalator, this is this green line, which is a lot smaller there, is damaged, so more of the pathogens are staying down in the bottoms of the lungs and you're getting.
Respiratory disease. Here's, here's one right that just stopped in time. This calf broke its leg, that's the initial bacteria which it did, the initial lung pathology which it didn't die of, but normally, you don't see that because they don't die, and then later on you see much more chronic pathology like this, bronchiectasis, distorted fibrosed airways and a set of lungs that just cranio ventral consolidation, not much you can see because it's old.
Hoping we're gonna hear more about this sort of pathology, this acute pathology, when we talk about ultrasound, later. Now, as I say, most lesions of BRD on my table are old, as in most of the time, the problem, the reason that the calf hasn't lived is not because of antimicrobial resistance, it's not because of, sort of treating with the wrong thing, it's because the calf. Has basically run out of lung.
Now here, as you can see is some old airway changes, so you can see bronchiectasis here, you can see this to some extent with your own two eyes, as in the airways themselves look fibros, they look distorted, you've got . Thickening around those airways, but histologically, you have to really put those into into histopathology because the histopathology will give you more information about what might have caused that chronic chronicity of that er change. Mycoplasma bovis, normally old viral pneumotrophic er damage.
Possibly lung worm if the thing has ever been outside, and again, it's telling you that the mucociliary escalator here has been buggered and you're gonna die later on because you're not getting rid of the pathogens because of old viral airway damage, which normally by the time they die, you've passed the window of being able to diagnose it. One of the things that causes this airway damage is Mycoplasma bobus, which usually grossly is fairly grossly obvious, as in you get casonecrotic change like this, . And it goes casiocrotic because the type of the inflammatory reaction that happens with Mycoplasma bobus is macrophages and lymphocytes and it tends to give you casonecrotic change rather than purulent or rather than emphysema or anything like that.
Histopathology is definitely characteristic if you. Need to confirm it, but, grossly I think you're most of the way there. The reason you get this is because you end up with a big fight between inflammatory cells and, Mycoplasma bovis.
You end up with a blind ending sock which looks like that. Each of those is a blind ending sock and it's a slow, slow, slow going, process. Again, knocks out the mucoceli escalator.
The other thing is old viral airway change which you've missed, so you end up with a set of lungs that looks like this, you have a suspicion of old viral airway change like that. Now I want to . Emphasise that you've got two possible ways to die later.
If you have old viral airway change like this, you could die of bacterial superinfection, as in your mucocere escalator is so knackered that more bacteria end up down in these lungs and so you lose a bit of. Lung and a bit of lung and a bit of lung and a bit of lung, and one day, 6 weeks later, you wake up dead because you've got no lung left, purely because of bacterial superinfection, because your mucoure escalator is knackered and you haven't been able to clear all that bacterial superinfection. That's method of dying number 1.
But there is also method of dying number 2, which is, I should say BIP bronchopneumonia and interstitial pneumonia. Now I want to explain this very briefly. You can see that this looks a little bit like grossly, like RSV, but this was from a 9 month old, rearing Sturk here.
What happens here, they reckon, this is a theory proposed by this, these Canadian. Lot led by Jeff Caswell and his lot, the theory is that you have chronic, chronic, chronic ongoing inflammation in the cranio ventral lobes caused by bronchopneumonia after bronchopneumonia after bronchopneumonia, and they reckon what happens is all that inflammation switches on the enzymes which turn 3 methyl indole. Into a toxic form of 3 methyl indole, which then causes widespread, interstitial pneumonia, and grossly interstitial pneumonia looks like overinflated lungs here.
Now I hear you thinking, where have I heard, 3 methyl indole before, and it's from fog fever in cattle out at grass. L tryptophan. You get a sudden increase in dietary protein that turns into 3 methyl indole in the rumen.
3 methyl indole goes to the lungs and it, you get pathology that looks like that. Well, they reckon that some of this is mediated by 3 methyl indole toxicity which is switched on after a period of chronic bronchi. Pneumonia, so there's a second way you can possibly die if you have chronic viral induced bronchopneumonia, and, obviously it goes without saying that you can only differentiate this grossly from RSV by histopathology because you haven't got bronchiolitis here, you've got interstitial pneumonia which is completely different, right?
Are you with me? I hope that makes sense. I just want to give you an example of how you can use, how histopathology is essential really to investigating these outbreaks of bronchial pneumonia.
