Thank you Stephen,
I am quite concerned about this lass is her gums are already white. The reason is because this suggests major blood loss and anaemia (even if we aren't seeing black feces yet). To see this in a bottle fed lamb with her signs (the teeth grinding and poor appetite), a stomach ulcer is going to be our biggest concern. And I must warn that if her gums are already white, thus blood loss significant, she will have a guarded prognosis here.
Just to note, I suspect any respiratory signs may be a secondary agent preying on her weakened immune system or may be a sign that she is refluxing material from the stomach.
Now in regards to supporting the GIT mucosa with this ulceration, you will want to start by using antacid therapy to neutralize stomach acid and prevent further erosion. Antacids are effective in increasing abomasal pH in ulcer cases when administered at 4-6-hr intervals though the efficacy is decreased by ruminal dilution. Therefore doses have to be high (oral doses required for cimetidine (100 mg/kg, 3xdaily) and ranitidine/zantac (50 mg/kg, 3xdaily)). Or, and preferably, we want to be administering antacids via injection rather then orally. But if that isn’t an option then you can use milk of magnesia (Magnesium hydroxide) is a good oral choice as this is a mucosa coating antacid. The dose for this would be 5ml for every 20 pounds of lamb twice daily and should be given via oral drench or stomach tube. And while she is showing pain, do avoid using non-steroidal anti-inflammatories (NSAIDS) since their side effects can increase the severity of ulceration.
As well, if she isn’t eating properly on her own, you need to correct this because an empty stomach is even more at the mercy of stomach acid eroding the delicate mucosa. You need to tempt her to eat but if she isn’t willing, then you need to start stomach tubing her (after letting any oral antacid sit in the empty stomach for 30 minutes). You can stomach tube electrolyte solutions or even ewe or goat’s milk to get nutrition into her and keep her hydrated.
In regards, to how much she will need at a time, this is going to be weight dependant. If you have already calculated out her daily milk intake at 250mls, then you can start with that. Otherwise, for example, for every 10 lb (5 kg) of body weight, she will need ¼ to ½ litres of fluid a day as normal maintenance fluid intake. Obviously, she will need more if there is scours associated, but this is a good start to keeping her from dehydrating/starving on top of the ulcer. And she will need this divided up over 3+ feedings, so as not to over fill her stomach. If you haven't stomach tubed a lamb before, you can find some good guidelines ( LINK) or you can pop over HERE to see a video on how to pass oesophageal feed a calf (these are not lamb specific links but it’s the same principal). You can usually find these feeders at your local feed store and they are quite useful to have on hand for cases like this.
As well, you can also consider using a broad-spectrum antibiotic therapy at this point to prevent secondary infection. Ideally, we want to treat for 5 days while keeping a close eye on her temperature. And I must note again, that while ulcers are very painful conditions, do avoid using any medications with non-steroidal anti-inflammatories. The reason is that these medications block mucus production in gut tissue and will lower the mucosa’s defences against stomach acid and can worsen the ulcer.
Overall, her signs are highly suspect of an acute stomach ulceration. If she is already paling significantly, then we have to be aware that this is likely severe and her prognosis guarded. Therefore, we do want to initiate the above now but do note that in some cases of severe bleeding ulcers, blood transfusions and fluid therapy may be necessary on top of our dietary management, and oral antacids to aid recovery. Therefore, you may want to consider getting her vet involved to give her the best chance but otherwise we would need to start the above, monitor closely for response, and know that this may have already progressed to a state where her chance of recovery is poor.
I hope this information is helpful.
If you need any additional information, do not hesitate to ask!
All the best,
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