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sheep
freeman
11/9/98

we left off before with pregnancy 
toxemia.
very common, maybe most common nutritional metabolic dz of small 
ruminants. no matter how well you explain how to feed, you will see some 
of these. the question is only how many. most of them die. 

preg 
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 effect, whatever it is, youcan'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: 
dpepression, 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, 
1/5/97

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. u/s - 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.
bloodwork? no, not needed, 
but if you do it, you can look at acid base status and calcium balance.


we started propylene glycol BID nad 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 broun soupy vag 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. 


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.


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.

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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.

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, 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. creat 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.


the feed company has reformulated the rations and has paid off the people 
and vet bills, by the way. 

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.

[i'm not taking much in the way of notes 
at this point...]

[she just told about an interesting case of chronic 
necrotizing rumenitis caused by feeding sheep kaiser rolls.]

[i'm 
skipping last hour. bye.]

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