Pregnancy losses or prepartum problems in does

1. Pregnancy losses or prepartum problems in does Lionel J. Dawson B.V.Sc, MS, DACT Veterinary Clinical Sciences Oklahoma State University and E (Kika) de la Garza Institute Langston University

2. Gestation • Does -145 to 155 days (average 150)

3. Prepartum conditions affecting does • Pregnancy disease – Twinning disease, pregnancy ketosis, pregnancy toxemia • Pseudopregnancy or false pregnancy • Injury – ruptured prepubic tendon or hernia • Vaginal prolapse • Abortions

4. Pregnancy toxemia • Pregnancy disease • Twinning disease • Pregnancy ketosis

5. Pregnancy Toxemia • Epidemiology • Multiple fetuses > 2 • Mature does/ewes • Too thin (≤1/5) or obese (5/5) • Last trimester • Predisposing factors • Poor-quality feed • Weather extremes • Stress- processing, transportation

6. Etiology • NEGATIVE ENERGY BALANCE • Rapid fetal growth • ↑ Late-gestation • Nutritional demands • ~80% fetal growth in last 4-6 w of gestation • ↑ Fecundity = ↑ Energy requirements • Single: 150 %, Twins: 200 %, Triplets: 200-250% • ↓ Rumen capacity • +/- Concurrent diseases

7. Clinical Signs • Initially • Lag behind • Isolated • Fail to escape • Depression • Stiff walk • Poor appetite

8. Clinical Signs… • As the condition progresses • Staggering gait → recumbency • Edema distal extremities • Apparent blindness • Teeth grinding • Sweet breath • Tachypnea • Muscle tremors • Constipation • ↓ Rumen contractions

9. Clinical signs • Eventually • Severe depression - comatose • Recumbency – unable to rise • Rumen atony • Dehydration • Nervous signs* • Muscle tremors • Opisthotonos • Death within ~ 3-4d

10. Other Clinical Observations • ↑ Incidence of dystocia • Fail to go in active labor – Uterine inertia • Ringwomb • Poor mammary development • ↓ Colostrum quality & quantity • ↓ Milk production vs. ↑ Demand • ↑ Neonatal mortality • +/- Renal failure

11. Uterine inertia

12. Pregnancy Toxemia Diagnosis Clinical signs ↑ fetuses Ketonuria ± Hypoglycemia & ↑ Ketones ↑ Serum BHBA* ( ketones are acetoacetic acid + BHBA ) NEFAs > 0.4mEq/L Rule out other common diseases

13. Pregnancy Toxemia • Treatment • Stimulate appetite/ forced feeding • Buffet • Propylene glycol PO* • Transfaunation, AAS drench mix* • B- vitamins • Treat ketosis, acid-base, electrolytes imbalance • IV fluids w/ dextrose 5% +/- amino acids • Insulin SC: 0.4 units/kg SC SID for 1-2 days • Abortion or c-section • Treat concurrent diseases if present

14. Treatment by inducing abortion • Can induce parturition after 143 days without compromising fetal survivability, in conditions like pregnancy toxemia, vaginal prolapse and ruptured prepubic tendon? • Does - Dexamethasone 16- 20 mg followed in 24 hours with 10 mg of Lutylase done in early induction. Parturition 24 – 36 hours. 16 mg Dex + 10 mg Lutylase – 30±5 hours. • Ewe – 16 to 20 mg of Dexamethasone, 24 hours apart. Parturition 24 – 36 hours. • Not recommended in final stages of Pregnancy toxemia (i.e. seizures, coma)

15. Pregnancy Toxemia Prevention Ensure good body condition score at breeding Good nutrition in late gestation Energy dense Parasite control !!! Ultrasound pregnancy check – 40 to 50 D Separate dams with >2 fetuses from the rest Ketostix on urine Plasma BHB levels

16. Prevention • Does should be on an increasing plane of nutrition the last 8 weeks of pregnancy. Should gain weight (9 lbs. for a single, 15 lbs. for twins). • Feed small quantities 3 or 4 times a day. • Exercise – especially if the doe is fat. • May want the obese doe at breeding to loose weight during the first 2 months of pregnancy.

