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Veterinary Treatment of Llamas and Alpacas

I would like to dedicate this book to Joy Duncanson. As a mother she taught me many
things, one of which was compassion for others and for animals. I was extremely lucky
to have such a loving mother.
Veterinary Treatment of Llamas and Alpacas

Dr Graham R. Duncanson BVSc, Msc (VetGP), DProf, FRCVS

Equine and Farm Animal Practitioner,


Private Veterinary Practice, UK
CABI is a trading name of CAB International
CABI CABI
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E-mail: cabi@cabi.org E-mail: cabi-nao@cabi.org
Website: www.cabi.org
G.R. Duncanson 2012. All rights reserved. No part of this publication
may be reproduced in any form or by any means, electronically,
mechanically, by photocopying, recording or otherwise, without the prior
permission of the copyright owners.
A catalogue record for this book is available from the British Library,
London, UK.
Library of Congress Cataloging-in-Publication Data
Duncanson, Graham R.
Veterinary treatment of llamas and alpacas / Graham R. Duncanson.
p. cm.
Includes bibliographical references and index.
ISBN 978-1-78064-006-8 (alk. paper)
1. Llamas--Diseases. 2. Alpaca--Diseases. 3. Llamas--Surgery.
4. Alpaca--Surgery. I. C.A.B. International. II. Title.
[DNLM: 1. Animal Diseases--therapy. 2. Camelids, New World.
3. Animal Diseases--diagnosis. 4. Surgical Procedures,
Operative--veterinary. SF 997.5.C3]
SF997.5.C3D86 2012
636.2'966--dc23
2012001020

ISBN-13: 978 1 78064 006 8

Commissioning editor: Sarah Hulbert


Editorial assistant: Alexandra Lainsbury
Production editor: Shankari Wilford

Typeset by SPi, Pondicherry, India.


Printed and bound in the UK by CPI Group (UK) Ltd, Croydon, CR0 4YY.
Contents

Foreword vii
Acknowledgements ix
Glossary xi
Abbreviations xvii
1 Animal Husbandry 1
2 Nutrition and Metabolic Diseases 13
3 Examination 22
4 Sample Taking and Simple Diagnostic Tests 32
5 Veterinary Equipment 44
6 Veterinary Medicines 48
7 Vaccines 63
8 Sedation, Anaesthesia, Surgical Conditions and Euthanasia 68
9 Medicine and Surgery of the Gastroenteric System 80
10 Medicine and Surgery of the Respiratory and Circulatory Systems 112
11 Medicine and Surgery of the Urino-Genital System 121
12 Medicine and Surgery of the Neurological System 145
13 Medicine and Surgery of the Locomotory System 153
14 Skin Conditions 157
15 Cause of Sudden Death and Post-Mortem Technique 168
16 Poisons 175
17 Zoonotic Diseases 214
References 225
Index 229

v
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Foreword

The New World camelids are a collective group inclusive of llamas, alpacas, guanacos and
vicunas, all originating in Central America. They are all members of the Camelidae family.
Llamas are traditionally pack animals and are increasingly found as companion animals in the
UK. While guanacos and vicunas are still scarce in the UK, alpacas are on the increase and are
primarily kept for their excellent fibre. Camelid numbers are rising but is our veterinary knowl-
edge keeping up? As a veterinary student I feel we are taught very little about the eccentricity
of the camelids but I suspect our graduated counterparts may sometimes fight back waves of
panic as an unusual looking fluffy sheep is produced for their examination. While a practi-
tioner cannot be expected to know everything at once, some respect from clients must be
earned through basic knowledge of all our patients. This unusual book should give the reader
the confidence to take on the majority of camelid-related cases.
Camelids are of increasing interest due to the recent discovery of their unique immune
system. It is thought that llamas unusually small antibodies, used by the immune system to
identify and counteract bacteria and viruses, could provide new and improved therapies for
diseases including cancer, Alzheimers and diabetes. Llamas and their camel relatives have
been found to have antibodies that are 90 percent smaller than the antibodies of humans,
allowing the immune system fighters to better target invading bacteria and viruses. The
reduced size could also improve drug delivery as antibodies could not only be administered
by injection but also orally or by inhaler. Bacterial growth of these antibodies could also lower
production costs. While not yet proven to be a spitting superhero, the llama is certainly becom-
ing more popular here so the required demand for knowledge of their veterinary care should
be met.
Camelids, too are vulnerable to infectious and non-infectious diseases as has been shown
by recent concerns over their susceptibility to tuberculosis. While arguments rage over how
the issue of bovine TB is to be solved in the UK it must not be forgotten that camelids are also
involved in the argument. It is well recognised that viruses, bacteria and parasites are capable
of changing their structures and re-emerging to present new problems for their animal hosts
and therefore local veterinary officers. This book will provide the knowledge necessary for the
veterinary surgeon to treat the arising problems and the owner to be better aware of potential
problems that may occur within their herd.
My father cant help but demonstrate his enthusiasm for life which is captured in this
book making it an invigorating read. Taking every opportunity for a holiday do look out for

vii
viii Foreword

the holiday snaps taken in the pretext of work. Having inherited some of his eccentricity and
all of his enthusiasm for life this book has made me more excited to get out into the world and
tract down and treat all the unusual creatures it provides. As a student I know I still have so
much to learn but it is reassuring to know that the thirst for knowledge goes way into the years
when you qualify for a bus pass! I really admire my dads continued professional development
and I hope I have the energy to do half as good a job.
Amelia Duncanson
BA Hons Cantab
Acknowledgements

I would like to record my thanks to all the members of the British Veterinary Camelid Society,
past and present who have shared their wide knowledge of camelids with me and made the
writing of this book possible. I hope they will advise me of any errors or omissions so that a
second edition will be more comprehensive.
I would also like to thank Ann Nickerson and Maria Contreras for their pictures. Finally,
I would like to thank the 400 camels who let me blood test them in record time on the morning
of 14th February 1967. This started my interest in these amazing animals and lead to my passion
for their smaller cousins.

ix
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Glossary

Abortion: the premature birth of young.


Annual: a plant which grows from seed, owers and dies within a year.
Anthelmintics: drugs that expel parasitic worms from the body, generally by paralysing or
starving them.
Antigen: a molecule or part of a molecule that is recognized by components of the host im-
mune system.
Autosome chromosome: a non-sex chromosome.
Awn: a bristle or hair-like appendage to a fruit or to a glume, as in barley and some other
grasses.
Bacteraemia: bacteria in the blood.
Base pairs: in DNA the four bases pair up to form the internal structure of DNA, adenine
with guanine and thymine with cysteine.
Biennial: a plant which owers and dies in the second year after growing from a seed.
Bradycardia: decrease in heart rate.
Bruxism: grinding of teeth.
Calculi: stones formed in the urinary system.
Cerebral: relating to the cerebrum, the largest part of the brain.
Cestodes: parasitic atworms, commonly called tapeworms, which usually live in the diges-
tive tract of vertebrates as adults and in bodies of various intermediate hosts as juvenile
stages.
Codon: 3-nucleotide sequences that encode a specic single amino acid.
Colitis: inammation of the colon; often used to describe an inammation of the large intes-
tine.
Coma: profound unconsciousness from which the patient cannot be roused.
Congestion: the presence of an abnormal amount of blood in an organ or part.
Contusions: severe bruises.
Convulsion: a violent involuntary contraction of muscles.
Corm: underground bulbous root.
Cria: a young South American camelid (SAC) in its rst year.
Cryptorchid: rig.
Cystitis: inammation of the bladder.
Deciduous plants: those which shed all their leaves annually.

xi
xii Glossary

Detoxicate: to render a poison harmless.


Distension: the lling of a hollow organ to more than its usual capacity.
Diuresis: excessive urination.
DNA ngerprinting: much like the ngerprint used in human identication, but done with
unique DNA characters for each individual animal. Utilizes PCR to replicate small sam-
ples.
Drenching: giving an anthelmintic dose by mouth.
Dysentery: an illness characterized by diarrhoea with blood in the faeces.
Dysphagia: difculty in swallowing.
Dysphonia: hoarseness heard when vocalizing.
Dyspnoea: difculty in breathing.
Dystocia: difculty at parturition.
Egg reappearance period: the time taken (usually expressed in weeks) for eggs to reappear
in faeces after anthelmintic treatment. Usually this is described for drug-sensitive worm
populations at the time of product licensing.
ELISA (enzyme-linked immunosorbent assay): a technique used primarily in immunology
to detect the presence of an antibody or an antigen in a sample. Basically, an unknown
amount of antigen is bound to the surface of a plastic well, then a specic antibody is
added and if specic will bind the antigen. This antibody is linked to an enzyme or is de-
tected by incubation with a second antibody that is linked to an enzyme. In the nal step a
substance is added that the enzyme can convert to some detectable signal (usually a colour
change, which is detectable by a spectrophotometer).
Emaciation: excessive body wasting.
Emesis: vomiting.
Emetic: a substance which causes vomiting.
Emphysema: air or gas in the interstices of a tissue.
Enema: rectal injection.
Epidemiology: the study of factors affecting the health of populations and often how dis-
eases are transmitted.
Exon: the coding part of a gene.
FECRT (faecal egg count reduction test): a test that measures the effect on faecal egg output
of anthelmintic treatment. Generally, efcacy is assessed by comparing FECs obtained on
the day of treatment with those obtained 14 days after treatment. This is an important tool
in detecting anthelmintic resistance in the eld.
Foetid: malodorous.
Gelding: castrated SAC.
Gene mapping: the gene on a given chromosome.
Genetic engineering: the direct manipulation of genes to alter the physical appearance of an
animal. Also used in recombinant vaccine technology.
Genome: an organisms entire hereditary information, encoded either in DNA or, for some
types of virus, in RNA: the genome includes the genes that code the proteins and non-
coding sequences of the DNA.
Genotype: the inherited instructions organisms carry in their genetic code.
Glabrous: without hair of any kind.
Granules: small grains.
Gravid: the pregnant horn of a uterus.
Haematuria: blood in the urine.
Haemoglobinuria: haemoglobin in the urine.
Haemolytic: a substance which causes breakdown of red blood corpuscles.
Helminths: a group of eukaryotic parasites that live inside their host. They are worm-like
and live and feed off animals.
Hembra: female SAC.
Glossary xiii

Hepatitis: inammation of the liver.


Herbaceous perennials: plants in which the greater part dies after owering, leaving only
the rootstock to produce next years growth.
Heterozygous: a genotype consisting of two different alleles at a given locus.
Homozygous: a genotype consisting of two identical alleles at a given locus.
Herd: the collective word for a group of SACs.
Iatrogenic: resulting from treatment.
Ileus: failure of peristalsis.
In cria: pregnant SAC.
In vitro: in the test-tube.
In vivo: in the living body.
Intron: the non-coding part of a gene.
Jaundice: a disease in which bile pigments stain the mucous membranes.
Larvae: juvenile forms that many animals undergo before they mature to an adult stage. Lar-
vae are frequently adapted to environments different to those adult stages live in.
Leucocytosis: increase in WBC in the blood.
Leucopoenia: decrease in WBC in the blood.
Linear leaves: those that are long and narrow.
Lumen: the inner space of a tubular structure, such as the intestine.
Macho: entire male SAC.
Markers: a short tandem repeat (STR) that may be used to aid in the identication of a trait.
Mediastinum: space in the chest between the lungs.
Melena: dark tarry faeces indicating bleeding high in the intestinal tract.
Metritis: inammation of the uterus.
Microsatellite: a stretch of DNA that is repeated several times in a row. These are located at
random throughout a chromosome. The variation in these markers allows for the parent-
age verication and other forensic activities.
Micturition: the passing of urine.
Mitochondrial DNA: DNA found only in the mitochondria. Only provided by the female.
Controls cellular metabolism.
Monoecious: when male and female owers are separate, but on the same plant.
Mutations: alterations in DNA sequence in a genome that spontaneously occur during meiosis
or DNA replication or are caused by factors such as radiation, viruses or chemicals. Muta-
tions can have no effect or alter the product of a gene from functioning properly if at all.
Myiasis: y strike.
Narcosis: sleep induced by a drug or poison.
Nematodes: roundworms, one of the most diverse phyla of all animals.
Nodule: a small round lump.
Non-gravid: the non-pregnant horn of a uterus.
Nuclear DNA: DNA found in the nucleus of all cells of the body. A copy is provided by each
parent. This DNA carries the code for phenotype (physical characteristics).
Nucleotide: the building blocks of DNA. Composed of deoxyribose sugars, a phosphate and
one of four nitrogenous bases.
Orchitis: inammation of the testicle.
Ovoid: egg shaped.
Panacea: a cure all.
Pathogenicity: the ability of a pathogen to produce signs of disease in an organism.
Pathognomic: a single specic sign of a disease.
Paracentesis: the technique of puncturing a body cavity.
Pediculosis: lice infestation.
Phenotype: any observable characteristic or trait of an organism: such as its morphology, de-
velopment, biochemical or physiological properties, or behaviour. Phenotypes result from
xiv Glossary

the expression of an organisms genes as well as the inuence of environmental factors and
possible interactions between the two.
Polydactyly: having an extra limb.
Polymerase chain reaction: a technique to amplify a single or a few copies of a piece of DNA
by several orders of magnitude generating thousands to millions of copies of a particular
sequence. Polymerase chain reaction relies on cycles of repeated heating and cooling of
DNA melting and enzymatic replication of DNA. Primers (short DNA fragments) contain-
ing sequences complementary to the target region along with a DNA polymerase (after
which the method is named) are key components to enable selective and repeated ampli-
cation. AS PCR progresses, DNA generated is used as a template for replication, setting in
motion a chain reaction in which the template is exponentially amplied.
Polydipsia: drinking excessive amounts of water.
Polyphagia: eating an excessive amount.
Premix: medicine available in a concentrated form to be added to food.
Primer: several thousand copies of short sequences of DNA that are complementary to part
of the DNA to be sequenced.
Proctitis: inammation of the rectum.
Ptyalism: excess saliva production.
Purgative: a strong laxative.
Pyrexia: raised rectal temperature.
Recumbency: unable to get up.
Rhinitis: inammation of the structures in the nose.
Rig: a male in which one or both testicles have not descended into the scrotum.
Ringwomb: failure of the cervix to dilate.
Rostral: towards the nose.
Ryegrass: a commonly grown grass Lolium perenne.
Schistosomus reexus: a deformity of a fetus in which the spine is bent backwards.
Sclerosis: hardening of a tissue.
Septicaemia: pathogenic bacteria in the blood.
Short tandem repeats (STR): sections of DNA arranged in back to back repetition.
Slough: dead tissue which drops away from living tissue.
Spasm: involuntary contraction of a muscle.
Staggers: an erratic gait.
Stomatitis: inammation of the mouth and gums.
Stricture: a narrowing of a tubular organ.
Subclinical: when the symptoms are not evident.
Syncope: fainting.
Syndrome: a group of symptoms.
Tachycardia: increased heart rate.
Tachypnoea: increased respiratory rate.
Teaser: a vasectomized male.
Tenesmus: straining to pass urine or faeces.
Teratoma: a developmental embryological deformity.
Torpid: sluggish.
Tourniquet: an appliance for temporary stoppage of the circulation in a limb.
Trismus: locking of the jaw.
Tuis: 12 year-old SAC.
Tympanic: distended with gas.
Typhilitis: inammation of the caecum.
Ubiquitous: everywhere.
Udder: mammary gland.
Ureter: the tube connecting the kidney to the bladder.
Glossary xv

Urethra: the tube leading from the bladder to outside.


Urethritis: inammation of the urethra.
Urine scald: inammation of the skin caused by persistent wetting with urine.
Urolithiasis: the formation of stones in the urinary system.
Uticaria: an acute inammatory reaction of the skin.
Vaginitis: inammation of the vagina.
Vagus: 10th cranial nerve.
Venereal disease: a disease spread by coitus.
Vesicle: a collection of uid in the surface layers of the skin or of a mucous membrane.
Viraemia: virus particles in the blood.
Volatile: a substance which evaporates rapidly.
Wether: a castrated SAC.
Zoonoses: diseases communicable between animals and humans.
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Abbreviations

ad lib As much as desired


AGID Agar gel immunodiffusion
AI Artificial insemination
AST Aspartate aminotransferase
BCS Body condition score
BDV Border disease virus
BHV Bovine herpes virus
bid Twice daily
BTV Blue tongue virus
BUN Blood urea nitrogen
BVD Bovine virus diarrhoea
C Celsius
Cal calorie
CAE Caprine arthritis and encephalitis
CCN Cerebro-cortico-necrosis
CFT Complement fixation test
CK Creatine kinase
CLA Caseous lymphadenitis
cm Centimetre
CNS Central nervous system
C-NS Coagulase-negative staphylococci
CPD Contagious pustular dermatitis
CSF Cerebrospinal fluid
CT Controlled test
cu Cubic
Cu Copper
DIC Disseminated intravascular coagulopathy
DM Dry matter
DMSO Dimethyl sulfoxide
DNA Deoxyribonucleic acid
EAE Enzootic abortion of ewes
ECG Electrocardiogram

xvii
xviii Abbreviations

EDTA Ethylene diamine tetra-acetic acid


EHA Egg hatch assay
EHV Equine herpes virus
ELISA Enzyme linked immunosorbent assay
EPG Eggs per gram
EU European Union
F Fahrenheit
FAT Fluorescent antibody test
FCE Feed conversion efficiency
FCR Feed conversion ratio
FECRT Fecal egg count reduction test
FMD Foot and mouth disease
FPT Failure of passive transfer
ft feet (measurement)
GGT Gamma glutamyltransferase
GLDH Glutamate dehydrogenase
GI Gastrointestinal
g Gram
GnRH Gonadotropin-releasing hormone
GVS Goat Veterinary Society in the UK
Hb Haemoglobin
IgE Immunoglobulin
IgG Immunoglobulin
im Intramuscularly
ip Intraperitoneally
IU International units
iv Intravenously
kg Kilogram
l Litre
LAT Latex agglutination test
LCV Large cell variant
LDT Larval development test
LN Lymph node
MCF Malignant catarrhal fever
MCH Mean corpuscular haemoglobin
MCHC Mean corpuscular haemoglobin concentration
MCV Mean corpuscular volume
ME Metabolizable energy
mg Milligram
min Minute
ml Millilitre
MOET Multiple ovulation and embryo transfer
MRCT Malignant Round Cell Tumours
MRI Magnetic resonance imaging
MV Maedi-Visna
NSAID Non steroid anti inflammatory drug
OIE Office International des Epizooties
Ov-VH2 Ovine herpes type 2 virus
PCR Polymerase chain reaction
PCV Packed cell volume
pH Negative logarithm of hydrogen ion activity
PHV Porcine herpes virus
Abbreviations xix

PI Persistently infective
PLR Papillary light reflex
pme Post-mortem examination
PMN Polymorphic nuclear cell
PMSG Pregnant mare serum gonadotropin
PO Per os, orally
pp. Pages
ppm Part(s) per million
PPR Peste des petits ruminants
PRA Progressive retinal atrophy
PUBH Polymerized ultrapurified bovine haemoglobin
PUPD Polyuria-polydipsia
qid Four times daily
RBC Red blood cell
RFI Residual feed intake
RNA Ribonucleic acid
rpm Revolutions per minute
RT-PCR Reverse transcriptase polymerase chain reaction
SAC South American camelid
SCV Small cell variant
SG Specific gravity
sid Once a day
SNT Serum neutralization test
sub cut Subcutaneously
TB Tuberculosis
TBF Tick borne fever
TDN Total digestible nutrients
tid Three times daily
TMS Trimethoprim-sulfadoxine
TPR Temperature, pulse and respiration
VDS Veterinary Defence Society
VNT Virus neutralization test
VLA Veterinary Laboratory Agency
vol Volume
WBC White blood cell
wt Weight
ZN Ziehl-Neelsen
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1
Animal Husbandry

Introduction The vast majority of camels in the old world


and Australia are actually feral. The only
South American camelids (SACs) were a vital exceptions are the wild camels of the Gobi
part of life in the Andes in the days of the desert found in China and Mongolia. Both
Incas before the arrival of the Spanish camels and SACs have the same number of
Conquistadors. Cattle, sheep and goats took chromosomes and if cross-fertilized can pro-
over in the following centuries but now SACs duce fertile young. Obviously their variation
are making a very strong resurgence. The area in size prevents natural mating.
of greatest rearing of SACs is on the Andean SACs actually evolved from a common
Cordillera in southern Peru, central Bolivia ancestor approximately 2 million years ago.
and northern Chile. There are significant There is evidence of domestication 6000 years
populations of SACs in Argentina, Australia, ago in the central Peruvian Andes at altitudes
New Zealand, USA, Canada and the UK. of over 4000 m. This plateau-type high altitude
Numbers are rising on mainland Europe. grassland has extreme variations of daily tem-
peratures. Frosts are frequent as are high winds.
The area is extremely dry with a very limited
Evolution rainfall.

Camelid evolution is traced back to North


America 40 million years ago. There were Numbers
probably several genera. Many became extinct
but some crossed the land bridge, which at In 2010 it was estimated that there were
that stage was across the Bering Strait so North 36,000 SACs in the UK. Of these 31,000 were
America was linked with Asia. The camelids thought to be alpacas and 5000 to be llamas
which evolved in Asia to become the camels with just a few hundred farmed guanacos
we know today are outside the remit of this and a very small number of vicuna in
book. The camelids in North America migrated zoos or private collections. There are slightly
to South America or died out, leaving the SACs more SACs in Australia, in the region of
we know today. These are mainly domestic or 40,000. A herd of 250 was first brought
semi-wild. It is not known whether the wild into Australia in 1858. In the USA there are
SACs are feral or whether they are truly wild. over 100,000 after an initial import in 1984.

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 1
2 Chapter 1

These numbers are very small compared to caudally and resemble a canine. So they
the 4 million in South America. appear to have two upper canines on each
side. SACs on their hemi-mandible have
three incisors and one canine. There are also
differences with the cheek teeth. Ruminants
Classification have three upper and lower premolars on
each side. SACs have one and maybe a
The normal classification is into four types, second, upper and lower premolar on each
llama, alpaca, guanaco and vicuna. To be side. Both SACs and ruminants have three
exact the first three are placed in the same upper and lower molars on each side.
genus, Lama, making the species L. glama, It is perhaps in the reproductive system
L. pacos and L. guanicoe. Vicuna are placed in where ruminants are at variance the most from
a separate genus, Vicugna. This genus is SACs. Ruminants have an oestrus cycle, with
divided into two subspecies, V. vicugna men- spontaneous ovulation and no follicular wave
salis from Peru and V. vicugna vicugna from cycle. SACs do not have an oestrus cycle and
Argentina. They are all classified in the lam- are induced ovulators. They have a follicular
ini tribe, which is part of the Camelidae wave cycle. Ruminants copulate in the stand-
family. SACs are grouped with camels, both ing position with ejaculation short and intense.
the Dromedary and the Bactrian, in the sub- SACs copulate in the prone position and have
order Tylopoda. Tylopoda and the subor- prolonged ejaculation. The male SAC has a
ders Cetruminantia, which includes cattle, cartilaginous projection on the tip of his penis.
sheep, goats, water buffalo, giraffe, deer, This is absent in ruminants. SACs have a dif-
antelope and bison and Suinia, which fuse placenta and the fetus is surrounded by
includes pigs and peccaries, make up the an epidermal membrane. Ruminant fetuses do
order Artiodactyla. not have such a membrane but have placental
Tylopoda has some important differences cotyledons.
from ruminants of the suborder Cetrumi- SACs are primarily nasal breathers with
nantia. Ruminants have red blood cells (RBCs), an elongated soft palate. Mouth breathing in
which are round and 10 microns in diameter. SACs is an extremely serious sign. Ruminants
SACs have elliptical RBCs, which are only 6.5 have a short soft palate and can breathe
microns in diameter. Ruminants have feet that nasally or orally.
have hooves, consisting of a horn wall and SACs kidneys are smooth and elliptical.
sole. SACs have toenails and a soft pad. Their Some ruminants have smooth kidneys, e.g.
second and third phalanges are horizontal, the sheep, or lobed, e.g. the ox. The female
whereas in ruminants the second and third SAC has a sub-urethral diverticulum at the
phalanges are nearly vertical. external urethral orifice. Ruminants have no
Both ruminants and tylopods are foregut such diverticulum.
fermenters, with regurgitation, rechewing and There has been less research carried out
reswallowing. However, tylopods have only on parasites occurring in or on SACs than
three stomach compartments and are resistant in or on ruminants. However, this is being
to bloat. Ruminants have four stomach com- rapidly rectified. Knowledge may well have
partments and suffer from bloat. been accrued before this book is published.
The teeth in SACs cause real confusion However, it appears that SACs have not only
where in ruminants they are fairly straight- unique internal parasites and protozoa but
forward. Ruminants have no upper incisors also share other species of parasite with cattle,
or upper canines. On their lower hemi- sheep and goats. The picture with external
mandible they have three incisors and a parasites is confusing. SACs certainly have
canine. This canine has migrated rostrally unique lice. They may also have unique
and resembles an incisor. They therefore mange mites but the classification is not yet
appear to have four lower incisors. SACs confirmed.
have on their upper hemi-maxilla one canine I take issue with camelid owners and
and one upper incisor, which have migrated veterinary surgeons who maintain that SACs
Animal Husbandry 3

are minimally susceptible to many infectious Alpaca Owners and Breeders Association will
diseases. I do not think this is an exact assess- allow only one or more of 16 standard colours
ment of the situation. SACs were meant to to be registered.
have some resistance to bovine tuberculosis. The official colours are:
The situation in the UK in 2010 makes non-
White;
sense of this statement where numbers of
Beige;
infected camelid herds are rising monthly.
Light Fawn;
SACs have been found also to be susceptible
Medium Fawn;
to human tuberculosis. SACs have been found
Dark Fawn;
to be a source of infection of bovine and
Light Brown;
human tuberculosis to humans. SACs are a
Medium Brown;
definite zoonotic danger. I do agree that there
Dark Brown;
is no evidence of bovine brucellosis in SACs;
Bay Black;
however, SACs are definitely susceptible to
True Black;
foot and mouth disease (FMD) and Blue
Light Silver Grey;
Tongue Virus (BTV). Further examples will be
Medium Silver Grey;
given in the text.
Dark Silver Grey;
There are two lines of alpaca, depend-
Light Rose Grey;
ing on their fleece types. The more common
Medium Rose Grey; and
huacaya has an even fine fleece and the less
Dark Rose Grey.
common suri has a fine crimped fleece.
In the USA huacaya outnumber suri by 9 to There can also be patterns of several colours.
1. They may freely be bred together but the Llamas are the same, with pinto and
results may not be as predictable as desired, appaloosa also being recognized. Guanacos
for example: a total of 1980 suri suri mat- are reddish brown in colour with an under
ings produced 278 huacaya and 1702 suri colouring of white. They often have black
offspring; 145 suri huacaya matings pro- marks on the top of their noses and heads.
duced 89 huacaya and 56 suri offspring; Vicuna are basically a yellowish light
19,637 hyacaya hyacaya matings produced brown. There are various bib markings of
19,633 huacaya and 4 suri offspring white.
(Sponenberg, 2010). No linkage or other
influence of sex was noticed. These results
are consistent with a single autosomal dom- Terminology
inant gene controlling suri fleece produc-
tion, with an additional relatively common
A female SAC is called a Hembra and a male
genetic mechanism that can suppress the
a Macho. Castrated males are called Geldings
suri phenotype in some animals. These
or Wethers. Young animals are called Crias.
results are especially important in cases
where the two fleece types are crossed with
one another, as they result in a relative
underproduction of suri fleeces. Fibre

The first SAC fibre known to be imported


into the UK was in 1834. Sir Titus Salt found
Colours some bales used as ships ballast on the
docks in Liverpool. Being a wool merchant
There are 22 colours recognized for alpacas, he realized its potential. Importation
ranging from black to white. Some also pro- increased during the next 50 years, particu-
duce multicoloured fleeces. In fact alpacas larly after Queen Victoria was given some
can come in a very wide variety of colours. garments. At the same time in Australia
The main colours, though, are brown, black, Sir Charles Ledger imported a herd of
white, palomino and grey. In the USA the 250 SACs.
4 Chapter 1

Behaviour and Behaviour Problems

Introduction

The single dominant male controls the family


group (Fig. 1.1). He decides its size and its ter-
ritory and he spends most of his time patrol-
ling and protecting the group. It is because of
this trait that male llamas have been used
with sheep flocks to protect young lambs
from foxes. His period of dominance only
lasts until he is deposed by another male.
Under him there is a strong hierarchy, with
the oldest female in top position with the
other females ranking below her. Crias tend
to have the rank of their mothers so young
weaned animals tend to be at the bottom of
the pecking order.
In the wild a group will consist of one
male with up to 20 females and their babies.
The adolescents are driven away. Young
females soon go to join another males family
group. The young males and the deposed males Fig. 1.1. A dominant male on the altiplano.
tend to live in large groups of up to 200.
In the wild groups stay well away from
SACs will also defaecate in water and so
each other and travel great distances
pollute it and increase the risk of coccidiosis.
(Fig. 1.2). SACs are very aware of their limi-
SACs are excellent swimmers and so ditches,
tations so that they will drive off small preda-
dykes and rivers will not contain them.
tors but run away from large predators or
Vocalization by humming is the most
packs of smaller predators. They depend on
common sound used by SACs. It is probably
body language for communication. In the
used to confirm contact as it will become
wild the normal age at death is 12, but under
louder on separation. The lack of humming
domestication they may well live on into their
may be a cause for concern. Groaning or brux-
early twenties. There are no toxic plants on
ism is a real cause for alarm for the keeper as it
the altiplano and so SACs are very sensitive
indicates pain. Veterinary attention should be
to poisoning.
sought. Snorting denotes mild aggression. This
SACs even in the wild tend to defaecate in
will turn to screeching in males if being han-
a pile. This is used by the male to smell for
dled or meeting other males. The position of
strangers and for receptive females. It is also
the ears and tail denotes status. Males may spit
useful as it is a natural way to reduce intestinal
and kick. They may even charge and bite.
parasites. Overcrowding should be avoided at
Submission will be shown by a drooping of the
all costs because all types of disease will flour-
upper eyelid and imitation mouth breathing.
ish. Disease control, particularly the control of
Males make an ogling sound before and dur-
internal and external parasites, will be very dif-
ing mating.
ficult, if there is overstocking.
Heat stress is a real problem for SACs.
Temperatures over 26C and humidity of over
80 % need to be avoided, so fans, shade and Behavioural problems
ponds need to be provided in hot climates.
However, liver fluke is becoming a major A number of behavioural problems have been
parasite in the UK so ponds should be avoided. found in captive SACs, but to date there has
Animal Husbandry 5

Fig. 1.2. Wild groups travel great distances.

been little research carried out into their Male Syndrome, which, like spitting at
causality. The two most common vices are people, is likely to have a root cause in over-
spitting at people and the Berserk Male familiarization with people at a young age.
Syndrome (this syndrome is not actually It is extremely common in orphaned animals
exclusively in males) where SACs respond that have had to be hand reared. The
aggressively to people. syndrome may slowly develop so eventually
SACs have a largely unfair reputation for the animal will pace a fence line, screaming
spitting, since they will rarely spit at people and spitting, when anyone approaches.
unless they have become over-familiarized. Such animals become highly dangerous and
The activity is part of the animals natural should be destroyed. However, the syn-
defensive mechanism, and is usually a response drome can be avoided by not bottle feeding
to the invasion of personal space. An unwary animals unless absolutely necessary and
person can be caught in the cross fire of two then only handling the animal at feeding
spitting animals. An animal that commonly time, leaving it with other crias for the rest of
spits at people is extremely rare. The actual the time.
contents of the spit can take three forms, food,
saliva or stomach contents, the latter is the
so-called green spit. Adults and more com-
monly crias will spit food and/or saliva when Wild South American camelids
they are eating to warn other animals to back
off and give them space. The green spit, which The wild vicuna (Vicugna vicugna) in southern
is much more unpleasant both to humans or Chile were pushed to near-extinction by
other SACs, is used in more severe confronta- poachers who shot and skinned the animals
tions. It is used by SACs to establish domi- for their very valuable fleece, until by the
nance. Most animals will pre-warn the 1970s only 6000 were left in the wild. A ban on
challenger by pinning its ears back very tightly trade in wild vicuna products has allowed the
and tilting its head back so that the nose is population to recover to over a quarter of a
pointing up in the air. If this warning is ignored million. In the 15th century the Incas were
then the animal will spit. using a system called Chaku, to round up,
The more serious problem involving shear and release the vicuna annually. This
humancamelid interaction is the Berserk system has been revived recently by the
6 Chapter 1

Aymara indians. It involves stretching a rope, grasping the ears acts like a twitch in horses.
decorated with brightly coloured ribbons, up Certain individuals, usually well known by
to a mile long, across a hillside and walking the owners, will kick if the handler is up close
the vicuna down. Eventually the animals are to them. This is of little consequence. It is only
driven into a corral which is made like a laby- if the animal is 3 feet away and the kick of the
rinth. The vicunas once caught are blind- hindleg lands at its full force that it is serious.
folded before being shorn and then are Llamas may strike forwards with their front
released back into the wild. legs. However, this does not seem to be a
problem if the handler grasps them firmly
around the neck. Many males will bite other
Restraint males but it is very rare for a human to get bit-
ten when holding an animal firmly.
Both llamas and alpacas will kush when
Some practitioners have issues with handling
restrained. They can be made to continue in
alpacas and llamas. There are some very wide
this position of ventral recumbency if they are
differences in behaviour and hence handling
held firmly around the neck or if they are
in individual animals and in types of animal.
chukkered. This is when a rope is looped
Practitioners familiar with cattle should reflect
around their abdomen in front of their pelvis
on the differences between handing dairy cat-
in a noose. Their hindlegs are brought for-
tle and suckler cattle that are kept extensively.
ward above their fetlocks through this loop.
Alpacas kept in small groups by one quiet
The nose is then tightened when they are on
kind owner are very different from a large
the ground.
group of semi-wild llamas herded on large
areas (Fig. 1.3).
Quiet animals can easily be handled by
firmly grasping them around the neck having Drug Administration
herded them into a small pen or stable with
long ropes (horse lunge-lines are ideal) or long SACs have an inelastic skin, which is thick.
white rods. For injecting animals intrave- There is little subcutaneous space. Most clini-
nously the author has found getting an assist- cians favour the subcuticular route for injec-
ant to hold both ears and stretch the neck tions as there is little muscular development
upwards to be useful. It would appear that in SACs. The best sites for subcutaneous

Fig. 1.3. Large groups are herded over a wide area.


Animal Husbandry 7

injections are in front or behind the shoulder. preputial adhesion (frenulum), which pre-
The author prefers the quadriceps muscle as a vents penile protrusion, until repeated sexual
site for intramuscular injection. However, the stimulation occurs. This normally occurs in
triceps and semitendinous/semimembranous the animals third year. In a normal size llama
can also be used. Intravenous injection is best the penis when extended is 40 cm, of which
carried out into the right jugular vein to avoid half extends beyond the prepuce. There is a
any danger of penetration of the oesophagus. very short cartilaginous process that dilates
In adults the skin is too thick for the raised the cervix during the prolonged copulation,
jugular to be visible. Some authors (DAlterio, which occurs with both animals on the
2006) prefer the use of the lower part of the ground. In the relaxed state, the prepuce
neck, using the ventral projection of the trans- points caudally and urination is in a caudal
verse process of the fifth and sixth cervical ver- direction. When sexually aroused the prepuce
tebrae (laterally) and the trachea (medially) as is directed cranially by the protractor prepuce
landmarks. There is some danger of injection muscle.
into the carotid artery as the carotid artery runs Testicles are small, averaging 24 g for adult
only just deeper to the jugular vein in this site. llamas and 20 g for adult alpacas. The males
Therefore the author prefers higher up the neck have two small paired bulbo-urethral glands
between the third and fourth cervical verte- and a small prostate gland. The volume of the
brae, where the carotid is deeper. To carry out ejaculate is 3 ml or less.
catheterization it is easier to cut through the The gross anatomy of the female SACs
skin with a scalpel rather than trying to place reproductive tract is very similar to that
the catheter directly into the vein. The hair seen in ruminants. The vagina of a mature
should be clipped, local anaesthetic should be female is approximately 25 cm long and 3 cm
infiltrated and the skin should be surgically in diameter. The external os of the cervix
prepared. protrudes slightly into the vagina. There are
Gastric intubation in SACs can only be two or three rings in the cervix. The uterus
accomplished orally. A calf-sized gastric tube has a short body 2.5 cm 2.5 cm and two
or an oral calf rehydration bag and tube is uterine horns 2 cm 6 cm in the maiden
ideal for this procedure. If a soft gastric tube mature female. As 98% of pregnancies occur
is used the mouth will need to be held open to in the left horn this is bigger in the bred
prevent damage to the tube from the sharp female even after involution. The gravid
cheek teeth. horn is roughly 3 cm 10 cm and the non-
gravid horn 2 cm 6 cm after involution.
Inactive ovaries are roughly 1.5 cm 1.0 cm
0.5 cm but will double in size with the devel-
Reproductive Anatomy and Physiology opment of multiple follicles or a corpus
luteum.
Introduction From puberty females normally have a 12
day follicular wave pattern with follicles
The reproductive anatomy and physiology of developing alternately on each ovary. Peak
SACs is quite unique, more closely resem- sexual activity is reached when the follicles
bling the horse than the ruminant by having a are over 1 cm in size. Ovulation will occur 24 h
gestation period of 335350 days, a diffuse after copulation, usually due to a luteinizing
placentation, the ability to breed back shortly hormone (LH) surge after the stimulation
after parturition, and very rare term twinning from the male. The LH surge is not increased
occurrence. Induced ovulation, which occurs by further breeding within 48 h. After ovula-
24 h after copulation in females with a tertiary tion the corpus luteum will develop in a
follicle in excess of 7 mm, is obviously not standard cottage loaf form approximately
comparable to the horse. 1.5 cm in size. If the mating is non-fertile it will
Males reach sexual maturity at 2.5 years. regress in 13 days with sexual receptivity
They have a fibroelastic penis and sigmoid recurring at 14 to 21 days after the original
flexure like ruminants. There is an embryonic mating. If the mating is fertile the corpus
8 Chapter 1

luteum will remain, as pregnancy depends on Post-partum females are often receptive
the corpus luteum in SACs. to the male soon after birth. It is prudent to
withhold the male for 2 weeks or longer if a
vulval discharge is seen. SACs are reproduc-
tively active for their whole lives, which is
Mating often over 20 years.

Mating has been seen in 6 month old SACs


but it is not recommended to breed animals
before 18 months. If young females are mated Breeding strategies
there is a danger of stunted crias and dysto-
cias. There are no significant differences in Domestic SAC breeders should reflect that
the reproductive anatomy and physiology wild vicuna and guanaco manage to repro-
among llamas, alpacas, guanacos and vicu- duce very satisfactorily without human inter-
nas. A non-pregnant sexually mature female ference. Therefore it is likely that given
will, after a few minutes in the presence of a sufficient area and adequate fencing herds of
normal sexually mature male, adopt a sternal alpaca and llama will reproduce very well
recumbent position, called the kush posi- with minimum interference. Often 350 females
tion. The male will straddle the female to are run with ten males on a vast area. However,
allow penile penetration. Initially semen is there are some disadvantages to such a man-
deposited in the cervix. However, with pro- agement strategy, which is called stud pasture
longed copulation the cervix will dilate breeding. The management is in the dark as to
enough for the semen to actually be depos- the pregnancy status of the females, which,
ited in the uterus. If a tertiary follicle is present because they are not handled, will be more
ovulation will be induced. The time taken for wild and harder to train. If such management
copulation will vary between 5 and 45 min is reduced to one male to 35 females there is a
with an average of 20 min. If the female then danger that without good and early preg-
refuses the male it is likely that ovulation has nancy diagnosis an infertile or sub-fertile male
occurred. This can be confirmed by a blood will not be found and pregnancies will be
test 57 days later, which will show a proges- missed. If more than one mature male is run
terone level greater than 1 ng/ml. with say a group of 70 females there is a dan-
Female SACs show extended periods of ger that the mature males will tend to fight
sexual receptivity, indicating that the associa- and injure themselves.
tion of oestrogens and sexual receptivity is The other end of the spectrum is hand
not quite related as it is in spontaneously mating, where females are bred to a selected
ovulating ruminants. In ruminants, females stud at a selected hour at various time inter-
are sexually receptive to the male only for vals. The advantages are that the manage-
a short period of time, in contrast to 1 to ment knows exactly what the breeding record
36 days in SACs. is for each female, progesterone samples can
In SACs pregnancy may result from ovu- be taken at the correct times and that all the
lations originating from either ovary; how- stock become easier to handle. Obviously
ever, implantation occurs over 95 % of the there is considerably more work required but
time in the left horn of the bipartite uterus. more importantly there is a danger that breed-
Implantation starts at approximately 30 days ings may be forced and lead to genital tract
after the successful mating and is complete by trauma and infections.
90 days. The ideal system if there are good facili-
Pregnancy cannot be readily seen even in ties may be a halfway house of stud pen
the advanced state in SACs. Mammary devel- breeding where one stud has one or more
opment may be observable 1 week pre- females living with him in a confined pen.
partum with some enlargement of the four The real problems come with very small
teats. Waxing of the teats is rare as is pre- herds without a stud or with a stud that is
partum milk let-down. related to the females. In these herds either
Animal Husbandry 9

the females have to be transported to a stud or landin (PG) production and subsequent
a stud male has to be brought on to the farm. In luteolysis. However, heat stress could cause
either case there are considerable disease con- worse problems if animals are left until it
trol issues. These are made worse if studs are becomes really hot just because they are
just moved from farm to farm. A risk table pregnant, i.e. the stress of shearing may be
(Table 1.1) should be completed by practition- less important than more persistent heat
ers for each holding so that owners are made stress issues. Additionally, the timing of
aware of the dangers they face from TB and shearing may depend on many outside fac-
also from other diseases called general disease tors. If a late pregnant animal is shorn in the
risk, which would include parasites, BVD etc. last couple of weeks of pregnancy and early
Practitioners should discuss the results of these parturition occurs, the chances are this will
tables with the owners. Targets should be set. be all right. However, if parturition is more
Owners should be made fully aware of the risks than 2 weeks early survival is less likely. The
they are taking. main problem of early parturition is that
mammary development may not be suffi-
cient to allow adequate colostrum produc-
tion. The cria may be a candidate for frozen
Shearing plasma transfer (FPT). The IgG concentra-
tions of the cria should be checked (see
Shearing during the first or last 60 days of Chapter 4). Clinicians should explain the rel-
pregnancy is a risk, due to the dependence of ative risks and let their clients choose what
SACs on the corpus luteum (CL) for mainte- they perceive to be the best option on the
nance of pregnancy. Stress results in prostag- basis of their farms situation.

Table 1.1. Breeding activities risk categories.

Activity TB risk General disease risk

No animals move on or off farm for breeding


No animals move on farm for breeding without 6 week quarantine
period on arrival at farm (includes males or females visiting farm)
Females visit farm for breeding: drive-by
Designated area
Pasture/management area used by farm for own stock
Females visit farm for breeding: board on farm:
Separate area >3 miles from home herd
Separate paddock but fence line contact with home herd
Mixed with farms stock
Males go out to do drive-by breedings:
One out and back visit (one destination, quarantine on return for 6
weeks between visits)
One out and back visit (one destination, no quarantine on return)
Male visits several farms in one day
Several males on trailer visiting multiple farms
Male visits multiple farms on different days without quarantine in
between: mixes with regular group in between visits
Males received by farm for drive-by breedings of farms own females:
Designated area
Not different from regular breeding area
Females going out for drive-by breedings on other farms:
Quarantine on return
No quarantine on return

The risks should be graded as between 0 and 5: 0 indicates an activity of no risk at all; 5 indicates an activity of
high risk.
10 Chapter 1

Physically shearing alpacas is more SAC rises it will shed this heat into the sur-
labour intensive than shearing sheep where rounding air by vasodilatation and concur-
several sheep catchers and wool packers are rent increase of blood flow to the skin and
required for one shearer. The alpaca needs to periphery. This occurs particularly around
be secured by ropes and its head is held. It is the perineum, between the legs and on the
then held in lateral recumbency. The dorsal ventral abdomen. SACs pant, thus warming
surface of the alpaca is shorn first. It is from the inspired air and cooling the lung fields.
this site that the fibre sample is taken and This increased air movement into the lungs
examined for quality (Fig. 1.4). will cause evaporation of fluid from the res-
piratory tract, and cause further cooling
down of the animal. SACs also sweat.
The thermoregulatory mechanism begins
Heat Stress to fail if the air around the animal becomes
stagnant. If the ambient temperature is the
Heat stress can be a serious problem in tropi- same or higher than the body of the SAC, or if
cal and subtropical countries and in temper- the ambient humidity is high enough to
ate countries in the summer. However, SACs decrease the effectiveness of evaporation,
are well adapted compared to other mammals then heat dissipation is prevented. The ani-
to maintaining a wide range of body tem- mals ability to respond to environment
perature somewhere between 98F (37C) changes that predispose it to heat stress are
and 104F (40C). Without a resting tempera- further reduced by exercising, breeding, or
ture in this range the body and organ sys- working during the hot part of the day.
tems of a SAC can be seriously compromised Obesity in SACs is very common and it
in their ability to maintain proper function, decreases the animals ability to effectively
particularly if the increased temperature is deal with excess body heat in the face of high
maintained for several days. Normal meta- environmental heat or humidity. A long and
bolic functions that generate heat include shaggy, poorly groomed fibre coat is a good
breathing, walking, eating, digesting, and insulator and decreases the animals ability to
assimilating nutrients, etc. To prevent heat rid itself of excess heat. Animals sweating
stress the animal has to utilize mechanisms excessively become dehydrated, further
to dissipate excess heat. If the body of the depressing the bodys ability to respond to

Fig. 1.4. Fibre is taken from this site for quality evaluation.
Animal Husbandry 11

rising temperatures. The evaporation of flu- also diminished. During hotter weather the
ids from the respiratory tract with panting rate of passage of ingesta through the gut
results in further dehydration. This results in tends to be slower than normal, therefore
a loss of blood volume and an increase in signs of colic may be seen as impactions may
heart rate. occur. With the association of altered ther-
Signs of heat stress include depression moregulatory ability the feeding of fescue
and anorexia. Animals with heat stress will infected with endophytic fungus Acremonium
have a rectal temperature of more than 104F spp. should be avoided.
(40C). They will be panting with a respira- In large countries, e.g. the USA and
tion rate greater than 30. There will be froth- Australia, the movement of animals from a
ing at the mouth and a drooping lower lip colder climate to a hotter climate should be
and a heart rate greater than 100. There is avoided. Equally, movement from the high
likely to be ventral oedema and oedema of altiplano to lowland areas should be avoided
the legs before collapse and death. in the hottest time of the year. It takes over 6
The most effective treatment is simply months for an alpaca or llama to adjust to a
cooling the animal down. This can be new climate. Owners should avoid regroup-
achieved by a hose, pouring buckets of cold ing animals during hot weather to avoid
water over it or standing it in a pond. Once it fighting.
is drenched the use of a fan is beneficial. A useful measure to decide if animals
Common sense should be used to decide the are at risk from heat stress is to add together
best methods to be implemented. Dehydrated the ambient humidity and the temperature
animals must be allowed to drink or if too in Fahrenheit. If this number is 120 or less
weak they should be given cold electrolytes only minimal problems exist. If the number
by orogastric tube. If they are very dehy- is 150 or more, as many precautions as
drated they should put on a drip of poly- are available should be taken. But as the
ionic fluids. NSAIDs are useful. Injectable number approaches or exceeds 180, extreme
B vitamins are useful to improve appetite caution should be exercised, as animals
and vitamin B1 will prevent CCN (see are at great risk.
Chapter 12). Recumbent animals are likely to
have a compromised immune system and
should be given antibiotics. Beware of exces-
sive feed on recovery as there is a danger of Normal Crias
acidosis from grain overload.
Prevention of heat stress is once again In many instances practitioners are less
up to common sense, with shearing being aware of normality than are owners. A nor-
carried out at an appropriate time and the mal cria will be lively and on its feet within
provision of shade at all times. Trees are 1 h. It will be sucking within 4 h and have
ideal to provide shade as are houses with passed meconium within 8 h. Most mothers
high ceilings. Breeding should be avoided will not allow suckling until the placenta
in the heat of the day. Parturition should be has been passed. The act of sucking and the
timed to avoid the very hot time of the ingestion of colostrum encourages the pass-
year. ing of meconium. A crias rectal tempera-
Diets high in poor quality roughage give ture will exceed 37C. The ear tips will be
off excess heat during digestion, and there- straight and the incisors can be felt.
fore should be avoided during times when Everything should be done to maintain the
heat stress is a danger. Energy requirements maternal bond. There should be no inter-
may actually be increased by panting and ference if there is no problem. If it is a cold
faster heart rates associated with attempts day then the mother and cria should be
by the body to maintain temperature in a encouraged into a warmer place, e.g. a
safe range. Unfortunately, with decreased shelter or under the trees out of the wind.
feed intake, which is commonly associated This should be achieved without stressing
with heat stress, the intake of nutrients is the mother.
12 Chapter 1

If all is normal after approximately 6 h, Abnormal Crias


often towards evening, the cria may be
quickly checked. The sex can be checked Most problems are associated with premature
together with the patency of the anus and in or dysmature crias (see Chapter 3). There are
females the vulva. The navel can be dressed some other factors relating to the female, e.g.
with iodine or oxytetracycline spray and be poor teat conformation, poor milk production
checked for an umbilical hernia. The cria can from very thin maidens or over-fat mature
be quickly weighed on bathroom scales in the females. There are of course outside factors, e.g.
paddock. bad weather and overcrowded paddocks.
2
Nutrition and Metabolic Diseases

Introduction should be exercised when animals are


trekking or are allowed into gardens on
To satisfy the five freedoms the ethical account of the possible ingestion of poison-
framework around which the codes of rec- ous plants (see Chapter 16).
ommendation for the welfare of farmed live- In an intensive situation, attention to
stock are presently crafted in the UK all stocking rates and the monitoring of sward
farm animals must be given access to proper height will allow the best use of grazing with
nutrition. SACs are included under this optimal swards of 46 cm being maintained.
umbrella. This means not just that forage and Properly managed grazing patterns coupled
water must be offered at all times but that the with good forage preservation are the goal.
nutrient balance is such that the animals do Complications to diets start as soon as supple-
not suffer from hunger, thirst or malnutri- ments are introduced. Balanced diets do not
tion. In the UK and in the EU there are strict need ad libitum mineral blocks or powder sup-
rules regarding the feeding and watering of plements and indeed either mineral blocks or
animals in transit. mineral supplements may cause dietary imbal-
The diet of animals must be suitable to ance by either competing with nutrients in the
their production needs and must overcome diet or by indirect competition. An example is
any potential dietary shortcomings such as the rich red mineral supplement that is often
mineral deficiencies, energy shortfall or con- supplied by farm wholesalers, which contains
stituent imbalance. Feeding practice in par- high levels of iron and will effectively lower the
ticular must be good to optimize the health, adsorption of copper from the gut, possibly
welfare and productivity of the animals. leading to marginal or deficient status.
Judicious use of grazing can be used to satisfy Similarly imbalances of calcium, magnesium
the nutrient demands for a large part of the and phosphates can be precipitated by injudi-
year for SACs in the UK. The grazing needs to cious use of mineral supplements.
be managed to maintain sward height and
ensure that fresh grazing is available to the
animals as needed or the animals must be
allow to roam to find new pasture. The roam- Poor Feedstuffs
ing may be timed to make best use of the
grazing to fit in with the weather or the har- Feeding mouldy forage is usually uninten-
vesting of forage for conservation. Great care tional and occasionally unavoidable. However,

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 13
14 Chapter 2

the potential disease impact and reduced pal- world. This may cause infertility, dystocia
atability of spoilt feed mean that this should be and reduced milk yield. Hepatic lipidosis is
avoided if at all possible. Incorrect storage of never seen in animals kept on the Andes.
forages intended for later feeding can result in However, it is often seen in other parts of
the ideal conditions for growth of various the world.
organisms capable of causing disease in SACs. Outside of South America it is common
These include: practice to feed SACs concentrate feed pre-
pared for horses or, even worse, pigs.
Listeria monocytogenes this organism is
Clinicians must advise against this practice.
associated with various neurological dis-
Concentrates specially prepared for SACs
eases (see Chapter 12).
are now available and should be fed to the
Fungal organisms diseases caused by
manufacturers recommendations. In fact
fungi include placentitis and abortion, so
non-breeding animals can exist totally on
particular care should be taken to ensure
good grass. In the winter in the UK or in
pregnant animals are kept away from
northern areas of the USA they require con-
spoilt feed. These fungi are not zoonotic
served forage, e.g. hay. An adult requires
diseases per se, however humans can be
approximately one 30 kg bale of hay every
directly infected by the spores. The fungi
15 days.
cause an extrinsic allergic alveolitis,
Digestibility studies conducted with
otherwise known as farmers lung. SACs
SACs on conserved forages have suggested
can develop a similar condition.
higher digestion coefficients in comparison
Bacillus licheniformis this organism can
with true ruminants when fed low or medium
cause abortions and stillbirths in SACs.
quality diets. SACs are reported to consume
It is therefore important that feedstuffs are less than true ruminants if live weight is taken
stored correctly. Where areas of mould are into account. However, this may not be the
seen these should be removed and destroyed case if they are grazed free-range. The myth
carefully. This care should also be exercised that SACs are less efficient than sheep at
with mouldy bedding material. digesting high quality forage has been proven
to be false.
SACs require a maximum dry matter
intake of 1.8% of body weight daily. This
Nutrition would appear to be low compared to sheep
and goats. SACs have a slower rate of passage
SACs perform better than ruminants when through the pregastric fermentation, which
grazing on poor quality pasture as the gas- allows a greater degree of fermentation of the
trointestinal tract is slower for particulate lower quality cell wall materials and greater
matter. On the other hand it is faster for flu- generation of available nutrients. This slower
ids. This may be due to the larger amount of rate does reduce the daily intake. To establish
saliva produced in relation to the volume of a good feeding programme, daily intake
the stomach. This is considered to be an amounts are important. Herd owners should
adaptive response to the coarse, highly lig- be encouraged to weigh amounts of feed that
nified vegetable material that SACs origi- are being fed daily, for several days, to estab-
nally grazed on the altiplano. Llamas lish how much of each feedstuff is being con-
perform better than alpacas. In the Western sumed daily.
world SACs are normally maintained at Along with the amount being fed, the
pasture all the year round but with access to nutritive value of each feedstuff must be
shelter not only to escape the sun and insects known. Since most of the diet should be for-
in the summer, but also to avoid the wind ages, forage analysis is critical to establishing
and cold in winter. Most SACs are given a viable feeding programme. Forages will
additional concentrate feed except when the vary greatly with stage of maturity when they
pasture is very abundant. Because of this, are harvested, handling procedures and soil
obesity can be a problem in the Western conditions. It is rare that forage will fulfil all
Nutrition and Metabolic Diseases 15

of the nutrient requirements for SACs. There Table 2.1. Alpaca recommendations.
are many useful generalizations that may be
Nutrient Maintenance Lactation
made, e.g. meadow hays will be low in
calcium. However, after the forage analysis Protein 12% 15%
has been carried out the clinician can see what TDN 5560% 6065%
is missing and see what needs to be added to Fibre 25% 25%
complement the forage. In many cases all that Calcium 0.60.85% 0.60.85%
is required is only the addition of a trace Phosphorus 0.40.6% 0.40.6%
mineral supplement. On the whole the sup- Selenium 1 mg/45 kg/day 1 mg/45 kg/day
Copper 1015 ppm 1015 ppm
plement will need to be energy rich, high in
Zinc 80 ppm 80 ppm
calcium, selenium, vitamins D and A and
Vitamin D 2000 IU/day 2000 IU/day
zinc. As a general rule, if more than 0.25 kg for Vitamin E 400 IU/day 400 IU/day
an alpaca or 0.5 kg for a llama is required then
better forage should be obtained.
The basic diet if not grass, i.e. in the win- Table 2.2. Llama recommendations.
ter in temperate countries or in the dry season
in hot countries, should be quality grass hay, Nutrient Maintenance Lactation
which will contain 810% protein. This should Protein 10% 12%
be the basis of the diet. Only certain groups of TDN 5055% 5560%
llamas, e.g. weaners and lactating mothers, Fibre 25% 25%
will need any supplementation. Alpacas will Calcium 0.60.85% 0.60.85%
require slightly more protein. This can be Phosphorus 0.40.6% 0.40.6%
given either as concentrates or as lucerne Selenium 1 mg/45 kg/day 1 mg/45 kg/day
(alfalfa) hay. Otherwise there is no cause for Copper 1015 ppm 1015 ppm
supplementation except in debilitated indi- Zinc 80 ppm 80 ppm
Vitamin D 2000 IU/day 2000 IU/day
viduals. The feeding of excessive protein
Vitamin E 400 IU/day 400 IU/day
should be avoided in hot climates as this will
result in an increase in water loss as urea
excretion will require excessive urination,
fed in a group and tend to push others away
which is to be avoided if there is a danger of
from the food trough. These animals may
heat stress (see Chapter 1). Protein require-
have to be fed separately.
ments should be met but not exceeded.
Mineral supplementation may be required in
deficient areas. Periodic blood sampling of
groups for selenium, copper, zinc and iron Body Conditioning Scoring in South
may be useful. American Camelids
In summary it should be stressed that on
the whole except for conditions in South The most commonly used body condition
America, the problem of SAC nutrition is one score system used in the UK is a 1 to 5 score.
of overfeeding rather than underfeeding. In the USA a 1 to 10 score is used. In both
Patrick Long DVM from Oregon has pre- systems 1 is very thin. In the UK 5 is obese
pared useful tables (Tables 2.1 and 2.2) for the but obese in the USA is 10. Body condition in
dietary requirements of llamas and alpacas. SACs is best assessed by palpating the trans-
Owners are advised to buy the best hay verse process of the lumbar vertebrae, areas
available, as SACs thrive on fibre rather than around the shoulders and over the loins.
concentrates. If quality hay is not available If the ribs are easily palpated, the condition
then lucerne should be brought into the diet is usually less than half way in both systems,
rather than just increasing the concentrates. but if the ribs are difficult to feel and if the
In the UK pet SACs are a particular prob- loin is bulging and slightly soft, the animal is
lem as they tend to be overweight. This leads going to be a 3 in the UK or a 6 in the USA.
to hepatic lipidosis. It is difficult to get these The lateral aspects of the transverse proc-
animals to lose weight, especially if they are esses of the lumbar vertebrae should not be
16 Chapter 2

sharp, but easily palpable. The shoulder parturition will result in a delay in breeding
should also be palpable with the bones and and poor conception rates. However, SACs
joint edges not sharp, but appearing to have are not like cows and body condition scores
slight smoothness. As animals gain weight are not directly related to breeding perform-
they begin to lay down fat on the brisket, ance. Practitioners will have a problem advis-
between the hindlegs, and around the peri- ing clients who have overweight females
neum. The pelvic bones can be easily felt. An towards the end of pregnancy. These animals
accurate set of scales will also be useful in will tend to lack appetite and be lethargic.
aiding the practitioner in herd dietary man- These signs lead to an increased prevalence of
agement. In the northern hemisphere SACs pregnancy toxaemia and dystocia problems.
naturally gain weight in spring and early If the parturition is due in late summer, heat
summer and tend to lose weight in the late stress will make things worse. However, prac-
summer, autumn and winter. If animals are titioners should not advise owners to starve
weighed at 2 monthly intervals, those adults these obese females or the risk of pregnancy
who do not show this seasonal pattern but toxaemia is even greater. They should be
continue to gain weight should be monitored allowed to hold their weight, obviously not
and fed accordingly. Where possible, body allowing any increase. Then hopefully the
weights should be evaluated on a yearly lactation will bring about natural weight loss.
basis, and steps taken to prevent continual If these animals have problems at parturition
and possibly insidious body weight changes, resulting in a dead cria, then after the metritis
which are difficult to observe on a day to day has been cleared up they should be dieted
basis. aggressively.
Maiden females also need to be monitored
during pregnancy. Obesity is not normally a
problem. They need to be fit not fat so that
Feeding During Pregnancy they have a normal parturition and have suffi-
cient milk.
Feeding prior to mating is very important.
The aim is for the female to have a body con-
dition score of 56 (US measurement) at mat-
ing and maintain this score throughout Cria Nutrition
pregnancy. Ideally this should be checked
and recorded monthly throughout pregnancy. Normal alpaca crias should weigh a mini-
What is even more ideal is for the female to be mum of 5.5 kg and llama crias a minimum of
weighed monthly. With constant monitoring 7 kg. Averages are likely to vary but 7 kg for
problems can be recognized early. Early dis- alpaca crias and 9 kg for llama crias would be
ease states can be treated. Stress-induced the norm. Like most newly born animals,
weight loss, e.g. when individuals are moved crias will lose weight initially, usually 0.25 kg
into new groups and bullying occurs, can be in the first 24 h. This should be replaced in the
recognized quickly. Poor feeding during following 24 h and from then on they should
pregnancy will be picked up at these moni- gain between 0.25 kg and 0.5 kg daily. To do
toring sessions. Pregnancy toxaemia will be this the cria needs to consume 10% of its body
prevented. Early births resulting in weak weight daily. This should be colostrum in the
underweight crias are less likely to occur. first 24 h.
Dams in a good nutritional state will produce Should a cria be too weak to stand colos-
ample good quality colostrum. This together trum may be given with a feeding bottle with
with strong crias will prevent failure of pas- a small teat. It will only be possible to milk
sive transfer of antibodies. Poor nutrition out approximately 30 ml at any one time from
during pregnancy leads to poor milk produc- a dam. Ideally this should be repeated at
tion. This will result in poor cria growth rates. hourly intervals for the first 24 h. Prudent
Obviously, weighing of crias should be owners will draw off colostrum from milky
encouraged. Poor body condition score at quiet females and store it in the deep freeze.
Nutrition and Metabolic Diseases 17

