Listeriosis in Goats

Listeriosis can strike fear into the hearts of goats owners, not only because it needs prompt treatment to increase the odds of survival, and because it can be difficult to diagnose due to the fact that it shares symptoms with several other serious illnesses, but also because Listeria bacteria exist everywhere. 

Today, Dr. Melissa Holahan, a postdoctoral researcher from the Washington Animal Disease Diagnostic Laboratory, is joining us to talk about listeriosis and how we can prevent these zoonotic bacteria from sickening both our goats and us. She details the symptoms to watch for, the most common approach to treatment, and the medications you should have available on your farm in order to offer swift treatment.

Dr. Holahan also touches on popular fermented hays, such as Alfahay and Chaffhaye, and whether or not they are putting your herd at risk of listeriosis. She also stresses the importance of proper hay storage to reduce mold and keeping feeding areas clean.

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Transcript

Introduction 0:02
For the love of goats. We are talking about everything goat. Whether you’re a goat owner, a breeder, or just a fan of these wonderful creatures, we’ve got you covered. And now, here’s Deborah Niemann.

Deborah  0:18  
Hello everyone, and welcome to today's episode. We are talking about a really important topic today, and that is listeriosis. And one reason that I wanted to do this is because it is so easily confused with other diseases. You know, if somebody has a goat that has these symptoms and they go on Facebook, they're going to have people telling them that they've got three or four different possibilities. And the thing is, you really need to get a good diagnosis as quickly as possible, because the faster you start the correct treatment, really, for any of those diseases that are confused with each other, the better the chances of recovery. So I'm really excited to be joined today by Dr. Melissa Holahan from the Washington Animal Disease Diagnostic Laboratory, where she is a postdoctoral research associate and lecturer, and she's been a vet since 2006, but she's been specializing in small ruminants–started with small ruminants in 2016. Welcome to the show today, Dr. Melissa.

Dr. Melissa Holahan 1:23  
Thank you, Deborah. I appreciate it. I have been listening to your podcast for quite some time now, so it's really great to be full circle and be able to interview with you today. And definitely talking about a disease that, you know, we were just chatting beforehand about some of the common diseases, and neurologic disease for me as a veterinarian, is definitely something that I see as one of the common diseases when I go out to a farm. Hopefully it's not common for most goat farmers or producers, but I definitely want everyone to be prepared. One, to prevent it, and then two, if they do start to see symptoms, we know how to get treatment quickly.

Deborah 1:58  
Yeah, we have only had one case of listeriosis on our farm, and I'm pretty sure now that it was listeriosis, because, like we're going to talk about, it's tough to know exactly when you're in the thick of it. And I feel like we got incredibly lucky. We already had an appointment at the University of Illinois to get pregnancy check ultrasounds on a bunch of our does, and the morning we went out there to load them all up, I had this doe that had some weird neurological things happening, and so I called them and I said, “Hey, we have an appointment. We're going to be there in a couple hours with these goats. They were supposed to just get ultrasounds, but one of them's got some, some weird neurological symptoms happening. So I just want y'all to be prepared that we're going to need more than just preg checks.” And we got there, and as is often the case, you know, just from examining her, they're like, Okay, it's either meningeal worm or listeriosis. We're going to treat her for both and see what happens. And she had a complete recovery, not a single symptom left over, which is why now, after having multiple cases of meningeal worm, like I lost all of my llamas to meningeal worm, I've had three goats with meningeal worm. Only one survived, and she had permanent neurological damage. So after seeing that and knowing that this other goat had zero after effects, I'm like, okay, yeah, I feel really comfortable now saying she had listeriosis, because meningeal worm, just, has done such horrible things to my animals that had it and survived–well, one survived–like it's killed the rest of them. 

Dr. Holahan 3:35
Yeah. And prompt treatment, no matter which neurologic disease you're treating, prompt treatment is really the key. And that goes for a lot of “diseases,” right? Or diseases in small ruminants. As soon as you can get treatment on board, the better for sure. 

Deborah  3:48  
Yeah, exactly. Before we get too far into that, I would love to have you tell people your story, because we have so few vets who raise goats and are goat vets, and now you're getting into research. So I am just so excited that, you know, you're like the trifecta, you know, like you're doing the research, you're out there practicing–in the–on the farms, and you're raising goats. Actually don't think I've ever met anybody doing all three of those things before. So tell us a little bit about how you got there. 

