Freshened Doe

General Aftercare

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2/12/02

The purpose of this page is to discuss some of the things that can go wrong with the doe as she approaches or the first few days after delivery. Some of the ailments involve some pretty serious metabolic disorders that may require the diagnostic skills of a veterinarian and/or pharmaceutical products that can only be obtained through a licensed vet.

Obviously, the doe should have lots of good feed and water available to her at this time of stress. She should be kept warm because she is susceptible to shock at this time. She should be kept clean, especially the teats, udder and vulva. Until the passage of the placental membranes (afterbirth), you may have to remove the babies from her. She may dig at her bedding, pace nervously around the stall and generally behave in an obnoxious manner. She may exhibit aggressive behavior toward the kids. We frequently put the babies in a large tub or box so that she can see them but not have contact. This seems to help her calm down.

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This may be due to a glandular problem in the fetus which interfers with the release of cortisol, which is necessary for the start of labor. Some plants when eaten by the pregnant doe can also cause this. The eventual death of the fetus will usually stimulate delivery. Otherwise, the veterinarian will need to inject glucocorticoids or perform a caesarean delivery. This is very rare in goats. The normal gestation range is 149 - 153 days. We have had normal deliveries after a gestation of 159 days. Beyond that, we have no experience. [This topic is duplicated here.]

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The general topic of abortion is discussed in our "Diseases" section. [Link to abortion.] When you have an abortion or delivery of stillborn or extremely weak kids, you should do as much as you can to try to discover the cause. A fetal death in late pregnancy is almost always infectious in origin; if more than one doe aborts, then you definitely have to consider the presence of a disease. In these cases, the fetus, afterbirth and blood from the doe should be submitted to a diagnostic laboratory by your veterinarian.

Abortions in early gestation are fruently due to the ingestion of toxic substances from plants or environmental contaminants. Other non-infectious causes include: malnutrition, Vitamin A deficiency, crowding, injury, fatigue, shock, drugs (including some wormers), poisons or chemicals.

In an abortion, there will not be the usual enlargement and discharges from the vulva. There will be little falling of the sides by the root of the tail. Frequently, there will be no preparatory signs whatsoever, especially if early in the pregnancy.

After an abortion, the afterbirth and bedding should be burned. She should be isolated from other members of the herd until a diagnosis has been completed. Treat her just as if she has delivered, with lots of "TLC." The abortion causes page may suggest some treatment measures for specific abortion-related diseases. Otherwise, give the doe a long-acting broad spectrum antibiotic such as LA200® or 48hr penicillin. Taking her temperature may provide some information about the seriousness of an infection (but not always). If she has a high temp or is in obvious pain, she can be given aspirin or other pain killer as recommended by your vet. Symptomatic treatment of other signs such has runny eyes or lameness may help her feel better.

If she has an infection of the uterus, that should be treated aggressively with Nolvasan® suspension or uterine boluses.

Pay careful attention to the cleanliness of the tail, vulva and back of the udder, keeping discharges frequently cleaned off.

Nutritional needs should receive careful attention. If she will not be producing milk, you will want to avoid large amounts of high protein feeds; but a well-balanced ration should be provided. It is extremely important that she not go "off feed" (stop eating) at this time of high stress. Make sure that she has access to her "favorite" treeats as well as leaves, branches, fresh grass, balanced concentrate ration and the like. If in doubt, it is much more important that she continue EATING than that she eat "properly." For once she stops eating, the situation can become grim real rapidly. If she has surviving babies to feed or if you decide to milk her, or at least to try, then she should receive a normal diet.

Pay attention to her general health. Has she been recently wormed? Does she need to be treated for liver flukes? Parasitic infections seem to blossom during times of stress.

Finally, there are some situations where it is probably best not to rebreed a doe who has aborted due to a serious disease. Even worse, the owner should consider removing from the herd a doe who could be a carrier of a serious infectious disease. These decisions are best made in consultation with your veterinarian.