This was grumbling pneumonia in a calf rearer. They, they'd done a few swabs, they didn't really know what was going on, but the calves were bad, cars were dying, and then a, a couple, did die, so he sent them in in a panic. These were the lungs.
To some extent you can guess what's going on by looking at them grossly. But really the final arbiter is the histopathology. Here you've got cranio ventral consolidation, you've got some areas of overinflation there, same here.
Here's a close up of the lungs. These lungs, I can tell you were rubbery. Rather than consolidated, they were rubbery, and here you've got what might be some, fibrosis around these airways.
But you can have a guess, but you can't really tell. So I did some histopathology, and what I normally do is I do the histopathology first, as I said earlier on, because that tells me is it appropriate then to do the PCR because are we in the window where the virus is going to be active and acute. If, yes, I do the PCR, if not, not.
In this case, I just want to pick out a couple of words here from the histopathology, which is in the lungs, there was common acute subacute bronchiolitis and epithelial epithelial attenuation. They are acute changes. So I said, right, well let's cough up, we'll do the PCR in the PCR we found bovine coronavirus, you know, reasonably low CT value, a reasonably high amount of .
virus, so I knew for a fact that that bronchiolitis there, here, subacute bronchiolitis, was caused by bovine coronavirus. All the others were negative, I should say, I haven't written that in here. All the others were negative, RSV, PI3, IBR, all the rest of it, all negative.
Bovine coronavirus. Interestingly, there was no histological evidence of. Mycoplasma bovis whatsoever in these lungs, but Mycoplasma bovis was found by PCR which just shows you that the Mycoplasmas was there but not doing anything, right?
So if it can do it, if, if coronavirus can do it there, it can do it on other farms and I do suspect that very often coronavirus is a is a sort of damager of the mucus. Mucoceli escalator, which you miss the initial er outbreak. Later on you find that you've got a chronic set of lungs with the damaged mucociliary escalator but the window for detection is been and gone, so I suspect that all these pneumotropic viruses, but particularly Coronavirus is underdiagnosed out there because the window we don't often have.
I would say histopathology is essential. I would say we often miss it because we're we've missed the window and I would say please take fixed tissue as well as the PCRs. In fact, use the fixed tissue if you have a dead one to determine whether it's appropriate to do a PCR.
And I now I think I'll pass over to Will, who's going to tell us more about some of the stuff that. I see on my table, but he sees it sooner. Yeah, thank you, Ben, .
And hanging with the guys, I hope you're not being, thrown away by, all the information come so far. Yeah, I just wanted to talk to you about thoracic ultrasound sonography, basically, tonight, in brief, not in too much detail, but it's a really good tool that I use in, on farm, in all aspects. So, I wanted to start basically with, if you're not doing it already, or if you've dabbled in it, that's where everyone started, that's where I started.
I started actually with adult cows, as well as sick calves, . So, just looking at lungs, getting the lungs, getting a scanner, the scanner used every day on some lungs and just start getting used to it, before I moved on to anything remotely thinking about routine. So yeah, this is, this is what I want to start with, like, what are we're doing basically.
So, this red line's supposed to represent where the scanner's moving, so I'm putting a point at the hip versus all the way down to. I aim for the thoracic inlet, to be honest, I think that works a bit better. Then we're starting on the right where the liver is, that's supposed to represent the liver, moving all the way down across the lungs to finally find that cranial lung lobe, just in front of the heart, you can see the two chambers potentially on the, on the right-hand side of that left image, which shows the heart, and that's the, that's really what you want to see.
That's the most sensitive area where I see the most problems, by far and away, so, trying to hit that, and sometimes it can be a bit tricky, especially in smaller calves. And then, forgive my, maybe, rushed PowerPoint diagrams here, but this is, hopefully, you can see representing the scanner probe in which orientation we're putting it in. So, there's two ways of going about it, and a lot of people do it this way.
So, across ribs, you can see the dotted line there representing the pleural surface, and obviously, the ribs labelled the ribs, and we can see in between the ribs, pockets. I really don't like that, to be honest, I like to see a full screen so I can compare long surface and see points moving across as the, as it's breathing. I put the dotted line just below the plural surface, so, hopefully you can see that really hyperchoic bright white line, and it, it, the, the biggest benefit is definitely showing, showing farmers, so, getting this on your phone, if your scanner can connect to your phone, and then showing them, describing that really bright white line at the top, in the, in the second square down and.
