FAMACHA Scoring: How to Check Sheep and Goats for Parasite Anemia, and What Each Score Means

FAMACHA is an on-farm anemia test for sheep and goats: a trained person rolls down the lower eyelid, compares the colour of the membrane underneath with a laminated FAMACHA card, and gives the animal a score from 1 (not anemic) to 5 (severely anemic). Because the barber pole worm (Haemonchus contortus) feeds on blood, that score is a practical way to decide which individual animals need deworming and which can safely be left alone, instead of treating the whole flock on a calendar.

The system was developed in South Africa, introduced to the United States in 2002, and validated there for sheep, goats, llamas and alpacas by researchers now organised as the American Consortium for Small Ruminant Parasite Control (ACSRPC). You cannot simply buy the card: producers have to complete an approved training course first, and Louisiana State University is the only distributor in North America. This guide covers what the five scores mean, the scoring technique, how often to check, and what FAMACHA cannot tell you. When you are ready to score a whole group, the eye-score round on Creatures (free with a Creatures account) walks the flock with you and saves each score to the animal’s record.

The eye score is one piece of a parasite program, not the whole thing. Deworming decisions, fecal egg counts and dewormer resistance are covered in our sheep deworming guide and goat deworming guide; this page is about the eye score itself. Your veterinarian sets the treatment plan.

What FAMACHA is and why it exists

The name comes from its developer. FAMACHA stands for Faffa Malan Chart, after South African veterinarian Dr. Faffa Malan, who with colleagues from the University of Pretoria developed the system in the 1990s as wireworm (their name for the barber pole worm) became resistant to dewormers, according to their 2015 conference abstract. A 2006 USDA Agricultural Research Service article describes the card as five photographs of sheep and goat eyelids at different stages of Haemonchus infection.

The problem it solves is dewormer resistance. According to the FAMACHA Information Guide used by the ACSRPC, years of overusing dewormers left many farms with worms resistant to every drug group, while most adult sheep and goats can actually cope with Haemonchus and only a minority cannot. If you treat only that minority, the worms in the untreated animals (the refugia) stay drug-susceptible and dilute the resistant survivors. The consortium’s open letter to producers puts it plainly: worm burdens are uneven, with roughly 20 to 30% of animals carrying about 70 to 80% of the worms, and what held selective treatment back was the lack of a simple field test for anemia. The same letter reports that South African trials cut dewormer treatments by up to 90% compared with earlier years.

The card works because blood-feeding worms make an animal anemic, and anemia shows as paleness in the mucous membranes of the eye. The ACSRPC targeted selective treatment fact sheet ties each card category to a packed cell volume (the share of the blood made up of red cells): a score of 1 corresponds to a healthy PCV above 28%, and a score of 5 to a dangerously low PCV below 12%. In a field study of 847 sheep and 537 goats in Arkansas, Georgia, Louisiana, Florida and the US Virgin Islands, ARS reported the chart was 92% accurate.

The five FAMACHA scores and what each one means

Every FAMACHA card shows five categories. The descriptions below follow the ACSRPC’s treatment categories, not a substitute for the card: the consortium is explicit that you should never print, copy or recreate the card colours, or score from memory of them.

• Score 1: not anemic, with a healthy packed cell volume. No treatment.
• Score 2: little or no anemia. No treatment.
• Score 3: borderline, and in research only occasionally anemic. Maybe, depending on the animal and the flock.
• Score 4: anemic. Treat with an effective dewormer.
• Score 5: severely anemic, with a dangerously low packed cell volume. Treat, and call your veterinarian.

The interesting decisions all sit at score 3. The fact sheet explains the trade-off: treating every 3 makes the system most sensitive, so you rarely miss an anemic animal, but research shows 3s are only rarely anemic, so treating them all greatly increases the number of doses and eats into refugia. The Information Guide says treatment can safely be withheld from adults until they score 4 or 5, but only if all of these hold:

• the animals are in good body condition and good general health;
• they are examined frequently, for example every 2 to 3 weeks;
• good husbandry catches animals that need help between checks (lagging behind, unthrifty, bottle jaw).

