0:39

Hello, and welcome back to Baws and Bleats.

0:41

Today we are talking to Dr. Michelle

0:43

Kutzler, who is a professor at Oregon State

0:46

University. Dr. Kutzler and I

0:48

have sat on the board of directors for the AASRP

0:50

together for the last few years, and

0:52

she is currently the treasurer

0:54

of our organization. It's great to see

0:57

you, Dr. Kutzler. Thanks for chatting with us. Oh,

0:59

thank you so much, Sarah. It's been my pleasure.

1:01

I, I have been, Waiting

1:03

an opportunity to, to speak

1:06

on your podcast. I feel like I'm one

1:08

of precious few people who've had

1:10

the honor. Well,

1:13

I don't know about that, but it worked out really

1:15

well, actually. So I always love

1:17

hearing everybody's history, kind of like

1:19

where you, where you went to school, how

1:21

you got here. Just kind of give us

1:23

a little background about yourself before

1:26

we jump into the papers. For sure.

1:28

So I'm originally from

1:30

Washington state. So I grew

1:32

up on a hobby farm in West

1:34

Seattle Washington and

1:36

went to veterinary school at Washington

1:38

State University. We didn't have

1:40

any small ruminants

1:42

growing up. But Since I,

1:45

I became a veterinarian. I have

1:47

had lots of came lids and still

1:49

have llamas and alpacas now,

1:52

and have served on a number

1:54

of national organizations for

1:56

llamas and alpacas over the years.

1:59

So again, not necessarily

2:01

associated with our topic of today,

2:03

but I have been a long

2:06

time a small room minute. Owner

2:08

at least for over 20 years. Awesome.

2:12

Awesome. And so Dr. Cutler teaches

2:14

and does research primarily

2:16

in the field of theriogenology, which

2:18

is the fancy word of saying reproduction.

2:21

But also does a fair amount of advising

2:23

both undergrads and graduates. So you have

2:25

your own animals, but you

2:28

do a lot at Oregon State with

2:30

animals but you don't not work in a vet

2:32

school, correct? It's Right. So I work in

2:34

the I, when I started at Oregon State,

2:36

I worked in the College of Veterinary Medicine.

2:38

I worked there for eight years and I've been in the

2:40

College of Agricultural Sciences

2:43

since 2010. And

2:45

I teach predominantly reproduction

2:48

classes an equine reproduction

2:50

class, calving school.

2:53

I teach the reproduction sections

2:55

of our sheep and goat production class

2:57

and our beef production class and a

2:59

companion animal production class. And, you

3:01

know, you're getting the idea that there's a common

3:04

theme here with reproduction. Nice.

3:07

Yep. So I, I mean, I grew up on the west

3:09

side of the mountains where there's

3:11

no veterinary school, but but my,

3:13

my heart was always to become a veterinarian.

3:15

So I lived in Pullman for seven

3:17

years while I was in veterinary school in undergrad.

3:21

Nice. Awesome. All

3:23

right, so let's jump in today.

3:25

We're actually going to be talking about two different papers

3:28

that Dr. Kutzler was involved with

3:30

and published. The first one was published in

3:32

2020 and it's entitled

3:34

developing a modified Apgar score

3:36

system for newborn lambs. The

3:38

second paper was published in 2021

3:41

and it is titled resuscitation

3:44

compression for newborn sheep.

3:47

I'm going to try not to jump between

3:49

the two papers, even though I know I'm

3:51

going to want to and just do one

3:53

at a time. So can

3:55

you give us a little bit of background? We were kind

3:57

of talking about this before we started recording, but

4:00

kind of how these papers came about

4:02

and like, what was your your ideas

4:04

that kind of first got you going. And I know you

4:06

were working with a graduate student on this at

4:09

the time. So you want to just give us

4:11

a little background? Yeah, absolutely.

4:13

So the, the, I

4:15

would say brainchild of this project is actually

4:18

Dr. Tasman Flores. She's now a practicing

4:20

veterinarian in Oregon. But

4:22

she came to me with a

4:25

question about using The

4:27

Madigan squeeze technique

4:30

on lambs. So the,

4:32

and here we are jumping between papers, like we said,

4:34

we weren't going to. But this

4:36

is a, a method of and

4:39

inducing a, a sleep like

4:41

state in a newborn animal

4:43

to overcome some of

4:45

the neurohormone suppression

4:48

that happens and, and increase

4:50

their, their viability afterwards. So,

4:52

so Dr. Flora was very interested

4:55

in this topic and since it hadn't

4:57

been done in sheep I was supportive

4:59

and I, and I would be remiss if I

5:01

didn't make a shout out to the Oregon Sheep Commission

5:04

because nobody can do any research,

5:06

no matter how big or small without

5:09

some funding. And the Oregon Sheep Commission

5:11

is the one who provided us with

5:13

the funding for this. And also our, our co author

5:15

on the paper Mary Smallman, she was

5:18

the the

5:20

sheet manager at the time. And, and

5:22

you know, there was a lot of samples that have

5:24

to be collected data points in the middle of the night

5:26

when lambs are being born. And so we

5:28

couldn't have done that without her help too, but getting

5:31

back to kind of the project.

5:33

So in order for us to

5:35

test this, this,

5:37

this method to see if this method would work in,

5:39

in sheep we needed to first

5:42

establish some, some normals.

5:44

And that led us to our,

5:46

our first paper is developing a modified

5:49

APGAR score for lambs.

