Broiler

disease
reference
guide

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 Broiler disease
reference guide

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 Photo credits:

shutterstock.com
Kharkhan Oleg: cover
Tsekhmister: page VIII.

Copyright © 2019 Elanco

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Warning:
Veterinary science is constantly evolving, as are pharmacology and the other
sciences. Inevitably, it is therefore the responsibility of the veterinary surgeon
to determine and verify the dosage, the method of administration, the duration
of treatment and any possible contraindications to the treatments given to each
individual patient, based on his or her professional experience. Neither the
publisher nor the author can be held liable for any damage or harm caused to
people, animals or properties resulting from the correct or incorrect application
of the information contained in this book.

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 Broiler
disease
reference
guide

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 Broiler disease reference guide

About the Health Tracking

System (HTSi®)
HTSi is a necropsy-based surveillance tool that goes beyond
simply lesion scoring to offer robust and holistic analysis of
broiler health.
HTSi is a broiler health platform for data capture, processing
and analysis designed to support customers in good decision
making in intestinal health and beyond.
HTSi adds value to our customers by helping to optimise the
birds’ potential through greater understanding and therefore
management of Intestinal Integrity and broiler health generally.

IV

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 Index
Intestinal Integrity   2

Alphitobius diaperinus - Darkling beetle score (BTL) ���  2

Cellular sloughing (CS) ����������������������������������������������������������������������������������  3
Excessive bile (BL) �����������������������������������������������������������������������������������������������  4
Excessive intestinal fluid (WC) ������������������������������������������������������������  6
Excessive intestinal mucus (MC) ������������������������������������������������������   7
Feed passage (FP) �����������������������������������������������������������������������������������������������  9
Gizzard erosions (GIZ) ���������������������������������������������������������������������������������  10
Gross examination for coccidial infections ��������������������  12
Gross Eimeria acervulina (gAC)  ������������������������������������������������������  14
Gross Eimeria maxima (gMX)  �����������������������������������������������������������  16
Microscopic Eimeria maxima (mMX) ��������������������������������������  20
Gross Eimeria necatrix (gNX) ��������������������������������������������������������������  21
Gross Eimeria tenella (gTN) �����������������������������������������������������������������  23
Hyperemia (HY) ��������������������������������������������������������������������������������������������������   26
Intestinal hemorrhage (IH) �����������������������������������������������������������������   28
Intestinal Integrity-broilers (I2) �������������������������������������������������������  31
Intestinal microbiota (IM) ����������������������������������������������������������������������  33

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 Broiler disease reference guide

Intestinal tone (IT) ������������������������������������������������������������������������������������������   36

Litter eater (LE) ����������������������������������������������������������������������������������������������������  37
Mouth lesions (ML) ����������������������������������������������������������������������������������������   38
Necrotic enteritis (NE) ���������������������������������������������������������������������������������������   40
Proventriculitis (PRV) ����������������������������������������������������������������������������������   42
Roundworms (RW) �����������������������������������������������������������������������������������������  44
Tapeworms (TW) ������������������������������������������������������������������������������������������������   45
Thick intestines (TK) ������������������������������������������������������������������������������������  46
Thin intestines (TH) ���������������������������������������������������������������������������������������  48

Respiratory Integrity   50

Airsacculitis (ARS) ��������������������������������������������������������������������������������������������  50
Ammonia burns in cornea (AB) �����������������������������������������������������   53
Aspergillosis (AP) ���������������������������������������������������������������������������������������������   55
Tracheitis (TRA) ����������������������������������������������������������������������������������������������������  57

Immunological  
60

Bursa measurement (BSM)  ���������������������������������������������������������������  60

Bursal atrophy (BUR) ����������������������������������������������������������������������������������   62
Bursal damage (BDM) ��������������������������������������������������������������������������������   63
Thymus (THY) ��������������������������������������������������������������������������������������������������������  66

VI

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 Index 

Skeletal  
68

Femoral head necrosis (FHN) ����������������������������������������������������������  68

Osteomyelitis (OM) ����������������������������������������������������������������������������������������  69
Rickets (RKT) �����������������������������������������������������������������������������������������������������������   71
Swollen head (SH) �������������������������������������������������������������������������������������������  72
Swollen hock (HK) ��������������������������������������������������������������������������������������������  73
Tenosynovitis (TN) �������������������������������������������������������������������������������������������  75
Tibial dyschondroplasia (TDS)  �������������������������������������������������������   77

Other conditions  
80

Ascites (AC) ���������������������������������������������������������������������������������������������������������������  80
Burned feet (BF) ������������������������������������������������������������������������������������������������   82
Cardiovascular (CDV) �����������������������������������������������������������������������������������  84
Inflammatory process (IP) �������������������������������������������������������������������  86
Retained yolk (RY) �������������������������������������������������������������������������������������������  87
Scratches (SC) �������������������������������������������������������������������������������������������������������  89

References   90

VII

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 Broiler disease
reference guide

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 Intestinal Integrity

Alphitobius diaperinus 1, 2
- Darkling beetle
score (BTL) 
HTSi® definition
Evaluation of the gizzard and/or crop for the evidence of beetle
parts or beetles (larvae or adults).
■ Score 0. No beetles or beetle parts.
■ Score 1. Beetles or beetle parts observed.

Score 1. Presence of beetles in the crop�

Clinical significance
The observation of beetle parts or beetles (adults or larvae) show
birds are eating beetles, which are not as nutritious as feed.
Data supports that chicks up to 7 days old that eat only beetles

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 Cellular sloughing (CS)

do not gain as much weight compared to chicks eating only

feed. 1 Chicks never recover the reduced early growth compared
to the chicks consuming only feed. Also, excessive amounts of
beetles or bettle parts could cause blockages. These beetles
have also been shown to be a reservoir for Salmonella species, 2
making this a food safety and biosecurity risk as well.

Control strategies
An effective beetle management program will reduce beetle
populations in poultry houses, thus reducing birds consuming
beetles instead of feed.

Cellular sloughing (CS) 3

HTSi® definition
Presence of excessive cellular debris in the proximal intestine.
It may be mixed with excessive mucus. Typically a white pasty
consistency in the proximal intestine and it may be mixed with
orange digested mucus more distally.
■ Score 0. Absence of the condition.
■ Score 1. Presence of excessive cellular debris in the proxi-
mal intestine, possibly mixed with excessive mucus.

Score 1. Excessive cellular debris in the proximal intestine�

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 Intestinal Integrity

Clinical significance
Infectious organisms such as coccidia, bacteria and/or viruses
can accelerate the normal turnover of intestinal-lining cells.
Excessive cell death can lead to decreased absorptive abil-
ity and poor performance. Secondary disturbance of normal
intestinal bacterial flora can also impair performance.

Control strategies
Ingredient quality control and prevention of intestinal disease are
a key part of controlling excessive cell necrosis. Attention to anti-
coccidial programs and ingredient quality control greatly reduces
the risk. Acidified water treatments can reduce the amount of
mucus and debris in the intestine; however, addressing the
underlying cause is the most effective manner of control.

Excessive bile (BL) 4

HTSi® definition
Excessive bile is marked by the presence of bile or excessive
bile staining in the intestines due to extended period off feed
or hepatic disease.
■ Score 0. Absence of the condition.
■ Score 1. Presence of bile or excessive bile staining of the
gizzard and intestines.

Score 1. Presence of bile or excessive bile staining of the intestines�

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 Excessive bile (BL)

Clinical significance
The presence of bile in the digestive tract, particularly in the
gizzard, is an indication of how long the bird has been off
feed. With extended feed withdrawals, birds begin to release
bile into an empty intestinal tract. Normal intestinal contrac-
tions cause the bile to move up to the gizzard, where the bile
stains the contents of the gizzard green. This occurs roughly
13 hours after removal of the feed. Normal movement of feed
through the digestive tract of birds (not feed restricted) pre-
vents this bile staining of feed ingredients in the gizzard. When
birds are off feed for as much as 13 hours during their growing
period, they lose efficiency in weight gain and feed conversion.
Increased mucus secretion in the intestinal tract is a natural
protective mechanism used by the birds when the digestive
tract is empty, but this can lead to changes in bacterial pop-
ulations favoring the growth of mucolytic bacteria, such as
Clostridium perfringens. Excessive bile in the digestive tract
is merely a sign that the bird evaluated had experienced an
extended period of time off feed. Reasons for the bird being
off feed may be as simple as a feed outage, inability of the
bird to access the feeder, or some sort of illness that resulted
in the bird’s inappetence. It may also be an artificial condition
created by too much time between the capture of the birds
and necropsy evaluation.

Control strategies
Evaluate the possibility of feed outages based on history and
scheduled feed deliveries. There may be a variety of mechan-
ical problems with automated feeding systems, including
bridging of feed in the bulk bins, equipment failures, feeder
height or restrictive feeding programs. The birds may have
ambulatory problems, which make them difficult or impossi-
ble to eat the feed that was available. In those situations, it is
important to address the inciting cause.

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 Intestinal Integrity

Excessive intestinal
fluid (WC) 4
HTSi® definition
The presence of excessive fluid in the intestinal tract upon
opening, or noticeably increased content in droppings. It may
be evaluated by other diagnostics.
■ Score 0. Absence of the condition.
■ Score 1. Presence of excessive fluid in the intestinal tract,
or noticeably increased content in droppings.

Score 1. Excessive fluid in the intestinal tract�

Clinical significance
An excessive watery content in the intestinal tract is commonly
associated with electrolyte or mineral imbalances in the diet,
particularly salt content. Some viral diseases may contribute to
damage in the intestinal tract resulting in a net fluid loss into the
lumen. Increased flushing can result in decreased feed transit
time in the intestinal tract, and therefore may impact the bird’s
ability to absorb nutrients. Additionally, excessive flushing may
cause a decrease in the cleanliness of birds being processed,
which may result in increased carcass contamination.

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 Excessive intestinal mucus (MC)

Control strategies
Quality control standards in regards to feed ingredients must
be maintained to ensure that diets are being formulated with
the correct mineral levels.

Excessive intestinal
mucus (MC) 4
HTSi® definition
The presence of excessive mucus in the intestine.
■ Score 0. Absence of the condition.
■ Score 1. Presence of excessive mucus in the intestine.

Score 1. Pale mucus seen in the duodenum�

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 Intestinal Integrity

Score 1. Brick red / orange mucus found in mid intestines�

Clinical significance
Although mucus production is a normal digestive function,
certain disease agents (coccidia, bacteria, viruses) and feed
toxins can stimulate excessive mucus production. Research
has shown that Clostridium perfringens, the leading cause of
necrotic enteritis, can use mucus as a growth medium and
energy source, further exacerbating bacterial enteritis.