Dr. Holahan  4:19  
Yeah, loving living my life through my passions for sure. So, my formal training–I did 12 years of schooling for emergency critical care, ICU medicine in small animals, so cats and dogs mostly. And then in 2016 when I started my own farm, I've had pretty much anything you can think of. I've had alpacas. I've had emus, Dorper sheep, several different breeds of goats. Currently, right now, raising, raising Nigerians and Alpines. So in 2016 when I started, I had a hard time, myself, finding a small ruminant veterinarian to come out and see the animals on the farm. So that is when, and I'm definitely one of those people, with my, my training background, I like to research things you know, like you do. I like to try to find the answers and get the best advice. So I just started doing all of the continuing education that was available for me as a veterinarian, as a goat producer, and that kind of just snowballed into practicing small ruminant medicine, kind of just right from the beginning for all of my friends and family, and ending up customers, people that were buying goats from me. And so my hobby job kind of became my side job. And two years ago, I started my own mobile small ruminant practice, which is “Caprine”--the name for goats–“and Ewe”--a female sheep–“Veterinary Consulting.” And so the majority of what I see is sheep and goats. I do see about 30% camelids, mostly alpacas, in our Michigan area. And then about a year ago, I have been working with WADDL, which is the Washington Diagnostic Lab, for quite some time. That's where I've always sent a lot of my diagnostic samples. I also send to Michigan State, but I love their small ruminant panel. I like having their biosecurity and some of the options they have. And so I had always known about the lab, and when this research position became available, I thought, Oh no, you know, like, I can't do that. But when I interviewed for it with my mentor, I realized that it was kind of the perfect situation. I have the background being a farmer. I have the background of being boots on the ground as a veterinarian doing mobile practice, and then my passion is just trying to find evidence-based medicine. So what more perfect position to do this? And so it's a two year grant. So right now, you know, it's not a permanent position, but I'm loving every minute of it, really enjoying being connected to the university and seeing, you know, what is out there. What are we seeing disease-wise? And being able to bring them the perspective of, what are breeders wanting to know? Because I also have, you know, the national and local show level. So I talk to a lot of people in the goat show world. What are they concerned about? What are they frustrated with and bringing that together on the farm. So it's, it's been a really, really fun experience and a great transition for me. 

Deborah 7:07  
That's awesome. Um, before we get too far into the disease, let's first talk about where listeriosis comes from. I know after we had that case, way back around 2005, the vet who treated my goat said, Oh, it's everywhere, which really freaked me out, because I was like, Oh my gosh. And, you know, and it's common, which really, again, freaked me out. And thankfully, here I am, 19 years later, still have not had another case. So, that's why I'm kind of like, okay, so it's probably common for a vet to see it, but not for most goat owners to actually experience it. So can you talk a little bit about, like, the actual pathogen, where it's at and how goats wind up getting it? 

Dr. Holahan  7:51  
Yeah, so, Listeria itself is actually a bacteria. It's a gram positive bacteria, and you're right, Deborah, it is actually really found everywhere. The most common forms that we think of is Listeria monocytogenes. That is the most common form that we're talking about when we're talking about sheep and goats. There is another form, Listeria ivanovii, which is “ivan-o-v-i-i.” That one, we're usually only going to see that as a culprit for abortions in sheep. So most of the time when we're talking about Listeria, we're not usually talking about that one. So Listeria monocytogenes is the one that we're talking about today, and most people just nickname it listeria. The other important thing is that it's zoonotic, which means that it can be transmitted from animals to people, and so it is important for us, when we're on the farm as a veterinarian to talk about that aspect and make sure that we're protecting the owners that are caring for these animals as well. And then it is found in the soil, most commonly. So it is everywhere. It can be found in the water. So they talk about, like, cattle being in very boggy pastures. Sometimes that could be an increased risk factor. But the most common place that we're going to see it usually is associated with feeding poorly fermented silage or moldy hay, moldy food. And so usually that's going to be like, a good example of that would be a round bale of hay and maybe a small goat herd, and by the time they get down to the center, the hay has rotted out, and we've got some mold there. So that's a good example of that. And one of the things I think to remember for people is outbreaks, usually for listeria, you're going to start to see clinical signs of listeria, or neurologic signs is the most common, usually about 10 days to 14 days after starting the moldy food. So that's something that's important for us as veterinarians, when we go out to take a history on looking at the feed, trying to figure out, when did they change the feed, if they did it all? You know, did they just put a new bag of feed in? Was there a potential that there was moldy food involved, or poorly fermented silage that had just been introduced? And so that's going to be kind of the main one when we think about introduction of this disease, or bacteria I should say, into small ruminants.

Deborah  10:10  
Oh, wow. Okay, so, because just within the last couple days, one of our Goats 365 members asked in our Member community, she's like, Has anybody ever fed haylage because I thought I was buying hay, but it's wrapped in plastic and it smells? And I'm like, Okay, you really need to know if they told you it was hay. It really needs to be hay, because if it's fermenting and it's not supposed to, then something bad could be growing. And she's like, Oh, well, my goats are fine. But what you just said is that her goats might, like, they might not be sick until next week, correct?