If any of those conditions is not met, the guide advises treating 3s as well. It also lists cases where 3s should always be treated: lambs and kids, which have small blood volumes and can slide from moderate to severe anemia quickly, and ewes and does from about two weeks before lambing or kidding through lactation, when their immunity to worms drops. The fact sheet adds that it is reasonable to treat 3s when scores are trending higher than last time, when more than 10% of the group scores 4 or above, when you cannot get back to recheck in time, or when nutrition is poor or reinfection risk is high.

Two signs override the card. Any animal with bottle jaw (a soft swelling under the jaw) should be treated whether its eyelids look pale or not. And a score of 5, an animal that is weak, lagging or down, or bottle jaw with a high score is a reason to call a veterinarian now, because a severely anemic animal can need more than a dewormer.

How to FAMACHA score a sheep or goat

The technique is the main reason training is mandatory. Gentle, practised handling matters as much as the card. In the Do’s and Don’ts of FAMACHA scoring from the University of Rhode Island, the method is taught as four steps:

1. Cover. Roll the upper eyelid down over the eyeball.
2. Push. Press gently down on the eyeball through the closed lid. With the right pressure, the upper eyelashes curl up over your thumb.
3. Pull. Pull the lower eyelid down.
4. Pop. The bed of mucous membranes pops into view. Score that bed, not the inner surface of the lower eyelid.

The same guidance adds a handful of rules that make the difference between a useful score and a misleading one:

• Score both eyes. They can differ. Use the higher score, so any error is on the side of caution.
• No half scores. If you are between two categories, round up.
• Match the pinkest part of the membranes to the card, as the New England FAMACHA guide describes.
• Use full daylight. Score outside in direct natural light, or at a barn door or window where daylight comes straight in. It does not need to be sunny. Do not score in shade or under artificial light, and do not let your own body shade the eye.
• Do not just pull the lower lid down. Without the cover and push steps, the membranes do not expose properly.
• Always use the card. Never score from memory or from a printout of the card found online.

Handling can be as simple as having a helper hold each animal or crowding a small group into a pen, and a head gate or raceway makes larger groups quicker. FAMACHA fits naturally alongside other handling jobs such as weighing, sorting, body condition scoring and vaccinating. The Information Guide notes that with good facilities and practice, South African farms report checking up to 500 sheep an hour. Llamas and alpacas are harder to score than sheep and goats, and larger or more spirited camelids may need a chute for safety.

Looking after the card

The card fades in light, so store it somewhere dark between uses. Sources differ on how long a card lasts: the URI Do’s and Don’ts says to replace it after 12 to 24 months of use depending on use and storage, the Information Guide says after 1 year, and the fact sheet says after several years depending on use and storage. The practical answer they all point toward is the same: keep a second card stored in the dark, compare the two every few months, and replace the working card when it looks faded next to the spare.

Getting trained and getting a card

Producers have to complete approved FAMACHA training before they can buy a card. Veterinarians can buy cards without the course, although training is still recommended, and vets and certified instructors who resell cards are expected to train their clients first. The card ordering notice from LSU says non-veterinarians must show proof of proper instruction to buy one.

There are two routes:

• In-person workshops, run by extension programs and certified instructors across the US. The ACSRPC keeps a list of certified FAMACHA instructors.
• Online certification, first offered by the University of Rhode Island in March 2016 and now available from several institutions, including a Spanish-language course. According to the ACSRPC’s online FAMACHA certification page, you watch training videos on integrated parasite management and technique, complete a quiz or survey, and submit a video of yourself scoring correctly. Once it is approved you receive a Certificate of Competence and can buy a card. The minimum age is 13.

Training also covers the parts of parasite control that sit around the score, which is why the consortium’s open letter warns that misunderstanding the system can lead to disappointing results and animal deaths.

How often to FAMACHA score

Regular checks are what make the system work, because the whole point is to catch animals before anemia becomes severe. The URI guidance sets the rhythm by how the group is scoring:

• Fewer than 10% at 4 or 5: every 2 weeks during peak barber pole worm season (warm, moist weather, usually summer).
• More than 10% at 4 or 5: recheck weekly.
• Outside peak season: the interval can stretch to every 3 to 4 weeks.
• Winter: checks can be further apart, but ewes and does around lambing or kidding should be checked more often, because worms that were dormant can resume development at that time.

