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Pre-Pubic Tendon Rupture

By Laurie Ball-Gisch

The Lavender Fleece

3826 N. Eastman Rd.

Midland, MI 48642




The lambing season of 2007 presented us with a new sheep lesson: Pre-pubic tendon rupture in a ewe during late gestation.

Pre-pubic tendon rupture is seen fairly often in horses, but rarely in sheep. So it came as quite a surprise when I found out that a fellow shepherdess, Valerie Black of Little Cabin Farm in Ohio, had a ewe come down with the same condition this season. I have decided it is important to share our experiences and reflections—to let our sheep’s misfortune educate other shepherds of this potential problem.

Side view of pre-pubic tendon rupture - post-lambing.
Side view of pre-pubic tendon rupture—post-lambing.

I always tell new shepherds that they are wise to observe their sheep as often as possible—especially when things are going right—because that prepares us to recognize more quickly when something has gone wrong.

This is our eighth lambing season (with 44 ewes on the farm this year), so I have seen a fair number of pregnant ewes through the years. One morning when walking through the flock, I noticed a ewe (named “Drifa” which means snow drift in Icelandic—we raise Icelandic sheep) whose belly suddenly seemed to be very asymmetrical. She had been normal-looking the day before, carrying her lambs out on both sides, but all of a sudden it looked like she was completely lopsided.

At first I thought that she must have triplets and that one of the lambs had moved to the left and bottom side of her uterus. But as the day went on, I realized that everything was hanging much too low to the ground, and that it was definitely bulging more on her rumen-side.

How the ewe 'Drifa' looked in pregnancy before the tendon ruptured.
How the ewe “Drifa” looked in pregnancy before the tendon ruptured.

I consulted Laura Lawson’s book and the only reference I found to something similar was a sketch of a herniated ewe. I had a ewe with a hernia a few years ago. The hernia happened within a week after the ewe lambed, and it looked like she was walking with a basketball lodged just in front of one of her hind legs.

This condition didn’t look like a hernia to me, so I called my vet and explained what I was seeing, and she said it was a “pre-pubic tendon rupture.”

Handling The Ruptured Ewe When She Hits Lambing Time

My veterinarian told me that this is very common in horses, due to the weight of the foals. In horses, they usually do what is called a “terminal caesarean.” We talked about different options with my ewe. She did not feel that we would have a good outcome and said that usually you lose the ewe and all of the lambs. Her suggestion was to do a terminal C-section and try to save the lambs. My feeling was that I would rather try to let the ewe go into a natural labor and try to deliver the lambs myself.

My vet had said that the ewe would probably present a water bag, and that leaving her enough time to dilate the cervix would be a good idea. With a ruptured pre-pubic tendon, the ewe doesn’t have the ability to have contractions strong enough to get the lambs delivered without assistance. Another option was to watch for the udder to fill out and then to induce labor, so that we could plan to be there for the delivery. I had talked about the situation with my husband (Daryl) and father-in-law (Willie) and so they knew that when she went into labor I would need to deliver the lambs, and would need help with restraining the ewe.

How 'Drifa' looked after the prepubic tendon ruptured-tore.
How “Drifa” looked after the prepubic tendon ruptured-tore.

As luck would have it, I had to leave town to do a one-day fiber show. Sure enough, Drifa went into labor while I was gone. Daryl and Willie noticed she had a water bag showing and they were prepared to help her out. (Note that my husband has never delivered a lamb; I am the one who does the assisting—he is the one who holds the ewe for me).

They put Drifa into a pen and Willie held the ewe. Daryl had a real “trial by fire” in delivering his first lamb. He was able to pull out a ram lamb alive, but he had trouble recovering the second lamb. Her neck was twisted backward and by the time he corrected the malpresentation and got her out, she had died. The dam was very strong throughout the ordeal and bounced right back from the delivery by immediately cleaning off her lamb and encouraging him to nurse. By the time I got home late that night, Daryl reported it all to me and said the lamb was nursing well and that the ewe was doing fine. He had given her an antibiotic and also supplemented her with an oral dose of CMPK gel (20 cc). Although CMPK is sold as a dairy cattle supplement, we have had very good luck using it to revive stressed ewes either in late gestation or after hard deliveries. It seems to work well with ewes that are looking like they are going into shock, and we’ve also used it with success with ewes that have late gestation signs of possible ketosis coming on.

Important Things To Do AFTER Lambing

Although we were prepared for lambing difficulties, what we didn’t realize was that there could still be problems after delivery.

Drifa side view after the prepubic tendon ruptured-tore.
Drifa side view after the prepubic tendon ruptured-tore.

First of all, the ewe’s body is very lopsided. The weight of her “insides” was pushing against her udder. In fact, one teat was aimed straight at the ground and there was no fullness to that side of the udder. The other side was aimed more upward (and was a bit fuller looking) and the lamb was able to nurse on that side. Her lamb seemed to be nursing well and milk was coming out. She was a great mom and was very protective of her son.

We put her in a smaller paddock area so she didn’t have to walk far for her food. I observed them every day and whenever she called him, he came to her to nurse and appeared to be doing fine. I weighed the lamb after a few days and to my dismay realized he was only gaining about .3 pounds per day. My experience has shown that lambs need to be gaining at least .5 pound per day to be growing. Anything less, especially in cold weather, results in lambs that are just “holding their own”—they are adding body weight, but aren’t adding enough to thrive.

We started supplementing the lamb with milk replacer. Unfortunately during the first week of this lamb’s life, our spring weather had turned into real winter weather, with lows in the mid-teens at night and it was raining/sleeting or snowing every day. In retrospect, I now know that the lamb was not getting enough milk from his mom from birth. In fact, I suspect he probably didn’t get enough colostrum either. We lost him to pneumonia at two weeks of age.