5:51

And I I am

5:53

going to guess that most of the audience

5:56

has heard of APGAR scoring

5:58

before. APGAR is an acronym.

6:00

It stands for Appearance,

6:03

Pulse, Grimace. Attitude

6:05

and respiration. And

6:08

those terms make a lot

6:10

of sense when you think about it used for humans.

6:13

But we had to modify like

6:15

the grimace response, you know, for animals

6:17

so that it fits in. Fun fact

6:20

the, we use the APGAR

6:22

as kind of an acronym, but APGAR

6:24

was actually named from Virginia

6:26

APGAR, who was a,

6:29

a human. OB GYN

6:31

nurse and wanted

6:33

to, again, measure

6:36

some of these viability parameters in

6:38

newborn humans and so we think of

6:40

it as being an acronym for APGAR,

6:42

but it actually came from her last name,

6:44

APGAR. That was so fascinating.

6:47

It actually says she's a human OB anesthesiologist.

6:49

Oh, there you go. Sorry. Thank you. Thank you for correcting me.

6:52

But, yeah, that was fascinating to know.

6:54

I mean, there, I mean, I'm sure maybe if

6:56

you haven't had a baby or you're

6:58

not a grandma or an aunt, you may not have heard of

7:00

Afgar. I hadn't heard of it till I had kids.

7:02

But yeah, so it's kind of, for those

7:04

of you who aren't familiar, like the

7:06

second a baby is born, they get an Afgar

7:09

score. They look at like Michelle, Dr.

7:11

Ketzer said, appearance, pulse, grimace,

7:13

attitude. Attitude and respiration,

7:16

and baby, like my, my daughter was

7:18

born with a very bad APGAR score, but

7:20

then they keep doing it every few minutes,

7:22

and I mean, she was fine, hers came up quickly,

7:24

but it's a way to like instantly

7:27

kind of tell if, if these

7:29

babies need more help. Which would be

7:31

awesome for our animal species. And,

7:33

and what they've, they've shown. So this,

7:36

this of course holds true with, with humans,

7:38

but in other species where Apgar

7:41

scoring has been done, so horses,

7:43

cows swine

7:46

and dogs they found

7:48

that low Apgar scores

7:51

are highly correlated with higher

7:54

neonatal mortality. And

7:56

so as a veterinarian, you

7:59

know, anything that we can do to prevent

8:01

mortality, we're all for. And,

8:03

and, and for our clients,

8:06

anything they can do to prevent

8:08

mortality, they're all for too. Now Often,

8:11

we as veterinarians maybe aren't there when

8:14

the offspring are born, or maybe our producers

8:16

aren't even there when they're born. So being

8:18

able to do that initial assessment might

8:20

not be possible, but one of the

8:22

things that we, and I feel like I'm jumping around,

8:24

but one of the things that we did with our

8:27

test is we looked at it. at

8:31

within five minutes of birth. So that's kind of similar

8:33

to what they do with people. And then we did

8:35

it at 15 minutes, which

8:38

like with people, they usually do it, like you said, every, about

8:40

every five minutes until they have a, like

8:42

a normal score. But then we also did

8:44

it at one hour because we're like,

8:46

well, what's more realistic, you know, if, if,

8:49

if, if. You're going to be there

8:51

every five minutes looking for lamb

8:54

Apgar scores. And we found that

8:56

there was no difference

8:59

in Apgar score between,

9:01

like those significant difference between those

9:03

time points. So you can still get

9:05

really meaningful. So that, that

9:08

lamb that has a bad Apgar score at 60

9:10

minutes, it, You had

9:12

a bad APGAR score at birth, but also the mama had

9:14

a good APGAR score at 60 minutes. They

9:16

had a good APGAR score at birth

9:19

as well. I feel like a

9:21

baby that's born and looks horrible

9:23

and then the mom licks it and stimulates

9:25

it. Like that should up their Apgar

9:28

score, but you're saying, no, they're pretty similar.

9:30

Well, so all of our lambs

9:32

were, were kept with their mom.

9:35

So they once we knew they

9:37

were lambing, we, we kind of isolated

9:39

them into a a pen,

9:41

but we have these, and I'm

9:43

sure a lot of producers have these too, but these

9:46

kind of like a temporary

9:48

wood fences. They're kind of like they're on a hinge

9:50

and they're, you know, so that you can make them into an owl

9:52

or. And

9:54

then that way, if the ewe is, you

9:57

know, laying in one area, we could just kind of like move

9:59

this fence around her and we don't have to

10:01

move her at all. She's still in like her

10:03

safe environment but we can keep,

10:05

you know, her and her lambs in an area

10:07

where some other ewe

10:09

is not going to try to get in there and like, you

10:11

know, take a lamb or, or you just

10:13

get up, get up all up in her business. And,

10:17

and so the

10:19

lambs that. All, all

10:21

of the lambs were cared for by their mothers in exactly

10:24

the same way as what I'm trying to say. So there wasn't

10:26

any, we didn't try to deprive

10:28

any like maternal stimulation or, or

10:31

increase any sort of maternal

10:33

stimulation either. Okay.

10:35

Okay. And I feel like as I was reading

10:37

this, I was kind of like, you know, so say

10:40

as a vet, you're there helping assisting

10:42

in birth. You know, we all kind

10:44

of do this in the back of our mind, right?

