Sudden death syndrome; morte

subita; acute death

syndrome; dead in good
condition; heart attack; flip-
over
disease

Dr.Kedar. Karki
M.V.St Preventive Veterinary Medicine
Post-Mortem /Parasitology Unit
Central Veterinary Laboratory Tripureshwor
Introduction
Flip-over disease has been reported in
most areas of the world that intensively
raise broilers. Young, healthy, fast-
growing broiler chickens die suddenly with
a short, terminal, wing-beating
convulsion. Many affected broilers just
“flip-over” and die on their backs; 60-80%
are males. The condition is uncommon or
unrecognized when low-density feed is
used and the ratio of feed intake to
weight gain is >2.5 at 6 wk, or when
broilers take 8 wk to reach 2 kg.
Etiology and Epidemiology:

The cause is unknown but probably is a

metabolic disease related to carbohydrate
metabolism, cell membrane integrity, and
intracellular electrolyte balance. Death
likely results from ventricular fibrillation.
The modern broiler tends to overeat and
continues to grow rapidly while
maintaining a low feed-to-gain ratio. Flip-
over appears to be related to high
carbohydrate intake. It is not known
whether a genetic predisposition exists.
Etiology and Epidemiology:

Incidence has been increasing since the

condition was first recognized, likely at
least in part because of continuing
improved growth rate of ~5% in broilers.
Mortality may now average 2% in North
America; in some all-male flocks,
mortality is >4%. In flocks with good
management and disease control, it may
be the most important cause of death,
responsible for up to 70% of the flock
mortality.
Table: 1. Epidemiology of Affected flock in Kathmandu Valley with sudden Death Syndrome in Month of August 2008:

Duration no.of farm Population Morbidity Mortality No. of

at risk (%) (%) samples
examined
First week 22 16620 4250 369 44
(25.57%) (2.22%)
Second 14 15450 1235 232 28
week (7.99%) (1.50%)
Third 20 10260 848 157 40
week (8.26%) (1.53%)
Fourth 30 15700 2380 149 60
week (15.16%) (0.94%)
Fifth week 13 16450 4750 1650 26
(30%) (0.3%)
Sixth week 12 18850 4550 876 24
(25%) (0.19%)
Total 111 93330 18013 3436 222
(17.01%) (1.56%)
Clinical Findings:

Broilers show no premonitory signs.

They appear healthy and may be
feeding, sparring, walking, or
resting, but suddenly extend their
necks, gasp or squawk, and die
rapidly with a short period of wing
beating and leg movement, during
which they frequently flip onto their
backs. They also may be found dead
on their sides or breasts.
Clinical Findings:

Flip-over may occur as early as day 3

and may continue until 10-12 wk in
roaster flocks. The time of peak
mortality varies but usually is
between days 12 and 28, although it
can be as early as day 9. It may
occur after day 28, particularly if
growth is restricted in young
broilers. Mortality of 0.25%-0.5% per
day can occur for 1-3 days.
Post-mortem Lesions:

. Postmortem examination of birds

that died of sudden death syndrome
revealed showed no outstanding
gross pathology. All birds were well
fleshed, with muscle edema and
general pulmonary congestion and
edema. Feed was present along the
entire digestive tract and the gall
bladders of birds were distended
usually filled with bile.
Post-mortem Lesions:

The liver was pale to yellow enlarged

molted appearance and kidneys were
usually slightly congested and have
patchy sub capsular hemorrhage.
Usually, the proventriculus contains
a milky fluid with hemorrhagic
patches and intact food particles are
present in gizzard.
Post-mortem Lesions:

Crop in some bird was full with

liquid intact food particles.
Intestine was ballooning in
appearance with thick mucous
filled ingesta was present
.Congestive spleenomegally was
observed in almost all birds.
Bursa was almost normal to
atrophid.
Post-mortem Lesions:

The ventricles of the heart are

contracted (but not
hypertrophied), and the atria are
dilated and blood filled. The
lungs are congested and
frequently edematous;
Laboratory Finding of Mycobiota
and Microbiota of Postmortem
Tissue samples:
A total 222 tissue samples of lung,
liver, spleen, proventriculus and
gizzard, were collected during
postmortem examination and were
subjected for both bacterial and
mycological culture. Results of
microbiological examination done are
given in Table 2.
Table: 2.

