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Parasites

Neonate diarrheic processes and cryptosporidiosis
By Martin Gomez
Feb 4, 2003, 8:36pm

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Neonatal diarrhea syndrome in ruminants

Sebastián MARTÍN GÓMEZ

Doctor en Veterinaria.
Veterinario clínico de pequeños rumiantes.
Colaborador Honorífico del Departamento de Patología Animal (Sanidad Animal) Universidad de León.
Apoyo Técnico Ovino en CEVA SALUD ANIMAL.

Article published in: Ganadería, Year I, No. 10, November 2001.

NEONATAL DIARRHEA SYNDROME IN RUMINANTS WITH SPECIAL ATTENTION TO CRYPTOSPORIDIOSIS: CURRENT IMPORTANCE IN SPAIN AND PROPOSAL FOR CONTROL OF THE DISEASE

INTRODUCTION AND AIMS

Ruminants are undoubtedly one of the bases of agrarian production in Mediterranean countries. Among the factors which determine the profitability of such production, special importance is attributed to sanitary conditions. As to the causes underlying production losses, perinatal morbidity and mortality are of great repercussion, since the production of calves, kids and lambs constitutes at least the second most important activity on these livestock exploitations.

Among the causes of neonatal mortality, those attributable to infectious and parasitic processes are of foremost importance, and mainly give rise to diarrheic, respiratory and/or septicemic disorders. In this context, diarrhea is the most important problem (3), in view of its economical repercussions — not only due to the high mortality it sometimes causes but also because of delayed growth of the animals, medication costs, and the expenses derived from veterinary care and working hours.

The nature of the agents causing neonatal diarrhea in domestic ruminants is highly varied, and includes bacteria such as the "coli" (Escherichia coli), viruses such as rotavirus and coronavirus and, importantly, "cryptosporidia" (Cryptosporidium parvum) — a parasitic protozoon in many animals species and in humans (zoonosis), which causes the disease known as cryptosporidiosis (7,21). Consequently, in addition to its economical importance, infection due to C. parvum also constitutes a major public health issue (21).

Taking into account the above, the present study was designed to provide an updated review of the subject and describe our own results obtained in different research projects — some of which have not been previously published — as well as the data derived from daily clinical activity.

NEONATAL CRYPTOSPORIDIOSIS IN RUMINANTS

Figure 1: Microscopic image (x400) of a fecal smear stained by the Heine method. The oocysts of C. parvum do not stain (white spherical structures).

Cryptosporidiosis mainly affects animals between the first and third week of life. The infection originates — even in the first 24 hours of life — when the newborn animal ingests oocysts of the parasite (Figure 1), which are found in the environment contaminating the bedding, walls, feeding troughs, drinking units, udders, etc. The oocysts in turn reach these locations through the feces of the first animals to become infected in each outbreak, and through the feces of the ewes which serve as asymptomatic carriers, i.e., they carry the parasite and eliminate it through the feces but do not actually develop the symptoms of the disease (no diarrhea due to "cryptosporidia"). The transmission route involved is thus referred to as fecal-oral (21).

The biological cycle of the parasite takes place in the intestine of the animals, with special predilection for the ileum, and destroying the parasitized enterocytes. The characteristic clinical manifestation is diarrhea (Figure 2), accompanied by an important elimination of oocysts, with dehydration, abdominal pain, apathy, loss of appetite and weight loss. Death may result in the more severe cases (1). The percentage mortality is around 10% provided only C. parvum is involved (21).

Figure 2: Young animals with neonatal diarrhea syndrome due to C. parvum infection.

The feces are usually foul-smelling, yellow in color and of a consistency ranging from pasty to liquid. These symptoms generally persist for 3-5 days in the mildest cases, and for 1-2 weeks in the more serious presentations. The condition posteriorly resolves spontaneously, and may go unnoticed in animals over 30 days old. A decisive role in the resolution of the infection is played by specific immunity acquired by the neonate on a passive basis through the maternal colostrum, and actively as a result of the development of the host immune system (24).

