Sheep goats Toxemia cases

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					                          Sheep & goats Toxemia cases
Pregnancy toxemia very common, maybe most common nutritional metabolic dz of small
ruminants.

Pregnancy toxemia:
 hypoglycemia, hyperketonemia. always present ketotic with ketones in urine. when
you see an adult female off feed who is pregnant you might check her glucose and find it
normal or high, though - stress reaction, somogyi (hyperglycemia following an episode of
hypoglycemia) effect, whatever it is, you can't base your dx on the glucose. The ketones
are diagnostic, though.

Occurs in last 6 wks of gestation; twin or triplet bearing ewes are predisposed.
Undernourished or obese ewes are predisposed. All have reduced feed intake prior to
onset.

the client may feed appropriately, but appetite is decreased, maybe animal got stressed
for some reason, whatever it is, maybe she's lame and can't get to trough, maybe she's not
dominant and other sheep are crowding her out, whatever it is, her intake goes down, and
toxemia can occr.
slide: acutely dead ewe - opened her up, big twins in there, late term.

Stress factors:
Bad weather, dogs, driving ewes, sudden dietary changes, health problems, foot rot,
shearing. it *is* ok to shear late gestation ewes, though.

Signs:
Depression, ataxia, blindness, muscle tremors, stargazing, griding teeth (odontoprisis),
labored respiration, recumbancy, coma, death. but *usually* you just see "depressed ewe,
off feed"

So, December - may, if ewe is off feed, first suspect this.
Dx:
Clinical signs, Ketonuria - mainstay diagnostics

Other: decreased plasma glucose, increased plasma free fatty acids, increased plasma
ketones.

Treatment: 5-20% glucose IV (not 50% dex),
Propylene glycol PO, anabolic steroids (maybe), oral rehydration solutions (maybe).
Really just start propylene glycol, induce parturition with dexamathasone (only works
half the time), do C-section, give bicarb,
potassium, sodium as needed.

So you start to correct the metabolic acidosis - have to give K+ with it.
She used to give all the ewes dextrose but now she just uses propylene glycol and figures
out how and when to terminate the pregnancy. it's not good to take lambs earlier than a
week early. can survive at 2 weeks early but not always, and 3 weeks is really pushing it.

Slide: doe in NBC with a potato chip in her mouth. Goats do not seem to get pregnancy
toxemia as often. not sure why more resistant, or better fed in general since they are
dairy does, or not group fed in such big groups, or whatever. when they do get pregnancy
toxemia, though, they get sicker, and they get sicker faster. this goat was off feed x 2
days and was recumbent.
Client started her on propylene glycol the first day she didn't eat. next day was recumbent
and acidotic.
She had FOUR babies!~ they induced her with lutalyse b/c goats ARE luteal
dependent unlike sheep. She ended up down, though - so they had to put her in a sling
and then swim her to get her back up again. obviously this isn't going to work in private
practice. Someone has to allow you to swim the goat in their pool.

questions about pregnancy toxemia? it is very hard to manage these medically. timeframe
is case by case - how sick is she? is she stable or going downhill?

case:
6 yr old dorset ewe, due to lamb in 4 wks, on 1 lb mixed concentrate/day and 4.5 lbs
alfalfa/day w/free choice salt. one morning was noticed to be slightly off feed. what do
you do? go see her. PE: T 102.4, HR 88, RR 48, rumenal motility slightly decreased, all
else normal. TPR normal, rumen motility decrease indicates she's been off feed more than
one day. urine - ketone positive (slight). body condition score is 3/5.no other ewes are
affected. are her lambs viable? not sure. Ultrasound it - lambs are alive. there are at least
2 heartbeats. had twins last year. always has had twins, in fact. Never sick before. no
vaginal d/c or fever present.