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These serious ailments are very difficult to discuss in a format such as this: they are very complex problems, web page viewers come with a wide variety of backgrounds, and I only understand a small part of what I know about them. Many sources describe different symptoms and terminology for the these diseases in cattle, sheep and goats. Furthermore, some of the treatment options can only be obtained from a veterinarian. Our emphasis, therefore, will be on early recognition of the symptoms and differential diagnosis from other similar disorders.

Another introductory comment: Pregnancy toxemia is not to be confused with the enterotoxemias produced by infections caused by Clostridium perfringens Type B and C. Pregnancy toxemia and ketosis are metabolic malfunctions and the other are caused by actual toxins produced by the micro-organisms, against which there are vaccines available.

This is a technical term referring to the presence of "ketones" in the blood and urine. It is readily recognized by the odor of nail polish remover. Generally, it is felt to be caused by a reduction of carbohydrate absorption. Whenever the body resorts to the breakdown of fat to meet its nutritional needs there is a danger of ketosis. It can be the primary cause of illness or the result of another disease (secondary ketosis). It is usually seen shortly after delivery and the symptoms include: lack of appetite (which only makes the problem worse), laziness ornervousness, drop in milk production, weight loss, constipation, a staring expression and some problems with coordination. Treatment involves glucocorticoid injections (vet only) and glucose, with or without oral propylene glycol (available through most suppliers). Prevention is easier to deal with: proper nutrition of the doe before and after delivery. Since the illness usually occurs in over-fat animals, the early stages of pregnancy should not be accompanied by overfeeding. The feed (especially grain) can then be increased during the later stages of pregnancy (when the babies are growing rapidly in the womb) and even more after delivery (when milk production begins in earnest).

Although the term "ketosis" generally refers to a condition which occurs after delivery and although "pregnancy toxemia" refers to a condition of the pregnant animal, the terms are often used interchangeably and this results in a great deal of confusion. This is because one of the major symptoms of toxemia is ketosis, the presence and odor of ketones. This is predominant a disease of sheep and cattle, it can occur in goats. Early detection is difficult because the signs may not be clear-cut. She may just appear a little "odd;" the classic description is that they act "stupid" and this is really the thing to watch for. There may be a certain listlessness, grinding of the teeth, leaning against objects and slight loss of appetite. If the situation gets more serious, you will see incoordination, recumbancy, coma and death.

The important differential is between toxemia/ketosis and milk fever, which is a deficiency in calcium due to milk productivity. With milk fever the animal will appear "drunk" as opposed to the "stupidity" of toxemia. Milk fever will cause as definite coldness of the extremities, which will not be found in toxemia. There will not be any odor to the breath and urine in milk fever, but there probably will be with toxemia.

Treatment is much more difficult than prevention. If delivery is near, it should be induced. Oral propylene glycol by itself may or may not be helpful. At any rate, you should consult with your vet.

Although pregnancy toxemia is not common in goats, attention should always be given to the proper nutrition of the pregnant doe. During the first two to three months, keep her "lean and mean." Then gradually increase the feed up to delivery, giving more grain during the last 6 weeks of gestation. If at any time during the last couple of weeks of pregnancy she should show any of the above symptoms, stress her a tiny bit by making her do some serious walking for a few minutes. If the symptoms become more pronounced, then this means that you could be on your way to a problem. Immediately increase her grain and maybe add a little molasses to the ration. If this solves the problem, then you may be turning things around. Keep careful watch of her and be ready to turn things over to the vet if they get worse. Problems with ketosis can occur after delivery as well and the demands of milk production require that you maintain a high level of nutrition.

As we indicated above, ketosis is basically a symptom. It can also be present in a large number of other disorders where there are metabolic disturbances and liver malfunction, such as poisoning, diabetes, etc.

Note to veterinarians: Should any veterinarians be willing to add comments or corrections to any of the material presented here, it would be greatly appreciated. This condition is obviously hard for the amateur to describe and deal with. A link to my e-mail address is provided at the bottom of the "main page."