Then seeing potential incongennuity in that, but I, I, I found this top, top way, going about it much easier, . And, as I say, you just need to get stuck in and just start getting numbers, similar to how everyone's probably learned to scan rectally. And then, yeah, it, it, I, I don't think it has to be that scientific, to be honest, it can be as scientific as you want, and as, data-driven as you want, so, there is, there are official scoring systems out there, this, this is just showing on the right-hand side, we can just go a treat, yes, no.
Or keep yes, no, all the way to, 0 to 3 or 3 to 0 to 5, sorry, low scoring. I tend to sit in this middle part here, just because it needs to still be relatively simple for farmers to understand if it gets too complicated. I think the information sometimes can get a bit lost in translation, or farmers begin to not really understand, whereas, If it's a yes or no, then it's, it's pretty simple to understand, we, we need to think about what we're trying to achieve here, and what's the fundamental aim of lung scanning, and where, where are we going to find the most benefit, which we'll come on to later, but, Fundamentally, when we're deciding what to do on farm, it comes back to the basics, and, and this is the evidence-based veterinary medicine that we should be fundamentally going off, Is it, this, this line here, 1 centimetre lesion shows potentially a 100 gramme a day difference in pre-weaning calves, so.
I know there's a question in the Q&A, hopefully I'll answer it here, that, oh, when we're lungs scanning and looking for problems in a in a path, whether it's routine scanning or if it's potentially got signs of pneumonia. If it's got 1 centimetre lesion, 1 centimetre lesion, that's when we're definitely looking to start jabbing stuff, because that's when we're gonna start affecting our productivity there. But whatever we're implementing on farm, as I say, this is the fundamentals here on this slide of what we're trying to achieve, and it's always worth coming back to that.
So, I just wanted to say, how, how do I use this on farm? I'll start with calves because this is probably the biggest opportunity. This is when we're going to be most sensitive with our testing under that 12 weeks of age, because we can see a much larger proportion of the lung field, whereas, if we use it a bit later in life, then we'd potentially be missing abscesses that are hidden within the lungs that our ultrasound, is not going to be able to penetrate through that air surface that's in between our body wall and the lesion.
So, I mean, I don't need to read a list off, off the slide, . You can see, these are, these are ways I've used it, it's, it's more ideas for how you can use it. Sometimes, like, post-movement TB testing, the TB test, it's, we're handling them anyway, it's ease rather than when it would be most ideal.
Weaning checks and six-week checks are what the vast majority are, to be honest. The only thing I'd say in that firefighting scenario, it is really useful to see what we need to treat here and now and what we don't, . What I'd come to is.
I'm maybe going a little bit away from the evidence-based ve of medicine, but in my personal experience, what we see, what I see in active pneumonia, so, particularly in this outbreak firefighting scenarios where you see it most, is what, when we talk about, comet tails or beelines coming down, you can see on the image on the right-hand side here, if you've got lots of little bee-lines of the pleural surface, so, you can't actually see any lesion microscopic, that's when I think there's probably an active pneumonia going on there, so. Even though we don't see a 1 centimetre lesion, I'd probably still treat if we've got a lot of lung surface with those B-lines, I think we could be pre-abscess formation there, but I, I, I've not got any data to back that up, unfortunately, but that'd be my only caveat to, to what I put on the slide earlier, . Secondly, as I said, adult cows, I rarely, rarely use my, stethoscope now for pneumonia or heavy breathing cows, I suspect, suspect pneumonia.
You can see on that image there, chronic whole load consolidation, so. Particularly when we're looking at, sick cows, well, we, instead of listening and saying, is it bad, is it not bad, or I can't hear much air, so I think it's really bad, we can grade it, we can have a look how bad it is and say, is this cow, gonna be future usable, or is, are we going to get it over this bout of a pneumonia and then it's the end of its productive life, or is it actually, we've caught it early, we can treat it, and it doesn't look too bad. As I say, we can put numbers on that as well, .
Finally, heifers, dairy heifers, I'm really talking about here actually, to be honest, . I had a look at the last year's NMR 500 reports for the average productive life of cows, and it's not good news, to be honest, for the dairy industry as a whole, with the dairy heifer age, not sorry, the dairy heifer, the, the dairy cow age coming down significantly since 2015, is that, 2014. So, what we're looking at is screening these heifers, whether it's a young calf or whether it's people in.
A bit older, obviously, potentially with the caveat, their sensitivity being a bit lower. What, what I really want to do is, these are the raw numbers, sorry, behind that data I've just shown is, is hammer down on these first lactation cows. Why 29% of them leaving the herd?