Control strategies
Ingredient quality control and prevention of intestinal disease
are a key part of controlling excessive cell necrosis. Attention
to anticoccidial programs and ingredient quality control greatly
reduces the risk. Acidified water treatments can reduce
the amount of mucus and debris in the intestine; however,
addressing the underlying cause is the most effective manner
of control.

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 Feed passage (FP)

Feed passage (FP) 4

HTSi® definition
The presence of undigested feed in the large intestine or
feces, comprising greater than 25 % content.
■ Score 0. No presence of undigested feed at the end of the
gastrointestinal (GI) tract.
■ Score 1. Presence of undigested feed in the large intestine
or feces, comprising greater than 25 % content.

Score 1. Presence of undigested feed in the large intestine�

Clinical significance
Feed passage is an indicator that digestion is sub-optimal or
transit time is too fast and adversely affects caloric conversion.

Control strategies
Specific causes for the feed passage must be identified and
can include toxins in the feed, various gastrointestinal path-
ogens and stress-induced hypermotility. The particle size as
a result of corn grind is also very important with regard to
feed passage. Remove or control the inciting cause, provide
high-quality feed presentation, acidify drinking water and
maintain good ventilation.

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 Intestinal Integrity

Gizzard erosions (GIZ) 4

HTSi® definition
Examination of the gizzard lining for evidence of erosions and
ulcerations.
■ Score 0. Normal smooth lining of the gizzard; no roughening
of the lining surface.
■ Score 1. Rough appearance of the lining but with no obvi-
ous ulcerations or hemorrhages.
■ Score 2. Erosion of the gizzard lining not extending into
the mucosal surface; enlargement in the distance of the
junction with the proventriculus may be seen; evidence of
hyperemia may be present in affected areas.
■ Score 3. Severe erosion of the lining extending into the
mucosal area; hemorrhages in both the lining and junction
with the proventriculus may be present.

Score 0. Normal
smooth lining of
the gizzard; no
roughening of the
lining surface�

10

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 Gizzard erosions (GIZ)

Score 1. Rough appearance of the lining with no ulcerations or

hemorrhages�

Score 2. Erosion of the gizzard lining not extending into the mucosal
surface�

Score 3. Severe erosion

of the lining extending
into the mucosal area�

11

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 Intestinal Integrity

Clinical significance
Even though the lining of the gizzard is very tough, certain
toxic compounds associated with feed can erode it. Biogenic
amines result from spoilage or improper processing of certain
proteins, especially meat meals and fish meals. Increased
amounts of copper sulfate can increase gizzard erosion. In
addition to the gizzard damage, these issues will also damage
the small intestine. Gizzard erosion is a good lagging indicator
for ingredient quality.

Control strategies
Ingredient quality is the most effective strategy in prevention
of gizzard erosion. Once lesions are present, very little can be
done to address the disease process.
Increased levels of Clostridium perfringens may exacerbate
gizzard erosions, therefore strategies to control C. perfringens
may have a positive effect.

Gross examination for

coccidial infections 5
Guide to diagnosis
Coccidia (Eimeria) are the most common enteric parasites
found in commercial poultry. Several species of cocci have
been identified. Species are generally host specific and can
infect birds of all ages. The economic impact of coccidial
infection on commercial poultry production ranges from insig-
nificant to catastrophic depending upon the species and the
severity of infection. The ability to accurately diagnose and
quantify the severity of coccidial challenge is critical to design-
ing management, medication and feeding programs to main-
tain flock health and production efficiency.

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 Gross examination for coccidial infections

An effective coccidial diagnosis begins with the removal of the

entire intestine, including the ceca, and freeing it from associ-
ated mesenteric tissue. The gross assessment should always
begin with a thorough examination of the serosal surface of
the unopened intestine under bright light. Look for pinpoint
lesions, white plaques, ballooning, thinning or thickening,
and changes in color. After the serosal surface is examined,
open the intestine down its length and observe the contents
looking for signs of lesions, blood, mucus, undigested feed
and excess fluid. Carefully clean the intestine of its contents
and continue the examination, paying particular attention to
intestinal tone, coagulation necrosis, caseous material, thick-
ness, color, cellular sloughing and the presence of lesions,
which may include petechiae, white plaques, and/or cecal
cores.
A confirmatory diagnosis is made by scrapping the infected
area of the intestine, placing the scraping on a slide, pref-
erably adding a drop of saline (water is acceptable) to the
sample, and covering with a coverslip. A microscopic exam-
ination of the slide (10x or 20x) will allow easy detection of
oocysts or other life stages. The size, shape, and appearance
of the oocyst will assist in species identification. Although
confirmation of a coccidial infection can be made using
microscopic visualization, the mere presence of the parasite
is not enough to make a diagnosis of clinical coccidiosis. The
detection of oocysts in the intestine of apparently normal
birds is not uncommon, as some degree of coccidial cycling
occurs in most every flock regardless of age and the use of
coccidial control or treatment methods. Clinical coccidiosis is
best diagnosed when gross lesions are observed, production
parameters are adversely affected, and oocysts of the sus-
pected species are present upon microscopic examination.
Severity of coccidiosis lesions is based on the scoring system
of Johnson and Reid. 5

13

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 Intestinal Integrity

Gross Eimeria
acervulina (gAC) 5, 6
HTSi® definition
E. acervulina invades the upper intestinal tract and is charac-
terized by white elongated lesions found on the inner intestinal
lining. Most infections are limited to the duodenal loop but
may extend to Meckel’s diverticulum.
■■ Score 0. No gross lesions.
■■ Score 1. Scattered, white plaque-like lesions containing
developing oocysts are usually confined to the duodenum,
but mucosal surface appears relatively normal. Lesions are
elongated with the longer axis transversely oriented on the
intestinal walls. There may be up to five lesions per square
centimeter. Lesions may be seen from either the serosal or
mucosal surfaces.
■■ Score 2. Lesions are much closer together and more numer-

ous, but not coalescent. Lesions may extend below the duo-
denum. The intestinal wall shows no thickening. Digestive
tract contents appear relatively normal.
■■ Score 3. Lesions are numerous enough to coalesce, lesion

size may be reduced, and give the intestine a coated appear-

ance. The intestinal wall may be thickened or thinned and
the contents are watery. Lesions and/or mucosal damage
may extend as far posterior as the Meckel’s diverticulum.
■■ Score 4. The mucosal wall is pale in color with lesions com-

pletely coalescent. Individual lesions are usually indistinguisha-

ble. Lesions may appear in the middle part of the intestine. The
intestine may be thickened or very thin. The entire intestine is
pale and is filled with a creamy or watery exudate.

14

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 Gross Eimeria acervulina (gAC)

Score 1. Lesions are usually confined to the duodenum, but

mucosal surface appears relatively normal�

Score 2. Lesions are much closer together and more numerous, but
not coalescent�

Score 3. Lesions
are numerous
enough to
coalesce and
give the intestine
a coated
appearance�

15

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 Intestinal Integrity

Score 4. The mucosal wall is pale in color with indistinguishable

lesions.

Clinical significance
Coccidiosis is one of the most prevalent enteric diseases of
poultry. E. acervulina can impact feed efficiency, weight gain
and pigmentation; however, mortality is rarely associated with
coccidia unless secondary bacterial infections are also present.

Control strategies
Intestinal health is protected by the use of anticoccidials in
the feed. Attention to management practices to control litter
moisture is also important. The bird’s immune system plays a
role in limiting the impact of the disease.

Gross Eimeria maxima

(gMX) 7, 8
HTSi® definition
E. maxima typically invades the middle section of the intes-
tine but will migrate throughout most of the intestine. Lesions
appear as small, discrete red pinpoint lesions (petechiae) on

16

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 Gross Eimeria maxima (gMX)

the outside of the intestine, and orange mucus is often pres-

ent in the lumen. Since numerous factors can cause intesti-
nal hemorrhaging and mucus accumulation, a microscopic
examination is necessary to confirm the presence of oocysts.
E. maxima oocysts can be easily identified because of their
large size, characteristic brownish color and rough outer sur-
face. E. maxima is thought to be the most immunogenic of
the chicken species.
■ Score 0. No gross lesions.
■ Score 1. Small red petechiae (pinpoint hemorrhages) may
appear on the serosal side of the intestine at any location.
There is no ballooning or thickening of the intestine.
■ Score 2. Serosal surface may be speckled with numerous
red petechiae. The intestine may contain orange mucus.
The intestinal wall may be thickened, but little or no bal-
looning is evident.
■ Score 3. Intestinal wall exhibits ballooning and may be thick-
ened. The mucosal surface is roughened. Intestinal con-
tents may contain significant amounts of orange or brown
mucus and perhaps some specks of blood.
■ Score 4. The intestinal wall may be severely ballooned in
one or more areas and the intestine contents may contain
large quantities of mucus, specks of blood and digested red
blood cells giving a reddish brown color and putrid odor.
The intestinal wall can be greatly thickened or very thinned.

Score 1. Small red petechiae�

17

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 Intestinal Integrity

Score 2. Speckled serosal surface� The intestine may contain some

orange mucus�

Score 3. Speckled serosal surface with intestinal wall exhibiting

significant ballooning�

Score 4. The intestinal contents contain specks of blood and digested

red blood cells giving a reddish brown color and putrid odor�

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 Gross Eimeria maxima (gMX)

Score 4. Intestinal wall is severely ballooned in one or more areas�

Clinical significance
E. maxima may impact feed efficiency, weight gain and pig-
mentation. Severe lesions may contribute to an increase in
mortality (although rare), and it may be a contributing factor in
bacterial diseases, such as necrotic enteritis. For the untrained
eye, E.  maxima can be one of the more difficult species of
coccidia to recognize grossly. The reason for this difficulty in
diagnosis is that lesions similar to those of E. maxima may be
produced by a variety of other conditions and diseases.

Control strategies
Intestinal health is protected by the use of anticoccidials in the
feed. The bird’s immune system also plays a role in limiting
the impact of this disease. Attention to management practices
to control litter moisture is important to decrease the level of
challenge in the houses.

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 Intestinal Integrity

Microscopic Eimeria
maxima (mMX) 7
HTSi® definition
■■ N: Not evaluated-Null.
■■ Score 0. No oocysts present.
■■ Score 1. 1–10 oocysts per 100x field.

■■ Score 2. 11–20 oocysts per 100x field.

■■ Score 3. 21–30 oocysts per 100x field.

■■ Score 4. More than 30 oocysts per 100x field.