How the ewe looked after her lambs were delivered.
How the ewe looked after her lambs were delivered.

During this time I had shared what I was going through with Valerie. One day she called me and said “I think ‘Snowy Lady’ has the same thing as Drifa.” My first reaction was “No, it can’t be!” If this is such a rare condition in sheep, how could we both suddenly have the same thing happen in the same season? I asked her to send me a photo of the ewe. She did send a photo, and sadly, it did indeed look like her ewe also had a pre-pubic tendon rupture. She consulted with her vet to confirm and her vet concurred that this was indeed the problem. Her vet felt that there wasn’t any reason the lambs couldn’t be delivered when she went into labor. So this was her plan. What does seem different between our two ewes is that I believe Drifa has a full tendon rupture, and from photos Valerie’s ewe seems to have only a partial tear at this point.

After we lost our ram lamb, I advised Valerie that she should watch any live lambs very closely. I suggested she give the lamb(s) extra colostrum and that she immediately start supplementing them with bottles. My feeling now is that even though there is an udder that produces milk—and even though the lamb nurses—I believe the extreme pressure on the udder from the added weight, causes it to not be able to produce/retain enough milk to sustain the lambs. At least this was the case with our ewe.

When Valerie called to say Snowy Lady had produced a water bag and was in labor, I suggested she give the ewe at least 30 to 45 minutes to dilate before she tried to go in and pull the lambs. She did this and was able to pull out a live ram lamb. Unfortunately she had the same result that I did—the second lamb, a ewe, was dead. However, in this case, she had observed the ewe fighting with another ewe a few days earlier and saw the ewe fall twice. So we believe that ewe lamb was dead from this injury, rather than having died during labor/delivery.

Her ewe was not as vigorous after lambing as mine was, so I advised her to offer her warm molasses water, give her an antibiotic, and to also administer CMPK gel. Valerie was concerned about her ewe; she didn’t act “right.” Valerie wasn’t sure the ewe had expelled all of the placenta. So her veterinarian administered 2 cc of Lutalyse® and they put her on five days of PenG. This has brought Snowy Lady around and she is doing great now.

Snowy Lady after her tendon tore. Her injury was not as severe, so that's possibly the reason why it was only a partial tendon tear.
Snowy Lady after her tendon tore. Her injury was not as severe, so that’s possibly the reason why it was only a partial tendon tear.

Snowy Lady’s lamb was weak at birth and Valerie kept a close eye on him throughout his first 24 hours, making sure he drank supplemental milk every few hours. Because of the proper intervention, the ewe got stronger and bonded well to her son. Valerie reported that he was nursing the first day, but it seemed there was just not enough milk. So with bottle supplementation right from the beginning, as well as some frequent doses of Nutridrench®, the lamb grew stronger and began nursing better, as well as taking his bottle.

Valerie reported a few days later that it was getting harder to catch the lamb and that he was refusing his bottle. She weighed him and he was gaining 1 pound a day (!) which was great. So she decided to back off on bottle feedings and was going to monitor his progress daily to make sure the ewe was still producing enough milk for her lamb.

Cause & Effect Reflections

While our experiences in dealing with a pre-pubic tendon rupture are very similar, Valerie says, “It took several days before I could see the slow change that was happening. My eyes knew something was wrong but couldn’t put a finger on it exactly. Not until the side was lowered by a few inches did I realize that it was probably the same as Drifa’s issue. My ewe did not bounce back as quickly as Drifa and had a hard time expelling all the afterbirth.”

The severity of the tear does not seem as bad with Snowy Lady as with Drifa.
The severity of the tear does not seem as bad with Snowy Lady as with Drifa.

I have searched through my many sheep production books and have been unable to find any reference to “pre-pubic tendon rupture.” I did an Internet search and found this reference from the on-line Merck Veterinary Manual: “Excessive fetal weight and the weight of accumulated fetal fluids, may lead to rupture of the pre-pubic tendon in ewes.” I also found a reference from another farm mentioning a ruptured pre-pubic tendon in a ewe, as a result of a fall on the ice. In the case of Drifa, I did find her “cast” (upside down on her back with all four legs in the air) about a week prior to the rupture occurring. What puzzled me when she was cast was that she lay cast next to the hay feeder, but on very flat ground. Usually sheep cast when they lie on some sort of hillside or “divot” in the ground that puts them off center and they cannot right themselves (this can quickly become fatal, as their own weight crushes their lungs and they can suffocate). I remember thinking to myself that it was very odd to find her upside down—in that particular area—and now I am wondering if perhaps she had taken a blow from another ewe, greedy to take her spot at the hay feeder? Perhaps there was a resulting injury, obviously not detectable at the time? It was about a week later that I found her with the rupture.

Unfortunately, the tear of this tendon is not reparable. The ewes can never be bred again. It’s devastating to have a quality breeding ewe just reaching her prime, become a non-breeder.

Drifa is doing fine, and has a good appetite. It takes her quite a bit longer to “run” out to pasture, but she drags her belly along as quickly as she can. I had asked my vet whether or not this condition was genetic, and she said no. It seems to be just “one of those things” that is non-predictable, unpreventable and non-curative. At this point, the only thing that I can salvage from this is to try to inform others of the condition and to let them be aware of the aftercare of the lambs if any are salvaged from the pregnancy. I am glad that my loss will hopefully be Valerie’s gain—she knew and was able to supplement her lamb at the beginning and he is thriving now just on his dam’s milk.

As another sheep breeder and friend of mine said to me one day, “I’ve been raising sheep for 50 years, and every single lambing season, the sheep teach me something brand new that I had never experienced before.” So we learn, move on, and await the next lessons and hope to continue to have the courage and tenacity to keep learning from these teachers, our sheep.

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