CASE REPORT

Nervous disease associated with coccidiosis in young cattle

TF JUBB
University of Melbourne, Bovine Medical Unit, 145 Johnson St, Maffra, Victoria 3860

SUMMARY: Four cases are described of nervous disease associated with coccidiosis in
young cattle. Prodromal nystagmus, ventromedial strabismus, sternal or lateral recumbency .
with contortions of the head and neck, near normal interictal periods and palpable proctitis
were common findings. Differentiation from other nervous disorders in young cattle and
the pathogenesis of the nervous signs associated with coccidiosis are discussed. It is
suggested that the clinical picture is sufficiently distinctive to allow a diagnosis to be
made on clinical grounds alone.
Aust Vet J 65: 353-354

Introduction of illness. It was in lateral recumbency when examined and

Neurological signs are occasionally seen in association with
enteric coccidiosis in calves. It is well known in North America,
particularly Canada and northwestern United States and has
been termed nervous coccidiosis. To the author’s knowledge
the syndrome has not been described in Australia although
there are numerous verbal reports of its occurrence. The
clinical signs associated with 4 cases described in this report
were consistent and unique and enabled a clinical diagnosis
to be made. Many hypotheses on the pathogenesis of nervous
coccidiosis have been tested but excluded and the pathophy-
siological mechanisms are still to be resolved (Isler et a1 1987a).
Case Histories
Case I Case 1 had not died by this time, the 2 cases occurring within
A 9-month-old Hereford steer was found in lateral recum-
bency and unable to rise. The calf was bright and alert, well
grown and in good body condition. It was moderately de-
hydrated and had watery, brown-green diarrhoea. It appeared
relatively normal at first but when stimulated displayed clonic
spasm of all limbs. Preceding the seizures, horizontal nystag-
mus developed; the eyeballs rotated ventromedially as the
seizures commenced. It would stretch and bend its neck,
placing its head in various awkward positions, then become
opisthotonic. These seizures could be precipitated with only
mild stimulation, such as trying to sit the animal in sternal
recumbency. The seizures would not last for more than about
I minute. The calf appeared normal in the interictal periods,
being bright and alert and aware of its surroundings. Menace
and pupillary light reflexes were intact during these periods.
The faeces were observed to be blood stained, and a thickened,
roughened rectal wall was palpable. Large doses of oxytetra-
cycline (5 g) and thiamine (1 g) were administered. Other cows
and calves in the herd were not observed to be ill or scouring.
within 24 h the calf was normal. Two grams of oxytetracycline
was administered daily by intramuscular injection for the next
3 days, and 300 mg of thiamine was administered at 6-hourly
intervals for 6 treatments, by intramuscular injection. Large
numbers of Eimeria zurnii oocysts (4,85O,OOO/g of faeces)
were recovered, suggesting a diagnosis of nervous coccidiosis.
Strongyle eggs were present at 650 eggs/g of faeces. A hae-
mogram displayed a moderate left shift, there was mild hy-
poproteinaemia (albumin 17 g/l: normal 27-40 g/l) and an
elevated serum glucose (14.1 mM: normal 2.0-5.0 mM). CSF
collected from the lumbosacral space was normal. Faecal
thiaminase levels were low. On day 5 the calf was found dead.
It had been observed daily and had been normal until this
time. Gross and histopathological examination of the brain
did not identify a lesion. The remainder of the carcase was
not examined.
Case 2
A 9-month-old Jersey heifer had become severely ataxic. It
was one of about 30 dairy heifers, the only one showing signs
Australian Veterinary Journal, Vol. 65, No. 11, November, 1988
when stimulated to rise it staggered to its feet, took a few
paces and then crashed to the ground in seizure. The seizure
was very similar in character to those of case 1, with spasm
of the limbs and ventral rolling of the eyeballs. Horizontal
nystagmus was observed just before entering the convulsive
state. The head was twisted and screwed into different posi-
tions (Figure 1) until it came to lie back under the shoulder.
These seizures could be easily stimulated and would last about
30 sec; the calf was almost normal between seizures, except
for signs of exertion. The calf was straining and slightly
prolapsing a very red and inflamed rectum; the faeces were
brown-green and fluid. A diagnosis of nervous coccidiosis was
made. Because of the apparent success with the previous case,
treatment with thiamine and oxytetracycline was commenced.
4 days of each other. A haemogram showed changes consistent
with mild dehydration. Hypoalbuminaemia was present (22
g/l) and serum glucose levels were elevated (16.8 mM). The
heifer was dead within 24 h; a necropsy was not performed.
A faecal sample contained 51,000 E. zurnii oocysts and 150
strongyle eggdg.
Case 3
A nine-month-old Hereford heifer was examined because
of dysentery and seizures. It was very sick with profuse watery
green diarrhoea containing shreds of mucous membrane and
fibrin clots. The rectal mucosa felt thickened and corrugated.
When released from the clinical examination it ran around
the yard and then slumped to the ground in sternal recumbency
and tucked its chin down under its chest, with its eyes rolling
ventrally. It then rolled into lateral recumbency and assumed
an opisthotonic posture which continued for at least 1 min.
Further seizures could not be stimulated. A haemogram was
normal, hypoproteinaemia was present (albumin 14g/l) and
serum glucose was midly elevated (5.9 mM). A faecal sample
contained 1,235,000 coccidial oocysts/g. The heifer was treated
with trimethoprim-sulpha antibiotics and thiamine. It stopped
scouring in a few days but occasionally had seizures. This
heifer was ane of about 15 young cattle, the only one dis-
playing overt coccidial enteritis at the time. Two more enteric
cases soon followed and recovered quickly with treatment,
neither displaying nervous signs. The heifer became quite
debilitated over the next few weeks, but 6 weeks later was in
good health.
Case 4
A 12-month-old Friesian heifer had been treated with tri-
methoprim-sulpha antibiotics following a provisional clinical
diagnosis of enteric salmonellosis. The dysentery and toxaemic
signs disappeared within 48 h but the animal began to display
intermittent nervous signs. The owner had observed the heifer
to fall down in lateral recumbency, roll the eyes downward
and develop tetanic spasm of all limbs. A number of times
353

