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The Five Point Check®
SUSAN SCHOENIAN (Shāy nē ŭn)
Sheep & Goat Specialist
Western Maryland Research & Education Center
sschoen@umd.edu – www.sheepandgoat.com
Background
• Anthelmintic resistance (AR)
• Targeted selective treatment (TST)
Anthelmintic resistance (AR)
• When deworming fails
to achieve expected
results.
1. When deworming fails
to alleviate clinical
symptoms.
 Death
 Production loss
2. When deworming fails to
reduce fecal egg count
by 95 percent or more.
Anthelmintic resistance
• Is widespread and
well-documented
(especially in
southeastern U.S.).
• Varies by species,
geographic location,
and individual farm.
• Is affected by past
deworming and grazing
practices.
. . . is inevitable!
No treatment is 100% effective.
Percent farms with anthelmintic resistance
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Benzimidazole Ivermectin Cydectin Levamisole
Mid-Atlantic (n=33) Southern (n=46)
Source: Howell et al (2008). O’Brien (2010).
Practices which accelerate drug resistance
1) FREQUENT DEWORMING
2) Underdosing
3) Injecting dewormers
4) Pouring on dewormers
5) Feeding dewormers
6) “Persistent activity” dewormers
7) Putting dewormer in mouth
8) Dosing on full stomach
9) Deworming when infection levels
(in animal and on pasture) are low.
10) Putting treated animals on clean
pastures.
11) Treating everyone.
12) Improper use and storage of
dewormers
How do you know which
anthelmintics work on your farm?
Anthelmintic didn’t work (?) Anthelmintic worked (?)
You should test for anthelmintic
resistance every 2-3 years
Fecal egg count reduction test Drenchrite® larval assay
Fecal egg count reduction test (FECRT)
• Collect fecal samples (> 200 epg) at time of
anthelmintic treatment and 7 to 14 days later.
• Calculate % reduction in fecal egg counts (epg).
Buck #325
2,650 epg on 6/27 (F1)
Dewormed with levamisole
200 epg on 7/11 (F2)
FECR calculation
[(F1-F2)/F1] x 100
[(2650-200)/2650] x 100
= 92.5% FECR
Drenchrite® Assay
• Prepare and send pooled fecal sample (> 350-500 epg) from
at least 10 animals to parasitology lab (e.g. Dr. Ray Kaplan’s
lab @ University of Georgia) where eggs are
isolated, incubated, and allow to hatch and develop into 3rd
stage larvae.
• Tests all three classes of anthelmintics simultaneously
• Also identifies worm species.


95-100% effective. Small number of
resistant worms may be present.
80-95% effective. Treatment
is effective, but resistance is
increasing.
Less than 80%. Production
losses become apparent as
effectiveness of dewormer
moves closer to zero.
Anthelmintic failure.
Animals die.
Adapted from Wormer
Resistance “The need for
change” Meat Promotion Wales
How effective are your dewormers?
Targeted selective treatment (TST)
Identifies those animals which
require treatment.
Identifies which animals would
benefit from treatment.
Targeted selective treatment (TST)
• For TST to be viable, there
must be practical tool(s)
that producers can use to
make deworming
decisions.
• The first tool developed
was the FAMACHA©
system.
• The Five Point Check© is
an extension of the
FAMACHA system.
FAMACHA© System
Clinical category Color PCV Tx recommendation
1 Red > 28 No
2 Red-pink 23-27 No
3 Pink 18-22 ?
4 Pink-white 13-17 Yes
5 White < 12 Yes
Five Point Check© (5)
• Addresses limitations of
FAMACHA©.
• Extension of TST to determine need
for deworming for all internal
parasites that affect sheep and
goats.
• Especially useful when deciding
whether or not to deworm
FAMACHA 3’s.
• Involves 5 check points on the
animal: eye, back, tail, jaw, and nose.
• Developed for sheep.
– Replace nose checkpoint
with coat condition.
Check Point Observation Possibilities
1. EYE
Anemia
1-5
(FAMACHA© card)
Barber pole worm (Haemonchus)
Liver fluke
Hook worms
Other worms and causes
2. BACK
Body condition score
1-5
(BCS card)
Brown stomach worm (Teladorsagia)
Bankrupt worm (Trichostrongylus)
Nodular worm
Other worms and causes
3. TAIL
Fecal soiling
(1-5)
Dag score card
Brown stomach worm (Teladorsagia)
Bankrupt worm (Trichostrongylus)
Coccidia (Eimeria)
Nodular worm (Oesophagostomum)
Other worms and causes
4. JAW
Soft swelling
“Bottle jaw”
1-5
Barber pole worm (Haemonchus)
Coccidia (Eimeria)
Liver fluke
Hook worms
Other worms and causes
5. NOSE Discharge
1-5
Nasal botfly
Lungworms
Pneumonia
Other causes
5. COAT Coat condition
1-3
Barber pole worm (Haemonchus)
Brown stomach worm (Teladorsagia)
Bankrupt worm (Trichostrongylus)
Coccidia (Eimeria)
External parasites
Other causes
# 1 Eye - ocular membranes
• Anemia is caused by blood-feeding parasites, such as
Haemonchus, hookworms, and liver flukes. Coccidiosis can
also cause anemia.