10:46

You're like, Oh, take a piece of straw

10:48

and stimulate the respiration. That one's

10:50

not breathing enough. You know, I put your hand

10:52

on the chest. How's the heart rate? You know, I

10:54

feel like we kind of

10:56

yeah. probably do this sort of

10:59

in our minds, but I think having

11:01

numbers next to anything is

11:03

always super important, right? Like knowing

11:06

exactly like where a pulse is, where

11:08

a respiration is. I mean, it's just, you

11:10

know, better for the whole situation, even though I'm like,

11:13

I kind of do that. I have a feeling

11:15

for that. So, so you mentioned

11:18

like using a straw in the nostril

11:20

to kind of stimulate a respiration. So

11:23

that was one of the modifications that we did

11:25

for the Grimace response.

11:27

And so in, you know, for,

11:31

and I should probably take a step back, you

11:33

know, regardless of the Apgar

11:35

scoring method of the species is

11:37

used there are three

11:39

essentially, like categories

11:42

under each of the criteria, and

11:45

the categories are either 0, 1,

11:47

or 2 points, and since there

11:49

are 5 criteria there's

11:51

the highest APGAR score is a 10,

11:55

and a Of course, the lowest half bar score would

11:57

be zero. But, but lambs

11:59

that didn't have you know, any response

12:01

at all to a straw

12:04

up the nose. And I, I'm sure if you've

12:06

delivered enough lambs, you've probably seen some

12:08

that, that don't, you know, they're just kind of hanging

12:10

there with their tongue and fluid running out

12:12

of their mouth and, and don't do

12:14

anything. And then some that just maybe

12:16

you know, barely shook their head, but then

12:18

didn't like try to sneeze or, you know,

12:21

do anything else, then that would have been a score of

12:23

one. So, so we, we

12:25

came up with these parameters

12:28

by observing lots of lambs

12:31

ahead of time. And then once we set the criteria,

12:34

then that's how we did the scoring after that. Okay.

12:37

So just give us a little brief

12:41

kind of what you looked at to score

12:43

each thing. So like and

12:45

in the table, one of the paper, when

12:47

you guys read it, you'll see this. But if you just

12:49

want to kind of give us a brief little

12:51

for appearance, we were looking at this kind of Yeah,

12:54

exactly. So, so appearance, we're using

12:56

mucus membrane color and, and

12:59

so, I mean, we, we, we typically

13:01

use gums and of course it's a

13:03

little bit, you know, if you've got a, you

13:05

know, dark faced animal sometimes their

13:07

gums, you know, kind of look a little bit more muddy.

13:09

So you have to know what, what, you know, normal,

13:11

like, appearance would look like. But

13:14

we, you know, pink would be a score of two.

13:16

That's what you desire. And

13:18

if it's like really muddy or what we call

13:20

here cyanotic, then that would have been a score of,

13:23

of zero. And then somewhere between that

13:25

pink and cyanotic what we call just pale

13:27

would have been a score of one. For

13:30

P that's actually pulse. So

13:32

we just measured pulse.

13:35

And again, we had to determine

13:37

what what we were going to call

13:39

normal, because there is a pretty

13:42

wide variation in the literature, what a

13:44

normal pulse is for a newborn lamb.

13:46

And so again, we just took data

13:49

from our own animals to make

13:51

a normal range and we determined

13:53

that if it was less than a hundred

13:56

that that was going to be a score of zero.

13:58

And of course, you know, we had some that were much

14:00

lower than a hundred and if it was greater

14:03

than 175, then

14:05

that was going to be a score of two

14:08

and then between 100 and 175,

14:10

that's a score of one. I already mentioned

14:12

grimace, that was the straw on the nose.

14:15

Attitude this is response

14:17

to croup or low, you know, loin

14:19

stimulation. So this would again

14:21

be like the mother, you know, nuzzling

14:23

the, the back or, or, or pawing

14:25

the back or doing something to stimulate the

14:28

lamb to, you know, rise or move.

14:30

And if there was no response, they got zero.

14:33

If they, if they try to stand that

14:35

was two, but if they just kind of, you know,

14:37

made a a, not a great effort,

14:40

then that was a score of one. And

14:42

the last one, R is resp, is

14:44

respiration. And and some

14:47

abgar scores, they actually measure

14:49

the number of breaths per minute, but in our

14:51

setting we used a pulse oximeter

14:54

right on the lamb's ear in

14:56

order to get a

14:58

idea of what the oxygen saturation

15:00

was. We felt that that was a, a more

15:02

reliable way to measure

15:05

respiration. And so for

15:07

lambs with a oxygen saturation of

15:09

less than 45%, that was zero.

15:11

That's obviously pretty desaturated.

15:13

And then if it was over 65%,

15:16

then we call that two, and then between

15:18

45 and 65 is zero. Is

15:20

a one. And I

15:22

know I'm just jumping forward between papers

15:25

and you said we weren't gonna do that, but when

15:28

we did the neonatal compression

15:30

test we, we

15:32

weren't looking necessarily for lambs

15:35

that had Apgar scores

15:38

of 10 or even eight.

15:40

We used three and a half as

15:42

a. And there were a lot of lambs

15:45

that had an APGAR score of less than 3. 5.

15:48

So it, it seems like, you

15:50

know, oh, they're all should be 10s

15:52

or 8s or something, but, but, That

15:55

that's not what we found and and

15:57

using these criteria. Interesting.