Is it because they've got chronic lesions? Is it because we have epigenetic, effects from pneumonia as a calf, and we don't have chronic lung lesions aren't of production limiting, but we've got the epigenetic factors where they fall out of the herd elsewhere or, They've not got the lung capacity there to cope with extra, Extra demand on the, on the cysts, on the body as a whole, so, I think if we can, potentially hit some of these replacement heifers early, reduce the epigenetic effects, stop any chronic lung lesions, then I think we can get that 29% down, much further. And then, yeah, increased longevity for multiple other reasons within the industry where we're trying to push that.
Yeah, and then, just finally, what, what's the point of doing something if it's not gonna look good in the books ultimately, because the taxman is gonna come for us, so. Dairy beef calves, As we said, 110 grammes a day, so, we're looking at 12 pounds, 12 pounds of calf gain just in the pre-weaning period there, . So, that, that's definitely going to pay the scan off in itself.
What we just talked about, dairy heft replacements, this is good evidence to say that 500 litre increase in the first lactation, if we stop those, chronic lung lesions, making it all the way into the dairy herd. So, it's not just about longevity. We've got a here and now, return once she gets into the herd to pay herself off for that rearing cost.
And then, finally, the suckle bred calves, a bit trickier to handle, a bit trickier to do things with, granted, but there's still a lot of, opportunity here. I've, I've put, I'll put it in two different ways, opportunity cost in terms of, can we get extra weight or literally taking money off the books in terms of reduced days on farm or extra slaughter weight. So yeah, thank you.
Thanks, Will. That's great. I'm just gonna put my video on.
There we go. And hopefully Ben's still here, although we know he has a child or children to pick up at 9. So, thanks for the questions so far.
I think if anyone else has, questions, feel free to put them in the Q&A, and we'll try and answer them before 9. So I'll just do the ones that we can see on the screen, and then we have a few others that got sent in as well. So firstly, I think we'll have addressed this sort of, but, for thoracic ultrasound, what level of lesions should be treated, and how do you interpret comet tails?
You did sort of cover that, but do you want to kind of summarise what you said previously? Yeah, so, a comic tail is basically, what we should see is that hyperchoic line at the top, and then just echoes of that below. Whereas a comic tail, we've got something blocking that sound getting through, and we see that white buzz, almost is probably the best way to describe it, that, that mixed echogenicity going down, in, when it comes out like this, if you can see on the screen.
So, that, that's what a comic tail is, A B line is, is a, a vertical line on the screen. I'd probably describe them as a bit smaller than the full comic tail because that lesion's inhibiting they go down, so. That's what they are, basically, so, if you see a full comic tale, you should be able to see the lesion there anyway, .
And then, what, what level should you treat 1 centimetre lesion, as I say, and then once you get more experienced, have the back of your mind that. I've seen a lot of active pneumonia cases with those, beelines, and it, It, it's not necessarily that scientific, but if you see the odd one or two, not to worry at all, that's normal, especially in adult cows, you definitely see them as, as normal, but when you've got a screen full of them, like, 1520, then, you know, that's probably the active pneumonia stage, I'd say. Yeah, I mean, I'd agree from my experience, I think.
When they, when the virus first comes in, you tend to get sort of multiple comet tails potentially coming to beelines, and then, and then you start to see the lesions. They actually did some study work where they infected animals with Mannheimer hemolytica and then scanned them sequentially, and they could see lesions from about 4 hours after they infected them. So, it's amazing how quickly these, these lesions can occur.
And, yeah, I think it's important to, to treat, particularly, like you said, over 1 centimetre. . And I was gonna, I was gonna go into this actually, because this is another question we've had, which is not on the list, but we got sent earlier.
How do you, sort of, well, how do you develop a kind of service around this, the thoracic ultrasound, because this is something we get asked a lot as well. And it's, do you have a sort of that service that you offer, or, or do you, do you kind of do it as and when, you know, how, how do you kind of sell it into the farmers? Yeah, so we've, we do a lot of routine scanning.
It's mainly on those, dairy beef calves or dairy replacement heifer calves, pre-weaning, but that's, as you saw on my last slide there, that's where the most, monetary gain is in it, so that's probably why I'd hit those, those time frames. And then, on farm, often, what, how it starts out is we've got a pneumonia outbreak, or, or you go and scan some sick calves, show, show people visually, how bad the pneumonia is or how not bad the pneum pneumonia is, and, that's kind of the foot in the doorway to, to realising, and it, it's so different to what farmers are seeing, it's not just, you need to trust your vet, and especially if you're a new vet on the farm, proving to people, seeing it in real life is, is such a massive tool, . And then it goes from there, really, doing it, going into routine, cos ultimately it's quite a big commitment for a farmer to pay for that routinely, .