• Anemia (packed cell volume) is estimated by evaluating the
color of the lower eyelid and comparing it to the colors on
the FAMACHA© guide.
Category Color PCV Tx
1 Red > 28 No
2 Red-pink 23-27 No
3 Pink 18-22 ?
4 Pink-white 13-17 Yes
5 White < 12 Yes
#2 - Back - Body condition score (BCS)
• Many worms can cause a loss of body condition.
• Poor or declining body condition can also be a
sign of age, poor nutrition, or other diseases.
• Animals also vary in their ability to carry and hold
body condition.
Body condition scoring (BCS)
• Is used to determine how fat
or thin an animal is.
• Cannot be determined by
simply looking at an animal.
• Is accomplished by feeling for
the amount of fat and muscle
over the back, ribs, and loin.
• Is one of the most useful
management practices.
Should be done on a regular
basis.
Body Condition Scoring Goats
Score Spineous process Rib cage Loin eye
1 Very thin
Easy to see and feel,
sharp
Easy to feel and can feel
under
No fat covering
2 Thin
Easy to feel, but
smooth
Smooth, slightly rounded,
need to use slight pressure
to feel
Smooth, even fat
cover
3
Good
condition
Smooth and rounded Smooth, even feel
Smooth, even fat
cover
4 Fat
Can feel with firm
pressure, no points can
be felt
Individual ribs cannot be
felt, but can still feel indent
between ribs
Thick fat
5 Obese
Smooth, no individual
vertebra can be felt
Individual ribs cannot be
felt. No separation of ribs
felt.
Thick fat covering,
may be lumpy and
“jiggly”
Source: www.smallstock.info
Langston University resources on
body condition scoring
Card
(similar to FAMACHA card)
Factsheet
YouTube video
#3 - Tail - dag score
• The hindquarters of the animal are assessed to
determine dag score or degree of fecal soiling.
• Many worms can cause scours (diarrhea).
• Stress and diet are other causes of diarrhea.
What are dags?
• Dried feces left dangling on the wool on a
sheep’s rear end.
Dag scoring
Score Description Action
0
No fecal soiling at all. No indication for
treatment/action.
None
1
Very slight soiling on edge of tail/on
each side
None
2 Slight soiling on edge of tail/on each side Usually none
3 Moderate soiling, dag formation
Consider
treatment/action
4 Severe soiling, severe dag formation
Treatment
recommended
5
Very severe, watering diarrhea
extending to hocks.
Treatment essential
Source: University of Pretoria
#4 - Bottle jaw
(submandibular subcutaneous edema)
• An accumulation of fluid
(swelling) under the
lower jaw of a
sheep, goat, or calf.
• Usually a result of anemia
(blood loss).
• Occurs primarily due to
the infestation of barber
pole worms (Haemonchus
contortus) or other blood-
feeding parasites.
#5 - Coat condition
• The condition of a goat’s hair coat can be indicative of its
overall health and thriftiness.
• At the Western Maryland Research & Education Center, we
use a scoring system of 1-3, where 2 is average coat quality.
Other factors to consider
…especially when deciding whether to deworm FAMACHA 3’s
• Scores of other goats
• Fecal consistency
• Weight gain
• Fecal egg count
• Risk of reinfection
• Frequency of
FAMACHA© scoring
and Five Point Check©
Which dewormer to use
FAMACHA© 4 or 5 Most effective dewormer
FAMACHA© 3 - High risk Most effective dewormer
FAMACHA© 3 - Low risk Less effective dewormer
Multiple drug resistance Drugs from 2 or 3 anthelmintic classes
Quarantine drench Albendazole + moxidectin + levamisole
(Valbazen® + Cydectin® + Prohibit®)
Tapeworms Fenbendazole or Albendazole
(SafeGuard® or Valbazen®)
Tapeworms tend to be non-pathogenic and there is
no evidence to suggest a treatment benefit (sheep).
Liver fluke Albendazole (Valbazen®)
Meningeal worm Fenbendazole + ivermectin
(SafeGuard® + Ivomec®)
Nasal bots and other external
parasites
Ivermectin (Ivomec® drench)
American Consortium for Small
Ruminant Parasite Control (ACSRPC)
www.acsrpc.org
Thank you for your attention.