17. Pseudopregnancy(Hydrometra or Mucometra) • ↑ seen in dairy goats and also does synchronized for off season breeding. • Have been in heat, may or may not been bred. Elevated progesterone - CL • Appear to be pregnant – ‘Cloud Burst’ at the end of five months • Hemorrhagic discharge • Ultrasound: Real time ultrasound – fluid filled • Usually will conceive subsequently, but can recur • Treatment – prostaglandin • Early diagnosis

18. Injury • Older does • Fighting • Head butting • Leading to hernia or ruptured prepubic tendon

19. Vaginal prolapse • Older does in late gestation • ↑ Pygmy does • Moldy or estrogenic feed • Lack of exercise in small pens • Obese does (BC>4)with excess fat in the pelvis causing laxity to the ligaments • Hereditary aspect to the laxity of pelvic ligaments • Tail docking in ewes • Reduce the prolapse, retaining suture or retaining device • Up to 40% will die, the rest are prone to dystocia and stillbirths • Induce parturition • Cull the affected animals and their daughters Linklater & Smith

20. Abortions • Infectious – late term • Nutrition – BC • Environment – cold weather • Stress – transport, processing • Vaccination - < 2 weeks before kidding • Hormonal • Trauma – Coyotes, dog bite etc

21. Infectious causes of infertility / abortions • Chlamydophila • Toxoplasma • Coxiella • Brucella • Campylobacter • Leptospira • Listeria • Salmonella • Mycoplasma • BVD • Border disease • Caprine Herpes Virus • Blue Tongue Virus • Cache valley Virus • Zoonotic

22. Chlamydiosis • Most common cause of abortion in goats in NA, also common in sheep • Chlamydophilaabortus, gram-negative intracellular bacteria • Stress • Late term abortions, ↑ stillbirths and weak kids • Pneumonia, keratoconjunctivitis, epididymitis, polyarthritis • Reservoirs – birds ( pigeons, sparrows ) • Transmission – oral/nasal from infected aborted fetuses and feces • Infected does may not show signs till the cotyledons are infected (90 days) • Bucks may transmit through natural service • Zoonotic – pregnant women

23. Clinical signs • Late term abortions • ↑ Still births and weak kids • Placentitis • Kids infected at birth → abort • Does infected early – abort • Does infect third trimester – abort subsequent pregnancy • Abortion – organism shed

24. Chlamydiosis - diagnosis • Diagnosis – Impression smears ( cotyledon, placenta & vaginal discharge ), PCR- Placenta, spleen, liver and culture • Impression smear- modified Ziehl-Neelsonstain stains elementary bodies bright red • Inter cotyledonary thickening, cheesy pinkish exudate, necrosis of cotyledons • Necrotic foci on the liver • Serology - unrewarding Elementary bodies Linklater & Smith

25. Treatment / Prevention • Treatment – Tetracycline in feed (400-500 mg/head/day) in last 4-6 weeks of gestation. Aureomycin 4 G crumbles – 8 to 10 does fed a lb/day. • Treatment: LA Oxytetracycline (20 mg/kg) q 14 days • Prevention– Killed vaccines available; if used, administer and booster before breeding • Prevention - 150 mg OTC in the feed staring 2-3 weeks before breeding and continue the first 50 days of gestation. • Prevention - LA OTC = 60, 90 and 120 days of gestation

26. Toxoplasmosis • One of the most common causes of abortions in sheep and goats – mummification, stillbirth and weak kids • Toxoplasma gondii – protozoal disease • Pathogenesis – cats are primary host - fecal contamination of feed with oocytes shed by the cats. • Kittens usually shed large quantities of oocytes in their feces. • Oocytes are ingested from grass, feed, water etc. • Oocytes develop into bradyzoites. • Bradyzoites are seen in muscle, liver, and brain in nonpregnant ewes and does, later in pregnant ewes and does they infect the placenta • In endemic areas only younger does may be affected • Zoonotic potential