Proprietary lambs colostrum is available in levels. Vitamin D will also be low. It is this
powder form, which is suitable for crias if low level of vitamin D that is reducing the
half as much again of powdered glucose is uptake of phosphorus and causing the rick-
added to the colostrum powder. Cow or goat ets. It is thought that in South America in the
colostrum can also be used, though once Andes where there are large amounts of sun-
again glucose should be added. The milk light, SACs have evolved to require less vita-
from SACs has a higher sugar content, i.e. min D in the diet as it is made in the body.
6.5%, and a lower fat content, i.e. 2.7%, than Poor levels of sunlight in the autumn and
ruminants. Colostrum from other species has winter in the northern hemisphere do not
the danger of being a source of disease. The allow the young SACs to produce their own
most dangerous likely diseases are Johnes vitamin D, leading to rickets.
disease and leptospirosis. Only small quanti- The most sensible preventive measure is
ties, i.e. 60 ml, should be offered at one time, to increase the vitamin D in the diet. Oral
ideally every 2 h to crias. Large quantities supplementation of vitamin D can be given
should be avoided as they will tend to pool in but this is difficult to administer and so
C1 rather than go straight to C3. Obviously if breeders tend to favour monthly injections
there is no suck reflex the colostrum will have of vitamin D in the form of an oily solution
to be given by stomach tube. This is easily of vitamins A, D and E. this should start at
accomplished with a lamb stomach tube. As 2 weeks of age and continue until the spring
these are not quite long enough they should equinox.
be pushed down the oesophagus to their full
length and the colostrum should be given
slowly. Larger stomach tubes, e.g. foal
nasogastric tubes, should not be used as they Copper deficiency
are too large and will damage the
oesophagus. Copper is an essential constituent of the diet
Creep feeding crias that are running with and is required for harvesting of energy from
their mothers is hazardous. There are several digested feeds and with iron is required in
dangers: crias may get stuck getting into the haemoglobin metabolism. It is required for
creep, small mothers may get stuck trying to bone, tendon, and cartilage and melanin
get into the creep or mothers with their production. It is also required by the body for
extremely long necks may find a way to eat protection against certain toxins. Copper is
an excess of creep and get problems with absorbed into the body from the small intes-
grain overload. tine and stored in the liver. Beta-carotene is
required to aid absorption. Copper availabil-
ity is depressed when there is an increase in
molybdenum, sulfur, iron, zinc, cadmium,
Trace Element Deficiencies selenium and calcium in the diet. Lush growth
of forages, particularly those raised on alka-
Vitamin D deficiency and line soils, are lower in available copper than
hypophosphataemic rickets syndrome hay and legumes. When evaluating the diet
for copper adequacy, the practitioner should
This is a particular problem in the northern try to maintain a copper to molybdenum ratio
hemisphere in autumn-born SACs. In their of between 6:1 and 10:1 (ratios of 15:1 have
first winter their growth rate will slow down. been implicated in copper toxicity; see
They will play less and appear to have stiff Chapter 16). Copper deficiency is more likely
backs. They will show an abnormal gait, to occur on improved grass pastures where
which has been described as a bunny hop. lime or molybdenum-containing fertilizers
Angular limb deformities will develop. This have been applied. If copper content of the
condition is said to be more common in dark- pasture is less than 5 ppm on a dry matter
coated animals. If tested these animals will have basis and/or where molybdenum exceeds
normal calcium levels but low phosphorus 1 ppm and/or sulfur exceeds 2000 ppm,
18 Chapter 2

copper deficiency may occur. This will cause Diagnosis is straight forward with plasma
signs of ataxia, anaemia, depressed immune samples to measure glutathione peroxidase.
function, infertility, loss of hair and skin pig- Heparin is the anticoagulant required (nor-
ments. It will also cause the growth of abnor- mally a green-topped vaccutainer). Treatment
mal bone, connective and tendon tissue, of selenium deficiency involves oral supple-
which will cause lameness and poor growth mentation or parenteral selenium injections.
rate. Production of stringy fibre and excess
shedding are normally the first signs observed
by the owner. Diagnosis is not as straight for- Zinc deficiency
ward in SACs compared with sheep as plasma
copper levels are less reliable. The ultimate
Absorption of zinc from the small intestine is
measure is a liver biopsy (see Chapter 4).
inhibited by phytase, oxalates, organophos-
phates and high dietary concentrations of cal-
cium, cadmium, iron and tin. Zinc absorption
Iron deficiency is enhanced by vitamin C, citrate, histidine
and lactose. On average legumes are better
This deficiency is only seen in crias and yet sources of zinc than grasses. Zinc is poorly
iron is absorbed more efficiently in younger available from cereals. The main sign observed
animals than in adults. Vitamin C, citrate, is usually in 12-year-old SACs as papules or
cysteine, histidine and lowered intestinal pH dry plaques of alopecia on the ventral abdo-
all serve to enhance the absorption of iron men, inner thighs and the bridge of the nose.
while high dietary concentrations of cadmium, The lesions initially are erythemic, but become
calcium, manganese, phosphorus, zinc, very thick and eventually crack. Biopsies of
phytates, tannins, tetracycline and heavy para- the affected skin will show parakeratosis.
sitism all depress iron absorption. When evaluating such biopsies, the patholo-
Clinical signs of iron deficiency in crias gist is reminded that the cellular infiltrate
include poor growth/chronic weight loss, around the arterioles of the dermis, which
diarrhoea and a non-regenerative microcytic, may appear to be suggestive of inflamma-
hypochromic anaemia. A decreased haemo- tion, are normal in SACs. Clinicians are
globin concentration will be indicative of the reminded that rubber contains zinc and any
condition but the ultimate diagnostic tool is a blood samples in rubber-topped bottles will
bone marrow biopsy smear. not indicate any zinc deficiency.
Crias do not seem to respond to oral sup- Treatment is simple, with oral supple-
plementation of iron. Parenteral administra- mentation of 1 g of zinc sulfate daily. It should
tion of iron dextran is required. The dose of be stressed that this is a very over-diagnosed
600 mg of iron as gleptoferron should disease and other causes of the parakeratosis
be divided into three and injected on alternate should be investigated.
days as three injections of 1 ml containing
200 mg.
Metabolic Disease

Selenium deficiency Hypocalcaemia

The minimum daily allowance of selenium is In SACs the condition of hypocalcaemia


0.1 ppm on a dry matter basis. The Altiplano occurs at peak lactation, i.e. 34 weeks post
in South America and certain areas in the UK parturition. The camelid will be anorexic
are known to have low selenium levels. and will normally go into sternal recum-
Selenium deficiency is associated with lame- bency. The rectal temperature will be
ness and acute cardiac death of white mus- lowered and the movement of compartment
cle disease in crias. It also causes infertility, one (C1) of the stomach will stop. The con-
stillbirths and very weak newly-born crias. dition can be confirmed on a blood serum
Nutrition and Metabolic Diseases 19

sample showing the low calcium level. most feeds, needs to be ingested daily and be
Treatment with intravenous calcium, nor- absorbed daily. If the transit time through the
mally 100 ml of a 20% solution for an alpaca, bowel is too rapid then insufficient magne-
will effect an improvement but not as sium will be absorbed. Although lush green
rapidly as in sheep and goats. Also this will grass is a very good source of magnesium, it
not be a one off treatment but will need to causes a rapid transit time of ingesta through
be repeated daily until the blood calcium the bowel and so can provoke the condition.
levels adjust. The cria should be left with If blood levels of magnesium are low then
the mother to encourage her recovery. The any stress will cause the signs. These are neu-
cria may need some supplementary feeding. rological. Sternal recumbency is rapidly fol-
Ideally this should be milk drawn from lowed by lateral recumbency and convulsions.
another mother, although there are special The heart rate is raised and so is the rectal
milk powders available. If the worst comes temperature. There is frothing at the mouth
to the worst goats milk can be used. It is and rapid eye movement. The legs will pad-
important to avoid over feeding or the cria dle. The sex of the animal is not relevant. In
will start to scour. Often full recovery will temperate climates it is a condition of the
take 3 or 4 days. Owners should be discour- spring and autumn. This is due to the likeli-
aged from giving any treatment by mouth hood of lush grass at these times and the very
as there is a considerable danger of inhala- changeable weather, which may act as a trig-
tion pneumonia unless an orogastric tube is ger. Such a situation will not arise for llamas
used (see Fig. 2.1). as they will tend to browse as well as graze.
The ingestion of certain plants that con- Alpacas are principally grazing animals and
tain oxalates may cause hypocalcaemia in in the UK are often kept on very lush pas-
SACs (see Chapter 16). tures. However, on the whole SACs do not
seem to suffer signs of hypomagnesaemia,
probably on account of the slower bowel tran-
sit time.
Hypomagnesaemia Treatment in SACs is rarely successful if
they are convulsing. Although blood magne-
This condition is extremely rare in SACs. sium levels can be restored to normal, there is
Magnesium, which is readily available in usually irreparable brain damage. Treatment

Fig. 2.1. An orogastric tube being used.


20 Chapter 2

can be attempted. It should consist of a subcu- wall of C3 should be examined by trans-


taneous injection of 100 ml of 25% magnesium abdominal ultrasound. In this condition
sulfate. It is important that this drug is given oedema of the wall is often seen as a dark line.
subcutaneously as it will cause death if given A small volume of fluid is normal. However, if
intravenously. It is prudent to give other it is flocculent this may indicate a perforated
supportive treatment, e.g. a mixture of 20% ulcer. This should be treated accordingly (see
calcium borogluconate, 5% magnesium hypo- Chapter 9).
phosphite and 20% glucose given intrave-
nously, coupled with NSAIDs. It should be
remembered that these cases are on a knife Pregnancy toxaemia
edge and so any treatment by any route may
well cause death.
This is a rare condition in SACs. As in sheep, it
occurs in late pregnancy. However, unlike
sheep it occurs when there is only a single cria.
Hypophosphataemia The aetiology is unclear. It is thought that stress
brings about inappetence, which brings on the
This condition, which causes recumbency in disease, which is then self perpetuating. The
cows, does not seem to affect SACs. A defi- less the animal eats the worse the condition
ciency in phosphorus may cause other signs, becomes. Initially, animals appear to be slightly
e.g. generalized lack of calcification of bones depressed and weak. They then appear to be
and a pica for anything containing phospho- reluctant to move. They then become ataxic,
rus, like bones. It has been recorded in Australia which will lead to recumbency. There may also
and South America. However, it is not likely to be neurological signs. Azotaemia, lipaemia or
occur in the UK where real deficiency of phos- hyperlipaemia may be shown on a blood sam-
phorus has not been recorded. ple. There will be an elevated GGT. There will
be a ketonuria. The underlying cause needs to
be addressed, e.g. parasitism; however, it may
Hyperlipaemia/keto-acidosis be too late, i.e. it may have been caused by
transportation or changing of animal groups.
Everything must be done to encourage the ani-
Keto-acidosis in SACs is a complex condition.
mal to eat. In severe cases a drip line will need
It can occur at any stage. However, the animals
to be established with normal saline, which
that are most likely to be affected are grossly
can then be spiked with glucose and B vita-
overweight and then receive a stressful situa-
mins. Corticosteroids should not be given as
tion, e.g. parturition, a long journey or even
they will abort the fetus, which will result in
husbandry procedures such as shearing, teeth
the death of both fetus and dam. Propylene
grinding etc. The animals will immediately
glycol by mouth is not advisable as there have
become anorexic and will show acute depres-
been reports of toxicity in SACs together with
sion. Movement of C1 will cease. The animals
the danger of inhalation pneumonia. Sadly the
are suffering from hyperlipaemia. Fat can be
prognosis for recumbent cases is poor.
seen in a blood sample. It is vital that the ani-
mals are encouraged to eat anything possible.
Hand-feeding is useful. Frequent high energy
drenches if given very carefully to avoid inha- Chronic Wasting Disease
lation pneumonia are useful. However, inges-
tion of fibre is important to get movement of Practitioners who are familiar with sheep and
C1. Intravenous injections of NSAIDs are use- goats will have to change their mind-sets with
ful. If the animal is recumbent, a drip should be SACs. Obviously it is the body condition scores
set up initially with normal saline as there is that will need to be examined, as fleeces may
some dehydration and followed by a solution deceive the eye. However, it should be remem-
of 5% glucose. All the time every encourage- bered that on the whole SACs will feel thinner
ment must be given to the animal to eat. The than sheep or goats.
Nutrition and Metabolic Diseases 21

Practitioners should be on the lookout for Abdominal masses may be seen to confirm the
tuberculosis with any SAC showing chronic diagnosis. Peritoneal taps are not helpful as
wasting signs. However, there are many other these tumours rarely shed cells. Obviously if
causes that can be ruled out by a careful clini- the tumour invades the liver, the liver enzymes
cal examination. It should be remembered that will be raised. Haemangiosarcomas and ade-
Johnes disease in SACs is not usually associ- nosarcomas will affect the liver and raise live
ated with diarrhoea, neither is chronic liver enzymes but they are extremely rare.
fluke infection. Lymphosarcoma is the most Liver abscesses are much more common
common tumour seen in SACs. It is usually than tumours. There will be a raised white
multicentric. Diagnosis is typically in the cell count and fibrinogen. The abscess may be
terminal stages due to failure to show clear visible on ultrasound. Prolonged antibiotic
clinical signs earlier. There is often weight loss treatment is required, i.e. for 1 month. Liver
over a period of months and then lethargy sets enzymes may not be markedly affected. On
in and after showing a reduced appetite the the other hand, with the very rare condition
animal becomes rapidly recumbent. Most of cholangiohepatitis the liver enzymes will
cases have ascites on abdominal ultrasound. be greatly increased.
3
Examination

Normal Temperature, Pulse emotionally. They have had a long gestation


and Respiration period. History of previous offspring is always
important, which should include pregnancy
The rectal temperature in SACs can vary from problems, parturition problems and post-
99.0 to 101.0F (37.438.3C). The thermoreg- parturition problems. It should also include an
ulatory ability of the neonate is so poor that enquiry for any congenital defects. This is par-
there can be a much wider range. Although ticularly relevant if the previous sire was the
SACs have evolved in harsh cool climates, the same. Also it is important to enquire whether
insulation ability of their fleece allows a cer- the previous cria grew as well as it was expected
tain tolerance to the sort of heat extremes to do. The actual rebreeding history of the dam
encountered in the UK and other countries since the last parturition is relevant. Enquires
outside of South America where SACs are should be made to find out if the afterbirth was
kept, and the fleece-free underside acts as an retained and whether there was any vulva
area for heat dissipation. tearing or any vaginal discharge. It is relevant
Resting heart rate of an adult SAC varies whether the dam bred successfully within
from 60 to 90/min and is best ascertained by 30 days of parturition or whether the dam was
auscultation caudal to the triceps in the fleece- thought to be pregnant and then found to be
free area medial to the elbow. Very few respi- empty and then re-served.
ratory sounds will be heard either here or Obviously some of these enquiries are
anywhere else unless there is some pathology. not applicable to a maiden. However, it would
Borborygmi are much quieter than in sheep be of interest whether it was difficult to get
and goats, mostly coming from the major the maiden pregnant and also the mothering
fermentation chamber C1. This first compart- ability of the maidens dam.
ment contracts between 3 and 5 times/min Of course the full history of the dam may
depending on feeding. be relevant. It would be important to know if
she suffered heat stress or any medical condi-
tion, e.g. colic, parasitism, diarrhoea or consti-
pation, or if she has had previous surgery, e.g. a
Normal Neonates laparotomy or Caesarean section, or if she has
had any problems with her husbandry, e.g.
These animals are particularly precious as they transport, showing or general mixing in groups.
are valuable not only financially but also often Her body condition score is relevant.

22 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Examination 23

The recent pregnancy history and ges- Soft silky hair;


tation length will be relevant. It should be Round domed head;
remembered that llamas on average have a Unerupted incisors;
longer gestation period by 10 days com- Hoof slippers do not readily peel off;
pared with alpacas. SACs are also capable of Tendon laxity;
an embryonal diapause, i.e. the fetus can Abnormal vigour (either very lifeless or
appear to hibernate in the uterus with an overactive);
extension of gestation length, which is abso- Droopy ears;
lutely normal and of no detriment to mother Congenital defects.
or offspring. Neonatal care will be influ-
enced by the delivery whether it was nor- Later signs may also be indicators:
mal or prolonged. It will also be influenced
Failure to try to get up;
by the birth weight of the cria. Fat mothers
Lying on the side rather than the kush
tend not only to have crias with lower birth
position;
weights but also tend to have more pro-
Abnormal mucous membranes. They
longed labour.
should be pink, not bright red indicat-
Normal gestation lengths are quite vari-
ing septicaemia, or blue indicating
able. The range is from 320 to 360 days.
heart failure, or purple indicating
However, a premature or dysmature cria can
toxaemia;
be born at 350 days. A normal cria should be
Cold ears;
lively and on its feet within 1 h and drinking
Mouth breathing;
within 4 h. Alpaca crias should be in excess of
Erratic heartbeat and rate;
6 kg and llama crias in excess of 8 kg. Crias
No evidence of sucking;
should have passed their meconium within
No evidence of the passing of the
8 h. This is aided by colostrum intake. Their
meconium;
rectal temperature should be in excess of 98F
No evidence of urination;
(37C). Their ear tips should be straight and
Broken off short umbilicus;
their incisors should be felt under the mucosa
Dull eye;
or already erupted.
Rectal temperature below 98F (37C).
A normal cria may lose a few hundred
grams in the first 24 h. However, they should The more of these signs are present, the more
gain at least 1 kg in the first week. Normal serious is the problem. Clinicians should be
crias will have doubled their birth weight slightly mindful of economic considerations
within 1 month. but of course their first consideration must
It is vital to maintain the maternal bond be welfare. Ideally a total blood count (TBC)
and so all fussing should be avoided. There and biochemistry should be taken, but a PCV
should be no interference if there is no and a total protein will be very helpful and
problem. probably sufficient. An initial blood glucose
When carrying out a cria check: to compare with a repeat sample after 24 h is
very helpful. A measurement of passive
Check the sex;
transfer of IgG is vital (see Chapter 4) and
Check the anus;
appropriate plasma transfusion may be
Dress the navel and check for an umbil-
required).
ical hernia;
The following tests may be helpful if
Weigh cria on bathroom scales;
available and economically feasible:
Check suck reflex;
Check teeth. Arterial blood gas analysis;
The following characteristics are evidence of Blood culture;
prematurity: Urinalysis;
CSF analysis and culture;
A truly short gestation; Abdominal fluid analysis and culture;
Low birth rate; Radiographs.
24 Chapter 3

Initial treatments will need to include the fol- species. Remember a normal cria requires in
lowing if appropriate: excess of 0.5 l of good colostrum within the
first 24 h of life.
Oxygen via nasal insufflation (pure oxy-
gen should not be given for more than
30 min);
Broad spectrum antibiotics; Examination of the Head
Oral colostrum; of Neonatal Crias
Plasma i/v or i/p;
Fluids; Mild ectropion of the lower eyelid can be nor-
Regular weighing. mal and should not be confused with either
congenital or acquired ectropion. The whole
If there is no sucking reflex, in a low tech
eye should be examined. There will be seen a
situation goats colostrum may be given,
large dorsal and a small ventral granula irid-
warmed to blood heat, via a stomach tube.
ica nigrum of unknown function but of no
Crias require 5% of body weight in the first
clinical significance. Occasionally an absence
12 h. Obviously the dams four teats should
of pigment will be observed. It will be seen
be checked for patency. Milking dams is a
that there is no fovea or tapetum but a pro-
real challenge as 500 ml of colostrum is
nounced vascular pattern to the retina. The
required.
nasolachrymal duct will be easily seen at its
Cria rejection is rare. It is more common
origin from the medial canthus. Its termina-
in maidens particularly if their cria is weak. It
tion will be observed within the nares on the
is also more common after Caesarean section.
cutaneous side of the mucocutaneous border,
Failure to pass the placenta may make moth-
1 cm dorsal to the floor of the ventral meatus
ers reluctant to allow the cria to suck.
on the lateral wall over the ridge formed by
Emergency intervention is required if a
the pre-maxilla.
cria is less than 5.5 kg in weight or has a rec-
The inside of the ears cannot be exam-
tal temperature of less than 97F (36C).
ined easily without sedation. However, ear
Intervention is required if the cria is lying
problems are extremely rare. In older crias ear
on its side, not in the kush position, and
infections can often produce a secondary
has laboured breathing. Treatment should
facial paralysis, and laceration of the pinna
be to warm the cria but keeping it with its
can be a common sequel of fighting. The
mother. Infra-red lamps can be a fire risk so
canines and the incisors can be examined by
hot water bottles are preferable. An intrave-
curling back the lips (see Chapter 9).
nous drip line should be set up so plasma
Malocclusion is common. Capillary refill can
can be given (see Chapter 11). If a drip line is
be determined using areas of non-pigmented
not possible the plasma can be given
gingival mucosa.
intraperitoneally.
Warm glucose can be given as an enema.
A dose of 20 ml of 20% glucose should be
given. This can be repeated in 30 min. Giving Examination of Adults
colostrum is difficult; it is not only difficult
to collect but also rarely is it given in suffi- Animals may have to be examined for vari-
cient quantities. If the cria is below 97F ous different purposes. These may include
(36C) no IgG will be absorbed. Equally if for insurance, for purchase, for entry into
the cria is over 24 h old there will be little another country or for fibre value. The
absorption. Cow and goat colostrum has forms shown in Appendices 3.13.3 will be
been tried with varying results, with the helpful for practitioners to act as an aid to
added danger of spreading diseases between memory.
Examination 25

Appendix 3.1. Physical Examination Screening Checklist for South American Camelids

(Disqualifying traits are indicated by asterisks)


Name of Import Date of inspection
Lot No. Ear Tag No. Microchip No. Date of Birth
Male Female Age
Head Disqualifying trait present? Yes No
Normal (Y / N)
Face: wry face slight (<2) , moderate (between 2 & 5)* , severe (>5)*
Nostrils: air movement in both nostrils
Ears: long , short , gopher* , frostbitten , curled*
Eyes: entropian* , ectropion , laceration ,
Tearing (evidence of blocked tear ducts) , corneal opacity , cataract* , dilated pupil ,
*
constricted pupil , evidence of blindness , persistent papillary membrane* .
Teeth: superior brachygnathism* (undershot jaw, with central incisors protruding more than
0.3 cm beyond the dental pad ) or inferior brachygnathism* (parrot mouth, overshot jaw,
with dental pad protruding more than 0.3 cm beyond the lower incisors )
retained deciduous incisors , canine teeth erupted .
Comments:
Neck and Body Disqualifying trait present? Yes No
Normal (Y / N)
Throat latch: swelling
Cervical spine: symmetrical , scoliosis*
Movement of neck
Thoracic and lumbar spine: scoliosis* , lordosis* , kyphosis*
Tail: twisted* (must be straight, no bends or kinks)
Comments:
Front limbs Disqualifying trait present? Yes No
Normal (Y / N)
Front view: base wide , base narrow , carpal valgus: slight (<5) , moderate (be-
tween 5 and10) , severe* (>10) ; bowed out at carpus , splay footed , pigeon
toed , polydactyly* , syndactyly* .
Side view: camped forward , camped behind ; angulation: OK , too straight , too
exed ; buck kneed ; calf kneed: slight (<175) , moderate (170175) , severe*
(<165) ; pastern angles: cocked ankle* (>90) , down in the fetlock* (<30) .
Comments:
Rear limbs Disqualifying trait present? Yes No
Normal (Y / N)
Rear view: base wide , base narrow , cow-hocked: slight (<5) , moderate (between
5 and 10) , severe *(>10) ; bowed out at hock , splay footed , pigeon toed ,
polydactyly* , syndactyly* .
Side view: camped forward , camped rearward ; angulation: post legged , too much
exion , sickle hocked: slight (hock angle <135) , moderate (hock angle 135125) ,
severe* (hock angle <125) ; cocked ankle* (>90) , down in the fetlock* (<30) ,
luxating patellas* .
Comments:
26 Chapter 3

Reproductive Disqualifying trait present? Yes No


Normal (Y / N)
Male
Testicles: both testicles not in scrotum* , cryptorchid* (one testicle) ; size* (length
>3cm) ; consistency*: hard , too soft ; scrotal oedema .
Female
Position of vulva
Clitoris enlarged* (evidence of intersex)
Comments:
Cardiovascular Disqualifying trait present? Yes No
Normal (Y / N)
Heart: murmur*
Comments:
Miscellaneous defects Disqualifying trait present? Yes No
Normal (Y / N)
Teats: Must have normal anatomical placement of not more than, nor less than, 4 normal teats*
Hernias: umbilical* (>1 cm) , scrotal* .
Toenails: elongated , curled , abnormal horn .
Other defects: Screening panel members are obligated to report any other serious defects that are
present and that should, in the veterinarians professional opinion, result in disqualication.
Comments:
Having conducted an examination of this alpaca, the undersigned veries that the animal is
[ ] Disqualied for the above-noted defect(s).
[ ] found to be free of the listed defects within the limitations of this eld examination done
without laboratory assistance. This verication does not constitute a guarantee that the
animal is free from all congenital or genetic defects.
Signature: Date:
Signature: Date:
[A second signature is generally necessary only for disqualication.]
Examination 27

Appendix 3.2. Alpaca Phenotype Characteristics Evaluation Form

A total of 55 or 60 points is available on this portion of the evaluation. An alpaca receiving a com-
bined (phenotype and fibre) score of 80 points will be accepted for registration if it otherwise
qualifies.
Name of Import Date
Height (32 in (80 cm) @ withers Minimum) Weight (105 lb (48 kg) Minimum)
Colour Ear Tag Microchip Male Female
Please circle the appropriate score, deduct total faults for each section from maximum points,
and record points scored.

CHARACTERISTIC POINTS SCORED


1. Shape of Head, Muzzle and Ear 10 points maximum
a. Head and Muzzle
1. Normal 0
2. Llama like 10
3. Moderately large 2
4. Fragile face or roman nose 2
Scored on degree of fault
b. Ear
1. Normal, spear shaped 0
2. Asymmetric spear 2
3. Rounded 2
4. Banana shaped 15
5. Pancake ear or other anomalies 15
2. Body Score 15 points maximum
a. Excessive thinness (emaciated) 20
b. Thin 0
c. Optimum 0
d. Somewhat overweight 0
e. Obese 15
3. Conformation and Balance 15 points maximum
a. Leg conformation
1. Correct leg conformation 0
2. Buck kneed or knee sprung
Moderate 5 (per front leg)
Normal 0
3. Calf kneed or sheep kneed
Moderate 7 (per front leg)
Normal 0
4. Sickle hocked
Mild 3
Moderate 10
5. Cocked ankle
Present 20
Normal 0
6. Down on the pasterns
Present 5 (per pastern,
possible 20)
Normal 0
28 Chapter 3

7. Post legged in rear or straight


legged in front
Present front 2
Present back 5
Normal 0
8. Front view
Knocked kneed
Mild 3
Moderate 10
Pigeon toed 5
Base narrow 3
Base wide 3
Bow legged 3
Normal 0
9. Rear view
Cow hocked
Mild 3
Moderate 10
Pigeon toed 5
Bow legged 3
Base narrow 3
Normal 0
b. Balance or correct proportion
of legs, body and neck
1. Normal 0
2. Long legged 5
3. Short legged 5
4. Short neck
Out of proportion 5
Normal 0
5. Long neck
Out of proportion 5
Normal 0
6. Tail set
Normal 0
High (llama like) 5
7. Sway backed or hump backed
Normal 0
Abnormal 5
8. Locomotion
Normal 0
Excessive winging 7
Crossing mid-line 7
Fleece Density (Huacaya) 15/20 points maximum
a. Light fleece 10
b. Average 3
c. Dense 0
d. Very dense +5
Luster and Curl (Suri) 15 points maximum
a. Absence of luster 7
b. Absence of curl 8
Examination 29

TOTAL POINTS of 55 or 60 (60 points possible with very dense fleece)


Pheno Screener Signature Date
Pheno Screener Signature Date
Fibre Characteristics Evaluation Form
The points for bre on this form are the results of a sample taken by the screener.
The tests are done by Yocom-McColl Testing Laboratories.
The points are determined by Yocom-McColl according to a computer program developed
exclusively for the Alpaca registry.
CHARACTERISTIC POINTS AVAILABLE POINTS SCORED
Huacaya bre characteristics
a. Micron count (deduct 10 points
or fraction thereof) 15
for every micro over the 26-micron maximum)
b. Standard deviation (deduct 5 points or fraction 15
thereof for every 0.5 micron over maximum)
17 or less max.std. deviation = 3.5
17.119 max.std. deviation = 4.0
19.121 max.std. deviation = 4.5
21.123 max.std. deviation = 5.0
23.1 and up max.std. deviation = 5.5
c. % of bre over 30 microns (deduct 5 points 15
for every % point in excess of 5% of eece i.e.
7% of eece over 30 microns would result in
loss of 10 points)
Suri bre characteristics
a. Micron count (deduct 10 points or fraction thereof 15
for every micro over the 27-micron maximum)
b. Standard deviation (deduct 5 points or fraction 15
thereof for every 0.5 micron over maximum)
17 or less max.std. deviation = 3.5
17.119 max.std. deviation = 4.0
19.121 max.std. deviation = 4.5
21.123 max.std. deviation = 5.0
23.1 and up max.std. deviation = 5.5
c. % of bre over 30 microns (deduct 5 points 15
for every % point in excess of 5% of eece)
Total Points 45
Signed: Date:
30 Chapter 3

Appendix 3.3. Certificate of Camelid Veterinary Examination

For alpacas aged 60 days or over


Date:
Owner: Address:

Animal I.D.: Colour:


Ear Tag: Microchip No:
Sex: D.O.B.: (or) Estimate of Age:
This is to certify that I , have today examined the animal described above,
and my opinion at the time of examination is as follows:
DETAILS OF EXAMINATION
1. Limbs and Locomotion:
Lameness: YES/NO Comment:
Limb deformities: YES/NO Comment:
Feet/Cleats/Pads: Normal/Abnormal Comment:
Joints: Normal/Abnormal Comment:
2. Lymph Glands:
Normal /Abnormal Comment:
3. Condition:
Poor/Lean/Good/Overweight
(Note: Lean condition in camelids is not necessarily abnormal)
4. Eyes:
Visual Assessment: Normal/Abnormal Comment:
Examination with YES/NO
magnication in a dark
area:
Cornea: Normal/Abnormal Comment:
Lens cataracts observed: YES/NO
Persistent papillary YES/NO
membrane:
Further observations:
5. Teeth:
Are incisors level with YES/NO
hard pad:
Are incisors Normal/Undershot/Over- If Undershot or Overshot, state by how much
shot e.g. < or > 5mm............
Number of incisors present:
Structure of incisors: Very good/Good/Poor
6. Mandible Palpation: Normal/Abnormal Comment:
7. Cardiovascular System Normal/Abnormal Comment:
Auscultation:
8. Respiratory System Normal/Abnormal Comment:
Examination:
9. A) Male
Both Testicles present: YES/NO
Measurement: Left: Length: cm Width: cm
Right: Length: cm Width: cm
Examination 31

(Note: Average length 4 cm, width 3 cm in an adult Alpaca at approximately 3 years of age).
Penis examined: YES/NO Normal/Abnormal
(Note: The prepuce can be adhered to the penis up to 2 to 3 years of age in some males.
Normal nding.)
B) Female External genitalia and mammary Normal/Abnormal
glands:
10. Comments
Other comments / detected abnormalities / or relevant information regarding examina-
tion:

Signed:
Address: Print name
Qualications
THIS SECTION TO BE COMPLETED BY OWNER
1. Breeding history:
2. Female History of Dystocia: YES/NO
Last mating recorded:
Tests done to support pregnancy status and dates:

3. a) Vaccination History
Last reported date of vaccine:
Vaccine used:
b) Worming History
Last herd worm egg count:
Including liver uke examination: YES/NO Present/Absent
Including coccidian examination: YES/NO Present/Absent
Last date of worming and product used:
Signed Date
PRINT NAME
4
Sample Taking and Simple Diagnostic Tests

Introduction most difficult, so swabs for bacteriology in


transport medium should be taken. Bacteria
Many textbooks assume that the parameters can be plated out and grown in the field. Only
for samples are the same the world over. This then can they be submitted for identification.
is not necessarily very helpful. This chapter Equally smears can be made and microscopic
will give a very broad range so that the reader evaluation can be made in the field after
can adapt this book by adding narrower appropriate staining. These slides then can
ranges for the environment of the individu- easily be referred to a more experienced
als practice and from the laboratory availa- pathologist. Antibiotic sensitivity testing can
ble. The term reference range is now widely well be carried out in the field. Relevant anti-
used, rather than normal range. Classically a biotic testing discs can be used. There is little
normal animal is said to be within 95% of the point in knowing the sensitivity of an isolated
normal range. By definition 5% of normal organism to an antibiotic that is not available
animals will not appear to be normal. Thus if or not useful in SACs. Serum samples after
20 tests are carried out every animal is likely centrifugation can be submitted rather than
to have one value outside of the normal range. whole blood. PCVs can be measured easily
Therefore there is a strong argument for only with a bench hand-driven centrifuge. Thick
carrying out specific tests for the parameters and thin blood smears can be used to look for
in which the clinician is particularly inter- protozoal infections. Dung samples can be
ested. Laboratories on the whole do not like examined for bowel worms, lungworms and
this arrangement as they favour a blanket liver fluke eggs. Coccidia oocysts can be
approach, which they find easier and cheaper. included in this screening. Their size can be
Clinicians are urged therefore to work closely evaluated, which is particularly important in
with their particular laboratory so that a com- SACs (see Chapter 9). Fungi can also be
promise regarding cost and relevance is grown. To help, practitioners can submit pho-
reached. tographs of post-mortems to referral patholo-
The author is well aware that getting gists. If e-mail is available this can be carried
samples to laboratories will not be easy or out throughout the world. Obviously histo-
quick in many parts of the world. High tem- logical samples will be extremely helpful in
peratures are likely to be a problem. The tropical climates, as they will withstand
logistics should be considered with the lab- higher temperatures. Care should be taken
oratory. Fresh samples are likely to be the when packing these, as any contamination

32 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Sample Taking and Simple Diagnostic Tests 33

from the formalin on to bacteriological sam-


ples will be disastrous. Vital signs will vary
from climate to climate like normal values
and will show a similar bell-shaped distribu-
tion curve. Clinicians will obviously routinely
carry out a full clinical examination. They will
build up their own range of normal values.
Experience will show how the climate varia-
tions in temperature, air movement and
humidity will affect these values. Naturally
the physical attribute of the SAC will have a
marked effect, for example type, age, gender,
pregnancy etc. The state of the individual, e.g.
stressed, recently transported etc., will cause Fig. 4.1. Taking a blood sample from a SAC.
variation.

in the peripheral blood. The number of


platelets will be reported. The total number
Collecting Blood Samples of white blood cells will be given, which is
then broken down into the total number of
When collecting blood samples it is impor- neutrophils, eosinophils, basophils, lym-
tant to collect into the right anticoagulant phocytes and monocytes. These can be
for the type of analysis required. The correct shown as a percentage, but this may be mis-
volume of blood for the amount of antico- leading. Total numbers are a better figure to
agulant in the bottle is also important. Blood be studied.
should be collected from the jugular vein
with as little excitement as possible, although
this may be difficult with certain individu-
als. Needles and syringes must be clean and
Normal Haematological Values
not contaminated with medicines. It should
be remembered that the carotid artery lies Erythrocyte parameters
just deep to the jugular in the caudal aspect
of the neck in SACs so this area should be The function of red blood cells (RBCs) is to
avoided, i.e. the jugular should be entered carry oxygen to the tissues at pressures suffi-
in the neck nearer to the head. Ideally, less cient to permit rapid diffusion of oxygen. This
experienced practitioners should blood is particularly important for SACs in the
sample SACs on the right hand side to lessen Andes. The carrier molecule for oxygen is
the danger of damaging the oesophagus haemoglobin. This is a complex molecule,
(see Fig. 4.1). For haematological samples formed of four haem units attached to four
the anticoagulant required is EDTA (these globins. Iron is added in the last step by the
bottles often come with a lilac-coloured ferrochelatase enzyme. Interference with the
stopper). Haematological samples will give normal production of haem or globin leads to
measures of the haemoglobin and the anaemia. Causes include copper or iron
number of red blood cells. It should be deficiency and lead poisoning. In the healthy
remembered that if a haematocrit tube is not animal, red cell mass, and thus oxygen-
filled from the top of the sample immedi- carrying capacity, remains constant. Mature
ately before it is allowed to stand the hae- RBCs have a finite lifespan; their production
matocrit will have a lower reading, i.e. there and destruction must be carefully balanced,
will seem to be fewer red blood cells in the or disease occurs. However, if animals are
sample than in reality. Anaemia may then moved to higher altitudes the red cell mass
be misdiagnosed. Even in profound cases of will increase over a period of 3 weeks. This is
anaemia, normoblasts are seen very rarely a normal physiological process. Pulmonary
34 Chapter 4

hypertensive heart disease, often called high- Table 4.1. The haematological parameters of adult
mountain disease (HMD) is recorded in cat- SACs in the UK.
tle but not in SACs.
Parameter Normal
Erythropoiesis is regulated by erythro-
poietin, which increases in the presence of Erythrocytes 109/l 13.8
hypoxia and regulates RBC production. In Size (mm) 3.2 6.5
SACs, the kidney is both the sensor organ Lifespan in days 60225
and the major site of erythropoietin produc- Haemoglobin (g/dl) 15.5
tion, so chronic renal failure is associated PCV (%) 2546.5
with anaemia. Erythropoietin acts on the MCV (fl/cell) 26
MCH (pg/cell) 11.2
marrow in concert with other humoral medi-
MCHC (g/dl) 43
ators to increase the numbers of stem cells Leucocytes/ml 16,200
entering RBC production, to shorten matura- Granulocyte/agranulocyte ratio 1.54
tion time, and to cause early release of
reticulocytes. Another factor that affects
erythropoiesis is the supply of nutrients e.g.
volume of the erythrocytes, is high. Normal
iron, folic acid and vitamin B12. Chronic
mean corpuscular haemoglobin (MCH)
debilitating diseases and endocrine disor-
values in SACs are low as their erythrocytes
ders, e.g. hypothyroidism or hyperoestro-
are small, as seen in Table 4.1.
genism, will suppress erythropoiesis.
A decreased RBC mass (i.e. anaemia)
may be caused by direct blood loss, haemoly-
sis or decreased production. In acute blood Leucocyte parameters
loss, mortality is usually related to loss of cir-
culating volume, rather than actual loss of The leucocytes consist of the granulocytes
RBCs. Iron is the limiting factor in chronic (neutrophils, eosinophils and basophils)
blood loss. Haemolysis may be caused by tox- and the agranulocytes (lymphocytes and
ins, infectious agents or congenital abnormal- monocytes). Although they are traditionally
ities. Decreased RBC production is very rarely counted by determining each as a percent-
a primary bone marrow disease in SACs. It is age of the total leucocyte white blood cells
much more commonly seen from other (WBCs) population, meaningful interpreta-
causes, e.g. renal failure, toxins or veterinary tion requires that the absolute number of
drugs. each type be calculated by multiplying the
SACs have developed at high altitudes, total white cell count by the fraction
therefore they have high haemoglobin val- attributable to the individual cell type.
ues. SACs have small ellipsoid erythrocytes, An increased percentage that is due to an
which circulate in larger numbers. This absolute decrease in another cell type is not
results in a lower packed cell volume (PCV). an increase at all.
The ellipsoid RBCs in SACs orientate with Leucocytosis is an increase in the total
the long axis in the direction of the blood number of circulating WBCs; leucopoenia is a
flow. This makes it possible to traverse small decrease. Changes in WBC counts and mor-
capillaries. Thus there are fewer problems of phologic appearance of various leucocytes
haemoconcentration when the viscosity of are evaluated by comparison with reference
the blood increases during dehydration. ranges for each of the three species. The leu-
This is helpful to the SAC living at altitude. cocyte count is higher in SACs. In neonates
The normal mean corpuscular volume the total WBC count is more variable and
(MCV) of SACs is low because of the smaller often higher than in adults.
erythrocyte size. Normal haemoglobin lev- Unsegmented neutrophils do not nor-
els in SACs are high and the PCV is low, so mally appear in peripheral blood. If they are
the mean corpuscular haemoglobin concen- reported it is an indication of a shift to the
tration (MCHC), which measures the ratio right, i.e. their presence indicates that the
of the weight of haemoglobin to the total neutrophils are young and therefore there is
Sample Taking and Simple Diagnostic Tests 35

an extra usage of neutrophils. This is likely to For example, histamine released by


be a bacterial infection. basophils or mast cells is modulated by his-
The granulocytes are produced in the taminases in eosinophils. The cytoplasmic
bone marrow from the myeloblasts. granules of eosinophils contain proteins
Neutrophils are the most numerous and in that are involved in parasite killing.
the peripheral blood are normally mature, Eosinophilia is induced by substances that
i.e. segmented. Morphological changes in promote allergic responses and hypersensi-
neutrophils cytoplasm, including toxic gran- tivity (e.g. histamine and allied substances)
ulation, may occur during systemic bacterial and by IgE. Eosinophils increase in response
infections or severe inflammation and are to parasitic infections, especially those that
referred to as toxic changes. Although all cir- involve tissue migration, due to the contact
culating WBCs are exposed to the same sys- of parasite chitin with host tissues.
temic diseases, only neutrophils are evaluated Eosinophilia also may occur with inflam-
for toxic changes. Toxic change is graded mation of the GI, urogenital, or respiratory
subjectively as mild, moderate, or marked, tracts, or of the skin.
based on the number of affected neutrophils On the whole the eosinophil counts are
and the severity of toxic change. Clinical sig- high in SACs. However, it should be noted
nificance is reflected by the type of toxic that it is easy to confuse the eosinophils of
change and its severity. Toxic granulation is SACs with the neutrophils. Careful attention
identified by the presence of pink to purple to detail should be taken when counting is
intracytoplasmic granules within neu- being carried out manually. If electronic
trophils; these granules represent primary counting is carried out there may well be
granules of the neutrophils that have retained some strange results. Usually the number of
their staining affinity. Diffuse cytoplasmic eosinophils will appear high as a percentage
basophilia and cytoplasmic vacuolation fre- of the totally number of granulocytes. If in
quently occur together. The cytoplasmic any doubt the sample should be recounted
basophilia is due to persistent ribosomes, manually. Eosinopaenia is commonly
and the cytoplasmic vacuolation possibly reported with corticosteroid-induced (stress)
due to autodigestion of the cell. conditions.
The magnitude of neutrophilia induced Basophils are rare in SACs. A basopenia
by inflammation is a function of the size of has no diagnostic significance. The granules
the bone marrow storage pool of granulo- in basophils contain histamine and heparin,
cytes, hyperplastia of the marrow, and rate of as well as mucopolysaccharides. Although
WBC migration into the tissues. The storage basophils and mast cells have similar func-
pool is quite large in SACs. Neutrophilia, tions and enzymatic contents, basophils do
often the cause of leucocytosis, generally not become mast cells and there is no proof of
characterizes bacterial infections and condi- a common precursor cell.
tions associated with extensive tissue necro- Lymphocytes originate from a marrow
sis, including burns, trauma, extensive stem cell and mature in lymph nodes, spleen
surgery and neoplasia. Extreme leucocytosis and associated peripheral lymphoid tissues.
is seen in blood-borne protozoal infections Mature lymphocytes consist of two subpop-
and closed cavity infections, e.g. abscesses. ulations, B cells and T cells. B cells are the
The wall of these inhibits the migration of precursor of plasma cells and produce anti-
neutrophils into the site of infection, but does bodies for humoral immunity. T cells engage
not impair the release of leucocyte chemotac- in cellular immunity. A lymphocyte in tissue
tic substances. The net effect is a high periph- may return to the vascular bed and recircu-
eral neutrophils count, which often includes late. Some lymphocytes are long-lived com-
an increased number of band neutrophils pared with other WBCs and may survive
(regenerative left shift). weeks to years. Care should be taken when
Eosinophils contain enzymes that mod- evaluating a peripheral lymphocytosis as it
ulate products of mast cells or basophils may be physiological. However, it may be as
released in response to IgE stimulation. a result of immune stimulation associated
36 Chapter 4

with chronic inflammation. Lymphopenia is through the lumbo-dorsal facia and the
a common finding. It is commonly associ- interarticulate ligament and suddenly less
ated with stress or viral disease. However, resistance will be felt.
clinicians should be aware that the adminis-
tration of corticosteroids will cause a
lymphopenia.
Analysis of Cerebrospinal Fluid Samples
Monocytes are formed in the bone mar-
row and enter the peripheral blood for a day
and then exit into the tissues. They tend to be Bacteriology
fixed or migrate to sites of inflammation.
Monocytosis is associated with chronic The sample should be cultured and a smear
inflammation and when there are bacteria in prepared. This should be examined after
the blood stream, e.g. in an endocarditis. Gram stain under the oil emersion on the
Granulomatous and fungal conditions will microscope.
also cause a monocytosis. Occasionally there
will be a monocytopenia, however, it is of no
diagnostic significance. Protein concentration
The ratio of granulocytes to agranulo-
cytes is high in SACs and the response to a
In a normal CSF sample this should be very
bacterial infection is also high.
low, i.e. <0.4 g/l.
High neutrophils and protein concen-
tration are indicators for surgery in colic
cases. The only differential would be a
peritonitis, which should give a high rectal White cell concentration
temperature.
The normal number of cells in CSF is low, i.e.
<0.012 109/l. A differential count is useful.
The macrophages should be examined care-
Obtaining Cerebrospinal fully as phagocytosed RBCs will indicate sub-
Fluid Samples arachnoid haemorrhage. A large number of
eosinophils will indicate meningeal worm
Collection of cerebrospinal fluid samples infection. The actual worm is unlikely to be
(CSF) can be carried out at the atlanto- seen.
occipital space, but most practitioners use
the lumbosacral space as this can be accom-
plished without a general anaesthetic.
It should be remembered that SACs have Important Principles for All
seven lumbar vertebrae and so the site is Laboratories and Samples
caudal to L7. The sample should be collected
in the kush position. Light sedation with It is important with all laboratory tests that
xylazine is helpful in all but the quietest of practitioners apply two important princi-
animals. The dorso-spinous process of L7 is ples. Each test should have a known test
easy to locate as it is much higher than the sensitivity and test specificity. Sensitivity
dorsal processes of the sacrum. A 3.5 inch is the percentage of diseased animals that
18 G needle will be required. After careful test positive and specificity is the percentage
skin preparation of the site a small bleb of of non-diseased animals that test negative.
local anaesthetic with a 23G needle should Ideally all tests would be 100% sensitive
be placed under the skin half an inch caudal and 100% specific. However, this is very
to the spine of L7 in the midline. The site for rarely the case although normally tests
collection is half an inch long and over an have sensitivities and specificities in the
inch wide. It should be entered vertically. high 90%s. Practitioners should be aware
Once through the skin the needle will pass of test limitations.
Sample Taking and Simple Diagnostic Tests 37

No practitioner should be without Anthrax Smears


minimal facilities for initial screening and
processing of samples for dispatch. Inevitably These are normally blood smears but they may
no practitioner will have the wherewithal to be taken from swellings around the throat.
provide all the specialist tests that might occa- Two microscope slides are required. A drop of
sionally be required. A compromise has to be blood or fluid is put on the end of one slide.
reached depending on the availability of The other slide is just dipped into this drop
trained technical staff, likely throughput of and drawn down the length of the slide to
samples, etc. Here are some specific hints make a thin smear. This is then dried in the air.
(MacDougall, 1991): The smear is fixed to the slide by passing the
General (internal or external labora- slide through a flame with the smear down-
tories): wards towards the flame. Once cool the slide
DO take samples before any therapy; with the smear is turned upwards. McFadyeans
DO examine samples as soon as stain (old methylene blue) is poured on to the
possible; slide and left for 30 s. The slide is then rinsed
DO dispatch samples as soon as under a running tap. Once dried, the slide can
possible; be examined under the oil emersion power of
DONT dispatch samples which are a microscope to check for anthrax bacilli. These
unlikely to be diagnostic. will take up the stain and have a characteristic
Internal (practice) laboratory: purple capsule.
DO keep any surplus samples in suitable
conditions in case further tests are
required; Abdominocentesis
DONT delay in preparation of samples.
External (specialist) laboratory:
This should be performed under ultrasono-
DO ensure all samples are adequately
graphical guidance. Pockets of fluid will be
labelled accompanied by full case details
found on the medial or lateral side of C3 at
and correctly packaged;
sites a few centimetres right of the midline or
DO be aware of the tests limitations;
close to the right costo-chondral junction.
DONT send sharps with the material.
Clip the area and prepare it aseptically. Instill
2 ml of local anaesthetic under the skin and
into the muscle. Make a very small incision
Safety in the Laboratory through the skin and then push a teat cannula
through the peritoneum.
Unlike large organizations with appointed High neutrophils and protein concentra-
safety personnel, small businesses such as tion are indicators for surgery. The only dif-
veterinary practices cannot readily dedicate a ferential would be a peritonitis, which should
large amount of time and manpower to health give a high rectal temperature.
and safety. However, equally high standards
of safety must be maintained. The most effi-
cient means of achieving them is to spend
some time identifying all safety hazards. Analysis of First Gastric
These can be categorized as being due to Compartment Fluid
infection, chemicals or equipment. This
should be done by a senior member of the Fluid from C1 can be collected from SACs via
practice who should be designated as prac- an orogastric tube or via percutaneous para-
tice safety officer. An accident book should centesis. The results are similar. However,
be kept for the purpose of recording all inju- unlike cattle, SACs strongly resist the pass-
ries, diseases (see Chapter 17) and dangerous ing of an orogastric tube and therefore percu-
occurrences in, or associated with, the work taneous paracentesis is the method of choice.
of the laboratory. Percutaneous paracentesis can easily be
38 Chapter 4

performed with a 7.5 cm 16G needle in the The internal wall of the abscess should be
left abdominal region caudal to the ribs, scraped if possible as the organism
which should be clipped and surgically pre- Corynebacterium pseudotuberculosis, which is
pared. The best position is 20 cm caudoven- fairly straightforward to grow, is more likely
tral to the costo-chondral junction of the last to be isolated than just culturing the pus.
rib. The needle can be guided ultrasono- There is no ELISA test available for SACs.
graphically. It should be pointed in a dorso-
craniomedial direction, perpendicular to the
contour of the body wall and pushed through Coccidiosis Oocysts in Faeces Tests
the skin and abdominal musculature for its
full length into the lumen of C1. Fluid can be
Modified McMaster technique
aspirated with a 20 ml syringe.
The results can be useful in distinguish-
ing different types of gastrointestinal distur- The oocysts are floated in a saturated sodium
bances and to facilitate the diagnosis of chloride solution (specific gravity 1.20) before
subacute acidosis of C1 on a herd basis. light microscopic examination; this method is
Microbial activity can be measured using the suitable for detecting small coccidia, for exam-
MBR test as follows: 1 ml of a 0.3% solution of ple, Eimeria alpacae, E. lama and E. punoensis.
methylene blue is added to 20 ml of rumen
fluid or less on a pro rata basis. The percent-
age of protozoa that stain with iodine can be Improved Modified McMaster technique or
measured, which will give an indication of saturated zinc sulfate technique (also called
carbohydrate depletion. This should be per- the modified Stoll technique)
formed immediately on sampling or an erro-
neous low result will be obtained. The oocysts are floated in a saturated zinc
sulfate solution (specific gravity 1.36)
before light microscopic examination; this
Bronchoalveolar Lavage Technique method allows the detection of larger
coccidia, for example Eimeria ivitaensis and
E. macusaniensis.
This rather specialized technique can be used
to diagnose viral and bacterial lower airway
disease. The animal should be restrained in the
kush position. The area 5 cm caudal to the lar- Two further modifications
ynx should be clipped and surgically prepared. of the McMaster technique
Local infiltration of local anaesthetic solution
should be carried out before a further surgical Saturated sugar solution is used in this tech-
preparation. A 12G 52 2.7 mm intravenous nique. It is prepared by dissolving 454 g of
catheter should be introduced at 45 to the skin sucrose in 335 ml of hot water.
so that the point of the needle is between two
trachea rings. A smaller tube of polyethylene Method 1
with a needle mount is then passed down the
catheter for roughly 180 cm. Then 30 ml of ster- Macerate 4 g of faeces with a little water and
ile isotonic saline is introduced, which is with- leave in a refrigerator overnight. Add 26 ml of
drawn in 5 to 10 s. Normally 5 ml will be the saturated sugar solution and filter. Fill both
recovered. sides of the McMaster slide and wait for 15 min.
Count both sides and multiply by 25. This will
give you the number of eggs per gram.

Caseous Lymphadenitis Test


Method 2

The gold standard caseous lymphadenitis Liquefy 2 g of faeces in 98 ml of saturated


(CLA) test is culture from pus from a lesion. sugar solution and then centrifuge 10 ml
Sample Taking and Simple Diagnostic Tests 39

@ 1000 rpm for 5 min. Discard the liquid and but effective precipitation method for meas-
re-suspend the solids in 10 ml of saturated uring plasma immunoglobulin levels and
sugar solution and re-centrifuge. Fill the tube results can be obtained quickly.
with more saturated sugar solution to create a Should values be low then measures
meniscus. Place a cover-slip and leave for need to be taken to raise immunoglobulin
10 min. Count the eggs and multiply by 5. levels.
This will give you the number of eggs per
gram.
Both these methods are suitable for the Fecal Worm Egg Count
examination of faeces for finding large
oocysts.
Massive high fecal worm egg counts (FECs)
are seen in adults with Haemonchus contortus
infestation worldwide. With thin animals
Determination of Passive clinicians should be aware that old SACs
Immune Status in Neonates with Johnes disease will also show high
counts.
Care must be taken using the McMaster
In order to provide young mammals with
technique as this test has a very low sensi-
passive immunity against disease for a con-
tivity for eggs from Capillaria spp. and
siderable period after birth, immunoglobulin,
Trichuris sp. The eggs can easily go undetec-
principally IgG, is transferred from the dam
ted, and yet are capable of causing extensive
in utero and/or by colostrum intake after
intestinal damage. The presence of these
birth. This immunoglobulin transfer is neces-
parasites irrespective of the number in the
sary for protection and survival of the new-
FEC warrants aggressive anthelmintic treat-
born since IgG activates the complement
ment. The eggs are easier to find using a
cascade which triggers an immune response.
modified Stoll technique. For a single worm
In humans, IgG is transferred directly to the
egg count only 6 g of faeces are required but
baby through the thin-layered haemochorial
for a combined fluke and worm count 40 g
placenta. However, SACs have a thick-layered
of faeces are required. For pooled worm egg
epitheliochorial placenta, which prevents
counts 10 3 g samples should be submitted
transfer of IgG and thus must obtain passive
separately and pooled in the laboratory. For
immunity by intestinal absorption of immu-
a pooled fluke egg count 10 5 g samples
noglobulins in colostrum. Colostral intake of
need to be submitted.
neonates can be influenced by a wide variety
of intrinsic and environmental factors.
However, it would appear that failure of pas-
sive transfer is a serious problem in SACs and Fluid Therapy
has been reported to be a major cause of neo-
natal deaths (Garmendia, 1987). Assessment SACs are very used to dealing with dehy-
of passive immune status of compromised dration and so estimating fluid deficit is dif-
SAC neonates is thus essential to enable ficult. Tenting of the skin cannot be used and
prompt remedial action to be instigated, par- so clinicians have to rely on the mucous
ticularly if there has been complete failure of membranes to look for dryness or tackiness.
passive transfer. Checking urination is useful. Any SAC that
The most reliable and easy test available does not urinate within 8 h should be sus-
to the practitioner is the zinc sulfate turbi- pected of being dehydrated. Hospitalized
dity (ZST) test. When zinc sulfate is added to SACs are often reluctant to drink. Clinical
a serum sample it dehydrates the proteins in pathology is not easy as SACs often show
the serum causing them to precipitate and haemoconcentration and hyperproteinae-
thus the sample becomes turbid. The degree mia. Water requirements seem to vary
of turbidity can be directly related to the between 2 and 10% of body weight. A 5%
protein content of the sample. It is a crude figure for maintenance would seem
40 Chapter 4

approximately correct. Fluids must be given is likely. This may be sepsis or gut compro-
slowly, ideally with a bolus of no more than mise. Potassium is always low in colic cases.
2%. Aminoglycosides and NSAIDs should A drop in sodium and chloride is not really
be avoided in dehydrated patients. Acidosis significant. However, if the drop in chloride
is rare in sick SACs but alkalosis is common, is more marked it is suggestive of an
so a plain balanced electrolyte solution is obstruction between the pylorus and the
best with an additional supplement of potas- ileocaecal junction. The lower the chloride,
sium. Most hospitalized gastrointestinal the higher up is the obstruction. Low albu-
patients are cachexic and will require partial men will indicate gastric ulceration. High
parenteral nutrition. An ideal solution would albumen will indicate dehydration. High
be 5000 ml of acetate containing electrolyte liver enzymes will indicate hepatitis and a
solution with 1000 ml 8.5% amino acid high amylase will indicate pancreatic
solution and 20 ml of B vitamins, together disease.
with 500 ml of 50% dextrose and 130 mEq In summary, the most important signs
potassium as KCl. This solution should be are when two samples are taken 1 h apart and
given at 2 ml/kg/h. As the amino acids and the values are seen to be deteriorating. This is
B vitamins are light sensitive it should be an indicator for surgery.
maintained warm in a black polythene bag.
Triglyceride levels are useful to monitor the
situation.
Liver Biopsy

Johnes Disease Test Hepatic diseases reported in SACs include


primary and metastatic neoplasia, keto-
acidosis/fatty liver syndrome and fluke
The gold standard test for Johnes disease in
infections. A liver biopsy will aid the clini-
SACs is the identification of the causal organ-
cian in making an accurate diagnosis and
ism Mycobacterium avium subsp. paratubercu-
prognosis of the case. A biopsy will also help
losis (MAP) following faecal culture. The main
in toxicological problems as well as deficien-
limitation of the test is the timescale. Standard
cies of iron, copper, selenium and zinc.
cultures take up to 12 weeks. There are modi-
Clinicians should be aware of the dangers of
fied liquid cultures that will give strong posi-
the procedure, which are: haemorrhage at the
tive results in 3 days. However, there is
site; initiation of a systemic inflammatory
reduced specificity.
response; and initiation of hepatic inflamma-
There are PCR tests available that give
tion and cholestasis.
more rapid results and claim similar high
The site for biopsy is 2030 cm from the
sensitivity and specificity but these must be
top of the back on the right side between
viewed with caution.
the 8th and the 9th rib or the 9th and the
Faecal smears can always be examined
10th rib. The area should be surgically pre-
after staining with Ziehl-Neelsen staining but
pared and local anaesthetic should be infil-
these will only show acceptable sensitivity
trated. A small skin incision should be made
values very late on in the course of the
and a 14G Tru-Cut Biopsy needle should be
disease.
inserted. Using ultrasound guidance the
needle is directed medially and caudally
through the edge of the diaphragm.
Laboratory Evaluation in Colic Cases The liver is in direct contact with the dia-
phragm, and so a biopsy can be obtained
Lymphopenia is the response shown by after the needle has only been inserted 3 mm
SACs to stress. There will be a normal or through the diaphragm. The skin is closed
high neutrophil count with no immature with a single non-absorbable suture.
cells. Fibrinogen levels will be normal. If The animal and the biopsy site should be
fibrinogen levels are up, bacteria involvement examined daily.
Sample Taking and Simple Diagnostic Tests 41

Liver Enzymes Tests for Cerebro-Cortico-Necrosis

Aspartate aminotransferase Blood test for transketolase estimation

Aspartate aminotransferase (AST) will be A blood sample in a heparinized tube (green


raised in liver disease, but it is not liver- top) is required to test for cerebro-cortico-
specific and so will also be raised as a result necrosis (CCN).
of muscle cell damage.