No. of Bacterial Fungi isolated Positive negative

sample isolated no no
s
111 E.coli, 70 41
Streptococcus,
Staphylococcus
111 Aspergillus, 80 31
Penicillium,
Candida
222 150 72
Diagnosis:

Good broilers found dead on their backs may be

assumed to have died of flip-over because that
position is rare in death from other causes except
cardiac tamponade, asphyxia, and ascites
syndrome ( Ascites Syndrome). Good birds on
their sides or breasts, scattered in a random
fashion in the pen also usually are considered to
be dead from flip-over. Diagnosis is supported by
the full GI tract (particularly the full intestine);
the large, pale liver; the large, normal bursa; the
contracted ventricles and dilated, blood-filled
atria; the lung congestion and edema; and the
lack of pathological lesions.
DDX
Sudden death in turkeys can be
caused by choke, aortic rupture (
Dissecting Aneurysm), focal
(obstructive) granulomatous
pneumonia, or by hypertrophic
cardiomyopathy (
Round Heart Disease Of Turkeys)
with lung congestion and edema,
splenomegaly, and perirenal
hemorrhage ( Perirenal
Hemorrhage Syndrome Of Turkeys: Introducti
).
Prevention and Control:

Activity caused by bright light (particularly

sunlight), noise, and other disturbances
may increase the incidence. After the first
3-4 days, low-intensity or low-intensity
intermittent lighting should be used, and
broilers should be disturbed as little as
possible. Long, dark periods (18 hr dark
for 3-4 wk) after the first 3-4 days reduce
flip-over. Slowing growth rate by feeding a
less dense or lower protein ration or by
reducing feed intake by 15-20% may
prevent the condition.
Treatment and Preventive
measure given to the rest of
birds in flock:
All birds remaining in flocks were subjected
to restricted feed up to 8-10%, and feed to
twice daily only. Supplementation with
glucose containing electrolyte, liquid toxin
binders, immunomodulator, and simple
broad-spectrum antibiotics were provided
in water. Vitamin B complex
supplementation was totally withdrawn. All
birds remaining in all affected farms
responded well to the above management
and there were marked improvement in the
overall condition of the flock.
Discussion.
Sudden Death Syndrome (SDS) is an
acute heart failure disease that affects
mainly male fast growing chickens that
seem to be in good condition. Although a
common condition in fast growing birds, the
pathogenesis remains unclear (Ononiwu
et. al. 1979). Cardiac arrhythmias are
involved in the pathogenesis of SDS with
ventricular arrhythmias (VA) being the most
common observation representing
premature ventricular contractions and
fibrillation (Olkowski and Classen, 1997;
1998).
Discussion.

It has been reported that broilers fed

with high vitamin D3 diet above the
recommended levels in an attempt to
prevent commonly occurring leg
problems were 2.5 fold more likely to
succumb to acute heart failure and
die of SDS (Nain et. Al. 2007).
Discussion.

SDS was also experimentally induced

by feeding diets containing the
mycotoxin moniliformin that resulted
to cardiac injury with subsequent
alterations in cardiac electrical
conductance (Reams et al, 1997)
suggesting the possible role of
chronic mycotoxicosis to the
causation of SDS.
Discussion.
Other implicated causes of SDS include
continuous artificial lighting (Ononiwu et al,
1979b), deviations in dietary calcium and
phosphorus (Scheideler et al, 1995), feeding
crumble-pellet diets (Proudfoot et al, 1982), dietary
fat content (Rotter et al, 1985) and feeding
frequency Bowes et al, 1988). The latter
recommendation of restricted feeding supports
well the previous observation that abdominal fat
deposition increases the risk of SDS such that
restrictions on calorie:protein ratio decreases the
incidence of SDS (Mollison et al, 1984).
Discussion.