E. maxima
oocyst are
approximately
30.5 µm x 20.7
µm.

Clinical significance
Coccidiosis is one of the most prevalent enteric diseases of
poultry. E. maxima may impact feed efficiency, weight gain
and pigmentation; however, mortality is rarely seen unless
secondary bacterial infections are also present. By observing
oocysts for E. maxima under the microscope, it aids in the
confirmatory diagnosis of E. maxima, as gross lesions are not
pathognomonic.

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 Gross Eimeria necatrix (gNX)

Control strategies
Intestinal health is protected by the use of anticoccidials in
the feed. Attention to management practices to control litter
moisture is also important. The bird’s immune system also
plays a role in limiting the impact of the disease.

Gross Eimeria necatrix

(gNX) 9, 10, 11
HTSi® definition
E. necatrix infections are mid-intestinal and are characterized
by hemorrhage and ballooning.
■■ Score 0. No gross lesions.
■■ Score 1. Small scattered petechiae and white spots easily
seen from the serosal side; little if any damage apparent on
the mucosal surface.
■■ Score 2. Numerous petechiae on the serosal surface; slight

ballooning confined to the midgut area may be present.

■■ Score 3. Extensive hemorrhage into the lumen of the intestine;

serosal surface is covered with red petechiae and/or white

plaques. The serosal surface is rough and thickened with
many pinpoint hemorrhages. Normal intestinal contents are
lacking; ballooning extends over lower half of small intestine.
■■ Score 4. Extensive hemorrhages giving the intestine a dark

color; intestinal contents consist of red and brown mucus.

Ballooning may extend throughout much of the length of
the intestine.

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 Intestinal Integrity

Classic “salt and pepper” lesions observed in mid-intestines. This

species is rarely seen in broilers but can be seen in layers, breeders
and birds older than 8 weeks of age. Rate of egg production will be
significantly decreased if laying birds are infected.

Clinical significance
Even moderate E. necatrix infections may cause severe weight
loss, morbidity and mortality. This species does not appear to
compete well when other Eimeria species are present and,
therefore, is usually only seen in older birds. E. necatrix is
rarely seen in broilers but can be seen in breeders, layers and
birds older than 8 weeks of age. Rate of egg production will be
significantly decreased if laying birds are infected.

Control strategies
All the ionophores and the commonly used chemical anticoc-
cidials appear to have efficacy against E. necatrix.

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 Gross Eimeria tenella (gTN)

Gross Eimeria tenella

(gTN) 12
HTSi® definition
This species is confined to the ceca. Lesions can be seen
on the outside of the ceca and the ceca often contain blood.
Observations may be associated with one or both ceca.
Note: gross lesions do not directly correlate with bird perfor-
mance.
■■ Score 0. No gross lesions.
■■ Score 1. A few scattered petechiae are found on the cecal
wall. There is no thickening of the cecal walls or blood pres-
ent. Cecal contents are normal.
■■ Score 2. Petechiae are more numerous and the cecal wall

is somewhat thickened. Cecal contents are of normal con-

sistency but may contain streaks of blood.
■■ Score 3. Cecal walls are greatly thickened with scattered

petechiae. The ceca may contain little fecal contents; blood

and white caseous material may be present.
■■ Score 4. The cecal wall is distended with blood and/or

caseous cores. Normal fecal debris is lacking or included

in cores. Dead birds are scored as 4.

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 Intestinal Integrity

Score 1. A
few scattered
petechiae on
cecal wall� No
thickening of the
walls or blood
present� Cecal
contents are
normal�

Score 2. Cecal contents are of normal consistency but may contain

streaks of blood�

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 Gross Eimeria tenella (gTN)

Score 3. Cecal walls

are greatly thickened
with scattered
petechiae�

Score 4. Cecal wall distended with blood and/or caseous cores�

Clinical significance
E. tenella has little to no impact on feed efficiency or weight gain.
Mortality can occur due to endotoxic shock in severe cases.

Control strategies
Intestinal health is protected by the use of anticoccidials in
the feed. Attention to management practices to control litter
moisture is very important. E. tenella generally produces a very
poor immune response.

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 Intestinal Integrity

Hyperemia (HY) 13
HTSi® definition
Hyperemia describes an increased blood flow to the intestine
and/or congestion of the vascular structure on the intestinal
tract. While more blood is present in the digestive tract, it
remains within the vascular structure. It can occur as a nor-
mal physiological response to a number of variables including
(but not limited to) ingestion of food, or a general response to
any irritation of the intestinal tract, including digestive enzymes
or acute stages of bacterial or viral enteritis. It does not, when
observed as the only finding in the intestinal tract, necessarily
denote a pathological condition. People performing postmor-
tem evaluations should be aware that, if birds are euthanized
for a posting session by means of CO2, the normal response
is dramatic hyperemia of the intestinal tract. For uniformity
sake, the portion of the intestinal tract observed for hyper-
emia should be the jejunum. Observation of the first loop (or
duodenum) can be misleading due to the impact of digestive
enzymes on that portion of the intestinal tract due to feed out-
ages and treatments with water acidifiers. The jejunum offers
a more consistent response.
■■ Score 0. No gross lesions. In the absence of dehydration,
the mucosal surface of the jejunum should be approxi-
mately the same color as the breast muscle. Dehydration
may cause the breast to be a little darker than normal, so
be sure the birds are hydrated normally for the purpose of
this comparison.
■■ Score 1. The color of the mucosal surface of the intestine will

have a uniform, diffuse rosy pink to red color that is dramati-

cally different to the color of the breast muscle tissue. The color
is due to the increased blood flow to the tissue but, because it
remains within the vascular structure, it is not well delineated
as you might see with actual hemorrhage.

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 Hyperemia (HY)

Score 1. Mucosal surface of the intestine has a uniform, diffuse rosy

pink to red color�

Clinical significance
There is no real clinical significance to hyperemia, particularly
if that is the only lesion noted in the intestinal tract. There are
a number of normal conditions that can lead to a physiological
response of hyperemia, and therefore it is not wise to jump to
any conclusions regarding the health status of a flock if this is the
only condition noted. It can be an indication of almost any irrita-
tion to the intestinal tract, including some that are quite normal
conditions for the bird, as well as some others that are pathogenic
(early stages of viral or bacterial enteritis). It is wise to look for other
lesions that may have greater significance with regard to the health
status of the flock or to try to understand what “normal” condi-
tions may have contributed to the hyperemia noted on the posting
session (such as time off feed or acidification products added to
the water). Hyperemia is such a generalized response, thus you
may never be able to fully appreciate or identify the actual cause.

Control strategies
There is no real control strategy required for hyperemia, as it is fre-
quently a normal physiological response to entirely normal condi-
tions. In fact, some people believe that a certain degree of hyperemia
may actually contribute to more efficient absorption and distribution
of nutrients from the intestinal tract. If it is a sign of some abnormal
irritation to the intestinal tract, such as early stages of bacterial or
viral enteritis, lesions characteristic of those conditions will manifest
themselves very quickly so that appropriate action for diagnosis and
treatment can be made. But hyperemia of the intestinal tract, as
such, does not require any control strategy as it is frequently just a
normal response in a bird that could be due to a number of factors.

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 Intestinal Integrity

Intestinal hemorrhage
(IH) 4
HTSi® definition
Intestinal hemorrhage describes the escape of blood from the
vascular system of the intestinal tract into the surrounding
tissue. This can be observed from either the serosal surface
or the mucosal surface of the intestinal tract, and the lesion
is described very basically in terms of the extent or size of
the lesion. As opposed to hyperemia, which has very diffuse
borders, hemorrhage typically has borders of relatively sharp
contrast.
■■ Score 0. Normal intestine with no hemorrhage.
■■ Score 1. Petechial hemorrhage: very small pinpoint hem-
orrhage, often multifocal. This is typically seen with Eimeria
maxima, and can be seen with Eimeria necatrix. Other
causes that must be differentiated from coccidial lesions
would include damage caused by roundworms and tape-
worms, and bacterial or viral enteritis. Multifocal petechial
hemorrhage can be in a very limited area or more diffuse
in nature, but close examination reveals a very well-defined
border to each small point of hemorrhage.
■■ Score 2. Ecchymotic hemorrhage: larger than a pinpoint

hemorrhage up to about the size of a marble. Causes may

vary from agonal hemorrhage (that which occurs as the bird
is dying from euthanasia) to more serious concerns such
as enteritis of various etiologies. While larger than petechial
hemorrhage, the borders of this particular hemorrhage are
still very well-defined.
■■ Score 3. Diffuse hemorrhage: widespread hemorrhage,

larger than ecchymotic hemorrhage, but again with reason-

ably well-defined borders (as opposed to hyperemia, which
tends to not have well-defined borders). Diffuse hemor-
rhage results in “angry-looking” intestinal tracts, which may

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 Intestinal hemorrhage (IH)

be an indication of serious pathology in progress (enteritis)

and potentially significant losses in performance. Potential
causes would include (but not be limited to): enteritis, and
intussusception (a folding over of the intestinal tract onto
itself, cutting off the blood supply). Diffuse hemorrhage can
be rather spread out but should still have rather distinctive
borders. This is the most difficult form of hemorrhage to
differentiate from hyperemia, and because of the difference
in terms of impact on performance of the flock, it is very
important to be able to tell the difference based on gross
appearance.

Score 1. Petechial hemorrhage�

Score 2. Ecchymotic hemorrhage�

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 Intestinal Integrity

Score 3. Diffuse hemorrhage�

Clinical significance
Almost always a sign of significant concern, it is of utmost
importance when seeing hemorrhage in the intestinal tract
to characterize the nature of the hemorrhage, and to try to
understand the cause. As noted above, the causes are many,
and some are more serious than others. Petechial and ecchy-
motic hemorrhages are relatively easy to diagnose, but dif-
fuse hemorrhage can be difficult at times to differentiate from
hyperemia, which is of far less concern. With regard to clinical
significance, the hemorrhage is not so much of concern as the
cause to which it points.

Control strategies
Determine the initial cause and address that issue. Petechial
hemorrhage may be the result of coccidia, roundworms, tape-
worms, or early stages of bacterial or viral enteritis. Ecchymotic
hemorrhage may be the result of numerous causes, ranging
from agonal hemorrhage (considered to be made worse as
a result of capillary fragility caused by mycotoxins) to various
causes of enteritis. Diffuse hemorrhage may be caused by
anything from the physical trauma of intussusception (caused
by some irritation of the gastrointestinal tract) to various causes
of enteritis.