Faeces test for thiaminase


Gamma glutamyl transferase
A total of 30 g of faeces is required.
Gamma glutamyl transferase (GGT) is spe-
cifically raised in liver disease. Although
there are high levels in the kidney it is excreted Triclabendazole Resistance Test
straight into the urine and does not get into
the blood. Researchers have found (Flanagan et al., 2011)
that a coproantigen reduction test (CRT) proto-
col can be used for the diagnosis of triclabenda-
Glutamate dehydrogenase zole (TCBZ) resistance using the BIO K201
ELISA. They suggest that the resampling time is
Glutamate dehydrogenase (GLDH) is raised 14 days after treatment (with the inclusion of
in acute fluke infections and is the most reli- positive and negative coproantigen samples as
able liver enzyme to detect this condition. controls), and that samples be stored in a fridge
or freezer before processing.

Lungworm Tests
Tuberculosis Testing
Normally lungworms eggs will not be seen
on the standard FEC. However, in cases of Skin testing procedure
Johnes disease there will be such high levels
that eggs will be seen. Normally lungworms Equipment required
are looked for as larvae using the Baermann
technique. A sieve and some gauze are posi- 1. Avian and bovine tuberculin.
tioned in a funnel connected to a tube and a 2. Disposable 1 ml syringes graduated to 0.1 ml.
tap. Faeces and some water are placed in the 3. Short 25G needles.
funnel and left for 48 h. The larvae migrate 4. Vernier callipers.
through the gauze and settle in the neck of 5. Marker pen.
the funnel. The water in the neck of the funnel
is then drained off carefully. This sediment Test technique
can then be examined under the high power
1. 0.1 ml of avian tuberculin is injected intra-
of the microscope to look for first stage lung-
dermally into a prior marked injection site on
worm larvae. A minimum of 50 g of faeces is
the right thoracic cage in the axilla.
required for the test.
2. The intradermal pea-sized swelling is felt
and measured to the nearest 0.5 mm.
3. 0.1 ml of bovine tuberculin is injected intra-
Paired Samples for Serology dermally into a prior marked injection site on
the left thoracic cage in the axilla.
These are useful for retrospective diagnosis 4. The intradermal pea-sized swelling is felt
for a variety of diseases. and measured to the nearest 0.5 mm.
42 Chapter 4

5. In the event of the pea-sized swelling not array to detect evidence of immune response
being felt on either side a further intradermal to TB. It appears to be more accurate than the
injection should be made on the same side other two blood tests. However, it may be too
810 cm away. cumbersome to use on large numbers of
6. The fold of skin on the same site should be animals.
re-measured after 72 h.

Reading and interpretation Ultrasonography of the Eye


SACs are considered potentially infected
(reactors) if a positive reaction (i.e. >2 mm This can be a useful technique in SACs to
increase or detectable oedema) is observed at assess the eye. It is best to use a transpalpe-
the bovine tuberculin injection site 72 (6876) h dral approach without a stand-off in a hori-
after injection and the skin thickness at the zontal plane. The retrobulbar space can be
bovine site exceeds that measured at the avian evaluated to establish the cause of any swell-
injection site. ings. Any fine-needle aspirates can be guided
The skin test is claimed to be 100% spe- by ultrasonography. Tumours and abscesses
cific, i.e. if they are positive they almost can be found in this space.
always have tuberculosis (TB). However, the
sensitivity is in the order of 20% and so four
out of five diseased animals are going to be Urine Tests
missed by the test.
Normal urine is clear and pale to yellow.
Cloudy urine indicates inflammation. The
Tuberculosis blood tests likely causes are:
Urethral rents or trauma;
At the time of writing there are three possible Pyelonephritis;
blood tests that might be fully developed in Cystitis;
time. However, the skin test is the only accept- Urolithiasis;
able test for the UK government. Urethritis.
Urine may change colour after it is voided due
Chembio Rapid Stat Pak test to the presence of oxidizing agents. Pigments
This test uses the principle of detecting cer- in the urine may also stain bedding a red
tain proteins in the blood, which show the colour. This may be misleading and give the
animal has mounted an immune response to impression that the urine itself is discoloured.
TB. It appears to be more sensitive than the Discoloration may be caused by:
skin test but less specific. Haematuria erythrocytes in the urine;
Haemoglobinuria haemoglobin in the
Camelid Specific Gamma Interferon test urine, secondary to haemolysis;
Myoglobinuria myoglobin in the urine
This test is an adaptation from the cattle inter- secondary to nutritional muscular dys-
feron test, which does not work in SACs. The trophy and in certain plant poisonings
camelid specific test uses camelid proteins resulting in muscle necrosis.
instead of bovine ones. It appears to be
promising. A free catch urine sample is the most appro-
priate sample to collect. Catheterization in
Multi Antigen Print Immunosorbent male animals is not possible and in female
Assay (MAPIA) test animals may cause trauma and give a con-
taminated sample. After a gross visual exami-
The Multi Antigen Print Immunosorbent nation some urine should be retained in a
Assay (MAPIA) test uses many proteins in an sterile container for bacterial culture.
Sample Taking and Simple Diagnostic Tests 43

The urine should be tested with dip- tail should be bandaged and the perineum
sticks. These reagent strips vary and therefore washed. A small mares speculum can be
it is important to read the instructions care- used to visualize the cervix. A pair of endome-
fully or a false result may be obtained. Most trial biopsy forceps should be passed through
sticks will give an indication of whole blood the cervix. Unless the SAC is very large and a
or the presence of pigment, either haemo- rectal examination can be performed the sam-
globin or myoglobin. They will give an indi- ple will have to be taken blind. The sample
cation of the presence of protein. The likely should be preserved in 10% formol saline and
cause of this will be inflammation. However, sent to the laboratory.
the inflammation may be occurring anywhere Ideally a clinician with small hands
from the kidneys down to the urethral orifice. should carry out this procedure using copi-
The presence of sugar indicates a clostridial ous amounts of lubricant. The owner of the
infection (see Chapter 9). However, sedation animal should be warned of the risks
with xylazine will also cause glycosuria. involved.
The specific gravity will range from 1006
to 1015. The average is 1010. However, rises
in the specific gravity must be viewed with
caution as it may just indicate the presence of
Uterine Culture
pigments in the urine.
Centrifugation of the urine and examina- Uterine culture can be performed in SACs with
tion of the supernatant may help. It will be a commercially available guarded culture swab
clear if red cells are in the sediment. However, in a similar manner to uterine biopsy. Frequent
if there is haemoglobinuria the supernatant pathogens isolated are Streptococcus spp.,
will remain pink after centrifugation. This Staphylococcus spp., Escherichia coli, Pseudomonas
should be carried out at 1000 rpm for 5 min spp. and anaerobes.
ideally within 30 min of collection. The sedi-
ment can be made into smears and examined
either immediately or after staining with Uterine Lavage
methylene blue. Cells, crystals and bacteria
may be seen. Sperm are a normal finding in
Uterine lavage can be performed in SACs
urine of sexually active males.
using a 12G Foley catheter. Placement of the
catheter is performed in a similar manner as
the uterine biopsy forceps. The procedure is
Uterine Biopsy made much easier with a piece of wire in the
catheter to guide it through the cervix. It can
Uterine biopsy may be performed to evaluate then be removed when the cuff is inflated.
reproductive failure. The endometrium of A volume of 1 l of isotonic saline should be
SACs contains fewer endometrial glands than instilled by gravity and then sucked back out
that of mares, and biopsy results when exam- by lowering the plastic giving bag. This
ined by an equine pathologist will be consid- should be repeated until the returning liquid
ered abnormal. An intramuscular injection of appears to be visibly clean. Then a 5 mega
2 mg of oestradiol cypionate given 24 h before crystalline penicillin vial diluted in 20 ml of
the biopsy will allow the cervix to dilate and water for injection and 10 ml of 10%
facilitate passage of the biopsy instruments. Franomycetin should be instilled before the
There is rarely a need for sedation or an epi- Foley catheter is removed. Penicillin can be
dural. Before performing the procedure the injected intramuscularly for 5 days.
5
Veterinary Equipment

Equipment for Handling and relatively inexpensive. A hand-driven


centrifuge for larger tubes is very cheap
Small halter. and can give adequate results.
Lunge line is useful for herding. Labels, notebook and a pen are all
5 1 m lengths of soft 1 cm diameter rope required for recording cases and sample
are required to help with restraint during taking.
Caesarean section. A magnifying glass is useful in skin
examination.
A McMaster slide is required for carry-
ing out faecal worm egg counts. Great
Equipment for Diagnosis care should be taken when handling the
cover slip (with the squares), as they are
Blood slides and coverslips. delicate and expensive.
Blood tubes are required with different A microscope is a delicate piece of equip-
anticoagulants. ment. I do not recommend that one be
Biopsy punches of the small 8 mm dis- carried in the vehicle as a routine.
posable type are useful for skin biopsies. However, the use of a microscope at
There are sophisticated biopsy gadgets ones base is vital. It needs to be equipped
available, which are vital for certain for oil emersion. Diff quick slides are
biopsies, e.g. liver biopsies. useful. Gram stain, Giemsa and methyl-
A digital camera is important so that the ene blue are important.
clinician has the ability to download the Sample bottles containing formalin are
photographs, label them, store them, and required for preserving biopsy material.
send them as attachments to e-mails. They should be stored separately from
Faeces sample bottles of sufficient size swabs required for bacteriological
are required. Clinicians should be aware sampling.
that quite large amounts of faeces are Small strong polythene bags are useful
required for certain examinations. At for skin samples and for double sealing
least 70 g should be collected. various other samples, e.g. faeces sample
Haematocrit centrifuge tubes can be used bottles.
without a centrifuge to get a quick idea of a Stethoscope is the second vital piece of
PCV. However, a mini-centrifuge is useful diagnostic equipment after the clinical

44 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Veterinary Equipment 45

thermometer. Ideally it needs to be slim so However, with modern plastering materials it


that auscultation is possible under the is seriously hard work to remove casts.
muscles caudal to shoulder. Also ideally An oscillating saw is quick and accurate.
both a bell and a diaphragm should be
present. Obviously there are sophistic-
ated stethoscopes available, e.g. Litmans. Splints
However, the inexpensive models are
quite adequate.
Where funds are tight there is no need for
A thin stomach tube is required with a
sophisticated splints. Smooth lengths of wood
rectangular piece of wood to act as a gag,
and plastic guttering are quite adequate.
with a hole to pass the tube through. This
Any sharp ends can be rasped smooth and
is useful for giving large volumes of
covered with gutter tape.
liquid.
Various types of swab are required. Some
should have transport media and some
plain. Sometimes a very narrow swab Equipment for the Eyes
will be required.
A clinical thermometer is vital. The tradi- Catheters
tional glass thermometers will last for
years if kept carefully in a plastic case. 1 mm 10 cm to cannulate the nasolachrymal
They are hard to acquire in the UK because duct.
of the mercury content. However,
there are digital thermometers available.
The clinician needs to choose whether Fluorescein strips
the thermometer reads centigrade or
Fahrenheit. It is just a matter of with which
These are inexpensive and vital not only for
the clinician is happy.
revealing the presence of deep corneal ulcers
Urine dip sticks are useful occasionally.
but also for testing the patency of the tear
ducts. It should be remembered that it takes
up to 30 min for the fluorescein to reach the
Equipment for the Feet nasal end of the tear ducts in llamas and
alpacas after instillation in the eye.
Gutter tape

A roll of this tape is very useful for making Lacrimal irrigation needle
bandages waterproof in the hoof area. It is
also useful for covering poultices.
A 22 gauge is required.

Small, sheep-size hoof clippers


Ophthalmoscope

These should be kept well oiled.


This is an expensive piece of equipment but is
important to the clinician. Much can be found
out by examining the eyes carefully with a
Equipment for the Limbs bright small torch and a magnifying glass.
Sadly, however, without a good ophthalmo-
Oscillating saw scope some pathological conditions will be
missed. Although a slit-lamp is very useful
This might be considered not to be essential for examining dogs eyes, it is not required for
as a hand-held plaster saw can be used. llamas and alpacas.
46 Chapter 5

Equipment for Dentistry, Including Small ruminant gag


Equipment for Sinoscopy
These are hard to obtain. At the time of writing
Dental elevators there are none manufactured commercially
(see Fig. 9.1).
As used for removing wolf teeth in horses are
helpful.
Equipment for Stitching

These items are self-explanatory. I will list


Dental picks them for completeness. The clinician can
manage with very few.
These should be strong to allow the practi-
tioner to pick out the food matter compacted
between the teeth in diastemata. Artery forceps

These can be straight or curved. Several pairs


are required.
Dental rasps

A small diamond-covered rasp is required. Clippers

These are a luxury. However, they make


stitching and wound management so much
Headlight
cleaner and easier. The ideal is the rechargea-
ble battery type.
There are some extremely bright torches
available with heavy battery packs. These are
not really required and a light, which is easily
Drapes
taken on and off, is preferable.

A single sterile drape is required as a tray


cloth by the ambulatory clinician. However,
Molar extraction forceps drapes will be required for other surgery.

Two pairs are required. They should be 20 cm


long, one should be straight and the other Dressing forceps
should have the extracting jaws at right angles.
The ends of these forceps are important: they
can be flat or rat-toothed. A pair of each
would be required.
Molar spreaders

A small pair 20 cm long is required. Dressing scissors

A pair of curved, blunt-ended scissors needs


to be readily available for trimming hair.
Mouth-washing syringe However, a straight pair with pointed ends is
required for a stitch-up kit. There are various
A catheter tip 60 ml syringe is adequate. different sizes.
Veterinary Equipment 47

Needle holders Towel clips

There are various types. The most convenient These are not normally required by the
for stitching up wounds is the combination of ambulatory clinician unless surgery is going
cutting and holding type called Gillies. to be performed under a general
anaesthetic.

Scalpel blades
Swabs
These come in different sizes and shapes for
different procedures. Sets of sterile swabs are required for a variety
of tasks.

Scalpel handle
Equipment for the
It is important that the scalpel handle is the Reproductive System
same size as the blades.
Vaginal speculum

Stitch-cutting scissors These can be disposable and used with a


small hand torch. The small duck-billed type
These small scissors need to be available for affords the very best visibility.
removing sutures.

Equipment for Post-Mortem


Suture material
These articles are not normally carried by an
This may be absorbable or non-absorbable. It ambulatory clinician (see Chapter 15).
may also be either monofilament or braided.
On the whole monofilament non-absorbable
will be required for skin wounds. Specialist Equipment

I have included these items for complete-


Suture needles ness. It would be very useful to have the
use of some of these items of equip-
These come in various shapes. They are also ment. However, within the scope of this
either cutting or non-cutting. On the whole book a full description would not be
cutting needles will be required for the skin worthwhile.
and non-cutting for soft tissue.
Blood analyser;
Centrifuge;
Gaseous anaesthetic machine;
Tissue forceps Operating table;
Refractometer;
These forceps are for lifting tissue. A mini- Ultrasound scanner;
mum of two pairs is required. X-ray machine.
6
Veterinary Medicines

Introduction Antibiotics in General

There are no medicines licensed for use in Although SACs are not ruminants, they do
SACs in the UK. The owners consent should have fermentation chambers in their foregut.
always be sought before any drugs are admin- It is very important that owners are instructed
istered to SACs, and the use of a consent form not to give oral antibiotics to adult SACs
is recommended by one authority (DAlterio, under any circumstances. They can only be
2006). Clinicians will need to use their judge- given to young crias.
ment, as drugs licensed for sheep and cattle Before deciding on an antibiotic it is rel-
can be used on the cascade principle. There evant to consider that it can only be given by
are a very few drugs which are useful for use injection. The owners ability must be care-
in SACs which are only licensed for humans. fully considered. If the antibiotic needs to be
These may be used using the cascade princi- given daily, unless the clinician is entirely
ple provided there is no similar drug licensed confident in the owners ability the clinician
for animals. must return to repeat the injection every day.
Correct storage of medicines is very The clinician might decide after instructing
important. Practitioners should always the owner to watch the owner actually carry-
follow the instructions on the data sheets. ing out the injection before deciding on a
The practice medicine store, the practice course of action. On the whole it is prudent to
refrigerator, the in-car refrigerator and the use an injectable antibiotic that can be given
car itself should have their temperatures subcutaneously to make it easier for the
monitored constantly. Medicines should owner. Another alternative is to use an antibi-
never become too hot or too cold. Freezing otic that is long-acting and therefore does not
may lead to the active ingredient coming have to be injected daily.
out of suspension. If this previously frozen Sadly antibiotic therapy is not always
product is used subsequently the amount of successful. There are many reasons. There
active ingredient given may not be consist- may be poor compliance by the owner.
ent, which could lead to both under- and The clinician can prevent this to some degree
overdosing. This problem is particularly by good communication skills. Obviously if
acute in the winter in temperate climates an incorrect diagnosis has been made or the
when products are stored in unheated wrong antibiotic has been selected therapy
buildings. will be unsuccessful. Clinicians should make

48 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Veterinary Medicines 49

sure that the dosage, route and frequency are testing before antibiotic therapy is started.
correct. Obviously, known drug interactions Subcutaneous injection of this antibiotic is
should be avoided. Similarly, the clinician unwise in SACs as serious skin reactions
cannot help if the patient has a depressed have been seen.
immune system. Every effort must be made
to avoid the use of an antibiotic to which the
bacteria are resistant.
Ampicillin

This is available in two preparations. There is


Injectable Antibiotics Licensed a 15% suspension, which should be injected
for Other Species in the UK intramuscularly daily at 7.5 mg/kg. This
works out at 1 ml/20 kg. There is also a
Amoxicillin so-called long acting preparation containing
100 mg/ml, which should be injected intra-
This antibiotic is available as two separate muscularly every 48 h at 7.5 ml/50 kg. There
intramuscular preparations: (i) containing is no real justification for this product in
150 mg/ml for daily administration; and SACs. Skin reactions have been reported after
(ii) containing 150 mg/ml for injection every subcutaneous use.
48 h. The dose for the normal preparation is
2.5 ml/50 kg and for the long-acting prepa-
ration it is 5 ml/50 kg. Although this antibi-
Cefquinome
otic is licensed for intramuscular injection
in sheep, it is licensed for subcutaneous use
in dogs and so can easily be given subcuta- SACs are not kept for milk. So there is little
neously to SACs. However, in many infec- need for this product for use in SACs, par-
tions in SACs there is no evidence of ticularly the ready-to-use suspension con-
resistance problems to procaine penicillin taining 25 mg/ml that needs to be injected
and therefore the use of amoxicillin is not intramuscularly at a dosage of 1 mg/kg
justified. daily. This is supplied by injecting
2 ml/50 kg. There might be a possible use in
SACs for the intravenous soluble prepara-
tion, which is supplied as a vial containing
Amoxicillin with clavulanic acid
1.35 g of cefquinome as a powder and 30 ml
of solvent. The dose is 1 mg/kg, which is
This is available as an intramuscular sus- supplied by injecting 1 ml/45 kg.
pension containing 35 mg/ml of clavulanic
acid and 140 mg/ml of amoxicillin. This
should be injected daily at a dosage of
1 ml/20 kg. Great care is required when Ceftiofur
drawing up this suspension from the bottle.
The syringe and needle must be completely This can be given intravenously or intra-
dry or the suspension solidifies. Rarely is muscularly and has excellent tissue penetra-
the use of this antibiotic justified in SACs. tion. Practitioners should avoid the ready
The exception to this is in cases of mastitis, to use preparation in SACs. The soluble
which are rare in SACs. SACs will suffer form, which is supplied as a powder for
from pyoderma as a result of secondary reconstitution, is more suitable. It is sup-
staphylococcal infection. Amoxicillin with plied in 1 g or 4 g vials. The small 1 g vials
clavulanic acid might be justified in are suitable for SACs. They are reconstituted
these cases provided the underlying cause by adding 20 ml of sterile water for injec-
of the skin condition has been treated (see tion. This makes a solution containing 50 mg
Chapter 14). Practitioners would be wise ceftiofur/ml. A dose of 2 ml is required for a
to carry out bacteriology and sensitivity 50 kg animal.
50 Chapter 6

Danofloxacin Framycetin

This antibiotic is available in two formula- This is available as a 15% injectable solu-
tions. One contains 180 mg danofloxacin/ml tion suitable for intramuscular injection at
and is suitable for subcutaneous and intra- a dosage of 5 mg/kg to be given twice daily.
venous injection every 48 h. The dosage of This works out at 1 ml/30 kg twice daily.
6 mg/kg can be attained by injecting There is no realistic usage for this antibiotic
1 ml/30 kg. The other contains 25 mg/ml and in SACs as it is short acting and needs to
is suitable for intramuscular or intravenous be given intramuscularly. Some practition-
injection every 24 h. The dosage of 1.25 mg/ ers have found it useful when included in
kg is achieved by giving 1 ml/20 kg. This large volumes of warm saline for uterine
product is licensed for cattle and could washouts.
be used in SACs. However, there are few
indications and so the likely need is very
limited. Gamithromycin

This is a macrolide licensed for use in cattle in


Enrofloxacin the UK against bacteria causing respiratory
disease. The dose is 6 mg/kg, which is equiv-
This is available in three different strengths: alent to 1 ml/25 kg of the solution containing
2.5%, 5% and 10% solution for daily subcuta- 150 mg/ml. The author has no experience of
neous injection. The dosage is 2.5 mg/kg. its use in SACs. However, it has been reported
This can be achieved by injecting 1 ml/5 kg to have a long-acting effect and appeared to
of the 5% solution. There is a fourth prepara- be safe.
tion for a single long-acting subcutaneous
injection of 7.5 mg/kg. This can be achieved
by injecting 3.75 ml/50 kg. It can be used Gentamicin sulfate
safely during pregnancy. It is advisable to
double the dose if treating E. coli mastitis. This antibiotic should not be used in SACs.
This product can also be given intravenously. It has a very narrow safety margin and it is
This is a very useful drug in SACs. It can be nephrotoxic. The damage to the kidneys will
given daily or by using the long-acting for- be shown as uraemia on a blood test.
mulation, which is useful in skin disease. Clinically the animal will be anorexic and
The 2.5% strength is very suitable for crias drooling. On examination of the oral mucosa
and small alpacas. ulcers will be seen. By this stage treatment is
unlikely to be successful and so euthanasia
is indicated.
Florfenicol

This is available as a ready-to-use solution Lincomycin


containing 300 mg/ml. It can be given intra-
muscularly every 48 h at 10 mg/kg or at a This is available as a sterile solution for
double dose (20 mg/kg) subcutaneously, intramuscular injection. The dose is 22 mg/
which needs only to be given every fourth kg, which can be achieved by injecting
day. This is the ideal drug for treating apical 1 ml/4.5 kg daily. This product is particu-
tooth abscessation in SACs. The 4-day larly useful for treating abscesses, infected
injection period is useful. There is a more wounds and purulent dermatitis in pigs, for
concentrated formulation containing 450 mg/ which it has a licence in the UK. There are
ml. There is no reason to use this preparation other more suitable antibiotics available for
in SACs. use in SACs.
Veterinary Medicines 51

Marbofloxacin Procaine benzyl penicillin

This antibiotic is available in a 2% solution This preparation contains 300 mg/ml of pro-
and can be given intramuscularly or subcuta- caine benzyl penicillin. In cattle it is licensed
neously daily at 2 mg/kg. There is also a 10% for intramuscular and subcutaneous use at
solution available but this is not recom- 20 mg/kg. This equates to 1 ml/kg and it is
mended for SACs. There is little advantage in claimed to give cover for 72 h. It is a very use-
using this antibiotic when compared to ful antibiotic in SACs, is long acting and can
enrofloxacin. be given by subcutaneous injection.

Neomycin Procaine penicillin G

This is only available as an injectable solution This is often given in combination with
suitable for intramuscular use when it is com- streptomycin. In the preparations containing
bined with procaine penicillin G. The contents penicillin alone the dosage is 10 mg/kg. It is
of 1 ml of the solution include 100 mg of neo- normally supplied in a suspension of
mycin sulfate and 200 mg procaine benzyl 300 mg/ml, so the dosage is 1 ml/30 kg. It is
penicillin. This antibiotic has no real use in claimed that given at double this dosage
camelid medicine. blood levels are maintained for 72 h. When
supplied with streptomycin it is in a suspen-
sion of 200 mg/ml with 250 mg/ml of
dihydrostreptomycin. A suitable dosage is
Oxytetracycline
1 ml/25 kg. This is a very useful antibiotic
combination for use in SACs. It can be given
This is a very useful antibiotic in SACs. This subcutaneously.
can be given intravenously or intramuscu-
larly or subcutaneously. Depending on the
dosage, longer treatment interval levels can be
achieved. The normal daily dose is 20 mg/kg. Spectinomycin
The solutions are supplied in various strengths
of 100 mg/ml, 200 mg/ml and 300 mg/ml. This is available as an aqueous solution
The more concentrated solutions are more for intramuscular injection. The dosage is
painful and should be avoided in young 30 mg/kg, which can be achieved by injecting
animals. 3 ml/10 kg daily. In the UK this product is
only licensed for calves and it is not widely
used. It has no specific use in SACs.
Penicillin-Na G crystalline penicillin

This can be given intravenously or intramus- Streptomycin


cularly. It needs to be repeated ideally every
6 h. It is really only suitable for hospital use This antibiotic is available on its own in an
when an intravenous catheter is in place. intramuscular formulation containing 150 mg
Dosage is 22,00044,000 IU/kg. It is normally streptomycin sulfate and 150 mg dihydro-
supplied in 3 g vials (5,000,000 IU) which can streptomycin sulfate/ml. The daily dose is
be reconstituted into 10 ml of water. Each 1 ml 10 mg/kg, which is attained by giving
will contain 500,000 IU. A 50 kg animal will 1 ml/30 kg. This product is very useful for
require 4 ml. In the UK this product is only treatment of Actinobacillosis spp. and
licensed for horses. However, it can be used Actinomycosis spp. in SACs. Its disadvantage
intravenously in SACs under the cascade is that it has to be injected daily and usually
principle. for prolonged periods.
52 Chapter 6

Tilmicosin can be achieved by injecting 1 ml/50 kg. The


solution contains 200 mg Tylosin/ml. Larger
This antibiotic has an extremely narrow safety doses, up to 10 mg/kg, are licensed for cattle.
margin in SACs and should not be used. This antibiotic can be used in SACs but it
must be injected daily.

Trimethoprim-sulfadoxine
Injectable Antibiotics in Combination
Trimethoprim-sulfadoxine (TMS) can be given with Injectable NSAIDs
intravenously or intramuscularly. However,
there have been fatalities recorded when the These products are available and licensed
intravenous route has been used so perhaps for use in cattle in the UK to treat pneumo-
this risk is best avoided. The dosage is 30 mg/ nia. They can have other uses in SACs as
kg. There are several 24% injectable solutions they are useful for owners to inject. Owners
available. The standard clear solution contains should be instructed carefully on the dos-
40 mg of trimethoprim and 200 mg of sulfadi- ages to be given and the frequency of
azine/ml. This gives a dosage of 1 ml/16 kg. injections.
There are two cream-coloured suspensions
available, which can only be given intramus-
cularly: one has a similar concentration of Oxytetracycline and Flunixin
ingredients and is used at the same dosage as
the standard clear solution; and the second
This is available as a solution containing
contains twice the concentration of antibiotic
300 mg/ml of oxytetracycline and 20 mg/ml
and has a dose rate of 1 ml/32 kg. There is a
of flunixin meglumine. The dosage is 1 ml
use for potentiated sulfonamides in SAC med-
per 10 kg. The disadvantage is that it has to
icine to treat infections and for treatment of
be injected intramuscularly and only gives
coccidiosis. Their disadvantage is that they
up to 36 h of anti-inflammatory activity.
need to be given daily.
However, it does give 56 days of antibacte-
rial activity and therefore does have some
uses in SACs.
Tulathromycin

This new antibiotic has a very long half life in


Florfenicol and Flunixin
the tissues and neutrophils and gives effec-
tive antibiotic cover for 14 days. It is licensed
for cattle and has been used safely by the This is available as a solution containing
author in SACs. It is a macrolide and should 300 mg/ml of Florfenicol and 16.5 mg/ml of
not be given at the same time as another flunixin meglumine. The dose is 2 ml per
macrolide or lincosamide. It is effective 15 kg. This combination is very useful in SACs
against bacteria in a similar manner to other as it can be given subcutaneously and gives 4
macrolides. It is supplied in a ready-to-use days of antibacterial activity.
solution of 100 mg/ml, to be injected subcuta-
neously. The dosage is 2.5 mg/kg, which is
equivalent to 1 ml/40 kg. It is particularly Oral Antibiotics
useful because of its long action.
These preparations must only be given to
young crias. There are many antibiotic tab-
Tylosin lets prepared for dogs and cats and there are
also boluses prepared for calves. However,
This antibiotic is available as an intramuscu- antibiotics in these forms are very difficult to
lar injection for a dosage of 4 mg/kg, which administer to crias and should be avoided.
Veterinary Medicines 53

Practitioners should use the liquid oral prep- intramammary formulations licensed for
arations prepared specifically for lambs cows. These should not be used in SACs
with a pump. These are much easier to on account of their small teat orifices.
administer to crias. Once again it should be Antibiotics are also available in ear and eye
stressed that oral antibiotics should not be preparations. One of the most common
given to adult SACs. preparations is eye ointment containing 1%
Practitioners are urged to submit faeces chlortetracycline hydrochloride, which
samples for bacteriology and sensitivity needs to be applied repeatedly, ideally every
before antibiotic usage. Many diarrhoea 6 h. Cloxacillin benzathine 16.67% w/w eye
cases in strong healthy crias are self limit- ointment has a longer duration of action up
ing and antibiotic usage is not useful or to 48 h. Only one application of cloxacillin
appropriate. benzathine may be sufficient to control
contagious ophthalmia in SACs.

Neomycin
Antifungal Agents
This is available combined with streptomycin
as an oral solution with 1 ml containing 70 mg Griseofulvin
neomycin sulfate and 70 mg streptomycin
sulfate. The dose is 1 ml/5 kg daily. This prod- This is a very effective treatment for
uct is licensed for lambs in the UK. It is useful Trichophyton spp. These are normally caught
in SACs for treating secondary infections fol- from cattle. However, it is banned for use in
lowing rotavirus infections. food-producing animals in the UK. SACs
should be given 5 g of a 7.5% powder/50 kg in
their feed daily for 7 days. Griseofulvin is not
Spectinomycin very effective against Microsporum spp. Care
should be taken by pregnant ladies when
This is available as a viscous liquid contain- handling griseofulvin as it is teratogenic. It
ing 50 mg/ml. The daily dose for a lamb is should be remembered that ringworm, par-
one measure of 1 ml from the doser. This ticularly Trichophyton spp., is a zoonosis (see
product is licensed for lambs in the UK. The Chapter 17). Vigorous scrubbing and strong
dose is 2 ml daily for a cria. disinfectants, which damage the skin, should
be avoided. Normal washing with soap is
preferable. Ladies and children are particu-
larly susceptible.
Streptomycin

This is available combined with neomycin as Miconazole


an oral solution with 1 ml containing 70 mg
neomycin sulfate and 70 mg streptomycin
This is a good topical treatment for Trichophyton
sulfate. The dose is 1 ml/5 kg daily. This prod-
spp. and Microsporum spp. It should be used
uct is licensed for lambs in the UK.
as a shampoo twice weekly.

Other Antibiotic Preparations Natamycin

These include topical antibiotics, which are This is also a good topical treatment for
available as creams, gels, powders and aero- Trichophyton spp. and Microsporum spp. It
sol sprays. The most usual ingredient in comes as a powder to be re-suspended. The
aerosol sprays is 2% chlortetracycline hydro- suspension is then sponged or sprayed on to
chloride. Antibiotics are also available as the affected area every 45 days.
54 Chapter 6

Virkon S pasture known to be infected with oocysts.


It is safe in crias from 1 week of age.
This is actually a broad spectrum virucidal
disinfectant. It is a very effective disinfect- Toltrazuril
ant and also can be used to treat Microsporum
spp. It should be made up as a 1% solution, This is available as an oral suspension con-
i.e. a 50 g sachet in 5 l water. This solution taining 50 mg/ml of toltrazuril. It is licensed
can be used as spray or sponged on to in the UK for the prevention of clinical signs
affected areas every 48 h. This use is not of coccidiosis and reduction of coccidia shed-
licensed in the UK but is widely used off ding in lambs on farms with a confirmed his-
licence. tory of coccidiosis caused by Eimeria crandallis
and Eimeria ovinoidalis. It can be used in crias
as a single oral dose of 20 mg toltrazuril/kg.
This is equivalent to 0.4 ml of the oral suspen-
Antiprotozoal Drugs
sion/kg. To obtain the maximum benefit the
crias should be treated before the expected
Coccidiostats onset of clinical signs, i.e. in the pre-patent
period.
Amprolium

This is available as a 9.6% oral solution. Crias Trimethoprim-sulfadoxine (TMS)


need to be treated daily for 5 days with This antibiotic is also effective against
3 ml/5 kg. It is not licensed in the UK for coccidia. It needs to be given at 30 mg/kg
ruminants. for 3 days.

Decoquinate

This is available as a 6% premix to add to Drugs used to treat other


creep-feed to treat crias. A weight of 1.67 kg protozoal parasites
of the premix can be added to 1 t of feed to
provide the recommended concentration of Diminazene aceturate
100 mg/kg. This can be used as a treatment
or a prophylaxis during a coccidial chal- This is the most hazardous of this group of
lenge. Treatment should be carried on for drugs. It is extremely effective against
4 weeks. It is also available as an individual Babesia spp. However, as less dangerous
treatment pack for calves, which can be used drugs are available to treat this protozoan
in SACs. This allows individual SACs to be they should be considered. On the other
treated in the food. Careful weighing of the hand it is the most effective drug to treat
animal and the complementary feeding stuff trypanosomiasis available. This includes
is required so that it is fed at the correct Trypanosoma brucei (Surra), T. vivax (acute
dosage. fly), T. congolense (chronic fly) and T. evansi
(camel fly). The first three trypanosomes
Diclazuril are only spread by tsetse fly. Therefore they
will only be seen in a tsetse area. Trypanosoma
This is available as a 0.25% aqueous oral sus- evansi is spread by biting flies and therefore
pension, which is licensed for use in lambs. It can occur outside of tsetse areas. As SACs
can also be used in SACs. The dose is 1 mg/ are not kept in tsetse areas they are not likely
kg by mouth, which is equivalent to to become infected. Trypanosoma evansi has
1 ml/2.5 kg. A single dose should be given not been reported in SACs either; however,
and repeated if indicated in 3 weeks. It can be if one did become infected diminazene
used as a preventative as well as a treatment, aceturate would be the drug of choice. It is
i.e. it can be given 10 to 14 days after move- supplied in 1.05 g sachets for reconstitution
ment of susceptible stock being moved on to in 12.5 ml of water to make a 12.5% solution.
Veterinary Medicines 55

This is the normal dose for an adult cow Anthelmintics


weighing 500 kg. The author has only had
experience using it on a pro rata dosage for Introduction
camels. It would be reasonable to use it on a
pro rata basis by weight for treating T. evansi In the 1960s and the 1970s there was the
in SACs. development of broad-spectrum anthel-
mintics in ruminants. These products, the
Imidocarb benzimidazoles, the imidazothiazoles/tet-
rahydropyrimidines (levamisole and mor-
This is the drug of choice for treating Babesia antel) and the macrocyclic lactones greatly
spp. These protozoan parasites are spread by improved global sheep production. They
ticks. Imidocarb is supplied in a 12% solution also improved goat production worldwide
in a 100 ml multidose vial. The risk of absces- and SAC production in South America.
sation is much less than with diminazene. Sadly there has been rather rapid resistance
The dose for SACs is 1.2 mg/kg by deep intra- built up to these products. Benzimidazole
muscular injection on two separate days (this resistance was first reported in the UK in
is only 1.0 ml for a 100 kg SAC). 1982. Levamisole resistance was reported in
1994 and macrocyclic lactone resistance was
Metronidizole reported in the UK in 2001. These reports
have been mirrored elsewhere throughout
This drug can be used to treat protozoal dis- the world. It is vital that effective strategies
eases. However, its principal use in SACs is to combat these resistances are put in place
to treat anaerobic bacteria. These may be in and that farmers should not rely on
the alimentary system or in wounds or infec- the recent manufacture of a new class
tions in the feet. The best method of admin- of anthelmintic, monepantel, an amino-
istration is by mouth at the rate of 15 mg/kg acetonitrile derivative.
every 8 h. The drug is supplied in 500 mg It is important for clinicians to realize the
tablets. It is also supplied as a 20 mg/kg difference between anthelmintic failure and
solution in 50 ml sachets. This solution is anthelmintic resistance. Anthelmintic failure
best used topically on wounds or hoof infec- occurs due to:
tions. However, some workers have used it
intravenously at 20 mg/kg every 24 h for Insufficient anthelmintic dose due to
35 days to treat clostridial enteritis and underestimation of animal weight;
peritonitis. The drug per se can cause diar- Failure to follow manufacturers
rhoea, so this side effect is very worrying in instructions;
animals with existing enteric problems. I Poor maintenance of dosing equipment;
would advise against intravenous use. It is Re-introduction of animals on to heavily
useful for treating Giardia spp. in immature contaminated pasture;
SACs. Use of incorrect drug for target worms.

Pyrimethamine In other cases of apparent failure, anthelmintic


resistance should be suspected.
This drug can be used to treat toxoplasmosis There are two anthelmintic resistance
and to lessen the rate of abortion in SACs. detection methods available in vivo; The
There is a synergism between pyrimethamine Faecal Egg Count Reduction Test (FECRT)
and potentiated sulfonamides and so the two and the Controlled Test (CT). The FECRT is
drugs are often given together. Pyrimethamine the most commonly used field assay for all
should be given by mouth at 0.10.2 mg/kg anthelmintic groups. It has a low sensitivity
daily. Sulfonamides should be given at the as there are many false negatives. On the
normal dose rate of 15 mg/kg. This regime other hand there are false positives with
may be given from 2 months after service levamisole. It requires two visits per farm
until parturition. and there is a seasonal variability. The CT is
56 Chapter 6

a comparison of parasite burdens in treated Tetrahydropyrimidines this group


and non-treated animals that have been includes morantel and pyrantel. They
artificially infected with worms suspected of act in the same manner as the
being either (i) susceptible or (ii) partially imidazothiazoles.
resistant; these two groups are then Avermectins this group includes
divided at random into medicated and non- abamectin, doramectin, eprinomectin,
medicated groups. After 14 days the ani- ivermectin and selamectin. They open
mals are killed and the worms are counted invertebrate-specific glutamate chloride
on post-mortem. channels in the post-synaptic membrane,
There are two anthelmintic resistance leading to flaccid paralysis.
detection methods available in vitro: the Egg Milbemycins this group includes moxi-
Hatch Assay (EHA) and the Larval dectin and acts in the same manner as the
Development Test (LDT). These are both avermectins.
cheap and highly sensitive but they are not Salicylanilides this group includes clos-
universally standardized or accepted. Farm antel and oxyclozanide. They uncouple
visits are not required as submissions can be oxidative phosphorylation, decreasing
sent by post. There is a seasonal variability the availability of high energy phosphate
and they are not generally predictive in terms compounds.
of clinical disease. EHA can only be used for Substitute phenols this group includes
benzimidazole anthelmintics and LDT is not nitroxynil. They act in the same manner
satisfactory for avermectins. as the salicylanilides.
There are various factors that influence Amino-acetonitrile derivatives this
the rate of development of anthelmintics group includes monepantel. They are
resistance. Farm management and hus- cholinergic agonists, which act on a novel
bandry factors can be affected by keepers. site on the receptor, resulting in spastic
These include stocking rates, mixed grazing, paralysis of the worms.
grassland management and anthelmintic
usage, e.g. frequency, choice etc. The climate
with its seasonal range of temperature and New classes of anthelmintics
rainfall is a very important factor. The para-
sitic species, i.e. its biotic potential and its
At the time of writing monepantel is from a
proportion in refugia, is an important factor
new family of anthelmintics, which have no
to be considered.
recorded resistance problems. It is vital that
such new products are used with considerable
care. Naturally it may be used as a quarantine
Modes of action of anthelmintic groups dose at the correct dose rate and also where
triple resistance has been proven. It should not
be used for routine worming. It is a very safe
Benzimidazoles this group includes
anthelmintic and the dose is 1 mg/kg.
fenbendazole, mebendazole, oxyfenda-
zole, albendazole and ricobendazole.
They bind to the parasites tubulin, lead-
ing to inhibition of glucose uptake, which Anthelmintics combined
then leads to glycogen depletion and with trace elements
death.
Probenzimidazoles this group includes There are available benzimidazoles, which
netobimin and acts in the same manner have added cobalt sulfate and sodium
as the benzimidazoles. selenate. Clinicians should guide their owners
Imidazothiazoles this group includes carefully on the need for such additives
levamisole. They are cholinergic ago- as areas requiring them are not common. On
nists, which cause a rapid and reversible the whole such drenches are best avoided
paralysis. for SACs.
Veterinary Medicines 57

Long-acting injectable products the symptoms are pyrexia, rapid respiration


and increased excitability. Patients should be
Certain injectable moxidectin products will give kept cool, and dextrose saline should be given
a sustained persistency against helminths in as a drip. In the normal course of events
sheep. Persistence of 44 days for Trichostrongylus nitroxynil should be repeated within 49 days.
colubriformis, 97 days for Teladorsagia circum- Nitroxynil can cause pain on injection.
cincta and 111 days for Haemonchus contortus is Clinicians are in a loselose situation with
claimed from a single injection of the correct treating SACs for fluke. Nitroxynil causes pain,
dose. This same preparation claims efficiency fleece damage and has a narrow safety margin.
against sheep scab for 60 days. Other intestinal Triclabendazole is a very safe drug in SACs but
nematodes controlled are the adults of has the risk of causing choke. The dose rate of
Trichostrongylus axei, Nematodirus spathiger, triclabendazole is 10 mg/kg in SACs.
Cooperia curticei and Chabertia ovina and the
third stage larvae of Gaigeria pachyscelis and
Oesophagostomum columbianum. Dictyocaulus
filaria and Oestrus ovis are also controlled by the Combination fluke and worm products
same product. It should not be used in crias
weighing under 15 kg. The liver fluke Fasciola hepatica requires the
presence of a water snail as the secondary
host. Diagnosis is not easy and relies on raised
liver enzymes in a serum sample and then
Flukicides very careful floatation of faeces to find the
eggs. The presence of one egg is significant.
An injection of 34% w/v nitroxynil is licensed For sheep the following licensed drugs are
for use in the UK as a treatment by subcutane- available: triclabendazole at 10 mg/kg; alben-
ous injection for Fasciola hepatica in sheep at dazole at 7.5 mg/kg; closantel at 10mg/kg;
10 mg/kg. It is claimed to be effective against and nitroxynil at 10 mg/kg. There is now a
mature and immature flukes. However, the age plethora of fluke and worm combination
of the immature flukes is not stated. The drug products on the market for use in sheep.
is probably not effective for the control of acute Naturally there is going to be a demand for
fascioliasis in SACs in the autumn in the UK. products for SACs. Although convenient they
However, no resistance has been reported and should only be used if there is a need to target
therefore it is a very useful medicine to use if both fluke and worms. This is a very rare
triclabendazole resistance is suspected. It is occurrence. Therefore they should not be used
also effective against Haemonchus contortus. without considerable thought. This will not
However, it is not a broad spectrum anthelmintic only save owners money but will also lower
and should not be used as such. Haemonchus the risk of drug resistance developing.
contortus and F. hepatica are both parasites that Combination products undergo extensive
cause severe disease and deaths in adult SACs. testing to ensure that the two components mix
Therefore it is an extremely useful product. It evenly and work properly together. It is not
can be used at the same time as, but in different acceptable to take two products and mix them
sites to, levamisole to provide broad spectrum together on farm. The greatest danger to SACs
capability in sheep but not in SACs on account from fluke infection is from acute cases. Not
of the danger of toxicity. It has some dangers. all fluke products will kill immature flukes. It
The solution contains no preservative so great is vital that SACs are treated early in the
care must be taken not to introduce a bacterium course of the disease with a flukicide which
into the solution. The discard time after broach- will kill immature flukes at the critical time.
ing of 28 days should be strictly adhered to. It This is in early autumn in the UK. A second
will stain the fibre so very careful injection treatment should be given 2 months later to kill
technique is required. It can be used in pregnant any more recent immature or mature flukes
animals but naturally they should be handled that were not killed by the first dose. It takes
with care. In the event of accidental overdose 1012 weeks for 2 mm immature flukes to
58 Chapter 6

develop into 23 cm adult flukes in the liver. and should be reserved for multiple nema-
These are the only flukes that will be killed by tode resistance problems. Accurate weighing
most flukicides. Therefore these products is vital. The oral preparation can be given at
should only be used in the late winter or early 8 mg/kg. The injectable formulation should
spring in the UK. It is unlikely that SACs will be given at a lower dosage of 6 mg/kg.
require worming in the autumn unless FECs
indicate a high burden. Therefore it is unlikely Moxidectin
that combination products will be required.
This drug has an extremely narrow safety
margin in SACs. Really accurate weighing is
vital. Its use should be restricted to multiple
Anthelmintics as individual drugs
resistance problems. It is only available as a
paste. The dose is 400 mg/kg.
Albendazole
This oral drug is in the same class as fenben- Organophosphorus drugs,
dazole but it is not so safe in SACs. It should diethylcarbamazine, morantel
never be given in the first trimester of preg- and pyrantel
nancy or to young crias. If possible it should
These drugs should not be used in SACs.
be avoided in pregnancy. A routine dosage is
10 mg/kg. It is only available in liquid form.

Avermectins Ectoparasiticides

Because of their injectable formulation and Alphacypermethrin


because they treat mange mites these drugs
have been used constantly in SACs. Resistance This is marketed to control nuisance flies,
is extremely common. The efficacy should be when applied every 14 days. It will control
regularly tested. They are obtainable in pour- head fly for 4 weeks. Blowfly strike can not
on formulations but these should not be used only be prevented but also treated by the
in SACs as there is poor absorption and there pour-on preparation. It will give 810 weeks
is a danger of skin damage. The only exception cover. It will also help to control mange mites,
to this is if they are diluted 50:50 with DMSO ticks and lice.
and are painted on to chronically mite-infested
skin lesions. The oral formulations should also
not be used in SACs as they are not as active
for as long as the injectable formulations. A Amitraz
routine dosage would be 300 mg/kg, which is
the equivalent of 1 ml of a 1% solution/33 kg. This is available as a clear emulsifiable con-
They should be injected subcutaneously. centrate for dilution and topical application
containing 5% w/v Amitraz for treatment of
Fenbendazole demodectic and sarcoptic mange. A volume
of 100 ml should be diluted in 10 l of water.
This oral drug is generally safe and can be After the animal has been washed in warm
given to pregnant females and young crias with water to remove any dirt it should be bathed
confidence at a routine dosage of between in this solution. It should then be removed
10 and 20 mg/kg. It is available in paste, liquid without rinsing and allowed to dry naturally
and granular form. in warm air. It should not be allowed to drink
or lick any of the solution. This should be
Levamisole repeated after 1 week. As there have been
reports of toxicity it is safer to wash only half
This drug has a very low safety margin in the animal at weekly intervals. Obviously the
SACs. Its use should be avoided if possible halves should be alternated.
Veterinary Medicines 59

Benzyl benzoate Dicyclanil

This acaricide, which is a lotion, is very effec- This is a pour-on product to prevent blowfly
tive against mange mites if applied daily to strike in sheep. It can be used in SACs. It is
all the affected areas. available as a 5% solution, which offers 16 weeks
protection. However, it is also available as a
1.25% solution, which protects for 8 weeks.
Benzoyl peroxide

This acaricide can be used to treat mange. Diethyltoludine

This midge repellent is extremely affective.


Coumaphos However, sadly it is washed off by rain and
even in dry conditions is rarely effective for
This so-called louse powder is not very effective. more than 6 h. It is rarely used in SACs.
It needs to be applied every 5 days to increase its
effectiveness. However, to avoid toxicity it
should not be applied sooner than every 14 days Fipronil
in SACs. It has no effect on mange mites.
This ectoparasiticide is not licensed for rumi-
nants in the UK. However, it is extremely
Cypermethrin effective against mange mites, when the spray
is applied to all the affected areas every 14
This is marketed as a concentrate for dilution days. It can be used in the UK under the cas-
to a solution, which can be sprayed on with a cade principle. It is very useful in SACs.
knapsack sprayer or sponged on. It will con- However, it is very expensive.
trol nuisance flies and lice. It is also marketed
as a pour-on for treating and preventing
blowfly strike. It gives 68 weeks protection, Ivermectins and moxidectin
but only in the area of the pour-on sweep. It
also gives protection against, lice, ticks and
These drugs, which are covered under
head flies.
anthelmintics, do have an ectoparasitic action
when given by injection. They do not appear
to have any ectoparasitic action when given
Cyromazine by mouth.

This is marketed as a blowfly strike preventative


but not as a treatment. It will last for 10 weeks.
Piperonyl butoxide

This can be used to control lice if applied


Deltamethrin
every 14 days. However, if it is required to
control midge irritation it needs to be applied
Deltamethrin is prepared in a 1% w/v solu- to the affected areas daily.
tion as an ectoparasiticide for the topical
treatment and control of ticks, lice, keds and
established blowfly strike. For prevention, it
should be used as a single spot-on between Dipping of SACs
the shoulders after parting the fibre. It may be
used by direct application to a maggot- The dangers of injury, organophosphate
infested area in established blowfly strike. toxicity and inhalation pneumonia make the
60 Chapter 6

dipping of SACs extremely hazardous and is extremely unlikely that they are effective unless
not recommended. However, it has been given at very large doses.
carried out in Belgium with a specially con-
structed cage to aid immersion, using an
organophosphate compound Phoxim.
Other Useful Drugs

Tetanus Antitoxin
Steroidal Anti-Inflammatory Drugs
Tetanus antitoxin (TAT) should be kept in the
There is a definite usage for steroids in SACs.
fridge. The dose is very empirical. However,
An injectable solution of 2% dexamethasone
the author would recommend 3000 IU for an
can be used at 0.1 mg/kg by intramuscular or
adult given subcutaneously and 1500 IU for
intravenous injection. This is quite safe in
crias. Some authorities regard TAT in SACs as
SACs except of course in pregnant animals.
dangerous, although there is no factual basis
SACs do not get laminitis. However, they do
for this. SACs will certainly get tetanus. The
get hyperlipaemia so care must be used with
author has seen tetanus in a male llama that
prolonged treatment. Some authorities think
had untreated wounds from fighting.
prednisolone at 1 mg/kg is a useful potent
short-acting steroid. The author has not
found this and certainly it is not effective by
mouth. GnRH

This hormone is useful in SACs to stimulate ovu-


Non-Steroidal Anti-Inflammatory Drugs lation (remember they are induced ovulators).
The dose is 1 ml given intramuscularly.
Non-steroidal anti-inflammatory drugs
(NSAIDs) need some careful evaluation in SACs,
not only because they are very prone to gastric Cloprostenol
ulceration but also some useful NSAIDs used in
horses (e.g. phenylbutazone) have a very short
This prostaglandin can be used for luteolysis in
half-life (under 2 h) (Table 6.1). Flunixin meglu-
SACs. The ideal dosage is 1 ml repeated in 24 h.
mine at 1 mg/kg, ketoprofen at 2 mg/kg and
meloxicam at 0.5 mg/kg all can safely be used by
subcutaneous or intravenous injection. The
length of action is not known. However, meloxi- Lignocaine local anaesthetic
cam is thought to give 48 h action where the other
two are unlikely to give as long as 24 h. Sadly, SACs are very sensitive to the toxic effects of
although they are widely used orally, it is local anaesthetic. Local blocks (e.g. for

Table 6.1. The dosages of both NSAIDs and opiates for injection in other species, which can be used as a
guide in llamas and alpacas.

Agent Dose Route Duration (h)

Pethidine 1 mg/kg i/m 2


Butorphanol 0.5 mg/kg Sub/cut or i/v 4
Buprenorphine 10 mg/kg Sub/cut or i/v 8
Flunixin meglumine 2.2 mg/kg i/v or i/m 24
Carprofen 1.4 mg/kg Sub/cut or i/v 24
Meloxicam 0.5 mg/kg Sub/cut or i/v 24
Ketoprofen 3 mg/kg i/v or i/m 24
Tolfenamic acid 4 mg/kg i/v 24
Veterinary Medicines 61

Caesarean section) should be given with care. intramuscularly. It is supplied in a solution con-
You should not exceed the maximum recom- taining 1000 mg in 1 ml. The dose is 2 ml per
mended dose of 4 mg/kg. For epidural anaes- adult. It can be repeated in 7 days. It is also
thesia, 1 ml is quite sufficient. available at a quarter of this strength in a 0.025%
w/v solution. The dose is 1 ml for crias.

Sodium pantoprazole
Selenium
There is a high incidence of gastric ulcers in
SACs. These occur in the caudal third compart- There is a long acting preparation licensed
ment of C3. The normal sign is low-grade colic. for use in sheep in the UK, which lasts for
Diagnosis may be aided by trans-abdominal 12 months. It is supplied in an aqueous sus-
ultrasonography. On being faced with a possible pension containing 50 mg/ml of selenium
acute ulcer liable to perforate, a human drug (175 mg/ml barium selenate). It should be
sodium pantoprazole should be injected given by subcutaneous injection. The dose is
intravenously after dissolving the 40 mg pow- 1 ml/50 kg, so normally an adult llama will
der in the vial with water for injection. Pain need 3 ml and an alpaca 2 ml. Owners should
can be controlled with NSAIDs but these be warned that in some instances a small
should be discontinued as soon as appetite nodule will be left at the injection site.
is re-established.

Vitamins B and C
Oxytocin
There is a licensed preparation of four
Oxytocin is vital to aid the third stage of B vitamins and vitamin C available for sheep
labour and milk let-down. The dose is 1020 in the UK. It can be used in any deficiency
IU given intramuscularly. If it is given intra- related to these five vitamins including
venously it must be diluted with at least 20 ml cerebro-cortico-necrosis (see Chapter 12).
of water or the animal will show quite severe Each 1 ml contains 35 mg thiamine hydro-
colic. Remember that it should be transported chloride (vitamin B1), 0.5 mg riboflavin
in a car fridge. sodium phosphate (vitamin B2), 7 mg pyri-
doxine hydrochloride (vitamin B6), 23 mg
nicotinamide (vitamin B3) and 70 mg ascor-
Donperidone bic acid (vitamin C). The dose is 510 ml,
which can be given subcutaneously, deep
This drug is said to help milk let-down. It is intramuscularly or slow intravenously. It is
available in paste form in the USA and as 10 mg suitable for llamas and alpacas. Thiamine
tablets in the UK. The dose of the paste is 1.1 mg/ injection on its own can also be used to treat
kg twice daily for 2 days then once daily for CCN. The dose is 15 mg/kg given either
5 days. intravenously or subcutaneously daily for
5 days.

Trace Element and Vitamin


Injectable Products Vitamin D

Cobalt/Vitamin B12 Rickets is a real problem in SACs in the UK


because of the lack of sunlight. Dosages
Cobalt can be given orally either separately vary; however, 1000 IU/month for crias
or with an anthelmintic. Vitamin B12, cyano- between November and March will give
cobalamin, can be given subcutaneously or protection.
62 Chapter 6

Injectable Medicines to be Carried by the Practitioner

Table 6.2. Veterinary drugs to be carried for ambulatory practice carrying out work with SACs.

Drug Trade name Dosage Comments

Acepromazine ACP Injection 2% 0.020.05 mg/kg iv im For milk let-down and


urethral relaxation
Butorphanol Torbugesic 0.1 mg/kg iv im Analgesia
Cloprostenol Estrumate 1 ml im Repeat in 24 h
Dexamethasone Colvastone 0.1 mg/kg im iv Not in pregnant alpacas
Diazepam Valium 0.1 mg/kg Useful in crias
Enrofloxacin Baytril 5 mg/kg SC Double dosage for 48 h
Florfenicol Nuflor 10 mg/kg SC Double dosage for 48 h
Flunixin meglumine Finadyne 1 mg/kg SC iv Oral not effective
Ketamine Ketaset Various im Anaesthesia
Ketoprofen Ketofen 2 mg/kg SC iv NSAID for pain relief
Lidocaine 2% Willocaine 4 mg/kg max dose 1ml epidural
Oxytetracycline various Vary im iv Higher dosage for
longer action
Oxytocin Various 10 IU im Dilute for iv
Pantoprazole Protium 4 ml iv Ulcer treatment
Penicillin Procaine im Crystapen iv 22,00044,000 IU/kg Often with Strep
Thiamine Various 15 mg/kg SC iv Every day for 5 days
Vitamin D Duphafral ADE 1,000 IU im Winter months
Xylazine Rompun 2% 0.3 mg/kg iv 0.6 mg/kg im Sedation

Table 6.3. Extra veterinary drugs to be carried by the ambulatory clinician.

