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    How to Conduct A Sheep Health Examination

    A caregiver examines the ear of a white sheep.
    Checking Maxine’s ears is a quick but important part of the exam!

    This resource has been fully reviewed and updated by a member of The Open Sanctuary Project’s team as of November 14, 2022

    Much like the common advice given to humans, it’s important to regularly check the health of sheep with a routine physical examination rather than waiting until a sheep is showing signs of distress or illness. Not only will this help you get to know what all aspects of a healthy sheep look and feel like, it can also help your sheep residents become accustomed to gentle human handling which might help them remain calm during other scenarios where restraint or handling are necessary. Be prepared to check them over every six to eight weeks*! For more information on why regular health examinations are important, check out our resource here.

    *An Exam Every Six to Eight Weeks Means Daily Observation
    Our recommendation to conduct routine health examinations every six to eight weeks must be done in conjunction with daily observation. Caregivers should be trained to observe animals both for behaviors that are abnormal for the species and also behaviors that are abnormal for each individual, keeping in mind issues that are common in a particular species and their warning signs. Thoughtful observation plays a crucial role in catching health issues before they progress into more serious situations. You can read more about daily observation for sheep health and well-being here.

    Residents With Challenging Backgrounds
    Close daily observation can be difficult with certain individuals or groups who come from challenging backgrounds. They may be more likely to hide signs of illness or injury, or they may not allow you to come close enough to them to thoroughly assess their well-being on a regular basis. Challenging backgrounds may include individuals who are not socialized, have lived feral, or were abused or malnourished. If you care for individuals who came from a challenging background, it is imperative to make time to foster a bond of trust so careful observation is possible. A monthly health exam is recommended for these individuals until they exhibit signs that they feel safe, and you are confident that close daily observation is possible.

    green sheep grahic

    New Resident? Conduct An Intake Examination!
    If you are conducting an initial health examination on a new resident, check out our intake examination resource to learn about what you should check for and document!

    Supplies

    Before conducting a health examination, it’s helpful to gather any supplies you may need and have them arranged nearby for easy access. Having everything you will likely need nearby can make the examination go more smoothly and will reduce the amount of time the individual must be restrained. If you are performing an exam on someone with a known health issue or detect signs of a certain health condition during the exam, you may need additional supplies besides those listed below. Otherwise, supplies to have on hand during sheep health exams may include:

    • Recordkeeping supplies
    • A halter (if using for restraint)
    • Hoof trimmers/shears and/or rotary tool
    • Gauze squares (​​non-sterile is typically fine, but there may be times when sterile gauze is necessary)
    • Exam gloves
    • Sheep-safe topical disinfectant (such as dilute chlorhexidine)
    • Saline flush
    • Sheep-safe ointments or creams such as a triple antibiotic ointment or silver sulfadiazine cream 1% (SSD)
    • Cotton-tipped applicators
    • Tweezers
    • Headlamp, penlight, or flashlight
    • Thermometer and lubricant (good to have on hand in case you suspect someone is ill based on exam findings)
    • Towels
    • Stethoscope
    • Clippers (to remove patches of wool if needed)
    • Fly treatments or deterrents (during fly season)
    • FAMACHA card (if applicable)

    Conducting The Exam

    Ask An Expert
    Prior to regularly conducting sheep health examinations, you should have a veterinarian or compassionate care expert give you hands-on training in order to be the best sheep health advocate possible. Being trained to rapidly distinguish healthy conditions from abnormalities can be crucial in early health issue detection and effective treatment!

    Before beginning individual exams (and, if possible, before entering your residents’ living space), it’s a good idea to take a few minutes to observe the group. Make note of their behavior, activity level, and general appearance. If residents are up, observe how they are standing and moving and whether or not they are actively eating. If they are lying down, make note of how they are positioned, whether or not they are chewing cud, and whether or not they are away from the flock or are the only one lying down. 

