# Metabolic Periparturient Diseases in Small Ruminants: An Update
## 5 Integrated Prevention Plan for Metabolic Diseases
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\begin{tabular}{l} \hline \hline Nutritional Management \\ \hline \(\bullet\) & Dietary apport: accomplish with nutrient and energy requirements for maintenance according the female body weight, and for production (fetuses and milk yield) [5; 132]. \\ \(\bullet\) & Basal diet bromatological analysis (e.g., grasses, silage, hay) should be performed when changing (or, in alternative, every six months) and balanced, according to the different production level of the animals. \\ \(\bullet\) & Apport adequate dietary calcium throughout lactation (dairy) and gestation (meat). Special care is needed due to the low vitamin D dietary apport during winter season (less solar exposition) or confined animals to mitigate hypocalcemia [133]. Dietary magnesium should not exceed 0.4\% of dry matter with a recommended potassium to magnesium ratio of 3.8-4:1 (2\% potassium), sometimes with additional magnesium in mineral supplement [134]: High potassium levels (e.g., use of potassium fertilizers in pasture) reduce magnesium \\ \(\bullet\) & High-risk pastures: avoid young grasses (low magnesium, sodium and calcium levels and high potassium levels mainly for cereal crops), grass fertilization with potassium, presence of oxalates (e.g., _Oxalis_ spp., _Rumex_ spp., _Chenpodium_ spp. in pasture) causing calcium chelation in rumen and animal fluid. \\ \(\bullet\) & Avoid alkaline diets, high in sodium and potassium, and low in sulphate and chloride. Use of acidogenic diets (dietary cation-anion difference \(>-50\) mEq/kg; ideally \(>-100\) mEq/kg) for high-producing animals at least for dairy goats [135]. The acidogenic diet can be \\ \(\bullet\) & apported during the last 10–15 days antepartum to provoke a transient metabolic acidosis in dairy animals, especially in flocks presenting high incidence of hypocalcemia. Restriction of calcium intake and metabolic acidosis induce urinary Ca++ excretion stimulating \\ \(\bullet\) & apparthormence secretion [136]. Urine pH evaluation is required to monitoring metabolic acidosis status. Inconsistent results can be observed mainly in ewes at pasture [101; 137], where the cation-anion difference of grass can significantly vary. Moreover, anionic salts (sulphates and chlorides-based) are unpalatable can reduce feed intake, mainly for high amounts of supplementation). The prepartum timeline can disagree for prepartum hypocalcemia (eg., meat sheep), when the demand of calcium is mainly required by fetuses (mainly for meat purpose). Nonetheless, it antepartum application can be useful for lactating ewes [138]. \\ \(\bullet\) & Sudden dietary changes or other stressors should be avoided during late gestation. Sudden, short and complete fast of dams with normal BCS are normally associated with environmental stressful factors. Abrupt dietary changes primarily cause digestive disorders with repercussion in nutrients’ absorption. A transition dietary period of 7–15 days is usually recommended. \\ \(\bullet\) & Prevent or mitigate females to loss or gain excessive body weight or BCS (\(\pm 1\) point on a 0–5 scale) considering fetal growth and milk yield throughout pregnancy and lactation. A BCS between 3.0 and 3.5 at parturition. Low and high BCS are associated with high levels of BHBA and PT [13; 84]. \\ \hline \hline Animal handing \\ \(\bullet\) & A flock breeding plan is needed. By day 50 of pregnancy, the number of fetuses should be evaluated by ultrasonography examination to make the nutritional adjustments according to singleton and multiple pregnancy (meat). \\ \(\bullet\) & In dairy, the formation of two groups according to the level of production should be carried out for high-producing animals. \\ \(\bullet\) & Keep an appropriate age structure of the flock. The older females (\(>\)3 years old) have more risk to present metabolic diseases. Involuntary (e.g., diseases, infertility) and voluntary (e.g., old age, low production, low fertility) culling should be evaluated to timely introduce new animals. Typically, an annual culling rate of around 20\% is desirable to maintain a stable average age structure of the flock without increasing farm size. \\ \(\bullet\) & Avoid (long) transportation of animals during late pregnancy. \\ \(\bullet\) & Maintain animals in appropriate health and welfare conditions. Implement herd health programs for the main diseases and breeding; concomitant diseases such as [PERSON]’s disease and liver fluke increase the risk of PT [128]. Provide accommodation especially during adverse environmental weather, for grazing animals. \\ \(\bullet\) & Early detection and treatment of metabolic diseases. \\ \hline \hline \end{tabular}
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