What is FAMACHA?
FAMACHA scoring is a practical tool used to estimate likelihood of anemia caused by blood-feeding parasites, most commonly Haemonchus contortus (barber pole worm).
It is primarily used in:
- Goats
- Sheep
- Occasionally camelids, under veterinary guidance
FAMACHA does not detect all parasites and is not appropriate for all species.
How FAMACHA works
FAMACHA scoring compares the color of the mucous membrane of the lower eyelid to a standardized color chart.
- Redder inner eyelid mucosa suggest adequate red blood cell levels
- Paler inner eyelids mucosa suggest anemia, often due to heavy parasite burdens
Because Haemonchus feeds on blood, anemia can develop even when animals appear otherwise normal.
What FAMACHA is good at
FAMACHA helps owners:
- Identify animals at higher risk for parasite-related anemia
- Make targeted treatment decisions
- Reduce unnecessary deworming
- Slow the development of parasite resistance
Used correctly, it protects both animal health and dewormer effectiveness.
What FAMACHA does NOT tell you
This is where many misunderstandings occur.
FAMACHA does not:
- Measure total parasite burden
- Detect non-blood-feeding parasites
- Diagnose disease
- Replace fecal testing
- Explain all causes of weakness or weight loss
Nutrition, mineral deficiencies, chronic disease, other parasites, and more can also cause anemia. FAMACHA scoring is a good tool to help you catch possible anemia early so you can consult with your veterinarian about how to help your animal.
How to perform a basic FAMACHA check
- Restrain the animal calmly
- Gently push down the upper eyelid and roll down the lower eyelid (do not put much pressure on the eyeball)
- Compare the color to the FAMACHA chart in good natural light
- Assign a score immediately
Scores typically range from 1 (red, healthy) to 5 (very pale, high concern).
Interpreting scores (simplified)
- Score 1–2: Adequate red blood cell levels
- Score 3: Borderline; consider body condition, age, season, and trends
- Score 4–5: Likely anemia; veterinary guidance recommended
Never base treatment decisions on FAMACHA alone. Consult your veterinarian if you are concerned! The way I learned how to remember what numbers are good and bad was the phrase “five is fatal”.
Common beginner mistakes
- Treating all animals instead of targeted individuals
- Using FAMACHA as the only parasite assessment tool
- Scoring in poor lighting
- Not rechecking after treatment
- Ignoring body condition or growth rates
FAMACHA works best when combined with other monitoring tools.
Best practices for responsible use
- Combine FAMACHA with:
- Body condition scoring
- Growth or production monitoring
- Fecal testing when available
- Keep simple records on scores
- Consult with your veterinarian for a plan for treatment if needed
When to involve your veterinarian
Contact your veterinarian if you see:
- Multiple animals with pale eyelids
- Poor body condition alongside anemia
- A bad score on an individual
Key takeaway
FAMACHA is a screening tool, not a treatment plan. When used correctly and thoughtfully, it helps owners make better decisions and supports long-term parasite control.
Download our FAMACHA Scoring Guide for a visual reference and simple record list.