Figure 1. The heifer in case 2, demonstrating seizure activity,
with rotation of t h e head.
he had to correct the cast position of the heifer first thing in
the morning after finding her with head and neck folded back
beneath her body. She would get up as though nothing had
happened. Seven days after the first sign of enteritis the heifer
was almost normal, having recovered most of her body con-
dition, but with stimulation she would slump into sternal
recumbency and show ventral rotation of the eyeballs, but
not enter a complete spastic convulsion. She had displayed
intermittent nervous episodes during this week. Samples for
laboratory examination were not taken to confirm the original
diagnosis of salmonellosis; the dysentry could have been caused
by coccidia. At the time of the second examination, 7 days
later, cardinal signs and faecal consistency were normal. One
month later the calf was in good health and had not displayed
signs for a few weeks. N o other cattle on this 150-cow dairy
farm had shown any signs of coccidiosis or salmonellosis over
this period.
Differential Diagnosis
Nervous coccidiosis must be differentiated from lead poi-
soning, PolioencePhaiomalacia, hypovitaminosis A, brain ab-
scess, salt poisoning, listeriosis, sporadic bovine encephalo-
myelitis, rabies, enterotoxaemia, idiopathic epilepsy and the
hypomagnesaemic convulsions seen occasiondly in -calves on
a whole milk diet. A number of clinical signs were peculiar
to the cases of nervous coccidiosis described above: the seizure
episodes were separated by periods of normalcy; all cranial
nerve reflexes were normal between seizures; ventromedial
eyeball rotation occurred during the seizure, and proctitis,
palpable as a thick, roughened rectal mucosa was present in
the 3 cases in which a rectal examination was performed. The
peculiar head postures adopted during the seizures would help
in supporting the diagnosis at clinical examination. Other
diseases affecting the nervous system of young cattle have
blindness, lack of normalcy in the interictal periods, somno-
lence, cranial nerve dysfunction or dietary aberrance as part
of the clinical picture, none of which occur with nervous
354
coccidiosis. With idiopathic epilepsy, and only rarely with lead
poisoning and polioencephalomalacia, would the seizures be
separated by periods of near normalcy. In the last 2 diseases
the animals should be blind. Dorsomedial strabismus may
occur with polioencephalomalacia.
Discussion
The literature on nervous coccidiosis has recently been re-
viewed by lsler et al (1987a), including reports from Europe
and North America. The syndrome can occur in up to 30%,
occasionally more, of calves affected with the enteric form.
Both E. bovis and E.zurnii have been associated with the
disease. The case fatality rate is very high in animals affected
with the nervous form, inspite of intensive supportive therapy.
Most calves showing only enteric signs of coccidiosis will
survive, unless they are unusually severely affected. It is seen
most frequently in feedlot operations and in the winter time.
Various hypotheses have been proposed for the pathogenesis
of the neurological signs associated with bovine enteric coc-
cidiosis. The role of serum disturbances of Na, K, Ca, P and
Mg, vitamin A and 3 deficiencies, uraemia, anaemia, toxaemia
and changes in intestinal bacterial flora have recently been
discredited (Isler ef al 1987a). There has been no evidence to
suggest that concurrent lead toxicity or bacterial meningoen-
cephalitis is associated with nervous coccidiosis. A labile neu-
rotoxin has been identified in the serum of calves with nervous
coccidiosis (Isler et al 1987b). Its pathogenetic significance is
unknown, but a coccidial toxin that effects copper deficient,
hyperglycaemic calves is the obvious hypothesis emerging from
research findings (Isler et a1 1987 a,b,c). It has been estimated
that 10,OOO cattle in the United States may die annually from
this disease (Fitzgerald 1975). Its prevalence in Australia is
much lower because of different husbandry and environmental
conditions; nevertheless, bovine enteric coccidiosis is not un-
commonly diagnosed. The 4 cases described in this report
were isolated cases on separate farms, all occurring in the
winter, the first 3 over a 2-week period. In no case were other
herd members showing signs of enteric coccidiosis a t the time
of presentation and only in case 3 did other herd members
develop overt clinical coccidiosis. Following laboratory con-
firmation of the first case, the next 3 were diagnosed on the
consistent clinical presentation. From the circumstances of
occurrence of these 4 cases it seems likely that the diagnosis
may easily be overlooked by veterinarians in this country, but
the nervous signs displayed are sufficiently unique for a clinical
diagnosis to be made.
Acknowledgments
The author extends his thanks to the professional and technical
staff of the Regional Veterinary Laboratory at Bairnsdale for the
laboratory information provided on the cases.
References
Fitzgerald PR (1975) - Bovine Pract 10: 28
Isler CM, Bellamy JEC and Wobeser G A (1987a) - Can J Vet Res
51: 261
Isler CM, Bellamy JEC and Wobeser GA (1987b) - Can J Vet Res
51: 253
Isler CM, Bellamy JEC and Wobeser GA (1987~)- Can J Vef Res
51: 271
(Accepted f o r publication 3 June 1988)
Australian Veterinary Journal, Vol. 65, No. 11, November, 1988