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A non-professional cannot attempt to describe the metabolic processes involved in sustaining the life of all animals. The basic thing that we need to understand is that overfed animals mobilize fat from body deposits and this leads to some really disastrous results. In the pregnant or recently delivered doe this can result in ketonuria, lack of appetite, weakness and even death. At the other extreme, underfeeding can cause an equal number of problems. So, pay careful attention to maintaining the proper weight level in your pregnant doe.

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Milk fever (postparturient paresis) is neither an infectious disease nor is it characterized by a high fever. It can occur shortly before or after delivery. It is a calcium deficiency that results from the movement of calcium from the body of the doe to the milk in the udder. It can occur before delivery as the udder expands. It is a fairly common occurance in high producing dairy cattle. Generally, you'll expect that there will be more of a tendency for milk fever to happen in those does which have large udders. Overzealous milking of the recently freshened doe, no matter what the size of the udder, can trigger a case of milk fever.

The first symptom that you will probably notice is an unsteady gait that will remind you of a drunken person. The eyes are dull, defecation will cease, appetite will completely disappear if standing they will rock back and forth, if lying down they may grind their teeth or assume a strange position and be unable to get up on their own. The doe may fall off the milk stand. The most diagnostic signs at this time are that the ears and extremities will be very cold to the touch and the doe may be shivering. If treatment does not begin immediately, she will lapse into a coma and die.

At this point you need to either get a veterinarian right away or provide her with an IV or IP injection of calcium gluconate. Do NOT try any of the old-fashioned remedies such as inflating the udder with a bicycle pump. I have only treated this disesase in cattle; I would start with about 75 ml in a goat. The calcium should be administered very slowly because of a very real danger of heart failure. It is best to monitor the heart rate throughout the prodecure. (An SQ injection is much safer, but will take longer to take affect and the dosage will have to be divided into 3 - 5 different sites.) If she doesn't get up in 8 to 12 hours or has a relapse, repeat the dosage. If everything goes well, you will feel like a real hero because recovery is rather dramatic.

(We will provide more info at a later date on giving IV and IP injections.)

When you milk the newly freshened doe you have to be careful to take out the right amount. Taking too much milk can lead to milk fever; not taking enough can cause mastitis. Our basic rule is "one-fifth per day," which means on day one, take one fifth of what's there, on day two take two fifths and so forth until you get to day five when you should milk her all the way out. The new pastes designed as preventive remedies in cattle work very well (adjust the dosage). Avoid sudden changes of feed in late pregnancy and avoid rations too high in alfalfa. In fact, alfalfa, clover, corn and other feeds high in calcium should probably be totally withdrawn from the diet during the last few days of gestation. Some say that a Vitamin A/D shot before delivery helps to prevent milk fever.

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The first time you witness a prolapse, I guarantee you will be very shocked. All this strange stuff will be hanging out of the back end of your dear Suzie Q! It can be her vagina and cervix, her uterus or her anus. None of it is very pleasant to think about. And YOU have to put it ALL back in!

Generally, a prolapse that happens before delivery is vaginal (aka cervical). It usually happens in overweight animals. It seems to have a genetic predisposition. If it happens once in an animal, there is an increased chance of it happening again. Although fairly common in sheep, it is good to know that it rarely occurs in goats

We have had it numerous times in sheep and that is the limit of my experience. Thay make devices called "Ewe Savers" or "retainers" which after you clean and push the vagine back in can be tied to the wool. This isn't possible on a goat and if you use one of these devices (which do work very well in sheep) you would have to get pretty creative to keep it installed. Standard procedure is to clean and reinstall the vagina and keep it in by means of sutures placed in the vulva. You obviously have to leave room for the passing of urine. The worst problem is that she will be straining quite vigorously while you are doing this. And, the sutures have to be removed prior to delivery and the presentation of the first baby should always be checked.