Speaker 3  10:48  
Yep, exactly. So it's definitely something to keep an eye out on, just general health for goats, right? Which I know we'll get into a little bit more on clinical signs, but just looking for decreased appetite, any change in their behavior, is going to be one of the first signs you're looking for. And I would talk about some of the fermented hays right now, because I feel like that's a big thing out there, and I'm definitely not against them, but I like to educate people that are using them. So the big ones out there, and I don't work for any of these companies, but the big ones out there right now are Alfahay or Chaffhaye. And those, I think, are the ones that are on the smaller, kind of more commercially available packages for smaller producers. But even then, the small one, I think, for Chaffhaye, comes in, like, a 20 pound bag. But even that, when you open that up, you oftentimes aren't going through that fast enough, depending on the size of your herd. And so there's a couple ways if you still really want to offer that, because it is great that it is a nice, readily available nutrition that is a good quality alfalfa hay that you're feeding, certainly there's some evidence to show that there's some nutritional benefits from that as well, because you do have some yeast and some trace minerals, micronutrients that are in there that help. So I’m not against using it, but I do say to be smart about using it. So some people will have a freezer that they're not using for human food, where they'll keep the bags and/or they'll break open a bag and then they'll freeze it in little smaller bags, so that you can take it out, you know, give it to them and let it thaw out, and you're protecting it that way. Because, in reality, you should open that bag, protect it from the air–and the companies do a good job about talking about it–but I think that I have definitely seen bags that are open for two weeks, and I'm like, oh, you know, we really need to try to use that up within about three to five days. 

Deborah 12:38  
Right. Yeah. So what are some of the first symptoms that someone would see if their goat has listeriosis?

Dr. Holahan 12:44  
So there's three main forms when we're talking about Listeria, and I think we'll focus on the neurologic form, or the encephalitis form, because I think that's the most common that we see in small ruminants. But I want to talk about the other two briefly, just so that, kind of, people have it in their head. And even though these are less common, a blood infection is certainly something we can see. And so that is usually called septicemia, and that's where it actually goes through–the bacteria actually enters the bloodstream. Those animals get very, very sick. They're usually going to have a fever, they're going to be depressed, they're not going to want to be eating, and that kind of all the things that go along with a goat not feeling good. So if they're lactating, they'll have decreased milk production, and so on. The other form that we don't see very commonly, but it can be related to listeria, is abortions. And so abortions in small ruminants, if we're talking about listeria, usually they're going to be later term abortions. And so those are going to be towards the last trimester. And most of the time they're pretty sporadic. You're only going to usually see about 10-20%, so multiple animals could be affected, right? Because they could all be eating this contaminated feed source. But usually you're going to see late abortion. Sometimes you can see still bursts though, or weak neonates, young animals. And then, interestingly, some of these animals with listeria can go on to develop metritis, which is an infection. And in those cases, they actually have seen reports where, because it's shed in the milk, it can be given to the kids, and so the kids could get septicemia, because, remember, the young kids are always going to be immunocompromised. They're going to have lower immune systems, so they're going to be more susceptible to getting bacterial infection in the blood. But the most common one we see is the neurologic form, and I think for me, that's why, whenever I go out to farms and I'm talking to producers, I'm usually always talking to the sheep and goat farmers, most commonly about trying to feed them twice a day, so that you are going out to the farm in the morning and the afternoon at least. You're checking on those animals. You're making sure they're eating. If you've ever raised goats or sheep, usually, you know, they act like they're starving almost all the time. They act like they don't have enough hay in front of them almost all the time. And I always tell people, um, I use the example of Hungry, Hungry Hippos, right? So, or they're like, literally, trying to inhale the grain. And I'm not saying that everybody needs to be on grain, but having something that is almost like a snack, or Timothy pellets is a nice one that I like to recommend if they have boys where they just don't want to, you know, they're getting too fat. So then you know that they're going right to that food. They're acting like normal goats. They're not acting out of their normal routine. You know, they're very habitual in their routine. They love that routine. And so if they're not coming up for food like they normally do, then that's your first key as an owner, that something's going on. But the first general signs that you see are pretty nonspecific. So if you're catching them and you're watching them early enough, you're just going to see depression, reduced appetite. Sometimes they can have a little bit of diarrhea. If you are taking a temperature, because you notice that they're off or they're just not acting right, you may see a fever early on, and then as the disease progresses, and it progresses pretty rapidly, usually within 12 to 48 hours, you're going to start to see neurologic symptoms and symptoms that are involving the brain. And so the most common ones we see is they kind of start to act like they're drunk. That's, like, how I like to describe it. They're usually weak. They lose coordination. They're having trouble walking. They might actually be circling to wander in one direction. So I've had owners comment to me, you know, they are going out in the pasture, but they only want to go to the right, and they'll notice that. The other thing that they will do is they'll actually have their head turned slightly to the right as well, or depending on which side it is, it doesn't have to be the right side, but it'll be to one direction. And then some of the other symptoms I see with this type of disease, again, it's nonspecific, so we'll talk about some of the other neurologic diseases, but they can have droopy ears. They can have a droopy face, a droopy jaw. And with that, oftentimes you'll see that they're not hyper-salivating, but they're salivating, and it's kind of coming out the side of their lips. And so you might notice, they call it a slack jaw, where the jaw might just be kind of hanging. And then if we've missed all of those symptoms, later stages, usually they're lateral, they're not able to get up, and they may also start to have seizures. And so that's kind of the rapid progression of this disease. And if it's left untreated, oftentimes we're gonna see death within, usually, a couple days. And so that's why it's so, so important if we are treating this disease, to treat it as quickly as we can.