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 Intestinal Integrity-broilers (I2)

Intestinal
Integrity-broilers (I2) 4
HTSi® definition
Intestinal Integrity is the optimal functionality of the intestinal
tract. Any lesion or agent which could compromise the func-
tions of the intestine will decrease the Intestinal Integrity of the
broiler. Evaluation of the intestinal tract for evidence of inflam-
mation that would result in performance loss. Cumulative
assessment of all enteric categories. Score range from 0–100
based on a weighted average of all intestinal parameters, with
the most weight given to coccidiosis and those lesions which
have the greatest impact on the birds’ intestinal health and
therefore performance. A score of 100 is considered perfect.
Score decreases based on degree of loss of Intestinal Integrity.

Feed
passage.

Wet litter
may often
be seen in
the case
of loss of
Intestinal
Integrity.

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 Intestinal Integrity

Poor
intestinal
tone.

Diarrhea.

Clinical significance
As Intestinal Integrity deteriorates, the ability to digest and
absorb nutrients decreases. In addition, the expenditure of
protein for cellular repair and inflammatory response, as well
as protein loss to the alimentary tract through secretion, dimin-
ishes its availability for muscle growth.

Control strategies
Individual control strategies are discussed under the specific
clinical sign. In general, preventing coccidiosis, maintaining
high-quality feed ingredients free of toxins, managing the gas-
trointestinal microflora, providing good air quality and reducing
preventable stressors will help ensure good Intestinal Integrity.

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 Intestinal microbiota (IM)

Intestinal microbiota
(IM) 14, 15, 16, 17, 18, 19
HTSi ® definition
The intestinal microbiome is, in its broadest sense, the entire
microbiota of the intestinal tract and includes bacteria, fungi,
viruses, and protozoa that are present in the intestinal tract of
the host. The term is however generally used to describe the
bacterial component of the microbiome. The bacterial micro-
biota of the hatchling has low diversity and density, but during
the development of the chick, the intestinal tract becomes
highly populated with organisms that either enhance disease
resistance or predispose to or even cause disease.

Ceca with yellowish

and foamy contents
indicating that the
bird does not possess
a mature microbiota.

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 Intestinal Integrity

Clinical significance
The microbiome has recently received a lot of attention
because of its influence on intestinal health, bird performance
and end product quality and safety. In addition to retarding
pathogen colonization, it has been shown to modulate the
immune system, stimulate development of organs and tis-
sues, alter fat deposition, enhance nutrient assimilation, and
even influence brain development. The microbiome is now
even referred to as the forgotten organ. 14
One of the most obvious opportunities to influence intestinal
health through microbiome manipulation is during the early
post hatch period. In modern poultry production each gener-
ation is physically separated from its parents making it difficult
for hatchlings to acquire organisms that initiate optimal intesti-
nal and immune system development. Beneficial pioneer spe-
cies can stimulate villus development, mucus layer composi-
tion and development of innate immunity. Their metabolites
include short-chain fatty acids and other factors that make the
ecosystem unfavorable for pathogens. During the first week of
life, the microbiome of the average commercial hatchling is
immature and easily colonized by unfavorable or pathogenic
organisms. In addition, the practice of meal-feeding breeders
may create an aberrant flora that is vertically transmitted, both
transovarially and on the shell, to the offspring, thus compro-
mising acquisition of beneficial pioneer species by the chicks.

Control strategies
Interventions using microbiome enhancing components such as
competitive exclusion, probiotics, prebiotics, toxin binders, and
organic acids promote rapid development of a mature intestinal
microbiota in chicks. The use of microbiome enhancing com-
ponents to establish an optimal microbiota in the parent flocks
is essential to ensure vertical transmission of pioneer colonizers

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 Intestinal microbiota (IM)

to the progeny. 15 The breeder flock is one of the most impor-

tant sources of microbiota for the chicks and management of
meat bird microbiota should start with the breeder flock. The
hatchery can also be the source of bacteria that colonize chicks;
therefore application of microbiome enhancing components in
newly hatched chicks can also improve development of a mature
microbiome. In addition, beneficial pioneer colonizers can also be
enriched in flock houses that contain used litter of good quality.
Long-term use of microbiome enhancing components for at least
four sequential flocks, may be needed to enrich the flock house
litter with pioneer colonizers. 16 Management of the breeder flock
and flock house microbiota enhances the acquisition of a ben-
eficial microbiome by the chicks. Prebiotics can be used as a
source of nutrients to nurture the intestinal microbiome enabling
better functioning of the intestine. Furthermore, use of exogenous
in-feed enzymes can alter the point of nutrient release/absorption
and consequently alter the feed’s nutritional value and the com-
position of the intestinal microbiota.  17 Essential oils have been
shown to have beneficial antimicrobial activity 18 and probiotics
have been reported to inhibit the growth of pathogenic bacte-
ria, neutralize enterotoxins, improve gut barrier function, and
enhance host immunity. 19
Microbiome enhancing components used as feed additives
can enhance nutrient acquisition, pathogen exclusion, and
maintenance of Intestinal Integrity leading to improved animal
health and welfare, and consequently production economics
for poultry producers. An understanding of the intestinal and
litter microbiome helps researchers and field veterinarians
improve bird performance and intestinal health.

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 Intestinal Integrity

Intestinal tone (IT) 4

HTSi® definition
Loss of folding and muscular function of the intestine upon open-
ing. Tensile strength may be affected. It is very important to evalu-
ate this lesion in fresh dead birds. Birds that have been dead for
an extended period of time will lose intestinal tone very quickly.
■ Score 0. Absence of the condition.
■ Score 1. Loss of folding and muscular function of the
intestine.

Score 1. Loss of folding and muscular function of the intestine�

Clinical significance
Optimal digestion and absorption requires sufficient cellular
function and intestinal peristalsis. Insufficient musculature
reduces digestive mixing and movement. This reduces the effi-
cacy of the digestive tract. Further, intestinal stasis can result in
ballooning associated with microflora imbalance and enteritis.

Control strategies
A feed formulation providing particle sizes and food products that
are required for intestinal cell health and integrity is a key to intes-
tinal tone. Anticoccidials and antibiotics reduce intestinal insult
and inflammation that can result in intestinal stasis and atrophy.

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 Litter eater (LE)

Litter eater (LE) 4

HTSi® definition
The presence of 50 % or more of the gizzard contents is made
up of litter. To some degree, litter eating is natural for birds.
They want coarse materials in the gizzard to help the digestion
of their food.
■ Score 0. Presence of minimal to no litter in gizzard contents.
■ Score 1. Presence of 50 % or more of gizzard contents is
made up of litter.

Score 1. 50 % or more of gizzard contents made up of litter�

Clinical significance
Excessive litter eating can be associated with enteritis. Birds
consuming litter increase their pathogen exposure, miss out
on a balanced nutritional ration, fail to get the medications
they need and have weight suppression with resulting loss of
uniformity. Gizzards may become impacted, punctured and/
or ulcerated from sharp pieces of litter material.

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 Intestinal Integrity

Control strategies
Causes for litter eating can range from normal bird behavior to
substantial enteric insult. Identification and elimination of the incit-
ing cause will reduce -but may not eliminate- litter eating, as some
birds will become “trained” and continue to peck at the litter.

Mouth lesions (ML) 4

HTSi® definition
The presence of any erosion, ulceration, necrosis, scabbing or
proliferation of tissue in the oral cavity, at the base of the tongue
or anterior portion of the esophagus.
■ Score 0. Absence of the condition.
■ Score 1. Erosion, ulceration, necrosis, scabbing or prolifera-
tion of tissue in the oral cavity, base of the tongue or anterior
esophagus.

Score 1. Erosion,
ulceration, necrosis,
scabbing or
proliferation of tissue
in the oral cavity�

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 Mouth lesions (ML)

Clinical significance
Mucosal ulcerations most likely result from exposure to toxins
produced by molds growing on feedstuffs more commonly
known as mycotoxins. The primary molds are Aspergillus,
Penicillium, Fusarium, Claviceps and Chaetomium. These
molds use a variety of feed ingredients as substrates and can
produce a multitude of toxic metabolites. Mycotoxins nega-
tively impact all metabolic systems, such as nervous, renal,
hepatic, respiratory, circulatory, reproductive, immunological
and mucosal/intestinal. These mycotoxins affect production
directly through tissue damage and feed-ingredient deterio-
ration, as well as indirectly through reduced bird health and
performance. Mycotoxicosis is painful and at high levels can
result in death and food adulteration. Other possible causes
of oral ulcerations include wet (diphtheric) fowl pox, vitamin
A deficiency, and use of caustic cleaning agents in feed pans
and drinkers.

Control strategies
Mycotoxins are effectively reduced through feed-ingredient
quality control. This includes all points from selection/pur-
chase through in-house consumption. Mycotoxins can be
formed or controlled in feed pans, feed lines and feed bins,
as well as in the field where grain is grown and harvested.
There are various preventive strategies (GAPs) and chemical
applications (inhibitors). Temperature and humidity should
be closely monitored in all areas of feed handling and stor-
age. Feed areas should be cleaned regularly and treated with
appropriate antifungal agents.

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 Intestinal Integrity

Necrotic enteritis
(NE) 20, 21
HTSi® definition
The diagnosis of necrotic enteritis due to Clostridium perfrin-
gens.
■ Score 0. Small intestine is grossly normal.
■ Score 1. There are areas of focal necrosis and/or ulceration
(1 cm).
■ Score 2. Severe extensive necrosis. Large areas of full thick-
ness mucosal necrosis of the small intestine. The surface
of these lesions is generally raised above the surrounding
tissue and consists of orange / brown necrotic debris.

Score 1. There are areas of focal necrosis and/or ulceration (1 cm)�

Score 2. There are larger areas of necrosis and/or ulceration (2 cm)�

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 Necrotic enteritis (NE)

Clinical significance
Clinical necrotic enteritis results in substantial intestinal ero-
sions and can lead to marked increase in mortality. The per-
formance and financial significance is readily recognizable.
These clinical flocks will also suffer from uniformity issues due
to high levels of morbidity.
Subclinical necrotic enteritis presents the larger challenge for
the poultry industry. This condition develops from compro-
mised Intestinal Integrity and reduces performance without
overt signs of mortality or even morbidity.

Control strategies
Necrotic enteritis is a result of bacterial toxins produced during
enteric overgrowth of C. perfringens. Control strategies should
target the reduction of conditions that lead to overgrowth of
Clostridium species. A program designed to reduce cycling of
Coccidia species is primary in control of necrotic enteritis. The
cycling coccidia cause intestinal damage, which promotes
growth of Clostridium species. Coccidia are best managed by
planned anticoccidial programs. It has been shown that cer-
tain feed ingredients such as wheat and fishmeal create intes-
tinal environments that are conducive to clostridial growth.
Clostridium species are known to be mucolytic, or use mucus
as a food source and a physical protective device against other
bacteria and immune recognition. A control strategy should
restrict conditions that promote enteric mucus production,
such as excessively coarse ingredients, cocci cycling and non-
specific enteritis (dysbacteriosis).