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A prolapse of the uterus is a more serious problem. It is more likely to occur if there has been a difficult delivery. If the animal is straining a lot due to constipation, this may increase the chances of prolapse. Diagnosis is fairly obvious. I really recommend that you get help from your veterinarian unless you are familiar with the procedure.

But here are the details if you want to try. First, separate the afterbirth from the uterus. If the bladder is exposed, empty it with a catheter. Wash the whole uterus with warm water and a mild antiseptic. It is said that sugar helps reduce the size. With your closed fist start pushing the thing back in. The uterus is very delicate at this time and will tear if you use your fingers. Push in between strains (which will be considerable in strength). It is important to make sure that both horns are pushed to a forward position. While holding everything in, insert a dosage of Nolvasan® or some suitable antibiotic. Then close the vulva with sutures, leaving a slight gap for urination. You will need to give penicillin or some type of systemic antibiotic for 5 days. Unless you are skilled at this procedure or have some pretty good luck, prognosis is grim.

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Your darling Suzie Q has delivered nice healthy babies. You are real proud of yourself because you followed the instructions here at goatwisdom and reached in there and pulled one of them out. And then you sit with her waiting for something to happen to this big ugly purplish thing that is hanging out of her rear end. Every time she turns around she swats one of the babies in the head with it. And you wait. And you wait. You heard somewhere that you're not supposed to grab it and pull it out. You go in and have dinner and when you come out, it's still hanging there.

You start getting tired and finally go to bed for a short nervous night's sleep. You go back out the next morning and, oh my gosh, it's still there. But now it has begun to stink. Oh, now what? You start calling vets asking what to do. They all tell you to leave it alone. And now poor Suzie Q is a stinking, disgusting mess. "This just can't go on like this," you say.

Some preliminary comments:

There is no one definite cause for a "retained" afterbirth. It commonly follows a premature delivery, a long labor or difficult birth, certain nutritional deficiencies or a uterine infection. But it also happens totally unexpectedly. Sometimes you will think that the doe has eaten it (a separate subject), only to find later that she has not passed it. Usually, if there is a retained afterbirth it is partially inside and partially outside, with the outside part about even with the ground.

The established protocol

You probably have a vision of the trusty old vet with his arm in a big old cow spending several hours releasing a retained afterbirth. Almost all textbooks now recommend that you should leave it alone and treat it with systemic antibiotics (tetracyclines such as LA200®). Traditional manual removal is no longer popular. Therefore, we will say that manual removal is NOT recommended.

You didn't hear it here...

If 12 hours have passed, then you can probably assume that she will not pass it on her own. If you decide that you are going to remove it, NOW is this time to get on with it. After this, it is very difficult to get your hand through the constricted cervix to do any work. To me, it just makes no sense to allow her to drag this thing around with her for several days.

There are two kinds of problems to deal with. One is failure to release the cotyledon (buttons) from the uterine wall. The other is blood vessels and membranes that fail to break loose. (None of this description will be technically accurate!)

If the cotyledons are still attached the afterbirth will not be just floating loose in the uterus. They must be "unbuttoned" one by one. This is done in much the same manner as you button a jacket, except that it is done with only one hand, in a place that you cannot see and with an animal abjecting in various ways. Utmost gentleness is required. The longer it has been since the completion of delivery the harder it will be to get you hand inside. Do it very slowly and with lots of lubricant. She will object strenuously and push against you all the way. Once you have all the buttons released you should be able to gently ease the placenta out through the cervix. If you feel any resistance, stop right away and re-evaluate the situation. NEVER pull on the afterbirth. As it comes out, gravity should be enough force to do the work. Always do this with the doe standing so that you can feel the pull of gravity.

