Clinical Management and Recovery of a 2-Year-Old West African Dwarf Doe with Peste des Petits Ruminants

History

On April 5^th, 2025, a 2-year-old West African Dwarf doe weighing approximately 15 kg was presented to the Large Animal Unit of the Magajin Gari Zonal Veterinary Hospital, Kaduna State, Nigeria. The doe was managed semi-intensively with one buck and fourteen other does and was fed wheat bran, bean husk, and hay. According to the owner, the animal had been off feed for three days, with progressive weakness, oral sores, and profuse foul-smelling diarrhea. No vaccination history against PPRs was reported in the flock. Importantly, no similar illness was observed among the other animals at the time of presentation, suggesting that the case was an isolated occurrence within the herd.

Clinical findings

On physical examination, the doe appeared weak, dull, and reluctant to move. The body condition score was assessed as 2/5; there was bilateral serous nasal discharge and extensive ulcerations of the lips, gums, and buccal mucosa, with a heavily soiled perineum due to projectile diarrhea with a fetid odor [Figure 1]. Bilateral sublingual lymphadenopathy was palpable. The mucous membranes were pale with a capillary refill time (CRT) of approximately 3 s, consistent with poor perfusion. Vital parameters revealed pyrexia (41.6°C), tachycardia (100 beats/min), and tachypnea (35 cycles/min). Dehydration was estimated at 6–8% based on skin tenting, sunken eyes, and delayed CRT, indicating moderate fluid loss.

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Figure 1:

Clinical presentation of a West African Dwarf doe with peste des petits ruminants (PPR). (a) Extensive necrotic ulcerations (orange arrow) of the oral mucosa and lips with excessive salivation observed on Day 0 (presentation). (b) Projectile, foul-smelling diarrhea with perineal soiling (orange arrow) on Day 0. Images were captured after obtaining owner consent and were anonymized to remove any identifying information.

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Differential diagnosis

At presentation, several differential diagnoses were considered due to the overlapping clinical signs observed. Contagious caprine pleuropneumonia (CCPP) was considered due to the fever and respiratory signs, but the absence of severe respiratory distress, pleuritic pain, and fibrinous exudates made this less likely. Bluetongue and foot-and-mouth disease (FMD) were also included in the differentials due to the oral ulcerations and salivation; however, FMD was discarded as there were no vesicular lesions on the feet or teats, and bluetongue was unlikely given the lack of cyanosis of the tongue and absence of vector exposure history. Contagious ecthyma (orf) was considered for the oral lesions, but the lesions observed were deep, necrotic ulcers typical of PPR rather than the proliferative crusty lesions of orf. Gastrointestinal diseases such as salmonellosis, coccidiosis, or severe gastrointestinal parasitism were considered due to the profuse diarrhea, yet these conditions typically do not present with severe necrotizing stomatitis or ocular/nasal discharge [Table 1].

Laboratory investigations

Laboratory findings

Hematological analysis of the affected doe revealed moderate anemia, as indicated by a PCV (23%) and Hb concentration (7 g/dL), both below the lower limits of the reference range. The total RBC count was 5 × 10¹²/L, which, although within the normal reference interval, was at the lower threshold, further supporting the presence of anemia. WBC count was elevated at 13 × 10⁹/L compared with the reference range of 4–12 × 10⁹/L, consistent with leukocytosis [Table 2]. Differential leukocyte evaluation showed a pronounced lymphocytosis (76%), exceeding the upper reference limit of 75%, accompanied by mild neutropenia (14%) and normal proportions of monocytes, eosinophils, and basophils. Plasma protein concentration remained within the normal range (6.4 g/dL) [Table 2]. Taken together, these hematological alterations reflected a viral infection characterized by anemia, leukocytosis, and marked lymphocytosis, which aligned with the clinical suspicion of PPR.

Molecular testing by RT-PCR provided definitive confirmation of infection. The nasal swab sample from the doe yielded a Ct value of 29.21 [Table 2], which fell well below the positivity cut-off of ≤35 established for the assay. This result indicated the presence of PPR viral RNA in the sample.