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The Five Point Check®

  • 1. The Five Point Check® SUSAN SCHOENIAN (Shāy nē ŭn) Sheep & Goat Specialist Western Maryland Research & Education Center sschoen@umd.edu – www.sheepandgoat.com
  • 2. Background • Anthelmintic resistance (AR) • Targeted selective treatment (TST)
  • 3. Anthelmintic resistance (AR) • When deworming fails to achieve expected results. 1. When deworming fails to alleviate clinical symptoms.  Death  Production loss 2. When deworming fails to reduce fecal egg count by 95 percent or more.
  • 4. Anthelmintic resistance • Is widespread and well-documented (especially in southeastern U.S.). • Varies by species, geographic location, and individual farm. • Is affected by past deworming and grazing practices. . . . is inevitable! No treatment is 100% effective.
  • 5. Percent farms with anthelmintic resistance 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Benzimidazole Ivermectin Cydectin Levamisole Mid-Atlantic (n=33) Southern (n=46) Source: Howell et al (2008). O’Brien (2010).
  • 6. Practices which accelerate drug resistance 1) FREQUENT DEWORMING 2) Underdosing 3) Injecting dewormers 4) Pouring on dewormers 5) Feeding dewormers 6) “Persistent activity” dewormers 7) Putting dewormer in mouth 8) Dosing on full stomach 9) Deworming when infection levels (in animal and on pasture) are low. 10) Putting treated animals on clean pastures. 11) Treating everyone. 12) Improper use and storage of dewormers
  • 7. How do you know which anthelmintics work on your farm? Anthelmintic didn’t work (?) Anthelmintic worked (?)
  • 8. You should test for anthelmintic resistance every 2-3 years Fecal egg count reduction test Drenchrite® larval assay
  • 9. Fecal egg count reduction test (FECRT) • Collect fecal samples (> 200 epg) at time of anthelmintic treatment and 7 to 14 days later. • Calculate % reduction in fecal egg counts (epg). Buck #325 2,650 epg on 6/27 (F1) Dewormed with levamisole 200 epg on 7/11 (F2) FECR calculation [(F1-F2)/F1] x 100 [(2650-200)/2650] x 100 = 92.5% FECR
  • 10. Drenchrite® Assay • Prepare and send pooled fecal sample (> 350-500 epg) from at least 10 animals to parasitology lab (e.g. Dr. Ray Kaplan’s lab @ University of Georgia) where eggs are isolated, incubated, and allow to hatch and develop into 3rd stage larvae. • Tests all three classes of anthelmintics simultaneously • Also identifies worm species.
  • 11.   95-100% effective. Small number of resistant worms may be present. 80-95% effective. Treatment is effective, but resistance is increasing. Less than 80%. Production losses become apparent as effectiveness of dewormer moves closer to zero. Anthelmintic failure. Animals die. Adapted from Wormer Resistance “The need for change” Meat Promotion Wales How effective are your dewormers?
  • 12. Targeted selective treatment (TST) Identifies those animals which require treatment. Identifies which animals would benefit from treatment.
  • 13. Targeted selective treatment (TST) • For TST to be viable, there must be practical tool(s) that producers can use to make deworming decisions. • The first tool developed was the FAMACHA© system. • The Five Point Check© is an extension of the FAMACHA system.
  • 14. FAMACHA© System Clinical category Color PCV Tx recommendation 1 Red > 28 No 2 Red-pink 23-27 No 3 Pink 18-22 ? 4 Pink-white 13-17 Yes 5 White < 12 Yes
  • 15. Five Point Check© (5) • Addresses limitations of FAMACHA©. • Extension of TST to determine need for deworming for all internal parasites that affect sheep and goats. • Especially useful when deciding whether or not to deworm FAMACHA 3’s. • Involves 5 check points on the animal: eye, back, tail, jaw, and nose. • Developed for sheep. – Replace nose checkpoint with coat condition.
