Pregnancy Toxemia and Ketosis in Does (Sheep and Goats)

Pregnancy toxemia and ketosis are the result of the high carbohydrate (energy) demand of multiple fetuses in late pregnancy. The kids require an increasing amount of carbohydrates the last trimester. Does bearing twins have a 180% higher energy requirement than those with just a single fetus. Does carrying triplets have a 240% greater energy requirement. When this demand exceeds the supply, fat is metabolized into glucose. The metabolic needs of the kids are met at the expense of the dam; this is what causes the ketotic condition. To complicate matters, multiple fetuses produce more waste products, which leads to the doe becoming toxic if she does not flush them from her system.

Risk Factors for Pregnancy Toxemia

• Multiple fetuses
• Poor quality of ingested energy
• Dietary energy level
• Environment
• Genetic factors
• Obesity
• Lack of good body condition or high parasite load
• Confinement - lack of exercise

Toxemia and ketosis are typically seen in does that are overweight and get little exercise. Under weight animals that are fed a poor quality feed are also candidates for toxemia. Look for does at the bottom and top of the pecking order. These does may be getting to much or not enough feed. Does should be in good body condition, and not overly fat when bred. They can be maintained on good roughage or forage during the first 100 days of pregnancy. During the last trimester the doe should gain approximately 1/2 lb. per day. The doe must intake enough carbohydrates to supply the demand of the growing fetuses and to keep her alive and functioning also.

I also believe that we are seeing an increase in toxemia this year due to the extended drought conditions. With these conditions the quality of the feed changes, the browse is limited, and the animals do not receive the vitamins and minerals that they get naturally from high quality feeds and browse. Extremely wet conditions, especially if following a prolonged drought can also cause a dramatic and quick increase in the worm load, and cause the doe to drop enough body condition to become a candidate for toxemia.

When there is a decrease of glucose levels in the doe's brain, they tend to lay down, become sluggish, and show a loss of appetite. They may get stiff, and walk with a staggering gait. Swelling (edema) of the lower limbs is not uncommon. Some does may also grind their teeth. Keto acidosis is also common during toxemia and needs to be treated also. As the disease progresses, the neurological systems become compromised due to lack of glucose. Blindness, stargazing, tremors, aimless walking, ataxia (uncoordinated staggering gait), are seen and eventually the doe becomes comatose. At this stage the fetuses succumb and release toxins that send the doe into endotoxic shock, and death. Does that survive toxemia need to be watched for dystocia, and lactational ketosis.

Diet should include high quality roughage and increased concentrates. At fist sign of decreased appetite, or unwillingness to rise, managers need to be wary. Exercise should be offered and forced if necessary. Some type of high-energy supplement needs to be given to keep the doe from coming ketotic. The carbohydrate (energy) level of the diet needs to be increased. This can be accomplished by adding corn, fresh alfalfa hay, or a soybean supplement to the diet. Increasing the protein does not necessarily increase the energy level.

High Energy Supplements

• Propylene Glycol
• Nutri-drench
• Dextrose
• Environment
• Magic (1 part Molasses, 2 parts Kayro, 1 part Corn Oil)
• Glucose IV

B Complex, thiamin, probiotics, and penicillin should also be given as support therapy. 3cc B Complex and 500mg thiamin should be given twice daily. Probiotics should be given at least daily, and a large initial dose of penicillin followed by substantial doses for 5 days total should also be administered. This also helps prevent primary and secondary pneumonia.

If the kids are within 7 days of due date, and the doe does not respond immediately to treatment, giving 20-25mg dexamethasone can induce labor. Labor will begin within 48 hours. Dexamethasone is preferred over hormonal induction of parturition because of its beneficial stimulus to appetite. Also, dexamethasone may also prepare the lungs of marginally immature kids increasing their chances of survival during labor or cesarean. Valuable does that fail to respond within 24 hours should have a cesarean immediately. Even with surgery and fluids, prognosis is poor for the survival of both the doe and kids.

The key to treating toxemia is catching the subtle symptoms promptly. Fist concern is to hydrate the doe and get enough sugars to the brain to get if functioning properly. We have been successful treating does with 50% Dextrose solution and magic. We give 20cc magic two to four times daily at first signs of toxemia. If the doe is completely off feed or becoming lethargic we give 4 ounces 50% dextrose (1/2 dextrose, ½ water) with 3cc B Complex, 500mg thiamin, 50cc Calcium Glutamate (orally) and probiotics. The dextrose solution is repeated every hour until the doe is standing, drinking, and urinating. We have also found it helpful to give water (drench if necessary) at every treatment. Once these does quit moving, they don't get up and drink, as they should. We give one pint of water with every treatment.

Be cautious given electrolytes or products that are high in sodium. Although in a pinch they will work to hydrate the animal, you don't want to give long term anything that has a lot of sodium in it. That is why we use the dextrose instead of oral electrolytes. You need to make sure that the doe urinates, giving a mild diuretic such as cranberry juice may also be helpful. The does need to flush the toxins from their system.

When the doe starts to respond we start decreasing the treatment intervals. Treatment is dropped to 4 times a day, and if the doe is back on her feed and eating well, we just give the magic mixture two to three times daily. The doe may scour the first couple of days & Pepto-Bismol or kaopectate can be given to relieve the dietary scours. Don't be terribly concerned if the doe scours it is caused by the drastic dietary changes and will clear up as the doe continues to eat.

Propylene glycol can be given orally at the rate of 4 ounces, 4 times daily. Nutri-drench can be substituted for propylene glycol, and is easier to dose orally - it doesn't taste quite as offensive to the doe. Intravenous glucose (25-50 grams - in a 5 or 10% solution), and B Vitamins, can also be given. If probiotics are not available give baking soda orally to prevent acidosis these need to be given at least once a day. Dextrose (50%) can be given IV in a single 60-100ml dose, followed by a 5% dextrose solution in an electrolyte drip. Be careful giving commercially prepared and oral electrolytes, they are usually high in sodium.

Ketoacidocis is precipitated by metabolism of fat. When the doe is not consuming an adequate amount of carbohydrate, that she metabolizes fat to make glucose. The byproduct of this is ketones, which must be secreted by the kidneys. The doe must have a fluid intake to allow this to happen. That is why plain water is given, drenched, or tubed, along with the 50% glucose, and other support therapy. When enough glucose is present, fat is not metabolized, and the body has time to get rid of it. As this happens, the doe will become more alert, and start to eat and drink on her own. This is a vicious cycle, and difficult to break. If caught early, and treated concienciously, the cycle can be broken. The doe must be monitored carefully until the kids are born, condition can change quickly and needs to be responded in a timely fashion.