16:00

Yeah, I found that interesting. I just wanna back up just

16:02

a little bit. So they literally use

16:04

those, those oxygen

16:07

saturation things that like people use

16:09

in the hospital, the finger ones that you just pinch

16:11

that now when you take your kids to the doctor

16:13

that they put on them and old people and everywhere.

16:15

So those are super easy to come

16:17

by as, you know, field veterinarian,

16:20

something like that is super exciting for me

16:22

as one more tool that I can add to my

16:24

tool chest to help monitor

16:27

not even just lambs, like animals in

16:29

respiratory distress, just in general.

16:31

I mean, I don't know what I'd do if it was low. I sound like I

16:33

carry oxygen, but it would be

16:35

good to know. You can use it as a response

16:37

to treatment though. I mean, and that's, you know, what we're,

16:40

what we're looking at is if they had a. you

16:42

know, low oxygen saturation. How

16:44

are they responding now to our resuscitation

16:47

efforts? Right, right, right.

16:49

So all right. So what else, what

16:52

else is in this paper? I mean, it's just,

16:54

it's just a lot of talking about that

16:56

and like realizing that, you

16:58

know, maybe a lot of our lambs need help, you

17:00

know, a lot more than we think, and

17:02

maybe we could save a lot more than we

17:04

normally do. Do you. I assume

17:07

all these moms and everything like

17:09

have good nutrition, you know, had

17:11

a good, you know, like they are like

17:13

normal, healthy, not parasitized. I

17:18

mean, we do our best, I think, to find

17:20

a flock of sheep that has no parasites

17:23

is a, is a unicorn.

17:25

But you know, definitely, you know,

17:27

we keep our especially our late gestation

17:30

ewes in the barn actually during

17:32

the winter because it's, it's quite wet

17:34

in western Oregon and there's

17:37

a greater risk that they can get infected. You know,

17:39

succumb to some other problems being

17:41

you know, out in the mud all the time, but

17:43

then of course there's trade offs because if they're in the barn,

17:45

then, you know, there's perhaps the increased

17:48

risk for, you know, parasitism because they,

17:50

you know, they're you're all in the barn. But so,

17:52

but they were all of the ewes they were all polype

17:55

ewes and they were all, you know, managed the

17:57

same way. This all took place over

18:00

one season. So this

18:02

wasn't a, like a combination

18:04

of. You know, multiple years of,

18:06

of data at all. Do

18:08

you have any, and I know this is an out

18:10

of the blue question, do you have any idea for this

18:12

flock what their normal percent

18:15

of loss is? So

18:17

our, our, I don't

18:19

remember off the top of my head. I know that we did look it up.

18:21

But we actually have a very

18:24

low loss rate. I think we're

18:26

currently doing a pregnancy toxemia study

18:28

right now. And last year

18:31

out of over a hundred years that we had

18:34

lamb, we only had You know, one

18:36

you that actually was down with pregnancy toxemia.

18:39

So we're, you're

18:42

part of it. The benefit is that it's,

18:44

you know, teaching institutions. So we have a lot

18:46

of student labor that can

18:48

catch animals, you know, quickly.

18:51

And and, you know, we keep our, our,

18:54

our late, later gestation

18:56

animals indoors. So we, you know, have

18:58

eyeballs on them a better But

19:00

our, our, you know, we have, we have hot

19:02

boxes for, you know, any lambs that are,

19:05

that are cold and lots of frozen

19:07

colostrum. So we, we,

19:09

we really rarely lose lambs cause

19:11

we get really aggressive and, you know, keeping

19:13

them, keeping them alive. Okay.

19:16

Okay. Just curious, you know, because

19:19

there are some flocks that like probably,

19:21

you know, A large portion of them

19:23

have bad at first, right?

19:26

Well, and here in the Willamette Valley

19:28

the grassy capital of the world, I should say

19:31

there are a lot of sheep that run

19:33

on, on grassy pastures

19:35

and are lambing you know outside

19:38

during the winter, you know, when it's raining

19:41

horizontally for days on end

19:43

and the lambs, you know, they survive,

19:45

okay, so what else before we move on to the really

19:48

fun paper? Okay. Should we take away from

19:50

this one? Yeah, so I had, I had

19:52

mentioned before that, that when

19:54

we Looked at. the

19:57

APGAR scores over time,

20:00

that when we compared singletons

20:03

at those three time points, five minutes,

20:06

15 minutes and an hour and,

20:08

and twins, there was no difference. We did see

20:10

a slight improvement in APGAR

20:12

scores in, in triplets. And,

20:15

you know, one could, could

20:17

argue that that last

20:19

lamb being born, you know, may have more

20:22

hypoxemia because of its

20:24

place in the birth order. But

20:26

we, we compared the

20:28

length of delivery and

20:31

we did that for twins and triplets

20:34

and then twins and triplets combined, where

20:36

the average, like, You know, length

20:39

between lambs for twins

20:41

was about 26 minutes. I'm reading here

20:43

the paper and, and, you know, 15 minutes

20:46

for triplets. I found that there was

20:48

no effect on delivery interval.

20:50

So, I mean, the idea that, you know, maybe they have

20:52

you know, longer, interval and that was causing

20:54

it. So that didn't, that was, did not make

20:57

an effect. There was also no significant difference

20:59

between birth order, at least with

21:01

respect to twin lambs. So first and second.