400 ml 20% calcium


400 ml 20% calcium with added 5% magnesium, phosphorus and glucose
400 ml 25% magnesium sulfate
400 ml 40% dextrose solution
2 100 ml barbiturate euthanasia solution
2 50 ml somulose solution; 400 mg/ml quinalbarbitone, 25 mg/ml cinchocaine hydrochloride
Coloured antibiotic aerosol spray
Obstetrical lubricant
J Lube lubricant powder
Dopram drops; 20 mg/ml doxapram hydrochloride
Powdered oral electrolyte
Vaccutainers coloured red, purple, green and grey, with needles and holder
Diclazuril solution
Triclabendazole solution
An oral anthelmintic
Doramectin injectable solution
An oral antibiotic with a dosing pump for crias
A pour-on to kill fly-strike larvae
7
Vaccines

Introduction cause reactions in the animal. It is also


important that the correct technique is used
The availability and the need for vaccination for administration.
against an individual disease will vary Most vaccines are required to be given
between countries and species. As a rule of subcutaneously, so a short needle can be
thumb, vaccines prepared for viral diseases used e.g. 5/8 ths of an inch. The gauge of the
tend to be more effective than vaccines needle is important. In essence the smallest
prepared for bacterial diseases. Equally, live gauge is best especially for small young
vaccines, which have been stored and used animals, e.g. 23G. However, a larger gauge
correctly, tend to be more effective than dead (e.g. 21G or 19G) will be more appropriate
vaccines. It should be remembered that if a for adults. Practitioners should be aware that
live vaccine has been used it would be diffi- small gauge needles are more likely to break
cult for a serum sample to differentiate at the hub. Immediate retrieval of the broken
between a vaccine titre and that of active needle is vital. Contamination of the vaccine
disease, unless the vaccine is a marker container must be avoided. Only a clean
vaccine. sterile needle should be used to draw out the
Storage of vaccines is extremely impor- dose of vaccine. A different needle should
tant. It is not only live vaccines that have to then be used to inject the animal. It is quite
be stored at controlled temperatures. reasonable for an assistant to be drawing up
Practitioners should read the data sheets doses of vaccine using the same needle in
carefully for storage instructions before the bottle of vaccine. The same second needle
reconstitution of the vaccine and after recon- can be used to vaccinate a number of ani-
stitution. Vaccines that require reconstitu- mals. However, this needle should be
tion with a diluent normally have a very changed at regular intervals. The use of
short life after reconstitution. This period multidose syringes is widespread and should
should be strictly followed. Refrigeration be encouraged in large herds as on the whole
storage should be monitored with maxi- there is less contamination. However, it is
mum and minimum temperatures recorded important that they are calibrated for the
on a regular basis. It should be stressed that correct dose of vaccine. Once again the nee-
it is vital that expensive vaccines are stored dle should be changed at regular intervals.
and used in the correct manner, as not only It is also important to consider the ani-
will they be ineffective but also they may mals to be vaccinated. They should not be

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 63
64 Chapter 7

unduly stressed. This is particularly impor- confusion as the sheep vaccines are not
tant for pregnant animals. Often there is a licensed for these species and there is no data
need for careful timing of vaccination in sheet available. To make sure these animals
pregnant animals so that the risk to the are adequately covered most clinicians give
pregnancy is kept to a minimum but the boosters twice a year. The practice of giving
level of immunity in the colostrum is at a twice the dose only once a year is unlikely to
maximum. The practitioner should give be sensible.
careful advice to the owner on the timing of To allow the mother time to produce ade-
vaccination in young crias. If the dam has quate colostral antibodies, booster doses need
not been vaccinated then quite young crias to be given a minimum of 2 weeks prior to
can receive their first dose of vaccine. parturition. There is little information availa-
On the other hand if the dam has received a ble to advise clinicians on the extent of the
booster during her pregnancy the first vac- period of maternal or so called passive immu-
cination should be delayed. There is no nity. It is likely to be about 3 months but this
harm in vaccinating crias too early, it is just period will vary with the vaccine. Therefore if
that the first dose may be ineffective and so clinicians are in any doubt it is prudent to
an extra dose will need to be given. Having give vaccines earlier and give an extra dose
vaccinated the female animals it is impor- later. Most vaccines prepared for sheep are
tant to remember to vaccinate the male ani- relatively inexpensive so that cost is not an
mals at the correct time so their immunity is issue with SACs, only the handling problems
maintained. and the fact that many are kept in small
In general wet animals should not be groups and therefore some vaccine has to be
vaccinated as there is a much greater risk of discarded.
needle contamination. It is worthwhile stress- Clinicians may be consulted when there
ing that dates of vaccination and groups of appears to be a failure of vaccination. Careful
animals should always be recorded carefully. detective work together with great tact will
There are various types of vaccine. Live be required. There are a large number of
modified vaccines usually stimulate high lev- factors that need to be considered.
els of solid immunity from a single inocula-
tion. Inactivated vaccines usually contain 1. Incorrect storage. Obviously this can
weaker antigens and require an initial course occur at any place along the chain from
of two doses. Vaccines often use multiple anti- manufacturer to wholesaler to merchant to
gens. There is no evidence to suggest that there owner to animal. As a veterinary surgeon
is diminution neither in the individual antigen one hopes that the route to the owner is
protection nor less protection in the face of not at fault. The manufacturers are nor-
field challenge. These vaccines are more eco- mally extremely helpful when there are
nomical to produce and also mean that ani- problems. Clinicians should make 100%
mals have to be handled less frequently. certain their controls (e.g. fridge tempera-
Most vaccines are licensed to be given ture monitoring) are in place before blaming
subcutaneously. An ideal place is over the the owner.
ribs behind the shoulder. Data sheets should 2. The method of administration should be
always be consulted as some vaccines need to checked. Not only the route must be correct
be given intramuscularly. The triceps can be but also the actual technique, i.e. the vaccine
used. must actually go into the animal.
With most vaccines circulating antibod- 3. We have discussed earlier the influence of
ies fall to apparently non-protective levels maternal immunity. Vaccines given during
fairly quickly. However, they are rapidly the period of high maternal antibody circula-
raised by a challenge in the field. Most inacti- tion will not be effective and will have to be
vated bacterins and toxoided vaccines require repeated.
annual boosters in sheep for which they were 4. Vaccination can be ineffective if disinfect-
specifically prepared. In SACs there is some ants contaminate any of the equipment and
Vaccines 65

needles. Equally vaccination will not be (Blackleg), which can be given safely to SACs
accomplished if there is bacterial contamina- to provide good immunity. SACs require two
tion and abscessation. doses separated by 6 weeks, boosted with a
5. Naturally the vaccine must be the correct single dose annually. To obtain passive
vaccine for controlling the disease in ques- immunity in crias, female SACs should
tion. There is always going to be doubt about receive the second dose 34 weeks before
the use of unlicensed vaccines. parturition.
6. The animals must be healthy when they
receive the vaccine. Animals in very poor
condition or suffering from a deficiency will
Blue tongue
not be able to respond to the vaccine.
7. Animal owners should obtain advice when
giving several injections at the same time. On SACs are definitely affected by this disease,
the whole the less the animals are stressed by which can be fatal. However, there are many
continual handling the better. However, strains. Clinicians should carry out a risk
giving anthelmintics, antibiotics and several analysis and use the appropriate strains.
vaccinations at the same time may be too Polyvalent vaccines do not seem to be effec-
much for the animal. tive and therefore single strain vaccines
8. Vaccination is a numbers game. The should be used. The vaccination regime rec-
majority of a group of animals may respond ommended for cattle should be used, not that
but certain individuals may not make an recommended for sheep.
antibody response. They may actually be
immune or of course they may not be
immune. Bovine respiratory
When using more than one vaccine there are disease
no hard and fast rules. However, following
these guidelines constitutes a good code of These cattle vaccines should be avoided in
practice: SACs until further research work has been
carried out. The only exception is vaccination
1. If possible separate the two vaccines by at against Parainfluenza 3 (PI3), which has been
least 2 weeks. used to good effect in an outbreak of this virus
2. If this is not possible it is better to inject in young llamas.
them at the same time rather than separate
them by only 2 or 3 days.
3. If two vaccines are going to be given it will
take longer, so stress should be minimized by Bovine virus diarrhoea
providing adequate food and water to wait-
ing animals. Bovine virus diarrhoea (BVD) will affect
4. Always use separate vaccinators and SACs. However, there are no reports of the
needles. safe use of any cattle vaccines in SACs so
5. Inject at different sites (e.g. left and right practitioners will have to consider very care-
side of the animal). fully any use of vaccination with the owners
of the SACs.

Vaccines Brucella melitensis

There is a live vaccine available, which is not


Blackleg licensed in the UK but is available elsewhere.
This organism has been isolated from SACs
There is a single component vaccine licensed so in exceptional circumstances this vaccine
for cattle and sheep against Clostridium chauvoei could be recommended.
66 Chapter 7

Cattle scour vaccines Clostridium septicum, Clostridium chauvoei


and Clostridium sordellii is worthwhile in
These vaccines, which are injected into most areas, particularly if there is any risk
cows in their last 6 weeks of pregnancy, of liver fluke Fasciola hepatica, as this para-
have been used in SACs. They offer protec- site damages the liver and makes the SAC
tion against rotavirus, coronavirus and more prone to succumbing to clostridial
Escherichia coli. It would appear that the infections. The timing of vaccination for
viral component is what is useful. Obviously crias is open for debate. However, a safe
immunity only occurs if the crias receive regime would be to start vaccination at
adequate levels of colostrum. There are 1012 weeks of age, if the dams are fully
passive immunity products that can be vaccinated and have been given a booster
given to calves in their first 6 h after birth. injection in the last third of pregnancy. If
These might be a safer option for use the dams have not received an injection in
in SACs. the last third of pregnancy, crias should
receive their first dose between 2 and 4
weeks of age with a second dose given 46
weeks later. All SACs should receive
Chlamydophila species booster doses twice a year.

If SACs are found to be suffering abortions


from this organism, the sheep vaccine may Equine herpes type
be used before service for the next preg- 1 vaccination
nancy. There appear to be no side effects.
Equine Herpes Virus (EHV) type 1 has been
isolated from SACs and has been shown to be
Clostridial disease vaccination the cause of death in SACs kept near to
affected zebra. SACs could be vaccinated
This is the most important vaccination that with an equine vaccine if the risk is thought to
needs to be carried out in SACs worldwide. be high. Vaccination should be carried out
SACs are very prone to getting tetanus. It is quarterly.
vital that they are fully vaccinated. If a
practitioner is called to a SAC that has been
cut or is going to perform a castration it is Leptospirosis vaccination
vital that the tetanus status is evaluated.
If there is any doubt the practitioner should In Leptospirosis-endemic areas a biannual
give not only a dose of a suitable tetanus vaccination should be carried out in suscep-
vaccine but also a dose of tetanus antiserum tible females using the cattle vaccine. This is
(TAT). A dose for an adult SAC would be prepared from formol-killed cultures of
3000 IU given either subcutaneously or Leptospira interrogans serovar harjo. Initial
intramuscularly. The dose for a cria is half of vaccination requires two doses separated by
that, i.e. 1500 IU. It is a myth that TAT is toxic 46 weeks.
in SACs.
Other than Clostridium tetani the most
important clostridia to affect SACs are
Clostridium perfringens Type C and D. All Pasteurellosis
SACs should be regularly vaccinated
against these types by an initial course of The Pasteurella vaccines prepared for sheep
two doses separated by 46 weeks then a do not confer any immunity to SACs and
booster every 6 months. The use of polyva- therefore should not be used. However, if a
lent vaccines including Clostridium novyi, specific vaccine is made for SACs it should be
Vaccines 67

used according to the manufacturers instruc- endemic areas; however, their efficacy has not
tions to animals at risk. been proven.

Rabies vaccination Toxoplasmosis

Rabies will occur in SACs. However, they are If SACs are at risk the sheep vaccine may be
an end host so are unlikely to transmit the used to help control this disease. It must be
virus. Killed rabies vaccines can be used in given before service.
8
Sedation, Anaesthesia, Surgical
Conditions and Euthanasia

Pre-Operative Considerations pre-operatively at 0.1 mg/kg every 6 h either


intramuscularly, subcutaneously or intrave-
Tetanus cover nously. NSAIDs can be given at the same time
except it should be remembered that they are
SACs are very prone to getting tetanus. It is nephrotoxic, so they should be avoided if there
vital that every effort is made to cover all ani- is likely to be any kidney damage. The practi-
mals in the case of an urgent surgical proce- tioner can use his judgement on which NSAID
dure. In the case of an elective procedure it to use (see Chapter 6).
should be delayed until full vaccination has NSAIDs are very good pre-operative anal-
been carried out. Full vaccination involves a gesics. However, it must be remembered that
double dose of vaccine separated by 4 weeks. steroids are more potent anti-inflammatory
The boosters should be given at 6-monthly drugs than non-steroidals. As inflammation
intervals. causes pain there may be good reason to use
If the procedure is urgent and the animal steroids for some analgesia. The clinician has
has had an initial course of two doses of vac- to consider the risks carefully. Steroids (e.g.
cine some time ago a single booster dose will dexamethasone) will delay wound healing.
be sufficient. However, if this has not been On the other hand wound healing is irrele-
carried out it is suggested that the patient vant if the animal has died from hyperlipae-
should receive its primary dose of tetanus mia from inappetence caused by inflammation
vaccine and 3000 IU of tetanus antitoxin and pain.
(TAT). This could be reduced to 1500 IU in
very young animals. Cover with antibiotics is
also important. If tetanus is a consideration,
the antibiotic of choice is penicillin. Antibiosis

These should be given as soon as possible in


urgent cases. In elective procedures they
Analgesia should be given before surgery is planned to
allow for good tissue levels. Unless there are
This is very important. The drug of choice with special considerations a combination of peni-
both sedation and anaesthesia is butorphanol. cillin and streptomycin is the antibiotic of
This can be given post-operatively as well as choice.

68 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Sedation, Anaesthesia, Surgical Conditions 69

Gut fill for heavy sedation in a 50 kg animal, a


combination of 0.5 ml of a 20 mg/ml solution
Ideally the gastroenteric organs should be as of xylazine and 1 ml of a 100 mg/ml of
empty as possible. However, practitioners ketamine.
should beware of withholding fluids from Yohimbine is not licensed for use in the
the young and from debilitated animals. UK. However, it is used elsewhere as a
Care should also be taken in hot climates. reversal agent for xylazine. It is obtained as
In some ways starving the patients is more a solution of 10 mg/ml. It should be given
important when heavy sedation or field intravenously at a rate of 0.25 ml/10 kg,
anaesthesia is used as there is no cuffed although its usage is outside the authors
endotracheal tube in place to prevent C1 experience. Many clinicians consider it to
contents being inhaled. A protocol suggested be a useful drug, equally others have found
is to withhold concentrates for 24 h pre-op, difficulties. There are anecdotal reports of
forage for 12 h and water for 8 h. In young acute cerebellar oedema causing fatalities.
animals under 4 weeks of age, they should The author has never had any difficulties
be treated as normal except they should not with recovery from xylazine sedation but
be allowed to suckle for 2 h before sedation considers monitoring very important. The
or anaesthesia. short-term signs to be on the lookout for
are: abnormal posture, reluctance to stand,
reluctance to move, abnormal gait, reluc-
tance to join the herd, bruxism (tooth grind-
Fly control
ing), raised TPR and marked pallor. If these
problems persist then intravenous fluids
This is important in all animals, particularly are advised together with flunixin at
fibre-producing animals. A cream contain- 1.1 mg/kg.
ing acriflavin and BHC should be applied As a rule of thumb alpacas on a weight
to all wounds. The whole animal should for weight basis require between 10 and 20%
be protected by synthetic pyrethrum higher doses of sedation to give the same
compounds. effect as Llamas. However, this may just be a
factor of lower actual weights in the same
way that ponies appear to require higher rates
Sedation of sedation compared to horses.
Acepromazine is not a very useful seda-
Alpacas are gentle creatures and can readily tive in SACs as it really only gives mild tran-
be controlled so sedation is rarely required. quillization at standard doses of 0.03 mg/kg
They will often go into the kush position or intravenously or 0.05 mg/kg intramuscu-
can easily be cast. This is not so with llamas, larly. It is useful in maiden females who are
which can be difficult. The main thing is to reluctant to allow crias to suckle. A single
get close into them so that any kick will not injection of 2.5 ml of a 10% solution and
be as painful. Xylazine is very effective; an 2.5 ml of a 10 IU/ml of oxytocin given intra-
injection intramuscularly of 1 ml of a 2% muscularly as soon as the problem is real-
solution will certainly sedate a llama, which ized is helpful.
may well then kush, whereas 0.75 ml of a Detomidine and romifidine can be used
2% solution is quite sufficient for a large in SACs. However, as xylazine is so reliable
male alpaca. Guanacos and vicuna are more their use must be questioned and it is outside
like wild animals and will require sedation for the authors experience.
most procedures. Various other sedation com- Diazepam is a useful sedative for use in
binations have been described, for example: small crias. It can be given either intrave-
for light sedation in a 50 kg animal, a combi- nously or intramuscularly at 0.1 mg/kg. At
nation of 1.5 ml of a 10 mg/ml solution of this dosage it will give safe profound seda-
acetylpromazine and 0.35 ml of a 10 mg/ml solu- tion. It is not nearly so effective in older and
tion of butorphanol given intramuscularly; larger animals.
70 Chapter 8

General Anaesthesia with two loops of bandage. The tube can then
be inserted into the trachea with the laryngo-
General anaesthesia using gaseous anaesthe- scope. This will be aided by an aluminium
sia is hazardous in SACs (Bradbury, 2008). rod inside the tube to add rigidity. An ideal
There is a considerable danger of regurgita- size of rod is the arm of an aluminium horse
tion. This is described as either passive or twitch with the string removed.
active. Passive regurgitation occurs under A preferred method is an intramuscular
deep anaesthesia and is manifest as a contin- injection of a cocktail into the quadriceps
ual flow of stomach contents through the muscle. The dose for a typical 18-month-old
mouth. Active regurgitation occurs during llama weighing 80 kg, which is a common
light anaesthesia. It is projectile, as it is in fact time for castration, is 5 ml ketamine (10%
antiperistalis. It is extremely dangerous and solution), 2.5 ml xylazine (2% solution) and
can lead to inhalation pneumonia particu- 0.5 ml butorphanol (1% solution). All these
larly if it occurs during intubation. Adult three medicines should be given in the same
SACs should be fasted for 12 h before surgery syringe. This will give 20 min of anaesthesia
and water should be withheld for 8 h. after an induction period of 510 min. The
Regurgitation is influenced by the anaes- dose for a typical 18-month-old alpaca weigh-
thetic agent used (Garcia Pereira et al., 2006). ing 60 kg for castration is 3.3 ml ketamine
Ketamine causes less regurgitation than thio- (10% solution), 1.7 ml xylazine (2% solution)
pentone, which should be avoided in SAC and 0.3 ml butorphanol (1% solution).
anaesthesia. Protocols using xylazine intra- Naturally larger or small animals can be
venously followed by ketamine intrave- anaesthetized with different dosages on a pro
nously may be used. This will allow rata basis. As intramuscular injections may be
intubation and gaseous anaesthesia with iso- sometimes less reliable than intravenous
flurane. There are considerable difficulties injections clinicians may prefer to inject a
with this protocol: (i) intravenous injections combined dose of 0.1 mg/kg of butorphanol,
are not easy as the owners do not like the 0.3 mg/kg of ketamine and 0.3 mg/kg of xyla-
wool clipped the skin is very thick so the zine intravenously. This method will only
jugular cannot be visualized. The carotid lies give approximately half the length of time of
only just below the jugular particularly in the anaesthesia i.e. 10 min.
caudal third of the neck; (ii) intubation is This cocktail is prepared by many other
very difficult unless you are skilled with a clinicians in a slightly different manner; they
long laryngoscope; and (iii) there is a real prepare a solution of the three drugs, which
danger of inhalation pneumonia on induc- they then give on a per kilogram basis.
tion and recovery. There are various tips sug- The stock solution is:
gested to aid intubation. An adult alpaca will
10 ml of a 100 mg/ml solution of ketamine;
require a 8 mm endotracheal tube and an
1 ml of a 100 mg/ml solution of xylazine;
adult llama will require a 10 mm endotra-
1 ml of a 10 mg/ml solution of butor-
cheal tube. These sizes of tube are readily
phanol.
available for large dogs. However, the canine
tubes are too short and so clinicians should This solution can be given at 1 ml/34 kg intra-
try to obtain foal tubes or have longer canine muscularly to provide heavy sedation. If given
tubes made specifically. A laryngoscope with at 1 ml/17 kg intramuscularly it will provide
a blade of 20 cm will be required. After pre- anaesthesia. This anaesthesia can be main-
medication with atropine, which can be given tained by giving 1 ml/34 kg intravenously.
intramuscularly at 0.04 mg/kg or intrave- The following gives a very sensible
nously at 0.02 mg/kg, the animal should be anaesthetic protocol for a 68 kg animal:
anaesthetized with one of the combinations
of anaesthetics described below. With the Inject 4 ml of the cocktail intramus-
animal in sternal recumbency the neck should cularly;
be stretched vertically. The top and bottom Inject 4 ml of atropine sulfate in a 600 mg/
jaws should be held open by an assistant ml solution intramuscularly;
Sedation, Anaesthesia, Surgical Conditions 71

When anaesthetized, establish a drip line recovered. The author does not recommend
with a 14G over-the-top catheter point- the use of intra-nasal tubes to supply extra
ing caudally (the skin will need to be oxygen because if too wide a bore is used
incised after surgical preparation); there may be severe haemorrhage or turbinate
Inject 2 ml of the cocktail every 30 min to trauma leading to nasal oedema. The use of a
maintain anaesthesia. very small tube will normally be counterpro-
ductive by restricting the airway.
A combination of ketamine and diazepam
has been recommended for anaesthesia fol-
lowing xylazine sedation for a 50kg animal:
Regional Anaesthesia
Inject 0.75 ml of a 2% xylazine (20 mg/
ml) solution intramuscularly;
Epidural anaesthesia
After sedation, catheterize the animal (a
bleb of local anaesthetic should be given
under the skin); The normal site used by practitioners is the
Inject 1 ml of a 100 mg/ml solution of sacrococcygeal space. A 1 inch 20G needle
ketamine intravenously; should be used perpendicularly to the spine.
Inject 0.1 mg/kg diazepam intravenously; The dose is 2 ml of 2% lignocaine for an adult
Inject 2 ml of atropine sulfate in a 600 mg/ llama. To give a longer action and some
ml solution intravenously; slight sedation 0.25 ml of 2% xylazine can be
Anaesthesia can be maintained by giving added to this. The dose of both lignocaine
0.5 ml of 2% xylazine, 0.5 ml of 10% keta- and xylazine should be reduced by 25% in
mine and diazepam every 30 min. alpacas.

Thiopentone, guaifenesin and propofol have


all been used for general anaesthesia in SACs;
however, as ketamine is such a safe and reli- Regional anaesthesia of the lower limb
able anaesthetic agent the author has never
found a need to use them. Apply a tourniquet immediately above the
carpal or tarsal joint. Two small rolls of band-
age should be inserted either side of the
Achilles tendon when applying the tourni-
Recovery from Gaseous Anaesthesia quet to the hindleg. The mid area of the meta-
carpus or metatarsus should be clipped and
SACs are obligate nasal breathers and gas surgically cleaned. A suitable superficial vein
exchange must be confirmed immediately should be selected. A bleb of local anaesthetic
after the endotracheal tube has been removed should be put under the skin using a 25G
as the airway may be compromised during needle. Using a 1 inch 23G needle, 2.510 ml
the transition from endotracheal tube breath- (depending on the size of the animal) of 2%
ing to nasal breathing. SACs tend to relax lignocaine should be injected extremely
after the endotracheal tube is removed as the slowly into the vein. Within 5 min full regional
stimulus is also removed. The endotracheal anaesthesia will be achieved. This will last for
tube should be left in place until the patient is over 1 h. Anaesthesia will cease as soon as the
able to swallow, chew, cough, and is actively tourniquet is removed.
trying to expel the tube. Sadly the tube is lia-
ble to damage, but at least the animal is not
put at risk. If regurgitation has occurred, the
endotracheal tube should be withdrawn with Common Surgical Conditions
the cuff inflated until the cuff reaches the lar-
ynx. Any ingesta must be removed from the Angular limb deformity
pharynx or buccal cavity. The animals head
should be kept elevated. Human assistance These deformities will be observed soon
must always be present until a SAC is fully after birth. They should be monitored but
72 Chapter 8

no immediate action should be taken. Atresia recti


Sometimes they will occur in crias with other
congenital problems. Careful assessment will Unlike atresia ani this condition is often not
have to be carried out to decide if euthanasia readily seen and its correction surgically is
is the most appropriate action. Assuming extremely difficult. Euthanasia is likely to be
limb deformity is the only problem then the the kindest and economic course of action.
cria should be allowed to mature for 6 weeks.
Radiographs should then be taken of the car-
pus and metacarpus, or in the case of the
extremely rare hindlimb deformity, the tarsus Castration
and the metatarsus. If the carpus or tarsus is
deformed euthanasia should be advised. There is a myth, strongly held by owners, that
Only if the metacarpus or metatarsus is bent castration should be delayed until puberty,
should surgery be attempted. The author i.e. 18 months. They feel that if animals are
advises a periosteal strip as no specialized castrated before sexual maturity the animals
instruments, screws etc. are required, and the will get weak long legs. It is difficult to dis-
risk of a second operation is removed. There prove this opinion as owners are reluctant to
is also less risk of post-operative sepsis. allow clinical audit.
Antibiotics and TAT should be given pre- Castration can be performed in two
operatively. The cria should be masked down ways. Naturally the veterinary charge will
with halothane or isoflurane and the limbs reflect the manner of castration. This can be a
prepared for surgery. Depending on whether proper sterile operation under general anaes-
it is varus or valgus the 2.5 cm long vertical thetic. The surgery is performed in a similar
incision should be made on the lateral or manner to castrating a dog. With the animal
medial aspect of the metacarpus. The perios- in dorsal recumbency the area around the
teum should be scratched off the metacarpus penis and the scrotum is surgically prepared.
for a length of 12 mm and width of 6 mm. The One testicle is pushed cranially into a pre-
skin should be closed with small interrupted scrotal position. A careful incision is made
skin sutures or staples. The wound should be over it, and it is then drawn out within its
covered by a protective bandage. The owners tunics. Two pairs of artery forceps are then
should be counselled that the cria has to grow clamped above the testicle. The pair nearest
more rapidly on the opposite side to to the testicle is removed and a tight ligature
straighten the leg. This growth cannot be of absorbable material is placed in the groove.
accurately predicted. The testicle is then removed above the sec-
ond pair of artery forceps. The forceps are
then removed carefully allowing the stump
to return to its normal position in the scro-
Atresia ani tum. This process is repeated with the second
testicle through the same incision. The skin is
This congenital condition may be inherited then closed with a single continuous subcu-
but this has not been proven. However, it is ticular suture of absorbable suture material
prudent not to breed from these animals. and the area is covered with antibiotic spray.
Normally the condition is not seen until With skill and forethought there is time under
sometime after birth. The place where the intramuscular anaesthesia without a top-up
anus should be located is bulging out full of to perform this surgical procedure provided
meconium. This area should be clean and a the surgeon is assisted by a competent thea-
skin bleb of local anaesthetic should be tre nurse, who can prepare the patient and
injected. A small cruciate incision should be the instruments while the surgeon is scrub-
made with a scalpel. No suturing is required. bing up.
The tetanus status of the cria should be The second method is to perform
checked. The cria should be examined in 48 h castration under local anaesthesia either stand-
to check that patency has been maintained. ing or in the kush position. Ideally the animal
Sedation, Anaesthesia, Surgical Conditions 73

is well restrained behind a solid gate, e.g. in there is chronic septic arthritis in one intra-
the front of a cattle trailer, with an inner parti- phalangeal joint. The operation is welfare
tion. Access can be provided from behind, e.g. friendly. It is best to carry out the surgery
the jockey door. The use of a trailer spares the under light sedation and a regional block.
surgeon from having to kneel down. Of course A tourniquet is required for both the regional
if there is no trailer the animal can be made to block and for the operation. The animal is
kush or be chukkered (see Chapter 1) on the given pre-operative antibiotics and NSAIDs.
ground. It is useful to lay a towel under the The foot is trimmed to remove any over-
hindquarters to keep the surgery site as clean grown horn on the tip of the hoof. Then the
as possible. A total of 5 ml of anaesthetic is whole leg below the middle of the metacar-
injected under the skin in the scrotum and up pus or metatarsus is clipped and surgically
into the cord on each side. The area is thor- prepared. A length of embryotomy wire is
oughly cleaned. The surgery is performed as positioned between the cleats. With an assist-
for castration of an adult pig. The testicle is ant holding the affected cleat with a pair of
squeezed into the scrotum. An incision is made vulsellum forceps the cleat is sawn off with
over the testicle and through the tunics. The the wire in a 45 upward angle. This cut will
testicle is then drawn from the scrotum and be made in the middle of the second phalange.
from the abdomen by pulling and twisting. The stump is then dressed with a suitable
There are two problems that may confront the antibiotic cream and covered with a suitable
clinician. The first is a prolapse of scrotal fat dressing. The whole foot and leg to mid
through the incision in a few hours, which will carpus/tarsus is bandaged with thin cotton
cause owners some concern. To avoid this wool and standard bandages. This is then
either the fat can be removed at the time of sur- covered by gaffer tape, taking care that the
gery or the incision can be closed with a single gaffer tape does not actually touch the skin.
horizontal mattress suture of absorbable suture The animal is kept under antibiotic and
material. The author prefers the former tech- NSAID cover for a minimum of 10 days. The
nique so the incision wounds can be left open dressing should be changed twice in this
for drainage. The second problem may be period. If a good healthy bed of granulation
experienced when castrating small 18-month- tissue has been formed a lighter protective
old alpacas. The initial incision through the bandage can then be applied.
scrotum may be made too deep so that the tes-
ticular substance shells out and the tunics are
hard to grasp. To avoid this, the clinician
should make a careful incision through the Entropion
scrotum so that the testicle is still inside the
tunics as if a closed castration was being per- This is extremely rare in SACs. It is an inher-
formed. A pair of artery forceps can be applied ited condition and causes severe welfare
to the cord, and the testicle within its tunics problems if it is not treated promptly. Every
can be drawn completely. effort should be made to stop using sires that
It is very important to remember to check have the gene. Often if the condition is
the tetanus status. The animal should be given observed at birth the curled-in eyelid can be
antibiotics and NSAIDs. The wound should be immediately uncurled and an entropion will
covered with antibiotic spray. If castration is not develop. However, if the condition is
carried out in the summer in the UK some sort missed then treatment has to be initiated.
of fly control should be considered. Antibiotic eye ointment provided no steroid
is included will help, but obviously will not
influence the long-term disease. The curled-
in eyelid needs to be turned out permanently.
Digital amputation The best treatment is to treat the cria like a
dog and carry out a cake slice op. After
This procedure is not commonly carried out. putting in the local, the area around the eye
However, it should considered by clinicians if needs to be clipped and prepared for surgery.
74 Chapter 8

A small slice of skin is then removed. The The mandible should be stabilized with wire
wound is then sutured with fine interrupted using the incisors, canines and rostral cheek
simple sutures. The eyelid is then perma- teeth. Any loose teeth should be left in situ as
nently in the correct position. The sutures they will often re-anchor. However, any actual
need to be removed in 10 days. Entropion has fractured teeth should be removed as fractured
never been recorded in the top eye lid as well enamel can not repair. The soft tissue should be
as the bottom eye lid although in theory it sutured. The animal should be given antibiot-
could occur. In this case two small slices of ics, NSAIDs and TAT. It should be fed on a
skin will need to be removed. sloppy diet or lush grass. The prognosis may
well be good.

Enucleation of the eye


Limb amputation
In all cases where there is no chance of the eye
condition in any disease or traumatic prob- This has been carried out in several species
lem recovering, enucleation should be con- larger than llamas or alpacas. Practitioners
sidered on welfare grounds. It can be carried must debate carefully the welfare aspects of
out under heavy sedation normally with limb amputation. On the plus side SACs
xylazine. kush and so have an advantage over other
Local anaesthetic should be instilled all Artiodactyla species of a similar size, in that
around the orbit not only under the skin but they can rise up relatively easily. It has been
into the deeper tissues with a single very deep performed on numerous occasions success-
injection of 5 ml behind the eye to block the fully in llamas and alpacas. The actual sur-
optic nerve. The eyelids should then be gery is outside the authors experience.
sutured together and the whole area clipped
and prepared aseptically. A careful incision is
then made through the skin parallel to the
upper eyelid margin but not entering the con- Ovariohysterectomy
junctival sac. Using blunt dissection the eye
muscles are sectioned around that half of the This surgery is outside of the authors experi-
eye. The same procedure is then carried out to ence. The rationale for such surgery can only
the lower half. Eventually a pair of curved be experimental and would be very difficult.
scissors can be used to section the optic nerve Obtaining access to the ovaries would cause
and the eye can be removed. The remaining considerable problems. Hysterectomy alone
socket can then be obliterated with subcuticu- would not be quite so difficult. However, the
lar suturing with absorbable material and the need to carry this out would be in the event of
remaining eyelids can be sutured with non- a uterine tear. If the tear was cranial then
absorbable material. The animal should repair should be carried out from an abdomi-
receive antibiotics and NSAIDs for a mini- nal incision. If the tear was caudal such a
mum of 5 days. The sutures should be repair would be very difficult and euthanasia
removed in 10 days. would be indicated.
It might be postulated that certain uter-
ine conditions might require hysterectomy.
However, treatment through the cervix would
Fracture of the mandible
appear to be an easier and safer option.

These are quite common injuries from fighting


and they appear horrendous. However, in fact
they heal very well. The animal should have Patella luxation
either heavy sedation or a general anaesthetic.
Radiographs should be taken. The wound This is a deformity that is normally bilateral
should be cleaned and debrided as necessary. as a result of the patella grove being too
Sedation, Anaesthesia, Surgical Conditions 75

shallow. Repair has been tried but was unsuc- Repairing an inguinal hernia
cessful. Euthanasia must be advised.
Inguinal hernias are extremely rare in male
SACs and are not seen in female animals.
Patent urachus They are a genetic recessive disorder and
therefore should only be repaired after castra-
This condition is normally congenital. The tion. The left side is more commonly affected.
urachus has failed to close at birth. Normally If there is a strangulation of the intestine
this can be ligated together with the vessels within the hernia, the animal will show colic-
lying beside it, without need for anaesthe- type pain. Because of the stoical nature of
sia. Prolonged antibiotic cover is vital as if SACs these affected animals are often found
sepsis develops further difficult surgery will dead. The animal should be given a general
be required. All the diseased infected tissue anaesthetic and placed in dorsal recumbency.
will need to be removed. This should be The area is surgically cleansed in the normal
done under a general anaesthetic with the manner. A careful scrotal incision is made
cria masked down with halothane or isoflu- over the testicle, taking care not to incise the
rane. Once the diseased tissue has been tunics. The testicle is drawn through the skin
removed the urachus and the vessels will incision milking any abdominal contents back
need to be ligated inside the abdomen. into the abdomen. When the surgeon is 100%
Drainage will have to be established so that certain that this has been accomplished two
the healing can occur from within. Further large pairs of haemostats are placed over the
broad spectrum antibiotic cover will be cord. The proximal pair is removed and a
required as well as wound flushing with transfixing ligature is tied in the grove left by
dilute povidone-iodine. the haemostats. The testicle is then removed
distal to the remaining pair of haemostats.
When the testicle has been removed the skin
should be sutured with horizontal mattress
Persistent hymen sutures. Similar surgery should be carried out
on the other side even if there is no inguinal
If this condition is actually a persistent hymen herniation. The animal should be given anti-
it is relatively easily rectified. It also does not biotics, NSAIDs and TAT by injection.
hold any ethical problems, unlike a similar
but rarer condition of vagina aplasia. This
condition is genetic and so surgery should
not be attempted. Repairing an umbilical hernia
The sign shown by the affected animals
by both conditions will be that of the male Umbilical hernias are extremely rare in SACs.
failing to fully penetrate the female. Normally They have a high heritability and so repair
the hymen containing uterine mucoid secre- should not be carried out in males unless they
tions can be perforated with a finger. The are castrated. It is reasonable to repair an
secretions are voided and the animal can be umbilical hernia in a female that is being kept
bred from in the normal manner. There is no for breeding on the understanding that her
need for further treatment. If this cannot be progeny will not be kept for breeding.
achieved the animal should be examined Repair of umbilical hernias should be
carefully with a small duck-billed speculum. delayed until the cria is at least 4 months of
If there is a persistent hymen it will be seen age. Often with age there is little reason to
bulging towards the operator. It should be repair them as the abdominal opening is rela-
pieced with a stab incision with a small scal- tively small. If no more than three fingers can
pel and widened with a finger. If there is be inserted into the abdominal opening the
aplasia of the vagina the animal should be hernia can be closed with an elastrator ring.
left as a fibre producer and not be considered The cria should be given antibiotic and
for breeding. NSAID cover with its tetanus status checked.
76 Chapter 8

It is then placed in dorsal recumbency. Raising the blood urea to be raised will not be helpful.
the hernia sack to ensure there are no bowel A peritoneal tap is required (see Chapter 4).
contents, a rubber ring is placed as near to the Normal peritoneal fluid has a potassium con-
abdominal wall as possible. Antibiotic cover centration of below 5 mEq/l; urine has a potas-
and fly control should be maintained for a sium level ten times that figure.
minimum of 10 days. Repair should be carried out under gen-
If the abdominal opening is larger than eral anaesthetic with the animal in dorsal
three fingers a full surgical operation will recumbency. In the male an incision will
need to be carried out under general anaes- have to made paramedian to get as much
thetic. The cria should be prepared as above access to the bladder as possible. The blad-
under general anaesthetic and the area der should be carefully examined and the
should be clipped and surgically prepared. patency of the urethra should be established
An elliptical skin incision is made around by flushing before closure using a double
the hernia sack. With blunt dissection the layer of continuous inverting sutures. The
skin is removed. With great care, with blunt abdomen should be flushed after closure of
dissection, the hernia sac is undermined the bladder before closing with two layers of
from the abdominal wall without entering continuous sutures. The skin should be
the abdomen so that there is a rim of 1 cm closed with single interrupted sutures of
around the orifice. Sterile nylon mesh is monofilament nylon.
then sutured to the abdominal ring over The welfare and ethical dilemma arises
the orifice with monofilament nylon con- when the bladder has ruptured because the
tinuous stitches. After closing the wound urethra of a male has become blocked with
with a continuous layer of subcuticular calculi. If these calculi can be flushed out with
sutures of absorbable material the skin is flushing, the bladder can be repaired as
closed with single horizontal mattress described above. However, if the urethra can-
sutures of monofilament nylon. The wound not be cleared the clinician has a dilemma.
is covered with antibiotic spray. The cria Several surgical approaches have been
should be confined for a minimum of described. These include ischial urethros-
10 days and receive antibiotics and NSAID tomy, urethrotomy and marsupialization. The
cover. Obviously fly control and tetanus problem is that invariably there is urine scald-
cover are vital. ing, at best there is continual pyoderma. At
worst there will be continual acute skin
inflammation with fly strike in the summer.
The authors own opinion is that euthanasia
Repairing a ruptured bladder is required. This opinion is influenced by the
authors poor surgical results in other species
This condition does not seem to occur in male and therefore the author readily accepts that
alpacas or llamas at birth as it does in horses. in better surgical hands the outcome may
It can occur in both males and females that are well be more favourable.
subjected to violent trauma from road traffic
accidents (RTAs) or from falls from high
places. It has been reported that a bladder has
been ruptured during rectal examination. The Replacing a prolapsed rectum
author has large hands and so does not carry
out rectal examinations in SACs. The more The causes of this very rare condition are
common cause is rupture as a result of ure- obscure. It has been suggested that homosex-
thral obstruction. ual behaviour might be a cause. It does appear
In the incidence of trauma the repair to be more prevalent in males. Severe cough-
needs to be carried out as soon as possible and ing caused by lungworm or pneumonia has
does not carry any welfare or ethical consid- also been postulated as a cause in pigs but this
erations. Diagnosis of bladder rupture is not is unlikely in SACs. The SAC should be given
easy. If it is suspected, the delay waiting for antibiotic and NSAID cover. The tetanus
Sedation, Anaesthesia, Surgical Conditions 77

status should be checked and fly control the tunics dorsally to a second pair of artery
implemented. With the SAC either in the forceps. The testicle should then be removed
standing position or in the kush position an and the subcuticular tissues should be closed
epidural regional anaesthetic should be given. with a continuous row of sutures of absorba-
The perineal area should be cleaned before a ble material. The skin should then be closed
purse-string suture is put in place. It is impor- with single horizontal mattress sutures of
tant that this is placed before replacement of monofilament nylon. The animal should be
the rectum, otherwise the rectum will repro- given antibiotics and NSAIDs. The tetanus
lapse while the suture is being placed. After status should be checked.
replacement of the rectum using plenty of Before deciding an animal is a rig, clini-
obstetrical lubricant the purse-string should cians should examine the groin very carefully
be drawn tight to only allow one finger in the not only to see previous scars but also because
orifice. The animal should be kept on a laxa- often testicles have descended and do not
tive diet and regularly checked. The suture lie in the scrotum but cranial to the scrotum
should be removed in 10 days. In the majority lateral to the penis.
of cases it will remain in situ. However, if it
re-prolapses euthanasia is indicated. The wis-
dom of performing surgery on these animals
is controversial. However, it is possible that Tendon contraction
with careful resection of the rectal mucosa the
problem could be solved satisfactorily. This is a rare condition when seen on its
own. It will be seen in crias with other con-
genital defects. In these instances euthanasia
may be indicated. If it appears to be the only
Rig operation defect then careful appraisal should be car-
ried out. If the limb or limbs can be extended
Retained testicles are very rare in SACs. but the cria chooses not to, the author gives
A SAC that has only one descended testicle the cria an injection of 500 mg of oxytetracy-
will definitely be fertile. In fact in the authors cline. There is considerable doubt on the
experience they have more libido and there- effectiveness of this treatment. Its virtue is
fore cause more problems than normal males. that it gives 48 h for further evaluation.
There is every reason to suspect that retained It is not prudent to immediately splint or
testicles are more likely to become cancerous. cast the limbs as many cases will self cure.
Therefore these animals will need to be cas- Splinting or casting is very hazardous as
trated. Such an operation should not be pressure sores are likely to be created with
undertaken lightly as some retained testicles life-threatening results. If after 48 h the limbs
may be up near to the kidney. In these can be extended then the owner should be
instances the best method is to carry out the instructed to house the cria and its mother.
removal laparoscopically. However, in most Then as many times as possible every day
cases the testicle will lie just inside the inner the limbs should be forcibly extended. In the
inguinal ring. In these cases a straightforward authors experience this will have a 50% suc-
surgical procedure can be carried out under cess rate. Should this fail or if the tendons
GA. The scrotum and the surrounding area are so contracted that the limb cannot be
should be clipped and surgically cleaned. An extended then surgery should be attempted
incision should be made over the external under general anaesthetic.
inguinal ring. The tunics covering the retained The cria should be masked down with
testicle will be found by blunt dissection over halothane or isoflurane and the limbs prepared
the inguinal ring. These should be grasped for surgery. The cria should be given antibiotics
by a large pair of artery forceps and the testi- and TAT by injection. The author does not give
cle should be drawn, slowly and carefully, to NSAIDs as these may be toxic in very young
the exterior. A transfixing ligature of absorb- crias. A 2.5 cm-long incision is made centrally
able suture material should be placed around in the palmer aspect of the metacarpus in the
78 Chapter 8

direction of the limb. The median artery and has been used has been successful. They
nerve will lie medially and the ulnar nerve will must certify that death has occurred them-
lie laterally. These should be reflected medially selves and not rely on any helpers. In the
and laterally so that the two branches of the normal circumstances euthanasia of any
superficial digital flexor tendon can be severed. animal by a veterinarian using blunt trauma
The skin should be sutured with small inter- is totally unacceptable. However, every vet-
rupted skin sutures or staples. The wound erinary surgeon is an individual and is
should be covered with a padded support legally and morally in charge in euthanasia
bandage. The weight of the cria will hopefully situations. The veterinary surgeon must
stretch the deep digital flexor tendon. use his judgement. For example, there is a
fire in a shed and a very badly burned small
cria. The off-duty veterinarian happens to
Urethral obstruction be passing, and he has no firearm or lethal
injection; is it better to administer one
sharp blow with a hammer to the crias
This is seen typically in young males fed on
head or to wait for another veterinarian to
dry concentrate diets. Surgery as described
arrive?
for a ruptured bladder is possible but carries
severe welfare implications.

Use of a firearm with a free bullet


Vasectomy
This method is quite satisfactory in SACs
This operation is not required in normal circum- provided the veterinary surgeon has a license
stances. However, it may be required for repro- for the firearm. The point to aim for is the
duction studies. The scrotum is not pendulous middle of a cross formed by two lines run-
and so the operation is best performed under ning from each eye to the opposite ear. This
general anaesthetic in dorsal recumbency. method should not be used in young crias.
The area of the scrotum and cranial to it, This method is not advised in normal circum-
is prepared for surgery. A 5 cm incision is stances in the UK.
made cranial to the scrotum over the sper-
matic cord but slightly medial to the cord. The
spermatic cord is then exteriorized by blunt Use of a captive bolt pistol
dissection. A pair of artery forceps is posi-
tioned between the skin and the cord. The The same point of aim can be used for eutha-
shiny vas deferens will be seen on the medial nasia of SACs with a captive bolt pistol as is
aspect of the spermatic cord. It can be grasped used for euthanasia with a free bullet.
with a pair of rat-toothed dressing forceps. Immediate bleeding out by cutting all the
A 5 cm length is removed having ligatured neck vessels is required. Captive bolt pistols
either end with absorbable suture material. should not be used in young crias. This
The skin is closed with two horizontal mat- method is not advised in normal circum-
tress sutures of similar absorbable material. stances in the UK.
The process is repeated on the other side.

Electrocution
Euthanasia
In theory this method could be used commer-
Introduction cially for euthanasia of SACs. Immediate
bleeding out by cutting all the neck vessels is
It must be stressed that veterinarians must required. This method is not advised in nor-
at all times check that whatever method mal circumstances in the UK.
Sedation, Anaesthesia, Surgical Conditions 79

Chemical euthanasia intramuscularly (5 ml for a large male llama)


or actually anaesthetized by a cocktail of
This is the normal method of euthanasia for agents given intramuscularly and then the
SACs. For skilled veterinarians who are triple-strength barbiturate or the solution
used to giving intravenous injections in containing 400 mg/ml quinalbarbitone and
SACs there are few problems in injecting 25 mg/ml cinchocaine hydrochloride can be
either a large volume (approximately 100 ml given intravenously when the animal is in
of triple strength barbiturate solution) or lateral recumbency.
25 ml of a solution containing 400 mg/ml Small crias can be destroyed by injecting
quinalbarbitone and 25 mg/ml cinchocaine 15 ml of triple-strength barbiturate into the
hydrochloride intravenously. However, nor- jugular vein. This in the authors experience
mally the skin of SACs is too thick to allow may be difficult in a totally collapsed mori-
the jugular vein to be visualized so inexperi- bund cria. In these cases it is humane to inject
enced veterinarians will find this difficult the triple-strength barbiturate straight into the
particularly if the SAC is large and poorly heart. To do this the cria should be held by the
handled. In these instances the SAC can be assistant either in lateral recumbency or with
heavily sedated with 2% xylazine given both arms across the assistants chest.
9
Medicine and Surgery of the
Gastroenteric System

Anatomy of the Teeth difficult as the time of the year of birth is not
always known.
SACs appear to have no upper incisors, only The migrated canine, which is actually
a dental pad. However, they do in fact have an incisor in the upper jaw, may have a decid-
an upper incisor that has migrated caudally uous precursor. These are very rare in females
and resembles a canine tooth. Thus in the but may be seen in the first 3 months of life in
upper jaw they appear to have two canines on approximately 5% of males. The permanent
each side. In the lower jaw they have a single migrated incisor teeth will erupt at approxi-
canine tooth. These six canines are called mately the same time as the real canines at
fighting teeth and can be very devastating 2 years of age.
structures. SACs are anisomatic, i.e. their upper
Certain authorities maintain that the cheek teeth are wider than their lower cheek
three pairs of deciduous incisors are present teeth. However, unlike equines, which tend
at birth. In reality this is rarely the case as the to develop sharp enamel points on the buccal
outside pair may not actually emerge for aspect of the upper cheek teeth rows from
3 months. These deciduous incisors are grinding, SACs maintain a normal occlusal
replaced sequentially starting with the cen- table and do not develop sharp enamel
trals at just over 2 years of age. The middle points.
incisors are replaced at approximately 3 years SACs have five cheek teeth in the four
of age and the corners at approximately rows, two premolars and three molars in
4 years of age. These eruptions do not appear each row. The two premolars are present at
in such a standard manner as in horses but birth but are not replaced rostrally from the
rough ageing of animals under 5 can be car- front until 4 and 5 years of age. The three
ried out. As practitioners are aware, most molar teeth erupt rostrally from the front
foals in a UK environment are born in the before this time at approximately 9 months,
spring and technically have a birthday on 2 years and 3 years, respectively. Thus a
1 January. Therefore teeth eruption and age SAC does not have a full mouth until
can be linked fairly satisfactorily. However, 5 years of age.
although most owners aim to have SAC crias All the roots of the lower cheek teeth lie
born in the spring in the UK this is often not in the mandible, so if there is any apical
accomplished and so crias are often born in abscessation it will start as a unilateral
the autumn. Therefore accurate ageing is swelling on the mandible before it fistulates.

80 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Medicine and Surgery of the Gastroenteric System 81

The roots of the upper premolars lie in outside of the mouth carefully first. Squamous
the maxillary bone so any apical abscessa- cell carcinomas will be found in the orophar-
tion starts as a swelling of the maxillary ynx of old animals. Tumours of the salivary
bone, which is likely to lead to a fistula. The glands will be seen but these seldom metasta-
roots of the upper molar teeth lie in the size to the local lymph nodes. If there is a frac-
maxillary sinus so an apical abscess will ture of one or both mandibles, the gag should
be manifest as a malodorous unilateral not be used. If there is any doubt, a radio-
nasal discharge. graph should be taken. This should be a lat-
eral oblique with the plate against the side of
the jaw most likely to be affected nearest to
the plate. The x-ray machine should be placed
Mouth and Dental Problems lower than the head and point up at a 30
angle. The whole mandible should be radio-
Introduction graphed, so a large plate will be required. If a
fracture at the symphysis is suspected then a
Obviously if several animals are affected with dorso-ventral view may be helpful. Once
mouth and possible dental problems, the dif- again a large plate will be required for the
ferential list is going to be different from a whole head. However, a small plate may be
single animal being affected. However, in useful for an intra-oral radiograph of the
either case individual animals have to be symphysis and the incisors. This later projec-
examined. First the clinician needs to decide tion is also useful for diagnosing the very rare
what signs are being shown. There is likely to dentigerous cysts usually found in the area
be excess salivation. This may be coupled surrounding the incisor roots.
with cud spilling, which is normally manifest
as a green discoloration around the mouth.
The whole head should be examined before
the lips are peeled back to examine the inci- Pytalism and pseudopytalism
sors and to examine the mucosa. Then with
the use of a gag and a good light source, pref- Both these conditions occur in SACs. Owners
erably a head torch, the inside of the mouth will complain of cud staining or the appear-
and the teeth can be examined (Fig. 9.1). It is ance of digestive fluid on the ground over-
very important that clinicians examine the night. It is important to establish whether

Fig. 9.1. Examination of the mouth.


82 Chapter 9

feed material is present or not. Various behav-


ioural vices or pathological lesions may pro-
vide an explanation for loss of saliva. Possible
causes are: ulcerative stomatitis, lingual pare-
sis, malposition of the parotid ducts, early
mega-oesophagus, or choke.
Passive regurgitation during sleep is a
relatively common problem in young SACs
between 6 and 18 months. It tends to be self
limiting and stops after the age of 18 months.
Parotid saliva in SACs is similar to ruminants.
It is alkaline and copious. Its loss leads to
acidaemia and hypokalaemia. Except in cases
of choke, which are extremely rare, the saliva
can be replaced orally.
Choke may be secondary to mega-
oesophagus. The normal cause of this is
Fig. 9.2. Prognathia.
iatrogenic following jugular veni-puncture
on the left side. It is very important that cli-
nicians use the right hand side for veni- however, prognathia is common and is a
puncture. Diagnosis can be confirmed by fault recognized by show judges and buyers.
radiographs. In a normal SAC plates exposed Therefore routine grinding of these incisors
immediately after a barium swallow rarely is carried out (Fig. 9.3). Not only is this prac-
show more than a trickle of contrast material, tice inhumane but also it is being used to
so any retained in the oesophagus is diag- mask an inherited conformation fault for
nostic. Treatment should include long monetary gain. Clinicians should consider
term antibiotics and NSAIDs and the ani- carefully whether they can condone such a
mal should be fed on pelleted lucerne or practice.
grass nuts.
Incisor removal

Incisor and canine problems in SACs This is a relatively straightforward procedure


if an incisor tooth is loose. However, even
Introduction then it is quite easy to fracture the root so
elevation is worthwhile. Local anaesthetic
This whole area related to the incisors and should be instilled under the mucosa rostral
the dental pad is very contentious. The and caudal to the tooth. An amount of 1 ml
author has fairly radical views. However, he either side is sufficient. A dental syringe
will endeavour to put forward a balanced makes this task easier. The clinician must use
argument. First of all there is the problem of judgement on whether removal is a help to
the over extension of the mandible, prog- the animal or not. Normally incisors should
nathia, and under extension, brachygnathia be left unless they are very loose or much
(Fig. 9.2). Both these conditions are inherited displaced.
and therefore such individuals should not be In rare cases the deciduous incisor teeth
bred from. Contrary to popular opinion nei- may fail to fall out and in other cases ani-
ther of these conditions affects the animal mals will appear to grow an extra row of
concerned. There have been no welfare prob- incisors (Fig. 9.4). The clinicians are advised
lems recorded related to either prognathia or to radiograph these teeth and think long
brachygnathia. Animals with these condi- and hard before attempting to remove them.
tions do not suffer from any degree of dys- Obviously if they are loose they should be
prehension and therefore suffer no problems removed. They should also be removed if
with loss of weight. Brachygnathia is rare; they are causing problems and it is easy to
Medicine and Surgery of the Gastroenteric System 83

Fig. 9.3. Grinding incisors.