As has been mentioned above, in addition to diarrhea, the affected animals also show a loss of appetite as a characteristic signs of the disease. The diminished milk ingestion is very marked at the start of the process, and the animals can even totally reject feeding. This, and the reduced utilization of nutrients by the damaged intestine cause the affected individual to lose weight (27). Thus, for example, experimental studies have shown the body weight of a group of healthy young animals after 35 days to be two kilograms greater than in animals infected with C. parvum (27). This loss in turn prolongs the required time to sacrifice of the infected kids and lambs, in order to ensure a sufficient body weight for marketing purposes. This in turn leads to important economical losses, fundamentally in periods of the year such as Christmas, Easter and the month of August, when the demand for such meat increases considerably and the prices fluctuate considerably in only short periods of time (15). In addition, such initial body weight loss has sustained repercussions throughout the growth period of the animal — with the resulting productivity losses implied.

CURRENT IMPORTANCE OF CRYPTOSPORIDIOSIS IN SPAIN

After commenting the nature of the disease, the way in which it is acquired and transmitted, and how it negatively affects neonatal ruminants, we will center our attention on the magnitude of the problem in bovine, ovine and caprine livestock in Spain.

In this country, the presence of C. parvum in bovine cattle was first reported in 1987 (14), and the importance of the condition has since been pointed out in many autonomous communities throughout Spain (8,19,23). Specifically, in Castilla y León, eight years later, a herd prevalence of 47% was reported, with 17% of the analyzed calves being found to be affected by cryptosporidiosis (19). In addition, the mentioned study also evaluated the presence of other agents capable of causing diarrhea; in this sense, C. parvum was seen to be the most frequently implicated pathogen, since infection due to rotavirus was detected in 15% of the animals versus coronavirus in 1.5%; no animals presented E. coli infection (19).

In ovine livestock, cryptosporidiosis was described for the first time in 1985, in young animals with diarrhea in the central and north-western parts of the country (26). Since then, different investigators have emphasized the growing importance of this parasitosis in small ruminants in Spain, both in diarrhea outbreaks and detected on randomly selected exploitations (4,16,20,22,27). Thus, in a study conducted in Castilla y León, 47% of the 22 outbreaks of diarrhea analyzed were caused by C. parvum (22). Special mention should be made of a posterior study carried out in this same Community, in this case involving a statistically representative number of randomly selected animals and exploitations, in which a herd prevalence of 52% was recorded (16).

More recent data, which provide alarming confirmation of the growing magnitude of this parasitosis, are provided by a study conducted between August 1999 and March 2001 (data not previously published), concerning 62 outbreaks of diarrhea documented in the same number of ovine exploitations located in a zone similar to that of the previously mentioned studies (Figure 3)(Table I).

As can be seen in Table I, most of the outbreaks of diarrhea occurred in the autumn/winter season (56 outbreaks), as is logical, since it is at this time of the year when animal concentration in the breeding stables is greatest in the study area — a situation which can also be extrapolated to other Spanish regions. In this study, 84% of the outbreaks of diarrhea analyzed were caused by C. parvum, the prevalence rate varying from 67% in Palencia to 91% in León, although no association was found between infection and any given geographic location. This lack of association has already been reported elsewhere (16), since infection is a problem acquired in the stable, regardless of where the latter is located. Likewise no association was observed between the presentation of infection and the season of the year, though the prevalence was greater in seasons with increased breeding stable activity: 85.7% in autumn/winter and 66.6% in spring/summer (Table I).

Table I: Outbreaks of diarrhea produced by Cryptosporidium parvum on ovine exploitations of north-western Castilla y León (1999-2001)*

Season

Location

Spring

Summer

Autumn

Winter

Total

León

100 (2/2)

100 (2/2)

95 (20/21)

75 (6/8)

91 (30/33)

Palencia

0 (0/1)

67 (2/3)

80 (4/5)

67 (6/9)

Valladolid

0 (0/1)

75 (3/4)

86 (6/7)

75 (9/12)

Zamora

67 (2/3)

100 (5/5)

88 (7/8)

Total

100 (2/2)

50 (2/4)

87 (27/31)

84 (21/25)

84 (52/62)

* Herd prevalence rate: % (no. positive herds /no. herds analyzed)

 

On the other hand, in goats, only limited data are available, and the study by Martín Gómez (1996)(16) may be regarded as the first survey conducted in Spain involving a statistically representative sample of randomly selected animals and herds. In this study, cryptosporidiosis was diagnosed in 14% of the kids belonging to 42% of the exploitations analyzed.

To summarize, the above cited data show that in this country a large percentage of bovine, ovine and caprine exploitations present cryptosporidiosis in breeding stables, since as will be commented below no totally effective control method has yet been developed.

Figure 3: Geographic distribution of the outbreaks of diarrhea analyzed on ovine exploitations.