Deborah 17:18  
If I remember correctly, my doe that they suspected had it had some vision issues. 

Dr. Holahan 17:24
Yeah.

Deborah 17:25
Her eyes were, I mean, they were weird. Her eyes were weird. And it seemed like, so, like, when I saw her eyes were like, not, they're not just looking straight ahead. They're like, quivering, kind of.

Dr. Holahan 17:36  
Yeah, yeah. So they can have twitching, but they can also have what's called nystagmus. And so the way to relate that is, if you ever remember those old school dolls that have the real weird eyes that move around. So normally, when you take an animal and you spin them in a chair, the eyes actually will track with, with movement. That's normal. However, when we have neurologic animals, we can actually see that movement just at rest. So you might be staring right at the animal, and their eyes are twitching, and that's usually something we can see with neurologic diseases. I think the problem becomes, and something we will, we'll talk about is there's other neurologic diseases that can mimic and look just like listeria. And listeria is not an easy, let's send out a test and we have an answer the same day. So you really have to, as the producer or farmer and as the veterinarian that may be going out to the farm, you need to know the signs and symptoms, and you need to start presumptive treatment right away, because oftentimes we're not getting a diagnosis.

Deborah 18:37  
Yeah, a few months ago, somebody sent me an email and said, What are the, what's the treatment for goat polio? And I said, Well, there's actually several diseases that can look like that, so tell me what you're seeing. And what she described really sounded way more like listeriosis. And, I, so I told her, I said, You need to get in contact with your vet immediately, because if it's listeriosis, the quicker you get treatment started, the better the chances of survival, it can kill a goat within a day or two. And so she did call her vet, and it did turn out to be listeriosis. So can you talk about some of the other diseases that can be so easily confused with that?

Dr. Holahan 19:20  
Yeah, yeah. So the big one is goat polio, right? So polio, encephalomyelitis, which is basically a lot of things, can cause polio. I always try to simplify it in anything that's going to cause a goat to go off feed can cause polio. Polio is, very simply, a reduction in thiamine, which is vitamin B1. And when the small ruminants are not eating, the rumen is really vital in production of thiamine, and so you're going to have a lack of thiamine. And that's the easiest definition of polio. They're very, very similar symptoms. Sometimes we can see a couple different variations. Like polio, sometimes you may see them be more blind. They may not be as clinically sick like they would be with listeria. Usually, with listeria, they can have a fever. They can have some other symptoms, but I definitely don't have any symptom where I'm like, that's definitely polio or that's definitely listeria. There are some cases that can be very, very confusing. Even, for example, if you have a very sick pregnancy toxemia animal, that can kind of mimic some of these signs as well, because they may be off food, they may not be acting right. So they may have some signs that are leaning towards polio, and they may be acting kind of neurologic and off. So Polio is the other big differential that we look at. Other things that can cause neurologic signs with these guys–the other big one is neurologic diseases in the young. So if we're talking about a young animal, we can see CAE. Remember, CAE stands for caprine arthritis encephalomyelitis. So the encephalo part, that's brain, but it's usually going to be more younger animals that we would see CAE in. So that's another big one depending on the age. And then for us, although it's less likely, we can see brain abscesses. I've seen, you know, ones that have actually gone to necropsy or had a basically, like, an autopsy done. I've seen brain tumors, so brain cancer. And then rabies is rare in small ruminants, but as veterinarians, we can't forget about rabies, because oftentimes we're not, depending on the situation, we may not be vaccinating them for rabies, because it's off-label vaccination using the large animal rabies vaccine for sheep and goats. But it's really, really important, because just like listeria, rabies is zoonotic. I wish I had a magic wand I could go out and say that goat has rabies, but you just have to be really careful, because there's a lot of kids involved in treating these animals and caring for these animals, and so in reality, most of the treatments, we might be giving injections, we may be feeding them, we may be by their mouth. So you want to make sure they're wearing gloves and make sure that they're protecting themselves, even though rabies may be very, very low on the differential list. Listeria is also zoonotic. So you really should be wearing gloves when you're treating these animals ,or any neurologic animal on the farm, especially for the small ruminants. But definitely polio and listeria are the top two. And actually, before I forget that–the meningeal worm. You know, we don't often, depending on where you're at in the US, we may not see it very often. We definitely see it in our camelids, so alpacas more commonly than llamas. So they are more prone compared to our small ruminants, but we do still see it in sheep and goats. So it should definitely be a differential, especially if you've got the environment where we see slugs, where we have white-tailed deer as part of the host circle. And it definitely is something that you should have on the differential list as well, although I would say polio and listeria, we're going to see more commonly.