2 years. I question the wisdom and the


ethics of this procedure. First of all it will
only be a problem if stud males run together
or if inadvertently two stud males get in the
same compound as one another. Should
such males be kept together? Certainly no
farmer would consider running mature
bulls or mature male goats together except
in a very extensive area. The author is aware
that rams, outside of the breeding season
are run in groups. However, shepherds are
very careful to pen such animals tightly
together for 24 h before letting them loose to
Fig. 9.4. An extra row of incisors. help to control fighting. Outside the breed-
ing season rams are less aggressive.
see which are the permanent teeth. Otherwise Whichever stance practitioners adopt
monitoring the problem must be the best one thing is for certain, that removal of fight-
advice. ing teeth needs to be carried out in a humane
manner. La Rue W. Johnson, DVM, PhD of
Canines Colorado State University (pers. comm.), an
extremely experienced SAC veterinarian,
There is the problem of fighting teeth in considers the procedure should be carried
adult uncastrated males. These are very out under a short acting anaesthetic (see
vicious weapons and can inflict severe Chapter 8), using embryotomy wire which is
wounds on other animals, particularly other continuously bathed in cold water to prevent
mature uncastrated males. The general excess heat. This must be considered best
opinion of eminent veterinarians in the UK practice. Any other method is likely to be
and elsewhere is that the erupted crown of unethical, particularly the use of Canine nip-
these teeth should be removed at the age of pers, which are liable to cause the tooth to
2 to 3 years. This procedure will have to fracture possibly in a vertical plane. This will
be repeated at regular intervals of roughly result in apical abscessation.
84 Chapter 9

Cheek teeth problems Extremely rarely there will be a malodor-


ous unilateral nasal discharge. Owners nor-
These are common. The normal referring mally seek veterinary attention in these cases
sign is a facial swelling. Swellings of the soft and in cases where the swelling fistulates.
tissue that enlarge rapidly are unlikely to be However, on occasions the abscess will drain
tooth related and are normally abscesses, into the mouth and the owner will only notice
although they could be insect or reptile bites. the malodorous breath.
The fibre should be trimmed away and the Radiographs, particularly with metal
area cleaned before an 18G needle is inserted. probes in the fistula, will be helpful to diag-
Pus will be seen in the needle and then the nose which tooth has an apical abscess. Long
abscess may be lanced. Digital exploration term antibiotics may be tried but the result is
should be carried out into the abscess rarely satisfactory. At least a month of daily
to make sure there is no foreign body, e.g. injections of penicillin or ceftiofur has been
a slither of wood or an air-gun pellet. tried or a ten-shot series of florfenicol at the
Antibiotics should be given and the tetanus higher dose given every fourth day is claimed
status checked. If the swelling is unrelated to to have a success rate of 50%. The fistula may
the underlying bone and not rapidly enlarg- appear to close but will re-open when the
ing it is likely to be an Actinobacillus ligneriesii antibiotic cover ceases. Tooth removal is the
infection. Lancing will be unrewarding. only option. However, if the SAC is pregnant
Treatment with daily injections of streptomy- such a stressful operation is best left until
cin for a minimum of 7 days should be car- after parturition.
ried out. Lymphomas will cause soft tissue Some authorities advise a buccostomy
swellings as will cud retention. The latter approach. This requires very careful surgery
might be tooth related, e.g. a loose tooth or a under general anaesthetic and is not advisa-
displaced tooth. Careful cheek teeth exami- ble for practitioners in the field. Removal by
nation should be carried out. Normally a repulsion is not an option on account of the
tooth problem is manifest as a slowly pro- fragile mandible or maxilla. The authors
gressive hard swelling related to the mandi- preference is removal per os with the SAC in
ble or less commonly to the maxilla (Fig. 9.5). the kush position under very light sedation
While osseous remodelling is taking place with xylazine. Radiographs should be taken
there will be changes to the swelling. On the to accurately pinpoint the diseased tooth.
other hand often these swellings will remain This is easier if there is external abscessation
unchanged for months. There may be some as a radiopaque probe can be inserted into
weight loss but other signs of food spilling or the fistula. However, if the roots of the upper
anorexia are rare. molars, i.e. the caudal three cheek teeth, are
involved there will be no external fistula as
the roots lie in the maxillary sinus. In these
cases there will be a unilateral malodorous
nasal discharge. The clinician will have to
study the roots very carefully on oblique
radiographs to decide which tooth is dis-
eased. If in doubt, referring the radiographs
to a more experienced practitioner or to a
human dentist is advisable. As stated earlier
unless the tooth is loose removal is extremely
difficult. Before surgery antibiotic cover
should be given, normally a mixture of peni-
cillin and streptomycin. NSAIDs should also
be given and the tetanus state of the animal
checked. The animal should be allowed to
kush with a holder astride the SAC holding
Fig. 9.5. A hard swelling on the maxilla. the head in a normal position. If the animal
Medicine and Surgery of the Gastroenteric System 85

is fractious a very small dose of xylazine theory a skilled surgeon could draw the colon
(0.05 mg/kg: 0.125 ml of a 2% solution/50 kg) back to the anal area and create a rectum and
may be given intramuscularly. A second anus.
holder using both hands should keep the
gag open and in the correct plane. With a
head torch the tooth to be removed should Mega-oesophagus
be examined and then with a very small
equine dental pick the gingival mucosa This is an extremely rare condition but it
should be elevated on both the lateral and does occur in SACs. It appears to occur in lla-
medial aspects of the tooth. The dental pick mas more commonly than alpacas. The main
should be forced between the tooth and the sign is repeated regurgitation. However, ani-
alveolar socket. A pair of small molar sepa- mals will show multiple non-specific signs
rators should be placed rostral and caudal to such as weight loss, ptyalism, choke and
the tooth to try to obtain some tooth move- halitosis. The cause is mainly unknown
ment. Then the tooth should be grasped with although a persistent right aortic arch has been
a pair of small right-angle molar extraction shown to be the cause in one case. Trauma to
forceps. Careful, persistent medial/lateral the vagus from jugular vein puncture is the
rocking motion should be commenced. most likely cause but this is difficult to prove
When the tooth is loose it should be elevated and clinicians are unlikely to raise this
using a long pair of artery forceps as a ful- hypothesis. Diagnosis is normally possible
crum. Antibiotic cover and pain relief should on radiographs without contrast material.
be maintained for several days. There is no worthwhile treatment but cases
The alveolar socket does not require pack- can normally be managed by only feeding
ing but flushing through the fistula daily is the animal from an elevated position with
helpful. The socket rapidly granulates. regular small feeds of highly digestible
well-soaked feed at a lower level. Effected
animals can live for several years if owners
Congenital and Hereditary Conditions are prepared to persevere with this feeding
Affecting the Gastrointestinal Tract regime and construct a suitable ramp for the
animal to stand on.
Atresia ani

It is reasonable to treat these cases but the Viral Diseases Affecting


owners should be warned of the genetic impli- the Gastroenteric Tract
cations. The diagnosis is normally straightfor-
ward as a young cria will be presented with a Blue tongue virus
swelling below the tail and an absence of an
anus. A small bleb of 1 ml of local anaesthetic Blue tongue virus (BTV) is arthropod borne.
should be injected over the swelling where It is therefore infectious but not contagious.
there should be an anus. A small stab incision It is found in many parts of the world where it
is made with a very small scalpel blade into affects wild and domesticated ruminants.
the swelling and faeces will be extruded. It used to be thought to be primarily a disease
Sutures are not required and normally the of wool sheep. However, that is no longer the
anus will remain open if the owner cleans the case. There are 24 serotypes of this Orbivirus.
area for a couple of days. The serotypes tend to be restricted to certain
areas and vary in virulence and in which
species they affect. The vectors are various
Atresia coli species of Culicoides. One of the most impor-
tant found in Africa and in the southern
In the authors opinion euthanasia is the Mediterranean area is Culicoides imicola.
correct option in these cases. However, in Culicoides pulicaris and C. obsoletus are found
86 Chapter 9

in the UK. These midges can live up to can be sequenced and isolated. If serology is
3 months. The virus is maintained in the required there is an ELISA, a serum neutrali-
Culicoides spp. and in the infected ruminants zation test (SNT) and a virus neutralization
or SACs. The climate has to be not only warm test (VNT).
enough for the Culicoides spp. to breed but When treating affected animals all
also warm enough for the virus to replicate in handling should be gentle with as little move-
the Culicoides. All stages of Culicoides are ment as possible.
influenced by moisture and require a semi- The differential diagnosis in SACs must
aquatic breeding habitat. They are strong fli- include foot-and-mouth disease (FMD) and
ers and also can be passively dispersed by vesicular stomatitis. On the whole, in FMD
wind. This has been shown to occur in the there is a much lower mortality than in BTV.
Mediterranean area for over 300 km. Therefore Facial swelling is much more marked in BVT
the disease is restricted to warmer temperate compared with FMD. On the other hand vesi-
areas and the tropics. The disease is found all cles and ulcers are characteristic of FMD but
through the USA and Europe. The disease has are less common in BTV. Clinicians should
been controlled in the UK, having first been remember that FMD is highly infectious but
detected from an infected plume of Culicoides BTV requires a vector.
from Belgium on 4 August 2007. Of the 24 There is no specific treatment for BTV.
serotypes worldwide, there are only five sero- Antibiotics and NSAIDs are helpful. Nursing
types in the USA and four serotypes in north- is vital. This should included offering water
ern Europe. There are more than 1400 species and mushy food, providing deep bedding out
of Culicoides worldwide, but only 20 or so are of the sun and heat. Affected animals will
possible vectors of blue tongue virus. Only never return to full health. There is an increase
female Culicoides are involved in disease in the incidence of mastitis. There is an
transmission. increased incidence of lameness. There will
BTV first replicates in the local lymph be long term fertility problems including
nodes. The viraemia seeds other lymph nodes, abortions, stillbirths, weak crias and early
spleen, lung and vascular endothelium and embryonic deaths. In alpacas there will be
replicates. The viraemia normally lasts for wool loss and staple breaks. There is an
35 days but can last up to 60 days. Endothelial increase in pneumonia cases and long term
damage and disseminated intravascular poor doers.
coagulopathy (DIC) cause the clinical signs. Since 1998 there have been 12 different
The incubation period is 69 days. Antibodies invasions of BTV into Europe with 12 differ-
can be detected from 6 days post-infection. ent vaccines required to help control. The vac-
The clinical signs are associated with virus cines available are inactivated (dead) vaccines
replication in endothelial cells, which results against specific serotypes. The most up to
in haemorrhage, ischaemia, inflammation date are highly purified by liquid chromatog-
and oedema. The lesions are common in areas raphy (see Chapter 7).
subject to mechanical trauma and abrasion,
e.g. the feet, mouth and eyes. There is fever
up to 42C. There are respiratory signs and
abortion. BTV causes not only gross abnor- Bovine viral diarrhoea
malities to the CNS of the fetus, but also
generalized growth retardation and foetal Bovine viral diarrhoea (BVD) virus will affect
lymphoreticular hyperplasia (Richardson SACs. It can spread in a herd of SACs as well as
et al., 1985). There is conjunctivitis, mucosal to other species, e.g. cattle, sheep and goats.
inflammation and oedema. Petechiae, ecchy- Crias will show weight loss and diarrhoea.
moses and cracked lips will be seen, leading Some crias will be stillborn or show congenital
to excess salivation. There is coronitis causing neurological signs. Ill-thrift and weight loss
lameness. will be shown in adults. Diarrhoea is rare.
The diagnosis is confirmed by PCR for The virus will cause abortion. Persistent infec-
viral RNA. It can detect all 24 serotypes. Virus tion (PI) has been demonstrated. SACs which
Medicine and Surgery of the Gastroenteric System 87

are infected in early pregnancy, i.e. between ulcers on the mouths and feet of a consider-
32 and 133 days, are 82% likely to be PIs. Most able number of animals. Crias suckling their
of these will be light at birth i.e. 6 kg rather mothers will be crying and hungry as a
than the normal alpaca cria weight of 8 kg. result not only of the disease but also as a
They will grow slowly and will die before result of the milk drop experienced by their
they reach 30 months of age. The disease is mothers. Several animals will be acutely ill
spread by mixing animals. Both type 1 and with pyrexia. With some strains recovery is
type 2 virus have been isolated in Chile but quick with the disease passing through the
only type 1 has been found in the UK. The herd in a few days. Recovery is not quite so
recommended test for detecting the virus in quick with some strains and may take a
SACs is a PCR. Seroconversion can be diag- considerable time. The earliest signs are ves-
nosed by the use of SNT. The standard sero- icles, fluid-filled sacs within the epithelium.
logical antigen and antibody tests used in The fluid is clear, slightly yellow and slightly
cattle are not validated and may give false viscous. The vesicles are thin walled and
results. therefore very transitory. Often the whole
infection will only last 2 days in an animal.
Over 90% of the herd will have foot lesions
Coronavirus and sudden severe lameness will be very
evident. This is the commonest clinical sign
associated with FMD in SACs. Whole groups
This is a relatively common finding in SAC
will frequently lie down and be very unwill-
crias. It is often brought into the herd by ani-
ing to rise. Serum will need to be tested for
mals returning from a show. The main sign
antibodies to confirm FMD. It is possible
will be diarrhoea. With careful hygiene and
that FMD may be confused with BTV but
the use of electrolytes it is fairly easily con-
careful assessment of clinical signs will
trolled. However, both hands and any equip-
clarify the diagnosis.
ment should be carefully cleaned between
The spread of FMD virus can occur in a
animals. It appears that crias will self cure.
number of ways. The most important is by
There is rarely a need for antibiotic support or
direct contact between infected and suscep-
NSAIDs.
tible livestock. However, it can also occur
with feeding infected milk, using infected
semen or infected embryos. The virus
Foot and mouth disease can be airborne or carried by people or spe-
cies of animal not susceptible. The virus
SACs definitely contract FMD as do camels. can be carried by vehicles and any other
They may only be carriers for a few days but fomites.
they definitely do spread the disease. This is Virus production in infected animals
contrary to the popular belief of SAC owners remains high until antibodies develop at
and many veterinary surgeons working with approximately 45 days post-infection.
SACs. The severity of FMD will vary mark- Some animals will remain as carriers for a
edly with the strain of virus, the breed of ani- considerable length of time but most own-
mal and the type of husbandry. The disease ers and their practitioners are in denial
spectrum will range from inapparent infec- about this. In the UK the disease is notifiable
tion detected only by subsequent herd sero- and the animals will be slaughtered as soon
surveillance through to high morbidity as possible.
outbreaks with very noticeable diseased
animals.
The main signs are lameness and reluc-
tance to move. Excess salivation is invaria- Malignant catarrhal fever
bly seen at some stage of the disease in
SACs. A thorough examination of the whole Malignant catarrhal fever (MCF) is a disease
herd will reveal the typical erosions and of cattle caused by a group of herpes viruses.
88 Chapter 9

These include Alcelaphine herpes virus 1, Peste des petits ruminants (PPR)
Ovine herpes virus 2 and Caprine herpes
virus 2. The most important is Alcelaphine Peste des petits ruminants (PPR) is caused by
herpes virus 1. The normal host of this virus a morbillivirus and is related to Rinderpest.
is the wildebeest (gnu) in which it is asymp- However, unlike Rinderpest it is not conta-
tomatic. The disease in cattle appears in the gious to cattle. On the other hand Rinderpest
Masai cattle in Kenya and northern Tanzania can affect goats but appears to be less viru-
at the time of the wildebeest calving season lent as the mortality rate may be as low as
from the end of January to the beginning of 50%, where the disease in cattle in the
March. Goats are not affected but occasion- authors experience causes 100% mortality.
ally Masai sheep will show symptoms. It is hoped that Rinderpest has been totally
These are lethargy and pyrexia. There is eradicated. PPR is often termed goat plague.
inflammation of the mucosal surfaces, It is a disease with a high morbidity and mor-
mainly mouth necrosis and keratitis with tality in goats, sheep and camels. It is seen in
conjunctivitis. The sheep are likely to recover Africa, the Middle East, central Asia and
unless they are suffering from malnutrition the Indian subcontinent. The Food and
or some other disease. However, in the UK Agriculture Organization (FAO) were con-
the sheep is normally an asymptomatic car- cerned at the end of 2010 about an outbreak
rier like the wildebeest in Africa. Cattle are in Tanzania, which was threatening over 13.5
the main host. In cattle there is a grave prog- million goats and 3.5 million sheep in the
nosis. Diagnosis is either with an ELISA or a country. FAO advised an emergency vaccina-
PCR. There is no treatment or vaccine tion around the disease outbreak with further
available. SACs are not kept in Africa and vaccination campaigns in the bordering areas
therefore are not likely to be infected. of Malawi, Mozambique and Zambia. Sheep
However, they can contract the disease in and goats are critical to food and income
the UK by close contact with infected cattle security for pastoral communities in sub-
or sheep. It is a very serious disease in SACs Saharan Africa. An Asian lineage strain of
with a high mortality but an extremely low virus has been isolated in Sudan and has
morbidity. Bovine herpes virus 3 has been spread to Morocco (Kwiatek et al., 2011). It is
found in pigs in the UK and these animals therefore now very close to Europe. SACs
could be infective to SACs. would be very susceptible but clinicians
should not be concerned that they will miss
this disease as the signs are very obvious.
There is high fever with erosions on the
Nairobi sheep disease (NSD) mucous membranes of the mouth and eyes.
There is acute bloody diarrhoea and also
Nairobi sheep disease (NSD), which occurs in signs of pneumonia. Whole herds will quickly
sheep and goats, is caused by a nairovirus. It become infected and the majority will die.
is spread by ticks, mainly the brown ear tick, There is no specific treatment. However,
Rhipicephalus appendiculatus. It is mainly seen oxytetracycline injections seem to reduce the
in areas in Eastern Africa where this tick number of deaths. NSAIDs may be useful.
occurs. SACs are not kept in these areas, There is a vaccine available for use in sheep
which is probably why it has not been and goats. This might be effective in SACs. It
reported in SACS, but it is likely that it would is likely that there would be immediate
cause deaths. slaughter of affected animals within the EU.
Diagnosis can be confirmed by blood
samples for an ELISA test. There is no treat-
ment. Prevention can be carried out by very
strict twice-weekly dipping in a suitable aca- Rotavirus
ricide or regular use of pour-on cypermethrin
products. It is hoped that there will be a vac- Rotaviruses have been found in most farm
cine prepared in the near future. animals in many countries. There are seven
Medicine and Surgery of the Gastroenteric System 89

serotypes recognized. However, their patho- Bacillary haemoglobinuria


genicity in crias is not clear cut. They will
definitely cause diarrhoea but often there is This has not been reported in SACs. It is pri-
another pathogen isolated at the same time. marily a disease of cattle in central Ireland and
This may be a bacteria, e.g. E. coli, or a proto- is sometimes called bacterial redwater. It is
zoan, e.g. coccidia. Clinicians cannot treat the caused by Clostridium haemolyticum. It might
virus so attention should be drawn to the well occur in SACs in the future if they are
other pathogen. kept in large numbers in Ireland. It is likely to
cause sudden death. The disease might occur
in other areas of high rainfall, particularly
when summers are wet. The signs likely to be
Bacterial Diseases Affecting shown would include abdominal pain, jaun-
the Gastroenteric Tract dice, dysentery and as the name suggests hae-
moglobinuria. The latter is likely to be the
Introduction main sign. Aggressive treatment with penicil-
lin, fluid therapy and particularly whole blood
Physiological diarrhoea is seen in crias, par- may be successful (see Chapter 10). On post-
ticularly in bottle-fed animals. The signs are mortem, anaemic liver infarcts are pathogno-
normally self-limiting. Unformed pasty fae- mic for the condition.
ces are commonly seen in bright neonatal
crias and are related to dietary change in the Blackleg
immature gut. The eating of solid food
before the stomach has sufficient microor- This is primarily a disease of cattle and is not
ganisms may be the cause. The crias con- known in SACs. It is caused by Clostridium
tinue to suck and thrive. If owners and chauvoei. The disease is meant to follow shear-
clinicians are concerned samples should be ing wounds and dog bites. However, it could
taken. However, it is wise not to rush in with occur in SACs as a result of dirty injection
antibiotic treatment as this may well make technique. The organism is common in the
the situation worse. Careful monitoring soil. The first sign shown would be lameness.
of the crias should be carried out. Normally On careful examination the animal will show
the condition is transient. If the faeces a very swollen painful area over a wound.
become profuse and watery much more Treatment with high doses of penicillin and
aggressive treatment will be required while NSAIDs is unlikely to be successful.
the clinician is waiting for diagnostics to be
carried out. Electrolytes are very useful but Blacks Disease
should be given at half dilution as pre-
scribed for calves as crias do not need as The correct name for this condition is infec-
much glucose or sodium. Escherichia coli tious necrotic hepatitis. It is caused by
infections will occur in crias but they are not Clostridium novyi type B. It has not been
common. There have been no K99 hyperse- recorded in SACs. The trigger factor is acute
cretory types isolated. Oral and injectable fluke activity, i.e. the migration of immature
antibiotics and injectable NSAIDs will help flukes through the liver. Acute fluke activity
support the cria. The isolation of either will occur in SACS but they tend to get the
E. coli or Salmonella spp. as a septicaemia is chronic form. Control can easily be carried out
very serious but will occur even if the bacte- by vaccinating all animals against C. novyi
ria are not isolated in the faeces. type B. Fluke control is vital not only to pre-
vent Blacks disease but also to prevent the
damage caused by the flukes in the liver.
Clostridial disease
Botulism
Clostridial diseases are important in SACs. There Unlike the previous two conditions, the
are some differences from other species. organism Clostridium botulinum multiplies
90 Chapter 9

in the soil, or in silage and not in the animal. so there is little excuse for vaccination
The organism produces toxin outside the failure.
body. Therefore the severity of the disease The disease is normally manifest by
will be related to the amount of toxin sudden death although observant keepers
ingested. It has not been recorded in SACs. will see sick lifeless cold moribund animals.
It could occur as it has been reported in There is no treatment. Diagnosis will not
camels in Chad. The author has seen a flock pose a problem on post-mortem. The abdo-
of sheep affected with botulism in Western men, pleural cavity and pericardium will be
Australia. There was a mortality of over filled with fluid, usually bloody. The kid-
50%. The animals had been in drought con- neys will be friable as the common name
ditions and there was no association with suggests.
silage feeding. Diagnosis is not difficult if
the pathognomic sign of a flaccid anus is Lamb dysentery
seen when the rectal temperature is taken.
There is no specific treatment. However, This is a rare condition in commercial flocks
animals will recover if they can be kept alive because of vaccination. It does not seem
with oral fluids. to occur in hobby flocks. It is caused by
C. perfringens type B and is a disease of young
Braxy lambs. Often they die before they develop
dysentery. It is not seen in SACs.
This is a disease that only occurs in sheep.
It is caused by Clostridium septicum. It Malignant oedema
appears to be a British disease, as the
author has discussed it with European col- This disease, which is found in SACs, is
leagues and they are unfamiliar with the caused by several clostridial organisms,
condition. Australian, New Zealand and namely C. septicum, C. chauvoei, C. perfringens
South African veterinarians also have not and C. novyi. Animals can be found dead or in
recorded the disease. The trigger factor is extremis. They show swellings, which are
thought to be eating frosted root crops. often gaseous. The disease may follow
These are fed classically in Norfolk in the wounds obtained by male SACs fighting.
UK throughout the winter. They include The organism may gain entrance at parturi-
stubble-turnips and sugarbeet tops. When tion and cause massive swelling of the hind-
they are consumed in a frosted condition quarters. Aggressive treatment with penicillin
they cause an abomasitis, which is thought and NSAIDs may be successful if started
to allow entry of C. septicum. Clostridium promptly.
septicum is included in several polyvalent
vaccines. This disease has not been Sordellii abomasitis
recorded in SACs. It could easily occur
following the feeding of frozen root Clostridium sordellii causes this disease in
crops. SACs in C3. It produces two toxins, one is
haemolytic and the other is lethal. It attacks
Enterotoxaemia C3 and has different manifestations in the
various age groups. In young crias over
Enterotoxaemia is more commonly called 3 weeks of age it will cause acute inflammation
pulpy kidney and is caused by Clostridium of C3. In older crias it will cause sudden death
perfringens type D. It is a sheep disease, but from damage to C3. In adults it will cause
it is also a very common disease in SACs. It sudden death or damage to C3, which leads
is the most common clostridial disease in to death often from ulceration and peritonitis.
the UK not only in sheep but also in SACs. It is one of the main clostridial diseases of
It is found in growing crias and adults that SACs. There is now a vaccine available,
have not been vaccinated adequately. The which is highly recommended in SACs.
toxoid is included in all the vaccines and As the same vaccine is prepared for cattle it
Medicine and Surgery of the Gastroenteric System 91

should be pointed out that there are two Escherichia coli pathogenic to crias
different dosages. It is a 2 ml per dose for
cattle and a 1 ml for sheep. SACs should This disease is rare in crias because of their
receive the sheep dose. extensive husbandry and the extremely rare
birth of twins. Basically E. coli infection is
Struck largely about poor management rather than
virulent pathogens. E. coli are the normal
This disease in sheep is common in Kent but inhabitants of a crias intestine. In the second
very rare elsewhere in the UK. It is caused by day of life a healthy cria will have 1010 E. coli
C. perfringens type C. As the name suggests it bacteria/g of its faeces.
causes sudden death. There is no standard Crias will harbour the E. coli bacteria
trigger factor. However, I think it is likely the with the K99 antigen but these enterotoxi-
very heavily fertilized grass under fruit trees genic E. coli are extremely rare. However,
is the culprit. Clostridium perfringens type C they may be found in 2% of herds. With this
has been recorded in SACs in similar disease there is nearly always a septicaemia.
conditions. The condition may be peracute so that death
may occur before the cria is seen to scour.
Tetanus Isolation of the organism from heart blood
is diagnostic. Often colostrum will be seen
The causative organism Clostridium tetani is
in the stomach but will be unclotted. Of these
well known as is its pathogenesis. In the
strains of E. coli, 40% are resistant to ampi-
authors experience it is now very rare in
cillin. Amoxicillin with clavulanic acid is
sheep, mainly owing to vaccination. The dis-
likely to be the antibiotic of choice. In the
ease is also seen in SACs. Vaccination is advis-
authors experience oral combinations of
able. The condition can be diagnosed by
neomycin and streptomycin are not effec-
observing the clinical signs. Adult animals will
tive. There is no licensed E. coli vaccine
appear stiff and reluctant to feed. They often
available in the UK.
appear slightly blown. Movement in C3 will
To sum up, E. coli is not a major pathogen
be absent. The neck will be straight out and
in crias but its importance should not be
there may well be saliva coming from the
discounted. Good management is vital.
mouth. The jaws may eventually become
Antibiotics should not be used to supplement
clamped together. Initial treatment should be
bad management.
large doses of TAT and also large doses of pen-
icillin. Animals may recover if they are given
adequate nursing. Acetylpromazine given
twice daily by intramuscular injection at Johnes disease
0.1 mg/kg may help to control the tetanic
spasms. Johnes disease is found in SACs throughout
the world. Johnes disease is primarily a path-
ogen of cattle but the strains affecting SACs
Escherichia coli 0157 tend to be fairly species specific. However,
clinicians should not be complacent and
This is not a pathogen in SACs. However, it is should always beware of the dangers, e.g.
carried by them and therefore they are a dan- milk or colostrum from infected cows should
ger to humans. The commensal bacterium of not be fed to crias, nor should colostrum from
concern is VTEC 0157:H7. It causes no clinical goats be fed to crias without checking on the
signs in alpacas or llamas but precautions health status of the goats. In cattle the main
must be taken by owners, particularly those sign is diarrhoea. This is not the case in
with farms open to the general public. In the alpacas and llamas, which tend to suffer ill-
UK it is found by routine testing to be present thrift. In all animals once clinical signs
in approximately 3% of alpaca faeces samples develop the disease is always fatal. On very
(see Chapter 17). rare occasions certain animals will show signs
92 Chapter 9

of remission. However, remission will be notifiable. However, there was only one
short lived and deterioration will soon set in. case in the whole country in 4 years
Euthanasia is the only option. It should be 20052008.
remembered that there is thought to be a link- Diagnosis in SACs is notoriously diffi-
up between Johnes disease and Crohns dis- cult. The gold standard is culture but this
ease in humans and therefore the disease may may take several months. Sheep strains are
be a zoonosis. Normally the infected alpaca notoriously difficult to culture. It is pre-
or llama will slowly suffer weight loss, which sumed that if SACs are infected with cattle
will eventually lead to emaciation. strains culture is easier. There is faecal shed-
The normal method of transmission is ding of bacteria earlier in the disease only
from dam to offspring soon after birth through later is there a cell-mediated response, which
colostrum, milk and faeces. Transplacental will show up on serology and so serology is
infection can also occur particularly in ani- much more reliable later in the course of the
mals showing advanced signs of ill-thrift. disease. Smear testing of faecal samples with
Johnes disease can be diagnosed by an ZN stain is very unreliable as the animals are
ELISA blood test, which is fairly sensitive intermittent shedders. On post-mortem a
once the animal shows signs of the disease. piece of large bowel is more reliable than
However, it is too insensitive to be used as a bowel contents. In sheep and goats the agar
screening test in clinically normal animals. gel immunodiffusion test (AGIDT) has been
Faecal smears stained with Ziehl-Neelson used to screen suspect cases for antibodies.
(ZN) have a high specificity but a sensitivity This test does not require species-specific
of only 30% as the shedding of the organism reagents and so could be used in SACs, but
is very intermittent in SACs. The strains the specificity and sensitivity of the test is
found in alpacas and llamas are very difficult unknown. Workers (Kawaji et al., 2011) have
to grow on culture. They are particularly slow found that a faecal quantitative PCR assay
growing and can take over 3 months to grow. was a sensitive and specific antemortem
The use of liquid cultures may speed up a diagnostic test for MAP in sheep. They con-
positive diagnosis but 3 months is required as cluded that quantification of MAP DNA in
a minimum for a negative result, which may faeces by PCR could provide immediate
not be that sensitive. information to estimate the stage of infec-
Clinicians might think that a post- tion, as well as the risk of transmission from
mortem examination might be definitive. infected animals. It is possible that a similar
However, gross pathology is not very reliable. test might be developed in SACs.
There may be granulomatous lesions in the The disease spread in SACs is not known.
intestines and local lymph nodes but these Feeding of infected colostrum either from cat-
may not be obvious. Histology from multiple tle or goats is thought to be a danger but this
sites is vital. The key point about this disease has never actually been proven.
in SACs is that it is difficult to diagnose and is Control of Johnes disease in SACs is
not manifest as diarrhoea as in cattle. However, possible using the Weybridge vaccine. Crias
like in cattle, the disease is likely to be present should be given half the cattle dose into the
in many more situations than would be imag- brisket at less than 4 weeks of age. Owners
ined and it may not be clinically apparent should be warned of the unsightly lumps that
until the animal is not only an adult but has may occur at the site of injection. Snatching
had several offspring. crias at birth to ensure adequate colostral
Figures for the incidence of Johnes dis- intake from known negative dams and rear-
ease in SACs are unreliable in the UK as the ing them artificially away from the dams
disease is not notifiable. There was a useful environment might be worthwhile but is
questionnaire sent to owners in 2004. There extremely difficult. It is vital to maintain clean
was only one case reported in a population rearing environments for crias. The infection
of 38 llamas, 18 alpacas and 8 guanacos may be spread congenitally as well as via
surveyed in the UK. In Australia there are infected milk and colostrum; family line
much more reliable figures as the disease is culling may be worth considering. All floor
Medicine and Surgery of the Gastroenteric System 93

feeding should be stopped and all the water The animals most at risk are those lowest in
troughs should be raised. the pecking order, that are likely to eat leav-
ings that fall out of feeders.
Diagnosis is straightforward with chron-
ically infected animals by floatation tech-
Protozoal Diseases Affecting the niques on faeces samples. Rapid diagnosis
Gastroenteric Tract can be made from dead animals by impres-
sion smears taken from the GI mucosa. The
Coccidiosis in SACs problem diagnosis is within the pre-patent
period when the animals can be very sick and
Coccidiosis is one of the most frequently yet are not shedding oocysts. ELISA and PCR
diagnosed diseases of British SACs, with tests have been developed to aid diagnosis in
affected animals usually showing clinical the pre-patent period.
signs of weight loss and diarrhoea (Twomey There are several lines of treatment.
et al., 2010a). There are five species involved: There are old-fashioned treatments using
Eimeria alpacae, E. lamae, E. macusaniensis, amprolium as a drench at 10 mg/kg for
E. ivitaensis and E. punoensis. Perhaps the most 3 weeks or sulfonamides at 160 mg/kg of
pathogenic are the two larger species E. macu- sulfamethoxine twice daily for 5 days fol-
saniensis and E. ivitaensis. They both originate lowed by 80 mg/kg for 10 days as a drench
from Peru, probably over 1000 years ago. or decoquinate at 0.5 mg/kg for 28 days
E. macusaniensis has been a problem in the UK mixed in the feed. Sulfonamides have been
for several years. E. ivitaensis has only been proven to be effective in crias but there is
isolated recently. Eimeria ivitaensis also occurs poor absorption of sulfonamides from the GI
in Germany, the USA and Argentina. Eimeria tract in adults and therefore this treatment is
macusaniensis is one of the most important not recommended for adults. Also oral
pathogenic parasites in SACs in North and sulfonamides upset the flora in C1. The old-
South America and in Australia. fashioned ionophores should be avoided in
The coccidia life cycle includes several SACs as there is a very low safety margin.
stages of multiplication; consequently a low On the whole clinicians are likely to advise
dose can result in a high level of infection. modern treatments licensed for sheep and
The average life cycle takes approximately cattle of diclazuril at 1 mg/kg as a drench
3 weeks and as the initial stage is confined to repeated in 3 weeks or toltrazuril at 5 mg/kg
the small intestine, symptoms consist of also as a drench. Both these treatments affect
weight loss and hypoproteinaemia with little all intracellular stages, and hence will not
diarrhoea until the infection spreads to only cure the infection but also reduce oocyst
involve the spiral colon and large intestine. shedding.
Thus, there may be extensive damage to the
small intestine before it is possible to diag-
nose the infection via faecal samples. It is very
important that the laboratories give the prac- Cryptosporidiosis
titioner an estimate of the numbers of the
large and the small species. The incidence of this disease in crias is ris-
Although immunity does develop with ing in the UK. Cryptosporidiosis is the result
age, it is species specific, so such individuals of an infection caused by a protozoan of the
remain susceptible to new species and any genus Cryptosporidium. There are as many as
immunity will wane in geriatric animals. 16 species. However, few of them are patho-
Even immune animals may continue to genic to domestic animals and SACs in par-
shed, leading to huge environmental contam- ticular. The most important species is
ination, which can be exacerbated by over- Cryptosporidium parvum. This will cause
crowding. Animals can maintain infectivity diarrhoea in crias and will also affect
for many years. Pastures can also maintain humans, although the most important spe-
infectivity for several months when not grazed. cies in humans is Cryptosporidium hominis
94 Chapter 9

(see Chapter 17). Cryptosporidium parvum The condition is easy to diagnose as large
has a direct life cycle with infection occur- numbers of oocysts will be seen in the
ring by the faecal-oral route. Normally the infected faeces. Ziehl-Neelsen is a useful
infection in SACs is not a monoinfection but stain as the oocysts are small and relatively
more commonly a mixed infection with non-refractile.
other pathogens. The highest mortality rates Control of the condition requires atten-
occur in crias under 21 days of age. tion to detail in all aspects of hygiene to lessen
Obviously it is impossible to ascertain cross-contamination and auto-infection.
whether the deaths are due to the Halofuginone lactate can be used for prophy-
Cryptosporidium or another pathogen. The laxis and treatment. It is licensed for use in
oocysts are fully sporulated and infective cattle in the UK and is available as an oral
when they are excreted in the faeces. Very solution containing 0.5 mg/ml of halofugi-
large numbers are excreted during the pre- none lactate. The dose is 2 ml/kg daily for
patent period resulting in heavy environ- 7 days.
mental contamination. Transmission can At the end of the breeding season it is
occur directly from cria to cria or indirectly vital to steam clean the houses used for birth-
via a fomite, which may be a human. ing SACs.
Infection in crias can result from faecal con- Cryptosporidiosis does not seem to be a
tamination of food or water. For bottle-fed problem in adult SACs, only in young
llamas or alpacas infection can be via con- animals.
taminated milk. For suckling crias infection In conclusion it should be stressed that
can occur from dirty contaminated teats. cryptosporidiosis is a zoonotic disease.
Female llamas and alpacas can contaminate Naturally, keepers of SACs must be warned.
the environment, as if they are harbouring However, what is more important is
C. parvum they will show a periparturient that members of the public, particularly
rise in oocyst excretement. Oocysts are children, must adopt strict hygiene meas-
resistant to most disinfectants and can sur- ures. These must be prepared in writing on
vive for several months in cool and moist farms that are opened to the public
conditions. Their infectivity can be destroyed commercially.
by ammonia, formalin, freeze-drying and
exposure to temperatures below freezing or
above 65C. The contamination of the envi-
ronment rises sharply as the numbers of Giardia
crias increase. The crias born later in the sea-
son are at more of a risk, particularly if This is a zoonotic pathogenic protozoan,
colostrum intake is low. Age-related resist- which is transmitted by the faeco-oral route.
ance, unrelated to prior exposure is observed It can affect SACs but only young animals
in lambs. This does not occur in crias. Case where it is associated with diarrhoea. It does
fatality rates in cryptosporidiosis are gener- not affect adults. However, it can affect
ally really low unless another pathogen, e.g. adult humans as well as children (see
a rotavirus, is also involved. The possibility Chapter 17). It has a long maturation period
of auto-infection should not be ruled out in of 2 or more weeks so it is not found in crias
crias, nor should an infection from calves under 4 weeks of age. In animals it rarely
either nearby or when they have been actually causes disease unless there is a
housed in the shed earlier in the year. The massive environmental contamination. This
infectious dose of C. parvum oocysts for a usually occurs when wildlife contaminate
neonate is very low. the drinking pond. The organism has a pre-
In clinical cases in crias the faeces tend dilection for the small intestine. Treatment
to be pale and liquid. Fresh blood may be should be either with fenbendazole at
seen but tenesmus is not a feature. In severe 10 mg/kg orally for 3 days or metronidizole
cases the animal will be depressed and at 25 mg/kg given either orally or as an
dehydrated. Abdominal pain is common. enema for 3 days.
Medicine and Surgery of the Gastroenteric System 95

Sarcocystis as Coenurus cerebralis cause Gid in sheep and


goats. It has been suggested that it occurs in
This parasite is seen all over the USA and in SACs in the UK but this has never been sub-
South America. It has only been seen in stantiated. They are also found in the muscles
imported animals in the UK. It is spread by and subcutaneous tissues as well as the brain.
dogs and wild carnivores and so safe carcass The metacestode stages of Taenia hydatigena
disposal is vital to prevent the spread of the referred to as Cysticercus tenuicollis occur in
organism. The SAC is the intermediate sheep and rarely in SACs. In very rare cases
host. They may exhibit a variety of signs, e.g. these may result in acute manifestation and
anaemia, fever, vasculitis, myositis, abortion, death. Hydatid disease or echinococcosis,
chronic wasting and sudden death. However, due to Echinococcus granulosus, occurs fre-
these signs are so diverse that the disease is quently in sheep in the UK but only rarely in
rarely diagnosed in life. SACs. This is not the pattern elsewhere in the
world where E. granulosus is quite common in
llamas and alpacas.
Cysticercosis was seen in 7% of 9000
Parasitic Diseases of the
lambs reared in Somerset on a single holding
Gastroenteric Tract in 2009 (Eichenberger et al., 2011). The infec-
tion was linked to footpath contamination
Intestinal cestodes by dogs. In such a situation SACs would
become infected. Metacestodes possibly
Adult tapeworms (e.g. Moniezia expansa) found in llamas and alpacas are shown in
occur in SACs if they are running with sheep Table 9.1.
in the UK. This species is found throughout
the world. Moniezia benedeni and Thysaniesia
giardi are found in Peru. The secondary host
for all intestinal cestodes found in SACs is Intestinal nematodes
an oribatid mite found on the pasture.
The pre-patent period is 40 days. Some Practitioners, like the owners of alpacas and
authorities suggest that they are of no clinical llamas need to radically change their think-
significance. However, in large numbers ing on the control of intestinal nematodes.
they may cause ill-thrift and intussusceptions The old instructions of regular use of
have been reported on post-mortem. They anthelmintics should be totally discarded.
are well controlled with albendazole. Care Animals should only be treated if they need
should be taken in pregnant animals as it is to be treated. The difficulty for practitioners
thought by owners to cause abortion. This and owners is the problem of knowing when
has not been substantiated. A further tape- they need to be treated. The over use of
worm Thysanosoma actinioides can be consid- anthelmintics has brought on universal
ered here. It does not actually live in the resistance to the standard three types of
intestines but in the bile ducts and the pan- anthelmintic. It is vital that the new class,
creatic ducts. They are considerably smaller which has recently been released, is not ren-
and their presence often goes unnoticed. It is dered useless by over use and the build-up
also found in the Rocky Mountains in North of resistance. One of the main new instruc-
America. Control is not easy, weekly dosing tions is that no animal must be under-dosed.
with double strength albendazole for three So if animals are in a group it is important
treatments is recommended. This species that the dose is worked out for the largest
causes clinical signs that vary from mild animal in the group and that is the dose
diarrhoea to violent diarrhoea and liver fail- which is used for the whole group. Now cer-
ure signs. Liver enzymes will be raised in tain anthelmintics have a narrow safety
serum samples. range in SACs, e.g. levamisole, so it is impor-
It should be remembered that the meta- tant that accurate weighing and dosing is
cestode stages of Taenia multiceps referred to carried out. This will not be a problem in
96 Chapter 9

Table 9.1. Metacestodes found in sheep and SACs.

Metacestode Where found in the


Cestode species Primary host species name secondary host Comment

Echinococcus Small carnivores Hydatid Abdomen and Very common


granulosus pleural cavity worldwide with a
high zoonotic risk.
Found in SACs
Taenia hydatigena Small carnivores Cysticercus Travel through the Deaths have been
tenuicollis liver to end in the reported in SACs
mesentery from the damage
caused by
migration through
the liver
Taenia multiceps Small carnivores Coenurus Brain, muscles Will possibly cause
cerebralis and subcutaneous the neurological
tissue condition of Gid
in SACs
Taenia ovis Small carnivores Cysticercus Heart and skeletal Asymptomatic, not
ovis muscles reported in SACs

small herds where each animal can be treated rise in faecal egg output by animals in the
as an individual. However, in larger herds it spring. This was called the spring rise. It is
is important if there is a marked difference in now known that spring was not the trigger
size that the dosing groups can be small but parturition was. Llamas and alpacas both
enough to accommodate the variations. have a post-parturient rise, which is not
When dosing animals with anthelmintics it related to the season of the year, the coming
is important that if there is mixed grazing of of the rains, nor the hemisphere where the
different species that the species are sepa- animals are kept.
rated and the correct weights for the two In SACs it is important to remember
groups are estimated accurately. When deci- that helminths should not be considered in
sions have to be made regarding the need isolation. The clinician has a goal of main-
for worming, the two species groups should taining the status quo, i.e. each animal has a
be treated separately. Equally it must be relatively small worm burden so that it
remembered that there is a close crossover of maintains some immunity to a large worm
helminth species between sheep, goats and burden but does not suffer disease or sub-
SACs. Therefore there will be a crossover of clinical disease. This balance is much easier
resistant species of worms between species. to attain if nutritional status of the grazing
If llamas and alpacas are running together is adequate, particularly if the amount of
they can be treated as one group as regarding protein available to the animal is adequate.
the need to dose is concerned. However, it is The provision of sufficient minerals and
vital that the weights of the two subspecies trace elements will also help to maintain the
are considered accurately for dosing. status quo.
It is vital to separate animals into age The aim of the practitioner and the
groups as the need for dosing will be different owner must be to minimize the use of
for most situations. However, clinicians anthelmintic treatment. Anthelmintics
should remember that where Haemonchus should only be used when it is necessary to
contortus is involved it is likely that all the prevent clinical disease. In this way the rate
animals regardless of age are treated. To com- of selection for resistance will be reduced.
plicate the situation further the hormonal The drug efficacy will therefore be preserved
state of the females must be considered. for as long as possible. To do this it is impor-
Historically it was thought that there was a tant that the number of worms in refugia is
Medicine and Surgery of the Gastroenteric System 97

increased. Worms that are not selected by nematophagus fungi) will reduce pasture
anthelmintic treatment are said to be in refu- burdens. Mixed species (e.g. rabbits and
gia. This includes worms whose larvae are horses) will also be helpful. However, owners
on the pasture. It also includes worms in must realize that sheep, goats and SACs are
untreated animals or whose larvae are at infected by the same helminths. There are
stages in animals that are not affected by some species-specific worms (e.g. Lamenana
treatment. The larger the population of spp.) in SACs that will be killed by sheep and
worms, which are in refugia, compared to the goats. Cattle grazing will also help but there
population of worms, which are exposed to are some species of helminths that cross
treatment, the slower resistance will develop. between cattle and sheep or cattle and goats
After treatment there are always some or indeed between cattle and SACs, so practi-
worms that survive in the host. These are tioners should not give blanket advice but
resistant worms. If the offspring of these continue to monitor the situation. Preventing
worms are in the majority, resistance to the close cropping of grass is good as rarely do
anthelmintic will develop rapidly. To pre- worms climb more than 3 cm up the stems.
vent resistance developing, a substantial The ideal control of pastures is to plough and
number of worms needs to be left untreated have a break crop (e.g. lucerne or kale).
each time anthelmintics are used so that Making hay also considerably helps pasture
these non-resistant worms essentially pro- contamination as does resting a pasture for a
vide the subsequent generations of worms. year, but neither is totally effective. Only rest-
It is now considered that where SACs are ing a pasture for 3 years can be considered
continually exposed to worms it is a good totally effective. Of course zero grazing is the
idea to have a few worms inside the animal ultimate method of control and may be con-
to not only help develop a form of immunity sidered in large herds of SACs. Young llamas
but also to prolong the effectiveness of the and alpacas are most at risk, so it is important
available anthelmintics. The selective treat- to protect them from contaminated pastures
ment of animals significantly increases the and also to remember that their mothers will
percentage of the worms in refugia. be contaminating the pasture on account of
Every holding and every group of ani- the post-parturient rise phenomenon. Each
mals must be considered separately. There herd has different problems. However, there
should be no blanket treatments. In fact effec- are various ideas that can be put forward to
tive worm control prevents unnecessary the owner. The time of parturition can be
dosing, which is also good economically. altered. This is easier with sheep and goats
However, it is vital to prevent resistant worms with their 5-month gestation period but
being brought on to a holding. Therefore in a harder for SACs with their 11-month gesta-
closed or semi-closed situation the aim with tion period. Parturition can be carried out
any new animals is total deworming. This indoors and turn out delayed until the moth-
may involve a combination of the old three ers faecal egg output is lower and the over-
wormers given at the correct dosage or the wintered larvae have died on the pasture.
new wormer recently available. Drugs may The minimum frequency of dosing
be given at the same time but should not be should be used and as stated earlier the cor-
actually mixed. After drenching, the animals rect dose must be used to avoid under-dosing.
should be housed or at least kept off the pas- The dose of the anthelmintic has been tested
ture for 48 h to allow any still viable eggs to be in sheep so that is not a problem provided the
shed. The new animals can then be intro- sheep are weighed. It should be stressed that
duced on to the originally grazed pasture to only anthelmintics licenced for sheep should be
pick up the non-resistant worms and thus used (not products licensed for cattle or
dilute any resistant worms. horses). The problem lies with SACs, which
Controlled grazing methods will help to have no licensed products. General advice
avoid infection. Any method of allowing pas- would be to use twice the sheep dose with
tures to rest will be beneficial as soil organ- benzimidazoles and avermectins, which have
isms (e.g. earthworms, dung beetles and a wide safety margin, in SACs. As stated
98 Chapter 9

earlier levamisole does not have a wide safety areas of the pasture forming dung hills. This
margin and so the dose can be increased to may affect their resistance to intestinal
one and a half times the sheep dose but no helminths. Alpacas may be more sensitive
higher than this. When to change anthelmintics than sheep to endoparasites when kept on
is problematic. The most up-to-date advice lush pastures with poor parasitic control.
must be only to rotate drugs when resistance They may carry heavier nematode burdens,
is suspected, not on an annual basis. Faecal which will be reflected in higher faecal egg
egg outputs should be monitored. It is impor- counts. These may persist for longer periods,
tant to sample individuals and not a bulked especially in alpacas with crias at foot. The
up sample or the egg count will be diluted. post-parturient rise may last for the whole
The number of samples is difficult to decide summer. An indication of clinical disease
upon. In very small herds each animal can be would be 2000 eggs/g. However, it may be
treated as an individual. In larger herds 10% that above 500/g will also indicate clinical
can be used as a yard-stick. In very large disease.
groups a compromise has to be reached. It must be remembered that the problems
Testing before treatment will provide infor- caused by nematodes will be very different in
mation about the worm status of the group SACs kept in the semi-arid areas of the alti-
and whether anthelmintic use is necessary. plano to those kept on lush pastures in the
Testing after treatment will show the efficacy UK or well kept fields in the USA, Australia
or otherwise of treatment. It takes 3 days for or New Zealand.
all the eggs in the gastrointestinal tract to pass Infection with just a single worm spe-
out, so if treatment is 100% effective there will cies is uncommon in all animal hosts graz-
be virtually no eggs present at that time. ing under natural conditions (Carmichael
However, there is a shock effect of the et al., 1998). The clinical signs of infection
anthelmintic, where it will stop egg produc- with worms are a mix of those caused by the
tion but not actually kill the mature worms. It various worm species contributing to the
is therefore prudent to wait for 2 weeks after infection. There will be host factors e.g.
treatment before sampling. Worms acquired immune status, nutrition and age. Animals
after treatment will not normally produce under two years of age are usually more
eggs for 3 weeks. The practitioner can there- affected both clinically and subclinically.
fore advise the owner on the likelihood of Interestingly geriatric animals also seem to
anthelmintic resistance to the drug being used be more affected. This may be because the
and the advisability of a change of drug. nutritional state of these animals is not so
Practitioners must stress that if there is resist- good because of poor teeth, poor locomo-
ance to one drug in that group of drugs then tion and bullying by younger stronger
there will be resistance to all the other mem- adults. Animals kept on massive acreages
bers of that group of drugs. Owners can eas- on the altiplano will have very different
ily get confused by the different packaging of worm burdens to animals kept in small lush
the products. paddocks. However in the Andes the ani-
As yet there are no natural anthelmintics mals are often brought together to give birth
available in plants e.g. garlic, which are effec- and so the risks of severe parasitism are
tive at controlling worms, although many increased. This particularly occurs as the
owners are totally convinced of their efficacy. females are stressed by giving birth, lactat-
Although SACs are affected by the same ing and becoming pregnant again in a very
nematodes as sheep (Table 9.2), it is thought short space of time. Other factors in the
that llamas are more susceptible because Andes also will bring animals together e.g.
they are principally browsing animals and shearing. There will also be factors relating
their resistance to these endoparasites is less to the worm e.g. numbers and species.
highly evolved. However, alpacas that are If alpacas are grazed with sheep they are
grazing animals should therefore follow certainly more likely to have high worm bur-
more closely to the sheep model. This may dens. The author assumes this would happen
be unlikely as alpacas tend to dung on certain with alpacas grazing with cattle but that is
Medicine and Surgery of the Gastroenteric System 99

beyond his experience. If other species are protein-losing enteropathy. This will cause
grazed with alpacas the benefits of their dis- set-backs in growth rates of young animals,
crete common latrines are negated. weight loss in older animals. Diagnosis will
Practitioners are hampered by the fact be made by raised individual faecal worm
there is no magical figure for worm egg egg counts. Individual counts are important
counts in faeces which are dangerous or to avoid dilution effects, which may give
should trigger dosing. Figures in excess of misleading results.
1000 epg might not be alarming during the Many of the intestinal nematode species
dry season in the altiplano but such figures encountered in SACs are encountered in
would be very alarming in other parts of sheep but there are also other species which
the world. Therefore practitioners should are found in SACs but are not found in sheep.
err on the safe side and suggest that all All these species are shown in Table 9.2.
intestinal nematodes in SACs will cause Nematodirus battus is a very serious
various signs and symptoms depending on nematode, which causes scouring in lambs
the species of nematode, which determines and crias. It may well be associated
the place where the adults are found. The with viral, bacterial or coccidial infection.
author considers statements like even one A heavy infection will cause profuse watery
nematode egg is too many are in error but yellowy green diarrhoea, leading to severe
equally it is difficult to give a definite fig- dehydration and death even before eggs are
ure. Probably the most serious is Haemonchus seen in the faeces. The eggs are roughly
contortus, which is a blood sucking parasite twice the size of other intestinal nematodes
in C3. It will cause severe life threatening found in SACs and are easily recognized.
anaemia in all ages of SAC. Diagnosis by Lower levels will cause ill-thrift. The clas-
faecal worm egg output is normally too sically described condition is changing in
late. Clinical diagnosis by assessing the pal- the UK. Historically N. battus affected
lor of the mucous membranes is vital so 48-week-old lambs that had been grazing
that prompt anthelmintic treatment can on pastures grazed by young lambs in the
limit the number of deaths. Ocular mem- previous summer. The eggs required a frost
branes can be examined and categorized as: before they could become infective. Now
1 = deep red (non-anaemic), 2 = red-pink the pattern in the UK is changing with infec-
(non-anaemic), 3 = pink (mild anaemia), tions occurring in older lambs. A similar
4 = white-pink (anaemic), and 5 = white clinical syndrome is seen in older crias.
(severely anaemic). Both eyes should be Owners should be urged not to graze either
examined in direct sunlight. If any animals young or older crias on the same pasture in
are 3 but there are no 4 or 5s, these animals consecutive years. This is difficult on most
alone should be treated. If any animals are 4 smaller holdings. Pastures that have been
then all the animals should be treated. If grazed by young cattle or ewes are no longer
any animals are 5 then all the animals safe. Nematodirus battus has now been found
should be treated with at least two different to be resistant to benzimidazole anthelmintics
groups of anthelmintics. in the UK (Mitchell et al., 2011). However,
Ostertagian nematodes cause the gas- at the present time the benzimidazole
tric glands in C3 to become hyperplastic and anthelmintics are still recommended for
cause an increase pH. This leads to a leakage treatment of N. battus as resistance at the
of pepsinogen into the plasma. This can be time of writing was not widespread. Many
measured in a serum sample to aid diagnosis. of the other species of nematode worms are
On post-mortem following heavy infections becoming resistant to the three standard
the mucosa of C3 in SACs will show necrosis wormer types. Treatment is difficult. It has
and sloughing. The sign in the living animal been suggested that worms should receive a
is violent blackish diarrhoea. therapeutic dose of all three wormer types
Intestinal nematodes produce villous at 3-weekly intervals if multiple resistance
atrophy and crypt hyperplasia. Diarrhoea is is encountered. The use of monepantel
then of a more chronic nature. There is a should be very carefully controlled.
100 Chapter 9

Table 9.2. Intestinal nematodes found in SACs.

Where found in the SAC


(Where found in the
sheep) Helminth species Where found Comment

C3 (Abomasum) Bunostumum Americas and UK Uncommon but will


trigonocephalum cause serious disease
C3 (Not found in sheep) Camelostrongylus Americas and Australia. Found in camels as well
mentulatus Not in UK as in SACs. Very similar
to Ostertagia spp.
Small intestine (Small Capillaria longipes Rare in UK Clinically significant in
intestine) SACs but not in sheep
Large intestine (Large Chabertia ovis UK Uncommon, of very
intestine) doubtful clinical
significance
Small intestine (Small Cooperia curticei UK Common
intestine)
Small intestine Cooperia mcmasteri Americas and Australia Found in SACs and cattle,
(Not found in sheep) will cause serious
disease
Small intestine (Found Cooperia onocophora Americas and Australia Caught from cattle and
in cattle) may cause clinical signs
C3 (SAC specific) Graphininema South America. Not found Only found in SACs
aucheniae in UK, Australia or NZ
C3 (Abomasum) Haemonchus contortus Worldwide Will cause very serious
anaemia
Small intestine (SAC Lamanema chavezi Only in South America Passes through the liver
specific) causing damage
Small intestine (Small Nematodirus battus Worldwide Life-threatening disease
intestine)
Small intestine (Small Nematodirus filicollis Australia and South Common and may well
intestine) America cause clinical disease
Small intestine (SAC Nematodirus lamae South America not in UK, Found in SACs
specific) USA, Australia or NZ
Small intestine (Small Nematodirus spathiger Australia Common and may well
intestine) cause clinical disease
Large intestine (Large Oesophagostomum Australia Common but causes little
intestine) venulosum disease
C3 (Abomasum) Ostertagia circumcinta Australia and Americas Common cause of clinical
disease of diarrhoea
and weight loss
C3 (Abomasum) Ostertagia Europe Infections caught from
leptospicularis deer
C3 and Duodenum Ostertagia marshalli USA Will cause problems in
(Duodenum) SACs
C3 (Abomasum) Ostertagia ostertagi Worldwide Will cause problems in
ruminants and SACs
when encysted in the
mucosa
C3 (Abomasum) Ostertagia trifurcata USA Common cause of clinical
disease of diarrhoea
and weight loss
C3 (Abomasum) Skrjabinagia kolchida South America Infections caught from
deer
Large intestine (Large Skrjabinema ovis South America Very common oxyurid
intestine) parasite
Medicine and Surgery of the Gastroenteric System 101

Table 9.2. Continued.

Where found in the SAC


(Where found in the
sheep) Helminth species Where found Comment

C3 (SAC specific) Spiculopteragia South America. Not found Found near Lake Titicaca
peruvianus in UK, Australia or NZ in Peru and Bolivia in
SACs
C3 (Found in kids not Strongyloides papillous South America Will cause clinical
in sheep) disease in young crias
C3 (Abomasum) Teladorsagia davtiani South America Common cause of
clinical disease
C3 (Abomasum) Trichostrongylus axei Worldwide Very common in cattle
seen also in equids
Small intestine (Small Trichostrongylus Australia, USA and UK Common cause of disease
intestine) colubriformis
Small intestine (Small Trichostrongylus Worldwide Common cause of disease
intestine) vitrinus
Large intestine (Large Trichuris ovis Worldwide Common but of no
intestine) clinical significance

Trematodes death from acute fascioliasis. Practitioners


should be aware that acute fascioliasis can
Introduction occur in llamas and alpacas but it is not a
common manifestation. In the UK deaths
In the UK there has been a massive increase will occur from September to December.
in prevalence of fascioliasis. It is no longer More chronic infections are seen in llamas
just found in the wetter, western areas of the and alpacas with adult flukes in the bile ducts
UK and Ireland. The distribution is depend- and will occur in February and March (see
ent on the presence of the snail intermediate Fig. 9.6). Llamas and alpacas with chronic
host, Lymnaea truncatula. This aquatic snail is fascioliasis will be weak and anaemic. The
now fairly ubiquitous. The levels of infection classic sign is oedema in the mandibular
and incidence of disease are linked to the space bottle jaw. Mild winters increase the
rainfall from May to October. The adult
flukes in the bile ducts of ruminants and
SACs lay eggs in the faeces on the pasture.
The eggs hatch in the warmer months
(>10C) in water, releasing motile miracidia.
These infect the snails in which the develop-
ment continues through sporocyst and redia
stages releasing cercariae. In wetter sum-
mers there is a massive shedding of cercariae
on the pasture during August to October.
These encyst into metacercariae on the herb-
age and are ingested by the ruminant or
SAC. The immature flukes migrate through
the liver to the bile ducts. In cattle and to a
large extent in llamas and alpacas this is not
a dangerous stage, but in sheep there is often
massive damage to the liver resulting in Fig. 9.6. Adult flukes in the bile ducts.
102 Chapter 9

numbers of hibernating snails, which shed and prevailing weather conditions. Draining
more cercariae in the following spring. endemic areas will help to eliminate snail
SACs seem to be particularly suscepti- habitats. Fencing off wet areas in the
ble to Fasciola hepatica infection. This may be autumn prevents access to these snail habi-
because of a deficiency of their immune tats. In average rainfall years all SACs likely
response. SACs have a relatively small liver to have become infected should be dosed
so they may more readily be severely twice in October and January with a drug
affected by the infection. SACs, particularly that is effective against immature stages,
alpacas, are like sheep and graze very close e.g. triclabendazole. They will need to be
to the ground and therefore are very much dosed again in May. This can be with a com-
at risk. Liver fluke infection is becoming bination roundworm and fluke drench at
more common not only in the UK but also in this time only (see Chapter 6). In high rain-
the USA. fall years SACs may require additional dos-
The most common clinical sign is weight ing in both the winter and the summer
loss. However, some will show pain and season.
recumbency. Diarrhoea is not a feature. There is strong evidence (Sargison and
Generally the infection follows the more Scott, 2011) that there is resistance of F. hepat-
chronic cattle-type model rather than the ica to triclabendazole. This has serious
acute or even peracute sheep model. Fluke economic consequences. The population
eggs may be seen in the faeces using a sedi- genetics of F. hepatica will inevitably prove to
mentation test. However, the eggs will only differ from those for parasitic nematodes,
be present in the chronic cases after the long and therefore refugia-based strategies that
pre-patent period. In the live animal diagno- have been developed to slow the emergence
sis may not be easy as the ELISA test used in of resistance in parasitic nematodes cannot
cattle has not been validated in SACs. The be extrapolated to F. hepatica. Owners should
disease is fairly straightforward to diagnose attempt to develop evasive strategies, such
on post-mortem examination. The signs seen as: fencing off snail habitats; managing snail
will include ascites, hydrothorax and subcu- habitats and areas that are conductive to the
taneous oedema. The liver will be increased survival of free-living stages of F. hepatica;
in size. Experienced operators will be able to and the strategic use of fasciolacidal
evaluate this on ultrasonographic examina- anthelminitic treatments with the aim of
tion. Naturally this could be confirmed on reducing F. hepatica egg shedding and mira-
liver biopsy. However, raised live enzymes cidial infection of snails. The diagnostic signs
will help diagnosis in the live animal. of fascioliasis in llamas and alpacas are
Examining the faeces for fluke eggs is not shown in Table 9.3.
very rewarding. In one study (Kutzler et al.,
2009) only seven animals were shown to
have fluke eggs in the faeces out of 25 ani-
mals that had adult flukes in their livers on Conditions of the Stomachs
post-mortem. At post-mortem in the acute and Intestines
case the liver will show the pathognomic
signs of the immature fluke tracts through Anatomy
the liver. In the more typical chronic case
there will be hepatic fibrosis, fibrinous peri- The stomachs
hepatitis, thickened bile ducts and the pres-
ence of adult flukes. Mural endocarditis has SACs have a long oesophagus, which leads
been described in a series of fascioliasis cases to their stomachs. Examination of the viscera
in North America (Firshman et al., 2008). in the abdomen of a camelid from the left
This has also been seen in the UK by the hand side reveals instead of a reticulum,
author in 2009. rumen, omasum and abomasum as
Control programmes must take into a ruminant, three compartments, called
account topography, geographic location Compartments 1, 2 & 3 (C1, C2 and C3).
Medicine and Surgery of the Gastroenteric System 103

There are no papillae and there is glandular have a gall bladder. Behind the liver will be
tissue in all three compartments. C1 occu- seen part of C1. Both C1 and C2 have glan-
pies the entire left hand side, except for the dular saccules (see Fig. 9.7), which contain
triangular spleen lying caudally. It has cra- mucus-producing glands. C2 lies on the
nial and caudal sacs, which are separated by cranio-dorsal aspect of C1 with C3 lying as a
a horizontal pillar. The oesophagus enters long slipper-like organ on the cranio-mesial
the C1 midline from a cranio-dorsal aspect. aspect of C2. Only the final fifth of C3 con-
There is only a single lipped oesophageal tains true gastric glands and is the true acid-
grove. Looking from the right hand side forming stomach. C3 has five longitudinal
directly behind the diaphragm a small part ridges of mucosa-like pleats. The lesser
of C2 and C3 can be seen but the rest will be omentum has no sling. The greater omentum
hidden behind the liver, which lies entirely is attached along the greater and lesser
on the right and has a fimbriated caudal bor- curvature of C2 and C3 and along the right
der. Camelids are like horses and do not surface of C1.

Table 9.3. The diagnostic signs of fascioliasis in llamas and alpacas.

Peak incidence in Eggs per gram


Disease type northern hemisphere Clinical signs Fluke numbers of faeces

Acute OctoberJanuary Sudden death or dullness, 1000+ mainly 0


anaemia, dyspnoea, immatures
ascites and abdominal
pain
Subacute OctoberJanuary Rapid weight loss, anaemia, 5001000 adults <100
submandibular and immatures
oedema and ascites in
some cases
Chronic JanuaryApril Progressive weight loss, 200+ adults 100+
anaemia, submandibular
oedema and ascites

Fig. 9.7. Glandular saccules on C1.