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 Intestinal Integrity

Proventriculitis
(PRV) 4, 22
HTSi® definition
Examination for evidence of inflammation of the proventriculus.
■ Score 0. Normal.
■ Score 1. Marked enlargement of the proventriculus with
edema of the glands.
■ Score 2. Significant increase of proventriculus, two or more
times in normal size, getting larger than the gizzard.

Score 1. Marked enlargement of the proventriculus with edema of

the glands�

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 Proventriculitis (PRV)

Score 2. Significant increase of proventriculus, two or more times in

normal size�

Clinical significance
The exact cause has not been definitively identified, but
proventriculitis has been recently linked to a birnavirus named
chicken proventricular necrosis virus (CPNV).  22 Clinical
signs attributed to proventriculitis have been stunted growth,
unthriftiness, feed passage and poor performance. Addition-
ally, enlarged proventriculi have been linked to increased car-
cass contamination in the processing plant due to breakage
at the proventricular junction.

Control strategies
There are no specific control or prevention strategies at this
time.

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 Intestinal Integrity

Roundworms (RW) 4
HTSi® definition
The presence of any roundworms in the intestinal lumen.
■ Score 0. Absence of parasites.
■ Score 1. Presence of roundworms.

Score 1. Presence of roundworms�

Clinical significance
An infection with roundworms may cause a decrease in
weight gain in birds with abundant infection. Additionally, if
birds are processed with a large worm burden, it may increase
the intestinal breakage in the processing plant and result in
increased carcass contamination.

Control strategies
Several water-soluble products are available to treat a round-
worm infection in chickens; however, most require a prescrip-
tion from the treating veterinarian.

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 Tapeworms (TW)

Tapeworms (TW) 4
HTSi® definition
The presence of any tapeworms within the intestinal lumen.
■ Score 0. Absence of parasites.
■ Score 1. Tapeworms within intestinal lumen.

Score 1. Tapeworms within intestinal lumen�

Clinical significance
Survival of the bird is rarely threatened with even the most
severe cases of tapeworms. They do, however, contribute to
inefficiency of production by absorbing nutrients that would
otherwise be available to the birds and by physical damage,
which occurs in the lining of the intestine at each location
where the tapeworm attaches to the wall by mechanical
means. Those attachments result in petechial hemorrhage
in the wall of the intestine that can be grossly mistaken for
E. maxima, particularly when observed from the outside of the
intestinal wall. As tapeworms are usually picked up by birds
that have been eating litter beetles, the presence of tapeworms

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 Intestinal Integrity

is generally considered an indication that the bird has been

diverting time and energy from eating balanced nutritional
rations at the feeders to eating insects from the litter.

Control strategies
Control strategies for tapeworms are generally directed toward
the next flock in the house, following identification of the prob-
lem. There is little to do to cost effectively treat the existing prob-
lem, so attention is generally directed toward control of the inter-
mediate host, or litter beetle, while the farm is between flocks.

Thick intestines (TK) 4

HTSi® definition
This lesion refers to a marked thickening of the epithelial layer
of the intestinal tract. Gross inflammatory changes including
hyperemia, lymphocytic infiltration or hypertrophy of Peyer’s
patches may be also evidenced with this lesion.
■ Score 0. Normal intestine.
■ Score 1. Marked thickening of the mucosal layer of the
intestinal tract.
1

Score 1. Marked thickening of the epithelial layer of the intestinal

tract�

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 Thick intestines (TK)

Clinical significance
Thickening of the intestine occurs as a result of a bird’s natural
immune response to an inflammatory agent or physical dam-
age. The normal tissue of the intestinal epithelium is infiltrated
with cellular components of the bird’s immune system in an
effort to keep the intestinal tract healthy. Thickening of the
intestine is an indication that something has happened to call
the bird’s defense system into play, resulting in decreased effi-
ciency since proteins that are important for growth have been
diverted to protection and immune response. Thickening of
the intestinal wall with cellular infiltrates may also interfere with
the physical efficiency of absorption of nutrients across the
epithelium of the intestinal tract, adding to the loss of perfor-
mance.

Control strategies
Thickening of the intestinal tract is actually a normal response
to threats imposed on the health of the intestine. Such a
response is designed to keep the bird alive, although at the
expense of efficient conversion of nutrients to proteins required
for growth. Rather than attempting to control the thickness of
the intestinal tract, which is a normal bird response, atten-
tion should be given to controlling the inciting cause of the
immune response that is calling for this cellular infiltration. The
inciting cause may be excessive coccidiosis, bacterial enteritis,
or even physical trauma caused by toxins or certain dietary
factors such as coarse or abrasive feed ingredients.

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 Intestinal Integrity

Thin intestines (TH) 4

HTSi® definition
Marked loss of the entire intestinal wall thickness, particularly
when noted in the upper half of the intestines. Intestine may
be friable and transparent prior to opening.
■ Score 0. No gross lesions.
■ Score 1. Marked loss of the entire intestinal wall thickness.

Score 1. Marked loss of the entire intestinal wall thickness�

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 Thin intestines (TH)

Clinical significance
The loss of the mucosal surface, including the villi, results in
substantial reduction in absorptive surface and removes the
protective capacity of the mucus layer.
Continuing degradation results in submucosal/stromal loss
and friable intestines, which are easily torn during processing.
Substantial fluid and protein loss may occur and is often noted
by very watery contents.

Control strategies
Thin intestines most often occur as the result of viral, bacterial
or protozoal insult. Provide intervention or control strategies
to reduce introduction or maintenance of pathogenic organ-
isms. Maintaining a vigorous immune system through quality
vaccination programs reduces the impact of viral organisms.
Protozoal organisms such as coccidia can be controlled using
various products. Bacterial organisms are generally secondary
invaders and often respond well to therapeutic treatment as
well as preventative intervention with antibiotics.

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 Respiratory Integrity

Airsacculitis (ARS) 23
HTSi® definition
The air sacs in the abdominal cavity should be clear and free
of exudate in the normal bird. Some mild airsacculitis may
result from normal reaction to vaccination, but the moderate to
severe airsacculitis is usually an indication of excessive reac-
tion, field challenge or secondary bacterial involvement.
■ Score 0. Normal. Normal air sacs should be clear and free
of all suds and exudate. Occasionally, in some older birds,
there may be a little fat deposition on the edges of the air
sacs, and care must be taken to distinguish from exudate.
■ Score 1. Mild airsacculitis. Light suds in the air sacs. Lesions
typical of what might be seen post-reaction with a mild res-
piratory vaccine.
■ Score 2. Moderate airsacculitis. Obviously, heavy suds in the
air sacs without consolidation of the exudate. Air sacs may
feel slippery to the touch.
■ Score 3. Marked airsacculitis. Milky to cheesy exudate in
multiple air sacs. Secondary bacterial infection often present.
■ Score 4. Severe airsacculitis. Milky to cheesy looking exu-
date involving more than one organ, such as liver, heart,
lungs, air sacs. Secondary bacterial infection often present.

Score 1. Mild airsacculitis�

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 Airsacculitis (ARS)

Score 2. Moderate airsacculitis�

Score 3. Marked airsacculitis�

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 Respiratory Integrity

Score 4. Severe airsacculitis�

Clinical significance
The presence of mild airsacculitis must be evaluated with the
knowledge of the vaccination schedule, as some reaction is
typical of certain vaccines. Moderate to severe airsacculitis
can be an indication of excessive vaccine reaction, field chal-
lenge with a respiratory virus or secondary bacterial infection.
Significant airsacculitis can impact overall bird performance,
health, morbidity, mortality and processing ability.

Control strategies
Quality control programs in the hatcheries are in place to help
ensure that vaccine is administered properly to chicks. Main-
taining good air and litter quality is important to assist birds
while reacting to the vaccination both in the hatchery and any
field boost that may be given. The bird’s immune system also
plays a role in limiting the impact of viruses and secondary
bacteria.

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 Ammonia burns in cornea (AB)

Ammonia burns
in cornea (AB) 24
HTSi® definition
The bilateral, or less frequently unilateral, damage to the eye
that is characterized by cloudiness and/or ulceration of the
cornea.
■ Score 0. Normal cornea.
■ Score 1. Bilateral or unilateral damage to the eye character-
ized by cloudiness and/or ulceration of the cornea.

Score 1. Ammonia burn fluorescein stained�

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 Respiratory Integrity

Clinical significance
Ocular tissue is known to be highly innervated. Ulcerations
to the cornea are painful and result in a reduced state of ani-
mal welfare. Levels of pain are also directly correlated to bird
health and performance. High ammonia levels directly impact
respiratory health and bird performance.

Control strategies
High ammonia levels indicate litter imbalance and/or improper
ventilation. Rate of ammonia formation is directly related to lit-
ter pH. Litter pH can be regulated by fresh-litter management
and litter amendments. Ammonia formation requires ade-
quate litter moisture. Drinking sources should be managed
to reduce water wastage. The moisture level of fecal matter
will vary with feed formulations and intestinal health. Fresh
feces should be observed for consistency, and appropriate
feed testing and intestinal monitoring should be performed.
The adequate movement of heated (drier) air into the house
and subsequent removal of moist (wetter) air from the house
are the primary means to reduce ammonia levels.

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 Aspergillosis (AP)

Aspergillosis (AP) 25, 26
HTSi® definition
Yellow or gray nodules and/or plaques in the lungs, air sacs or
trachea. Found less frequently in peritoneal cavity, liver, brain
or at other sites. It can also occur as a possible gray or white
opacity in one or both eyes.
■ Score 0. Absence of condition.
■ Score 1. Yellow or gray nodules and/or plaques in lungs, air
sacs, trachea, peritoneal cavity, brain or other sites.