Deborah 22:45  
Okay. The person who contacted me, the thing that made me say, you, I would call your vet immediately, was that she said the goat was circling. And I said the nickname for listeriosis, like the old-fashioned name, people called it “circling disease.” So if a goat is circling, like, listeriosis would be my first guess. Do, do you see them circling with goat polio?

Dr. Holahan  23:11  
They can, but more commonly, they'll stargaze, or they'll kind of look up and kind of head press. So they just are kind of acting weird and acting like maybe they see some, see stuff that's not there. But they can, they can still progress to convulsion seizures, and once the goat goes down, or once the, the animal goes down, sometimes it's hard to tell how they were walking, if it's an advanced stage. But yeah, we usually do see circling more with listeria and more lateralization of the signs, meaning that they may be going to the left more, they might be having a droopy face more, very similar to, like, a stroke in people, where you might see an asymmetry to what's going on with their face.

Deborah 23:55  
Yeah. With meningeal worm, I have had three goats that have had it, and one time, two sisters got it within, like, a week or two of each other. And the second one that got it, like we were really thinking, like, Oh, this is probably meningeal worm, because she and her sister were both grazing in the same place not that long ago. But the crazy thing about it is that she had her whole body twisted to the left, just like you see in listeriosis. 

Dr. Holahan 24:26
Yeah.

Deborah 24:27
You know, so it was really kind of tough, because I took her to the university, and it's like, well, you really want to say it's got to be meningeal worm, but the fact that her body was twisted to the left was, just, it's so much like listeriosis, you know? But it probably was meningeal worm, because she permanently–she's the only one that ever survived, and she was permanently twisted.

Dr. Holahan  24:48  
Yeah, and that's a good point, Deborah. So they can have some residual signs, if we are lucky enough to pull them through. Depending on whether you're looking at cattle or sheep or goats, it's about 30-50% survival when we are able to catch it early and treat it early. But when you talk about the twisting, that's called torticollis, is what we call that. And so it could start with a head tilt, but they can actually progress to twisting and turning. And one of the most severe cases that I saw this past year was an animal that was on a round bale. It was a Boer goat. She was a unique case in that she was pregnant with twins. And it's interesting that you said that you were taking them in for pregnancy ultrasounds, because I knew for sure, I had been on this farm a couple days prior, and I had done a preg check. We had confirmed that everything was good. We were doing some teaching ultrasounds with the 4-H kids, and this goat was completely normal. I was there, saw it myself, right? So if I had not been there several days before, I wouldn't have believed the rapid onset of the clinical signs. And come to find out, it was associated with a round bale that had just been introduced about a week and a half, two weeks prior. And that was a unique case in that it was a Boer. So it was about a 200 pound animal, so not an easy animal to really work with nursing care wise. And this animal progressed so rapidly, even though we were treating her aggressively, and she ended up surviving, but she was what I called it turtling at the time, because she, she was turning and twisting so badly that she would flip herself over. And you know what happens when a ruminant flips? And so we actually worked with the owners, and they built almost like a pig shoot for farrowing, that she couldn't turn for a couple days, that she had to stay upright, and they had video cameras on her and everything. These owners were very committed to her treatment, and I was just so amazed as to how well she did, and that we were able to kind of troubleshoot all the things. Because, I mean, they knew, and I knew, if she got on her side in the middle of the night and she couldn't get up, she was going to get bloated and not, you know, do well. So it was a very unique case as well, because we obviously were doing everything we could to save her, and ultimately did, but she was pregnant with twins, so we didn't really want to hit her really heavy with steroids. As you know, steroids can be a treatment, but it can also cause abortions, you know, depending on where they're at in the stage of their pregnancy. 

Deborah 27:08  
Yeah. I'm so glad you mentioned rabies, because I think rabies is not really on the radar for most goat owners. And every few years, whenever I think about it, I check the Illinois State website to see, you know what the status is on rabies. And most of the time, you know, it's like, there's a skunk here or there that, that got diagnosed with rabies. But a few years ago, there was a cow that had it, and it was actually in the next county over from us. So I was like, Oh my gosh, a cow had rabies, like, not that far from here!