But yeah, sit down, do an ROI on it as well, because it is there, definitely, picking it up so early. Once you, once you're doing it regularly in the pre-weaning phase, most of my farmers will say, we bet, we'd never ever treat anything, calves never go backwards, and they don't, it's not just in the pre-weaning phase, it's after that as well. Yeah, we've got a system.
I think the, the vets, we know that are using it, successfully are doing it as a regular, like, you know, every 2 weeks or so, scanning the animals of a certain age and then, and then making treatment decisions. That does seem to be the, the way of using it. I'm gonna go to Ben, I think, and, just go into a bit more about testing.
I know obviously. They showed a lot of postmortem images, which was good, and postmortem is nice to have. If they can't do postmortem, do you have a sort of favourite test that you prefer people to send in?
We, we do get a lot of questions around, bowel, versus nasal swabs. So, do you have an opinion on the kind of testing that you think is probably the most useful in the absence of postmortem? Yeah, I think, I think I prefer nasal swabs.
To serology, but, probably if you can do a bowel that's probably better because there's like I showed you, those 3 pneumotropic viruses, they'll be long, further down the lungs in the, in the airways, further down for longer than they are in the nasopharynx, so they'll be in the nasopharynx for a bit, but they probably natural home is further down the lungs, so, if you can do a bowel and be asked to do it, then that's probably better cos you're probably gonna find it. You know, for longer down there, but it's just how much of a palaver is it, personally, I, I don't really, I just ignore the virus, the bacteria, I ignore Mannheimer hemolytica, Histophilus somni, Pasorella maltosida, and probably Mycoplasma bovis in a, in an upper airway, I just ignore them. I, I, I don't really know why they're there, so really you only need a, a, a, a, a three-way, .
Viral PCR for you know, young calves and possibly a four-way for older ones, you know, but I think I'd personally, I'd rather have a PCR than a than serology because. Yeah, if you can get it in the in the in the outbreak, it's it's better. It's true because we we we we do a lot of this subsidised testing and I see the results and we get Mannheimer hemolytica, H.
Somni and PMtoster in in everything. It comes back in all of them. Yeah.
Histo that tells you that you've got primary bacterial bronchial pneumonia and you have Mannheime hemolytica, well then the ball's in the back of the net, but if you haven't got that, I just don't think, I, I don't understand it. So I think there's a couple of questions for me, but I'll also see if the other speakers have got anything to say on those around ventilation. So one is saying, do you have any resources for ventilation calculations in non-standard buildings?
The AHDB did have a ventilation calculator where you could put. Like the size of the building, you know, the space, the inlets and the outlets, and it would help to calculate that. So, that was the one I've used previously.
And I know also the University of Nottingham have some quite good resources around, buildings, and calculations. So, those are probably the first two places I would look. I don't know if, is there anything you use Will or, Ben for that?
Not necessarily putting numbers on it, I think that if it's a non-standard building, then the smoke test can actually tell you a lot, how it acts, cos if you've got adult cows in, even just a slanted slope, it still can go out one side. Hm. Yeah.
It, it's not very scientific a number, but it's another way of visualising it to farmers as well, rather than just believing you. Yeah, smoke test is very useful. If you go, you've always got humidity in pig buildings, you never have humidity in cattle buildings.
I think humidity is quite important and overlooked. And that, you know, you can get, devices that will measure it. I think it's called a hydrometer.
And, like, people just don't have these, have these devices in their calf sheds, but there are some very sophisticated devices now, which can measure wind speed, humidity, etc. I can be a bit lazy when I go and look at buildings because I tend to just look at them rather than do calculations because I, I feel like I've got a good sense for it now. But yeah, I think the smoke test is, is certainly one of the, the, the most useful things you can do.
. And he said, what about the ventilation showing airflow? It looks OK to me. Maybe you were referring to the image I put with the calf and then the outlets and the inlets.
What I was trying to say with that image is that when you have very young calves like pre-weaning, they don't produce enough heat to facilitate the stack effect. So, in older animals, they produce heat and the air goes up and then it's taken out the top and there comes in the sides, which is great. But Three-weaning calves don't produce enough heat to, to facilitate that.