104 Chapter 9

The small intestine leaving carbonic acid rather than bicarbonate,


thus reducing the buffering effect so the bicar-
The duodenum is dorsal to the right side of bonate is generated when fatty acids are
C1 running into the jejunum, which is folded absorbed under low energy conditions. This
around the root of the mesentery in the right has led to the myth that camelids are more
caudal abdomen. The jejunum joins with the resistant to grain overload. This is not the case
ileum, which begins ventrally and courses as bicarbonate is not generated under high-
medially and dorsally to enter the large intes- energy conditions. Camelids are very suscep-
tine at the caecocolic junction. tible to grain overload.
A second myth is that camelids are dis-
The large intestine criminate feeders and thus not prone to
engorgement. High-density confinement
The caecum lies midline and runs towards increases completion between animals and
the pelvis. The colon is roughly similar to that alters feeding behaviour. Camelids with
of the ruminant in that it runs cranially and access to highly fermentable feedstuffs will
ventrally before entering a spiral loop. certainly gorge themselves. Naturally,
However, there are five coils in the spiral engorging can be prevented by dividing
colon contrasting with three in the sheep. The grain feeding over the day, making feed
colon narrows from a diameter of 5 cm to 2 cm changes slowly and providing adequate
in the spiral colon but widens again as it roughage. Feeding of grain should not be
becomes the transverse colon, which runs encouraged. If really necessary whole grain
caudally to the rectum. rather than crushed or cracked grains should
be fed. Oats are preferable to barley and
wheat should definitely be avoided. Owners
Physiology of digestion should make sure that the feed-room door is
locked.
SACs are adapted to survive in a harsh, Other than a break-in there are two
nutrient-poor environment. Their gastric other likely chances of grain overload. First
fermentation of fibre is more efficient than in the debilitated, or old, animal, which
ruminants. It is likely that the non-keratinized requires feeding up to increase its body
epithelium of their gastric saccules contrib- weight. Such animals will develop acidosis
utes to this efficiency by providing a large with the addition of very little grain to their
surface area for rapid absorption of volatile diet. Second, in the housed camelid group
fatty acids from the gut lumen. The pH in C1 where an aggressive animal will consume
in a camelid eating a natural high fibre, low more than its fair share of the grain ration. In
energy diet is 6.5, which encourages the loss either case the signs will be similar and
of a hydrogen molecule from volatile fatty include acute depression, gastric atony, sub-
acids, thus slowing absorption. However, normal temperature and neurological signs
once in the gastric saccules, the volatile fatty including pain.
acids can become re-ionized by claiming a Confirmation of a diagnosis of acidosis
hydrogen molecule from the carbonic acid can be made by taking a sample from com-
that is a by-product of fermentation, thus partment one (C1) with a long 16G needle
increasing speed of absorption and leaving through the flank. This avoids salivary con-
behind bicarbonate. tamination. The normal pH of the contents
of C1 is 6.46.8. This will rise with anorexia
or salivary contamination. Camelids suffer-
ing from acute acidosis will have pH values
High energy diets lower than 4.5. In reality anything under 6 is
suspicious. Some camelids on grain-based
On a high energy diet the pH is much lower diets have subclinical acidosis with pH val-
(i.e. 4.5), the volatile fatty acids retain their ues of 5.5. However, unlike ruminants,
hydrogen molecule and are rapidly absorbed, camelids cannot adapt to low gastric pH and
Medicine and Surgery of the Gastroenteric System 105

will suffer from bouts of low grade pain, neutralization. Stress factors tend to decrease
diarrhoea and weight loss. Such animals appetite and peristalsis. Under conditions of
may well suffer from gastric ulcers. This is a poor gastric emptying, such as anorexia,
relatively common condition and is usually intermittent feeding, dehydration and elec-
associated with stress, e.g. movement, mix- trolyte imbalance, the acid contents would
ing or parasitism. All three stomach com- remain un-neutralized and damage the
partments can be affected, although lesions mucosa. This would be exacerbated by a low
are most common in C3. They can perforate gastric pH in cases of grain overload. Bile
the stomach wall and cause peritonitis. reflux is seen in half of camelids with ulcers.
The condition can be seen in crias as well as It is not known if this is a cause or an effect
in adults. but is a useful sign to look out for when per-
forming a post-mortem. Ulcers are often
seen in the mouths of these cases. They are
secondary to uraemia due to renal failure
Gastric ulceration is a common problem from acute nephritis, which is seen in the
end stages of these cases.
It is important to treat the acidosis before gas-
tric ulcers develop as they are a very serious
sequel, which may cause the death of the ani-
mal if an ulcer should perforate. Treatment Diagnosis of ulcers
for acidosis if ulcers are not suspected should
be prompt and aim to correct dehydration A definitive diagnosis is difficult to make.
and systemic acidosis. Intravenous fluids The history will be helpful. Ulcers take some
containing magnesium bicarbonate or mag- time to form so the animal will have been off
nesium hydroxide are ideal. If intravenous colour for some time. It is only when they
fluids are not practical then oral fluids con- become acute that the clinician is normally
taining magnesium oxide should be given. called. Practitioners might consider testing
Antibiotics such as penicillin or ceftiofur the faeces of affected animals for occult
should be given by injection together with blood. Sadly this is unreliable. C3 may be
B vitamins to prevent secondary complica- full of blood and yet the test is negative.
tions. Cover with non-steroidal anti-inflam- Equally if the soil is high in iron the test will
matory drugs (NSAIDs) by injection is useful show positive in normal animals. There
together with activated charcoal by mouth. is no evidence that Helicobacter spp. are
Most affected animals will survive with involved in camelid ulcers. There is debate
immediate diagnosis and this treatment. that copper deficiency is linked with ulcers
A few may become chronic poor doers with in cattle but this has never been confirmed.
intermittent fever, depression, hypoprotein- Gastric ulcers are so widespread in camelids
aemia and weight loss. These animals will be that such a sole cause is unlikely in this spe-
likely to have gastric ulcers. cies. Clinicians are well aware of the large
Ulcers typically form at the point where number of foreign bodies found in the retic-
C3 abruptly turns dorsal and cranial. The ulum of cattle, occasionally with disastrous
mucosa at this point is 0.71.0 cm thick, where effects. This phenomenon is not seen in
the rest of the mucosa in the rest of the organ camelids as they are selective feeders.
is only 0.30.5 cm thick. There is a small region Erosive hairballs may lead to gastritis in
in this area that secretes hydrochloric acid at a youngsters at weaning when they tend to
constant rate. It is likely that gastric emptying suck each others coats and ingest large
function is very important in ulcer develop- amounts of hair. These are not seen in adults.
ment. Ulcers are seen in 6% camelids on post- However, adult camelids do suffer from
mortem. In a normal camelid, the acid gastroliths.
secretion would be rapidly propelled against The non-keratized epithelium of the gas-
gravity by peristalsis and the onward push of tric saccules is protected from the abrasive
digesta, out of C3 into the intestine for action of ingested fibre by muscular sphincters
106 Chapter 9

coated with keratinized squamous epithe- at double the dose, i.e. 2 mg/kg. Pain can be
lium. If large particles pass this sphincter, controlled with NSAIDs, but these should
they are trapped in the saccular lumen. Large be discontinued as soon as appetite is
grains may do this. Once in the lumen min- re-established.
eral is laid down around them forming stones.
The minerals occur out of solution by minor
shifts of pH. However, these stones are very Spitting/Vomiting
common in adult camelids that appear fit and
well. They can be seen on radiographs. There
SACs have a largely unfair reputation for
is no reason to believe that they cause any
splitting, since they will rarely spit at people
ulceration.
unless they have become over-familiarized.
Clostridium perfringens and other
The activity is part of the animals natural
Clostridium spp. are known to cause disease
defensive mechanism, and is usually a
in camelids. It is possible that these organ-
response to the invasion of personal space.
isms that cause haemorrhage in the bowel
An unwary person can be caught in the cross
wall might cause ulceration. However, these
fire of two spitting animals. The actual ani-
organisms are normally associated with acute
mal that commonly spits at people is
or peracute disease. Gastric ulcers are nor-
extremely rare. The actual contents of the spit
mally chronic in nature and only cause acute
can take three forms, food, saliva or stomach
disease on perforation. Therefore the cause of
contents. The latter is the so called green
gastric ulcers remains an enigma as they also
spit. Adults and more commonly crias will
occur in the Andes on the altiplano but cer-
spit food and/or saliva when they are eating
tainly not as frequently as in camelids fed a
to warn other animals to back off and give
high energy low fibre diet.
them space. The green spit which is much
more unpleasant both to humans or other
SACs is used in more severe confrontations.
Treatment of ulcers It is used by SACs to establish dominance.
Most animals will pre-warn the challenger
by pinning its ears back very tightly and tilt-
All treatment in camelids is difficult as there
ing its head back so that the nose is pointing
are no licensed medicines in the UK.
up in the air. If this warning is ignored then
Although clinicians are allowed to use
the animal will spit.
medicines on the cascade principle they are
Vomiting is extremely rare. It is indica-
well advised to discuss all treatments with
tive of gastritis, normally from ingestion of
the owners and obtain written consent to
poisonous plants, e.g. rhododendron. It may
their use.
be associated with mega-oesophagus, which,
Treatment of ulcers is not going to be
although recorded in camelids, is very rare.
easy. Obviously prevention is to be encour-
aged. Measures would include; feeding high
fibre and low energy diets, avoiding stress
and treating all underlying disease particu- Colic
larly intestinal parasites. On being faced with
a possible acute ulcer liable to perforate a Because camelids are foregut fermenters tym-
human drug sodium pantoprazole (marketed panic colic as occurs in horses is extremely
as PROTIUM i.v. Nycomed GmbH Konstanz rare. However, SACs like horses with colic
Germany) should be injected intravenously pose a diagnostic challenge to the practitioner.
after dissolving the 40mg powder in the vial They need to be divided into surgical and
with water for injection. This should be fol- medical cases.
lowed with further injections of sodium pan- Recognition of colic in camelids has two
toprazole on a daily basis. Ideally the sodium major difficulties. Many clinicians expect colic
pantoprazole should be given intravenously to be an active violent process as in equine
at 1 mg/kg but it can be given subcutaneously practice. This is extremely rare. Equally
Medicine and Surgery of the Gastroenteric System 107

inexperienced owners may mislead clinicians not only narrow but tortuous. Intraluminal
by over-interpreting non-specific signs such obstruction can occur in the duodenum or
as sternal recumbency, anorexia and lack of the first two-thirds of the jejunum. The last
faeces and so many animals that do not have third of the jejunum to the transverse colon
colic will be included. and the spiral colon have long mesenteric
At first animals will appear bright and attachments. These pendulous parts of the
alert when handled but will lie down when bowel are very susceptible to torsion, entrap-
left alone. They may appear restless getting ment or strangulation. These are surgical
up and down. Then they may go from sternal cases (see Fig. 9.9).
recumbency to lateral recumbency (see Abdominal distension due to the accu-
Fig. 9.8). They may keep stretching out their mulation of fluid within the gastric com-
legs. Signs may become more violent or may partments is commonly seen with phyto/
lessen if shock sets in. Clinicians will have to trichobezoars or other obstructions between
examine their patients carefully. The mucous the pylorus and the cranial jejunum.
membranes will be helpful as will the tight- Obviously grain overload and gastric acido-
ness of the skin. Naturally pulse strength sis will need to be ruled out. Only mild colic
and heart rate will be extremely helpful. signs will be seen with cranial intraluminal
Respiratory rate will be raised in severe cases. obstruction. Faeces distal to the obstruction
Mouth breathing will occur in animals that will continue to be passed for 24 h. With
are just on the edge of extremis. Rectal tem- enteritis or pancreatitis, diarrhoea as well as
perature will be raised with peritonitis, pan- colic signs will be seen. Small amounts of
creatitis, nephritis or hepatitis but otherwise raspberry jam faeces will occur in cases of
will be subnormal in most cases of colic intussusceptions. Tenesmus without diar-
where shock is setting in. Gastric atony will rhoea is often seen with faecoliths, other
occur. A tense painful abdomen is a more obstructions or impactions in the large intes-
serious sign. tine. It will also be seen in colitis, peritonitis
Most gastrointestinal colic is due to and peri-rectal abscesses. Tenesmus with
ischaemia, inflammation or fluid-distended diarrhoea is indicative of internal parasites.
gut tugging on mesentery. Large diameter The diameter of the spiral colon decreases
gastric compartments, full of fibrous mate- rapidly. It has short mesenteric attachments
rial, empty into the small intestine, which is between loops. In the lumen the faeces are

Fig. 9.8. Lateral recumbency in a colic case.


108 Chapter 9

diarrhoea, parasitism, pneumonia and hospi-


talization. They do not normally show colic
but have a reduced appetite with reduced
gastrointestinal sounds and faecal output.
Ultrasonographic examination is useful. The
small intestine will appear to have a thinner
wall with an increase in fluid showing as
black rather than grey loops. The blood
picture will show a raised total protein and
an increase in polymorphs. Diagnosis is
straightforward on laparotomy. Enterotomy
should be avoided as such surgery lowers
survival rates. The obstruction should be
Fig. 9.9. Torsion of the intestine. milked through giving a possible survival
rate of 33.3%.

dehydrated. Whether the cause is due to


impaired motility, too rapid dehydration of
Computed tomography of the abdomen
faeces or abnormal material in the faeces is
unknown and probably varies from case to
case, but this part of the gut is very suscep- This is a useful diagnostic tool used with but
tible to impaction or faecolith obstruction. not to replace other imaging modalities, par-
These are normally medical cases in adults ticularly ultrasonography which gives a mov-
but will require surgery in crias (see ing picture. The tissues show up in a similar
below). way to radiographs, i.e. mineralized tissues
Torsion of the spiral colon may well be and bone appear radiopaque, soft tissue as
linked with coccidiosis as nearly all cases shades of grey, air appears black. Fat can be
have a significant coccidian burden. differentiated from fluid. Fasting and a con-
Intussusceptions are extremely rare in the trast agent are required. The animal will
jejunum but are not that uncommon at either require heavy sedation. The small intestine,
the ileocaecal junction or at the caeco-colon spiral colon, C1, C2, C3, spleen, pancreas and
junction. In theory visualization should be kidneys can be seen. The caecum can be seen
possible with ultrasound, however it is not in most animals.
easy. All that can be seen is an excess of fluid.
As these cases are likely to be surgical the cli-
nician has little choice but to perform an Tumours affecting the stomachs
exploratory laparotomy.
Differentiation between a surgical and Tumours affecting the gastric compartments
medical case in gastroenteric disease in of the SAC stomach are extremely rarely
camelids is difficult for even experienced cli- recorded and are only seen on post-mortem.
nicians. Restlessness is a key sign. Constant The most common are lymphosarcomas.
shifting indicates pain and trembling more Practitioners must always be alert for
severe pain. If clinicians are in any doubt a tuberculosis if such masses are seen on
laparotomy must be performed even if the ultrasound.
case turns out not to be a surgical case.

Spiral colon impaction Tumours of the intestines

This is a relatively common condition in crias Squamous cell carcinoma is the most com-
under 4 months of age. There are known mon primary tumour affecting the intestines
trigger factors, e.g. recent diet change, recent of SACs. However, the most common tumour
Medicine and Surgery of the Gastroenteric System 109

to actually affect the intestines is multicen-


tric lymphoma but these are seen as second-
aries in the intestines. Obviously the primary
site will be in the lymphatics with secondar-
ies not only in the intestines but also in
the lungs, heart, liver, kidney and spine.
The main presenting sign will be diarrhoea.
The course of lymphoma in young animals
(i.e. 2 year olds) is really quick and so diar-
rhoea signs should be taken very seriously.
Squamous cell carcinomas and adenocarci-
nomas tend to occur in older animals. The
early signs are often missed and so they will
appear to owners to have a rapid onset.
Surgery is not justified and euthanasia
should be carried out.

Ultrasonographic imaging of the


gastrointestinal tract

Trans-abdominal ultrasonographic imaging


of the abdomen is useful to aid diagnosis of Fig. 9.10. Trans-abdominal ultrasonography.
sick SACs (see Fig. 9.10). Starting on the
right flank the liver will be seen ventral to
the diaphragmatic lobe of the right lung. these cases should be taken in lateral recum-
C2, C3, the intestines and the right kidney bency. If there is distension of C1 there will be
can be seen. If time is taken compartmental cranial distension of the diaphragm and com-
contractions and fluid movement will be pression of the thorax. There may be displace-
seen. On the left side C1 can be seen. With ment of the intestine into the pelvis. Small gas
careful observation the sacculated and non- pockets or fluid lines in C1 are abnormal.
sacculated regions can be seen together Gas-filled intestines indicate intestinal
with their motility patterns. The left kidney obstruction. Bezoars may be seen.
is superficial to C1 and immediately caudal
to the spleen. Ventral to the kidney will be
seen the small intestine and the spiral
colon. The larger diameter loops of the
Diseases of the Liver
colon compared to the small intestine will
contain more echo-dense fluid. Visceral Introduction
oedema will possibly be seen ventrally
between C1 and C3 in the right paralumbar Practitioners should be aware that the liver of
fossa. Visceral oedema may also be seen in the SAC is very different in gross appearance
the left paralumbar fossa near the left kid- from the liver of a ruminant. It is multilobu-
ney, spleen and C1. lated with a fringed pattern (see Fig. 9.11).
SACs do not have a gall bladder.

Radiographic imaging of the abdomen


Abscesses
Ideally this is best performed with the animal
standing. However, this may not be possible These may form in the livers either by haema-
in severe colics and therefore radiographs in tological spread or by local invasion from C1.
110 Chapter 9

and yellowish brown, in the faeces. There will


be raised liver enzymes. Treatment is with
albendazole at 7.5 mg/kg on successive days. If
the patient is pregnant it is advisable to spread
the dosage further and give 3 mg/kg of alben-
dazole for 5 days.

Fascioliasis

This is the most important liver disease in


SACs.

Fig. 9.11. Liver of a llama.

Hyperlipaemia
They may be caused by a variety of organ-
isms. The most common is Escherichia coli. This is an important condition of SACs (see
Clinically the animals will be ill with pyrexia. Chapter 2). It is widely thought that insulin is
Jaundice may be a feature. There does not a useful treatment. This has not been the
seem to be a chronic condition as seen in cat- authors experience.
tle. Diagnosis may be helped by raised liver
enzymes, liver biopsy and trans-abdominal
ultrasonography. Obviously, aggressive anti- Plant toxicity
biotic treatment is required.
This can occur in SACs (see Chapter 16). As
there are very few toxic plants on the altiplano
Black disease SACs are likely to ingest toxic plants with
which they are not familiar.
This is caused by Clostridium novyi. It is
mainly a sheep disease but the author sus-
pects that it may also occur in SACs. Rift Valley fever (RVF) and
Nairobi sheep disease (NSD)

Dicroceliasis Rift Valley fever (RVF) is a viral disease


occurring primarily in sheep and goats.
This condition mainly seen in the eastern USA It will occur in camels and so potentially
is becoming more common. It is caused by the could occur in SACs. However, hopefully it
lancet fluke Dicrocoelium dendriticum. It has will not be exported to areas where SACs are
been recorded in the UK. The first intermediate found and so it will not be a problem. It does
host is the terrestrial snail, Cionella lubrica. The affect humans and so technically it is a zoo-
second intermediate host is the ant Formica nosis. However, it is normally spread by
fusca. Ants are eaten on the herbage by the SAC. insect vectors. The disease is caused by a
The young flukes do not migrate through the bunyavirus.
liver tissue but reach the bile ducts from the Another bunyavirus is Nairobi Sheep
intestine and begin to lay eggs 1012 weeks disease (NSD) which also in theory could
after infection. There appears to be no immu- affect SACs. Both diseases are spread by mos-
nity so there may be heavy infections causing quitoes and maybe by other insects. It is also
cirrhosis. Clinical signs are only seen in heavy possible that there is direct spread from virae-
infections. Diagnosis can be made on seeing the mic sheep and goats. It is only likely to be a
eggs, which are quite small, 25 40 microns, problem in SACs kept in these countries.
Medicine and Surgery of the Gastroenteric System 111

Sheep blood taken from a live animal diaphragm. Primary liver tumours are rarely
and in heart blood taken from a newly dead malignant and do not cause emaciation. This is
animal can be tested with an ELISA for confir- only seen in malignant tumours that rapidly
mation of the diagnosis. The liver shows grow large and invade the lymph nodes.
grey-yellow necrotic foci distributed through- Polycystic lesions are commonly seen in the
out its parenchyma. Virus isolation will give liver of healthy animals and are not cancerous.
a definitive diagnosis. There is no specific In theory liver tumours could be seen on ultra-
treatment. Administration of 30 ml of serum sound or by luck picked up on liver biopsy.
collected from convalescent animals given
intravenously or intraperitoneally may
reduce mortality rates.
Diseases of the Pancreas

Pancreatitis as a clinical entity on its own is


Tumours of the liver not recorded in SACs. However, it may
become an entity as a secondary complication
Tumours of the liver are found. They are nearly to peritonitis or liver disease. The pancreas
always formed from liver tissue except for may also be infested with cysticerci from
very rare melanomas that have normally Taenia spp, whose primary host is a small
started in the lungs and spread through the carnivore.
10
Medicine and Surgery of the Respiratory
and Circulatory Systems

Non-Infectious Conditions of the Infectious Conditions of the


Upper Respiratory Tract Upper Respiratory Tract

Hyperplasia of the soft palate Nasal myiasis

This condition of unknown aetiology is rare. Oestrus ovis is found in SACs in the UK
The main clinical sign is a rattling noise on and Europe but it is extremely rare. The
inspiration. The animals do not appear to be adult fly of O. ovis deposits larvae around
ill or to suffer from respiratory distress. the nostrils. These invade the nasal cavity
Neither antibiotics nor anti-inflammatory and develop into second stage instars,
drugs seem to alleviate the signs. The author which invade the sinuses in the head. The
has seen the condition on post-mortem when mature larvae are sneezed out up to 1 year
the adult gelding had died from a twist of the later.
spiral colon. The conditions appeared to be The signs of sneezing can be controlled
unrelated. by eliminating the larvae with ivermectin
treatment at 0.2 mg/kg by subcutaneous
injection.
Cephenemyia spp. are nasophyngeal bots
Rhinitis found in the USA. The primary host is the
deer. SACs are very rarely affected. The
This condition is extremely rare and is infection can also be controlled with iver-
thought to be allergic. The main sign is an mectin. However, as the SAC is not the pri-
intermittent clear nasal discharge from both mary host there may be a granulomatous
nostrils. Sneezing is not seen but there is an reaction in the nasopharynx. This will be
eosinophilia on blood test. Antibiotics and manifest as severe dyspnoea, i.e. mouth
NSAIDs do not seem to be helpful, nor do breathing. Diagnosis can be made with radi-
antihistamines. In the UK the condition ography of the skull. Treatment has to be
seems to get better in the autumn. Owners aggressive with prolonged antibiotics,
think nasal nets are helpful but the author is NSAIDs and double dose ivermectin, i.e.
not convinced. 0.4 mg/kg injected subcutaneously.

112 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Medicine and Surgery (Respiratory & Circulatory) 113

Non-Infectious Conditions of the animal in lateral recumbency. Blowing


the Lower Respiratory Tract into the nostrils does not seem to inflate the
lungs and so inspiration can be aided by lift-
Aspiration pneumonia ing the rib cage behind the last rib. This pro-
cedure can be used very carefully in newborn
crias.
So called inhalation pneumonia is a real
danger in SACs undergoing a general anaes-
thetic, particularly if a gaseous anaesthetic is
used. The occurrence can be lessened by care- Pleural effusion
ful monitoring of the animal on recovery.
Aspiration pneumonia can also occur after This will occur with infectious pneumonia
faulty drenching technique in adults. This is and with tuberculosis. However, it will occur
particularly common in SACs that have not idiopathically. The animal will be in respira-
been handled regularly. It is also seen in lac- tory distress and will be mouth breathing.
tating females that have hypocalcaemia and There will be dullness on percussion of the
have been treated per os by the owner. ventral thorax and a fluid line may be seen
on ultrasound. Clear straw-coloured fluid
may be drawn off by aspiration below this
line. This will bring about some clinical
Diaphragmatic paralysis improvement. Sadly this is not sustainable
and euthanasia is then warranted. A full
This is a condition of the young SAC post-mortem (see Chapter 15) should be car-
between the age of 2 months and 3 years. ried out to eliminate infectious pneumonia
It tends to occur in the winter in the north- and tuberculosis.
ern hemisphere. The cause is unknown but
might be damage to the phrenic nerve,
which has a motor component, which sup-
plies the diaphragm. This nerve comes from Trauma
the lower cervical region. It could be dam-
aged by trauma. The main clinical signs are This can have a variety of causes. The most
tachypnoea and dyspnoea. There is an important cause in adults is road traffic acci-
abdominal effort and paradoxic breathing, dents causing rib fracture. Trauma can also
i.e. the chest goes out as the flank goes in. occur when there is fighting between males
Often the animal will adapt a dog-sitting causing thoracic penetration by bite wounds.
posture. Radiographs are useful in the former.
Diagnosis is on clinical signs, having ruled Aggressive antibiotic treatment is required in
out upper airway obstruction. Diaphragmatic the latter. NSAIDs are useful in both
hernia and pneumothorax can be ruled out by incidences.
radiography. Diaphragmatic paralysis is better Trauma of the rib cage can occur in crias
seen on fluoroscopy. Treatment is non-specific from problems at parturition. Owners should
and supportive. Survival rates are 75%. be urged to take care when assisting birth and
when trying to revive crias.

Drowning
Infectious Conditions of the Lower
SACs can swim well. However, in winter in Respiratory Tract
the UK they become exhausted if they are not
able to get out of the water on account of the Introduction
heavy fleece. If artificial respiration is
attempted, expiration may be aided by press- Infectious pneumonia is extremely rare in
ing the ribs firmly behind the shoulder with SACs. Bovine respiratory viruses could affect
114 Chapter 10

SACs if cattle and SACs were housed closely Coronavirus


together. Equally SACs could develop pas-
teurellosis if they were housed closely with There are early reports of a coronavirus caus-
sheep and goats. Finally, equine herpes virus ing respiratory disease in SACs. There is no
was isolated from SACs in close proximity to concrete evidence at the time of writing.
infected zebra and Rhodococcus equi has been However, the author has included this com-
found in SACs in close contact with infected ment for completeness.
foals.

Melioidosis
Actinomycosis
This disease is caused by Burkholderia pseu-
Actinomyces lamae has been isolated from domallei. It is often called pseudo glanders.
lung abscesses. It is not clear whether this It causes disease in many species, including
was an opportunist pathogen or a primary humans (see Chapter 17). The organism lives
cause as it was isolated at post-mortem. The in warm swamps in tropical and semitropi-
animal had shown signs of semi-acute pneu- cal areas. In llamas and alpacas it is mainly a
monia. Antibiotic treatment with tetracy- respiratory disease with abscesses in the
clines had been given and was not effective. lungs and associated lymph nodes. The
Large prolonged doses of streptomycin organism may be cultured from the purulent
might have been effective. However, tuber- nasal discharge and confirmed with a PCR.
culosis should always be considered as a dif- Treatment with broad spectrum antibiotics is
ferential diagnosis and therefore any rarely successful and so euthanasia must be
treatment was unwise. advised.

Anthrax Pasteurellosis

This may cause sudden death (see The causative organism is Mannheimia haemo-
Chapter 15). The pulmonary form has been lytica, so pasteurellosis is actually nowadays
described in the USA and in South America. a misnomer. However, the organism histori-
The animal will show marked dyspnoea cally was called Pasteurella haemolytica. This
and have an extremely high rectal tempera- organism will cause pneumonia in alpacas
ture, as high as 44C. Treatment is possible and llamas, which can be serious if not treated
with large doses of crystalline penicillin promptly with broad spectrum antibiotics
every 6 h intravenously. The diagnosis can and NSAIDs. It is particularly prevalent in
be confirmed on a blood smear stained 12-year-old animals that have been stressed
with McFadyeans stain (see Chapter 4). by travelling or have been in the same air-
The zoonotic problems with the disease space as infected lambs or calves. Diagnosis
need to be addressed not only with the can be confirmed by culture of nasal swabs or
owners but also with the disease control paired serum samples. Clinicians should note
authorities. that the Pasteurella vaccines prepared for
cattle or sheep do not seem to provide immu-
nity in SACs.
Colibacillosis

Escherichia coli will cause neonatal septicae- Rhodococcosis


mia and will often be isolated from the lungs
of dying crias. It is unlikely to be a primary This is an equine disease and is caught by
respiratory pathogen. SACs kept in close proximity with infected
Medicine and Surgery (Respiratory & Circulatory) 115

foals. It causes chronic pneumonia and so cli- pathogen is Mycobacterium bovis. This was iso-
nicians must have tuberculosis as a differen- lated from 68 submissions to the VLA from 14
tial. Both conditions will show infected lungs alpaca herds in 2009. However, there were
on radiography. As the treatment with also two submissions of Mycobacterium microti
rifampicin and erythromycin used orally in and a single isolation of Mycobacterium avium
foals cannot be used in SACs, euthanasia in the same year.
should be carried out and a proper diagnosis The clinical signs are very confusing as
should be obtained by a post-mortem and individuals vary enormously. There may be
culture of the abscesses. ill-thrift and loss of weight. Coughing may be
a feature but it does not occur in all lung cases
and certainly does not occur if another organ
Streptococcosis (e.g. the liver) is infected. Occasionally a
peripheral lymph node will be swollen.
Even the post-mortem signs are confus-
Streptococcus equi causes the mainly upper
ing. The most marked signs are in the lungs,
respiratory disease of strangles in equines.
trachea and liver. There is extensive caseous
SACs will become infected but it is rare in
necrosis and little mineralization. It is often
the UK. However, it is relatively common in
difficult to link the post-mortem findings
Peru and is known as alpaca fever. It is a
with the clinical picture. Sometimes the ani-
very serious disease in crias and young
mal is in explainable poor condition but in
adults, causing a high fever and pneumonia.
other cases with extensive post-mortem
The normal manifestation of abscesses in the
lesions the animal is in good or even fat con-
parotid and mandibular lymph nodes as
dition. Sometimes there are cavities in the
seen in equines is not commonly seen in
lung lesions, which are likely to be very infec-
alpacas. Diagnosis on culture of the purulent
tious if the human model is followed. Lymph
nasal discharge is relatively straightforward.
nodes in normal camelids are small and diffi-
As in horses the fear is that a carrier state
cult to find. However, in tuberculous cases
may be established. However, this does not
they may be much enlarged. They may con-
seem to be a problem in SACs, perhaps
tain a large amount of caseous material or
because they lack a guttural pouch. Therefore
they may contain multiple small foci. The
the author considers antibiotic therapy with
lesions in the liver are usually not as marked
high doses of penicillin to be very worth-
as in the lungs. They may be multifocal.
while. Resistance of a Streptococcus to peni-
Clinicians must be careful not to confuse
cillin is unlikely. Clinicians should remember
mineralized lesions in the liver, caused by
that S. equi can live for a considerable time
parasitic migrations, with multifocal tubercu-
outside the animal. Therefore biosecurity is
lous lesions. Cutaneous lesions are often
important to prevent the spread of the
linked with a discharging superficial lymph
disease.
node. There may be other granulomatous
lesions in the body. These should not be
mistaken for lymphosarcomas.
Tuberculosis Practitioners should be aware that there
can be severe side effects following the skin
This disease is increasing in the UK in SACs, test. These side effects appear to be linked to
which is a worrying phenomenon. It does in actual infection. Clinicians should warn the
some way mirror the increase in bovine tuber- owners accordingly.
culosis. However, as the disease is particularly
difficult to diagnose in live SACs, because the
skin test is unreliable, it leaves the industry
and the government regulatory body, Defra, Nematodes which Affect the Lungs
in a difficult position. There is a blood test, the
Chembio Rapid Blood test; this is hardly bet- In general in SACs, lungworms are of no
ter than the insensitive skin test. The main real significance. However, there is one
116 Chapter 10

exception to that rule. When there is mixed hindleg lameness. This animal showed pain
grazing with cattle, Dictyocaulus filaria can on movement and the right hind was notice-
cause real problems in younger animals, i.e. ably colder than the left hind. The condition
first-season crias. There is a vaccine availa- was confirmed on rectal ultrasound examina-
ble in cattle using live irradiated larvae. This tion. The animal was given daily doses of a
has not been used in SACs and therefore combination of penicillin/streptomycin for
cannot be recommended. Treatment with 10 days. The lameness after 2 days made a
injectable ivermectins is very effective. steady improvement.
Dictyocaulus filaria has a direct life cycle in
SACs so that cattle are not required to con-
tinue an infection. The signs that occur in
Poisonous plants
late summer are pathognomic. They are a
rasping cough in animals at grass. Although
ivermectins by injection will eliminate the There are very few poisonous plants that
adults in the lungs, supportive therapy with actually stop the heart. Foxgloves and olean-
antibiotics and NSAIDs is useful. A second der (see Chapter 16) are the most common
dose of ivermectin should be given at an plants in the UK to actually cause cardiac
interval of 3 weeks. The pasture will be con- signs.
taminated the following year so it is advis-
able for it to be used as a hay or silage field
until later in the season. Schistosomiasis
Protostrongylus rufescens, Muellerius capil-
laris, Neostrongylus linearis and Cystocaulus These trematode parasites live in blood ves-
spp. have all been found on post-mortem in sels and as such they cause a variety of dif-
the lungs of SACs but they have not been ferent signs and symptoms. They occur
associated with clinical disease. throughout the tropics but are also found in
Parelaphostrongylus tenuis, the meningeal central Asia, the Middle East and in the
worm, will cause transitory respiratory signs, Mediterranean. They are elongated trema-
e.g. coughing, as it passes through the lungs todes that have separate sexes unlike liver
(see Chapter 12). flukes. The male lives in a groove in the
female. They are found in SACs as well as a
variety of other species including humans.
Diseases of the Cardiovascular System They mainly live in the mesenteric and portal
veins and so they cause diarrhoea, dysentery,
Heart attacks anaemia, emaciation and death. The pulmo-
nary form causes respiratory signs. Oral
Heart attacks as described in humans are praziquantel at 25 mg/kg is effective treat-
very unlikely to occur in SACs. Therefore ment if repeated at weekly intervals for a
sudden death cannot be attributed to this minimum of 5 weeks.
cause. However, muscular dystrophy, white
muscle disease, affects crias (see Chapter 2).
It can occur in neonates and also in older Vegetative endocarditis
animals. The animal will normally be found
dead.
This condition occurs in SACs (Fig. 10.1). If the
tricuspid valve is affected it is called right-
sided heart failure. There will be ascites and
Iliac arterial thrombosis peripheral oedema. There will be a marked
jugular pulse. A jugular pulse is difficult to feel
This condition can occur in SACs. However, and impossible to see in SACs as their skin is
the author has only diagnosed the condition relatively thick. If the bicuspid valve is affected
once in a large old male llama with right it is called left-sided heart failure. There will be
Medicine and Surgery (Respiratory & Circulatory) 117

Diseases Affecting the Haemopoietic


and Lymphatic System

Anaplasmosis

This is an arthropod-borne, bacterial disease


of ruminants. There is confusion as the main
organism Anaplasma phagocytophilum used to
be classified as a rickettsia. The disease is
normally called tick-borne fever. It is an
obligate intracellular bacterium. The pre-
dominant vector in the UK is the tick Ixodes
ricinus. In the north-eastern USA it is Ixodes
Fig. 10.1. Vegetative endocarditis. scapularis. Ixodid ticks feed on most terres-
trial vertebrates. There is a potential for
cross-species transmission within such a
oedema of the lungs. This may show as a dull large reservoir of different species, e.g.
area in the ventral thorax. The animal may sheep, goats, cattle, deer, rodents, humans
well have a cough when it is exerted. The rest- and SACs.
ing pulse rate may well be raised. Clinicians The clinical signs are very variable but
should remember that dropped beats are nor- include fever, lethargy and anorexia. Some
mal in SACs. It is possible to have vegetative animals may show neurological signs,
lesions on both sides of the heart. The combi- mainly ataxia. These are thought to be caused
nation of signs will be confusing. by focal CNS lesions secondary to localized
Diagnosis can be confirmed with a 5.0 MHz vasculitis. The blood picture will show
scanner. There are a variety of bacteria that can lymphopenia, anaemia and thrombocytopae-
cause the condition. Erysipelas rhusiopathiae is a nia. Intracytoplasmic inclusions are com-
common cause. Animals should be treated for monly seen in the neutrophils and are
at least 2 weeks with antibiotics. The author diagnostic. The diagnosis can be confirmed
normally uses a penicillin/streptomycin com- by a PCR on anticoagulated blood. Paired
bination. However, clinicians may prefer to use serology showing rising titres is also diag-
a longer acting antibiotic if the owners are nostic. Splenomegaly will be seen on post-
unable to inject the animals themselves. The mortem.
condition may be incurable. However, if the Mixed infections with Mycoplasma haemo-
signs diminish that is excellent, but if the animal lamae may be seen. Treatment is the same for
is pregnant the owner should be advised to give both infections, which is 20 mg/kg of tetracy-
a 2-week course of antibiotics immediately after clines on alternate days for a minimum of
parturition in case the condition flares up. 10 days.

Ventricular septal defects Babesiosis

Ventricular septal defects are relatively com- Babesia spp. are tick-transmitted protozoan
mon in crias. Clinicians are advised to check parasites of the red blood cells. In the UK
the hearts of young crias. SACs can be infected with Babesia motasi
caught from sheep and Babesia capreoli caught
from red deer.
Viral myocarditis Ticks become infected when they ingest a
blood meal from a parasitaemic host. Within
This condition is seen in SACs. It is associated the tick, the Babesia spp. probably reproduces
with FMD infection and results in sudden death. sexually, and is transmitted between larval,
118 Chapter 10

nymph and adult stages, and trans-ovarially care as the organism can be transmitted on
by infection of the eggs by a vermicule stage contaminated needles. Transmission may also
of the parasite. Babesia spp. enter the salivary be transplacental. Workers in Oregon have
glands of the ticks and are transmitted to the investigated crias born to infected dams. They
SAC. Rapid, asexual division of the parasite found that crias may be PCR-negative both
occurs within the hosts red blood cells; this before and after suckling from an affected
leads to haemolysis. The severity of the dis- dam. Equally, other crias born to infected
ease depends on the pathogenicity of the dams are positive before and after ingestion
Babesia spp., host immunity and the level of of colostrum, and remain positive for up to
challenge. The diagnosis of babesiosis is 6.5 months (Tornquist et al., 2011). Large doses
based on knowledge of Babesia spp.-infected of tetracyclines (i.e. 20 mg/kg every other day
tick activity and can be confirmed by identifi- for 10 days) should be used for treatment.
cation of the parasite in Giemsa-stained red This may not totally eliminate the organism,
blood smears. It is an extremely rare condi- so a carrier state may occur and there may be
tion. Treatment is with imidocarb, which is recrudesce if the animal is subsequently
supplied in a multidose vial as a 12% solu- immunosuppressed. Florfenicol and enro-
tion. An amount of 1 ml/100 kg should be floxacin do not seem effective.
given intramuscularly. Abscess formation is
possible, so owners should be warned.
Theileriosis

Mycoplasma haemolamae Theileria ovis and Theileria recondite cause


this disease. They are tick-borne protozoa
similar to Babesia spp. They initially infect
This used to be called Eperythrozoon spp. It
the lymphocytes followed by the erythro-
will affect SACs worldwide and it has been
cytes of the SAC. They have been isolated
isolated in the UK. Affected animals are not
from SACs, but have not been associated
necessarily anaemic but normally will show
with disease.
an acute onset of weakness, fever, depres-
sion and recumbency. They will have pale
mucous membranes and often are anorexic.
They often show respiratory distress. It can Trypanosomiasis
affect all ages. Show animals may be symp-
tomless carriers. On careful questioning the Trypanosomes are, except for a very few
owners may have noticed a weight loss. The exceptions, spread by tsetse flies (Glossina
pathogen is believed to be an opportunistic spp.). These flies are found in Africa south of
invader. It may be seen on thin blood smears the Sahara and north of the Limpopo river.
stained with Giemsa and examined under Trypanosomiasis is therefore mainly restricted
the oil emersion power of a microscope. Care to this very large belt of Africa. The tsetse can-
has to be taken as Mycoplasma haemolamae not withstand low temperatures and so it is
attaches to the surface of the red blood cells, not found at altitudes of over 1500 m. As SACs
causing damage without penetration. The are not kept in these areas of Africa, they are
blood film should be examined immediately not affected by trypanosomiasis caused by
after collection to avoid missing the organ- the three main species Trypanosoma brucei,
ism. It can be positively diagnosed by a PCR T. vivax and T. congolense. Camels can be
test on a blood sample collected in EDTA infected with these three species as well as with
(purple top). The organism has been seen in a fourth specific trypanosome, T. evansi, which
healthy animals, which may then become ill is spread by biting flies. In theory SACs could
if stressed or immunosuppressed. be infected by this trypanosome but such an
The normal mode of transmission is infection has never been recorded. Trypanosoma
thought to be by biting insects but this has evansi has been recorded in North Africa, the
never been proven. Clinicians should take Middle East and in India. If ever SACs are
Medicine and Surgery (Respiratory & Circulatory) 119

imported into these areas they are likely to There will be raised liver enzymes and
become infected. Diminazene aceturate low albumen. Eggs are not likely to be
would be the drug of choice for treatment. It found in the faeces unless the condition
is supplied in 1.05 g sachets for reconstitution has become chronic. However, chronic fas-
in 12.5 ml of water to make a 12.5% solution. cioliasis is more common than the acute
This is the normal dose for an adult cow disease. In the acute disease the migrating
weighing 500 kg. The author has only had immature fluke tracts in the liver are eas-
experience using it on a pro rata dosage for ily seen. Although gastric ulcers are
camels. It would be reasonable to use it on a quoted as causing anaemia in SACs, such
pro rata basis by weight for treating T. evansi a cause is rare. Death will be caused by a
in SACs. ruptured ulcer, which will be obvious on
post-mortem. Mycoplasma haemolamae has
been isolated in the USA, in the UK and in
South America. It will cause anaemia and
Investigating and Treating can be diagnosed from an EDTA blood
Anaemia in SACs sample with a PCR. TB and Johnes dis-
ease are always said to cause anaemia.
SACs have a different basic haematology However, signs of anaemia will only occur
from ruminants with respect to red cells. very late on in these diseases. The lack of
They have small ellipsoid erythrocytes iron, copper, zinc and phosphorus all has
with higher haemoglobin content. Therefore been associated with anaemia. The diag-
their normal packed cell volumes (PCVs) nosis can be confirmed with blood sam-
are lower (2545%) and they have a higher ples taken: serum for iron, heparin for
mean corpuscular haemoglobin concentra- copper, serum in a non-rubber tube for
tion (MCHC). It is thought that these zinc and oxalate for phosphorus.
attributes have been helpful to SACs living In old SACs neoplasia is common.
at altitude with reduced oxygen. Any con- Tumours, usually lymphosarcomas, will be
dition that causes a reduction in the number seen on post-mortem.
of erythrocytes, a reduction in haemoglobin Apart from haemorrhage the only
concentration or a lower PCV will cause other likely causes of anaemia are the inges-
anaemia. The signs are normally weight tion of mouldy sweet clover or anticoagu-
loss, dyspnoea, lethargy and pale mucous lant rodenticides.
membranes. However, the anaemia will Treatment of the primary cause of the
have to be severe for the colour of the anaemia is vitally important. Then the clini-
mucous membranes to be a reliable indica- cian has to decide if a transfusion is appropri-
tor. Blood samples should be taken into ate. Increased heart rate, mucous membrane
EDTA for a full haematological profile pallor, acute lethargy and recumbency are all
together with blood smears stained with signs for consideration. The ultimate decid-
Giemsa. A serum sample should be taken ing factor will be the PCV. In cases of acute
for biochemistry. Practitioners who are blood loss, if it falls below 15% a transfusion
used to anaemia in other species will be is warranted. In chronic anaemia cases a
very alarmed by the low PCVs shown by PCV of 12% would be an indicator for a
SACs. transfusion.
Parasitic gastroenteritis, particularly In large herds donor selection is rela-
Haemonchus contortus, will cause severe tively straightforward. Large males usually
anaemia and death. The mucous mem- geldings with high PCVs are the animals of
branes will as white as a sheet. The FEC choice. Ideally their PCV should be greater
may be very high or zero if the clinical than 30%. Cross matching is not required for
signs are manifest before completion of a first time single transfusion.
the pre-patent period. The vast number of SAC blood volume can be estimated at
worms will be found in C3. Acute fascio- about 8% of the body weight in kilograms. It is
liasis will also cause anaemia and death. safe to remove up to 20% of the donors blood
120 Chapter 10

volume. This equates to approximately 2 l from rarely fibromas are seen in the heart muscle.
a 100 kg animal. The blood should be collected These do not normally show clinically, only
aseptically into specially prepared bags. on post-mortem.
With the administration of the blood it is
prudent to start slowly for the first 10 min at a
rate of 1 ml/10kg. If there is no evidence of Malignant Round Cell Tumours
anaphylaxis the rate can be radically increased.
Up to 40% of the blood loss can be replaced.
The malignant round cell tumours (MRCT)
In small herds when there is no suitable
group includes lymphoma, neuroblastoma,
donor or if the clinician feels collection is not
rhabdomyosarcoma and MRCT. They are
possible, SACs can be given Polymerized
extremely rare in SACs but will occur. Using
Ultrapurified Bovine Haemoglobin (PUBH).
immune-histochemistry they can be further
This is available in 125 ml bags but is natu-
classified as B cell lymphoma, T cell lym-
rally very expensive.
phoma and MRCT. Diagnosis is normally at
post-mortem as they rarely show lymphad-
enopathy and therefore biopsies are not car-
Tumours of the Cardiovascular System ried out in the live animal. The signs are all
non-specific and include anorexia, weight
By far the most common tumours are hae- loss, respiratory distress and weakness lead-
mangiomas. These may be found in the ing to recumbency. The disease is normally
spleen, the liver, the intestine and the sub- insidious but they can die suddenly. The
cutis. They are normally benign but will blood picture is also non-specific with
haemorrhage and cause anaemia. The clinical hypoalbuminaemia, anaemia and raised
signs will resemble haemonchosis. Extremely liver enzymes. The main differential is TB.
11
Medicine and Surgery of the
Urino-Genital System

Congenital and Hereditary Conditions 10 days. Its tetanus status should be


of the Urinary System ascertained. A careful check by the clinician
should be carried out in 10 days. Fly control is
Renal agenesis important.
In the event of the urachus not closing
This condition may be hereditary. However, with this treatment or if it has become patent
it is normally seen as a terminal condition some days after birth as a result of infection,
and so euthanasia is advised. It is often linked more aggressive surgery needs to be carried
to gonadal agenesis. If it is unilateral both out. The cria should be anaesthetized by
renal agenesis and gonadal agenesis may masking down with halothane or isoflurane
well go unnoticed in females. In males there and surgically prepared. The practitioner
may be a misdiagnosis, considering them to should perform a laparotomy so that the ura-
be rigs. Hopefully surgery will not be chus can be traced back to the bladder.
attempted. In the authors experience ultra- It should be sectioned and the bladder closed
sonography is not helpful, but perhaps with with a double layer of continuous Lembert
more sophisticated equipment and a more sutures of an absorbable material. The umbil-
skilled operator, that may be the way for- ical vessels should be ligated proximally to
ward. Equally laparoscopy could make diag- any infected and diseased tissue. This tissue
nosis clearer. should then be totally removed. The abdo-
men should be closed with interrupted
sutures of monofilament nylon. These all
should be laid individually before any are
Persistent patent urachus tightened in a vest over pants configuration.
When the practitioner is satisfied that there
This is usually a congenital condition as the are enough sutures to close the abdomen and
urachus fails to close at birth. However, if it that no small intestine is trapped the sutures
occurs a few days after birth it is likely to be can be tightened. It is very important that no
as a result of a septic omphalophlebitis. extra sutures are added after this on account
Differentiation is important as treatment is of the danger of perforation of the small intes-
likely to be different. If the urachus remains tine. A subcuticular layer of continuous
patent at birth, it can be ligated immediately. sutures of an absorbable material should be
The animal should receive antibiotics for laid before the skin is closed with interrupted

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 121
122 Chapter 11

horizontal mattress sutures of monofilament projection at the tip of the glans. Gelded
nylon. It is important that the animal receives males appear to be more susceptible to
aggressive antibiotic treatment until 10 days obstruction than entire males. Obstruction
when the sutures if clean and dry can be is virtually unheard of when the animals are
removed. If there is any doubt, they should be at grass but can be seen rarely in animals
left in place and further antibiotic treatment fed dried food. The animals will be seen
should be given. to strain. The urethra can be felt pulsating
just below the anus. No urine will be passed
and the hair near the tip of the prepuce will
be dry.
Medical Conditions of the Surgical treatments have a low success
Urinary Tract rate and have welfare implications and so
preventative measures are very important.
Nephritis and nephrosis occur in SACs. The They should be based on reducing calculus
presenting sign will be general malaise and formation. The most common types of cal-
low grade abdominal pain. It is rarely painful culus seen in animals on a cereal-based
enough to be termed colic. The most common ration are phosphates, usually calcium or
bacterium isolated is Escherichia coli. Yeasts, magnesium salts. They form in the kidney
namely Candida albicans, have been isolated medulla. They are often found at post-
on rare occasions. Nephrosis is a distinct clin- mortem as incidental findings. However, as
ical entity in young crias, between 2 and 4 soon as they start to obstruct the flow of
weeks of age. They will stop sucking and yet urine they start the development of clinical
appear to be thirsty as they will stand over signs. If they block a single ureter this will
the water supply. The cause is unknown. cause nephrosis, which will remain subclin-
Clinicians may be asked to examine these ical as the second kidney will compensate.
cases post-mortem. They may be mistaken for There is a danger of pyelonephritis in this
clostridial disease. Indeed the condition may diseased kidney. The animal then will
be as a result of an unknown toxin. There is become ill with a raised rectal temperature.
no treatment. However, if both become blocked the animal
Prostatitis is seen in young male SACs, will quickly be become clinically ill, ano-
particularly when stressed at weaning. rexic, have a hunched gait and painful
Signs will look like cystitis/ bladder stones. kidneys.
Indeed, struvite crystals will be seen in the Urethral obstruction has the signs
urine, which is usually alkaline with a pH described above. These will quickly turn to
of 9. However, the presence of struvite bladder or urethral rupture, renal failure
crystals is difficult to interpret as they are and death. Early diagnosis is very important
seen in normal urine that is allowed to and can be aided by ultrasonography.
stand. Long-term antibiotic treatment with Images of the abdomen and bladder can be
penicillin and NSAIDs should be given. readily obtained using a 5 MHz sector trans-
Glycosaminoglycans might be used in treat- ducer connected to a real-time, B-mode
ment following the model of idiopathic cys- ultrasound machine. Scans can be recorded
titis in other animals. using a thermal printer or digital recording
equipment. These scanners can be used to
examine the abdomen, although the depth
of field is limited to 10 cm. The bladder of a
Surgical Conditions of the normal male is contained within the pelvis,
Male Urinary Tract and therefore cannot be visualized during
ultrasonographic examination; a bladder
Introduction that extends for up to 10 cm or more over
the brim is considered an abnormal finding.
In SACs the urethra is long and narrow, with Every effort must be made to prevent
a sigmoid flexure and a small cartilage the formation of calculi. One of the main
Medicine and Surgery of the Urino-Genital System 123

problems is the excretion of phosphorus in Abrupt weaning will reduce both fluid
the urine. Naturally there are differences intake and urine excretion. Both will be
between individuals. Obviously the mineral halved at weaning. High water intake and
content of the diet is important. Cereal diets hence high urine output has a high heritabil-
are high in phosphorus and low in calcium. ity. It is linked to the potassium composition
Additional phosphorus must not be fed. of the red blood cells. So certain individuals
Normally in prepared SAC diets a good will have a higher urine output and there-
regular supply of magnesium is very impor- fore will be less at risk. The normal SAC
tant. However, in this instance the diet urine from animals fed on an ad libitum
should not contain more than 0.2% of mag- roughage diet is alkaline. On the other hand
nesium. Magnesium is absorbed more than a high cereal diet lowers the pH, making the
twice as efficiently from a concentrate diet urine acid. This effect is beneficial to the ani-
when compared to a roughage diet. High mal as an acid diet lessens the formation of
magnesium predisposes to urethral block- calculi. The SAC keeper therefore has a bal-
age. Calcium has a direct link with phos- ancing act to perform as high cereal diets are
phorus so extra calcium needs to be fed to not necessarily going to have an adverse
make sure the calcium:phosphorus ratio is effect, i.e. they will cause the urine to be acid
greater than 2 to 1. This will lower phospho- but will increase the level of phosphate in
rus excretion in the urine. the urine.
Another part of the problem is the
nature of the diet. High roughage diets
require chewing. This stimulates saliva flow.
Phosphorus is excreted in the saliva, which Key factors to prevent urolithiasis
then is swallowed allowing phosphorus to
be lost in the faeces rather than excreted by Ensure an ad libitum supply of fresh
the kidney and hence to the urine. If rough- clean water from accessible drinkers.
age is fed ad libitum the amount of phospho- Wean crias which are suckling from their
rus in the urine is halved. Even feeding mothers when they are still on grass or
pellets rather than a coarse mix of concen- outside on roots etc., rather than straight
trates has an adverse effect as loose concen- on to a cereal diet.
trates increase saliva and hence increase Do not supply free access to minerals
faecal loss of phosphorus. Apart from the containing phosphorus to castrated ani-
effect on phosphorus excretion, a high con- mals except at grass.
centrate/low roughage diet has an effect on Add calcium carbonate, calcium chloride
the excretion of urinary mucoproteins. These or calcium sulfate to the cereal diet to
act as a nidus for phosphorus calculi forma- maintain a calcium:phosphorus ratio that
tion in the kidney medulla. is greater than 2:1.
Urinary volume has a direct effect on Feed palatable forage ad libitum.
calculi formation. The higher the flow of Do not feed pellets.
urine the less likely are calculi to form. Acidify the urine by adding ammonium
Urinary volume is obviously linked directly chloride to the feed at the rate of 1 g per
to water intake. SACs must have a constant head.
supply of clean water. This may well be com- Add salt to the diet at the rate of 2 g per
promised in sub-zero temperatures. The head to encourage water uptake.
moisture content of the food has an effect. Give access to urea blocks to encourage
However, what is more important is the fre- water uptake, provided they do not con-
quency of feeding. Intermittent feeding trig- tain phosphorus or high magnesium.
gers a renal response, so that urine production If there has been a problem of water
is decreased and hence urine concentration supply do not handle animals or move
is increased. Ad libitum feeding of roughage them violently as this may make a formed
stimulates urine production, which in turn calculus move into an obstructive
stimulates thirst. position.
124 Chapter 11

Treatment of obstructive urolithiasis prepuce and anchored to the peritoneum,


musculature and skin. A very small hole is
The welfare of the animal must be at the fore- pierced in the bladder and this is stitched
front of the clinicians mind. Equally very with many small sutures to the peritoneum,
careful consideration must be given before musculature and skin. It is very important
undertaking surgery, which may cause pain- that there is a seal between the bladder and
ful urine scalding and the risk of fly strike. the peritoneum so that urine cannot leak into
Sadly the use of muscle relaxants is extremely the peritoneum. The rest of the abdomen and
rarely successful. Also catheterization with- skin is then closed in the normal manner. On
out severe damage to the urethra is impossi- recovery the animal should be draining urine
ble. Therefore retrograde flushing is also through the small hole in the skin, which
impossible. Obstruction can occur at three should be at the animals lowest point on the
points, which influence the surgical proce- ventral body wall.
dure. This must be performed as soon as pos-
sible on welfare grounds. Bladder rupture SURGICAL TUBE CYSTOTOMY This has been
will occur within 48 h. Urethral rupture with described by workers in India (Malik et al.,
urine escaping into the tissues may occur 2010). It is a minimally invasive technique
sooner than that. through the left paralumbar fossa, which can
be performed in lambs or kids. A catheter is
At the sigmoid flexure there placed in the bladder lumen through a metal-
are three options for surgery lic cannula and fixed to the skin with a stay
suture. The surgery can be performed either
URETHROSTOMY This can be performed under
standing or in right lateral recumbency. With
a general anaesthetic (see Chapter 8) or seda- acidification of the urine the urinary crystals
tion and local anaesthesia. The penis is are dissolved leading to the restoration of full
located just below the anus. A linear incision urethral patency in successfully treated ani-
is made over the penis and it is drawn mals within a few days. No hospitalization is
through the incision by blunt dissection. The required. The catheter is removed after nor-
penis is then incised and the urethra is located mal urination occurs. No recurrence of the
within. The urethra is then sutured to the condition was noted by the workers in a
skin with multiple small sutures leaving an 6-month follow-up. There would appear to be
orifice of at least the size of a pencil. Urine no reason why such a technique should not
will flow out and the bladder should be be used in SACs.
flushed with warm sterile water to remove
any further stones. The animal should
At the glans penis
receive antibiotics and NSAIDs daily and the
wound should be cleaned. Penile amputation has been described by
other authors (Hay, 1990). The perineal area
MARSUPIALIZATION In theory this surgery could from the anus to the scrotum is clipped and
be performed under sedation and local anaes- prepared for surgery. The tail is held upwards
thesia. However, in reality this would be very and out of the way by an assistant or by
difficult and both welfare and sterility would anchoring in position to the pelvic fleece.
be compromised and therefore a general A 45 cm vertical incision is made in the mid-
anaesthetic must be advised. The animal is line from the level of the tuber ischii down-
placed in dorsal recumbency. A linear incision wards. Using blunt dissection the incision is
is made through the skin and abdominal deepened until the penis is identified as a
muscles just anterior to the preputial orifice firm, smooth, yellowish organ 12 cm in
towards the umbilicus. The full bladder is diameter. By blunt dissection and manual
drained by puncture through a sterile needle traction, isolate the penis and pull it out-
attached to a sterile piece of tube to the out- wards through the skin incision. Sever the
side of the abdomen. The rostral end of the penis at the lower end of the incision, but
bladder is then drawn to just in front of the above any area of urethral obstruction, making
Medicine and Surgery of the Urino-Genital System 125

sure that the proximal stump will be long increasing the chances of undesirable gene
enough to be fixed outside the wound, par- pairing to produce abnormalities. There is no
ticularly in fatter animals. Non-absorbable evidence to demonstrate that defects are more
simple interrupted stitches are used to suture or less common in alpacas compared with
the periurethral tissues to the dorsal end of llamas.
the skin wound. Care must be taken not to
puncture the urethra with sutures, or to
occlude it by excessive dorsal flexion of the
Atresia ani
stump.
This may be linked with a recto-vaginal fistula.
Practitioners should make a careful evalua-
Tumours of the Urinary System tion. Surgery is simple (see Chapter 9) and can
be carried out immediately if the atresia is just
Adenocarcinomas are seen in the kidneys of of the anus. If a fistula into the vagina is
SACs. They are highly malignant and will involved surgery may be delayed until the
metastasize not only locally but to other cria is older as it will be more complicated.
organs throughout the body. Atresia recti cannot be left. Animals will need
to be humanely destroyed or complicated
surgery will need to be undertaken.
Congenital and Hereditary
Conditions in SACs
Cardiac abnormalities
Introduction
These are not common but appear to be more
These conditions are common not only in the common in SACs compared with the num-
Andes but also in countries that have imported bers in other domestic farm animals. The
SACs. The gene pool is small in both situa- most common are septal and valve defects.
tions as travelling in the Andes is not easy Heart murmurs in neonatal SACs should be
(Cubero et al., 2002). In fact SACs have the noted and investigated with ultrasonography
highest incidence of newborn with congeni- at a later date. It is not advisable to breed from
tal/genetic defects of any domesticated ani- a male with a heart murmur. Arrhythmias
mals. Failing absolute proof, if the incidence will be heard in stressed animals, which may
of the condition seems unusually high as well not be evident when the animal is less
compared to other species, the chances are it stressed. Three-chambered hearts have been
is genetic. Clinicians should advise clients recorded. Patent ductus arteriosus and a per-
that just because a breeding pair produces a sistent truncus arteriosus will often explain
congenital abnormality they do not have to weak crias.
stop breeding them, as any breeding pair
might produce a congenital abnormality.
However, if either or both are again involved
in producing the same abnormality chances Choanal atresia
are it is genetic and culling should be consid-
ered. The main reason why genetic abnormal- Non-patency of the choanae can be bilateral or
ities are likely to be high in SACs is because unilateral. The former will result in the cria
the gene pool was nearly annihilated by the mouth breathing and has a hopeless prognosis
invading Spaniards. Also the numbers and so euthanasia is advised. Unilateral cases
exported to the USA, Europe and Australia can survive, but as the condition is very likely
has not been large. There are 71 known defects to be inherited animals should not be bred
(see Table 11.1) (Johnson, 2009). A further fac- from. It can be differentiated from a cleft palate
tor is phenotypic inbreeding prompted by the by visually looking in the mouth and also
show ring or fibre quality resulting in further because milk comes down the nose when a
126 Chapter 11

Table 11.1. All the congenital and hereditary conditions seen in SACs.