Dr.Holahan 27:43  
Yeah, and I think that the biggest thing is, it's not that it doesn't happen, it's that what happens to us on a farm when our livestock passes away. Well, in most states, usually we're not going to get a necropsy, depending on, you know, what you're looking at. Most of the time we're not going to, you know, pay for that. It's, you know, probably a couple hundred dollars, so most farmers are not going to pay for that, depending on the situation. And then we're usually going to bury it on the farm, depending, again, on what state you live in. And so I think that, not that it's like prevalent and we're missing it, but I think that especially for livestock, it's not like we're doing necropsies on all these animals when they pass away acutely from a neurologic disease. Or, you know, they go down so quickly, we don't know what, how they died. But it, it is really important, even for that too, neurologic diseases, listeria can be zoonotic, and rabies can be zoonotic, and it only takes one case. I've had a lot of owners that are in the medical field in some way or another, and decide to go into farming. And it only takes one case, you know, I had a nurse that had a small cut on her hand. You know, we all do usually when we're farming, and she had been treating this goat, and it progressed and progressed and progressed and it was drooling and not eating right. And, you know, I was like, gosh, I just need to let you know, rabies is a differential, and we need to wear gloves. And she was like, Oh, I was treating this animal, you know, a day before you came out and didn't have gloves. I had a cut on. What do I do? And as a veterinarian, all I can really say is, you know, you have to talk to your physician and see if rabies prophylaxis is warranted, but again, minimal, but you know, anxiety is high on everybody, because we don't know. And ultimately, that case did end up going to necropsy, and it had a brain abscess that was not responding to treatment, unfortunately. So, you know, an interesting case, but you just want to try to prevent that. So it's very easy, throw some gloves on. If you have a farm, you know, you should have a pair of disposable gloves, just for safety, for those things, and just making sure that we're protecting them.

Deborah 29:40  
Yeah, exactly. Rabies has a almost zero cure rate among humans, so it is not a disease that you ever want to get. And listeriosis too. I mean, especially if you're pregnant. Like listeriosis can be especially bad for pregnant women. Do you want to talk about that for a moment? 

Dr. Holahan 29:58  
Yeah. So, when we're talking about the zoonotic potential, I think the two things to kind of circle back, because we talked briefly about it, but two routes usually, obviously humans can get it from the environment as well. But if we are talking about the farm environment, we're usually going to either be ingesting milk. So again, the importance of raw milk versus pasteurized milk. So if they're shedding it, it could be going in the milk if we're drinking that on the farm, and then just fecal-oral contamination. So feces is getting on our hands or and or being introduced into the GI tract. So those are the two main ways that we as people may get it. And obviously immunocompromised people or pregnant people are going to be higher risk. And so pregnant females, if we are talking about risk of listeria, is usually going to be abortions, and so they can, they can also have stillbirths. They can have issues with the fetus. They can have septicemia in the fetus itself, or an infection in the baby. And then people can actually get septicemia or flu-like symptoms and break out in rashes. So, you know, those are very non-specific things, right? It's not like you're going to get that and be like, Oh, it looks like I have listeria. You know, your physician is going to have to put together those pieces of the puzzle and the exposure on the farm. And a lot of times, human physicians are just not trained to think about zoonotic diseases like we are in the veterinary world. So a lot of times, you know, we're trying to play that other side of the role and alert the physicians that, hey, you know, we have exposure on the farm. 

Deborah 31:31
Yeah. So if a goat has listeriosis, what is the treatment for that?