On the other hand, the studies made to evaluate the economical losses produced by this disease are limited. The only study in this direction was carried out in the United States in bovine livestock for the period between 1970 and 1976 — i.e., 17 years before the disease was first diagnosed in Spain — estimating the losses attributable to "cryptosporidia" to total 6.2 million USD (approximately 992 million Spanish pesetas)(13). These figures are most likely far below the actual current total, however.

INFECTION TRANSMISSION RISK FACTORS

Having examined the spread of the disease in Spain and gained an idea of the economical losses involved, an analysis should be made of the factors that contribute to create this situation, and which posteriorly must be taken into account to define possible control measures.

1.- Firstly, mention should be made of the great proliferative capacity of the parasite. As an example, an infected animal with diarrhea can eliminate between 1 and 10 million oocysts per gram of feces (4,17,27). Taking into account that the daily fecal mass is 150g, the animal excretes around 1000 million oocysts a day. Since only 1-5 oocysts are required to infect a newborn animal, this means that the oocysts eliminated in a single day are sufficient to infect over 100 million animals !

2.- The second important factor to be taken into account is the resistance of the oocysts. In effect, they are able to survive in the environment - bedding, walls, feeding troughs, drinking units, utensils, etc. — and maintain their infective capacity for prolonged periods of time, with great resistance to the environmental conditions and to the usual disinfectants. This greatly facilitates diffusion of the disease. The only physical conditions which affect their infective potential are extreme temperatures (-20ºC during 8 hours; >60ºC for 30 minutes), and especially drying (25).

3.- The poor hygiene and sanitary conditions found on many ruminant exploitations also contribute to the important presence of the parasite on such farms, particularly those that raise sheep and goats. Since transmission is via the fecal-oral route, the most hazardous source of infection for the newborn animal is the diarrheic individual nearest to it. On most exploitations, birthing typically concentrates over a short period of time, in which crowding of the animals is common — thereby facilitating contact between diseased and healthy individuals. If the hygiene and sanitary conditions are moreover deficient, the conditions for a diarrhea outbreak are favorable. In this sense, an increased prevalence has been observed on larger ovine exploitations — a situation that does not normally imply larger installations but rather crowding of the animals (16).

4.- Lastly, and derived from the above factors, it is easy to understand that the greatest incidence of the disease coincides with the end of the breeding stable period, since the lack of hygiene facilitates progressive contamination of the environment with large amounts of oocysts — thereby increasing the risk of infection.

SPECIFIC AND SYMPTOMATIC TREATMENT

A large number of drugs have been used, including coccidiostatic agents and broad spectrum antibiotics, though few have been shown to be effective (11). Among these drugs, mention may be made of spiramycin, halofuginone lactate, lasalocid and paromomycin — their use in some cases proving toxic or too costly. The use of such products gives rise to a partial reduction in the fecal elimination of oocysts and, in some cases, the associated diarrhea is less severe as a result.

Thus, in the absence of totally effective specific treatments, symptoms management is a priority concern once a diarrhea outbreak has appeared on an exploitation. The application of such measures can prevent mortality in the herd and even reduce the morbidity-associated losses to tolerable levels.

1.- In first place, it is essential to isolate the diarrheic animals in a concrete area, or where possible in a separate building which may be referred to as a "nursing ward", since as has already been commented above these animals are the principal source of infection for other healthy newborn animals.

2.- The first measure to be applied to the diarrheic animals should be the total restriction of milk (maternal or artificial), replacing it with oral solutions containing electrolytes (mainly sodium) together with glucose and amino acids — though from the practical perspective these measures are difficult to apply in most cases. The rationale of milk restriction is that the suckling animal with a damaged intestine does no correctly digest milk, thereby causing the latter to clot and favor the growth of other enteropathogens — thereby worsening the diarrheic process. Another important consideration is the administration of a formulation based on Lactobacillus to help restore the normal intestinal flora.

3.- Intestinal motility inhibitors should not be used, for although they suppress the diarrhea, their use is counterproductive in that bowel movements exert a protective function by facilitating pathogen elimination in feces. The use of such products causes both the pathogens and their toxins to be retained within the intestine, thus facilitating their fixation and absorption.

4.- Finally, the use of antibiotics should be supported by laboratory tests confirming the presence of enteropathogens other than "cryptosporidia". The corresponding antibiogram will in turn define the antibiotic of choice in each case.