The Information Guide suggests starting in spring, or several weeks before lambing or kidding, at every 2 to 3 weeks. It also treats the trend as an early warning: a fast drop in the number of 1s with a matching rise in 2s and 3s tends to come before a period of heavy Haemonchus challenge. If 5 to 10% or more of the group scores 4 or 5 at one check, it may be advisable to treat all animals at 3 to 5 and move to a different pasture if you have one, in consultation with your veterinarian.

For a large flock, the guide allows a random sample of 50 animals. If 1s and 2s together make up more than 80% (preferably 90%) of the sample and none score 4 or 5, it is unlikely to be dangerous to skip checking everyone that time. If any score 4 or 5, or 3s exceed 10 to 20%, check the whole group. Whatever the schedule, pull out and score any animal that lags behind the flock.

Sheep, goats, lambs and kids: who needs a lower threshold

The card and technique are the same for sheep and goats, but the guidance is not identical:

• Goats. The fact sheet notes that goats tend to have lower packed cell volumes than sheep, and that it is not uncommon to deworm any goat scoring 3 or higher. Lactating does can stay anemic after treatment because milk production competes with making new blood.
• Lambs and kids. Small blood volume and fast progression mean 3s should be treated.
• Periparturient ewes and does. From about two weeks before birth through lactation, especially young females nursing multiples, treat 3s.
• Hair sheep and parasite-tolerant lines. FAMACHA research in the US has included Katahdin lambs, in a Virginia Tech led study comparing their eye scores with fecal egg counts. A breed’s reputation for tolerance does not replace checking; the score is about the individual, not the breed label.

The same eye score works whether you run Tunis or Hampshire sheep, Nubian dairy goats or Pygora fiber goats. What changes is how you weigh a 3, and that decision belongs to you and your veterinarian.

What FAMACHA cannot tell you

The card reads anemia, and only anemia. The Information Guide is blunt that the system can only monitor Haemonchus and cannot be used on its own.

It misses worms that do not feed on blood. Bankrupt worm (Trichostrongylus) and brown stomach worm (Teladorsagia) cause scours and poor growth without much blood loss. Where they are the main problem, FAMACHA will not flag the animals that need help. The ACSRPC’s Five Point Check, developed by the same South African researchers, extends the eye score with four more checkpoints:

1. Eye: the FAMACHA score.
2. Jaw: bottle jaw.
3. Back: body condition score.
4. Tail: fecal soiling or dags.
5. Nose: nasal discharge, often from nasal bots. In goats this point is sometimes swapped for coat condition.

Pale is not always worms. The Information Guide lists other causes of anemia, including liver fluke, external parasites, blood parasites, bacterial and viral infections and nutritional deficiencies. The fact sheet adds Johne’s disease, caseous lymphadenitis and coccidia, and suggests running fecal egg counts on the animals scoring 4 or 5 to confirm worms are the cause on your farm.

Red is not always healthy. Some conditions make the membranes look redder than they are and can hide anemia: hot or dusty conditions that irritate the eyes, driving animals a long way without a rest, fever, infectious eye disease and circulatory failure.

It assumes your dewormer works. With FAMACHA, animals are allowed to become anemic before treatment, so an ineffective drug is dangerous. The Information Guide says to test which drugs still work on your farm before relying on the system, using a fecal egg count reduction test with your veterinarian or a lab-based larval development assay. Our deworming guides for sheep and goats explain those tests and refugia in detail.

When a score does not improve. Langston University’s Steve Hart writes in the ACSRPC’s explainer on scores that stay high that an animal at 4 or 5 should improve by at least one score two weeks after deworming. If it does not, the likely reasons, from most to least common, include lactation competing with blood production, heavy pasture contamination, dewormer resistance (often brought in with new animals), liver flukes, sucking lice, coccidiosis and Johne’s disease. Each of those is a conversation with your veterinarian, not a reason to dose again.

Turning scores into better animals

A single round tells you who needs help today. A season of scores tells you which animals keep needing help, and that is where FAMACHA pays off long term. The Information Guide notes that both resistance (keeping worm numbers down) and resilience (coping with worms) are moderately heritable, so you can select for them. Its rule of thumb: animals needing two more treatments than the flock’s average should be considered for culling, and those needing three or more extra should be culled.