21:03

But one of the things that

21:05

was of interest is that

21:07

there was an effect of sex. And

21:10

so even though there wasn't a difference

21:12

in birth order, birth weight. So birth weight

21:15

itself didn't correlate

21:17

with Apgar score. For females

21:20

they tended to have a

21:22

higher attitude. All right. That's

21:24

the, that's the rump stimulation

21:27

compared to other compared

21:30

to males or compared to the other categories.

21:32

So, so there was an effect

21:34

or a difference that we saw with females.

21:37

And we also saw that, that. females

21:40

in, I mean, in our group of animals

21:44

had a tendency to stand

21:46

faster than males. And,

21:49

and that's kind of interesting too, because I don't think

21:51

that we pay a lot of attention

21:53

to that. If they're all market lambs, it doesn't

21:56

really matter if they're, you know ram

21:58

lamb or you lamb. But you know,

22:00

if you might want to not

22:02

discount those little ram lambs, if they're not standing

22:04

up right away, they might need some intervention. Cause it,

22:06

you know, there could be a problem. All right.

22:08

Those are very interesting. Were

22:10

any of them assisted births? Yeah.

22:13

So that, that included

22:15

the ones that were assisted. And

22:18

I, I can't remember how many

22:20

that there were, but there really weren't that many that,

22:22

that that had that other

22:24

than just, you know, like gentle

22:26

guidance, it wasn't a

22:29

dystocia that required a

22:31

veterinary and we didn't include any animals

22:33

like that. Okay. Okay.

22:35

Good to know. I just

22:38

wanted like one like kind of concluding thing

22:40

about APGAR scoring is

22:43

that if you, if you don't measure it,

22:45

we won't know, right? That's the

22:47

thing. So, and, and it's really easy

22:50

to train your, producers,

22:53

you know, how to do this APGAR scoring.

22:55

And if they find that the lamb has

22:57

a low APGAR score then,

22:59

then, you know, hopefully they can like

23:02

put that little piece of information away and, and

23:04

provide, you know, maybe additional colostrum

23:06

to that one or additional, like you know, warmth,

23:09

you know, some additional support to

23:11

keep that lamb from dying, because

23:13

again, there's a strong correlation

23:15

with low outpour scores and neonatal mortality.

23:18

So rather than just coming

23:20

back and finding that, you know, one of the three lambs

23:22

dead and say, well, you know, what was I going to do with

23:24

that third lamb anyway? You know, you can

23:26

so you could keep that lamb alive and then have to figure out

23:28

what you're going to do with that third lamb. Right.

23:30

She worked hard to grow that baby. All

23:35

right. Well, that, that, yeah, I love

23:37

that paper. I, I think it's very

23:39

applicable, which is what we're going for here.

23:43

Okay, so we're gonna move on to the second paper.

23:45

So many of you in the vet community

23:48

will have heard about What's

23:51

called the Madigan squeeze which is named after

23:54

the veterinarian that kind of invented it.

23:57

I know I see it I was telling Michelle

23:59

mentioned all over the vet to vet

24:01

groups talking about it primarily in

24:04

foals and calves. So

24:06

it was very fascinated. I guess I hadn't even

24:08

crossed my mind to apply

24:10

it to small ruminants. And now that I

24:12

will be Avgar scoring every baby that I

24:14

see I will be, I'll have my

24:17

little rope ready. And so

24:19

the AVGAR score was like, because

24:22

you wanted to do this, but you needed a way to

24:24

measure so that, that makes

24:27

sense. So I think you've already given

24:29

us a good background of kind of how this

24:31

came about. So let's just kind

24:33

of jump into the materials and methods

24:35

and And you know,

24:38

how this went and yeah, it's

24:40

a really fascinating paper. So go ahead.

24:42

Sure. So I know that we probably

24:45

messed some people up when we called it

24:47

resuscitation compression because

24:50

I think a lot of people know it

24:52

as a Matican squeeze or a

24:55

neonatal squeeze.

24:57

But those terms are really

25:00

I didn't feel, particularly

25:02

helpful. And you know, what

25:04

we, what we were looking for was

25:06

a way to you know, resuscitate

25:09

these low Apgar limp lambs,

25:12

and we were doing it by compression. So that's

25:14

why we, we are

25:16

trying to coin this term resuscitation

25:18

compression instead of like the, you

25:20

know, the Madigan squeeze, but it is essentially

25:23

the same term. the same thing. And

25:25

I don't know whether it's necessary to, to take a step

25:28

back, but what happens

25:30

when the animal is

25:32

squeezed particularly around their

25:35

thorax is it

25:37

induces a release of

25:39

excitatory

25:42

neurohormones. So

25:45

during the in utero period,

25:48

neurohormones are Suppressed

25:50

so that the fetus isn't moving around

25:53

so much. I mean, of course, if you were

25:55

to do an ultrasound, you'd probably see the

25:57

fetus move, but, but you don't want

25:59

it to be kicking and flailing, especially during

26:01

the delivery process. You want it to

26:04

remain as motionless

26:06

as, as possible. And, and that

26:08

squeezing that's happening. In

26:11

the uterine body vagina

26:13

as the animal is being born.

26:16

That is essentially what we're mimicking,

26:18

that thoracic squeeze with

26:20

these, with these ropes. And, and

26:23

again, this, this method of neonatal

26:26

resuscitation compression was first

26:29

you know, very well demonstrated

26:32

in foals. And you know, we,

26:34

we. We kind of,

26:36

you know, collectively call these dummy foals because

26:39

they are typically

26:41

non responsive. They don't, they have, don't

26:43

have a suckle reflex. They may not be able to

26:45

walk around. They may just stand with

26:47

a sawhorse stance, staring at

26:49

the wall as though they're, they're blind.