CONTROL OF CRYPTOSPORIDIOSIS: IMMUNE PROPHYLAXIS, SANITARY-HYGIENE MEASURES AND MANIPULATION

As to control of the disease, considering that no totally effective pharmacological treatment is available and that the critical period is reduced to the first 2-3 weeks of life, together with the apparent importance of the immune system in resolving the disease (24), the possibility of treating neonates with colostrum and milk formulations hyperimmune to "cryptosporidia" obtained from vaccination of the ewes in the last period of gestation, constitutes an attractive alternative management approach (5,17,18). In this sense, it has been seen that intramuscular vaccination of the sheep one month before birthing, with an intramammary infusion two weeks later (both involving proteins of the parasite) significantly increases the specific antibody titers in colostrum and milk for at least 20 days after birth. In this way in young animals suckling from immunized ewes, the onset of the disease was delayed two days, its duration was shortened by three days, and oocyst elimination in feces was reduced 77%. Moreover, the diarrhea observed was both less severe and shorter lasting, with a body weight increase 1.9 kg greater than in infected animals suckling from non-immunized control ewes (17). However, although these results are truly encouraging, it is still too soon to register a vaccine against "cryptosporidia" on the market (6).

Thus, the best measure currently available in clinical practice for dealing with this disease is the implementation of adequate sanitary-hygiene and manipulation measures, with the purpose of avoiding neonate contact with the parasite as far as possible, and preventing propagation of the disease to other healthy animals (12,18). Consequently, special attention should focus on the following:

- Isolation, cleaning and handling of the infected animals, since as has already been mentioned, they constitute a source of infection for the healthy animals. The care takers should always manipulate the healthy animals first, and posteriorly treat the sick individuals, using different clothing and utensils in each group.

- Although under field conditions it is sometimes complicated, cleaning and disinfection of the installations should be carried out at least once a week to prevent the accumulation of oocysts and other pathogens in the bedding, floors, walls, feeding troughs, drinking units, etc. (18). As to cleaning, since the oocysts are sensitive to high temperatures and drying (9,25), the best cleaning method is the application of high-pressure hot water, posteriorly allowing the installations to dry for several days before reintroducing the animals. Unfortunately, the efficacy of commercially available disinfectants is limited by the great resistance of the oocysts, as has already been commented. Among the products evaluated to date, Oocide® (2)(not marketed in Spain), a combination of quaternary ammonium and sodium salts, is the option affording the best efficacy. Other disinfectants with a similar composition (personal experience) also offer some efficacy against the parasite.

- Crowding of the animals is to be avoided as far as possible. To this effect, correct reproductive planning on the exploitations is essential, separating the females into mating batches, synchronizing heat periods (vaginal sponges or implants with melatonin), and programming birthing dates (ultrasound), to organize the breeding stables according to the number of females expected to give birth, etc.

- During gestation, the females should be well fed, since this will not only ensure stronger newborn animals but also improved quality colostrum.

- The ingestion of colostrum should take place in the first hours of life and should involve sufficient amounts, in order to increase the resistance of the newborn animals to this parasitosis and to other neonatal infections. In the event the ingestion of colostrum is natural, the udders of the ewe should be washed with warm water and soap, if possible before the newborn animals suckle for the first time. This serves to eliminate possible contamination with oocysts present on the udders and which would be ingested by the young animal upon suckling. On the other hand, it has been shown that maximum reduction of contact between the ewe and the newborn animal after birth, together with the administration of pasteurized (heated to 57ºC) natural colostrum, followed by artificial lactation, allows the control in part of cryptosporidiosis and facilitates the symptomatic treatment mentioned above, based on rehydrating solutions and Lactobacillus in the artificial milk. In addition, such measures reduce contagion by other pathogens which are transmitted by natural lactation, such as Visna-Maedi, Mycoplasma agalactiae, etc.

- Lastly, measures should be adopted to prevent all births from taking place in the same installations or area, separating the ewes expected to give birth in the subsequent days into individual batches. In this way it is possible to prevent the newborn animals from progressively contaminating the birthing zones as the breeding period progresses, while also preventing the older animals (which have overcome the disease but continue to eliminate the parasite in feces) from remaining in contact with the younger and more receptive animals and serving as sources of infection of the latter. In this sense, the separation of animals into batches by age is important.