Dr. Holahan 31:38
So typically when we’re talking about listeria on the farm–I am usually prefacing this with any neurologic animal, or any neurologic goat or sheep when we go on the farm–so the biggest thing is, I don’t like to throw the kitchen sink at them, but this is definitely one of the diseases where we are treating them with several different therapies so that we’re covering our bases. Again, polio is going to be a diagnosis of exclusion. It’s usually going to be diagnosed based off of response to treatment–how fast are they responding to thiamine? Listeria is very hard to diagnose. Usually it’s going to be on necropsy, which is after death, or by culture, and culture takes time. And we don’t have time on our hands to wait a couple of days for a culture to get back, so we’re usually not, as veterinarians, going to say, yeah, let’s send out the test or the culture to figure out if we need to treat. And then any of those other neurologic diseases are going to be symptomatic treatment. So, meningeal worm, you know, we’re going to potentially be doing prophylactic treatment for that, if that’s a higher risk area. You know, brain abscesses or infections, we’re going to cover the antibiotics there. Rabies, there is no true treatment, so in those cases, all of the above in supportive care, and if the animal survives, likely it’s going to be one of the other diseases. So, I break this up into a couple of different categories. For me, the first and foremost one is we want to include antibiotics in our treatment. Most of the time if we’re covering for listeria and other types of brain infections, we’re going to usually do high dose penicillin. If we are covering for abortive diseases, we may treat with oxytetracycline, but high dose penicillin is usually going to be the primary go-to one. It’s also not super expensive. It’s easy for our farmers to administer it. And so, I want to have antibiotic coverage on board as soon as possible, and that is usually going to be given intramuscularly or subcutaneously. And a lot of times I’ll start off with every six hours, just depending on how severely affected the animal is and, you know, case-by-case basis. The second category of things that I like to add on are antiinflammatories. And so then you have to make a decision as the owner, or as the veterinarian, are we grabbing banamine, which is a non-steroidal anti-inflammatory? That is a very nice anti-inflammatory to use. It also helps to bring down their fever. But in some more severely affected cases, and in animals that may not be pregnant, we may want to reach for steroids or dexamethasone as the treatment there. Again, it’s also an anti-inflammatory, but in some cases it may also help reduce the inflammation in the brain. So it kind of just depends on the situation. There really haven’t been any studies to show that one is better than the other, but in some cases, like the pregnant goat that I just talked to you about, we reach for banamine because, you know, initially, you know, we’re trying to save mom and babies and so that’s a decision time. Vitamin B is definitely something you want to have treatment-wise for any neurologic goat. Even if polio wasn’t on the differential list, if you’ve got a neurologic goat, they’re not going to be feeling well, they’re going to be dizzy, they’re going to have a decreased appetite. And any time, again, you’ve got reduced motility in the rumen, and the rumen’s not making thiamine as it normally would or B1, you’re going to want to supplement. And thiamine is one of those vitamins that I always tell people, the amber bottles, you really want to pay attention to the expiration date on those amber-colored bottles because they’re amber-colored for a reason. Those vitamins can disintegrate or kind of break down over time and so you don’t want to use an expired bottle in those situations. And you want to try to keep those in the house where they’re not going to be exposed to extreme temperatures. So there’s a couple of ways you can supplement thiamine. I always talk to people about the difference. So, thiamine B1 you can actually get at, you know, Valley Vet, PBS Animal Health, all of the website pharmacies. You don’t typically need a prescription for that. But thiamine itself, or B1, is 500mg/ml versus the more common B-complex, or high potency B vitamins, is, has thiamine in it, but it also has B12 and some other B vitamins, and it only has thiamine at 100mg/ml. And that is important for me as a veterinarian to educate my owners up front because I would rather give a 1ml injection if I had to versus a 5ml injection in a goat. And I think that most of my owners would as well. So, depending on the size, which Nigerians are very common, you may have to just give a smaller injection and it just makes it easier. So if you don’t have pure thiamine, you’re going to have to give five times the dose if you have high potency. And I just think that’s important to make sure you’re reaching the appropriate B-supplementation when you’re treating them. And then, for me, the rest of the treatment, if they’re not eating well, if they’re not doing well, sometimes we will do IV fluids–so intravenous fluid therapy which we usually do in the jugular vein on the farm and/or we’ll teach the owners how to give fluids under the skin so that they can continue to do fluid support. Nutritional support is really big, as a lot of people know, for small ruminants, they need to keep eating. And so sometimes, depending on the case, if they’re still up, and they’re still able to swallow, they’re still able to take food, you know, we may be trying to support them if they’re not eating on their own. We may be tubing them. That’s certainly something that I would do as a veterinarian if I am out on the farm, is I’ll run a tube down so I can get a larger quantity of nutrition and/or electrolytes in and/or we’ll have the owner syringe or support them with trying to feed them that way. And then a lot of it is nursing care. You have a neurologic goat that’s down or rolling like that one case, trying to make sure that they are sitting upright, that we’re giving them the support they need, what with hay bales or whatever it might be, and getting them up and moving them is really important for ruminant health. Even if we have to sling them or help them, trying to get them up and moving them every day. 

Deborah  37:21
Okay. And then you talked a little bit about survival rates earlier in recovery. Could you talk about that a little bit more? 

Dr. Holahan 37:29
Yeah, so, in the literature for listeria, they quote about 30%, and I think that’s kind of across the board. I do feel it’s a little higher if we are able to get to those animals in kind of the first 12-24 hours, and we’re able to get treatment on board very rapidly. So I do think that it may be a little bit higher than 30% if we’re treating them promptly. But again, just the importance of going out and looking at your goats every day, feeding them in the morning and at night, because goats can go from I’m perfectly normal to I feel like I’m going to die in 12 hours. And, so, really important to make sure that we’re trying to stay on top of them and seeing even just those subtle signs.

Deborah 38:08
Yeah, exactly. So what else do people need to know about listeriosis?