    Now is also a good time to observe the respiratory rate of individuals in the flock since this may become elevated once residents are moved or restrained. While you can certainly assess the respiratory rate for each individual, for starters, you may simply spend a few minutes observing the group, checking to see if anyone appears to be breathing more rapidly or with more effort than the other residents. If anyone jumps out as breathing differently than the rest of the group, you could then take their respiratory rate and further evaluate them during their exam (or, depending on other signs they are presenting, you may opt to call your veterinarian). To assess a sheep’s respiratory rate, watch their chest movements, counting how many times their chest expands/contracts over one minute. You want to count each paired expansion and contraction as one respiration. The normal resting respiratory rate for an adult sheep can vary quite a bit depending on the ambient temperature and whether or not they are in full wool. In fact, different sources offer different ranges, but according to Large Animal Internal Medicine, 5th Edition, the resting respiratory rate of adult sheep ranges from 12-72 breaths per minute with an average of 36. Because there can be a wide range of normal, it’s a good idea to observe the group and note what seems to be normal for the group, generally, while looking for anyone whose respirations are much faster or slower than their flock mates. Keep in mind that individuals who are active will have an elevated respiratory rate compared to someone at rest. In addition to being an indication of illness, an elevated respiratory rate can also be indicative of a sheep being stressed, hot, or in pain.

    During this general observation of the group, watch for anyone who stands out as looking or acting differently from the rest of the flock. While this may not necessarily be an indication of a health concern, it certainly warrants further observation and assessment during the exam. For example, if you notice that all members of the flock except for Winnie are actively eating hay, you’ll want to keep an eye on Winnie and gather more information to determine whether or not there’s a problem brewing.

    When In Doubt…
    Unless you are a qualified veterinarian or have been trained to handle specific conditions, The Open Sanctuary Project strongly advocates that you promptly report any health concerns you find during the course of an exam to your veterinarian or care expert. You should be your resident’s advocate, not their doctor. Additionally, routine health exams performed by a caregiver are not meant to be a replacement for veterinary assessment. The goal is to catch potential signs of concern as early as possible so you can bring concerns to your veterinarian. If necessary, they can then perform a more in-depth examination of the individual.

    Up next, we’ll go over important components of a health examination. Please note that while these “steps” do not have to be completed in the order listed below, it is helpful to have a set order you follow consistently so as to avoid accidentally missing a step. Some folks like to start at the feet and work their way up, while others like to start at the head and work their way back.

    Check their weight and body condition
    Monitoring your sheep residents’ weight and body condition gives you important information about their health. A healthy, mature sheep should generally maintain a steady weight. If at all possible, it’s a great idea to invest in a scale that can accurately weigh your residents. This way, not only can you track your residents’ weight, but you’ll also be able to ensure proper drug dosing by calculating dosages using the individual’s actual weight rather than an estimated or outdated weight. 

    Body condition scoring can also be a useful tool, particularly if weighing residents is not possible. We recommend working with a veterinarian for proper training in body condition scoring to ensure the most accurate results. If you are not trained in body condition scoring, you can still roughly evaluate their body condition. A thin individual will have a prominent spine, whereas in an overweight individual, the spine will be difficult to detect.  

    Be sure to share concerns about a resident’s weight with your veterinarian. Flock-wide issues warrant a closer look at your residents’ diet, but flock-wide weight loss could also be due to contagious disease or parasitism. Isolated instances of weight gain or loss should also be discussed with your veterinarian. There are a number of reasons a resident may be losing weight, such as parasitism or ovine progressive pneumonia (OPP), which is why it’s important to work with an experienced veterinarian to have the individual assessed. You’ll also want to discuss how the individual is doing overall. Losing weight despite a healthy appetite will suggest different possibilities (such as Johne’s disease) than weight loss accompanied by inappetence. Particularly in elderly sheep, weight loss might be the result of dental disease and may require permanent alterations to the individual’s diet.
    Check their head and neck
    Certain areas of the head require a closer look and are discussed in detail below, but you can start by checking their head for any sign of asymmetry, a head tilt, or frequent head shaking. If a resident has a head tilt or one side of their face is drooping, this is cause for concern, and your veterinarian should be consulted. Also pay attention to how they are holding their head. While their head will be close to the ground when grazing or otherwise eating from the ground, constantly holding their neck and head low to the ground is not normal. Other concerning signs include constant extension of the neck, holding their head so that they are looking straight up, or arching their neck backwards.