Score 1.
Yellow or
gray nodules
and/or
plaques�

Clinical significance
This is not a typical lesion found on necropsy evaluations for
“normal/healthy flocks”. It is, however, relatively common to
find when exploring issues of chick quality involving high mor-
tality during the first two weeks. This lesion is noted when
chicks pick up spores for this fungus, usually from the hatch-
ery, or at the time of placement on the broiler farm. The spores
prefer an environment rich in oxygen, so it usually grows in the
respiratory tract or in the eyes. It can be particularly serious

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 Respiratory Integrity

when growing in an area of limited space for expansion, such

as the trachea, where airflow obstructions can lead to death.
Infection with Aspergillus sp. has been shown to cause ascites
in birds that survive the initial infection. 25

Control strategies
The control strategy should involve an attempt to locate
the source of infection. Eggs that are sanded or allowed to
sweat due to rapid temperature shifts provide an opportunity
for introduction of spores through the protective surface of
the eggshell. Contaminated eggs can become exploders in
the hatchery and infect a large number of eggs via airborne
exposure. In some cases where hatcheries are located near
feed mills, exposure resulting from the loading and unload-
ing of grains high in mold contamination can contribute to
the problem. Hatchery sanitation programs fight against
constant exposure and potential threat from incoming eggs
and from airborne particles. Hatchery modifications involving
ventilation ducts can lead to significant Aspergillus challenge
as spores that have been present for years can be dislodged
while remodeling. The addition of “fresh” litter in a poultry
house while young birds are present is very risky with regard
to Aspergillus challenge.

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 Tracheitis (TRA)

Tracheitis (TRA) 4
HTSi® definition
The gross appearance of the trachea may be a reflection of the
bird’s exposure to respiratory disease or an indication of the air
quality (ammonia, dust, etc.) in the poultry house.
■ Score 0. Normal trachea. Pearly white color on the mucosal
surface of the trachea with no sign of excessive exudate.
■ Score 1. Mild tracheitis. Slight rosy color on the mucosal
surface of the trachea due to petechial hemorrhage in the
wall of the upper one-third of the trachea.
■ Score 2. Moderate tracheitis. Similar to a lesion score of 1,
but extending farther down the trachea. There may be some
excess mucus present in the lumen of the trachea.
■ Score 3. Severe tracheitis. Similar to a lesion score of 2, but
necrotic debris and/or blood accumulates in the lumen of
the trachea resulting in obvious physical restriction of the
airflow through the trachea. Be careful not to confuse with
blood that may have been inhaled as the bird was eutha-
nized for postmortem evaluation.

Score 1. Mild tracheitis�

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 Respiratory Integrity

Score 2. Moderate tracheitis.

Score 3. Severe tracheitis.

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 Tracheitis (TRA)

Clinical significance
A healthy trachea is critically important to the health of the bird.
The normal lining of the trachea is composed of ciliated epi-
thelial cells. These cilia, or hair-like projections, are important
because they help to sweep dust and debris containing bac-
teria and viruses out of the respiratory tract, to a point where
the bird can swallow them to get rid of the potential threat.
When damaged, the trachea loses this protective mechanism
resulting in a bird that is more susceptible to viral and bacterial
disease. While mild damage to the trachea results in increased
susceptibility to disease, more severe damage may be a reflec-
tion of direct pathology on the trachea. Specific diseases of the
respiratory tract can be difficult to differentiate based on gross
lesions. Mild to moderate lesions may be noted on everything
from high levels of ammonia to diseases such as infectious
bronchitis, laryngotracheitis, Newcastle disease or even avian
influenza. If widespread tracheitis is noted, additional diag-
nostic tests may be required to determine the actual cause.

Control strategies
The most common cause of tracheitis, and the one factor
over which most immediate and direct control is made, is
air quality. Air quality should always be of utmost importance
because it can lead to various other respiratory problems, and
good air quality can help to minimize problems caused by
other disease conditions. It should be kept in mind, however,
that almost all of the respiratory conditions, which cause great
concern, could appear early on as tracheitis. If the tracheitis
is serious (lesion scores of 2 or 3) or widespread, additional
diagnostic tests should be considered to determine the spe-
cific cause.

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 Immunological

Bursa measurement
(BSM) 28
HTSi® definition
An instrument to measure the bursa with holes of different sizes
is used to rate the bursa from 1 to 8, with 1 being very small
and 8 very large. The smallest hole that the bursa will easily
pass through indicates the bursa score. The bursa should not
need to be forced through the hole and it should not bulge
significantly past the edges of the hole once it passes through.

Measuring
instrument
with holes
of different
sizes used to
rate the bursa
from 1 to 8,
with 1 being
very small and
8 very large.

Clinical significance
The size of the bursa in a broiler reflects the birds’ health sta-
tus with regard to B-cell production and the capacity to mount
an immune response. This organ typically grows proportionally
as the bird grows until sexual maturity. Sick or stressed birds
may have smaller bursas, while healthy productive birds may
tend to have larger bursas. There are many things that can

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 Bursa measurement (BSM)

impact the size and age at which a bursa experiences atrophy:

disease challenge, vaccination programs and environmental
factors, just to name a few. Monitoring bursa size is one piece
of information that can help to tell a producer how the birds
are responding to stresses, challenges and vaccination pro-
grams on the farm.

Control strategies
Interpreting bursa size should start by establishing a normal
baseline for the flock. It is important to take into consideration
the age of the bird and the vaccination practices that are imple-
mented, such as IBDV field vaccine. Evaluation of the bursa
should be done by selecting normal, healthy birds that represent
the flock and not cull birds. After several bursa measurements
are performed, the producer can learn what to consider as “nor-
mal size range” for the flock according to the bird’s age. After
establishing the bursa size baseline, if a flock is evaluated and
bursa size is out of the “normal size range”, then it is important to
investigate the possible cause(s) for this occurrence. Reasons for
small bursa size include infectious bursal disease virus (IBDV),
Marek’s disease virus (MDV), bacterial infections, reovirus, tox-
ins, environmental or physiologic stress, etc.

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 Immunological

Bursal atrophy (BUR) 28

HTSi® definition
Gross examination of the bursa of Fabricius for evidence of
infectious bursal disease (IBD) challenge. Birds up to 28 days
of age recorded.
Bursal size varies with size and age of bird. As birds mature,
bursal size regresses. Size and age of bird must be considered
when scoring bursal size. For a more detailed assessment of
this condition, it is also an option to measure bursal size as
described on page 60 using an Elanco Bursameter. This may
replace or supersede the scoring of bursal atrophy and give a
more accurate assessment of bursa size relative to age.
■ Score 0. Normal bursal color. No change (reduction) in size
due to virus challenge.
■ Score 1. Mild bursal atrophy (25 % atrophy). Evidence of
longitudinal striations and/or yellowish transudate covering
the serosal surface may be seen; starting to lose the “rosing
out” response when cut.
■ Score 2. Moderate bursal atrophy. As much as 50 % of
normal size; tissue may have changed to yellow color; no
“rosing out” response.
■ Score 3. Severe bursal atrophy (more than 75 % atrophy).
Minimal to non-detectable size.

Score 0.
Location
of normal
bursa in
bird�

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 Bursal damage (BDM)

Clinical significance
Bursal atrophy indicates the possibility of a degraded immune
system and increased susceptibility to disease. If bursal atro-
phy is observed in birds less than 15 days of age, a variant
IBDV strain may be a factor in causing this atrophy.
Affected birds may exhibit very strong negative impacts from
otherwise mild or even non-pathogenic challenges. Increased
incidence and severity of IP, dermatitis, coccidiosis, bacterial
or viral enteritis and respiratory disease are common.

Control strategies
Various vaccines are available for prevention of IBD. Biose-
curity and adequate lay-out time between flocks can help in
control programs.

Bursal damage (BDM) 28

HTSi® definition
Birds challenged with infectious bursal disease (IBD), an
acute contagious viral disease of young chickens, could exhibit
clinical signs such as diarrhea, incoordination, vent pecking
behaviors, trembling, dehydration and immunosuppression.
The main gross lesion induced by classic IBDV strains is char-
acterized by an acute inflammation followed by atrophy of the
bursa of Fabricius (the major affected organ). By second and
third day post-infection, the bursa contains a gelatinous yel-
lowish transudate at the serosal surface, then bursa returns
to normal size and the organ is gray and hard followed by
atrophy. Variant IBDV strains may not cause inflammation;
instead, they result in early atrophy of the bursa and severe
immunosuppression.

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 Immunological

■ Score 0. Normal.
■ Score 1. Yellow edematous serosal surface mainly due to
classic strains and/or presence of petechiae inside.
■ Score 2. Obvious hemorrhage internally.
■ Score 3. Cherry-like bursa.

Score 1.
Yellow
edematous
serosal
surface�

Score 1.
Presence of
petechiae
inside the
Bursa�

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 Bursal damage (BDM)

Score 2.
Obvious
hemorrhage
internally�

Score 3.
Cherry-like
bursa�

Clinical significance
IBD occurs in young chickens, and clinical signs can be more
severe in birds that are 3 to 6 weeks old. Chickens less than
3 weeks old may not show clinical signs but will have destruc-
tion of the bursa of Fabricius, resulting in various degrees of
immunosuppression. The younger the chicken at the time
of challenge -especially with variant IBDV strains-, the more
immunocompromised is the bird, resulting in a higher degree
of susceptibility to other pathogens and poor response to rou-
tine poultry vaccination programs. Other lymphoid organs that
can be damaged to a lesser extent are the thymus, the cecal

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 Immunological

tonsils and the spleen. In addition, gross lesions such as hem-

orrhages of the leg and pectoral muscles, sometimes a hem-
orrhagic area at the proventricular-gizzard junction, swollen
kidneys and increased mucus in the intestine can be seen.
The kidneys may be affected due to dehydration. Because
IBDV impacts the bird’s immune system, several diseases
have been correlated with IBDV infection; these include inclu-
sion body hepatitis, chicken infectious anemia, gangrenous
dermatitis and coccidiosis, among others.

Control strategies
A common practice involves the vaccination of breeders to
provide passive immunity to the progeny, especially during
the first 3 weeks of life. Broiler chickens can be vaccinated
against IBDV; however, the timing of vaccination in maternally
immune chicks can be a challenge. If a “hot” or “intermedi-
ate” IBDV vaccine is used in chicks with low maternal immu-
nity, it may result in bursal atrophy. However, vaccination with
“mild” IBDV vaccine will not be effective in birds with high
levels of maternal IBDV antibodies. Therefore, it is important
to evaluate the passive immunity of the chicks prior to vaccina-
tion for proper timing of the vaccine if vaccination will be given
at the hatchery and/or in the field.

Thymus (THY) 4
HTSi® definition
Thymus is a primary immunologic organ that arises from
epithelial cells of the third and fourth pharyngeal pouch dur-
ing embryogenesis. It consists of 7 irregularly shaped lobes
located along each side of the neck close to the jugular vein.
■■ Score 0. No change (reduction) in size.
■■ Score 1. Marked atrophy of thymus size.

