[Me]

I have found vets not that great at diagnosing

Really? I'd take on a non-vet in a game of "diagnose this" and I'm pretty sure i'd win

[Thyme]

Thanks all.  I'm heading over to check on him in an hour so will see how he is this morning.

I'd like to make it extra clear that I don't think he is in pain aside from it hurting if he puts weight on that leg.  Aside from the limp he is behaving absolutely normally.  Using NADIS to check my own judgment he shows none of the behaviours on the "Recognition of pain in farm animals" list.  In addition when I pet him his body is relaxed, he's not tensed up which to me would be one of the big warning signs of ongoing pain.

Regarding pain medication in general, I guess I default to what I would do for myself, which is pain relief for things that are ongoing (as opposed to the "Doctor, it hurts when I do this -- well, don't do that!" variety) or especially severe, but I generally don't take pain relief for a sprain or cut.  The only time my vets have prescribed pain relief for one of my animals was Loxicom for a cat with a very badly infected paw.  For comparison, I think my two ewes who had bad pinkeye earlier in the year showed more signs of needing pain relief than this boy does now, but the vet didn't suggest it then (and Alamycin fixed them up within a few days).

Also, let me go on the record as firmly pro-vet.  My vets (a team of six) are great and I consult with them regularly.  But part of experience is knowing when to get the vet and when to wait.  If I went straight to them every time one of my fifty birds or animals had a lump or a bump or a sniffle, they'd see me every day, and even though I like them and they like me, no-one wants that.  It's helpful to be able to come here and check how others make that judgment call.   

In particular in this case, I haven't been certain how limited the vet would be in being able to diagnose in the field, as opposed to at the office where they have x-ray etc, but which would require that trailer ride.  If the answer is that they have a van full of helpful gadgets and/or magically experienced fingers and will be able to do the needful in the field, then that is helpful to know.

[ScotsGirl]

If you are talking gadgets etc that's different. I am just going from my experience 'Me' that I have vet out for lame goat, lame sheep and really poorly sheep. Poorly one died and vet had just shrugged giving some meds but had no idea and no suggestions. Lame once similar, no idea just recommended AB and metacam just in case.


I could have done that without the £60+ cost of call out and exam. However, that does not mean I don't use or call the vet! I am just more fussy as to when to make that call.

[Thyme]

Okay, today's update, short version:  ram seems happy and still gradually improving.  Took video of him on my phone, stopped in at vet to confer.  Vet looked at video, listened to my description, said they could come see him and/or give me metacam for him if I wanted but as long as he was improving and seemed good in himself then me just continuing to monitor him seemed fine.  She did suggest a follow up dose of Alamycin.

Long version, for those who find the details interesting or valuable:  When I went over this morning he was lying down with the other rams in the sun at the top of the paddock.  I walked over and stood about 2 metres from him and held out my hand.  He got up, stretched, had a pee, and then came over to me for chin scratches, putting a little weight on his bad leg as he came.  I used my phone to video him coming over and while he was standing for attention.  Then I put the phone down and picked up his bad leg with my left hand while continuing to give chin scratches with my right.  I moved his shoulder around and squeezed around it gently, he was completely relaxed, no reaction at all.  Same with the knee and down the leg.  At the front of his foot just above the hoof he reacted a little to pressure, just a bit of a twitch/flinch, but not pulling away.  No heat that I could detect, maybe the slightest of swelling, hard to tell.  No reaction to pressing the back of his foot.

So, from that I say:  he's not in much pain, if he's comfortable enough to stretch and motivated to walk over just to get attention, and he doesn't react to me manipulating and squeezing his leg even though he's not restrained in any way.  And it's probably not his shoulder or knee seeing as he seems completely comfortable with me moving those joints around.  And he seems to be putting weight on it just another little bit more than he was yesterday, so I think he's improving but slowly and gradually.