System Defect Occurrence Comments

Muscular Umbilical hernia Common Genetic and possibly


acquired
Muscular Inguinal hernia Rare Genetic and possibly
acquired
Muscular Diaphragmatic hernia Rare Likely acquired at parturition
but ?
Muscular Schistosomas reflexus Rare Unknown, usually combined
with arthrogryphosis
Reproductive female Segmental aplasia Common Genetic/and occurring at all
levels
Reproductive female Uterus unicornis Occasional Genetic; most commonly
missing is the right horn
Reproductive female Double cervix Occasional Genetic
Reproductive female Cervical agenesis Rare Likely genetic
Reproductive female Imperforate hymen Occasional Genetic/should be thin tissue
Reproductive female Fusion of the vulval lips Rare Genetic
Reproductive female Ovarian hypoplasia Occasional Genetic
Reproductive female Ovarian aplasia Rare Genetic
Reproductive female Free Martin Occasional Associated with mixed sex
twins usually resulting in
agenesis of the female tract
Reproductive female Intersex Occasional Likely genetic but ?
Reproductive male Hypogonadism Common Genetic
Reproductive male Ectopic testicle Occasional Genetic/located along
prepuce
Reproductive male Cryptorchidism Occasional Genetic
Reproductive male Crooked penis Rare Genetic?/may be acquired
Reproductive male Penile hypoplasia Rare Genetic
Reproductive male Persistent frenulum Occasional Genetic?
Reproductive male Hydrocele Occasional Genetic?
Skeletal limbs Angular deformities Common Genetic/nutritional/uterine
positioning?
Skeletal limbs Patella luxation Occasional Genetic if en utero/dystocia
induced?
Skeletal limbs Carpal ankylosis Rare Genetic/uterine positioning?
Skeletal limbs Arthrogryphosis Rare Genetic/teratogenic
Skeletal limbs Scoliosis Rare Unknown
Skeletal limbs Talus rotation Occasional Genetic
Skeletal limbs Polydactyla Occasional Genetic
Skeletal limbs Syndactyla Occasional Genetic
Skeletal limbs Tail agenesis Occasional Genetic
Skeletal limbs Crooked tail Occasional Genetic
Skeletal limbs Hemivertebra Rare Genetic
Skeletal limbs Contracted tendons Occasional Unknown/nutrition/uterine
positioning?
Skeletal limbs Tendon laxity Occasional Unknown/nutrition/
prematurity?
Skeletal head and face Choanal atresia (CA) Common Genetic, based on high
incidence
Skeletal head and face Campylognathia Common Genetic and related to CA?
(Wry face)
Skeletal head and face Cyclopia Rare Teratogenic/genetic
Skeletal head and face Cleft palate Occasional Genetic
Medicine and Surgery of the Urino-Genital System 127

Table 11.1. Continued.

System Defect Occurrence Comments

Skeletal head and face Brachynathism Common Genetic


Prognathism
Skeletal head and face Retained deciduous Common Developmental
teeth
Nervous Arhinencephaly Common Genetic/associated with CA
Nervous Cerebellar hypoplasia Rare Genetic/BVD?
Nervous Hydrocephalus Rare Genetic?
Nervous Intention tremor Rare CNS anoxia/BVD?
Nervous Hypermetria Rare CNS anoxia/BVD?
Digestive Atresia ani Occasional Genetic/teratogenic?
Digestive Atresia coli Rare Genetic/teratogenic?
Digestive Mega-oesophagus Occasional Likely acquired but?
Integumentary Ichthyosis Rare Genetic/conjunctivitis
Integumentary Epitheliogenesis Rare Genetic
imperfecta
Integumentary Crooked toenails Occasional Genetic
Integumentary Supernumerary teats Occasional Genetic
Integumentary Teat agenesis Occasional Genetic
Cardiovascular Ventricular septal Common Genetic
Cardiovascular Atrial septal Occasional Unknown
Cardiovascular Ductus arteriosus Occasional Unknown
Cardiovascular Tetralogy of Fallot Rare Unknown
Cardiovascular Persistent right aortic Rare Unknown
arch
Cardiovascular Transplantation of Rare Unknown
great vessels
Urinary Cystic kidney Occasional Genetic?
Urinary Renal agenesis Occasional Genetic/associated with
gonadal agenesis
Urinary Persistent urachus Occasional Likely acquired but?
Eyes Cataracts Occasional Genetic if at birth
Eyes Entropion Rare Genetic
Eyes Ectropion Rare Unknown
Eyes Blue eyes Common Genetic/associated with
deafness
Eyes Blindness Occasional Dysmaturity or unknown
Eyes Blocked nasolachrymal Common Genetic if at birth but ?
duct
Ears Gopher ears Occasional Genetic/frozen?
Ears Crossbred ears Occasional Huarizo
Body as a whole Dwarfs Rare but Genetic
increasing

cria, with a cleft palate, sucks. This does not eye animals may be deaf but this is difficult to
happen in choanal atresia. ascertain. Congenital cataracts are recorded.
Blocked tear ducts are relatively common.
The normal site for the blockage is near the
nasal puncta. Under general anaesthetic a
External abnormalities piece of nylon suture material can be pushed
down the tear duct from the eye and then
These are rarely life threatening but should be can be felt at the nasal puncta. The suture
recorded. Ears may be fused or short. Blue material should then be grasped and a very
128 Chapter 11

small incision made to allow it to be exteri- Fusion of the vulval lips


orized. It should be left in situ for 10 days to
prevent refusion. Practitioners when carrying This is quite a common finding (Fig. 11.3). If it
out pre-purchase examinations are warned is total it will be observed after 48 h as a fluid-
about persistent papillary membranes. This is filled swelling below the anus. A small bleb of
an extremely rare defect. Fused toes or even local anaesthetic should be inserted over the
extra toes are seen (see Fig. 11.1). Absence of position where the vulva should be (see
toes and leg deformities are seen (Fig. 11.2). Fig. 11.4). Then an incision should be made
Luxating patellas are seen and carry a poor with a scalpel. Urine will pour out. The inci-
prognosis as surgery is unlikely to be success- sion may have to be enlarged slightly with a
ful. Undershot jaws are relatively common as pair of straight scissors. Suturing is not
opposed to overshot jaws, which are rare. required. Often the labial fusion is not com-
Wry nose is also extremely rare. Short or plete so that urine will be seen to come out of a
crooked tails are not that rare. Scoliosis, small hole in a thin stream. Occasionally the
kyphosis and lordosis all occur. Extra teats condition will not be observed until the first
are rare. Testicular hypoplasia is reported as mating. The correction is similar to that carried
are rigs, but both conditions are rare. out in neonates.

Genetic female abnormalities

Because of inbreeding in the past both in South


America and in other countries where SACs
are kept there seems to be a large number of
genetic female abnormalities. These include:
True hermaphroditism;
Segmental aplasia;
Hypoplastic gonads;
Uterus unicornis;
Persistent hymen;
Double cervix;
Fig. 11.1. Extra toes are seen. Vaginal stricture.

Medical Conditions of the


Reproductive System

Acquired infertility in females

There is often a very short length of time


between parturition and subsequent mating,
so any problems are significant. Vaginal infec-
tions as a result of trauma at parturition will
require aggressive antibiotic treatment.
Penicillin is the antibiotic of choice. Metritis
cases may require antibiotics both parenter-
ally and dissolved in warm sterile isotonic
saline as a uterine wash. After such wash
Fig. 11.2. Leg deformities. outs, 20 IU oxytocin should be injected
Medicine and Surgery of the Urino-Genital System 129

Fig. 11.3. Labial fusion of the vulva.

Fig. 11.4. A small bleb of local anaesthetic should be inserted over the position where the vulva should be.

intramuscularly. Sexual rest should be advised adhesions rendering that ovary unable to
with small doses of prostaglandin given by deliver eggs.
intramuscular injection.
Cystic ovaries are very rarely seen on
ultrasonography. They should be treated
with GnRH injections not only before Causes of abortion
mating but after service. Manual popping
of cysts should be avoided on account of As in all species the cause of abortions is
the danger of trauma to the rectum and of rarely diagnosed and so most spontaneous
possible haemorrhage from the ovary. The abortions are thought to be non-infectious.
later can be life threatening or can lead to Twins definitely play a part as they only
130 Chapter 11

extremely rarely come to term. Other causes are seen mainly in the first pregnancy.
may be: Prophylactic antibiotics do not seem to
be helpful. The best diagnostic tools are
Thermal stress; a PCR and an ELISA. The complement
Physiological stress; fixation test is unreliable);
Anaphylaxis; Toxoplasmosis (this condition is
Allergies; extremely rare in SACs. However, there
High dietary levels of toxic chemicals, is a fairly long window during preg-
e.g. nitrates, selenium and arsenic; nancy when the SAC dam can become
Deficiencies of vitamins A or E, copper, infected. Infection occurs from cat fae-
iodine or selenium; ces on the food. Up to 2 months of preg-
Various poisonous plants (see Chapter 16). nancy the SAC will appear to have
The most notable is the ponderosa pine absorbed the fetus and be barren, but
Pinus ponderosa. The needles whether from then on until the tenth month of
fresh or dry have definitely been indi- pregnancy the dam will either abort or
cated as a cause of abortion; have a stillborn full-term cria) (Buxton,
Clostridial disease vaccination (this has 1989).
also been implicated in abortion in sheep.
However, it is thought in sheep to be due The following organisms are likely to cause
to the stress of handling rather than the abortions in SACs but as yet there have been
vaccine itself. This may well be the case no published isolates in the UK:
in SACs). Blue tongue virus;
A list of infectious causes of abortion might Brucellosis spp.;
well include: Salmonella spp.;
Listeria monocytogenes;
Campylobacter foetus foetus (this organism Infectious bovine rhinotracheitis (IBR);
will cause abortions, stillbirths and weak Bovine virus diarrhoea (BVD) (this has
crias. The placentitis is easily seen); been widely reported in the USA. The
Chlamydiphilosis (this organism is rare virus can be readily found in the saliva
in SACs; it will cause abortions in late and in the salivary glands. Antibody posi-
pregnancy. In contact female SACs could tive animals are readily found in infected
be given a long acting dose of oxytetracy- herds with occasional persistently infec-
cline to try to limit the number of abor- tive (PI) crias being seen. These are defined
tions and reduce the excretion of as virus positive but antibody negative
organisms); despite repeated tests. These crias may be
Escherichia coli (this organism has been slightly underweight and woolly looking
isolated in pure culture from SAC aborted but are impossible to definitely detect
fetuses); clinically. Some PCR-positive animals
Leptospirosis (L. harjo of cattle origin have become positive only at 15 weeks of
has been isolated from SAC aborted age. This implies that it is possible that not
fetuses); all animals identified as PIs are persist-
Q fever (this has been diagnosed in ently infected, but instead are slowly
SACs in the UK and elsewhere in the developing an antibody response and
world but not in New Zealand. The combating the disease. True PIs may show
organism is shed intermittently in the reduced growth rate and be prone to
milk, faeces, vagina and placenta. The infections or sudden death. In the USA
latter has a gritty feel. There are abor- the virus in SACs is related to diarrhoea
tions normally within 6 weeks of the but in the UK respiratory signs are more
expected parturition date. There are common);
stillbirths and weak crias. The organism Equine herpes virus 1 (EHV1) (this has
can stay in the environment for a con- only been isolated when there is very
siderable length of time. The problems close proximity to equines).
Medicine and Surgery of the Urino-Genital System 131

Clinicians should be aware that infectious Male infertility


abortion is very rare and therefore animals
should not be vaccinated unless the cause is The majority of infertility cases in male SACs
proven and the owners have signed a dis- are actually immaturity rather than infertility.
claimer. Blue tongue virus vaccination No SAC should be said to be infertile or even
caused some concern in the UK but no vac- sub-fertile until it is over 3 years of age. Sperm
cination reactions have been implicated. needs to mature in the male so that although
Obviously owners should be counselled in there is adequate libido and intromission
any SAC abortion of the danger to other takes place pregnancy does not necessarily
SACs, other species and to humans. follow. However, given a few more months
However, a large number of abortions are such males will become fertile.
unlikely. Whole fetuses and some mem- There are certain physical congenital
branes should be submitted to a laboratory. problems that will cause infertility in
Paired serum samples should be taken from unproven males:
the dam.
Persistent frenulum;
Corkscrew penis;
Preputial stricture;
Embryonic death Hypospadia;
Hypoplastic testicles;
Causes are largely unknown, but these are Cystic testicles.
some of the considered likely reasons for
embryonic deaths: There are other physical problems that will
cause infertility in previously fertile males:
Polyspermia;
Gamete ageing; Preputial tears;
Infection (there is no recognized bacte- Scarring strictures;
ria but streptococci, staphylococci, colif- Haematomas;
orms, Clostridia, Actinobacillus pyogenes, Adhesions.
Peptostreptoccus spp. and Bacteroides spp.
Heat stress and diseases causing pyrexia
have been isolated);
will cause transitory infertility for some
Endocrine imbalance (this may be an
weeks but fertility normally returns after
oestrogen/progesterone imbalance);
3 months.
Stress of lactation (this may be because of
When clinicians are asked to evaluate a
too early post-partum breeding);
stud male for infertility they should carry out
Poor nutrition (this is unlikely; however,
a full clinical examination and record a his-
mouldy feedstuffs or feedstuffs with a high
tory not only of the breeding records but also
oestrogenic activity may be responsible);
any history of illness, stress, movement etc.
Age or more likely parity;
Then the mating behaviour should be
Uterine crowding (twins are extremely
observed, including libido, mounting,
rare in SACs);
intromission and ejaculation. Post-breeding
Thermal stress;
observations are important regarding dis-
Physiological stress;
charges from the prepuce or from the vulva.
Genetic incompatibility;
Breeding records of frequency of services,
Immunological incompatibility.
duration of service and records of abnormal
In sheep and goats approximately only 25% behaviour should be studied as well as the
of embryos are lost. A larger percentage pregnancy rates.
is expected to be lost in SACs. However, Practitioners may have to resort to a short
there is approximately a 50% loss in embryos intramuscular anaesthetic (see Chapter 8)
in alpacas in Peru. This loss needs to be for a detailed physical examination of the
investigated, as such a large loss is not penis. The most common cause of infertility is
acceptable. the inability to extend the penis because of
132 Chapter 11

trauma and lacerations to the prepuce and thanks to successful collection and transfer of
the glans penis. SAC embryos, excellent herd health and
Obviously during this anaesthesia elec- reproductive management of the donor,
troejaculation can be carried out to assess recipient, and the male.
the semen quantity and quality. If this is Males need to be over 2.5 years of age as
unsuccessful another means can be used at a before this the sheath may adhere to the
later date, e.g. an artificial vagina or intrav- glands. Males have a prostate and a pair of
aginal condom or just vaginal retrieval. bulbo-urethral glands but no vesibular gland.
None of these methods is consistent and Testicles should be approximately 6 3 cm.
therefore observations on the semen can The penis is a fibroelastic type with a sigmoid
only give a picture, not a definitive result. flexure, which when extended measures
Evaluation of viscosity and motility is approximately 40 cm. Half of this length (i.e.
extremely difficult. At least 50% of individ- 20 cm) is beyond the prepuce. When relaxed
ual spermatozoa may be motile and yet the penis points caudally. It has a very short
there will be no overall motility. Probably cartilaginous process.
the best assessment will be from individual There are the following methods of
spermatozoa. At least 50% should be normal semen collection:
after staining. Clinicians should be aware
Electroejaculation;
that occasional elliptical shaped red blood
Intravaginal device (condom, sac or
cells will be present as contaminants and
sponge);
these may give the impression of spermato-
Vaginal aspiration;
zoa with no tails.
Artificial vagina;
Hormone values (e.g. testosterone) can
Surgically from the male reproductive
be monitored on a daily basis. One single
tract (normally from the epididymis).
sample will be of no relevance. Figures are
available for the effect of gonadotropin- Electroejaculation is only carried out under
releasing hormone (GnRH) on levels of lutei- general anaesthesia using intramuscular
nizing hormone and follicle stimulating ketamine, xylazine and butorphanol (see
hormone in male SACs, which can be tried Chapter 8). However, there is actually no
when all other avenues have been exhausted. need for this as electroejaculation has been
Testicular biopsy and epididymal aspirates carried out in the bull and the ram by the
are very invasive and controversial tech- author without any ill effect. Welfare consid-
niques and should be avoided. erations have been studied carefully and
It should always be remembered that although the animals appear to be distressed
mating in SACs is a drawn-out affair. Semen they readily accept further ejaculations.
volume is low and so are sperm counts. There Electrical stimulation can be carried out with
is no storage of semen and so males should a well lubricated 12 V ram electroejaculator.
not be used more than twice daily. The success rate is variable and could not be
used for routine semen collection. Obviously
this method gives no indication of the mating
ability or the libido.
Semen collection The use of an artificial vagina is a much
simpler method, particularly with trained
There were problems that limited the wide males. Males, particularly animals with a
use of artificial insemination (AI) in SACs. high libido, only require two or three training
These included inadequate methods of semen sessions with a receptive female on hand to
collection, poor post-ejaculation spermatozoa be trained. However, certain males will not
motility and lack of standard technique for accept the artificial vagina. This method does
freezing semen. These have largely been over- give some indication of libido and mating
come. Good pregnancy rates are now being ability. It can be carried out regularly by one
obtained in several centres in several coun- person and the quality of the semen is not
tries. Embryo transfer has also been perfected influenced.
Medicine and Surgery of the Urino-Genital System 133

Semen can be used for AI and conserva- standard sheep trailer with its rear end
tion as well as assessment of sperm morphol- pushed up to the jockey door. It will then be
ogy and concentration. in the kush position with its body 75 cm
above the ground. The scrotum is cleaned
with chlorohexidine. A volume of 5 ml of local
Ovarian tumours anaesthetic is injected in a line along the scro-
tum and into the cord over each testicle. The
animal is injected with antibiotics, NSAIDs
These will occur and are normally related to
and tetanus antitoxin (TAT). This can be given
lymphosarcomas throughout the abdomen.
on a weight basis but it is sensible to give half
However, dysgerminomas occur extremely
the equine dose of TAT. After further clean-
rarely. They will be seen on ultrasonography.
ing, the scrotum is incised over the testicle.
They can be confirmed on laparotomy with
An open castration technique is performed in
removal possible but difficult. Teratomas are
a similar manner to that carried out on calves.
found on the ovaries of young adult animals,
The testicle is pulled and twisted so that the
which on ultrasound will look like ovarian
cord is severed by tension high up in the
abscesses. Removal by either a flank or mid-
abdomen (see Fig. 11.5). Any scrotal fat which
line approach is possible but difficult.
is present is also removed. The area is sprayed
with an antibiotic spray after the second testi-
cle has been removed. The animal is allow to
Tumours of the genital tract rise and kept out at pasture. If the surgery is
performed during the fly season fly repel-
These are rare but more common than in other lents are applied.
farm animals. Primary uterine adenocarci- In certain situations it may be preferable
noma, leiomyosarcoma and trophoblastoma to perform a close method under a general
have been diagnosed. As with ovarian anaesthetic. This can be performed under a
tumours, lymphosarcomas will invade the xylazine/ketamine combination injected
genital tract.

Surgical Conditions of the Reproductive


System of the Male South American
Camelid

Normal castration

The testicles are present in the scrotum at


birth, and therefore the option of castration
before sexual maturity is possible, and indeed
castration is vital in hand-raised crias in order
to prevent those becoming aggressive,
imprinted adults. However, SAC owners are
reluctant to castrate animals below the age of
18 months because they perceive that animal
will not mature to its full potential.
Practitioners are therefore normally asked to
castrate animals between 18 months and 3
years of age.
The simplest method of castration is an
open method performed under local anaes-
thesia. The animal is restrained ideally in a Fig. 11.5. Pulling and twisting the testicle.
134 Chapter 11

intramuscularly (see Chapter 8). The animal vital that the practitioner records the testicle
should be placed in dorsal recumbency with that has been removed. Then a rig test can be
the hindlegs drawn forwards, which allows performed. If that is negative all is well. If it is
good access to the site. After standard pre- positive then a further general anaesthetic
surgical preparation a closed castration is must be given and the abdominal testicle
performed through a single incision in the must be located and removed.
midline raphe, just cranial to the scrotum, There are three possible approaches for
large enough to allow the testicles to be this search. The standard midline approach in
squeezed through. The penis should be pal- dorsal recumbency is not recommended as it
pated to avoid exteriorization or accidental is difficult to make the incision caudal enough
incision, and the testicle is pulled through the to follow the gubernaculums to the kidney.
incision and sufficient tension applied to A flank incision also has this disadvantage as
expose as much of the spermatic cord and fat well as causing damage to the fleece, which
as possible. A large pair of artery forceps is may not be acceptable in show animals. The
applied as high up the spermatic cord as pos- paramedian approach is recommended by
sible near to the inguinal ring. A transfixing the author as this allows a good enough
ligature of 0 Polyglactin is applied above approach caudally. The closure of the abdo-
the forceps. The cord is then severed distal to men is also more secure than a midline
the forceps. This is repeated for the second approach. An approach through the inguinal
testicle. The wound is then closed with a sub- ring should not be attempted on account of
cuticular layer of continuous suture of 0 the difficulty in closure and the danger of
Polyglactin. herniation.
The future may well be a laparoscopic
approach. However, this is outside the
authors experience.
Castration of animals with
a retained testicle
Rig test
Before any attempt at surgery is contemplated
a very thorough examination of the whole
This should only be performed if there is no
inguinal area should be carried out. Clinicians
testicle palpable on either side. A blood sam-
will often be surprised at the strange posi-
ple is taken to give a baseline level of testo-
tions of testicles that are outside the scrotum
sterone. The animal is stimulated to produce
but are also outside the abdomen and under
testosterone by either an injection of 750 IU of
the skin. Surgery on these animals is rela-
human chorionic gonadotropin or 10 mg of
tively easy. However, surgery of rigs is not so
GnRH. Two further blood samples are then
easy The left testicle is more commonly
taken at 30 and 120 min. A cryptorchid is
retained than the right. Luckily the condition
likely to show some basal level of testoster-
is very rare. The testicle is normally intra-
one but will normally respond with a mini-
abdominal. It is rarely visualized on ultra-
mum of a twofold increase from the baseline
sound. If there are adhesions over the scrotum
level in 30 min (the 120-min sample can then
the practitioner cannot be certain whether the
be discarded). A fully castrated male is likely
testicle has been removed or if there has been
to have a negative baseline level of testoster-
an abortive attempt at removal. The scar
one, which will show no increase after 30 or
should be examined carefully under general
120 min.
anaesthetic. If the scar is only skin deep the
inguinal ring needs to be investigated. If a
testicle is located it should be removed as well
as the testicle in the scrotum. If it cannot be Hormonal castration
found the practitioner has a dilemma. The
scrotal testicle can be removed and the animal This has been attempted using canine gona-
can be left for a minimum of 1 month. It is dotropin releasing factor. Although there was
Medicine and Surgery of the Urino-Genital System 135

a temporary reduction in testosterone con- early as 10 days post-ovulation. Uterine con-


centrations and testicular width the overall tractibility and embryo motility can be
conclusion was that the response was incon- observed up to 35 days.
sistent and short-lived. There was no evi-
dence of meaningful reduction in sperm Pregnancy diagnosis
production.
There are dangers in carrying out rectal preg-
nancy diagnosis using a rigid guide for the
Surgical Conditions of the Reproductive rectal probe. However, it can be carried out at
30 days post-service. In the UK the Veterinary
System of the Female SAC
Defence Society (VDS) do not advise the prac-
tice, having lost a test case in the courts. It is
Ovariectomy safer to delay pregnancy diagnosis until 60
days when it can be performed trans-
The indications of ovariectomy in SACs abdominally using a 3 MHz probe. After
include prevention of pregnancy, to treat 90 days a 5 MHz probe is more useful.
ovarian tumours and to provide jump Lubricant can be used but most operatives
females for semen collection. The method of prefer iso-propyl alcohol as this is much less
choice for ovariectomy would appear to be messy. Surgical spirit should not be used as
laparoscopically through a ventral abdominal this will damage the probe.
(Rodgerson et al., 1998). This was easily The probe should be pressed firmly high
accomplished and led to no complications on up in the inguinal region (see Fig. 11.6). The
an 18-month follow up. left or right side may be used at this stage.
After locating the bladder the uterine bifurca-
tion should be visualized. The skull can be
Reproductive ultrasonography seen in a pregnant animal but the veterbrae
will not be seen until 67 days. By 83 days the
Early pregnancy events skull can be measured and the ribcage can be
seen. Twins are extremely rare. However, they
The corpus luteum is first visible trans- can reach maturity and be viable.
rectally at 6 days post-breeding, i.e. 4 days If trans-rectal ultrasonography is used
post-ovulation. The initial diameter is 810 mm, the normal non-pregnant uterus will appear
which will increase to 1314 mm 20 days post- as mid-echogenic dense tissue with no fluid
ovulation. The conceptus may be visible as and an indistinct lumen. The uterus in a case

Fig. 11.6. The probe in the inguinal region.


136 Chapter 11

of mucometra, usually caused by a persist- Uterine cysts are much more common
ent hymen, will be fluid filled without mem- than uterine tumours. Differentiation is dif-
brane folds or a fetus. It will have a snowy ficult. Animals will get pregnant with a
appearance. A pyometra will have a thick uterine cyst in the wall of the uterus. Ovarian
uterine wall without membrane folds or a cysts are much more common than ovarian
fetus. It will have a cloudy appearance. abscesses. Differentiation on scan is diffi-
A heartbeat should be visible from day 25. cult. Size is the only differential between a
The cross-sectional horn diameter will be follicle and a cyst. A female with a follicle in
810 cm at 60 days. Fetal loss is high. Fertilization excess of 4 mm in diameter is worth mating.
rates are high with 85% of ovulating females A follicle up to 13 mm might be normal.
having an egg fertilized. Only 50% of embryos Mating should be carried out with an injec-
survive after 30 days. About 10% of confirmed tion of GnRH given 30 h after service. If the
pregnancies are lost up to day 45. The normal follicle/cyst is still present after 10 days it is
abortion rate is around 5%. likely to be a cyst. Mating again should be
Pregnancy can also be confirmed with a carried out with 1500 IU of chorionic gona-
progesterone assay. Ideally blood should be dotropin given intravenously on the day of
collected 20 days after breeding and again 30 service.
days after breeding. Any value over 1 ng/ml Practitioners should be aware that in rare
on both occasions is likely to be positive. cases pregnancy will be achieved with a cyst
on one ovary. Also, rarely females will accept
Infertility investigation the male when pregnant.

This has to be carried out per rectum.


However, it is prudent for practitioners to
require owners to sign a disclaimer. The Prolapse of the vagina
probe should be inserted into the rectum
using plenty of lubricant. Unless the animal This is an extremely rare condition but it will
has just urinated the bladder should be eas- occur not only in the pregnant SAC but also
ily located as a fluid-filled ball. Moving in the non-pregnant animal. Initially the
slightly more cranially the body of the uterus pink mucosa of the vagina may be noticed
should be visualized. Rotation of the probe protruding slightly between the lips of the
will reveal the horns. In maidens the uterus vulva in a animal lying down, only to disap-
is just above the bladder. However, in older pear from view when she stands up. Later
animals it will be more cranial. The normal the vagina fails to return to its normal posi-
diameter of the uterine horn of a maiden tion when the animal stands and the pro-
SAC is between 25 mm and 30 mm. A diam- lapse progresses until the vagina is
eter of 20 mm would indicate immaturity completely everted and the cervix is visible.
and would not necessarily indicate hypopla- Initially the vaginal mucosa is pink, moist
sia unless the animal was over 3 years old. and smooth but, if not treated, the vagina
The normal ovaries should be round. Ovarian becomes swollen, oedematous and con-
hypoplasia is very difficult to evaluate on a gested. It is very susceptible to injury. After
scan. It is easier to take a blood sample 5 days prolonged exposure, the dried vaginal
post-mating to measure progesterone levels. mucosa becomes rough and haemorrhagic.
This can be repeated in another 5 days for The animal is now constantly straining as
further confirmation. In maidens the most the urethra is kinked and the bladder is full
common abnormality is either a persistent and may even lie inside the prolapse. Trauma
hymen or vaginal aplasia. Both of these con- at this stage may lead to vaginal rupture,
ditions will be seen on ultrasound as a muco- prolapsed bowel and death.
metra. Surgical correction of a persistent All vaginal prolapses should be treated.
hymen is relatively straightforward with a With the animal in the kush position a sac-
duck-billed speculum. However, vaginal rococcygeal epidural anaesthetic should be
aplasia cannot be corrected. administered (see Chapter 8). In the pregnant
Medicine and Surgery of the Urino-Genital System 137

animal, after replacing the vagina and cervix underneath it. The afterbirth should be
the lips of the vulva should be sutured with removed and the organ should be cleaned
a single Buhner suture of uterine tape. with warm very dilute chlorohexidine solu-
A long Seton needle is inserted into the skin tion. An epidural anaesthetic should be given
at the ventral end of the vulva. It is pushed together with antibiotics and NSAIDs. The
carefully in a dorsal direction subcutane- organ should be replaced into position. This
ously and slightly laterally to emerge ventral is normally relatively easy to accomplish.
to the anus. The tape is treaded and with- It is vital that the uterus is totally returned to
drawn. This is repeated for the other side of its normal state. Then 30 IU oxytocin should
the vulva. The two ends are tied with a bow be given intramuscularly. The author favours
so only two fingers can be inserted into the using a Buhner suture as described for vag-
vulva. The owner is advised to untie the bow inal prolapse (see above). However, in theory
but not remove the suture if the animal is if the uterus has been correctly placed this
thought to be parturient. If this is the case should not be necessary. Antibiotics and
the cria can be drawn and the suture removed NSAIDs should be continued for 5 days.
as the condition should not reoccur in the Irrigation with 2 l warm isotonic saline twice
non-pregnant animal. However, if the cervix during this period is beneficial. Further oxy-
is closed and the animal is not parturient tocin should be given after each irrigation.
then the suture should be re-tied as the con- There is no evidence available to give advice
dition will reoccur until parturition has on the likelihood of a reoccurrence at a subse-
occurred. The animal should not be bred quent pregnancy. However, prudence sug-
from as the condition will reoccur at a subse- gests further pregnancies would be unwise.
quent pregnancy.
If the condition occurs in the non-pregnant
animal the prognosis is guarded. Under
epidural anaesthesia the vagina should be Normal Parturition
cleaned and replaced and then a Caslicks
operation as in the mare should be per- Dystocia in SACs is relatively uncommon
formed. A strip of mucosa should be with less than 5% requiring any assistance.
removed from both sides of the vulva Dystocia may be defined as failure of transi-
including the dorsal end. The lips should tion from stage 1 to stage 2 of labour or when
then be sutured with single interrupted little or no progress is made for 30 min or
sutures of monofilament nylon. A small ori- more after the start of stage 2 of labour. Stage
fice should be left at the ventral end of the 1 of labour for a veteran female will not last
vulva to allow for urination. The animal more than 46 h but may last for up to 24 h in
should be given antibiotic cover and pain a maiden.
relief with NSAIDs for 10 days, when the Normal delivery occurs from the stand-
sutures can be removed. ing position between dawn and noon
(Fig. 11.7). Before parturition the dam makes
no effort to leave the herd. The dam tends to
show little in the way of mothering behaviour
Prolapse of the uterus while being watched but can be surprisingly
aggressive if she thinks the cria is being
This condition is rare. It will occur immedi- threatened (Fig. 11.8). Spring-born crias in the
ately after parturition and should be treated northern hemisphere are stronger, grow faster
as a real emergency. Normally the animal and have fewer hypovitaminosis D problems.
will be in the kush position. She should be The reverse is the norm in the southern hemi-
allowed to remain in that position. It is sphere. Supervision should not be too intense
important than no attempt is made to stretch or the mother will become distracted.
out her hindlegs as is advocated in cows. However, it is important that the cria suckles
This is very painful for SACs. The uterus as soon as possible as the cria needs to con-
should be protected with a clean sheet sume 10% of its body weight of colostrum
138 Chapter 11

Fig. 11.7. Normal parturition.

Fig. 11.8. Mothering behaviour.

within the first 24 h. Most crias will get up if the weather is bad or if a maiden is being
and be steady on their legs within 2 h. Equally crowded out by curious older females. The
the placenta is normally shed in 2 h. Some placenta is not consumed in SACs.
mothers are reluctant to allow the cria to The navel of the cria should be dressed
suckle until the third stage of labour, i.e. void- only after 2 h if the parturition has been unas-
ing of the placenta has been completed. sisted. Iodine or tetracycline spray should be
Owners should not interfere with crias in this used. If the cria has not been seen to suck after
time if possible (Fig. 11.9). An injection of 10 2 h the mammary gland should be checked
IU oxytocin may be given at this time subcu- for mastitis. The wax plugs are normal and
taneously. Normally a placenta is said to be should be left in situ. They will act as an indi-
retained if it has not been shed in 6 h (see cator that each individual teat has been
below). Owners should interfere before 2 h sucked. The meconium should be passed in
Medicine and Surgery of the Urino-Genital System 139

Fig. 11.9. Owners should not interfere too early.

36 h. If not, the cria should be given an enema. The pelvis is too small to allow a hand to
There are several human preparations freely be introduced to manipulate the fetus;
available. The uterus has insufficient room to grasp
SACs have a very small milk cistern for and manipulate the fetus;
each teat so that frequent sucking is required. There is insufficient room for a fetotomy
This is normal and does not necessarily mean to be performed on a dead fetus.
a female does not have enough milk. It is nor-
mal for the cria to keep moving between teats. The most common cause of dystocia is fetal
Sucking is good for the dam as it will stimu- malpositioning. Relative fetal oversize is an
late the production of endogenous oxytocin, extremely rare occurrence. Poor cervical dila-
which will aid uterine involution. Exogenous tion similar to ring womb in sheep is also
oxytocin can be given in small doses (i.e. 10 extremely rare. Pelvic problems (e.g. frac-
IU) to aid milk let-down. There is a drug don- tures, tumours and abscesses) can cause
peridone that is available in paste form in the problems.
USA and tablet form in the UK. The dose is
1 mg/kg orally.
Uterine torsion

Dystocia Uterine torsion, which is actually torsion of


the anterior of the anterior vagina, will occur.
General It is much more common in SACs than in
sheep. This should be corrected by rolling. At
least three people will be required (Fig.11.10).
As with all species the decision to treat the
The animal should be rolled in the direction
dystocia per vagina or by Caesarean section
of the twist and allowed to get up immedi-
can be difficult even for experienced clini-
ately. If the twist has been corrected but the
cians. These are guidelines for when a
cervix is only partially dilated the practitioner
Caesarean section should be carried out:
should not delay but apply traction after
If the cervix is inadequately dilated or making sure the fetus is in the correct posi-
the pelvis is of an inadequate size to tion. This traction will naturally dilate the
extract the fetus; cervix. If the practitioner delays the cervix
140 Chapter 11

Fig. 11.10. At least three people are required to roll a SAC.

will become indurated and fail to dilate and doe. Removal with 30 IU oxytocin given intra-
Caesarean section will have to be performed. muscularly should be attempted within 6 h of
Uterine torsion can also occur in the last parturition. Antibiotics and NSAIDs should
third of pregnancy and not at parturition, as also be given. If the placenta is still in situ in a
in the mare. This is a true torsion of the body further 6 h uterine irrigation and more oxy-
of the uterus and not the anterior vagina. tocin should be given. This should be repeated
Diagnosis is difficult as it is inadvisable to in a further 6 h. Gentle traction will then nor-
perform a rectal examination. The presenting mally accomplish removal.
sign will be colic. As most SACs are very stoi-
cal this will not be very violent. However, in
any cases of colic in pregnant animals well on Embryotomy
in their pregnancy uterine torsion should be
suspected.
In cases where the cria is putrid and rotten,
Rolling could be tried in an ad hoc man-
the vagina will be dry and swollen. The cria
ner. The most likely direction is clockwise, so
will be emphysematous and cannot be deliv-
this should be tried first. The animal should
ered per vagina. Caesarean section carries a
be allowed to stand for 10 min to access any
very poor prognosis and therefore a decision
improvement in pulse rate and pain. If there
is likely to be made to destroy the animal on
is no improvement rolling in the opposite
welfare grounds unless a simple embryotomy
direction should be tried. Failing improve-
can be performed.
ment a left flank laparotomy should be car-
The animal should be given antibiotics
ried out to ascertain a diagnosis. If there is
and NSAIDs. Her tetanus status must be
torsion of the spiral colon this will not be
checked. If the cria is in anterior presentation,
effected by rolling but it will be discovered
using a large amount of obstetrical lubricant
promptly. Obviously if there is a uterine tor-
or J lube a rope should be put around one
sion it should be corrected, leaving the fetus
carpus and the leg should be drawn out as far
in situ to come to term.
as possible. An incision should be made with
a scalpel on the medial side of the leg to allow
insertion of a disposable embryotomy knife.
Retained placenta The knife should be put up as far as possible
to cut the skin up into the axilla and if possi-
As the SAC has a diffuse placenta this rare ble over the shoulder joint up to the top of the
condition is more acute than in the ewe or scapular. All the attachments of the shoulder
Medicine and Surgery of the Urino-Genital System 141

blade to the chest wall should be broken ventral midline laparotomy. Clinicians should
down with an outstretched hand pulling the use whichever technique they are comforta-
leg constantly. The whole front leg can then ble with. The thin, tense abdominal muscula-
be removed after cutting the remaining skin. ture and friable linea alba present problems.
This process should be repeated on the oppo- General anaesthesia allows a midline
site side. A rope is then placed on the head approach and leads to good relaxation and
and the whole of the rest of the cria can be repair but decreases the chances of the sur-
removed. vival of the cria. Not only is the cria depressed
In cases of a hung cria, i.e. when the by the drugs used, but it then receives no
head is out and the legs cannot be felt, it is immediate attention from the dam as
vital to make 100% certain that the cria is she needs time to recover. A recovery area
dead. In these cases the head can be cut off as heated to 90F (32C) should be prepared for
near to the body as possible to allow the fore- the cria.
legs to be located and extended. The cria can The author favours a paralumbar fossa
then be drawn. If the cria is alive it is usually approach. If there are good handlers, seda-
possible to repel the head, after putting a tion is rarely required. If needed, 0.1 mg/kg
rope over the poll and into the mouth, and xylazine and 0.1 mg/kg butorphanol can be
locate the legs. It is best if both legs are given in the same syringe intramuscularly in
extended before drawing the cria. However, the quadriceps.
if one leg is in extension and the other is Lignocaine without adrenaline is then
totally back against the body it is normally filtrated at the proposed incision site. This
possible to draw the cria. If the cria is in a should be kept to the minimum as an over-
posterior presentation it normally can be dose can be toxic. No more than 4 mg/kg
drawn. If it is dead and emphysematous an should be given. This is 15 ml of a 2% solution
embryotomy may be required. The hocks of lignocaine for a 75 kg alpaca. Systemic anti-
should be brought caudally and sectioned biotics and NSAIDs should be given and the
with embryotomy wire just distal to the tetanus status checked.
hocks. The ropes can then be attached to the An oblique (30 from vertical) skin and
hock joint and the cria can be drawn using a then muscle incision should be made, follow-
large amount of lubricant. ing a line between the tuber coxae and the
angulation of the ribs. This follows the apone-
urosis of the internal abdominal oblique mus-
cle and also mimics the line of the uterus,
Caesarean Section making it easier to exteriorize. The incision
does not need to be long, only the width of a
In dystocia, if the uterus or cria is not acces- hand. If possible the uterus should be exteri-
sible or the cervix is closed immediate orized to lessen contamination. It is usually
Caesarean section is indicated. Damage to the possible as 95% of pregnancies are in the left
cervix or uterus is more likely when trying to horn.
force manipulation of the cria when there is After removal of the cria and feeling to
inadequate space or cervical dilation. Uterine make sure there is no twin (under 0.1%
laceration is more likely to occur in SACs chance), if the placenta is beginning to sepa-
compared with sheep. If the size of the dam rate it can be removed before closing the
precludes transvaginal examination a uterus, otherwise it can be left in situ.
Caesarean section should be performed. However, it needs to be peeled away from the
Delay in the decision to perform surgery may incision in the uterus to allow easier suturing.
result in death of the cria or even the mother. Toxic metritis as seen in horses is not a feature
However, in the authors experience there in SACs, nor is prolonged retention as in
appears to be an adequate amount of room cattle.
even in small alpacas. The uterus should be closed with a single
Caesarean section is most easily per- inverting layer of Lembert sutures using syn-
formed via the left paralumbar fossa or thetic absorbable suture material. If the uterus
142 Chapter 11

is oedematous and friable a second layer required teat. A pair of small Burdizzos is
should be put in. Obviously clinicians should placed at the bottom of the spare teat and
be mindful of subsequent pregnancies. The clamped shut. After 30 sec they are removed
uterus is more vascular than in the ruminant and the spare teat is removed by cutting
but there is no need to place an inner blanket with a pair of curved scissors along the clamp
layer as in the horse. An intramuscular injec- line. The tetanus status of the animal should
tion of 20 IU oxytocin should be given after be checked and fly control should be
replacement of the uterus. Intra-abdominal implemented.
antibiotics should be instilled before abdomi-
nal closure with two layers of continuous
sutures of synthetic absorbable suture mate-
rial. The deepest layer must include the peri- Mastitis
toneum. The skin should be closed with single
interrupted mattress sutures of monofilament Mastitis is a very rare condition in SACs. It is
nylon. often brought on by trauma, e.g. dog bites or
Antibiotics should be continued for 5 jumping out of pens soon after parturition.
days and NSAIDs for 3 days. A variety of organisms can be involved.
Treatment with antibiotics and NSAIDs is
required. SACs will develop peracute masti-
Induction of Parturition tis immediately after parturition if there is
failure of sucking. The organism is either
E. coli or Klebsiella pneumonia. The condition
This intervention should not be encouraged
is more likely with human interferences, e.g.
as often service dates are unreliable. If own-
hand stripping. Owners should be urged to
ers insist, it is best achieved with a prostag-
be hygienic. The condition has a poor prog-
landin injection of 187.5 mg of cloprostenol
nosis and if the animal is severely shocked
(equivalent to 0.75 ml of the standard solu-
and toxic with a low rectal temperature,
tions) intramuscularly. This should be fol-
euthanasia should be carried out. If clinicians
lowed by 125 mg of cloprostenol (equivalent
feel that there is a chance of recovery, treat-
to 0.5 ml of the standard solution) injected
ment should be aggressive, i.e. hospitaliza-
24 h later. Fluprostenol 40 mg intramuscu-
tion, warmth, intravenous fluids, NSAIDs
larly can also be used to induce parturition
and appropriate antibiotic treatment for
in SACs within 10 days of their due date.
Gram-negative organisms.
Parturition will occur on average in 21 h
Mycobacterium bovis has been found to
(Bravo et al., 1996). Neonatal survival is
cause mastitis in an alpaca (Richey et al.,
not affected. Neither dexamethasone nor
2011). The 8-year-old animal had a period of
oxytocin is suitable to induce parturition
ill-thrift with respiratory signs before devel-
in SACs.
oping a discharging sinus involving the left
quarter of the mammary gland. Gross post-
mortem examination identified multiple
Diseases of the Mammary Gland caseous lesions in the lungs, liver, lymph
nodes, kidney, omentum and pericardium.
Removal of supernumerary teats The udder contained multiple variable-sized
abscesses. The supramammary lymph nodes
SACs have four teats and rarely have extra and accessory superficial lymph nodes were
teats. They should not be removed unless cli- enlarged with multifocal caseous material.
nicians feel they will interfere with crias suck- Mycobacterium bovis was isolated. This dem-
ing. A small amount of local anaesthetic onstrates the potential for direct exposure to
should be injected into the base of the teat to M. bovis via milk and possible spread to other
be removed. Practitioners would be well herds via movement of crias before the devel-
advised to check with the owners to make opment of clinical signs. Obviously this has
100% certain that they are removing the zoonotic implications (see Chapter 17).
Medicine and Surgery of the Urino-Genital System 143

Failure of passive transfer Collection of plasma

The aim is for crias to receive 12% of their Ideally this needs to be done in advance and
body weight of colostrum in the first 12 h of then the plasma is stored in a deep freeze on
life. However, if it receives 10% within 24 h it the clients holding. The plasma can be stored
will probably have received sufficient. safely for a year provided it is kept deep in
Failure of passive transfer (FPT) occurs the freezer, i.e. not near the door where it
with weak crias or ineffective nursing from might defrost. Obviously power cuts are a
blocked teats, mastitis, poor milk production problem but they would be the owners
and poor maternal instincts. It can be moni- responsibility. If really cold temperatures (i.e.
tored by measuring the birth weight and re- lower than 20C) can be found, then the
weighing at 8 h. Milk secretion should be plasma can be stored for 5 years. The veteri-
checked and effective nursing (a white mous- narian should charge for the collection and
tache) should be observed. The passage of giving of the plasma. Disease control prob-
meconium and urine by the cria is encourag- lems are avoided by using the owners own
ing. Post-partum blood samples compared animals for plasma collection. The temptation
with 1824 h later is ideal as a practical assess- to use plasma from another holding should
ment of FPT. The PCV of the cria should have be resisted as any problems would be a legal
dropped and the total protein in the blood nightmare.
should have risen. The treatment of FPT is to Ideally a large healthy well-handled
give plasma collected from a healthy animal in gelding should be used for collection. A 70 kg
the same environment. The argument against alpaca can donate 500 ml of blood. A large
intraperitoneal transfusion compared to intra- llama can donate twice that figure. The dou-
venous is that it is not so effective and might ble bags available in the UK normally take
cause peritonitis. However, intraperitoneal 500 ml. It is important not to exceed the
transfusion is much less stressful for the cria amount of blood or there is a danger of clot-
and is much quicker as administration can be ting, through lack of anticoagulant. The blood,
done in 10 min after careful aseptic prepara- unlike equine blood, needs to be centrifuged.
tion. Plasma can be given orally but as it only With the double-bag system 500 ml of blood
contains one-fifth of the IgG level of colostrum should yield 300 ml of plasma. This would be
it is not very efficient. It is always worthwhile sufficient for one cria.
giving more colostrum as although no IgG is After the plasma is separated and the
absorbed after 24 h local immunity in the intes- bag is tied off, it is advisable to place an elas-
tine will be enhanced. Antibiotics orally should tic band around the bag to form a waist. After
be avoided as they tend to upset the gut flora. freezing, the elastic band can be removed.
Antibiotics can be injected to prevent septicae- This will give the practitioner a warning if
mia. However, they will in no way replace the bag has become defrosted in the freezer
good colostrum within 24 h of birth nor will as the waist will be lost. It is very important
they be as effective as giving plasma either that the plasma bags are handled with care as
intravenously or intraperitoneally. the plastic becomes brittle when frozen.
FPT may be the fundamental cause of Double wrapping them with the label on the
neonatal mortality, which is under 3% in the outside is a prudent precaution.
USA but is approximately 12% in Peru.
Treatment of premature or dummy crias
is difficult. Rather than tube these crias sev-
eral times a day it is better to place an ind- Giving of plasma
welling nasogastric tube in crias that are
either unable or unwilling to suck their dams Cross matching of plasma is not required as
or a bottle. In this way colic and bloat can be SACs have only one blood group with one
avoided. A volume of 10% of the body weight factor. The plasma needs to be defrosted very
of the cria should be given daily, ideally on slowly in a water bath at 37C. This will take
an hourly basis. 20 min. A microwave should not be used as
144 Chapter 11

there is a danger that some of the proteins will a second for the first 10 min to check for any
be damaged. Plasma can be given intrave- adverse reactions. After that the rate can be
nously or intraperitoneally. Clinicians must speeded up to almost a steady stream. Even so
use their judgement. Intravenous administra- the transfusion will take over 1 h for an alpaca
tion will be more stressful for the cria. cria and obviously more for a bigger llama
However, this procedure is likely to be carried cria. If there is a mild reaction dexamethasone
out in weak crias and so this fact may not be can be given intravenously at 0.1 mg/kg. This
so significant. More IgG is absorbed intrave- is approximately 0.25 ml of a 2 mg/ml soluble
nously so more plasma has to be given if the solution. This dose can be massively increased
intraperitoneal route is chosen. Either way if there is a bad reaction or 1:1000 adrenaline
strict surgical antisepsis precautions should can be given at 0.01 mg/kg. Hypertonic saline
be taken. If the intravenous method is used a would be useful and obviously oxygen if it
blood administration set should be used with was available. Such reactions are rare and
a filter to remove any cryoprecipitates. The therefore if this procedure is being carried out
jugular or the cephalic vein can be used. It is on the farm there is not a need to transport
prudent to give the plasma slowly at one drop bulky oxygen cylinders.
12
Medicine and Surgery
of the Neurological System

Neurological Diseases unlikely. Humane euthanasia should be


carried out promptly.
Congenital conditions

These may be inherited or acquired. Prolonged Degenerative conditions


parturition may lead to hypoxia and brain
damage. Damage to crias by poor parturition Spondylosis
technique is very rare.
This is a condition of geriatric animals. The
Atlanto-occipital malalignment pathology is the formation of excess sponge-
like bone in the lumbar area of the spine. This
This condition may be iatrogenic from rough has a slow onset. The excess bone pinches on
correction of a neck deflection at parturition. It the nerves as they emerge from the spine. The
is important that practitioners place the head- most common chronic manifestation is the ani-
rope behind the ears and through the mouth mal will drag the toes of its hindlegs. The con-
like a bit rather than around the neck. Animals dition does not seem painful but is progressive.
can have Atlanto-occipital malalignment with- NSAIDs are often given but they rarely appear
out any interference at parturition. The prog- to be beneficial. In certain cases the extra bone,
nosis is extremely guarded. Clinicians should the spondyle, may fracture. This will cause
be aware of welfare issues. acute lameness with pain and even crepitus
over the area. However, the animals can recover
Hydrocephalus as this small fracture can repair. Clinicians must
use their judgement on whether euthanasia
This condition is rare and is thought to have a
should be performed.
hereditary element. Unlike in cattle the skull is
rarely large enough to cause parturition diffi-
culties. The condition will be seen by the owner
after birth. Euthanasia is the only option. Infectious diseases

Kyphosis Abscesses

This is mainly seen in premature fetuses. It Any abscess either in the brain or the spinal
could be an inherited condition but that is column will give serious neurological signs.

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 145
146 Chapter 12

Borna disease Louping-ill

This virus has been found in the brains of lla- This virus certainly occurs in SACs. It is
mas and alpacas that have died showing neu- manifest as ataxia, seizures, opisthotonous
rological signs of ataxia and recumbency. and sudden death. Diagnosis can be con-
NSAIDs caused some short-lived improve- firmed by virus isolation. There is a PCR test
ment. Liver enzymes showed raised levels available.
but there were no other diagnostic signs.
The main differential must be rabies. The Otitis media
diagnosis can be confirmed by PCR and
immunohistology. It is a very rare condition. Ear conditions are very rare in SACs.
Foreign bodies (e.g. barley awns) may cause
problems as can functional narrowing of
Clostridial myositis the ear canal. The tympanic membrane is
This is caused by Clostridium chauvoei and is very difficult to visualize in SACs. Ear ticks
called blackleg in cattle. It can occur from a can cause infections as can misplaced ear
wound over a muscle which does not drain or tags and microchips. Equally, infection can
by trauma which becomes infected. It can be come up the Eustachian tubes from upper
caused by poor intramuscular injection tech- respiratory conditions caused by a variety
nique. The animal will be acutely lame and of organisms including Actinomyces spp.,
very ill. There is often marked swelling. Group D Streptococcus spp., Listeria monocy-
Treatment with high doses of penicillin is togenes, Proteus spp. and Pasteurella spp.
rarely effective. Animals should be covered There may be a head tilt and facial nerve
by adequate clostridial vaccination. deficits, e.g. flaccidity of ear and lip with a
deviation of the muzzle. The condition is
normally painful. Treatment should include
Equine herpes virus (EHV) parenteral antibiotics and NSAIDs, which
will need to be given long term. If surgery
Equine herpes virus (EHV) is exceptionally
is considered the animal should be at least
rare in SACs. It has been reported in SACs
radiographed. CT scanning is appropriate if
running with zebra. EHV 1 was the virus type
finances allow.
isolated (Rebhun et al., 1988). The zebra did
not show any marked signs but the SACs
were very ill with acute neurological signs. Protozoal meningitis
These included blindness characterized by A cryptococcus has been found in a CSF tap
dilated unresponsive pupils and funduscopic in an 8-year-old alpaca in Australia that died
evidence of varying degrees of vitritis, retinal showing neurological signs (Goodchild et al.,
vasculitis, retinitis, chorioretinitis and optic 1996). It is likely that this is not a primary
neuritis. pathogen.

Listeriosis Rabies

This is a rare condition in SACs compared to This disease will be seen in SACs in endemic
sheep mainly because SACs are rarely fed areas. It will be caused by a bite from a
silage. The disease normally has an acute carnivore. The SAC is the end host and so
onset with a marked fever and severe neuro- there is very little likelihood of the SAC
logical signs including seizures. Diagnosis having virus in its saliva. However, practi-
can be confirmed with a CSF tap. This will tioners should take care. The history will
show a raised protein, a raised CK and a large probably give the diagnosis. SACs may
number of monocytes. Tetracycline or flor- become aggressive but that is rare. Once
fenicol is the antibiotic of choice for treatment. neurological signs are apparent the progno-
These should be coupled with NSAIDs and sis is hopeless and euthanasia should be
careful nursing. carried out.
Medicine and Surgery of the Neurological System 147

Septic bacterial meningitis fluid therapy including large doses of


vitamin B.
This is seen mainly in crias below 1 year of
age. The invading organism is usually
Escherichia coli. The antibiotic of choice is a Hypocalcaemia
combination of penicillin and gentamicin. This is a metabolic condition of the lactating
Other authorities suggest florfenicol. female (see Chapter 2).

West Nile virus (WNV) Hypoglycaemia


West Nile virus (WNV) is an arthropod-borne This is a condition of the newborn cria. It
flavivirus. The vector is the mosquito. There is mainly seen in premature crias (see
is some debate as to whether there is a suita- Chapter 11).
ble vector in the UK. Dead birds found in the
UK have been shown to have seroconverted
to the virus but no live virus has been found Hypomagnesaemia
in the UK. However, an outbreak may occur This metabolic condition is extremely rare in
in the UK in the future as it is on mainland SACs (see Chapter 2).
Europe and of course extremely widespread
in the USA. The disease is primarily spread
by birds and then from them to humans, Uraemic encephalopathy
horses and SACs. The horse and the SAC are This neurological condition is the terminal
the end hosts. They cannot spread the disease. condition of several other syndromes, e.g.
Humans can actually spread the disease to intestinal volvulus or ruptured gastric ulcers.
horses and SACs. In horses and perhaps in There will be ulcers in the mouth and there
SACs the virus is common but very rarely will be a strong smell of urea on the breath.
causes disease. However, when there is dis- There is renal shut down and the prognosis is
ease it is very serious with up to 35% mortal- normally hopeless. Obviously the animal
ity. The clinical signs are ataxia, general needs to be put on to intravenous fluids and
weakness and general torpor. Treatment can the primary cause of the condition needs to
only be supportive. Control is through vacci- be addressed. However, euthanasia is likely
nation, which is very effective in horses and to be the most humane option.
may well be very effective in SACs, and by
controlling mosquitoes. More radical meas-
ures include draining swamps and killing
birds. Miscellaneous

Facial paralysis

Metabolic diseases This sign of damage to the facial nerve is nor-


mally seen immediately after trauma.
Hepatic encephalopathy However, it can be seen with a slower onset
as a result of the development of a hae-
Advanced liver disease will lead to hepatic matoma. There is a danger that this will
encephalopathy, which carries a very poor become infected and so make the condition
prognosis. The animal will show acute neu- worse. Antibiotics and NSAIDs should be
rological signs indicating pain, e.g. head given.
pressing. Liver enzymes will be raised.
A liver biopsy will show how advanced the Heat stroke
condition has become. Practitioners cannot
be faulted for encouraging euthanasia. This is not common in the UK but is seen in
However, in a few instances remarkable cures Australia and the USA. SACs must be given
have been recorded after hospitalization and adequate shade and water. Shearing at the
148 Chapter 12

correct time of the year is helpful. Rectal rate are normal. They may have diarrhoea as
temperatures will be very high. The animals a result of the dietary changes.
will show tachypnoea and tachycardia.
Recumbency carries a poor prognosis. The Tumours of the brain and spinal cord
animals need to be immersed in ice cold
water until the rectal temperature returns to These tumours are extremely rare. However,
normal. This should be carried out immedi- they will occur more frequently in SACs than
ately. No time should be lost while a drip is in some other animals because SACs are
set up. Intravenous corticosteroids are allowed to become geriatric. The most com-
helpful. While an ice bath is being prepared mon are metastases from other sites, e.g.
ice packs should be placed in the groin and malignant melanomas or adenomas of the
axilla. Some authorities suggest an enema of adrenal glands. Gliomas and meningiomas
ice cold water. However, this is hazardous will be found in the brain of crias.
on account of the danger of rectal tears.
Hosing down is a better immediate
treatment. Musculoskeletal

Hypothermia Bilateral luxating patellae


This is a condition of young crias born in the This condition is probably present at birth but
winter or very early spring left in exposed is only noticed by the owner as the cria grows
conditions. Obviously it should be prevented. and becomes more mobile. Diagnosis is not
However, if it does occur in crias over 24 h of difficult. However, surgical repair is extremely
age it is vital that they receive a glucose enema difficult and likely to be unsuccessful. As the
before they are warmed up otherwise the condition is inherited euthanasia is a more
CNS will die through lack of glucose. If the humane option.
cria is under 24 h, of age it should be tubed
with colostrum. Obviously the crias need to Gait abnormalities
be warmed up. However, the use of hot air
blowers should be avoided as initially they There is no end to the different gait abnor-
cause a drop in cord temperature as a result of malities shown by young crias. Rarely is the
the latent heat of vaporization. cause known. There have been some remark-
able improvements shown so even quite seri-
Mega-oesophagus ous abnormalities should be monitored before
euthanasia. However, clinicians should
This condition is rare (see Chapter 9). always be mindful of welfare. Normally if the
condition deteriorates to recumbency the
Polioencephalomalacia prognosis is hopeless.