26:51

And if they have

26:54

the squeeze technique done, then

26:56

they now completely wake up

26:58

and are moving around

27:00

without any impairment and finding the udder

27:03

and nursing. So it's just incredible if

27:05

you have an opportunity to watch one of these

27:07

YouTube videos with foals because it, it, it's,

27:10

it's so. effective, you

27:12

just don't believe your eyes that this could actually

27:14

be happening. Well, this technique has been

27:17

done before in cattle

27:19

as well. And so we thought, well

27:21

why not in sheep? And again, like I said, the

27:23

brain, the real brains behind this was

27:25

Dr. Tasman Flora, who just graduated

27:28

from Oregon State University Veterinary

27:30

School this year in 2024. So

27:33

In this project, we had

27:35

three main groups. We

27:38

had the control group, which

27:40

we didn't do anything with. So

27:43

we, I mean, we still, like, measure the APGAR score,

27:45

and we recorded the time to stand and the time to

27:47

suckle, but we didn't apply any sort of

27:50

compressions or touch

27:52

by us at all. That was our, our control

27:54

group. We had a placebo

27:57

group, where we put

27:59

the ropes on, but

28:01

we did not tighten the

28:03

ropes. So that way they

28:06

still had the ropes on

28:08

them, if it was just some sort

28:10

of like just a pressure point thing

28:12

that would have worked out in the, the,

28:16

Like the placebo group and

28:18

then for the actual treatment group, we

28:20

applied the ropes and

28:22

then we we had a little weight

28:25

that you can determine how much

28:27

pressure or force you're putting on. So we

28:30

identified that about one pound

28:32

of pressure applied to the

28:34

ropes was sufficient. I mean,

28:36

we obviously don't want to break the

28:38

ribs, you know, crush their chest at all. They still have

28:40

to breathe while this is happening. But

28:43

we wanted it to be of a sufficient force

28:45

to, to essentially induce

28:48

sleep. And, and that's exactly what happened.

28:50

So in one of the videos, you can see the

28:52

lamb is standing we

28:54

apply the ropes and, and

28:56

then start, you know, pulling back on the

28:59

rope to apply some pressure,

29:02

some, some force, and the lamb

29:04

just crumbles, like it just like

29:06

falls asleep. And we maintained

29:09

that hold for five minutes.

29:11

Now, someone said, why five minutes? You know,

29:13

why not one minute or 10 minutes? So

29:15

that was, that was a little bit arbitrary,

29:18

but again. wanting to be

29:20

long enough that if we were going to see an effect

29:23

that should be there. And then at the

29:25

end of five minutes, we

29:27

took off the ropes and usually

29:30

the lamb was already starting

29:32

to wake up and trying to run away as

29:34

the tension was coming off the ropes. But if

29:37

they were still laying down, we would just scratch

29:39

their wool over their rump and

29:41

then they would jump up and In

29:44

these three different, like, groups,

29:47

we had lambs that

29:49

had normal APGAR scores. Again,

29:51

we set kind of a low APGAR score threshold

29:54

as being less than 3.

29:56

So, so over 3. 5, and

29:58

then, and then in that, if you call

30:00

them the normal LAMs, those

30:03

are LAMs that, that stood and

30:05

nursed without any sort of delay.

30:07

We had another group where they had

30:10

a normal APGAR score,

30:12

so greater than 3. 5, but

30:15

had a delay in standing and nursing.

30:17

So they hadn't nursed yet. And again, I think

30:19

this is, you know, maybe a lot of, I

30:22

guess Problems that, that people might run into,

30:24

that the lamb is born, everything

30:26

seems fine, but it just doesn't wanna stand in nurse

30:28

or, or, or you can hold it up but

30:30

it won't suckle or, you know, so these

30:33

are some of the problems. And then our last group

30:35

was those that had a

30:37

low Apgar score, less than 3.5,

30:39

and also, you know, had a delay in standing

30:42

in nursing. And, and the real

30:44

exciting thing that we found is

30:46

that for the animals.

30:50

that were normal to start off

30:52

with. So it had an APGAR score that was normal,

30:55

stood and nursed just fine. There

30:57

was no adverse effects of the

30:59

treatment at all on them. So it didn't,

31:02

it didn't impair their ability to

31:04

continue to thrive interfere with the

31:06

bond with you at all for

31:08

the ones that had a delay

31:11

in standing and suckling with a normal APGAR

31:13

score or those that had a delay in

31:15

standing and suckling. a

31:19

normal APGAR score we

31:21

saw an increase in the time

31:23

it took for them, or sorry a delay then

31:25

say like that they stood and nursed

31:27

faster. And really, the, the,

31:30

you know, most exciting were those lambs

31:32

that either couldn't stay standing

31:34

on their own or couldn't

31:37

couldn't stand and suckle on their own

31:39

after the squeeze, they were able to stand

31:41

and suckle on their own and and

31:43

and that's, you know, that that that was huge.

31:45

So again, you get back to these situations

31:48

where you may be a you. lamb's

31:50

out in the field and the lamb is, you

31:52

know, dull well, this is another technique

31:54

that you can use to help to

31:56

help revive it in order

31:58

to get it to start suckling on its own. So

32:02

I just, for those of you who have never

32:04

heard of this Madigan squeeze before,

32:06

it sounds like voodoo and it feels

32:08

like voodoo. But it is amazing.