27. Toxoplasmosis - diagnosis • Infection early- resorption • Infection later may be accompanied by abortion with variation in fetal ages • Stillborn kids may be accompanied by mummified fetuses • Late infection leads to abortion and perinatal losses • Placental lesions usually limited to the cotyledons • Cotyledons dark red, speckled with white foci of necrosis/mineralization • Histology – cotyledon and brain of the fetus ( leucoencephalomalacia ) • Serology - precolostral Linklater & Smith

28. Prevention/Treatment • Vaccination – available in Europe and NZ, not in the U.S. • Control – prevent exposure of pregnant females to oocyte contaminated feed and bedding • Cat control, especially pregnant queens & kittens • Treatment – Decoquinate (2 mg/kg bwt/day) or monensin (15-30 mg/head/day) throughout gestation • Zoonotic

29. Query fever • Coxiellaburnetti – intracellular rickettsial organism • Reported in NA and many other countries • Cattle, sheep, goats, wildlife, and humans may carry infection • Spread by inhalation of dried organism, or contact of fetuses, vaginal discharge and placenta • Tick bites • Vaccine available in Europe • Zoonotic – causes acute, influenza-like disease, may progress to hepatitis and endocarditis.

30. Q-Fever - Pathology • Stillbirths and late term abortions • Fresh fetuses • Naïve animals • Severe placentitis, placenta thickened/ leathery covered with brownish red exudate • The organism can be demonstrated in uterine discharges and fetal stomach contents using a modified Ziehl-Neelsen stain • Serology – ELISA & IFA Linklater & Smith

31. Producers should burn or bury the placenta • Isolate the aborted animals • Oral tetracycline similar to chlamydophila during out break • Tetracycline in the feed (400-500 mg/head/day) in last 4-6 weeks of gestation • LA OTC every 72 hours for 3 to 5 treatments

32. Leptospirosis • Small ruminants not often affected by Leptospirosis • Goats are more susceptible than sheep • Leptospira interrogans serovars icterohemorrhagiae, grippotyphosa, pomona, hardjo, bratislava all have been reported • Caused by exposure to environments contaminated by cattle, pigs, wildlife, rodent urine • Secreted in the urine • Transmission – skin, ingestion • Causes abortion, renal disease, anemia, hemoglobinuria

33. Leptospirosis • Diagnosis – dark field microscopy, FA on the kidney, silver stains on the placenta, PCR on the urine and paired sera • Treatment and Prevention – multivalent cattle vaccine, tetracycline in the feed • Zoonotic

34. Salmonellosis • Salmonella typhimurium, S. dublin, S. montevideo, S. arizonae, S. abortus-ovis • Infection may cause abortion, metritis, diarrhoea and systemic illness – precipitated by stress • Sources of infection include birds, cattle, wildlife • Route - oral • Diagnosis – culture abortuses &discharge

35. Brucellosis • Brucella melitensis – causes abortion, weak kids, mastitis in goats – historically not in U.S., but there has been recent outbreaks • Brucella ovis – rarely causes abortion, more commonly causes epididymitis in rams – widespread in sheep in western U.S. • Brucella abortus can cause abortion in ewes and does. • Zoonotic – Malta fever

36. Listeriosis • Meningoencephalitis, abortion, septicemia • Listeriamonocytogenes and L. ivanovii • Caused by ingestion of organism found in soil, silage, hay, forage in boggy areas, pH >5.5 • Bacteria ► injury or infection in the mouth - ► facial nerves carry to the brain. • Encephalitis, abortion and mastitis • Diagnosis – culture from abortus or vaginal discharge • Treatment – Tetracyclines • Zoonotic