I took the video and stopped in at my vet and asked if someone could chat with me about my lame ram to make sure I'm doing the right thing.  Showed the vet the video and filled her in on the whole timeline and what I'd done each day.  She said at the top of the hoof it could be a bit of infection or a hairline fracture, and they could come out and look at him if I wanted but if I was happy to keep monitoring him as long as he seemed to be improving, that should be fine too.  She offered Metacam but agreed from the video and my description that it probably wasn't needed.  She suggested a follow up dose of Alamycin at this stage might be sensible, so I bought a fresh bottle to be sure it was effective.

I have an additional suspicion, which I forgot to say to the vet, that it might be a bee sting.  My neighbour keeps beehives next to that pasture and the pasture itself is tall grass and flowers (only grazing appropriate ones) so the bees are in there.  That seems to me like it could be an explanation, although I would have thought it would have healed faster than this.

Video here https://www.youtube.com/embed/F-8NWLhWx40

[farmvet]

I would advise having another look at nadis http://www.nadis.org.uk/bulletins/pain-management-in-livestock.aspx.
Disuse of a limb means its painful. Also in your video you can see the pain when the tup puts the leg forward then touches the foot to the ground quickly changes his mind and withdraws the limb. You cant really make any diagnosis from the clip.  This is not being critical of your choices or vets treatment but i do question your conclusion re pain
try feeling gently around the coronary band - that's where the hair & hoof meet - for any softness or hot spots that may indicate an abscess in the hoof wall. Tubbing the foot twice daily or poulticing if youre competent at bandaging may help if there are any suspicious areas

[Thyme]

No question that it hurts when he puts the foot down.  But I don't think it hurts aside from that, i.e. it's not the kind of constant pain that leads to the NADIS list.  I think it is like when I had RSI, and it hurt to use my elbow but that meant I avoided using my elbow, I didn't need pain medication. 

The coronary band is indeed where he had flinched slightly.  I was feeling more on the hair side than the hoof side so I'll try exploring it some more.  Thanks for the advice.

[SallyintNorth]

What a sweetie

I'd agree that the level of discomfort when he does use it, given that he does have to use it in order to eat and not die, when it's improving so slowly, probably does warrant pain relief.  Especially with such a tame boy, so there's no issue with causing more upset catching him than the pain relief warrants.

I'd also be giving him feed so that he isn't needing to walk around quite so much; with some foot issues they need to be encouraged to exercise but that type of pain may be a sprain or a fracture, so rest will help.

[fsmnutter]

As a vet, the level of pain where he won't put it on the ground is severe.
From the video, it still looks like he is very lame after over a week so this is not going to just go away.
Most likely he has a serious problem having made this little progress.
Without seeing in person my best guesses would be abscess, which may be trying to burst out around the coronary band where he is tender; to fracture of one of the bones of the foot or lower leg; to infection of one of the joints.
Pain relief in my opinion is not optional here.
If I was your vet and saw this video I'd be suggesting much more than "possibly could repeat the alamycin". At the very least poulticing for abscess, preferably a visit to look at the foot (I agree he's too lame to take to the vet) and see if a source of abscess can be found, or if the infection looks like the joint affected. Then I'd be using some strong antibiotics, antiinflammatories and strict movement restriction in a pen with food and water.

[Thyme]

He is a big sweetie.

Well, I must say I appreciate all the advice very much but it is also very confusing that it is so counter to what my own vet has said, so I don't really know what to make of that.  Thinking things over...

[SallyintNorth]

We've seen the video on computer screens; if the vet was looking at it on your phone, the pain may not have been so evident?

[Thyme]

Maybe so.  I think I will ask the vet to come see him, that seems the only way to sort through this uncertainty.

My vet specifically looked at the bit toward the end of the video where he puts his bad foot forward and down and then picks it up again quickly, so it's not that she didn't see that.  I think we're all in agreement that it hurts when he puts his foot down.  Where we seem to diverge is:

1) A few days ago he was strictly holding that foot up and going on three legs, not putting his foot down at all.  Now  each day he is putting the foot down a little more, even though clearly it still hurts.  My vet seems to say that is enough of a sign of improvement to continue antibiotics and monitoring as long as he is okay in himself.  Recent advice here seems to say that lameness that is not significantly more improved after one week is much more cause for alarm and should have more serious intervention.