Ok, what do you do? client likes this sheep, but she is 6 yrs old. reproductive life of sheep
is probably about 8-12 yrs. 6 is "middle aged." she might have only 2 yrs left, might have
4. but client wants to treat her.
Give her propylene glycol - 2 oz BID.
Give glucose IV.
Give cream of wheat - as much as she'll eat. usually 4-6 oz 4 times a day.
blood work? No, not needed, but if you do it, you can look at acid base status and
calcium balance.
We started propylene glycol BID and cream of wheat QID. Started force feeding hay.
Four days later, ewe is eating well and all tx stopped.
Urine now negative for ketones. so, keep an eye on her. took back to teaching flock.
Three weeks from date she got sick, was noted to be off alone and straining. presume
she's lambing.vaginal exam - dystocia - thick brown soupy vaginal d/c. delivered 3
lambs, two mummified, one alive and covered with thick brown d/c.

what happened? well, two of the lambs died during the toxemic crisis. one lived. the
dystocia occurred not because of the size of the lambs, but there was this thick brown
discharge that wasn't lubricating well. ewes sometimes do this thing where they kill off
some of the lambs in utero. not all the time, though.The two mummies had some hair on
them. the surviving lamb did do well.

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Case :
6 yr old Suffolk ewe (black face)
Call comes in for "down ewe, was up one hour ago" - is she pregnant? not sure. ram was
with flock 4-5 mos ago. is she eating? not well last night, this am slow to stand and
refused to eat. what is she fed? is on pasture now in january, w/supplement of hay and
grain not sure how much, once a day.
These sheep were purchased 9 mos ago. client never had sheep before.
PE: recumbent, weak, barely
Holding head up, temp 99.8, HR 90, RR 16, mm normal, lungs normal, no rumen
motility, mild bloat, dried manure in rectum. neuro normal. no mammary development
present.other sheep in the flock are fine.
supplement was cracked corn.no vaginal d/c present.
Temp and RR low, no manure, no rumen motility, not eructating - think hypocalcemia.
this is weird. what do you do? you're there and they are asking you what is wrong with
her. she is hypothermic. sheep do not get hypothermic unless really about to die. low RR
unusual. so what do you do? give calcium.
60 ml 23% cal gluconate very slowly, IV.ewe defecated, lifted head, eructated,
stood up in 15 minutes. in sheep, this occurs prelambing, not at lambing or after lambing.
also is very rare in this part of the country. this case is from 1993.
ok, now what? well, she's not in labor. she's not ready to lamb. check urine - she is
ketotic. now, treat that. this ewe was carrying a single lamb. they treated her x 4-5 days.
she ate, lambed 4 wks later. you can draw blood prior to calcium administration - put
blood in green top tube, run it later to confirm the dx.
In sheep: hypocalcemia, toxemia - last trimester
Goats: like w/cows - postpartum.


Case:
10 yr old dorset ewe - june 1 1991
hx: ewe depressed, won't get up, owner on way in with ewe, ewe is worse an hour after
initially being depressed and not getting up.is she pregnant? no, nursing 1 mo old lamb.
when last normal? she was out on pasture and came up to eat with all the other sheep -
she took one bite then laid down and wouldn't get up. 1-2 lbs of commercially prepared
concentrate per day supplement; also on pasture.

PE: laterally recumbent, rigid, aware, T 101, HR 80, RR 40, H/L WNL, can't pry mouth
open to visualize gums, sclera normal, no rumen motility present,
neuro: no cranial nerve deficits, limbs rigid, occasionally paddling, seems
hyperresponsive. has had tetanus vaccine per routine health maintenance plan.
Potential rabies case? Tried to get urine - couldn't .polio? These animals are rigid, often
in lat recumbency, usually blind and not aware. This sheep is very aware. She knew you
were there, she looked at you.
Listeriosis? No cranial nerve deficits. Those animals usually dull and depressed, too, and
she isn't.

Think history -
She walked up at 4 pm and it is now 7:30 - she was walking 3.5 hrs ago.
This was a rapid onset disease. She’s nursing a 1 mo old lamb. Think about her diet.
hhmmmmm. calcium, copper, magnesium are things people are mumbling about. So let's
give her some fluids and some calcium. Gave 60 ml 23% cal gluconate, 60 ml Mg sulfate
6% IV, and then some additional Ca/Mg subcutaneously. She got up and started eating
and running around.

Why did this happen? any change in nutrition? low calcium pasture in spring? Grass
tetanus - hypomagnesemia. in spring, Mg level isn't high in grass. so, she needs a
supplement. feed her separately for a few days - she needs Mg in her grain. 1/2 oz BID x
5 days. also ask farm about giving trace mineral sheep block, or other mineral mix.