    Caseous lymphadenitis (CL) is common in sheep and could result in abscesses on the head (namely under the ear or along the jaw) or on other parts of their body. CL is contagious and spreads via discharge from abscesses, so if you find an abscess, work with your veterinarian to determine if it is caused by CL and take measures to prevent disease spread. You can read more about CL here

    If the individual has horns or scurs (horn-like tissue that, unlike a true horn, is attached to the skin rather than the skull), be sure to check that these are not growing in such a way as to cause injury or irritation to the face. Work with your veterinarian to determine the best course of action if a horn or scur is causing a problem. 

    Feel along the neck for any swelling, lumps, lesions, or areas that are sensitive to the touch.
    Check their eyes
    Sheep should have clear, bright, alert eyes that close fully when blinking. Squinting, crusting, or discharge could indicate an issue. However, be aware that sheep have sebaceous glands located near the inner corner of their eyes. These produce an oily substance which may build up in this area and should not be confused with ocular discharge. Check that the eyelids are not rolling inward. This condition is called entropion and requires veterinary intervention to correct. Without correction, this condition can cause corneal scarring and ulceration. In sheep with wooly faces, check that the wool is not growing in such a way that it makes contact with the eye, which can cause irritation, and also ensure that it is not covering the eye and obstructing their vision (this is referred to as “wool blindness”). If needed, wool should be carefully trimmed or parted around the eye.

    Make note of how the eye is sitting in the eye socket. Sunken eyes may be a sign of moderate to severe dehydration, or they could be due to fat loss in very thin individuals. Bulging of the eye should also be noted. Check the mucus membrane of the lower eyelid to look for evidence of anemia (pale mucous membranes) which could be a sign of barber pole worm infection or other serious condition. If you are trained in FAMACHA scoring, be sure to use your card and record their score (please note that your veterinarian may recommend performing FAMACHA scoring more often than just at routine health checks). You can also check for a menace response by moving your hand towards each eye a few times (without touching their eyelashes or eyes). Sheep over 2 weeks of age should reflexively blink in response to this test.

    Now check the eye itself. Sheep have an elongated horizontal pupil. These should be symmetric and should constrict in response to bright light. Check for thickened blood vessels or an abnormal color to the eye, which depending on the part of the eye affected, could indicate a number of issues including edema or scarring.

    All eye issues should be raised with your veterinarian as soon as possible. They can do a much more thorough examination, if needed.  
    Check their ears
    Some sheep have ears that are more upright, while others may have ears that are held parallel to the ground. It’s important to know how each individual’s ears typically look so that you can look for signs that they may be drooping. Also check that their ears are symmetric. In a healthy sheep, the inside of their pinnae should face forwards (rather than facing downwards). The ears should be warm (but not hot) and soft. Cold ears could be cause for concern, and cold scabby ear tips could be a sign of frostbite. If a sheep has hot and swollen ears, they should be evaluated by a veterinarian. Hematomas of the ears could be a sign of ear mites, resulting in frequent head shaking, and subsequent trauma to ears. If the pinna is hard, this could be a sign of scarring. Red skin on the back of the ears could be a sign of sunburn. Individuals with bald ears may need sun protection to prevent sunburn.

    Next, look inside the ears, checking for any discharge or dirtiness and also checking for any unusual odors.
    Check their nose
    A small amount of thin, clear, discharge from the nostrils may be normal, but copious amounts of discharge or discharge that is thick is cause for concern and could be a sign of infection. Also pay attention to the skin and hair under the nose. Hair loss or skin irritation could be a sign that the individual has intermittent nasal discharge, even if they do not currently have active discharge. 

    Pay attention to their breathing. Flaring of the nostrils could indicate increased respiratory effort. If you hold your hand in front of their nose, you should be able to feel air coming from both nostrils equally. Also make note of any abnormal smells coming from their nose. Contact your veterinarian immediately if you suspect a respiratory issue.