37. Listeriosis - Pathology • Infection of the placenta leads to acute placentitis – thickened, leathery placenta • Fetal death may result in autolysis in utero • Small necrotic foci may be found in the liver and other organs • Culture – fetal stomach, liver and placenta • FA - placenta Linklater & Smith

38. Mycoplasma • Causes abortion in goats • Can cause other conditions like mastitis, arthritis, keratoconjunctivitis • Mycoplasma mycoides, M. agalactia • Diagnosis – culture cotyledon, fetal liver, spleen. Serotyping • Treatment – Tetracyclines • Cull

39. Akabane virus and Cache Valley virus • Abortions in sheep and goats • Transmission by culicoides and mosquitos. • Infection early in pregnancy – deformities like head defects, arthrogryposis and muscle atrophy. • Late pregnancy – abortions and stillbirths. • Cache Valley virus is common in the U.S • Serology – doe, precolostral fetal serum for AB Linklater & Smith

40. Bluetongue Virus • Infectious, noncontagious disease of ruminants, especially sheep • cattle may serve as reservoirs • goats frequently serology positive, but clinical signs rare • Caused by an orbivirus transmitted by Culicoides spp. gnats • Clinical signs – infected ewes febrile, swollen discolored tongue (blue), mucosal ulcerations, lameness • Fetal infection – abortion, hydranencephaly, skeletal defects • Diagnosis – Sera from the aborted fetuses for AB, VI and PCR

41. Caprine Herpes Virus • Transmission – nasal and genital routes • Latent infection in adults • Kids – viremia and enteritis • Adults – Vulvovaginitis, balanoposthitis, respiratory and abortions • Multifocal necrosis in different organs of the fetus

42. Bovine Viral Diarrhoea • BVDV has been implicated in the infection of pigs, alpacas, sheep, goats, and wild deer • Sheep and goats represent the most likely chance of cross-species infection, due to the fact they are frequently pastured with cattle • BVDV outbreaks have been reported in sheep, with abortions and PI lambs • It is reported that infection in goats results more in abortion, only very rarely with PIs

43. BVDV in pregnant goats study – Dr C. Broadus • Objectives: • (1) Can BVDV cause goat abortions under “natural” conditions? • (2) Can BVDV infection in goats result in PI kids? • 24 goats: 6 groups of 4 goats each • Exposed at 40, 60, 80, 100, 120, 140 days gestation

44. BVDV natural infection study 3/4 stillborn or weak and later died at term 4/4 normal births, all alive 2/4 stillborn or weak/euthanized 4/4 aborted d 100-120 2/4 stillborn or weak/euthanized * 2/4 stillborn or weak/euthanized 0 20 40 60 80 100 120 140 150

45. Gross pathology • In one placenta, pinpoint white areas scattered along the chorionic surface of the cotyledons • Marked brachygnathia was noted in one fetus • Mild, mandibular prognathia noted in one fetus • Serology – ELISA or SN, PCR, VI

46. Toxic plants • Broom weed, loco weed, sump weed and tobacco - can cause abortions and altered fetal development. • Pine – Stillbirths in ewes • Lupinusspp – altered fetal development. • Lathyrus and Sophora spp. [ limb defects] • Clover – hyper estrogenic • Gossypol (Cotton seed) Infertility • V. californicum consumption on day 14 causes – resorption, cyclopia and shortening of the metacarpal and metatarsal bones and prolonged gestation. • Nitrate accumulators – sweet clover, Johnson grass, sorghum, Lamb’s quarter, jimson weed, sun flower, pigweed and oat hay – can cause abortions

47. Veratrum californicum – 14 D Deformed Cyclopia Linklater & Smith

48. Diagnosing abortions • Frustrating • Proper sample submission to rule out infectious. • Dr Tom Thedford - proper tissue and serum submitted we can get our diagnosis up to 50%, if they are infectious. • One serum = < 10% Paired serum = 15 to 20% Fresh placenta + fresh fetus + Paired serum = 25% 3 sets of serum + fetus + placenta( frozen ) = 50%

49. Questions?