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Young ram back on his feet after months of treatment by UF veterinarians

By Sarah Carey

A 2-year-old Katahdin ram named Lionel, who reportedly loved listening to Frank Sinatra and watching the Barbie movie while a patient, is back home with the University of Florida-IFAS sheep herd, after an altercation with another ram in early December left him with spinal injuries and unable to walk.

Discharged from UF’s Large Animal Hospital on Jan. 31, Lionel was clearly excited to exit his pen, which he did with help from several members of his care team — who kept him under good control with a harness while he posed for pictures prior to being loaded into a trailer for transport back to the sheep unit.

“He will continue his recovery process back at the sheep unit, but he will continue to be housed separately from the other rams for several months while we watch how he progresses,” said Brittany Diehl, D.V.M., a clinical assistant professor at UF’s College of Veterinary Medicine and its small ruminant extension veterinarian. “We are very thankful for the team effort that has taken place to provide Lionel with such great care and get him back on his feet again — literally.”

The Katahdin breed has grown in popularity throughout the southeastern United States in the last 10 to 15 years, Diehl said, adding that the breed was one UF has chosen to focus heavily on at the sheep unit due to its applicability to other outside producers for the purposes of teaching, extension and research.

A valuable member of the sheep unit due to his breed and phenotypic characteristics, which includes natural resistance to a specific parasite of concern to small ruminants,  Lionel was found in his pasture on Dec. 5 showing signs of weakness in his front and back legs and unable to stand. Soon after, Diehl and her team decided the ram’s injuries were beyond what they could manage in the field.

“Lionel and another ram he is typically housed with were segregated off and fighting with one another when they were found by the sheep unit staff that morning,” she said. “It’s known that rams fight from time to time, and since it was during the fall — breeding season was over for us, but the ewes who were not pregnant are still cycling — that was the most likely reason for his injury.”

Diehl then contacted the UF Large Animal Hospital, located across the street from the sheep unit on the southwest side of the UF campus, and Lionel was transported there for a full set of diagnostic tests.

“We had a pretty good idea of his diagnosis; we just didn’t know the severity of it until the imaging tests were completed and we could confirm,” she said.

Upon admission, the hospital’s medical team also suspected that Lionel had sustained a spinal cord injury or possibly was experiencing an infection of the spinal cord.

“We knew right away that it was something serious, as he was unable to walk and had delayed spinal reflexes to his limbs, which meant that the signals that travel along the spinal cord to the legs were not getting there normally,” said Marcela Valdes Soto, D.V.M., an intern with the large animal medicine service who was involved in the case.

Veterinarians conducted a neurological evaluation and a lumbosacral spinal tap to get a sample of cerebrospinal fluid. Fluid analysis showed mild inflammation, but no evidence of infection. The results of a CT evaluation, which included Lionel’s head and bones that make up the spine all the way to the pelvis, showed fractures in the neck bones associated with an area of suspected spinal cord compression.

An additional MRI, recommended by the hospital’s neurology service, allowed for a closer investigation of the soft tissues of the neck and spinal cord. The results showed inflammation of the muscles in the neck and confirmed mild compression of the spinal cord, which explained why Lionel had weakness in all four legs.

“Due to the mild nature of the spinal cord compression and relative stability of the fractures in the neck vertebrae, we decided to do medical management and physical therapy rather than pursuing surgery,” Valdes Soto said.

Lionel, who weighs approximately 175 pounds,was treated with pain and anti-inflammatory medications to ensure he remained comfortable. During the first few weeks of hospitalization, which Lionel spent mostly lying down, the care team made sure he had plenty of clean, dry bedding and wasn’t sitting in the same position for more than a few hours at a time.

“These practices are vital to the care of a recumbent animal to prevent the development of pressure sores,” Valdes Soto said. “At first, he wasn’t really interested in eating or drinking, so we started offering a variety of hay types, as well as molasses-flavored water. The sheep unit staff made sure we had a supply of his normal grain, which was always his favorite. We also found that he enjoyed fresh grass and started collecting fresh grass for him to eat while receiving his therapies.”

Weeks of rehabilitation ensued, spearheaded by the UF Small Animal Hospital’s integrative and mobility medicine service, which primarily works with dogs and cats but occasionally assists with large animals.

“When our team, consisting of myself and our two residents, Dr. John Schwartz and Dr. Lizeth Montano, first began working with Lionel, he would only walk with the help of four people in sling support and had significant neck pain and muscle spasms,” said Christina Montalbano, V.M.D., a clinical assistant professor with the service.

Lionel initially received passive range of motion exercises of his limbs to prevent contracture, along with acupuncture, transcutaneous electrical nerve stimulation, or TENS, and therapeutic laser treatment to help with his neck pain. As his pain levels improved, his rehabilitation plan began to focus on strengthening therapeutic exercises, including down-to-standing transitions and weight shifting while standing.

His caregivers eventually stopped using a sling and moved to a harness, which was originally designed for large dogs but was adjusted to Lionel’s size. Once he was able to get up and walk with only a little support from the harness, his therapy sessions moved from his stall to an outdoor pen where he could work on walking longer distances — occasionally trying to make a break for the gate, Montalbano said.

Integrative medicine specialists performing the various PT exercises kept Lionel distracted by playing music and movies on their phones, and relayed that he appeared to have a special fondness for Frank Sinatra and the Barbie movie.

“Sinatra’s soothing melodies relaxed Lionel, while the colorful and upbeat Barbie scenes motivated him to work hard,” Montalbano said.

Recovery from an injury like Lionel’s can be unpredictable, she added.

“His excellent outcome is thanks to a collaborative team approach that involved multiple services, doctors and veterinary students in his care,” Montalbano said.

The large animal medical team also acknowledged the team effort that made Lionel’s recovery possible.

“This effort included not only doctors from seven different services, but also the hard work of many dedicated veterinary technicians and veterinary students,” said Lisa Edwards, D.V.M., a clinical assistant professor of large animal medicine who oversaw much of Lionel’s care. “During the initial weeks of hospitalization, we needed at least four people to put Lionel in the sling, so without everyone’s help, we wouldn’t have been able to provide the level of care that he received.”