Why did we give calcium first, then Mg? b/c animals that are hypomagnesemic have
another bad thing happen to them. they become hypocalcemic. if you just give the
mag sulfate, you could kill them.
if you just give calcium you probably get her back up and then she will go back down
quickly
. but if you just give Mg then Ca will go further down. Always CA FIRTST


Hypocalcemic ewes can start out with stiff gait and depression, then become recumbent.
They aren't always going to be recumbent right away. in goats - signs are ataxia,
constipation, depression, failure to complete kidding, recumbency.

dx: history, signs, response to tx.
serum calcium - ewe 3-6,
doe under 5 mg/dl
they will respond quickly but also often they will relapse (does more than ewe).
so usually give some subcu morning and evening for a few days for sheep. for goats, they
often need to stay a
few days b/c they do not bounce back so rapidly either.

tx: 23% ca borogluconate. PO4 and Mg. avoid udder insufflation in the doe though some
want you to do it. avoid risk factors.

if no response to tx, something else is wrong. find out what it is.


Case:
7 mo old ram. 3 day hx
anorexia, lethargy, diarrhea. this is a show rambouillet ram. very valuable ram.
dewormed x 1 mo ago. been home x 1 month since last show.
fed grain and hay - lots of grain. I’m not writing down the details of this case.this sheep is
icteric, panting, febrile, high HR, decreased rumen contractions, and clumped feces,
brown urine. other sheep on farm are ok.

Hematuria ―› copper toxicity, Leptospirosis or bacillary
Hemoglobinuria could be cause.
PCV was 24% - low, but not horrible. should be 29-30. now what? diet analysis:
commercial sheep mix,
commercial mineral mix, also pasture and grass hay. how long have they had the ram?
since birth. so they know what he has eaten in the past.

Liver enzymes are elevated. liver biopsy is pretty invasive. to assess for copper crisis, can
also look at creat/BUN and look for copper in blood. serum copper 6.7 ppm (1.3 = high
normal) he has copper toxicity.
client is arguing with you on the phone b/c they feed "the best" food and they want
another diagnosis. what do you do?
Cu/Mo levels in feed and minerals. Give fluids D-penicillamine (most effective and most
expensive
copper chelator)
Monitor PCV/creat/BUN/TP/CVP

He died. crea increased massively over time.

feed analysis: mineral: Cu was 24.5 ppm and Mo about 1. - label said 6.38 ppm
hay: 6.05 ppm Cu, Mo 1.68 pellets 18.5 Cu, 1.62 Mo - copper also too high.

What do you tell the client? change feed companies.these foods had been prepared for
sheep!! it all went off to
several labs for testings and was NOT prepared correctly for sheep at all.

rx: change grain mix. test new grain mix. can you identify animals at risk? all the other
sheep on the farm were on the same diet. blood work: what would you look at? they
aren't in copper crisis yet. check
liver enzymes. GGT and AST may rise 6-8 wks prior to hemolytic crisis.


Goats are resistant to copper toxicity.

Sheep get a lot of it. you can see severe hematuria
Goats drinking cold water can get hematuria
Any animal coming in with severe dark red urine and icterus, though - think hemolysis.
sheep/goats don't get icteric from anything else. If icteric they are hemolyzing.
Case:
four lambs and three goats got into two 100 pound bags of grain. it's now 8 am and they
look sick, have diarrhea. if you travel 30 miles at 65 miles an hour over hilly terrain, what
time will it be when the first sheep dies? no just kidding. seriously, what's going on? what
do you ask?

What kind of grain? cracked corn when did they get into it? last night.
Is any left/how much did they get? Some is left, not sure how much they ate - as much as
they wanted.
Have not been vaccinated
Temperatures? Not taken
all one year old or older. "look sick."normal diet *does* include some grain

PE: 2 goats and 1 sheep are normal. others: depressed, grinding teeth, decreased rumen
motility, diarrhea, head pressing, one has splashy rumen and is bloated, HR 90-130,
bloated sheep has highest HR.