That only works if every score and every treatment is written down against the right animal. The guide says treated animals should be permanently marked unless individual animal records are kept, and the ACSRPC publishes a paper FAMACHA anemia record for tallying scores by date. If you already keep a sheep flock record book or follow our goat record keeping guide, the eye score belongs right next to weights, body condition and lambing or kidding dates.

Running an eye-score round on Creatures

Creatures has a free eye-score round built for exactly this job: walking a group, entering a score for each animal, and ending with a summary instead of a page of tally marks. You score with your own FAMACHA card in daylight; Creatures does not show card colours and reminds you that scores need training to be reliable.

What you need. A free Creatures account and an individual profile for each sheep or goat (llamas and alpacas work too). A round needs individual animal profiles, so animals tracked only as a head count in a group cannot be scored one by one. If you are starting from scratch, add each animal and put them in a group, as described in creating and managing animal groups.

Starting a round. Open the eye-score round from the Eye-score round button on the animals tab of your profile or your farm’s profile, or on a group’s page. Choose whose animals (yours, or a farm you manage), then choose who to score: one of your groups, or all of your sheep or all of your goats.

Scoring each animal. For each animal the round shows its name, tag, sex and age, its previous FAMACHA scores with dates, and its last recorded medication (including a milk hold date if one was recorded). You tap a score from 1 (least anemic) to 5 (most anemic). You can find an animal by name or tag as it comes through the chute, skip one you cannot catch, add a note (say, “bottle jaw” or “thin”), and move to the next. If the signal drops in a far paddock, scores wait on your phone and the round shows which ones still need to save. Each score is saved as a FAMACHA record on that animal’s profile, alongside its other health and medical records.

The round summary. When you finish, the summary shows how many animals scored 1, 2, 3, 4 and 5 and what share of the scored group each represents, which animals scored higher than last time, and any medication recorded within 30 days for animals now at 4 or 5. If more than 10% of the scored animals are at 4 or 5, it flags that the programme suggests checking weekly. It links straight to the ACSRPC guidance used in this article.

Recording treatments. From the summary you can select the animals you treated (there is a shortcut to select everyone at 4 or 5) and open one medication record for all of them, linked back to the round. Enter what your veterinarian advised; Creatures does not suggest products or doses.

The next round. For a sheep or goat group, one tap sets a reminder every 2 weeks, which you can pause, resume or change as the season turns (the summary notes the programme’s 3 to 4 week off-season interval). Ready-made care plans cover sheep and goat eye-score rounds and a combined FAMACHA and fecal egg count monitoring plan; see care plans for animal groups and reminders and upcoming care.

Scoring days are also a good time to track condition. If you do not have scales, the free sheep weight calculator and goat weight calculator estimate weight from tape measurements, and the sheep group care records guide shows how to log flock-wide work while keeping individual exceptions visible.

Frequently asked questions

What does FAMACHA stand for?

Faffa Malan Chart. It is named after Dr. Faffa Malan, the South African veterinarian who developed the system with University of Pretoria colleagues in the 1990s.

Can I use FAMACHA without training?

Not properly, and in North America you cannot buy a card as a producer without it. LSU sells cards to non-veterinarians only with proof of training, and the ACSRPC warns that untrained use can lead to animal deaths. Online certification is available if there is no workshop near you.

Should I deworm a sheep or goat with a FAMACHA score of 3?

It depends on the animal. ACSRPC guidance treats 3s in lambs, kids and ewes or does around birth and through lactation, and in any animal that is thin, unwell, trending higher or not going to be rechecked soon. Healthy adults in good condition that are checked every 2 to 3 weeks can often wait. Goats are more often treated at 3 than sheep. Agree your threshold with your veterinarian.

How often should I FAMACHA score?

About every 2 weeks in warm, wet worm season, weekly if more than 10% of the group scores 4 or 5, and every 3 to 4 weeks in cooler months. Check ewes and does more often around lambing and kidding.

Can I print a FAMACHA card or use a photo of one?

No. The ACSRPC says never to reproduce the card colours, score from a printout or score from memory. Colours on a screen or home printer are not calibrated, and a wrong match can mean a missed anemic animal.

Does FAMACHA work for llamas and alpacas?

Yes. It was validated for camelids in the US, though they are harder to restrain and score. The Creatures eye-score round accepts llamas and alpacas as well as sheep and goats.

Do this next on Creatures

Running eye-score rounds this season? These are the steps most flock and herd keepers take next.