    While checking their nose, make note of any lesions, scabs, swelling, or areas of discoloration. You can also feel along the bridge of their nose for any asymmetry.
    Check their mouth and jaw
    Start by looking at their lips for any sign of scabbing – this could be indicative of orf (also known as sore mouth), which can be spread to humans. Always wear gloves if a sheep is showing signs of orf. Pay attention to their breathing, looking for open-mouth breathing, which could be a sign of overheating or a respiratory issue. Look for excessive drooling or green liquid around the mouth. Also make note of the area under the jaw, checking for fluid build up (bottle jaw). This can be caused by low concentrations of protein in the blood, which may be the result of barber pole worms. Contact your veterinarian if a resident has bottle jaw.  

    Check/feel their jaw for any lumps, lesions, or areas of swelling or discharge. A lump on the lower jaw could actually be due to the individual collecting cud in their cheek and could be a sign of a dental issue. Your veterinarian can perform a dental examination to determine if they require any dental work, and they can also make recommendations if the individual requires dietary changes due to their dental issues. Lumps along the jaw that are not packed cud should be evaluated by your veterinarian. 

    Carefully part their lips so you can see their teeth and gums. Do not put your fingers inside the sheep’s mouth, particularly near their molars, which are incredibly sharp! Sheep have four pairs of lower incisors, but no upper incisors; instead they have a dental pad. While a full dental exam is beyond the scope of a caregiver-performed health examination and should be reserved for your veterinarian, you can look for missing, broken, or visibly loose incisors, which are not uncommon in older sheep. You can also check their gums which should be moist and, unless pigmented, should be pink. Red, pale, or tacky gums can indicate a problem.

    While checking their mouth, make note of any abnormal smells on their breath or originating in their mouth. An abnormal smell could be a sign of a respiratory infection, dental issue, or even an issue with the rumen.
    Check their rumen
    As ruminants, assessing the digestive tract is an important part of evaluating sheep health. While your veterinarian can perform a more in depth evaluation of a sheep’s digestive system, you can gather some basic information during your routine examinations. First, you can visually assess the individual. When standing behind them and facing them, their rumen will be on the left. A slight asymmetry in the contour of the abdomen is normal due to the presence of the rumen on the left side. In sheep with wool, this asymmetry may not be noticeable. You can also feel their abdomen, especially in the area of the paralumbar fossa on their left side. This is the triangular area behind the last rib and in front of the hip bone. If the sheep has eaten recently, the paralumbar fossa will be about flush (give or take a little) with the last rib. If they have not been eating, this area will be depressed, and in the absence of thick wool, you may even be able to see a clear outline of the triangular area. If the paralumbar fossa is distended significantly past the last rib and/or feels tight, this indicates bloat, a potentially life-threatening condition. Other signs of bloat include labored breathing, grunting, open-mouth breathing, extension of the neck, frequent urination, and other signs of discomfort. As the condition progresses, the sheep may become recumbent. When you tap on the paralumbar fossa of a bloated sheep, it may produce a kettle drum-like sound. Contact your veterinarian immediately if a resident is showing signs of bloat as prompt intervention is imperative.

    You can also listen for rumen contractions by placing a stethoscope over the paralumbar fossa on their left side. You should hear a rumen contraction (sometimes described as sounding like a thunderstorm or dull roar) approximately 1-2 times per minute. If you note long gaps between contractions or weak contractions, please consult with your veterinarian.
    Check their sides, underside, and back
    While checking their rumen does require checking part of their left side, you want to also take time to check the rest of their left side as well as their right side, underside, and back. Check for any lumps, swelling, wounds, edema, etc. In sheep with thick wool, these issues can be concealed by the wool, so it’s helpful to feel through the wool for any issues. While checking the sheep’s left side, you can listen to their heart and record their heart rate. To do this, place the stethoscope on their left side, right behind their elbow. An adult sheep’s resting heart rate is typically between 60-120 beats/minute with an average of 75. Consult with your veterinarian if you have any concerns about a sheep’s heart rate or the way their heart sounds.