Treatment and clinical course

The doe was immediately isolated and commenced on a multimodal supportive treatment plan to stabilize vital functions, prevent secondary complications, and promote recovery. Tylosin (20%) (Tylodox^®, Kepro B.V., Netherlands) was administered intramuscularly at 10 mg/kg once daily for 3 consecutive days as an empirical prophylactic measure against secondary bacterial pneumonia caused by opportunistic pathogens such as Pasteurella and Mannheimia spp., which frequently complicate PPR. Although thoracic auscultation did not reveal adventitious lung sounds at presentation, tylosin was included due to the high risk of bacterial overgrowth in immunocompromised animals. DIASTOP-plus (Novax^®, Afgon Hydrotec, Nigeria), an oral combination antidiarrheal preparation containing oxytetracycline (25 mg), furazolidone (1.5 mg), mebendazole (1.4 g), sulfadimidine B.P.C (1.5 g), and light kaolin (2.5 g) per 15 mL, was given at 7.5 mL orally twice daily for 5 days to empirically control mixed enteric bacterial and protozoal infections associated with profuse diarrhea. This product was used due to local availability and clinical urgency; however, the goat was not intended for food production, and the owner was explicitly informed that furazolidone is prohibited for use in food animals under the National Agency for Food and Drug Administration and Control (NAFDAC) in Nigeria’s regulations due to carcinogenic residue concerns. To address concurrent helminthiasis, which can worsen immunosuppression and delay recovery, Rafoxanide (3%) (Rafoxidad^®, DADVet, Jordan) was administered orally at 15 mg/kg once. The flock had a known history of fasciolosis and strongyle infestations, and although a fecal egg count was not performed at presentation due to logistical constraints, empirical deworming was justified based on regional parasite prevalence and field practice guidelines. Multivitamin supplementation (V-Multinor^®, Jubaili Agrotec, China) was given intramuscularly at 1 mL/10 kg once daily for five days to support immune function and enhance recovery.

Given the presence of moderate dehydration (estimated at 6–8% based on skin tenting and sunken eyes) and ongoing gastrointestinal losses, Ringer’s lactate (Baxter Healthcare, Belgium) was administered intravenously at 80 mL/kg/day, divided into four doses (≈300 mL every 6 h). The calculated requirement included estimated deficit (0.9–1.2 L) + maintenance (0.75 L/day) + estimated ongoing diarrheal losses (~0.25 L/day). Clinical monitoring included CRT, mucous membrane color, skin tenting, body weight, urine output, and daily PCV and total protein to guide fluid adjustment and prevent overload. For analgesia and anti-inflammatory care, flunixin meglumine (Flumeg^®, Bimeda, Ireland) was administered intramuscularly at 1.1 mg/kg once daily for 3 days to reduce mucosal pain, pyrexia, and systemic inflammation. This was given after initiating fluid therapy to minimize the risk of renal compromise, and the animal was closely monitored for adverse effects such as melena or signs of gastrointestinal irritation. Oral ulcerative lesions were irrigated once daily with a 0.01% potassium permanganate (KMnO₄) solution (Merck KGaA, Germany) prepared by dissolving 0.1 g of crystals in 1 L of clean water. Care was taken to avoid ingestion of excessive solution and aspiration. Handlers wore protective gloves and eyewear due to the caustic nature of concentrated KMnO₄. Rapid improvement was observed: Pyrexia and tachycardia resolved within 48 h, appetite and water intake normalized by day 3, diarrhea resolved by day 5, and complete clinical recovery was achieved by day 7 [Table 3]. Because this goat was not intended for human consumption, meat and milk withdrawal times were not applicable. In food-producing goats, withdrawal periods would be required for each drug class: Tylosin (minimum 8–14 days for meat), oxytetracycline (21–28 days for meat), sulfonamides (7–14 days), flunixin (4–8 days), and rafoxanide (28 days) based on Nigerian and international veterinary drug regulations.

A 21-day follow-up was conducted to monitor the remainder of the herd for evidence of new infections. During this period, the 14 other does and one buck were observed closely for clinical signs of PPR, including fever, nasal or ocular discharge, oral lesions, or diarrhea. No additional animals developed clinical illness, suggesting that early isolation of the index case was effective in preventing immediate spread. However, due to logistical and resource constraints, serologic screening and RT-PCR testing of the apparently healthy cohort animals were not performed, and the presence of subclinical or incubating infections could not be ruled out. Following the recovery of the affected doe, the owner was counseled on the importance of preventive measures. Flock vaccination with the live attenuated PPR vaccine was strongly recommended and was scheduled. The recovered doe was kept in isolation for three weeks post-recovery, and the pen, feeding troughs, and water sources were disinfected using a 1% sodium hypochlorite solution. The owner was advised to implement strict biosecurity, including footbaths at entry points, restriction of animal movement, and proper disposal of bedding and manure from the isolation area to minimize environmental contamination and reinfection risk.

Limitations

Although this case report confirmed PPRV infection through RT-qPCR, lineage characterization of the virus was not performed due to the unavailability of sequencing facilities and lineage-specific RT-PCR reagents at the time of analysis. Such data would provide greater epidemiologic utility by revealing circulating strains, and future investigations will incorporate partial F- or N-gene sequencing to strengthen molecular surveillance and support eradication efforts. The affected herd was observed for 21 days following isolation of the index case, and no serological or PCR testing was performed on apparently healthy animals. This limited the ability to detect subclinical infections or accurately determine the extent of viral circulation within the flock. Future case reports should include follow-up laboratory testing of in-contact animals to strengthen epidemiological interpretation and improve understanding of PPR transmission dynamics.