What’s the problem? Lactic acidosis. How do you fix this? rumenotomy? that's one
option. bicarb? how will you give the bicarb? IV? any other way? can you give it another
way? yes, orally. oral bicarb. realize there are 4 affected animals here. client says "i do
not want any of them to die." you could try surgery on all of them. bloated goat with
splashy rumen and high HR really needs the surgery. she's the main one. the two sheep
that
are depressed and grinding teeth, etc - these aren't bloated or splashy. just give them
bicarb. or could do surgery. if he wants to do surgery on all four, you start with goat - that
will take you about 2 hrs...then others are waiting. What do you do? Give them bicarb
orally while waiting.

We did surgery on the little goat, also medically treated others with oral bicarb and
transfaunation with normal rumen contents from fistulated animal. also could try feeding
yogurt. or one of those probiacin paste products.
vaccinate them, too - for something in particular but I can't hear what she said. also
antitoxin type C/D.

For diet from here on out - do not let the guy buy grain any more. put them on hay or
grass or other forage for next few days.

Surgery - empty out the rumen, put back in a warm liquid, some hay - one or two
handfuls, some bicarb.

another potential complication is laminitis - 1-2 days after getting into the grain.

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Plant toxicity. Most common in east are rhododendron and azalea toxicity. yew is also
common - yew bush is very fatal. Causes sudden death from cardiac complications.
Rhododendron, they vomit. this is the most common cause of vomiting in sheep and
goats.
Tx depends on how much it is vomiting, how sick it is. If profuse, very sick - do
rumenotomy and remove plant material. usually they didn't eat that much and all you do
is give some dexamethasone and watch for vomiting to stop.
Usually just off feed a day or so, a bit depressed, oh, give a vitamin shot too. sometimes
they vomit, stop, look fine, then vomit again -t hen you go to surgery. if you do this in the
field under local, sometimes they vomit while you're operating so that's not good, they
can aspirate, so now it's considered best to send them to surgery with general anesthesia
and intubation to protect the airway. tubing and charcoal is common, hard to do in goats.


Case:
Sheep is down, 3yr old ewe, had her lambs a few days ago and is lying down, anemic,
etc. talked about giving blood 10ml/kg. this was in August. there were 2 ewes and five
lambs on pasture. lambs were weaning age. how do you explain why this happened to
ewe and not lambs? ewe had haemonchus (nematode worms); she's lactating so she's
susceptible...lambs are nursing so they don't have it b/c they haven't grazed enough to be
so heavily parasitized.

Case :
5 month old pygmy goat buck. Client calls, buck has had diarrhea for four days, eating
well, not growing well. Well managed herd, 35 goats in herd, buck living in pen with 10
other animals mostly adults.
Vaccinations/deworming up to date. no new goats in. dewormers are rotated
Diet free choice hay, 1/2 pound/head/day grain and minerals (goat chow), no one else is
sick.
Size of pen? Less than 1/4 acre - small pen.
ddx:
parasite? well, he's not grazing but could get it from eating off the ground, from water but
that isn't likely since not drinking from stream.
BAR, mms slightly pale, TPR ok, H/L ok, rumen ok, round belly, rough hair coat, not
growing well.
 (small, rough haircoat, big round belly).
HR 90-120 WNL btw (goat)

Dx: fecal exam, PCV, TS, blood selenium level

While waiting for test results...
Tx: Ivermectin, vitamin B, vit E/selenium, coccidiostat

Fecal: lots of Eimeria. blood Se high normal, WBC normal, PCV 24, TS 4 (anemic,
hypoproteinemic)
Tx: strongid PO, SMZ PO SIDE, probiocin SID (like yogurt)
Diarrhea didn't resolve over 2 wks. wt loss continued. was euthanized due to financial
constraints.

Necropsy: tapeworms - usually we think of these as not causing problems but they
obviously can. this case went on over about 4 wks...he was in the hospital, we did all
kinds of tests. big bummer.

what was the deal with the eimeria? they went down in number after we treated him. but
normal goats often have coccidia in there.

what works for tapeworms ? Albendazole (valbazen - cattle dewormer)

Case:
5 mo old alpine goat kid: you are the vet at the nat'l dairy goat show. you have to check
incoming goats for signs of dz. one goat went down within ten minutes of arrival and
looks really bad. recumbent, weak. lying on sternum, head stretched out. other goat kids
her age ok.
T 102, HR 120, RR 16, mm pale, no Scleral injection, rumen motility normal, no nasal
d/c or cough, dried feces near tail. Owner is hysterical was on the road about 3 days but
stopped often. Plenty of water and hay on the road.