  • 16. Check Point Observation Possibilities 1. EYE Anemia 1-5 (FAMACHA© card) Barber pole worm (Haemonchus) Liver fluke Hook worms Other worms and causes 2. BACK Body condition score 1-5 (BCS card) Brown stomach worm (Teladorsagia) Bankrupt worm (Trichostrongylus) Nodular worm Other worms and causes 3. TAIL Fecal soiling (1-5) Dag score card Brown stomach worm (Teladorsagia) Bankrupt worm (Trichostrongylus) Coccidia (Eimeria) Nodular worm (Oesophagostomum) Other worms and causes 4. JAW Soft swelling “Bottle jaw” 1-5 Barber pole worm (Haemonchus) Coccidia (Eimeria) Liver fluke Hook worms Other worms and causes 5. NOSE Discharge 1-5 Nasal botfly Lungworms Pneumonia Other causes 5. COAT Coat condition 1-3 Barber pole worm (Haemonchus) Brown stomach worm (Teladorsagia) Bankrupt worm (Trichostrongylus) Coccidia (Eimeria) External parasites Other causes
  • 17. # 1 Eye - ocular membranes • Anemia is caused by blood-feeding parasites, such as Haemonchus, hookworms, and liver flukes. Coccidiosis can also cause anemia. • Anemia (packed cell volume) is estimated by evaluating the color of the lower eyelid and comparing it to the colors on the FAMACHA© guide. Category Color PCV Tx 1 Red > 28 No 2 Red-pink 23-27 No 3 Pink 18-22 ? 4 Pink-white 13-17 Yes 5 White < 12 Yes
  • 18. #2 - Back - Body condition score (BCS) • Many worms can cause a loss of body condition. • Poor or declining body condition can also be a sign of age, poor nutrition, or other diseases. • Animals also vary in their ability to carry and hold body condition.
  • 19. Body condition scoring (BCS) • Is used to determine how fat or thin an animal is. • Cannot be determined by simply looking at an animal. • Is accomplished by feeling for the amount of fat and muscle over the back, ribs, and loin. • Is one of the most useful management practices. Should be done on a regular basis.
  • 20. Body Condition Scoring Goats Score Spineous process Rib cage Loin eye 1 Very thin Easy to see and feel, sharp Easy to feel and can feel under No fat covering 2 Thin Easy to feel, but smooth Smooth, slightly rounded, need to use slight pressure to feel Smooth, even fat cover 3 Good condition Smooth and rounded Smooth, even feel Smooth, even fat cover 4 Fat Can feel with firm pressure, no points can be felt Individual ribs cannot be felt, but can still feel indent between ribs Thick fat 5 Obese Smooth, no individual vertebra can be felt Individual ribs cannot be felt. No separation of ribs felt. Thick fat covering, may be lumpy and “jiggly” Source: www.smallstock.info
  • 21.
  • 22. Langston University resources on body condition scoring Card (similar to FAMACHA card) Factsheet YouTube video
  • 23. #3 - Tail - dag score • The hindquarters of the animal are assessed to determine dag score or degree of fecal soiling. • Many worms can cause scours (diarrhea). • Stress and diet are other causes of diarrhea.
  • 24. What are dags? • Dried feces left dangling on the wool on a sheep’s rear end.
  • 25. Dag scoring Score Description Action 0 No fecal soiling at all. No indication for treatment/action. None 1 Very slight soiling on edge of tail/on each side None 2 Slight soiling on edge of tail/on each side Usually none 3 Moderate soiling, dag formation Consider treatment/action 4 Severe soiling, severe dag formation Treatment recommended 5 Very severe, watering diarrhea extending to hocks. Treatment essential Source: University of Pretoria
  • 26.
  • 27. #4 - Bottle jaw (submandibular subcutaneous edema) • An accumulation of fluid (swelling) under the lower jaw of a sheep, goat, or calf. • Usually a result of anemia (blood loss). • Occurs primarily due to the infestation of barber pole worms (Haemonchus contortus) or other blood- feeding parasites.
  • 28. #5 - Coat condition • The condition of a goat’s hair coat can be indicative of its overall health and thriftiness. • At the Western Maryland Research & Education Center, we use a scoring system of 1-3, where 2 is average coat quality.
  • 29. Other factors to consider …especially when deciding whether to deworm FAMACHA 3’s • Scores of other goats • Fecal consistency • Weight gain • Fecal egg count • Risk of reinfection • Frequency of FAMACHA© scoring and Five Point Check©
  • 30. Which dewormer to use FAMACHA© 4 or 5 Most effective dewormer FAMACHA© 3 - High risk Most effective dewormer FAMACHA© 3 - Low risk Less effective dewormer Multiple drug resistance Drugs from 2 or 3 anthelmintic classes Quarantine drench Albendazole + moxidectin + levamisole (Valbazen® + Cydectin® + Prohibit®) Tapeworms Fenbendazole or Albendazole (SafeGuard® or Valbazen®) Tapeworms tend to be non-pathogenic and there is no evidence to suggest a treatment benefit (sheep). Liver fluke Albendazole (Valbazen®) Meningeal worm Fenbendazole + ivermectin (SafeGuard® + Ivomec®) Nasal bots and other external parasites Ivermectin (Ivomec® drench)
  • 31. American Consortium for Small Ruminant Parasite Control (ACSRPC) www.acsrpc.org
  • 32. Thank you for your attention.