These global measures are no panacea against cryptosporidiosis in ruminants, since each exploitation presents a series of particularities — installations, number of animals, etc. The veterinary professional should analyze the procedures adopted on each individual exploitation, diagnose the maximum-risk practices, and introduce a minimum preventive program including those measures mentioned above which he/she considers most opportune.

CONCLUSION

In conclusion, the idea transmitted by this article is summarized below:

Neonate diarrheic processes in general, and cryptosporidiosis in particular, presently constitute one of the most serious problems on ruminant exploitations. Considering the absence in many cases of an effective medication capable of resolving the disorder with a single injection, emphasis must be placed on the importance of implementing strict sanitary-hygiene and manipulation measures for controlling all infectious-contagious processes found in stables.

BIBLIOGRAFÍA

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  2. Blewett, D.A. (1989). Desinfection and oocysts. In: Proceedings of the 1st International Workshop on cryptosporidiosis. (Eds. Angus, N.W. & Blewett, D.A.). Moredum Research Institute, Edinburgh, pp. 107-115.

  3. Cármenes-Díez, P. & Rojo-Vázquez, F.A. (1993). Gastroenteritis en corderos y cabritos. Ovis, 27: editorial.

  4. Causapé Valenzuela, A.C. (1997). Contribución al conocimiento de la criptosporidiosis ovina y métodos de control. Tesis Doctoral. Facultad de Veterinaria. Universidad de Zaragoza.

  5. Crabb, J.H. (1998). Antibody-based Immunotherapy of Cryptosporidiosis. Advances in Parasitology, 40: 121-149.

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  14. Juste, R.A.; García, A.L.; Gelabert, J.L.; González, L. & Marco, J. (1987). Presencia de Cryptosporidium spp. en casos de diarreas neonatales de rumiantes. II Jornadas sobre Producción Animal ITEA, Volumen extra Nº 7, Zaragoza, pp. 256-258.

  15. Lavín, P. & Mantecón, A.R. (1993). Los sistemas de producción ovina en la provincia de León. I Jornadas de Producción ovina. 23-24 Nov., León. Excma. Diputación Provincial de León. Comisión de agrcultura y ganadería, pp: 9-22.

  16. Martín Gómez, S. (1996). Aspectos epidemiológicos de la infección por Cryptosporidium parvum en corderos y cabritos. Tesina de Lincenciatura. Facultad de Veterinaria. Universidad de León.

  17. Martín Gómez, S. (2000). Contribución al conocimiento de la inmunoprofilaxis de la criptosporidiosis ovina. Tesis Doctoral. Facultad de Veterinaria. Universidad de León.

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  20. Muñoz, M. (1992). Sobre la etiología, la epidemiología y la clínica de las gastroenteritis neonatales en ovinos y caprinos. Tesis Doctoral. Facultad de Veterinaria. Universidad de León.

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  22. Pilar-Izquierdo, M.; Ortega-Mora, L.M.; Pereira-Bueno, J. & Rojo-Vázquez, F.A. (1993). Participación de Cryptosporidium parvum en brotes de diarrea en corderos en el NO de Castilla y León. III Congreso Ibérico de Parasitología. Lisboa, 1: 223.

  23. Quílez, J.; Sánchez-Acedo, C.; Del Cacho, E.; Clavel, A. & Causapé A.C. (1996). Prevalence of Cryptosporidium and Giardia infections in cattle in Aragón (northeasten Spain). Vet. Parasitol., 66: 139-146.

  24. Riggs, M.W. (1997). Immunology: Host Response and Development of Passive Immunotherapy and Vaccines. In: Cryptosporidium and cryptosporidiosis (Ed. Fayer, R.). pp: 129-162.

  25. Robertson, L.J.; Campbell, A.T. & Smith, H.V. (1992). Survival of Cryptosporidium parvum oocysts under various environmental pressures. App. Environm. Microbiol., 58: 3494-3500.

  26. Rojo-vázquez, F.A.; Gass, A. & Alunda, J.M. (1985). Denuncia en España de la criptosporidiosis ovina. IV Congreso Nacional de Parasitología, Tenerife, p. 166.

  27. Troncoso, J.M. (1992). Cryptosporidium parvum en la diarrea neonatal en pequeños rumiantes y algunos aspectos epizootiológicos de la cryptosporidiosis en corderos. Tesis Doctoral. Facultad de Veterinaria. Uniersidad Complutense de Madrid.
  28. http://www.exopol.com/in/circulares.in/68.in.html

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