Dewormed with ivermectin 4 wks ago. currently too weak to stand. no diet changes

Plan:
get goat blood and give to patient, you have to call a vet hospital get IV cath, infusion
sets, heparin, bag to put blood in, filter, needle, syringe, panacur, strongid...

Ddx: haemonchus, abomasal ulcer, trauma.


We gave transfusion, strongid. this animal wouldn't make it to referral center. she died as
we were putting cath in - took 40 minutes to get supplies. could euthanize w/nolvasan,
btw

Spiral colon/terminal small intestine full of blood. she bled out into that part of her
bowel. no blood anywhere else. what parasite makes them bleed into the bowel?
coccidia




Parasite control:
Parasites are one of the most serious problems faced by producers .H.contortus here is the
most common nematode. eimeria common in young goat kids and lambs eimeria a really
common problem in kid rearing
it's a dynamic situation and everything changes year to year with weather etc. client
education is important - teach them about susceptibility (lactating moms, young animals,
drylot aniamls) and immunity; life cycles, prepatent periods (3 wks).

Reality on most farms: limited pasture space so no safe pasture exists.
pasture rotation is difficult to do. animals often graze heavily
contaminated pastures. danger period occurs late in summer, early fall,
when many clients forget to deworm.
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parasite program

visit farm - look at:available pasture space, how is feed delivered overall cleanliness of
facility groupings of animals stocking rates in pens, pastures.
goals: decrease production losses, minimize anthelmintic use
(though resistance not a huge problem here)

three approaches:

-tactical program: dewormings concentrated in danger times - late summer, early fall.
this allows big buildup of larvae on pasture in spring. this method allows you to deworm
animals "when they need it" - not a good program.
-strategic program: Dr. Johnstone's method. dewormings are strategically performed in
winter and spring. this prevents the spring buildup of larvae on pasture, but often fails
during the danger period of late summer due to lack of clean pasture. remember - you
deworm at lambing or a month before (which is in winter). then, the clean animals go out
on pasture. then deworm while on pasture every 3 weeks, four times. from Mid-April to
July. then move to safe pasture. this has stopped you from getting contamination on the
first pasture, but do you have a second "safe" pasture? one that was plowed under,
reseeded, and grazed by another species for two years or idled for two years? this is best
in terms of using fewer drugs, but fails as noted.

-traditional program:
animals are dewormed monthly throughout the grazing season. relies heavily on
anthelmintics for control. this is what we do on problem farms. this works, we do this til
november 1st. we want people to then deworm once midwinter, too.

recommendations: sheep:stress pasture rotation, monitor fecal egg counts
(controversial)(doesn't tell you much )
consider dry lot confinement for market lambs being creep fed, be flexible


clients tend to tell you anthelmintics do not work - usually b/c they aren't giving enough.
but if they are and you do fecal egg counts before and after (10 days after) you should see
85% suppression in fecal egg count if it is working. clients do tend to underdose, though.
dairy goats: anthelmintics can't be used in lactating goats. so...monitor fecal egg counts.
deworm does with ivermectin at drying off (and do not tell the milk inspector).
discourage intensive grazing in lactating does. manage kids similar to lambs.

companion animal owners: healthy adults in small nonbreeding groups do not need
frequent deworming - once or twice a year is all. but if they bring a new animal in, they
need to deworm.



case:
7 yr old ramboulet wether. client calls b/c his pet wether is sick, not eating x 2 days. only
sheep on farm. never sick before. no changes in life, diet - grass, hay, cookies, potato
chips. Vaccinated and wormed regularly (neighbor comes over once a year to do it). only
sheep owner has ever had confined on long rope. Has doghouse.no access to poison
plants client takes him for walks.other pets? cats and dogs vaccinated for rabies No
mineral supplements