2) Whether pain relief is needed if the animal seems good in himself aside from the limp and is able to avoid using the lame leg while otherwise behaving normally.  My vet seems okay with no, you guys are saying yes.

Anyway, I will ring the vet and ask them to come, and find out whether their recommendation changes when they've examined him in the pasture.  (Although given the six of them in the practice, chances are the vet that sees him won't be the vet I conferred with yesterday).

[pgkevet]

What a scary thread! The indiscriminate use of antibiotics, failure to attempt a proper diagnosis, speculation and myth...
The video only shows so much ..and a short snippet like that just shows lameness.

At a pinch waiting a day or two for a simple knock or sprain is one thing.. but this sheep needs a proper attempt at diagnosis - hands on by someone who knows what they're doing.

As a simple example (and I'm not suggesting that's the problem here) Both times I've had lame sheep it's turned out to be thorns in the foot....but only because i spent a heck of a long time washing feet and examining them with a hand lens - and I'm supposed to know what I'm doing. (retired SA vet). the principle is sound .start at the foot and work up.. if you find one problem then look for a second. But if you're not familiar with the degree of reaction to palpation, sensations of heat or swelling - call in someone who is.

[Foobar]

After 5 days and he still won't put barely any weight on it, then yeah, get the vet to look.

It is a fine line between when having limited experience and having to call the vet out at extreme cost (often more than the worth of the animal itself), and trying to fix the problem yourself.  You've done the right thing by showing the video to the vet as a first step.  Had it been me I would have done the second jab of Alamycin, as per your vets instructions, had a closer look at that area that you've identified as being sore, and if there was still no difference after another a day I'd get it to the vet.

It's all a learning curve, so don't take any of the criticism you get here to heart and feel that you have dealt with this wrongly.

What a cutie though .

[Thyme]

Vet is coming for 3pm, so we shall see.  Thanks Foobar for the encouragement and pgkevet for the clear and direct comments

Seriously, part of the question here is different expectations/culture between farmers and vets, and different groups of farmers.  Where I am the farmers appreciate the vets but at the same time are a bit skeptical of them, probably more so because most of the farmers have decades more experience than the vets do (I think the oldest vet in my practice is the mid-30s one who took it over from his dad).  And although I'm not skeptical of the vets, I've been mentored by the farmers. 

I'm at the point now in my learning curve where I'm moving from strictly doing what my mentor does to making changes based on reading SCOPS and NADIS and similar and talking to the vets, but it's a step by step process.  Also, it's pretty clear to me that the vets here are pragmatic about modifying their advice a bit to what they think the farmers here will accept, and when I go to them it's noticeable that they sometimes give me different advice at different times, I think affected by how many farmers they've already talked to that day and whether they remember I'm a newish smallholder with a science doctorate thus less skeptical of them.

I should probably remember to test their advice a little by saying "Okay, if it was your animal, is that what you would do?" to get to what they really think.  I'll do that when the vet visits today.

My mentor has a shearling ram same age as mine, running with mine.  A bit earlier this year his ram went similarly lame.  Mentor came over, tipped him, trimmed his hoof (a point on which I have already diverged), sprayed him blue, and shot him up with intramuscular antibiotics.  He didn't stop limping right away, I think it was somewhere between a week and ten days before he was back to normal, but then he was fine.  So that's the example I started out from. 

[pgkevet]

Sady as with all professions (and the world in general) you'll find vets that are good, bad, indiffent and those whose moral compass is slewed by their mortgage. The public usually judge a vet more by personality than by ability.

You want to see a good clear, precise approach to clinical examination in a logical manner. Any half decent vet is going to be only too happy to give a running commentary on their exam and findings if you ask them..the best way to learn.

I decided when moving here and retiring to meet the locals..so go to the pub once a week and now know a lot of the farmers. Most of them are very friendly and happy to help with simple stuff.. but equally chatting with them many have a very poor approach to animal welfare with the blunt bottom line taking precedence rather than a charitable balance. That was most highlighted in the bad winter 2-3years ago.. Only a very few farmers were out there trying to find and help their sheep..the majority just left the stock to it and scraped the corpses up when it melted.