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 Thymus (THY)

Score 1.
Marked
atrophy of
thymus size�

Clinical significance
In young birds, the thymus is active and produces mature
T cells until sexual maturation. It provides an environment
for differentiation of stem cells to T lymphocytes, and thymic
processing takes place with the purpose of T cell selection
prior to travel via bloodstream to the secondary lymphoid tis-
sues. Its maximum size is reached at 16 weeks of age, and it
regresses at sexual maturity. Atrophy of the thymus may indi-
cate the bird is in a state of immunosuppression. Thymus size
can be affected by many factors such as stress, malnutrition,
mycotoxins and infectious agents (chicken infectious anemia
virus -CIAV-, Marek’s disease virus -MDV-, runting-stunting
syndrome -RSS-, etc.).

Control strategies
Minimize environmental, nutritional and infectious factors
that can diminish thymus activity and function. An adequate
vaccination program should be performed to breeders and
progeny for the protection against common infectious agents
(especially CIAV in breeders).

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 Skeletal

Femoral head
necrosis (FHN) 31
HTSi® definition
The shattering of the femoral head (FH) or the fracturing of
the neck of the FH with the FH remaining in the acetabulum
during normal disarticulation of the coxofemoral joint. Detach-
ment of the musculature from the proximal femur is also pres-
ent. Not to be confused with detachment of the cap of the
head of the femur only.
■ Score 0. Absence of the condition.
■ Score 1. Shattering of femoral head or fracturing of the neck
of the femoral head with osteomyelitis.

1
Score 1.
Shattering of
femoral head
or fracturing
of the neck of
the femoral
head with
osteomyelitis�

Clinical significance
FH necrosis results in painful bone deterioration, and birds
become reluctant to move. As the birds grow larger, mortality
may increase due to down birds; loss of uniformity will occur
as lame birds do not eat well; increased leg breakage and mor-
tality during live haul may be evident; and at the processing
plant birds will be downgraded. The causes of FH necrosis
may reside in the breeder flock, hatchery or on the farm. Sys-
temic bacteremia preceding the onset of FH necrosis may be
noted as increased airsacculitis.

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 Osteomyelitis (OM)

Control strategies
The focus of control should be on identifying the source of
infection. Hatchery sanitation and incubation can be respon-
sible for significant incidence of FH necrosis. Placing “green”
chicks at the farm may create a false impression that the
issue is farm-related, but careful analysis should indicate
wider distribution. Tracing back to specific breeder flocks
allows for intervention at the breeder level or the farm level
to minimize the impact. Good breeder and chick immune
system management will reduce the incidence.

Osteomyelitis (OM) 32
HTSi® definition
Osteomyelitis is the inflammation of the bone caused by
staphylococci, Escherichia coli, Mycoplasma avium, or a vari-
ety of other microorganisms. Certain forms of osteomyelitis are
caused by fungi. Bacteria may enter through damaged skin or
other portals of entry, are transported in the blood and lodge
in the area of fenestrated blood vessels. In this area, bacteria
multiply without being disturbed by the bird’s body defense
mechanisms. Bones and sites most frequently involved are
the proximal tibiotarsus and proximal femur. Gross lesions of
osteomyelitis in bone consist of focal yellow areas of case-
ous exudate or lytic areas, which cause affected bones to be
fragile.
■■ Score 0. No gross lesions.
■■ Score 1. Focal yellow areas of caseous exudate or lytic areas
mainly in proximal tibiotarsus and proximal femur.

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 Skeletal

Score 1. Focal yellow areas of caseous exudate or lytic areas�

Clinical significance
Early clinical signs include ruffled feathers, lameness of one or
both legs, drooping of one or both wings, reluctance to walk,
and fever. Staphylococcal infection may frequently lead to
acute death in immunocompromised birds.

Control strategies
Any management procedure reducing damage to host
defense mechanisms will help prevent osteomyelitis. Because
wounds are a portal of entry for S. aureus and other bacte-
ria into the body, anything reducing the chance of injury will
help prevent infection. Particular attention should be given to
hatchery management and sanitation as well as the mainte-
nance of good litter quality. S. aureus infection sometimes can
be treated successfully, but sensitivity tests should always be
performed, because antibiotic resistance is common.

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 Rickets (RKT)

Rickets (RKT) 33
HTSi® definition
The folding without fracturing or slight breaking of long bones,
the bending of the lower beak without fracturing, pronounced
widening of the growth plate in long bones, or beading of the ribs.
■ Score 0. Normal presentation of the bone.
■ Score 1. Folding without fracturing or slight breaking of long
bones, bending of lower beak without fracture, pronounced
widening of growth plate in long bones, or beading of ribs.

Score 1.
Widened
growth
plates�

Clinical significance
The presence of rickets may contribute to an abnormal growth
rate and a potential altered gait. Abnormal skeletal growth
results in poor performance. Skeletal variation can increase
plant errors and reduce yield. Rickets most commonly results
from relative or absolute calcium deficiencies. A relative cal-
cium deficiency is the result of excessive phosphorus or
reduced vitamin D (fat-soluble vitamin), which aids in calcium
absorption. Reduced absorption can also indicate poor feed
quality, altered particle size, fat source errors and a general
reduction in intestinal health.

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 Skeletal

Control strategies
Care must be taken in producing feeds with an adequate cal-
cium and phosphorus ratio. This is particularly important when
using phosphorus sparing enzymes. The metabolic level of cal-
cium is most influenced by the feed particle size, the true avail-
able level of the formulated phosphorus and vitamin D. Special
care must be taken to evaluate the interaction between all the
factors influencing calcium homeostasis. Although rickets can
occur at any age, the rate of bone growth is most dramatic from
4 days to 18 days of age. The incidence of rickets will be best
controlled through management of feed, vitamin D, growth rate
and intestinal health during this period of skeletal development.

Swollen head (SH) 4

HTSi® definition
Swelling of the peri- and infraorbital sinuses, generally appear-
ing as a “swollen head”. In live chickens, depression, torticollis
and cerebral disorientation are also observed.
■ Score 0. No clinical signs.
■ Score 1. Swelling of peri- and infraorbital sinuses.

Score 1. Swelling
of peri- and
infraorbital
sinuses�

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 Swollen hock (HK)

Clinical significance
Swollen head may have a variety of causes. Physical trauma
from inappropriately adjusted feeder slots, infectious bronchi-
tis, mycoplasmosis, infectious coryza, fowl cholera, bordetel-
losis and fowl pox are the most common causes, but others
causes are possible. Depression, blindness and disorientation
result in poor feed intake and loss of uniformity.

Control strategies
Disease control strategies have greatly reduced the incidence
of swollen head. It is most often seen in an individual flock
and the specific cause should be identified and eliminated.

Swollen hock (HK) 34, 35, 36

HTSi® definition
Presence of swelling signs at the hock joint.
■ Score 0. Normal.
■ Score 1. Swollen hock.

Score 1. Swollen hock

(leg on the right)�

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 Skeletal

Clinical significance
Several factors can induce swollen hock in chickens. This con-
dition can be the result of physical stress on the intertarsal joint
of growing heavy broilers, which frequently can result in rup-
ture of the gastrocnemius or peroneous tendons. Clinical signs
are described as swelling and red to green discoloration at the
affected area. Viral infections with reovirus (tenosynovitis) and
Marek’s disease virus (MDV) can also induce swollen hock.
In addition, bacterial infections such as Mycoplasma synoviae
(infectious synovitis), Streptococcus, Staphylococcus, Entero-
coccus, Pasteurella, erysipelas and others can result in swol-
len hocks, and the condition is commonly known as bacterial
arthritis. Swollen hock can be characterized by tenderness,
warm to the touch at the affected area and fluid accumulation.
The fluid could be clear, bloody or yellow pus, depending on the
degree of infection. In chronic cases, the affected tendon has
fibrosis and less inflammatory exudates. Other non-infectious
factors (such as nutritional disease including biotin deficiency,
vitamin D3 and phosphorus deficiencies) should be considered
as possible causes of swollen hock. In all cases of swollen hock,
ensure that it is not a case of tenosynovitis.

Control strategies
It is important to evaluate the situation and rule out the pos-
sible causes of swollen hocks, including viral, bacterial or
non-infectious causes, by using history of the flock, serology
test, culture, histology evaluation and/or virus isolation. If the
condition is related to viral infections such as reovirus and/
or MDV, proper vaccination of the birds and breeder flocks is
required. If the condition is related to bacterial arthritis, then
culture of the affected area will give the indication of the most
common isolated bacteria and treatment can be performed.
If Mycoplasma synoviae is the primary cause in broilers, then
evaluation at the breeder flock is essential, so corrective meas-
ures can be taken. If swollen hock is not related to infectious
conditions, then evaluation of the feed formula should be per-
formed.

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 Tenosynovitis (TN)

Tenosynovitis (TN) 37
HTSi® definition
Unilateral or bilateral swelling of the tendons of the shank and
above the hock. It might be associated with rupture of the
gastrocnemius tendon; it includes swollen joints.
■ Score 0. Normal joint.
■ Score 1. Unilateral or bilateral swelling of shank tendons
above the hock.

0 1

Score 0. Normal tendons� Score 1. Tendons sheath shows

Clearly defined straight noticeable swelling and edema�
tendons, white in color with
no visible edema of the
tendon sheath�

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 Skeletal

Score 1. Swelling of
shank tendons above
the hock�

Clinical significance
Tenosynovitis is reported in the literature to be caused by a reo-
virus. It causes the lesions described above, such as swelling of
the tendons, occasional rupture of the gastrocnemius tendon,
excessive joint fluid, lameness, gizzard myopathies and malab-
sorption syndrome. The disease can be costly in terms of lost
performance as well as downgrades for bad legs at the process-
ing plant. Malabsorption syndrome is often seen in conjunction
with tenosynovitis and can have a tremendous impact on per-
formance resulting in smaller, stunted birds in a house with very
poor feather conditions (bent feather shafts contribute to this
disease sometimes being called “helicopter disease”). There are
other situations that can cause lesions very similar to viral teno-
synovitis, and it is important to verify the gross diagnosis by other
means to be certain that reovirus is the cause.

Control strategies
Birds are most susceptible to reovirus infections during the
first week of life. The most effective means of control is to
provide the breeders with very high levels of protection by
vaccination programs, and therefore protect their progeny
via maternal antibody protection. This disease is usually seen
when poorly designed vaccination programs are used by
breeders, or certain flocks have been missed with regard to
their reovirus vaccination.