PE: depressed, trying to get away.Sunday was seen by one of our vets who asked her to
go see him b/c she couldn't figure it out. smells funny
T 105.6, HR 60
wool on neck looks weird - different color. looking under wool didn't show anything.
looking for bite, abscess, worms there were three maggots in the water bucket.there were
a LOT of maggots on the neck.

tx: shear, clean off maggots, kill maggots, antibiotics given where he lives (suburb) -
suggest flyspray, suggest keeping him sheared (usually shears once a year) we had to
hospitalize this sheep - had maggots all the way down his back - like a foot and a half
patch of maggots and dead skin. clip, scrub, remove maggots, apply screw bomb spray
but not too much b/c can kill them.
why did this happen? could have been a bite wound. could have been abrasion from a
collar. dirty wool from diarrhea. other. he didn't have a bite wound. didn't have diarrhea
on his neck. collar was ok.

Owner was bathing this sheep once weekly, btw - probably his skin never dried out. that
could have contributed to the problem. sheep grazing really nice grass also get fly strike.
Out west, people will dip the sheep a few times in the summer - can make them swim or
put them under sprinklers or something.
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Dystocia:
 is a major cause of perinatal mortality; more common in ewes than does in our practice;
very common though. in sheep, hopefully you can keep it under 10% in flock.
Etiology: fetopelvic disproportion is rare except in pygmy goats it is the most common
cause of dystocia.

Maldisposition/malpresentation of fetus - very common in dairy goats and sheep
Ringwomb - basically, failure to dilate cervix - one ring fails to dilate
Uterine inertia not common
Uterine torsion very uncommon
(ewe early dilation syndrome - may be a manifestation of ringwomb, ignore)


Other causes - siamese twins - head very broad, four front and four rear legs, pelvises
attached, one torso. this ewe had a live lamb behind this!

other fetal monsters - sometimes you get them out whole, sometimes you have to cut
them up.

diagnosis:
1 1/2 hours of active straining per textbook. really, wait 1/2 hour before checking via
vaginal exam. reach
in and feel what's going on. Active labor ceases stage I longer than 12 hrs over an hour
b/w fetuses if no fetus 15 min after entering stage 2, probably you should check. if you do
a vaginal exam and THINK it's a
dystocia, and cervix really just isn't dilated yet, you'll have problems if you try to rush
things. the vagina only dilates when the head is starting to come down.


ringwomb cases require c section or cerviotomy
(which makes them infertile). when you see this in sheep, probably go
ahead and cut the cervix, because if you do the c-section it's expensive
and ringwomb may recur next time. so you do cerviotomy, then cull the
ewe. to do it, snip the tight band at dorsal midline area of cervix, or
rupture manually with finger. she'll bleed a little but not too much.
this is just for sheep, not goats - goats do not tolerate it well, act
like it is very painful, it's not good for the goats. but it is fine for
sheep, they deliver live lambs and act nonpainful.

when handling these
animals be clean and gentle -uterus not as tough as cow.
pygmy goats have
very high rates of dystocia - up to 60%. you can tell the clients about
how to breed differently to avoid this problem but apparently these goats
that do not kid normally are prizewinners in the show ring. one herd near
here has 70% c-section rate; these uterine inertia problems do seem
heritable. if you are size 7 glove or larger, you can't manually examine
pygmy goats. plus the uterus ruptures really easily. b/c sometimes
clients wait 2-3 hrs to bring goat in, pygmy goats strain really really
hard, uterus has a lot of pressure on it, the goats are very small. must
be really really gentle. you can make a lot of money doing c-sections,
though. if you work for 15 minutes on pygmy dystocia and no progress, go
immediately to c-section (other goats - give it 1/2 hr or so).


Treatment:

be gentle, clean, use lots of lube, always scrub first
thin
walled uterus, more prone to rupture
subcu embryotomy
c-section

goats
are noisy in labor - they will tell you when they are in stage 1 - noisy,
sniffing, moving around, sometimes if you do a vaginal exam they think
your hand is the kid and they chase you.
gloves - good to prevent q
fever; up to you. someone to hold the tail is a help. be gentle - extrude
head and legs, pull down toward hocks. once out, hold it upside down,
clean crap off its face. hang upside down x 30 sec so blood goes to the
brain.

				
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