Treatment of Hypoproteinemia (‘Swelsiekte’) following Brown Stomach Worm and Cocidiosis infection
By Dr Mackie Hobson BSc(Agric),BVSc

1. Field Studies

Brown Stomach worm and coccidiosis can have a significant impact on weaned Angora goat kids especially in the autumn and early winter (March-June).
Brown stomach worm may lead to the following clinical signs:

• Loss in production without obvious clinical signs
• Poor appetite
• Weak
• Weight loss
• Oedema of the abdomen and limbs ‘waterpens’ ‘swelsiekte’ as well as submandibular oedema and ascites.
• Diarrhoea
• Anaemia may also occur.

A field study was conducted on an Angora goat farm by the SAMGA Vet to investigate Angora kid deaths. Faecal samples and blood Albumin (blood protein) were evaluated from 36 Angora kids from this outbreak.

The samples averaged:

• 8600 eggs per gram (epg) Brown Stomach Worm
• 22 600 epg Coccidiosis
• Albumin level of 14.7 g/l (Range 22 -9)

Post Mortems were conducted on kids that had died in this outbreak which confirmed Brown stomach worm, coccidiosis and ultimately HYPOPROTEINEMIA as the cause of death.

What are normal Albumin levels in Angora goat kids?

• 6 normal kids of similar age were sampled and Albumin levels average 33 g/l (Range 30 -38)
• From previous ‘Swelling disease’ studies by SAMGA the average Albumin level in ‘swelling goats was 16.5 (n=30) and those not swelling 4 g/l.

These average values (30.4-33g/l) can be compared to the average of the effected kids 14.7g/l

What causes the blood protein levels to drop?

• The inflammatory response and loss of protein through the mucosal wall of the abomasum caused by the penetrating brown stomach worm larvae.
• Damage to the parietal cells of the abomasum causes an increase in abomasal pH resulting in Pepsin and Trypsin not being formed and ineffective protein digestion.
• Loss of protein through diarrhoea and decreased protein uptake via the intestine.
• The loss of appetite by the kid reduces protein intake
• Adult worms also suck blood (3-4 weeks after initial infection) but the effect is not as pronounced as wireworm.
• ‘Swelling’ disease – capillary leak syndrome.

How can we get these kids to recover as quickly as possible?

Different on farm treatments were administered and compared in order to normalise the blood protein (Albumin) as soon as possible.

The treatments used:

• Vecoxan (Elanco): Treatment of coccidiosis as per manufacturers guidelines on day 0
• First Drench (Virbac): Abamectin treated at 1.5x manufacturers guidelines on day 0
• Byboost Kickstart (Bayer): Mineral and Vitamin on day 0,3,7 and 14
• Steroid (Dexamethazone) and Antihistamine on day 0,3,7
• Peni LA (penicillin) on day 0,3,7
• Ad lib pelleted feed while other kids were in the veld with ‘normal’ grazing

The screening test involved 5 kids in each treated treatment group.

Blood samples were taken on day 0, 3,7,14,21,28,38 to evaluate changes in Albumin levels

Faecal samples were checked on day 14 and were clean

GROUPS AND TREATMENTS RECEIVED

In Addition to Coccidiosis and Brown stomach worm being treated with Vecoxan and First Drench (except Group F only coccidiosis treated) the different treatments groups in addition  received:

A: Byboost (Kickstart) Bayer (day 0,3,7,14)

B: Steroid injection (Dexamethasone) and Antihistamine injection (0,3,7)

C: Antibiotic injection (Peni LA) (0,3,7)

D: ad lib pellets

E: No additional treatment

F: No treatment until day 7 when the kids were treated as E (just parasites) due to welfare concerns.

Group F (Vecoxan only) were treated for with First Drench) on day 8 due to welfare concerns.

What are the possible reasons for the differences in the recovery rates of the treated groups?

Remember this is a very small sample (n=5) in each treatment group so must be taken in context.

F: No treatment

We can see from the graph that the protein levels continued to drop. For welfare reasons we treated these kids for BSW on day 7 after which they started to improve. It is quite obvious that the underlying the main underlying problem of Brown Stomach must be treated.

E: No additional treatment (apart from treating parasites)

It is clear from the graph that these kids were slower to recover after only receiving the parasite treatment. They recovered at a similar rate to Group D (ad lib pellets)

D: Add lib Pellets (feed)

It appears that up until day 28 the kids with ad lib pellets did not perform much better than the equivalent kids in the veld (E). The rate of improvement increased after day 21.

The damage to the parietal cells (acid secreting) lining the abomasum will result in a sub-optimum pH of the abomasum (more alkaline). The higher pH results in Trypsinogen and Pepsinogen not being converted to Pepsin and Trypsin so digestion of the pellets is ineffective. The lack of fibre and an adaption period may also contribute to this extended period. I would speculate that it takes about 3 weeks for the abomasum and intestinal wall to recover from the damage caused by the BSW and coccidiosis. The initial feeding to day 21 does not appear to be of any benefit. From day 21 we see a rapid closing of the gap as the protein in the pellets starts being utilised after abomasum function and healing of the abomasum and intestinal wall has occurred.

C: Antibiotic (Peni LA)

This was a surprise to me as I was not expecting much benefit from the use of antibiotics in these cases as is evident in the first 14 days. Due to the mucosal damage of the intestinal wall (Cocci) and abomasum wall (BSW) there could be a secondary bacterial invasion which the antibiotic may have eliminated resulting in a quicker healing process. The antibiotic may also have an influence on bacterial overgrowth following the altered digestive system.

B: Steroid (Dexamethasone)

The improvement in the kids injected with dexamethasone (steroid) may be due to the reduction of the inflammation of the abomasum and intestinal wall following damage by the BSW and cocci.

A: Byboost ‘Kickstart’ (Bayer)

Byboost Kickstart is a concentrated liquid containing vitamins, trace elements, essential amino acids and essential fatty acids with added nucleotides. Byboost provides a nutritional and energy boost and hence the reason aided recovery

CONCLUSION:

It can be concluded that there is a benefit to treating hypoproteinaemia in kids following brown stomach worm and coccidiosis on the farm by:

1. Treating BSW and Cocci
2. Giving effected kids a long acting antibiotic and repeating this at day 3 and 7
3. Using a multivitamin and mineral supplement (repeating at day 3, 7 and 14)
4. Providing an additional source of protein (pellets) after 2-3 weeks to help the kids regain lost ground.
5. Most farmers will not have dexamethasone (steroid) at hand so is listed as a last treatment.
6. It is likely that the use of a probiotic would be of benefit during the initial week to assist bacterial population stabilisation (not tried in this trial).
7. The importance of NUTRITION in PREVENTION is demonstrated in work done by M.A. Snymana & A.E. Snyman at Grootfontein discussed below.

It is interesting to note the extended time for the group as a whole to recover from HYPOPROTEINEMIA. The Albumin level recovery period appear to take 50-60 days in these badly effected kids as can be  seen in the graph below. (‘normal’ albumin level of >30g/l)

Blood Albumin levels at days 0, 3, 7, 14, 21, 28 and 38 after treatment for BSW and Coccidiosis.

Extracts from work done by M.A. Snymana & A.E. Snyman at Grootfontein on experimental infection of Angora goat kids with Coccidiosis and Brown stomach worm.

The importance of NUTRITION as

• a buffer against BSW and Coccidiosis
• reducing the effect of swelling

NUTRITION

References:

M.A. Snymana & A.E. Snyman at Grootfontein on experimental infection of Angora goat kids with Coccidiosis and Brown stomach worm