    Be sure to check for pressure sores, particularly in the areas that typically make contact with the ground when the sheep is lying down. Early signs of pressure sores include wool/hair loss and irritated skin before becoming open sores or scabbed areas.

    When checking male residents, check around the preputial opening for crystals, sandy deposits, blood, scabs, sores, or dryness. If they urinate during the exam, watch that they are not straining and that they have a normal stream of urine. Straining, dribbling urine, or producing a weak stream of urine could be signs of urinary blockage, and your veterinarian should be contacted immediately. Left untreated, this condition can be fatal. Lesions around the preputial opening could be due to pizzle end rot. If hair or wool is covering the preputial opening and becoming soaked with urine, this can be carefully trimmed to prevent skin ulceration.  

    When checking females, observe and gently palpate their udders, checking for signs of mastitis such as asymmetry, abnormal temperature (hot or cold), swelling, firmness, pain, or discharge. Contact your veterinarian immediately if you suspect mastitis. If one of your residents, male or female, appears to be producing milk, consult with your veterinarian for guidance. 

    When checking a sheep’s back, make note of any hunching when the individual is standing. Their back should be fairly flat. Hunching could be a sign of a variety of things, including white muscle disease.
    Check their legs
    Carefully check their front and back legs for any signs of swelling, particularly noting if there is asymmetry between the right and left corresponding legs (i.e. note if a sheep’s front right leg is larger than the front left leg). Swelling, heat, or sensitivity in the carpi (often referred to as the “front knees”), tarsi (“hocks”), or fetlocks (“ankles”) could be a sign of infection, injury, or arthritis (including the arthritic form of OPP). When checking the front legs, be sure to continue your observation all the way up into their shoulder area, and in the back, check all the way up to the hips. Particularly when checking their back legs, look for any signs of pressure sores (wool/hair loss, irritated skin, scabs, or open sores). 

    Also check for any signs of pain by observing how they stand and move. They should bear weight evenly, and there should be no crepitus (cracking or crunching sounds) when they move. You can carefully assess their range of motion and feel for crepitus by gently flexing and extending the joint, particularly the carpi, tarsi, fetlocks, and stifles. Do not force movements if the individual resists or if the motion elicits a pain response. Also make sure you do not bend the joint in an unnatural position or overextend the joint, which could result in injury. 

    Osteoarthritis is quite common in sheep as they age, so it’s important to keep a close eye on their mobility and discuss any concerns with your veterinarian. An appropriate pain management plan is an important part of caring for arthritic residents.
    Check their feet
    Pay attention to how the individual is standing. A sheep with a foot abscess may be reluctant to bear weight on the affected foot. Look and feel around the coronary band and between the claws for any redness, heat, swelling, sensitivity, odor, or discharge. Be aware that sheep have a sebaceous gland on their foot above the coronary band and in line with the space between their claws. This naturally releases thick oily secretions, which should not be confused with a draining abscess. However, this gland can also become impacted or even infected, so connect with your veterinarian if you have a concern. If there is any debris stuck between the claws, gently remove it. In muddy conditions, mud can build up and harden between the claws, resulting in discomfort and lameness. A foul odor and/or a black tarry appearance between the claws likely indicates footrot. Crustiness under the dew claws could be a sign of chorioptic mange.

    Next, examine the bottom of the foot. You can use a cloth or piece of gauze to remove any dirt or debris so you can more clearly assess the foot. Evaluate the length of the hoof wall and check for separation from the sole. Trim or even out the hoof as needed. You can read more about hoof trimming here. Overgrown hooves can predispose residents to various health issues, so regular trimming is important. 
    Check their rear end
    A sheep’s rear end and tail should be free of fecal matter. Feces-matted hair or wool is a sign of loose stool (normal feces should be pelleted). Not only should the cause of the issue be investigated, the individual will also need to be cleaned up to prevent flystrike. Cleaning the individual will also make it easier to observe if the issue continues or not. If their back end remains dirty, it’s difficult to assess whether or not they continue to have loose stool unless you are able to watch them defecate. If their rear and tail has been cleaned but becomes matted or stained with feces again, this confirms that the issue is ongoing. In females, also check their rear and tail for urine-soaked wool, cleaning or shearing as needed to prevent flystrike and urine scald. 