SDS seems to worse when Vitamin B

complex are in excess.
Among many drugs used in poultry
anticoccidial drugs are in question?
There are evidence of higher SDS
mortality when these drugs are being
used
Recomendetion
The present investigation indicates that broilers in
good body weight condition when not harvested
timely and remain in poultry shade for prolonged
periods suffer stressful events and even sudden
death. Also, it is possible that the increased
humidity and hot season favors the growth of mold
and fungus in stored feeds increasing the risk of
birds to mycotoxicosis. This incidence of sudden
death syndrome in birds in Kathmandu Valley was
reported for the first time and needs to be
investigated further.
Review of literature
Sudden death syndrome (SDS) is the name given
to
death in healthy, fast-growing, commercial broilers
that
die suddenly. It has been recognized as a specific
condition
since the 1950s when broiler chickens began to be
grown commercially in large numbers. SDS occurs in
all
countries where broilers are grown rapidly under
intensive
conditions (Jackson et al., 1972; Volk et al.,1974;
Julian, 1996a). In healthy flocks it is the most
frequent cause of death with up to 4% mortality
Review of literature
Young, healthy, fast-growing boiler chickens die
suddenly while standing, walking, sparring or
feeding.
They die with a short terminal wing-beating
convulsion
and frequently are found on their back. SDS can
start as
early as day 3, and continues for 8–12 weeks with
the
highest losses between days 9–22. The faster-
growing
males make up approximately two-thirds of
affected
birds (Julian, 1986; Newberry et al., 1987).
Review of literature
There are no diagnostic lesions in
broilers that have
died from SDS, but the sudden death in
a previously healthy broiler (Bowes
and Julian, 1986, 1988) would
suggest that death is the result of
ventricular fibrillation (Julian and
Bowes, 1987; Greenlees et al., 1989;
Olkowski and Classen, 1997a;
Blanchard et al., 2002).
Review of literature

There is a specific association with

feed intake. SDS can be prevented
completely by restricting feed intake
to 75% of what would be eaten free-
choice (Bowes et al.,1988). There is
some evidence that carbohydrate
availability and type, rather than
protein or fat are part of the
pathogenesis (Julian and Bowes,
1984).
Review of literature
Much of the published literature on
SDS relates to feeding trials to try to
induce or prevent SDS (Rotter et al.,
1988; Olkowski and Classen, 1997b).
Except for the use of mash feed or
other methods that reduce feed
intake or growth rate there is little
evidence that feedstuffs or vitamins
have an effect on the incidence of
SDS in commercial broilers on the
farm.
Review of literature
The confirmation of SDS at necropsy is difficult
since
there are no lesions that are pathognomonic. The
condition was first reported as being caused by
lung oedema
(Hemsley, 1965) and the lungs are oedematous,
except in
freshly dead birds (Julian, 1996a). The bursa is large
and
normal, which again suggests that the bird was
healthy
immediately prior to death. Heart ventricles are
contracted,and atria are dilated and filled with
blood, a
Review of literature

There are no specific gross or

histopathological lesions that would
distinguish broilers that have died
from SDS from a healthy broiler that
had been euthanased. Changes that
have been described(Ononuwu et al.,
1979a; Riddell and Orr, 1980;
Greenleeset al., 1989; Riddell, 1993;
Grashorn, 1994; Crespo and
Shivaprasad, 2003) are artifact,
Review of literature
post-mortem change or incidental findings
(congestion, haemorrhage, lymphoid and
myeloid foci) that might be present in any
normal healthy broiler that has been
euthanased or that dies suddenly from
hypoxia or hyperthermia (Julian 1996b). It
is unlikely that broilers that are ‘found
dead on arrival’ at the processing plant
have died from SDS. SDS is probably a
metabolic disease, in which an imbalance
of metabolites or electrolytes results in
ventricular fibrillation.
Review of literature
Lowering energy intake by changing feed
texture or density (mash), or management
methods such as feed restriction or long
dark periods (Classen and Riddell, 1989)
will reduce mortality from SDS. Increased
mortality is associated with crowding,
unusual activity or bright light (Ononuwu
et al., 1979b), particularly sunlight, so
low-intensity light is recommended and
the flock should be disturbed as little as
possible
Review of literature

Sudden death syndrome in broiler

breeders, reported from Australia, is
a different condition occurring in
hens at the commencement of
production. It is associatedwith low
dietary potassium and hypokalaemia
(Hopkinson, 1991).
Reference
Production and growth related disorders
and other metabolic diseases of poultry –
A review Richard J. Julian *Department of
Pathobiology, Ontario Veterinary College,
University of Guelph, Guelph, Ont.,
Canada N1G 2W1
Accepted 28 April 2004The
Veterinary Journal
www.elsevier.com/locate/tvjl
The Veterinary Journal 169 (2005) 350–369