So, we don't get the stack effect, and then, subsequently, we may not have sufficient ventilation for them. But then there's the converse where they also become the most cold. So, they need to have enough, to, to protect them from, from, from prevailing winds, but also to take away the, the stale air.
So that's why, calf buildings, particularly for very young calves are so, so tricky. I think I'm just, yeah, go. I was just gonna say that I think it's definitely possible to have significant damage to the mucociliary escalator, which means you're going to get pneumonia when you're older, but to have absolutely no clinical signs whatsoever that anybody noticed, either because of a pneumotropic virus, say a mild one like PI3 or because you've got, you, ammonia or you've got, you know, dust or you've got something like that that you're not even gonna see and.
The younger you go, the more benefit you're going to get later, and I don't think, as you said earlier on, Kat, you have to knock down all your buildings and start again. There are so many things you can do with existing buildings to change where the airflow's going and it. Isn't that difficult.
Yeah, I, I fully agree. Somebody's put, does it have a vaccine? I don't know what that was about, but there are, what I will say is there are vaccines for most things, except for Pasorella maltoscia, but there's pretty much a vaccine for everything, but, you know, it may not be the only answer.
I think, it's useful to have the vaccines that we do have. We have a lot of good vaccines that are available, but it is part of that ho holistic, approach for sure. So the final 10, we have a couple more.
This is it for you, Will. Would you scan both sides by ultrasound or is one side sufficient? I think You, you need to scan two sides of the standard, really.
My only caveat to that would be, what are we aiming to do? So if we've decided we're going to treat everything with Oxitetracycline, if it has a lesion, we scan one side, it has a lesion. We're on a, a, a per minute, per hour, like time payment way of going about it, save time, jab it, be done with it.
That's the only time I'd skip both sides, but if we don't find anything on one side, yeah, we have to do the other. And it's particularly if you're picking it up early, it's often unilateral rather than both sides, it's normally when it progresses, it goes into both sides, so, and as I say, it's often on that, that perennial lung lobe, so hit that first, and then we know if there's, if there's something going on. Coming back to that, on one side, I might see loads of bee lines, .
Suspect something's going on the other side, a big, a big abscess or something, it's just not come fully onto that, that other side of the lung, yeah, so, yeah, both sides are standard, really. Yeah, the only time I've maybe just been lazy and done one is if you're putting through a large number of animals, say like calf rearing, and all you're, the only thing they want to know is do they have a lesion? And once you've seen the lesion, you know they have a lesion like you said, then you would treat it.
It's a treatment or not treatment decision. So if they are being split on arrival into treat and not treat, and you see a lesion on one side, you're like, OK, I've treated that, so I don't need to look on the other side. But I'd say for like, like you, I agree that in most cases you would, you would certainly scan both sides.
Yeah, we, we have a per calf fee, but some calf rearers been doing big numbers, just think that they can do it better on time than, than per calf. So that's why they're just trying to push stuff through as quick as you can, as quick as you can put an ultrasound scanner on that waiting for you. Cool.
Well, we're pretty much at the end. Someone's also left a comment about, New Zealand and calf sheds, where they are designed differently, with one side open and small groups. Yeah, it's interesting and different, whether it's, partly a shed design or potentially a climate thing.
And where they have less respiratory disease, but there do seem to be a lot more of these purpose-built sheds coming through now, from particularly like calf rearing companies where they design the sheds and the sheds are put in and the calves are put in them. So I think there's a lot more focus on calf housing, which is good. So, I'm gonna hand back now to Sarah, who will wrap up the webinar for us.
Brilliant, thanks Kat. So yeah, a massive thank you to Kat, Ben and Will, for such a really interesting and informative session, and thank you to you all for joining us this evening. We've covered a lot of stuff and I hope you found it really interesting and useful, and I think from the, the number of questions and the level of questions that have been asked as well that yeah, it's been very engaging and it's great to have a discussion going on.
So just a bit of housekeeping to finish off this evening. Your CPD certificate will be emailed across to you within the next 24 hours, so don't worry if you don't receive that this. Evening, it will be coming across to you.
So yeah, finally I just want to say a massive thank you also to MSD who have sponsored tonight's session, and thank you to everyone for joining us. I hope you've found it really useful and have taken away some practical ideas. Please do share the session as well, so it will be available on demand, so share that with your colleagues and clients and yeah, please come back for more.
Thank you again for joining us and have a great rest of the evening.