    You should also visually check their rectum, and in females, their vulva, ensuring that they do not have any prolapsed tissue. When checking the vulva, make note of any discharge, crystal deposits, or lesions. Though perhaps not as common as with some other farmed animal species, females can develop various reproductive issues, so be sure to contact your veterinarian if you observe abnormal discharge. Caregivers in sunny locales have reported that some female residents with tails that were docked very short developed skin cancer on their vulva. Contact your veterinarian if you see lesions or other abnormalities on the vulva.

    Check the tail for signs of injury (including fracture) or paralysis. Individuals with long thin tails that are not covered in wool may be more at risk of frostbite during colder weather, so pay close attention to their tail tip for signs of this which include the tail being cold, stiff, and discolored.
    Check their wool/hair and skin
    Check for any hair or wool loss. Keep in mind that hair sheep do shed in the spring and will have a shorter summer coat. Woolen individuals do not shed, and instead need to be shorn, typically once a year in the spring. Some individuals may be a mix of breeds and have some hair and some wool. In woolen residents, make note of the condition of their wool, looking for unexplained areas of wool loss, raggedy wool, and areas of wool that are matted. Also be on the lookout for a change in the color or texture of an individual’s wool, which could be a sign of concern.

    During this part of the exam, you want to make sure you are thoroughly checking their entire body for external parasites, skin issues, or other concerns that may be concealed by their hair or wool. Thick wool, in particular, can hide a number of ailments, so it’s helpful to closely examine any dirty or matted areas and to feel all along the individual’s body for any lumps, lesions, discharge, etc. If you feel something odd, part their wool for closer examination. 
    Whether they have wool or hair, be sure to investigate if a sheep is showing signs that part of their body is itchy (signs include biting or rubbing the area), and be sure to look more closely at any area that is covered in flies, as this could be a clue that they have an open wound and are at risk of developing flystrike.
    Isolate if necessary
    If you notice that a sheep is unhealthy, it’s crucial to consult with a veterinarian or compassionate care expert and prioritize accurately diagnosing the problem. Depending on the health concern, it may be necessary to isolate the sheep in order to protect the rest of the flock from a potentially infectious disease. However, with some illnesses, once a sheep is showing symptoms, the other residents in the flock may have already been exposed. In these instances, you will need to consider what is in the best interest of all of your residents. A sick sheep who is isolated from their flock may become more stressed, which could delay recovery, but in some situations keeping them with the flock may not be safe for them. Depending on the health concern, separating the sheep with a calm companion might be a good compromise.

    Though it may seem like an overwhelming amount of factors to be aware of, once you’ve gotten to know a sheep and what good sheep health looks like, you’ll be an excellent sheep health ally in no time!

    Writing It All Down

    As you may know, regular documentation is a critical part of responsible sanctuary animal care. In order to maximize the value of your sheep health examinations, we’ve developed a free printable sheep health exam form for sanctuaries and rescues!

    SOURCES:

    Small Ruminant Handling And Assessment | North Valley Animal Disaster Group

    Sheep And Goat Medicine, Second Edition | D.G. Pugh And A.N. Baird  (Non-Compassionate Source)

    Large Animal Internal Medicine 5th Edition | Bradford P. Smith (Non-Compassionate Source)

    Identifying Sick Livestock With Dr. Lisa Lunn | UAF Extension (Non-Compassionate Source)

    The Basic Clinical Exam: Key To Early Identification Of Sick Animals | AgriLIFE Extension (Non-Compassionate Source)

    Ewe Body Condition Scoring | Virginia Tech (Non-Compassionate Source)

    Non-Compassionate Source?
    If a source includes the (Non-Compassionate Source) tag, it means that we do not endorse that particular source’s views about animals, even if some of their insights are valuable from a care perspective. See a more detailed explanation here.

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