32:11

You can definitely look it up on YouTube, but I

32:13

will. In the podcast notes,

32:15

put the links to Michelle's

32:17

videos that they made Dr. Kutzler's

32:20

during the that are associated

32:22

with this paper. So you can kind of watch how

32:24

they, how they do it and how

32:26

quickly they, they respond.

32:28

I'd like to joke with my clients that we're making

32:30

the animals Christians because they're being born

32:32

again, because that's

32:35

really like what it's like, like

32:37

you are almost like redoing. their

32:39

birthing process for them.

32:41

So for those of you who have never heard of

32:43

it, I know this sounds like out of the blue craziness,

32:46

but it's definitely been circling around in the

32:48

veterinary community for a while. I feel

32:50

like people I talked to, a lot

32:52

of the horse owners more about

32:54

it than other species. Like, I think it's slowly

32:56

trickling into the ruminant community. But

32:59

multiple people that I've talked to non

33:01

vets in the horse world had heard of it. So I

33:03

think that's, that's super interesting, but if you haven't

33:06

seen it watch a video, watch the one

33:08

that's attached to this podcast. So sorry

33:10

to interrupt you, Michelle. I just wanted to make

33:12

sure that we are not insane.

33:16

And, and the rope that we use, I

33:18

mean, it was just a soft cotton

33:20

like one inch diameter rope and

33:23

it just needs to be long enough in order

33:25

to do those two essentially half hitches

33:28

over the Like the thoracic spine,

33:30

that's where the compression kind of is,

33:32

is, is cinched down. I think, I

33:34

want to say ours was like seven or eight feet

33:36

long, but it, you know, we bought it from

33:38

just a local hardware store and it,

33:41

it, you know, wrapped right, right up real easily

33:43

into a Ziploc bag that we kept, you know, kept

33:45

in the barn. So it was, you know, Really

33:48

easy to, like, throw, you know, in

33:50

on your, like, your lambing supply

33:52

card or, you know, in your, in your

33:54

truck if you have to and just to,

33:56

just to mention that, you know, if you are using something

33:59

like this for horses, you're going to need to scale

34:01

down a little bit the size of the the

34:03

rope for the lamb just because they're, they're

34:06

more petite compared to a foal.

34:08

Do you think you could use baling twine?

34:11

You know, we actually thought of that because,

34:14

you know, what does everybody always have around

34:16

is, is baling twine. You need,

34:19

because you have to, you

34:21

know, apply this, like a, a substantial

34:24

amount of pressure, I, I think

34:26

that I would worry that the baling twine might,

34:28

might, I don't know, cut in

34:30

a little bit more rather than, than

34:32

apply the compression that we were

34:35

thinking of, but, but maybe you could

34:37

take three pieces of baling twine

34:39

and braid them together and get the

34:41

same, you know, get the same thing, but I think

34:43

a single piece of baling twine would,

34:46

would not be as effective because

34:48

of how it would kind of dig into

34:50

the skin rather than, you know, stay on the

34:52

top. Yeah, yeah, yeah. Yeah.

34:54

Okay, what else? What was significant?

34:57

Well, like, as I mentioned before, so after

34:59

compression, you know, there was a

35:02

reduction in the time to stand and,

35:04

and to suckle and, and,

35:06

you know, that's, of course, when it comes to,

35:09

survivability. If they can't

35:11

stand and suckle, then they're not going to

35:14

survive or it's going to be really labor intensive

35:16

for the, the owner.

35:18

And and then I guess the other, you know, main thing

35:20

was that let's say you're

35:23

not sure whether this lamb

35:25

needs to be squeezed or not. You know,

35:27

you, you're not sure whether, you

35:29

know, which one of the three of these lambs

35:31

has already stood and nursed,

35:34

we found that there is no adverse

35:36

effects of applying this technique

35:39

to normal lambs. So there's

35:41

essentially no reason why not

35:44

to do it if you have one that

35:46

is slow to stand and suckle. And,

35:48

and there's lots of reasons for,

35:51

for doing this. Yeah,

35:54

that's, that's a good, really good point. Yeah. Have

35:56

you tried it on a camelid? Nope.