Dr. Holahan 38:13
So the big one, I think, is prevention. You know, this is a disease that is easily preventable. I mean, we’ve all been there, you know, you open that hay bale, and nowadays depending on where you’re getting it from, you know that could be a $3 hay bale or a $10 hay bale, and you see a little bit of mold and you don’t want to waste it. And I get that, you know, because I run my own farm. But making sure that we have good hygiene on the farm, good sanitation, if we see anything that’s moldy it goes right into the compost pile, or wherever the animals aren’t going to have contact with it. I think the other one that I try to remind people is wild birds can be a part of the transmission if they’re having access to feed storage. And that’s one of the reasons that, you know, I’m not against having chickens on the farm, but I’ve been there, done that, and they like to deposit their feces all over the hay. And so, just making sure food is covered, food is in airtight containers where they’re not going to have moisture getting into the containers, and that the hay is stored somewhere off the ground. I think the easiest, easiest thing is having pallets that we can get some airflow underneath that hay, and making sure that it doesn’t have contact with the ground level so it’s not getting moldy. The other one that I always talk to people about is there’s a million and one different hay feeders, but a lot of them have the basins, and if those get wet, and then we also have goat kids that like to jump up in there and add some feces to that, and then we’ve got the moldy hay, and if that’s not being, you know, kept dry or continuously cleaned out, then that’s going to serve as another area where we could have contamination. So I always tell people, you know, keep the food off the ground for many, many reasons, you know, feed off the ground. Continue to clean those areas that they’re putting their mouth on to get the food. 

Deborah 40:00
Awesome. That’s a lot of really great advice. I know in some places it’s even more expensive. In my UMass class, I always have my students do a budget, and it’s shocking that, you know, like, out west, people can pay $15-20, and in Hawaii $30. I, I just, for a bale of hay–I just don’t understand how anybody can have goats unless you’re a millionaire. 

Dr. Holahan 40:24
It has gotten more and more expensive, that’s for sure. Yeah, I mean I really think the price in general, I mean, a lot of people that are raising small ruminants, it’s getting much, much harder. Like I remember even just looking at the bag of feed, like, I remember chicken feed, it’s gone up almost double the cost. So, you really have to think about what are your hobbies and your passions and how much, you know? I have expensive hobbies, that’s for sure. 

Deborah 40:53
Yeah, and so it’s hard, like if you see mold or something, it’s really hard to say, Yeah, I’m going to throw all of this out. You know it’s very tempting to just think, like, oh, I can pull the moldy part off, and the rest of it is fine. But the reality is, you can’t see mold in its smallest form, so, like, there could still be mold in places where you can’t see it yet.

Dr. Holahan 41:17
Yeah, that’s a really good point. And, just, the time it takes to treat these cases, and the cost associated, because a lot of times it’s going to be an emergency visit. It usually happens pretty rapidly. It’s not a routine appointment–you know, like you were saying, you happened to be going in for pregnancy checks. You know, it’s typically going to be an emergency call. And not only that, the treatment usually is at least two weeks, sometimes longer. If they’re responding to treatment, you’re usually going to have a two or three week course that’s pretty labor intensive. Some of these injections are going to be three or four times a day initially. And I like to taper those things off, especially the vitamin B1 or thiamine, I like to taper that off and do that, usually, every couple days for week three even. So, it’s time consuming to treat these cases, even if they are responding well.

Deborah 42:04
Well, thank you so much for joining us today. I know people are going to find this really helpful, and, hopefully, whenever their goat does have some of these crazy neurologic symptoms, they will call their vet sooner rather than later. 

Dr. Holahan 42:18
Yeah, I mean these are definitely a lot of the things that we were talking about. If you have a good relationship with your veterinarian, and I already have a client-patient relationship with them, these are things where I usually already have them have a bottle of penicillin, I educate them to have a bottle of banamine. Those are my two favorite things to have on the farm with my clients, and I typically have them source their own, or get it from a veterinarian, having a bottle of thiamine. So, in this situation, you could start the majority of these treatments on your own, and I often do say, ok which animal are we talking about, what’s the size, and we get doses started right away. Because the sooner we can get some of these treatments in, the better. And many of these treatments are going to be more benefit than harm, especially when we’re talking about, you know, trying to stay away from dexamethasone or steroids if they’re pregnant. But, getting these treatments on board as soon as possible, and unfortunately, you know, I know you know that, Deborah, with your own personal experiences, you know meningeal worm is another example of that rule of trying to get treatment on board as soon as possible. So, thank you so much for having me, Deborah. I really appreciate it, and being able to talk small ruminants, you know, is one of my favorite things to do, so hopefully this helps people treat the disease and get on track as soon as possible, and it hopefully helps save some of their animals.

Deborah 43:33
Absolutely. Thanks so much for being here!

Deborah 43:36
And that’s it for today’s show. If you haven’t already done so, be sure to hit the “subscribe” button so that you don’t miss any episodes. To see show notes, you can always visit ForTheLoveOfGoats.com and you can follow us on Facebook at Facebook.com/LoveGoatsPodcast. See you again next time. Bye for now!