The second problem is one that I have only experienced in goats and I do not know the technical terminology for the details. In this situation, the major part of the afterbirth will be dragging around behind with a taught string-like thing being the only thing attaching it all to the doe. By reaching FAR forward on the lower part of the uterus you will find a point of attachment to the uterine wall. If the cervix is still well dilated and if the vessel is about the size of your little finger, leave her alone for 4 - 6 more hours. Then, if it hasn't broken free, reach to the forward point of attachment, come back toward you a couple of inches, place the cord between your thumb nail and middle finger. By sliding the thumb nail back and forth you will be sawing through the cord. When completed, the afterbirth will be free and can easily be removed the rest of the way.

After either or both of the above, immediately use a pipette to insert a half tube of Nolvasan® or similar product and give pen G or LA200® for 4 - 5 days. You will want to give the doe lots of "TLC" and it would be good to take her temperature daily.

"Plan B"...

The following suggestion was sent to me by a reader who got the tip from her vet. I have not tried it, but it is supposedly an old farmer's trick that I was unaware of. He recommended that you tie a five pound weight to the hanging afterbirth and let the doe drag it around behind her. This may eventually help things along.

Please remember that the above procedures are not a substitute for consultation by a licensed veterinarian.

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During a difficult delivery there will sometimes be damage to the tender tissues lining the birth canal. In the excitement of getting the kids out, you may not notice that damage has been done. It is a good idea to make a quick check of things after each delivery. Any tears over &fract14; inch should probably be sutured. There is a significant danger of infection in any open areas and vigorous treatment with local antibiotics should begin right away. Nolvasan® is a good choice for internal injuries. NTZ® eye puffers are good because the powder tends to have a drying action. On external sufaces, iodine can be applied frequently. You may observe some bruising and there is little you can do about it. It is important to keep these areas clean in the face of uterine discharges and fecal contamination.

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The terms metritis and pyometra are often used interchangeably. Metritis means an inflammation of the uterus. Pyometra refers to pus being retained in the uterus. For our purposes here we will use the single term metritis, and by it mean any uterine infection.

There are any number of organisms that can cause an infection of the uterus. Likewise, these infections can, in turn, compromise the uterus and lead to incidents of infertility and fetal death. Since the treatments available to treat these infections are quite limited in number, it may not be practical to worry about the identity of the specific germs by means of laboratory testing.

Incidents of uterine infection usually are first noticed a week or two after delivery. It is more common in those cases where there has been an assisted delivery, particularly if this has been a difficult event. Because of this, it behooves us to remember to practise extreme cleanliness whenever we assist in a delivery.

The first sign is usually a foul smelling vaginal discharge. This is different from the normal fluids that come out after delivery, which will not contain pus. This will frequently be accompanied by fever, lethargy, a drop in milk production and lack of appetite. Therefore, as in every post partem disorder, it is extremely important to do everything you can to keep the doe eating well. All others remedies are more apt to fail if she goes off her feed. You may also notice that the milk has an "off" flavor (kind of sour).

Treatment consists of antibiotic injections (broad spectrum such as penicillin or oxytetracycline) and local infusions. The uterus should be thoroughly lavaged (washed out) with a sterile solution, such as: one part peroxide and 10 parts sterile saline. This can best be administered via a pipette (like they use for articial insemination in cattle) carefully inserted through the cervix. (This may take a little practice!) A small catheter will also work. It is best to have the doe standing on a sloped surface with the rear end elevated. Take your time and wait for the liquid to drain out. Most of the old-fashioned remedies are no longer considered safe to insert into the uterus. We use Nolvasan® uterine suspensionfor this purpose. Since the tube contains sufficient amount to treat a cow, a goat would probably only need a half tube.

If the above treatment is not successful, you can repeat the procedure. In some cases, it is necessary to add hormone injections to the regimen and to do this you must consult with your veterinarian. An infection that has been ignored for some time is also more resistant to treatment. NEVER breed a doe where there is any suspicion of a current or recent infection.

WWW Resources

Univ of Minnesota   [Pregnancy toxemia]

Univ of Minnesota   [Prolapse]

Goat Handbook   [Metabolic disorders]

CONSULTANT ©   Cornell's Diagnostic program