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 Tibial dyschondroplasia (TDS)

Tibial dyschondroplasia
(TDS) 30, 38
HTSi® definition
The lesion of tibial dyschondroplasia (TDS) is typically eval-
uated by making a cut through the bone on the medial side
of the proximal end of the tibiotarsal bone. The growth plate
is then evaluated. There are other locations to observe this
lesion, but this is one of the most frequently used.
■■ Score 0. Normal. Growth plate is normal in thickness all the
way across the cut, and it is uniform in thickness from one
end of the cut to the other.
■■ Score 1. Mild TDS. Slight increase in thickness from normal

on the anterior edge to three to four times the normal thick-

ness of the growth plate on the posterior edge.
■■ Score 2. Moderate TDS. Greater than three to four times the

normal thickness of the growth plate, but still roughly one-

third of the length of the growth plate (usually the anterior
portion) being normal thickness.
■■ Score 3. Severe TDS. Little or no normal growth plate left. Car-

tilaginous plug extends down the shaft of the bone and may
have an area of central necrosis as the blood supply has a
difficult time penetrating this tissue with oxygen and nutrients.

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 Skeletal

1 2

Score 1. Mild TDS� Score 2. Moderate TDS�

Score 3. Severe TDS�

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 Tibial dyschondroplasia (TDS)

Clinical significance
Most losses associated with TDS are the result of reluctance
or inability to move. This can result in increased scratches,
inflammatory process or gangrenous dermatitis. In severe
cases, fractures can occur resulting in trims at the plant and
carcass downgrades. Generally found in the fastest-growing
birds in the house. Mycotoxins produced by Fusarium sp.
have been implicated in the development of TDS. 38

Control strategies
Genetics, calcium:phosphorus ratio, mycotoxin control, and
chloride ion balance are considered important control points
for TDS.

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 Other conditions

Ascites (AC) 25, 39

HTSi® definition
The accumulation of variable amounts of straw-colored fluid
in the abdomen.
■ Score 0. Absence of the condition.
■ Score 1. Accumulation of straw-colored fluid in abdomen.

Score 1.
Significant
distention of
abdominal cavity�

Clinical significance
This condition is most commonly associated with cardiovas-
cular disease (CDV). Cardiac muscle damage is accumulative
because the tissue is non-regenerative. Early oxygen depri-
vation in the hatchery and brooders can manifest itself as
ascites as the bird grows rapidly. The modern bird’s growth
rate requires a high level of respiratory exchange of oxygen
and carbon dioxide. The larger the bird and the more rapid the

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 Ascites (AC)

rate of growth, the greater the cellular respiration and therefore

the need for CO2 and O2 exchange. Insults to the cardiovas-
cular system compound the condition and cause the heart to
work harder and harder to keep up with the growing demand.
The heart itself may weaken, and vascular pressure changes
result in fluid movement and accumulation from the blood
into the abdomen and pericardium. The fluid around the heart
(hydropericardium) creates pressure on the heart and further
exacerbates the condition. The increased pulmonary blood
flow cannot be received by the avian lungs. This will result in
vascular pressure changes and fluid shifts. It also complicates
the oxygen deprivation. The liver enlarges from increased
portal pressure. The lungs darken as evidence of pulmonary
hypertension (DZ), which causes poor lung function.
Primary liver damage can result in ascites without primary
cardiopulmonary problems. In poultry, liver damage may be
caused by aflatoxin or by toxins from plants such as Crota-
laria, and obstructive cholangiohepatitis (caused by Clostrid-
ium perfringens infection) is the most common cause of the
liver damage, which results in ascites. Previous infection with
Aspergillus sp. has also been shown to be a cause of ascites. 25
Ascites has also been observed with early chilling of poults.
Ascites results in increased mortality and reduced perfor-
mance.

Control strategies
Ascites can be best controlled by managing bird growth com-
patible with respiratory function. This includes maintaining
optimal respiratory function. Poor air quality, low temperatures,
dust and ammonia are all additive components that increase
the oxygen requirements. Efficient air exchange is compro-
mised by bacterial, viral and renal diseases. Good manage-
ment practices and feeding programs could help to reduce
the incidence of cholangiohepatitis from C. perfringens.

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 Other conditions

Burned feet (BF) 40

HTSi® definition
Usually bilateral dark lesions on feet due to poor litter conditions.
■ Score 0. No lesions. No or very small superficial lesions,
slight discoloration on a limited area, mild hyperkeratosis.
■ Score 1. Mild lesion. Discoloration of the footpad, superficial
lesions, dark papillae.
■ Score 2. Severe lesion. Ulcers or scabs, signs of hemor-
rhages. It goes beyond the footpad to include the toes or
between. Very often accompanied by signs of swelling and/
or hemorrhage.

Score 0� No
lesions�

Score 1. Mild
lesions�

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 Burned feet (BF)

Score 2. Severe lesions�

Clinical significance
Ammonia burns can be a site of introduction of bacteria
into the footpads and tendon sheaths of birds causing lame-
ness. The incidence of burned footpads is also being used
as an indication of animal welfare by many customers. Foot-
pad lesions can be a cause of significant downgrades and
decreased economic returns in plants harvesting paws.

Control strategies
Mainly centered on controlling litter moisture and optimizing ven-
tilation. Close attention should be paid to maintaining high-quality
litter throughout the life of the bird as this impacts the incidence
of burned feet as well as other animal health and welfare issues.

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 Other conditions

Cardiovascular (CDV) 41
HTSi® definition
The heart undergoes some rather characteristic changes as
congestive heart failure progresses. Care must be taken to
observe before the pericardial sac and large vessels on the
heart are disturbed by reflecting the breast and frame.
■ Score 0. Normal. Pyramid- or cylindrical-shaped heart,
relatively firm, with a very small amount of straw-colored
pericardial fluid at the base of the heart.
■ Score 1. Mild. Excess of pericardial fluid and a slight
enlargement of the right side of the heart.
■ Score 2. Moderate. Obvious enlargement of the right side
of the heart. The wall of the right side of the heart becomes
very flaccid, and a moderate-size clot will remain in the right
chamber even when the muscles are contracted in death.
Ascites may also be present. The liver may be swollen with
rounded edges, and perihepatitis may be present.
■ Score 3. Severe. Similar to moderate, but the signs of con-
gestive heart failure have begun to affect the other organs of
the body. Ascites may be present. The liver may be swollen
with rounded edges, and perihepatitis may be present.

Score 1. Mild�

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 Cardiovascular (CDV)

Score 2.
Moderate�

Clinical significance
Associated with oxygen levels in the body tissues. As the
heart has to work harder to compensate, nutrient resources
are expended versus directed toward growth. Fastest-growing
birds are most susceptible.

Control strategies
Management measures to ensure adequate ventilation and
temperature management greatly reduce the finding.

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 Other conditions

Inflammatory
process (IP) 42
HTSi® definition
The presence of white-to-yellow material located underneath
the skin, primarily in the region of the ventral abdomen. Also
referred to as cellulitis.
■ Score 0. Absence of the condition.
■ Score 1. Presence of white-to-yellow material underneath skin.

Score 1. Presence of white-to-yellow material underneath skin�

Clinical significance
Inflammatory response results in lost performance related
to pyrexia and anorexia, as well as direct tissue damage. A
significant loss is performed through condemnation of parts
and carcasses at processing. The subcutaneous material is a
product of the immune response to foreign material, including
bacteria. The most probable bacteria implemented in IP are
Escherichia coli, Staphylococcus aureus, and Staphylococcus
epidermidis. The insulting bacteria are likely introduced dur-
ing cutaneous trauma from piling associated with equipment
and chicken toenails (scratches).

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 Retained yolk (RY)

Control strategies
The prevalence of scratches has been most closely linked to
the incidence of IP. Care should be used to limit bird crowding,
especially during older ages. Limited feeder and water space
will become problematic as the birds reach mature size. This
can lead to climbing and piling activity to compete for limited
space. These actions are exaggerated by restricted feeding
and/or water and feed outages. Both light intensity and light
restriction influence bird activity and should be considered
with feeding schedules. Management should give considera-
tion to activities inside and outside the house which will result
in bird climbing and piling. The management of equipment
surfaces and equipment heights should attempt to reduce the
incidence of traumatic insults to the birds.

Retained yolk (RY) 4

HTSi® definition
Any portion of the yolk sac that is present on Meckel’s divertic-
ulum or that is remaining in the abdominal cavity after 7 days
of age.
■■ Score 0. No remains.
■■ Score 1. Any portion of yolk sac present on Meckel’s divertic-
ulum, or remaining in abdominal cavity after 7 days of age.

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 Other conditions

Score 1. Portion of
yolk sac present
on Meckel’s
diverticulum�

Clinical significance
When due to bacterial infections associated with hatching, this
can serve as a source of bacteria for other types of infections.
In some severe cases, the retained yolk can also result in bird
contamination at processing. Typically associated with heat
and humidity issues in incubation or bacterial contamination
of hatching eggs. Used as an indication of chick quality.
Size of retained yolks can be very varied. In customers where
there is a need to track this lesion in particular, the Elanco
Bursameter can be used to record sizes.

Control strategies
Attention to hatchery and egg sanitation as well as tempera-
ture and humidity control in the hatchery and dehydration in
the broiler house yield the best control of retained yolks.

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 Scratches (SC)

Scratches (SC) 4
HTSi® definition
The presence of cuts or lacerations on the skin.
■ Score 0. No cuts or lacerations on the skin.
■ Score 1. Cuts or lacerations on the skin. “Deep scratches”
which have broken the skin.

Score 1. Cuts or
lacerations on the skin�

Clinical significance
Scratches are a portal for entry of bacteria and may result
in inflammatory process or gangrenous dermatitis. Scratches
may indicate competition at the feeder or drinker lines, or
heightened activity within a flock. Downgrades and increased
mortality are often sequelae. Scratches should not be classi-
fied if they have occurred in transit or post mortem.

Control strategies
Ensuring constant and consistent food/water supply, man-
aging lighting programs to minimize activity and reduction of
activities that excite the birds will help reduce scratches. Toe-
nail removal for larger birds may be beneficial.

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 Broiler disease reference guide

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 Broiler disease reference guide

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36
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PY091791_Broiler_Disease_Reference_Guide_Elanco.indd 94 8/1/20 10:56
 The Health Tracking System (HTSi) is a necropsy-
based surveillance tool that goes beyond simply
lesion scoring to offer robust and holistic analysis
of broiler health. HTSi is a broiler health platform
for data capture, processing and analysis designed
to support customers in good decision making in
intestinal health and beyond. HTSi adds value to
our customers by helping to optimise the birds’
potential through greater understanding and
therefore management of Intestinal Integrity and
broiler health generally.

For poultry industry leaders who seek to

continuously improve their business, HTSi is a
data management platform that enables better
understanding of flock health to drive timely
data-based decisions and robust benchmarking,
leading to improved performance and profitability.
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of Elanco or its affiliates.
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