35:59

I haven't tried it on a camelid yet. We

36:01

you know, we don't have enough in my

36:03

own farm to, to you know, have it

36:05

be of, any sort of

36:07

meaningful study and, and at our sheep

36:09

center you know, all we have are geldings for,

36:12

you know, for guards, so and,

36:14

you know, someone. You know, could

36:17

ask, well, what about, you know, adult

36:19

animals? I mean you know, certainly, you

36:21

know, when you use, you have pregnancy toxemia

36:23

or something, there are some mentation problems

36:25

too. You know, would this be something that you could

36:27

actually use on, on older

36:29

animals with impaired mental mentation

36:32

to, you know, after you've like corrected

36:34

their metabolic state, they still have some lingering

36:37

mentation problems. So that's a, I

36:39

think it's a great, a great question. I

36:41

just. Don't know the answer to that. But, but

36:43

again, I, there won't,

36:45

wouldn't be any, any harm in trying

36:48

if you were, if you were out on the farm and, And

36:50

I think it's a lot more humane

36:53

than, than trying to, you know,

36:55

get into them with a, you know, a hot shot

36:57

or something like that too. When you know, if

36:59

they're having impairmentation you know, shocking them isn't

37:01

going to make them any better. I

37:03

mean, even, you know, before we started recording,

37:05

we were talking about how just like

37:07

pressure, like the weighted blankets and all

37:09

of that. The human world's realizing

37:12

how calming it could be, you know, you think

37:14

of the dogs with the Thunder jackets

37:16

now that are kind of a big thing, my

37:18

thought would be, what if we're like asking

37:20

a very stressful thing of our pet, of

37:22

our small ruminants, you know, like you've never

37:25

been to a show and you're sleeping at

37:27

the show for the first night, you know, with some sort

37:29

of little like. Weighted blankets,

37:31

some sort of little compression thing, like help

37:33

them be calmer and like happier,

37:35

you know, and just, not go off feed

37:37

and like all the things, like who knows, like I

37:40

think we're just tipping, starting on the iceberg

37:42

here. And, and, and for the

37:44

lamb project, you know, of course, we want

37:46

them to to fall asleep, but we also

37:48

want them to wake up right away so

37:51

that that way you can get busy. We want

37:53

you to get up and we want you to start nursing.

37:56

And so you can have a little, a

37:58

little nappy poo to, to you

38:00

shake off all of those residual

38:02

neurohormones from delivery, but,

38:04

but then we want you to get up. Right, right. And

38:06

one of the places that we take advantage of those

38:09

neurohormones is when we do things

38:11

to young animals, like

38:13

disbudding or, you know,

38:15

stuff like that, that might be painful.

38:18

So they're good also. But,

38:21

yeah, I wonder if you could swaddle

38:23

lambs or kids and take

38:25

advantage of the somnolescence

38:28

that you get. When you have to do a

38:30

painful procedure like, you know, disc butting

38:32

or tail docking or what have you, that's

38:35

a great idea. Have to, have to do

38:37

that one. I mean, you can even start with

38:39

something simple, like giving a shot, you know,

38:41

like something that's not as painful,

38:44

but is painful. Maybe while they're asleep,

38:46

they get their, their selenium injections

38:48

or whatever. Yeah. At

38:51

least out here, we do selenium injections. Yeah,

38:53

oh no, we do in Oregon too, for sure. In fact

38:55

Dr. Oldfield, who are, are one

38:57

of our buildings is named after, is, we, we

39:00

call him Mr. Selenium because he did a

39:02

lot of the, the pioneering selenium

39:04

research in livestock. Nice.

39:06

Nice. Okay. Anything else

39:08

like from this paper that that

39:11

we're not, we're not getting or that you

39:13

feel like we skimmed over?

39:15

No, I, I think that that, that was it. Like

39:17

I said, you know, I mean, that, you know, the biggest take

39:19

home messages is just really that it's

39:22

that this is perfectly, perfectly

39:24

safe. And you know, if

39:26

you, Misjudged, you know,

39:28

who needed it and you, you, you

39:30

did it to an animal that didn't need

39:33

to, to have this done, there was no harm.

39:35

And then of course, the, the fact

39:37

that, you know, it, it, it does

39:39

wake those animals up and then they stay

39:42

awake and continue to search and nurse,

39:44

which is, is really a you

39:46

know, the main factor for, you know, survivability

39:49

and these lambs. Yeah,

39:52

awesome. Awesome. So as

39:54

always in the podcast notes, I'll have

39:56

where you can find these papers how

39:58

you can ask Dr. Kutzler the million

40:00

questions you're going to have after you listen to this podcast

40:04

so, my final question that I

40:06

always like to ask what do you

40:08

see as the next big problem that researchers

40:10

need to think about and address

40:12

in the small ruminant world? Oh,

40:15

that's a good one. So you

40:17

know, we're right now we're doing

40:19

a a vitamin

40:22

D supplementation project

40:24

and use and pregnant use in

40:27

the Pacific Northwest we have

40:30

Many, many gray days during

40:33

the fall and winter. And

40:35

even though we don't really think of like vitamin D

40:37

deficiency, and she. I

40:40

mean, this of course is when we're asking

40:42

them to be pregnant and, and deliver healthy

40:44

lambs. And sure enough

40:46

the sheep in our area are vitamin D

40:49

deficient. So, so we are, you

40:51

know, currently doing a study looking at supplementing

40:54

just giving injections like at a time of

40:56

ultrasound and then at a time of, you

40:58

know, crutching essentially. So two time points

41:01

during the winter, but when

41:03

when use would be already handled

41:05

to see if this improves their,

41:08

their pregnancy performance, decreasing

41:11

either pregnancy toxemia or increases

41:13

the birth weight of the lamb or their ability to care

41:16

for the lamb. So we'll see. We'll hopefully

41:18

have some results from

41:20

that this spring because we're, we're starting

41:23

this project on the ewes that are being

41:25

bred right now. Oh, that'll

41:27

be interesting too. We also have no sunshine

41:29

here in Buffalo. That

41:33

would be awesome. It's our

41:35

nightly routine at our house. Everybody gets vitamin

41:37

D before bed in the winter. And

41:39

maybe I need to add the small ruminants in

41:41

my life. Awesome. I look forward to that. Well,

41:43

thank you so much, Dr. Kutzler for joining

41:46

us today on Boz and Bleeds, the

41:48

American association of small ruminant

41:50

practitioners podcast. And we will see

41:52

you next time. Thanks.