The actual cause of this disease as in CCN in Hip problems


sheep and goats is unknown. It certainly
responds to treatment with thiamine (vitamin The hip joint in SACs is well formed.
B1) injections ideally 15 mg/kg intravenously Dislocations are extremely unlikely. Correction
at 6 h intervals, but these can also be given may be accomplished but the joint will never
subcutaneously. The prognosis is good pro- be stable, and therefore early euthanasia is
vided the SAC is not recumbent. It is mainly advocated.
seen in 1 year old or young adult animals fol-
lowing a change of diet or overfeeding of con- Peripheral nerve damage
centrates. Animals are blind and wander
away from others. They are depressed but Peripheral nerve damage can occur to any
will eat if the food is in front of them. Their nerve. Clinicians should always check for loss
rectal temperature, heart rate and respiratory of sensation and for motor reflexes. The most
Medicine and Surgery of the Neurological System 149

important condition is radial paralysis, which recumbent. The pathognomic sign is the flac-
will give the impression of fore limb fracture. cid anus when the temperature is taken. These
However, if the leg is placed for the animal it animals may recover with good nursing.
can bear weight without pain. It is miraculous Penicillin and NSAIDs should be given.
how in 610 weeks they will learn to flick the
foreleg forward and appear normal. Sensation Ionophone toxicosis
may or may not be recovered. The nerve will
only regrow at 1 cm/month. These drugs are very toxic to SACs. Toxicity
normally occurs if animals gain access to
food destined for chicken feed. Animals will
Parasitic diseases be recumbent and then show convulsions.
These may be controlled with intravenous
Meningeal worms barbiturate but they will soon return. In the-
ory C1 should be emptied and flushed.
These worms are contracted in North America However, such treatment has not been
from the white tailed deer, Odocoileus virgin- recorded.
ianus. As the name suggests this deer was first
found in the state of Virginia. The deer is Rye grass staggers
mainly found in the eastern USA. It is the
migrating larvae of Parelaphostrongylus tenuis This toxicity is caused by an endophyte that
that causes the problems. These are ingested grows on rye grass, particularly in dry
by the SACs by eating infected snails, which weather. The main sign in SACs is ataxia and
in their term have eaten the worm eggs. It a head tilt. This will occur in several animals.
takes over 1 month for the SAC to develop the Normally animals recover if moved to a new
signs. These cause an interference with the unaffected pasture (see Chapter 16).
gait starting with the hindlegs. This signs
may lead to ataxia and recumbency. Tetanus
Occasionally the brain will be affected and
the animal deteriorates rapidly. Obviously This is a potential threat in SACs. Vaccination
the sooner treatment starts the better. is advised. Tetanus antitoxin should be given
Recumbent animals have a poor prognosis. at half the horse dose in high risk situations
The specific therapy is fenbendazole at 50 mg/ (see Chapter 6).
kg for 5 days. However, symptomatic treat-
ment is also required. This needs to be aggres- Tick paralysis
sive if the animal is recumbent. The definitive
diagnosis is made by a CSF tap. The CSF will This condition is an acute, progressive,
show an eosinophilia and a raised protein. In ascending motor paralysis caused by a sali-
many areas in the USA where the disease is vary neurotoxin produced by certain species
common veterinarians will advise monthly of ticks. Ixodes spp. and Dermacentor spp.
prophylactic treatment for meningeal worm. have both been involved in causing the con-
There are no reports of resistance to dition in the UK. These and other species
anthelmintics; however, with such regular have been involved in other parts of the
usage there is likely to be resistance built up world. The first signs seen are normally
in bowel nematodes. hindleg paralysis. Normally there is a seri-
ous tick infestation. The ticks should be
killed and removed as soon as possible.
Toxicities Antibiotics should be given as there is often
sepsis at the site of the tick bite. Animals
Botulism will normally recover with supportive
treatment. If they are quadriplegic recovery
This condition as in sheep and goats is very is less likely, particularly if there is drooling
rare. Animals will drool and may become of saliva.
150 Chapter 12

Traumatic conditions but treating the ulcer without curing the entro-
pion, which is causing the ulcer, will be a best a
Cerebral hypoxia waste of time and at worst a welfare issue
resulting in the loss of an eye. Practitioners must
This occurs with a delayed parturition. Crias be mindful that if an eye condition cannot be
will not lift up their heads and certainly will treated satisfactorily and is causing long term
not make any effort to get up. Euthanasia is pain, the eye should be removed.
indicated. Mild forms will just appear dazed. The history should obviously include
If they can get up and suck they may manage the age and the number of animals affected.
to survive. Great care needs to be taken at A record should be kept as to which eye is
weaning. affected. Indeed if both eyes are affected that
needs to be noted. If the eyes appear normal
General trauma both from a normal visual examination and
from an examination with an ophthalmo-
Any SAC found dead or moribund with neu- scope, then there is likely to be an underlying
rological signs should be examined carefully central lesion. Obviously the examination
for signs of trauma. This seems more com- should include the eyelids and the other
mon in SACs than in sheep and goats. structures around the eye. The lens and the
Fractured vertebrae in the neck are commonly retina may well help with diagnosis, but
reported. It can occur at parturition but is oedema of the optic disc does not appear to
extremely rare as relative fetal oversize is not be a useful sign in SACs. There is therefore no
a problem in SACs. Crias may be attacked by indication given of intracranial pressure by
dogs, predators or very rarely male SACs. studying the optic disc. The visual pathways
Mis-mothering and aggression by females can be tested for integrity by the menace
does not seem to occur. response or lack of it. This blink test needs to
be carried out with care. It must be remem-
Vertebral body subluxation bered that if there is air movement the animal
may well blink even if it cannot see in that
Prompt treatment with realignment under
eye. The swinging light test can be used to
general anaesthetic may be successful if the
test brain to eye pathways. A light shining in
subluxation is in the neck region and a sup-
one eye will make the pupil in that eye con-
portive collar can be kept in place for 6 weeks.
tract. It will also make the pupil in the other
Radiographs should be taken to rule out a
eye contract but to a lesser degree. This will
fracture.
be reversed if the light is moved to the other
eye in a normal animal. If there is a defect the
Vertebral body fracture pupil will not contract. It should be remem-
If these are diagnosed rapidly with radio- bered that there is a crossover of the optic
graphs these cases may survive with good nerves. Depending where the lesion is situ-
neck support. However, normally they are ated will depend whether there are effects
fatal or require immediate euthanasia. seen in the opposite eye or in the same eye.

Eye Disorders and Visual Eye Disorders and Visual Defects in


Defects in General Neonatal Crias

As in all conditions a good history is vital. Eye Cataracts


disorders and visual defects may appear to
have an obvious cause but the clinician must Congenital cataracts may be seen in prema-
endeavour to make not only an actual diagnosis ture crias or in full term crias. They may be
but also to find out the underlying cause of the inherited. There is no treatment. If the cria has
condition. A corneal ulcer may appear obvious some vision, it is reasonable to wait to see
Medicine and Surgery of the Neurological System 151

how it will adapt. However, if it is totally considered vitamin A deficiency but this
blind euthanasia should be performed. seems very unlikely as all the cases seen
occurred at grass.

Entropion
Causes of blindness without
This condition is extremely rare in SACs. It visible visual defects but also
should be corrected surgically by carrying showing some signs of illness
out a cake slice op. After putting in the local,
the area around the eye needs to be clipped Cerebro-cortico-necrosis (CCN)
and prepared for surgery. A small slice of skin
With cerebro-cortico-necrosis (CCN), the ani-
is then removed. The wound is then sutured
mals will be severely depressed and show
with fine interrupted simple sutures. The eye-
ataxia. They will have a papillary light reflex
lid is then permanently in the correct posi-
(PLR) but will appear blind. This condition is
tion. The sutures need to be removed in 10
going to have a sudden onset. Any cria that is
days. Owners should be urged not to breed
recumbent, blind, showing strabismus and
from these crias.
opisthotonous is likely to have CCN. There will
be no pyrexia. Response to intravenous thia-
mine at 10 mg/kg is the best pointer to a correct
Eyelid, hypogenesis early diagnosis. A heparinized blood sample
can be taken for transketolase estimation. This
There are various manifestations of this is a specific test for CCN. Thiaminase can best
extremely rare condition. Clinicians need to estimated in a faecal sample or in C1 contents if
use their own judgement on surgery, leaving the animal has died. The pathognomic sign at
alone and euthanasia. post-mortem is seen in the brain. The cerebral
hemispheres will macroscopically show a yel-
low discoloration and fluoresce under ultravio-
let light (see Chapter 15).
Non-pigmented iris
Coccidiosis
This condition is not rare. The affected ani-
mals do not seem to be bothered by this con- A very severe neurological type has been
dition throughout their lives. described. There will be a papillary light
reflex (PLR) (see Chapter 9).

Eye Disorders and Visual Defects Gid


in Older Crias and Adults
As yet this parasite has not been recorded in
SACs. There is likely be a head tilt and a PLR
Causes of blindness without visible visual in at least one eye (see Chapter 9).
defects and no other illness

Keto-acidosis
Sudden onset of blindness will occur in older
crias and even adults without visible visual There is normally a severe energy deficit and
defects and no other illness. Vital signs will hypoglycaemia. There will be a PLR (see
all appear normal. The animals will eat food Chapter 2).
presented to them or in the case of crias will
suckle when shown the teat of their mother. Meningitis with or without hypopyon
In the authors experience the cause is never
found even on post-mortem. The condition The animals will be very ill with a raised tem-
appears to be irreversible. The author has perature. Normally they would have a PLR.
152 Chapter 12

In adults Listeria monocytogenes should be sus- cause blindness. The animals will have a PLR
pected. In crias other organisms may be (see Chapter 16).
involved.
Vitamin A deficiency
Trauma to the head
The animals have fixed dilated pupils. In
The animals will have fixed dilated pupils.
advanced cases they will be ataxic and may
The head should be very carefully and gently
show head-pressing. The condition is
examined. Radiographs will be useful.
irreversible.

Various plant poisons


Tumours of the eyelids
Amongst other plant poisons, aflatoxins,
bracken, brassicas and deadly nightshade The most common are squamous cell carcino-
will cause blindness. A PLR will not be present mas of the third eyelid. These have a good
(see Chapter 16). prognosis if they can be removed before the
tumour has invaded the conjunctiva. Surgery
Various poisons is straightforward as the eyelid can be
removed with a pair of scissors under anaes-
Lead, sulfur, salt (caused by water depriva- thesia. Haemorrhage is minimal and suturing
tion), arsenic, mercury and antifreeze will is not required.
13
Medicine and Surgery of the
Locomotory System

Conditions of the Limbs documented in SACs, particularly crias. It is


thought that SACs bred up in the Andes rely
Introduction on high levels of sunlight to make vitamin D.
This is denied them in other areas of the
Crias need adequate amounts of calcium, world particularly the UK, therefore supple-
phosphorus, protein and vitamin D for their mentation of vitamin D either by mouth or
skeletons to grow properly. While there will by injection is required regularly by crias,
always be occasional animals that accidentally particularly those crias born later in the year
break a leg there are certain problems that in the northern hemisphere.
increase the risk of fractures. If practitioners
have the slightest doubt about the presence of
a fracture (this is particularly important in Abnormal kushing in neonates
crias which are very stoical) they should splint
the affected limb. Welfare is paramount. Neonates are often shaky when born and
Radiographs should be taken and treatment have difficulty in getting into the kush posi-
should be carried out promptly. tion. They are in danger of being trodden on
Increased risks of fractures may develop by their mothers and other animals. It is
over long periods of time. The bones may important that they are separated until they
become increasingly fragile. Severe copper have become stronger. Owners should assist
deficiency has been reported to cause frac- them to kush normally.
tures, as copper is needed for development
of a normal framework within the bone.
Long-standing parasitic infections, particu-
larly intestinal nematodes, also predispose to Dropped pasterns
fractures because damage to the gut wall
prevents the young animal absorbing Hyperextension of the metacarpal-phalangeal
enough phosphorus. Where animals are kept joint is a condition of llamas. It is rarely seen in
in areas of old lead mining the continual alpacas. It is mainly a condition of old animals
daily intake of small amounts of lead as they but can affect young llamas. The condition has
graze makes the bones liable to fracture. With been linked with raised serum zinc levels and
all three conditions the young animals will decreased copper levels. However, a direct
be ill thriven. Problems with rickets are well causality has not been established. Most

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 153
154 Chapter 13

affected llamas can live normal lives but there been carried out without compromising the
are concerns over the wisdom of pregnancy. welfare of the individual.
There is no treatment. Certain old SACs may suffer from oste-
oporosis. The cause is unknown but they will
often develop multiple fractures. Euthanasia
Flying scapular is indicated.

This is a very rare condition that may occur in


SACs, normally after weaning but before Luxating patellas
maturity. The muscles securing the scapular
to the ribcage become weak and rupture to This not uncommon fault is often not noticed
some extent so that the ribcage drops. The until after weaning. It is an inherited defect
spine is then lower in the thoracic area com- and has nothing to do with early castration or
pared to the lumbar-sacral area. The animal is rickets. Obviously there are various grades of
still mobile. The condition is irreversible. the condition. Surgery is unwise and euthana-
sia is indicated if the condition becomes
worse.
Fractures

Fractures occur in SACs and are particularly a Sequestrations


concern on account of the length of their long
bones. Crias are most at risk. Practitioners These can form in the bones of young grow-
need to be particularly vigilant on account of ing animals from a week onwards. The com-
the stoical nature of SACs. Fractures are par- mon presentation is peracute lameness.
ticularly easy to dismiss. Many types of repair Radiography will not reveal a fracture and at
have been described in the literature: intramed- this stage there are no other radiological signs
ullary pins, screws and plates, external fixa- but these will develop later. Clinicians should
tion pins as well as external splints and casts. radiograph these limbs in a further 2 weeks.
Very great care has to be taken with external Dead bone fragments will then be seen. There
casts on account of the dangers of pressure is no known definite aetiology of this condi-
necrosis (Fig. 13.1). Even amputations have tion. The most likely explanation is septic

Fig. 13.1. External cast.


Medicine and Surgery of the Locomotory System 155

necrosis in the diaphyseal region of the bone.


Sadly, high doses of antibiotics on day one do
not seem to help the condition. Once a diag-
nosis has been made surgery appears to be
the only worthwhile treatment. Antibiotics
and tetanus antitoxin should be given prior to
surgery. Surgeons should cut down on to the
sequestrum and remove it. There is no need
to splint or bandage the leg but the cria and
its mother should be kept separate from the
rest of the group.

Scapulo-humeral joint luxation Fig. 13.2. Eroded pad.

This luxation in alpacas has been reported by


a group of authors in the USA (Rousseau et al., on soft ground. They should be trimmed
2010). Only ten cases have been reported regularly.
throughout the USA so this is by no means a
common condition. It is much more common
in males. Various surgical options were pur- Surgical Removal of the Digit
sued with varying results. It should always
be considered in cases of fore limb lameness Septic pedal arthritis does occur in SACs.
in SACs. However, it is rare. Antibiotic treatment
even if prolonged is rarely successful.
Welfare must always be considered.
Total spasticity of the limbs Euthanasia is certainly an option to relieve
further suffering. Full drainage of the distal
This condition seen in neonates looks very phalangeal joint with subsequent arthrode-
similar to the spider lamb syndrome in sis may be considered. However, this will
sheep. The outcome is hopeless if the animal result in a long period of severe pain.
is quadriplegic. However, if the animal can Surgical removal of the digit is a more
use its front legs normally but it is only para- humane option. However, it is vital that this
lysed behind, time and good nursing may surgery is not attempted if there is sepsis in
bring about a recovery. the proximal joints as pain will persist. If cli-
nicians are in any doubt, radiography
should be carried out.
Regional anaesthesia can be used (see
Foot Problems Chapter 8). The distal limb can be cleaned but
full asepsis is not required. A length of embry-
SACs have a soft pad and a terminal toenail. otomy wire is placed between the digits. The
The pad may look eroded and pitted, especially sawing direction should be at an angle of 45
in wet weather (Fig. 13.2). Footrot is extremely above the horizontal. The skin, soft tissue and
rare. Treatments with formalin or zinc sulfate half the second phalanx should be removed.
do not seem to be effective. Animal husbandry The foot then should be bandaged before
methods must be used to keep the feet dry. removal of the tourniquet. The animal should
Copper sulfate is not only ineffective but dan- be given antibiotic and NSAID cover for a
gerous on account of the toxicity. minimum of 1 week. The bandage should be
Overgrown toes are common in SACs removed every third day until clean granula-
outside of South America when they are kept tion tissue is seen.
156 Chapter 13

Tumours of the Skeletal System that unusual. Diagnosis may be difficult


as it is often difficult to find out how long
In SACs bone tumours are exceptionally the tumour has been present. It may
rare. They are only really seen as a metasta- resemble an old fracture occurring as early
sis of a melanoma in the mandible. However, as at parturition or trauma to the ribs later
tumours of the cartilage of the ribs are not in life.
14
Skin Conditions

Introduction The ultimate diagnostic tool is the skin


biopsy. When skin is processed for histopa-
When dealing with skin conditions it is important thology some potentially important surface
to not only obtain a full history (e.g. what spe- features may be partially lost through
cies, age groups and genders are affected, the chemical processing. Consequently
have new animals been brought on to the there should be no surface preparation of
holding etc.) but also to carry out a full clinical the skin prior to collecting a skin biopsy. It
examination of the animal. Careful observa- is quite acceptable to clip the surrounding
tion is required to check for pruritis. If pruritis hair. If an entire nodule is going to be
is observed the clinician needs to eliminate removed then it should be sent in sufficient
ectoparasites before investigating other condi- formal saline to preserve it. If it is large it
tions. Direct visual examination should be should be cut in half to allow the formal
carried out with the naked eye and a magnify- saline to penetrate it. If just a biopsy is
ing glass. Many larger parasites can be visual- going to be taken it is best to use a specially
ized. Skin scrapings can be taken from the prepared 6 mm biopsy punch. Multiple
moister marginal areas of lesions after clip- biopsies may be taken and sent. The sites of
ping away the hair or wool. One or two drops each biopsy should be recorded. A biopsy
of 10% potassium hydroxide solution can be may be taken and labelled from normal
added to soften and clarify the scraping before skin. However, it is best not to include too
direct microscopic examination for ectopara- much normal skin with the biopsy as when
sites or fungal hyphae/spores. Culture can be the section is prepared it may not be appar-
carried out of skin scrapings, plucked hair or ent which is normal and which is diseased
moist material from lesions. Direct impression skin. It is very important to give a full
smears can be stained with Gram, Giemsa or a report to the pathologist so that the pathol-
modified Wrights stain such as Dif Quik. ogist is aware of the extent of the diseased
Scabs covering active rather than healing tissue and the time scale as to when the
lesions can be taken, kept dry and referred for changes arose. It is also important to select
further investigation. It should be remem- the pathologist carefully. The pathologist
bered that it is dangerous to include scalpel not only needs to be familiar with skin
blades with referred samples. disease but also with SACs.

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 157
158 Chapter 14

Viral Skin Diseases a live vaccine and very bad reactions have
been reported.
Blue tongue virus

Blue tongue virus (BTV) causes hyperaemia Foot and mouth disease
of the oral mucosa with excoriations of the
tongue, lips and gums that become ulcerative Vesicle lesions of foot and mouth disease
and necrotic. There is also a coronitis with (FMD) are found on the oral mucosa and the
hyperaemia and swelling around the coronet coronary band. The condition is included
leading to obvious lameness (see Chapter 9). under skin disease for completeness (see
It is only included as a skin disease for Chapter 9).
completeness.

Malignant catarrhal fever


Contagious pustular dermatitis
In the UK, malignant catarrhal fever (MCF) is
This is primarily a disease of sheep, however caused by ovine herpes type 2 virus (Ov-
it will affect SACs. It is perhaps the most VH2). The sheep is thought to be the natural
important viral skin disease of sheep and is host. In Africa the natural host is the wilde-
called Orf. It is highly contagious and is beest. It is thought to cause cutaneous mani-
found worldwide. It is caused by a Parapox festations in SACs. The lesions are a severe
virus. The lesions most commonly occur on generalized alopecia with granulomatous
the commissures of the lips, muzzle and occa- mural folliculitis. A definitive diagnosis may
sionally on the feet and genitalia. It can be be made on PCR. The condition is normally
manifest as a flock outbreak or can be seen in fatal. There is no treatment and so euthanasia
the lambs in spring and summer. If the crias is recommended if a definitive diagnosis has
are still sucking the teats of the females they been made.
will get infected udders with disastrous
results, i.e. mastitis.
The initial lesion consists of a number of
red papules within which vesicles develop, Peste des petits ruminants
rupture and a thick scab is formed. Prolif-
erative changes may then occur resulting in Peste des petits ruminants (PPR) is caused by a
papillomatous lesions. Secondary bacterial morbillivirus and is related to Rinderpest. PPR
infection is common with all lesions and in will infect camels and has been seen by the
females with mastitis deaths may occur. author in northern Kenya. It has not been
Difficulty in sucking may cause weight reported in SACs. Clinicians should not be
restriction in crias and lesions on the coronary concerned that they will miss this disease as
band may result in lameness. the signs are very obvious. There is high fever
Diagnosis should be straightforward clini- with erosions on the mucous membranes of
cally. It can be confirmed by virus isolation. The the mouth and eyes. There is acute bloody
disease will spread rapidly. Although it is a diarrhoea and also signs of pneumonia. The
virus, antibiotics are useful. A blanket dose of a author would expect whole herds to become
penicillin/streptomycin injection is very help- infected and the majority to die. There is no
ful. Really bad lesions should be treated with specific treatment. However, oxytetracycline
oily creams. Antibiotic aerosols should be injections might reduce the number of deaths.
avoided as they tend to cause the scabs to NSAIDs may be helpful. No vaccine appears
harden. When these scabs are knocked off there to be available but the literature claims that
are large eroded areas underneath. one has been developed. It is more likely that
There is a live vaccine available for sheep. regulations will require all the animals to be
This vaccine should not be used in SACs. It is slaughtered as a disease control precaution.
Skin Conditions 159

Pseudorabies Actinomycosis

This disease is often called Aujeszkys disease. This condition is really a disease of cattle
It is primarily a virus affecting swine. It is mainly called lumpy jaw or if it occurs in the soft
a neurological disease (see Chapter 12). tissues of the mouth it is called wooden
tongue. The syndrome is seen in SACs quite
frequently. Actinomyces spp. form firm nod-
Rabies ules on the face. Lancing is unrewarding as
they are granulomatous and only release
small amounts of yellowish white granules.
This virus disease affects SACs. It is primarily a
Treatment with penicillin is unrewarding.
neurological disease (see Chapter 12).
However, prolonged daily dosing with strep-
tomycin is normally effective. A minimum of
10 mg/kg for 10 days is suggested.
Rinderpest

Hopefully this has been eradicated from the Anthrax


world thanks to the excellent vaccine pre-
pared by Sir Walter Plowright. It is caused by
This is normally a systemic disease in SACs.
a morbillivirus. The primary host is cattle but
It can be manifest as a cutaneous form like
camels have been affected. It has never been
that seen in humans (see Chapter 17). It takes
reported in SACs.
the form in camels of a malignant pustule,
normally on the face, but the author has seen
it in the groin. Smears made from the lesion
Vesicular stomatitis will reveal the bacteria on staining with old
methylene blue. The disease in the UK is noti-
This rhabdovirus is very rare. It is really only fiable and is extremely unlikely to be seen.
of relevance as it may cause confusion with However, the author has treated cases in
FMD. It mainly occurs in other species and Africa that have responded well to 5 days of
has not been reported in SACs. procaine penicillin.

Bacterial Skin Diseases Caseous lymphadenitis

Actinobacillosis Caseous lymphadenitis (CLA) is caused by


Corynebacterium pseudotuberculosis. It occurs
This condition commonly occurs in SACs. It is in sheep and goats throughout the world. It
normally associated with the head and neck was first isolated in the UK in 1990 (Baird,
but it has been reported on the body in Norfolk 2003) from an importation from Germany.
in the UK. It is characterized by thickening of Studies have revealed that all cases in the UK
the skin with multiple granulomatous swell- have come directly from that case. There has
ings often associated with the lymphatics. been no official action as control was thought
These swellings are unrewarding to lance as not to be feasible. The disease could affect
the pus is only in small pockets. The actual SACs.
organism is Actinobacillosis lignieresi. This is Abscesses would be likely to develop in
thought to gain entry either through wounds in the lymph nodes under the skin but could
the skin or the mucosa of the mouth. Treatment also occur in internal organs, e.g. in the lungs.
with penicillin is unrewarding. However, pro- It will then be manifest as a respiratory condi-
longed daily dosing with streptomycin is nor- tion (see Chapter 10). Swollen abscessed
mally effective. A minimum of 10 mg/kg for 10 lymph nodes are easy to see. If incised they
days is suggested. would take on an onion-like appearance with
160 Chapter 14

concentric rings of fibrous tissue and inspis- of crystalline penicillin should be given
sated pus, or they could be just filled with intravenously together with NSAIDs.
soft pasty pus. The main spread is from the
rupture of abscesses into the environment
where the organism can survive for a seri-
Dermatophilosis
ously long time. If there are abscesses in the
lungs the disease can spread by the respira-
tory route. The herd can contract the disease This is often called mycotic dermatitis in
by importation of infected animals but can textbooks, which is a misnomer as it is
also obtain the disease from contaminated caused by a bacterium Dermatophilus congo-
fomites, e.g. clipper blades. lensis. It is also called fibre rot. The disease
Diagnosis could be made on clinical is manifest as an exudative dermatitis
grounds and confirmed by culture of the affecting the back and flanks. The disease is
organism from an abscess. Culling is the progressive. It starts with exudation, which
only course of action as there is no effective then crusts and scabs. The initial penetra-
treatment. Total eradication could be tion is facilitated by prolonged wetting of
achieved. In theory the organism is sensi- the fleece during periods of prolonged wet
tive to several antibiotics but penetration weather. Diagnosis may be made on clinical
into the abscesses is impossible. There is a grounds and confirmed by Giemsa stain of
vaccine available. It is not licensed in the the scabs. Treatment in severe cases is
UK and its use has not been reported in parenteral antibiotics and antibiotic cream
SACs. on the raw areas. Most mild cases will heal
spontaneously.

Clostridial cellulitis Morels disease

This is often called malignant oedema and This disease is clinically very similar to
can occur in SACs. It is most common in CLA. It is seen in goats in Europe in Poland,
males as a result of fighting wounds. The Germany and France. It has also been seen
causal organism is Clostridium septicum; in Africa and Asia. However, the causal
Clostridium sordellii has also been isolated. organism is Staphylococcus aureus ssp. aero-
Both these organisms are now covered by a bius not Corynebacterium pseudotuberculosis.
licensed vaccine for sheep. This same vac- It has a shorter incubation period of 3
cine is licensed for cattle at double the dose. weeks, rather than months with CLA. The
It can be used in SACs but it should be used abscesses are not as closely related to the
at the sheep dose. The higher cattle dose lymphatics as in CLA. Initially it has a mor-
causes adverse reactions in the form of cold bidity of 7090%. This falls to 1020% as it
abscesses. becomes endemic. It could occur in SACs. It
It is a very serious condition. The area of would only be differentiated from CLA by
swelling is initially hot and painful with culture. In goats, antibiotic treatment
crepitus. This then turns cold and gangre- appears to be ineffective. Autogenous vac-
nous. Initially the animal has a fever but this cines do not offer protection. It must be
rapidly abates before death. Diagnosis assumed that SACs would follow the goat
should be made on clinical grounds. model.
Confirmation is difficult as there is rapid
autolysis after death. However, if smears are
obtained promptly they will confirm the
diagnosis using fluorescent antibody tech- Necrotic dermatitis
niques (FAT).
Treatment may be attempted if the dis- This condition is caused by Pseudomonas
ease is caught in the febrile stage. High doses aeruginosa. It is a very serious condition as
Skin Conditions 161

not only is it very difficult to treat but also it days with amoxicillin with clavulanic acid
predisposes the animal to myiasis. Preventive and local treatment with the same antibiotic,
measures need to be stepped up. It appears which is available as an intramammary prepa-
to follow prolonged rainy conditions, partic- ration for cows.
ularly within 6 weeks of shearing. However,
the exact trigger mechanism is not known.
Animals can become very ill if the area of the
Scald
affected skin is large. The local lymph nodes
will become swollen. The diagnosis can be
confirmed on culture. Treatment is parenteral This is also called benign footrot in lambs.
broad-spectrum antibiotics together with It mainly occurs in warm moist conditions
local creams containing miconazole nitrate, with animals on lush pastures. It only occurs
prednisolone acetate and polymyxin B in crias that are kept on the same pasture as
sulfate. affected lambs. The interdigital skin becomes
inflamed and painful. Normally there is no
separation of the horn or suppuration. There
is no smell as in typical footrot. The bacteriol-
Nocardiosis ogy is not straightforward. Certain strains of
Bacteriodes nodosus are involved. Normally
This disease was first reported in goats by Fusibacterium necrophorum is not present.
Peter Jackson at Cambridge (Jackson, 1986). It Individual cases respond well to antibi-
is very rare in the UK although it seems to be otic aerosols. If large numbers are affected
widespread in central Asia. Abscesses are then foot bathing in 0.5% zinc sulfate is
common in central Asia but the actual bacte- helpful.
ria involved appear to be similar to those seen
in the UK. There is a very rare bacteria
Actinomadura madurae which causes granular
pus in similar abscesses all over the body. Staphylococcal dermatitis
This condition is also called actinomycetic
mycetoma. In theory it could occur in SACs. This may actually be the same condition as
Treatment in goats is unrewarding. High peri-orbital eczema, as it occurs on the face
daily doses of streptomycin are recommended and nasal bones in SACs. However, it also
over a period of at least 1 month. occurs on the limbs, vulva and prepuce. It is a
suppurative condition that takes 46 weeks
to resolve. The causal organism is a beta-
haemolytic Staphylococcus aureus. Treatment
Peri-orbital eczema
would be the same as for peri-orbital eczema.

This condition is thought to be bacterial and is


likely to be caused by a Staphylococcus. The
condition characteristically affects trough-fed Staphylococcal folliculitis
SACs. The early lesion is seen as a small
inflamed and scabbed area on one or other of This is a benign condition that affects young
the bony prominences of the face or less com- crias. It is normally a condition associated
monly on the nose. This extends, usually with housed animals. The clinical signs are
around the eye, hence the name, to give normally mild with small pustules on the
an alarming scabbed, discharging sore. lips, muzzle and nostrils. Diagnosis should
The condition is not serious except in the rare be made on clinical grounds. However, it can
occasions when the infection spreads actually be confirmed on the isolation of Staphylococcus
to the eye. Most cases are self-limiting and do hyicus or histologically as a pyogenic folliculi-
not require treatment. However, severe cases tis with ulceration of the epidermis. The con-
may require aggressive antibiotic treatment. dition will normally resolve without treatment
The author recommends daily injections for 3 in a few days.
162 Chapter 14

Fungal Skin Diseases papules and aural plaques on the ears. It may
be related to ear tags. It appears to be self
Aspergillosis limiting.

This is a rare disease caused by Aspergillus


fumigatus. It has been found in vicuna kept in Pythiosis
captivity. The condition shows the form of
ulcerating nodules in the groin. It is refractive This rare fungal disease is seen in South
to treatment. As the disease may be conta- America in alpacas. It seems that the causal
gious, slaughter should be advised. The dis- organism, Pythium insidiosum, can only affect
ease may be diagnosed by culture but false the skin of wool animals that are exposed to
negatives will occur. Histopathology is a safer total immersion in water for some hours. The
method of diagnosis. ulcerated plaques will heal if the animals can
be kept dry for 34 weeks.

Cryptococcosis
Ringworm
This is an extremely rare skin disease. The
nodules are seen on the head and may become This is a rare condition in llamas. It is much
ulcerated. Cryptococcus neoformans can be iso- rarer in alpacas, where it is normally seen on
lated on culture. Treatment is rarely success- the non-fibre-covered areas. In llamas it may
ful. Long-term broad-spectrum parenteral be found all over the body. The most common
antibiotics and natamycin washes might be organism is Trichophyton verrucosum, which is
helpful. normally caught from cattle. It must be
remembered that it is a zoonotic condition
(see Chapter 17), therefore the practitioner
Malassezia dermatitis should warn the owner to take normal hygi-
enic precautions. Washing carefully with soap
Malassezia spp. may be isolated from the skins and water or dilute chlorohexidine is worth-
of normal SACs. They can be seen on impres- while. Owners should avoid rigorous scrub-
sion smears stained with a modified Wrights bing or strong disinfectants as the skin barrier
stain such as Dif Quik. If very large numbers will be breached, allowing the fungi to
of peanut shaped yeast organisms are found penetrate. The other organism isolated from
on diseased skin they may well be significant. llamas is caught from dogs. It is Microsporum
Swab samples may be cultured on ordinary canis. Trichophyton mentagrophytes has been
Sabourauds media. The clinical signs will found in SACs kept with goats. The clinical
include erythema, scale, hyperpigmentation picture of round crusting lesions is the same
and malodour. Various baths seem effective, for all three species of fungi. Pruritis is more
e.g. chlorohexidine, enilconazole, miconazole marked with T. verrucosum infection.
or selenium sulfide can be used twice weekly Obviously several animals are likely to be
for a minimum of 3 weeks and then regularly infected.
at weekly intervals until the condition resolves. The areas most commonly affected in
However, if there is a trigger factor involved llamas include the face, ears and back. In very
this will need to be treated at the same time. rare instances the legs and tail head are
affected. The lesions are first seen as firm
raised plaques attached to the underlying
skin, which then become detached to reveal
Phaeohyphomycosis circular raised crusts with local thickening of
the skin. Thickening of the stratum spinosum
This disease is caused by an opportunist free- with hyperkeratosis and proliferative derma-
living fungus, Peyronellaea glomerata. It forms titis will be seen on histological sections.
Skin Conditions 163

However, histology is not normally required not been recorded in SACs. However, SACs
to confirm a diagnosis. The organism is read- may act as secondary hosts to intestinal
ily grown on proprietary plates and will be Sarcocystis spp. found in carnivores in South
identified by a red colour change within America.
10 days. Often there will be secondary bacte-
rial infection. Only debilitated animals will get
a bad infection. In normal animals the infec-
tion is self limiting in a few months. If treat- Parasitic Skin Diseases
ment is required for special animals (e.g.
showing animals), there are topical fungicides Blowfly strike
like natamycin and oral antibiotics like griseo-
fulvin. The later is very effective against T. ver- Myiasis is rare in SACs high in the Andes.
rucosum and T. mentagrophytes but not so However, it can occur in all other temperate,
effective against M. canis. Griseofulvin must subtropical and tropical areas. Most blowflies
not be used in food-producing animals in the are secondary strikers, i.e. there has to be a
UK but could be used in SACs. wound first for the maggots to invade the
skin (Fig. 14.1). There are three genera of flies
involved: the blue bottle, Calliphora spp.; the
green bottle, Phaenicia spp.; and the black
Protozoal Skin Diseases bottle, Phormia spp. In the Americas there is a
primary striker, Cochliomyia hominovorax. This
Besnoitosis is a screw worm and will invade healthy skin.
It has largely been eliminated in North
This is a disease of llamas in South America. America. Once a SAC has been struck, the
It does not seem to affect alpacas. It is caused area of skin under the fleece which is involved
by the protozoan Besnoitia caprae. Diagnosis is will be permanently damaged, ruining the
difficult as it causes large areas of thickened animal for show and lessening the fibre
skin, which is very similar to scabies. production. The condition if advanced can
Diagnosis can only be made from skin biop- be life-threatening and so treatment needs to
sies. The condition is refractory to treatment. be aggressive. The animal should receive
Euthanasia is advised. antibiotics and NSAIDs immediately. If it is in
severe shock the author gives dexamethasone
at up to 4 mg/25 kg intravenously in place of
Leishmaniosis the NSAIDs. If the animal is cold it is warmed
up with hot water containers under blankets.
The area around the strike is trimmed of fibre
This disease has not been recorded in SACs.
and cleaned. All the maggots are removed
It is seen in sheep in South Africa. If SACs
with warm salty water. If this is difficult the
were imported into South Africa it is possible
author uses a hairdrier. Cypermethrin in a
that they might become infected.
1.25% w/v non-aqueous liquid is applied to
all the affected parts at the rate of 2.5 ml per
100150 cm2 (roughly the size of a hand). The
Sarcocystis capricanis whole wet area is dressed with oily cream,
normally a mixture of acriflavin and BHC.
This organism, which causes skin disease in The tetanus status of the animal is checked.
goats, has been reported in central Asia The animals progress is monitored. The anti-
although in fact it occurs throughout the biotics and anti-inflammatories are repeated
world. The author found the organism in at the correct intervals.
goats with severe alopecia in Mombasa in At the present time the author considers
Kenya. However, demodectic mange was the risk of blowfly strike too low to warrant the
present at the same time and so the cause of routine application of synthetic pyrethrums to
the alopecia was in doubt. The organism has alpacas in the UK.
164 Chapter 14

present time it is Chorioptes bovis. It causes


mild pruritis, alopecia and scaling. Lesions
are commonly found on the head, ears, feet
and perineum but can also extend to the
limbs and ventral abdomen. A high preva-
lence has been reported (DAlterio, 2005) in
the south-west of England. Over 20% of
alpacas were affected and mites were iden-
tified in 40% of these cases. Of animals that
actually had no skin lesions, 55% were
found to be harbouring mites. The most
likely area to find mites was in the interdig-
ital space.
Fig. 14.1. Blowfly strike. The commonly used treatment is the
injection of doramectin at 1 ml/33 kg given
every 3 weeks. This does not seem to be very
Lice effective and leads to resistance in internal
nematodes. Even weekly treatments have
These are easily diagnosed by their shape been tried on the whole herd without lasting
and the fact that they cause pruritis. This in cure. Certain individuals may well show an
turn leads to matted fibre and eventually allergic response. Orthoparakeratosis and
alopecia. There are two types found in SACs parakeratosis with thickening are seen in
worldwide. Sucking lice Microthoracius spp. these individuals (Fig. 14.2). It has been
are found on the fore end of the SAC mainly postulated that this is linked with a zinc
on the head, neck and withers. They can be deficiency. However, although zinc levels
treated with injectable avermectins. Oral have been shown to be low in certain indi-
avermectins are ineffective. Biting lice viduals, levels do not correlate with infec-
Bovicola breviceps are found all down the tion. Equally individuals do not respond to
spine from the neck to the tail head. Neither zinc supplementation.
injectable nor oral avermectins are effective. Some owners do manage to clear up
They require topical applications. However, the condition with very persistent treat-
they need to be used with care as some ment. This treatment is based on topical
spot-on and all pour-on products may dam- application of either eprinexin diluted with
age the skin and the fibre. The safest is dimethyl sulfoxide (DMSO) to affected
fipronil put on as a spray or cypermethrin areas weekly for three months or fipronil
diluted as a spray. All the treatments for lice spray applied weekly for a similar length of
require a repeat treatment in 10 days to con- time.
trol the unhatched eggs. Bovicola breviceps
is the only louse confirmed in the UK
Sarcoptes mites
(Foster, 2008). A light infestation reported
in llamas was reported to be of little clinical These mites may well be more common than
significance by authors in the UK (Twomey was previously thought as differentiation
et al., 2010b). from C. bovis is not easy. The mite which has
been found on SACs is Sarcoptes scabiei var.
auchinae. It should be remembered that this
Mites mite is a potential zoonosis. It causes more
intense pruritis than C. bovis. Mites can be
Chorioptes mites found all over the body. There will be hyper-
aemia, papules and pustules with crusting.
These are the most common mites found in As the mite seems to burrow deeper than
SACs in the UK. There is some doubt as to C. bovis, treatment with regular avermectins
the naming of the species. However, at the by injection seems to be effective.
Skin Conditions 165

Iodism

Alopecia and scaling will be seen in SACs if


they are fed foods very rich in iodine (e.g.
seaweed) over long periods of time.

Sulfur deficiency

This is extremely rare but has been reported in


SACs. It is more marked in fleece animals as
there is fleece biting and alopecia. Diagnosis
can be made from serum or liver samples.
Fig. 14.2. Chorioptic mange.

Vitamin A deficiency
Psoroptes mites

The mites found on SACs are indistinguisha- It is extremely rare for SACs to be fed a diet
ble from those causing sheep scab and so it is deficient in vitamin A. The coat will show a
to be expected that SACs become infected generalized seborrhoea. However, the main
from this source. Equally it is likely that SACs sign is an irreversible retinal atrophy causing
can harbour the mites and spread them to blindness.
healthy sheep. They are also indistinguisha-
ble from the mites affecting rabbits. It is very
likely that Psoroptes ovis and Psoroptes cuniculi Vitamin C deficiency
are the same species. They can infect all areas
of the animal. However, they are particularly
This deficiency has been recognized in SACs.
likely to be found on the ears and in the ear
It is non-pruritic and shows marked alopecia
canal. Treatment with injectable avermectins
and some scaling. It may not be a true defi-
three times at weekly intervals is normally
ciency but rather a vitamin C responsive
successful.
alopecia.

Vitamin and Mineral Related Skin


Vitamin E deficiency
Diseases
This condition is seen in SACs. It is not a real
Cobalt deficiency deficiency but rather a vitamin E/selenium
responsive dermatosis. The animals appear
Deficient animals will have a rough brittle healthy and are non-pruritic but lose their
hair-coat or wool. Other deficiency signs (e.g. hair.
weight loss) may be severe.

Zinc deficiency
Copper deficiency
This is rarely a zinc deficiency but usually a
The other signs of copper deficiency are much zinc responsive condition. There is marked
more important (see Chapter 2). However, scaling and crusting. Clinicians should
black SACs will show a lack of pigment. Fibre remember that any blood samples for zinc
animals will show a lack of crimp. levels must be taken into bottles without
166 Chapter 14

rubber stoppers or erroneous results will be and build-up of the photodynamic agent phyl-
obtained. loerythrin in tissues. The plant bog asphodel
Narthrecium ossifragum has been implicated in
this secondary type (see Chapter 16).
The clinical signs typically occur in non-
Physical Causes of Skin Disease
pigmented areas of the animals free from fibre
in alpacas and anywhere on llamas. Diagnosis
General may be made on clinical grounds with confir-
mation by showing raised serum levels of phyl-
Clinicians should never forget commonplace loerythrin and, in the case of hepatogenous
trauma. Air-gun pellets will cause abscesses, disease, raised levels of serum liver enzymes.
normally on the flank. They may be found Animals should be housed and any severely
when lanced or confirmed quite simply with a affected areas treated with oily creams. The
rectal linear ultrasound scanner. Tethered ani- condition is often first seen when animals are
mals will develop tether galls or bell strap turned out on to lush green pastures (e.g. silage
galls. Working llamas may get saddle sores. aftermaths), having been on poor pasture. The
These are welfare issues and owners should be liver is unable to cope with the increased
counselled carefully. Chronic foot lameness in amounts of dietary chlorophyll.
the front legs will result in excessive kneeling
and the formation of hygromas on the carpi.
Burn cases will often result in keloids and
crusty nodules. Sunburn

The harmful effects of ultraviolet radiation


from direct sunlight in shorn alpacas should
Frostbite not be forgotten as a potential cause of skin
damage particularly in areas where there is
This condition has been seen in SACs when no shade. Encrustment of the non-pigmented
outside in extreme weather conditions. It is skin with ultimate necrosis of the epidermis,
normally the ears that are affected. The skin upper dermis and superficial sebaceous
will slough. The animals should be given glands may occur. Animals should be housed
antibiotics to prevent secondary bacterial and oily creams applied to the affected areas.
infection and NSAIDs to lessen the pain. Antibiotics and NSAIDs may be required in
Obviously the animals should be brought severe cases.
inside until the weather improves.

Trauma
Photosensitization
SACs can obviously be burnt by either a
Sunburn will cause crusting in photosensitized naked flame or a hot piece of metal. There are
animals. This condition occurs because of some more unusual forms of trauma, e.g.
the presence of photodynamic substances in attacks by magpies. Shearing wounds are
the skin capable of causing severe dermatitis in sadly rather common.
the presence of sunlight. Such agents release
energy obtained from the light in hyperoxida-
tive processes harmful to the skin. This may be
primary as a result of a photodynamic agent Toxic Causes of Skin Diseases
(for example a plant, e.g. St Johns wort
Hypericum perforatum; see Chapter 16) or a Milk toxicity
photosensitizing drug (e.g. phenothiazine), or
secondary due to impairment of liver function Crias will develop toxicity similar to photo-
resulting in failure to denature chlorophyll sensitization when suckling on dams that are
Skin Conditions 167

suffering from hepatic toxicity from eating


certain poisonous plants, e.g. Sacahuista bear-
grass (see Chapter 16).

Tick toxicosis

This occurs sporadically. Several species of


tick have been incriminated. The tick, usually
a pregnant female, produces a toxin that
causes a systemic disease. All the fibre falls
off leaving a thickened, reddened skin. The
animal will recover if kept out of the sunlight
and given antibiotics parenterally to prevent Fig. 14.3. Pemphigus foliaceus.
secondary infection. The animal should have
all the sore areas covered with oily cream.
signs include a generalized severe pustular
eruption involving most of the body.
Treatment is difficult as all the secondary
Neoplastic Conditions bacteria, fungi and parasites have to be
removed before regular steroid treatment is
The malignant tumours that may occur in the carried out. Although in theory dexametha-
skin anywhere on the body are histiocytomas, sone should not be effective if given orally,
lymphosarcomas, malignant melanomas and that has not been the authors experience.
squamous cell carcinomas. The latter occur in The dose is 2 mg/kg given every other morn-
the conjunctiva, on the third eyelid, on the ing throughout the summer in temperate
penis and on the vulva. Melanomas are not countries. Normally the condition calms
restricted to white SACs. They can occur in down during the winter months only to flare
animals of other colours. up again in the spring.

Skin Diseases of Uncertain Aetiology Wool slip

Pemphigus foliaceus This condition is associated with winter


shearing. It seems to affect animals in poor
This condition causes a diagnostic challenge conditions. There may be a link with either
for the clinician. It is an auto-immune medi- low copper levels or secondary low copper as
ated disease (Fig. 14.3). Bacteria, fungi and a result of high molybdenum levels. This alo-
even parasites may well be found as second- pecia is non-pruritic and the underlying skin
ary invaders. If the skin condition persists appears normal. There is no treatment.
after treatment for these conditions the prac- Prevention can be carried out by raising the
titioner should suspect pemphigus. It can be nutritional level at times of stress, e.g. chang-
confirmed by a biopsy. The main presenting ing the time of shearing/housing.
15
Cause of Sudden Death
and Post-Mortem Technique

Iatrogenic Causes of Sudden Death Lumbar/sacral collection of cerebrospinal


fluid
Sudden death is a misnomer. In reality it is
found dead since last seen. The owner will Lumbar/sacral collection of cerebrospinal
very rarely see an animal die. It is even rarer fluid (CSF) is not a hazardous procedure.
for the clinician to see death. Sadly when such However, unless clinicians have been ade-
deaths occur it is usually at the time of veteri- quately trained it is a procedure that does
nary treatment. The likely causes of iatrogenic have risks as the spinal cord is actually present
deaths in SACs are shown in Table 15.1. at this site.

Anaphylaxis from administration Massive haemorrhage


of medicines
This can occur at parturition without human
This must be a very rare event. It has been interference. However, it is extremely rare
reported following the use of the antibiotic without trauma caused by rough parturition
tilmicosin, Micotil, which is licensed in techniques. Very great care should be taken
sheep. This antibiotic has been associated by clinicians when assisting the parturition,
with sudden deaths in SACs and should not particularly in small alpacas. Haemorrhage
be used in this species. occurs from the middle uterine artery. This
artery may also be ruptured at the time of
uterine prolapse.
General anaesthesia

General anaesthesia in adult animals is Intra-arterial injection


bound to carry a high risk, particularly if the
surgery is likely to be long and gaseous This type of injection is always an error.
anaesthesia is required. The risk can be However, it is relatively common with most
minimized by careful monitoring and super- clinicians admitting that it has occurred when
vision of recovery. they have been attempting an intravenous

168 G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson)
Cause of Sudden Death and Post-Mortem Technique 169

Table 15.1. Possible iatrogenic causes of sudden Reasons for Animals to be Found Dead
death.

Anaphylaxis from administration of medicines True sudden deaths are very rare. Possible
General anaesthesia causes of sudden deaths in SACs are shown
Lumbar/sacral collection of CSF in Table 15.2.
Massive haemorrhage (this could occur at parturition
where there is no human involvement)
Intra-arterial injection
Intravenous injection Anthrax
Sedation
This is not easy to diagnose from gross
pathology in SACs. As it is so rare clinicians
injection in SACs. The carotid artery lies just are unlikely to take a blood smear and find
deep to the jugular vein in the caudal third of the classical bacteria with their capsules.
the neck. Obviously if an enlarged spleen is found on
post-mortem anthrax should be suspected.
In cattle haemorrhages are seen from exter-
nal body orifices. This feature is not often
Intravenous injection seen in SACs. However, there will be
enlarged lymph nodes with ecchymoses
There are no licensed medicines in SACs in and petechiae seen on the mucosal
the UK. Most medicines, which are licensed surfaces.
for sheep and cattle, can be used in SACs
using the cascade principle. There are certain
licensed medicines that anecdotally cause
Cast on the back
collapse and death in cattle and horses when
given intravenously. The most notable are
potentiated sulfonamides and vitamin B This is only a problem in an over-fat,
complexes. It is not suggested that these unshorn pregnant female, heavy in the
medicines are never given intravenously. wool, which has rolled into a depression.
However, clinicians should consider care- Animals can survive for many hours and
fully before using them by this route and will recover when righted. However, it is
should always inject them extremely slowly. vital that the individual is shorn without
It is well known that magnesium sulfate, delay as they often will be cast again in the
which is supplied in a 25% solution, should next 48 h.
never be given intravenously to any animal
but only subcutaneously. Even the 5% solu-
tion should be injected very slowly if given Table 15.2. Causes of sudden death.
intravenously. Anthrax
Cast on the back
Chemical poisons
Clostridial disease
Sedation
Drowning (this may occur at dipping or in deep
water)
Although xylazine is widely used as a sedative Electrocution
it should be used with caution. The safety mar- Hypomagnesaemia
gin is not large. It is prudent to dilute the 2% Lightning strike
solution, which is manufactured for cattle, Poisonous plants
when injecting crias and young growing Ruptured aneurysm
alpacas. Weights can be deceptive particularly Ruptured uterine artery
Snake bite
in fleece-covered animals. Accurate weighing
Trauma (this is mainly road traffic accidents or
is very useful. Very small doses of xylazine are
fighting in males)
required.
170 Chapter 15

Chemical poisons Electrocution

There are very few chemicals that will actually This is an extremely rare cause of death. It is
cause sudden death, as normally quite large only likely to occur if an animal gets tangled
quantities need to be consumed. Metaldehyde up in an electric fence powered from the
in slug bait is a possibility, as is nicotine from a mains. Young animals might chew through
pipe smokers pouch full of tobacco. Both these electric leads, resulting in electrocution.
poisons will be found in C1. Normally lead poi-
soning is a chronic toxicity but acute deaths
with neurological signs will be seen when ani- Hypomagnesaemia
mals have ingested paint from old gates or
doors. The paint will readily be seen in C1.
This condition can occur, though it is
extremely rare in SACs. The classic situation
for the disease to occur is when the grass has
Clostridial disease been very heavily fertilized. Actual sudden
death is unusual. The area around the carcass
This is the most likely cause of sudden death should be examined carefully, as often the
in well-fed SACs. Clostridium perfringens signs of the convulsions before death will be
types A, C and D will all cause sudden death. seen. Normally the animal will be recumbent
It is nearly always seen in animals that have showing severe neurological signs, which
access to lush grass. Type D has been seen in even with magnesium treatment are irrevers-
animals on high concentrate diets. There is ible. A serum blood test from an animal that is
rapid autolysis. An excess of abdominal fluid still alive will be diagnostic. Testing the aque-
and pericardial fluid will be seen. The small ous humor from a carcass will be helpful.
intestine will be hyperaemic and ulcerated. Haemorrhages may be seen on the endocar-
Diagnosis can be confirmed by toxin neutral- dium but these are not actually diagnostic but
ization tests. Glucosuria is only seen in sheep only indicate that the animal has died after
and not in SACs. Clostridium chauvoei will having convulsions. However, the history
cause black leg in ruminants; there is doubt if will indicate that hypomagnesaemia is a pos-
it has been seen in SACs. Given the circum- sible cause.
stances (e.g. a contaminated needle from an
injection), it is likely that it would occur.
There will be an area of crepitus. Smears
should be taken for testing for fluorescent Lightning strike
antibodies. Clostridium novyi, which will cause
Blacks disease in ruminants, has not been Diagnosis is likely to be circumstantial. There
recorded in SACs. Clostridium septicum will has to have been a thunderstorm in the last
cause sudden death in SACs. Oedematous 24 h! The whole body should be examined for
swellings without any gas formation will signs of burning. Then careful skinning should
be seen. Clostridium botulinum has not been be performed so that lines of subcuticular
recorded in SACs but it is certainly likely to haemorrhages are not missed.
occur as it has been seen by the author in
camels in northern Kenya.
Poisonous plants

Drowning There are poisonous plants that will cause


sudden death in SACs. However, these are
The diagnosis is likely to be obvious, with the rarely consumed in large enough quantities
lungs being full of water or dip. Inhalation to bring about almost instant death. Diagnosis
pneumonia from incorrect drenching tech- of plant poisoning can be made by examina-
nique will not cause sudden death. tion of the contents of C1. The plant, which is
Cause of Sudden Death and Post-Mortem Technique 171

often quoted in the textbooks, is yew. This parturient animal is found dead, with the cria
certainly causes sudden death in cattle, which alive and well. Obviously on post-mortem the
require very little to cause rapid death. The abdomen will be full of blood.
author has seen a case in an alpaca. However,
there is considerable doubt now if yew is as
toxic to small ruminants as previously
Snake bite
thought (Angus, 2010; Scott, W.A., 2010;
Stevenson and Swarbick, 2010). These authors
indicate that certain breeds of sheep and deer The author doubts that an adder would have
are relatively resistant. However, herd and sufficient venom to kill an alpaca or llama in
flock owners should still be vigilant, particu- the UK. However, in countries where there
larly when other feeds are not available, e.g. are more venomous snakes this is certainly a
in snowy conditions. possibility. Normally animals are bitten on
Llamas are particularly at risk from plant the face and so the small puncture wounds
poisoning when tethered on a trek. In this sce- should be looked for if the head is swollen.
nario normal feed will be eaten first and then
the animals may consume a large volume of a
toxic plant. Obviously alpacas and llamas are Trauma
at risk if they escape from their normal habi-
tat or if they are presented with cut toxic
The signs shown from road traffic accidents will
plants on rubbish dumps or compost heaps.
be broken bones, subcutaneous haemorrhage
If plant poisoning is suspected then the
and rupture of internal organs. Trauma from
mouth should be checked to see if there are
fighting in males will be obvious externally and
any parts of the plant still in the mouth. Some
can be checked with careful skinning of the neck.
plants containing alkaloids that directly affect
This will reveal the haemorrhages from the bites.
the heart are so toxic that death will occur
Careful examination of the neck may also reveal
instantly. SACs will die very rapidly if they
a fracture. Very great care will be required open-
consume laburnum seed pods. The area
ing the neck vertebrae to examine the spinal
around the body should be checked for evi-
cord. Samples should be taken for histology.
dence of browsing.

Ruptured aneurysm Post-Mortem Examinations

Aneurysms can occur anywhere in the animal. Equipment required


If they occur in the brain the animal will be
found dead. Diagnosis without multiple his- Large plastic bucket with disinfectant,
tological sections will be very difficult. If the warm water, soap and towel;
rupture occurs in the mesenteric vessels then Butchers knife and flaying knife;
the abdomen will be full of blood. This is seen Scalpel and blades that fit;
in horses on account of the damage done to Rat-toothed forceps (15 cm);
mesenteric blood vessels by the migration of Fine forceps (15 cm);
large strongyle larvae. This does not happen Blunt-nosed straight scissors (20 cm);
in SACs so such a rupture is extremely rare. Bowel scissors;
Bone cutters, saw and hedge loppers.

Ruptured uterine artery


Sampling materials
This is a very rare occurrence in SACs and is
seldom seen. It may occur while there is an Plastic trays (50 30 5 cm);
assisted parturition but more commonly the Plastic bags of various sizes;
172 Chapter 15

Sterile universal bottles; 10. Faeces can be collected from the rectum.
Plastic jars (1 l); 11. Blood samples can be taken from the
Bottles of formalin (kept separate); heart blood. These would not be useful for
Pots containing 50% glycerol for virus biochemistry or haematology. However, cer-
isolation; tain serological examinations are useful and a
Swabs (plain, transport media and spe- zinc sulfate turbidity test is meaningful in
cialized for respiratory pathogens); young crias.
Vaccutainers: 12. The entire thyroid gland should be dis-
Red top serum routine serology sected out for later weighing.
and biochemistry 13. Samples of diseased lung should be taken
Green top heparin glutathione from the edge of the lesions after swabs have
peroxidase (selenium) been taken. As antibiotics do not penetrate
Lilac top EDTA haematology consolidated lung tissue, samples for bacteri-
Grey top oxidase/fluoride glucose ology can be taken from such a site.
Blue top acid wash special ions, e.g. Zn 14. Samples from abscesses should include
Pasteur pipettes and rubber sucker; scrapings from the interior of the abscess
Clip-board; wall.
Post-mortem report form, lab submission 15. Abnormal heart lesions are often best
form. examined microscopically after swabs have
been taken of the heart blood.
16. Swabs should be taken from joint
cavities.
Sampling 17. Muscles can be stored fresh in plastic
bags, or bottles and some should be put aside
1. If the animal is presented alive and blood to have 10% formalin added later.
is required for examination, then it is better to 18. Smears can be made from bone marrow
take it before the animal is killed. and some can be retained to have an addition
2. If you require examination of the brain then of 10% formalin later.
it is better to use chemicals for euthanasia, 19. Swabs should be taken from liver, spleen
rather than a humane killer or free bullet. and kidney.
3. Before sampling it must be decided if swabs 20. 100 g of both liver and kidney should be
are going to be taken and/or bacteriological retained for toxicology.
plates are going to be prepared immediately.
Only after these samples have been taken are
4. Abnormal lymph nodes should be trans-
the intestines examined and opened.
acted and put into two universal bottles.
These must be labelled. One will be kept fresh 1. Bezoars should be preserved in universal
and the other at a later stage will be filled bottles.
with 10% formalin. 2. 1 kg of rumen contents should be taken
5. As a rule of thumb there should be ten into a plastic bag for toxicology.
parts of formalin to one part of tissue. 3. The contents of C1 should be examined
6. Impression smears should be taken from the carefully for the presence of poisonous plants.
cut surfaces of any malignant oedema subcuta- If they are found they should be stored in
neous tissues or muscles and air dried. plastic bags for identification.
7. Individual samples can be put into plastic 4. The contents of C1 can be tested for thia-
bags or universal bottles. If histology is required minase to diagnose cerebro-cortico-necrosis
at a later date, 10% formalin can be added. (CCN).
8. Urine can be collected into a universal bot- 5. For helminthological studies, the entire
tle (testing for glucose is not useful for the contents of C3 and/or the small intestine
diagnosis in SACs of possible clostridial should be collected into a large jar for wash-
disease). ing and sieving later.
9. Milk can be collected into a universal 6. The contents of affected parts of the small
bottle. intestine should be collected into universal
Cause of Sudden Death and Post-Mortem Technique 173

bottles (minimum 20 ml) to examine for 12. Examine the organs in situ in the abdo-
clostridial toxins. men. Starting at the xiphisternum C2 will just
7. 30 g of caecal contents or faeces should be be visible. Caudal to C2, C3 will just be visible
taken into a plastic bag for worm egg counts below the liver, which will rise up into the
and bacterial culture. thorax and slightly caudal to the last rib
8. Histological samples are only worthwhile (12th). Caudal to the liver will be seen the
from the intestines if the carcass is absolutely glandular saccules of C1. Dorsal to these sac-
fresh. cules will be seen the caudal sac of C1. Cranial
to this is the duodenum. Caudal to the sac-
cules on the body wall will be seen the proxi-
Technique for post-mortem when single mal loop of the ascending colon. The right
handed without a trough to hold kidney will be visible on the dorsal surface of
the SAC in dorsal recumbency the abdomen halfway between the last rib
and the hindleg. The rest of the abdomen will
be filled with jejunum. (If the SAC had been
Examine the external surfaces and feel the
placed with its left side uppermost, C3 would
superficial lymph nodes. Record the breed
be seen lying on the ventral wall of the abdo-
and sex.
men with the glandular saccules of C1 just
1. Weigh the SAC and note its condition above it. Above them would be seen the cau-
score. dal sac of C1 reaching up to the spine. Behind
2. Examine its incisor teeth and its eyes. Take the caudal sac of C1 close to the spine the
a sample of its aqueous humor into a red spleen would be seen. The rest of the abdo-
vaccutainer. men is filled with the spiral colon. A small sec-
3. Look at its feet and feel its peripheral leg tion of the descending colon will be seen
joints for swellings. caudal to the spleen and a small amount of
4. Examine the udder/scrotum. jejunum will be seen just cranial to the ilium.)
5. Place the SAC in lateral recumbency with 13. Cut the diaphragm with a pair of blunt-
it right side uppermost. nosed scissors under the ribs.
6. With a knife cut through the skin in the 14. With the garden loppers cut the ribs either
axilla and the muscles of the shoulder so that side of the sternum so it can be removed.
the whole of the right foreleg can be reflected 15. Cut the intercostal muscles with a knife
back to lie on the floor. between every other rib and then break them
7. With a knife make a bold cut through the back over the backbone.
skin in the groin. Cut through the muscles 16. The right lung will now be visible crani-
into the hip joint, cutting the femoral liga- ally with the liver caudal to it.
ment, and lay the right hindleg on the floor. 17. Starting under the mandible elevate the
8. Flay the skin from the front leg caudally tongue with a knife so that the whole pluck
along the midline to the incision near the (i.e. larynx, trachea, lungs and heart) can be
hindleg so the skin can be laid back over the removed for examination later after the
backbone. The inside surface can be used to oesophagus has been tied. Examine the cheek
lay out visceral organs. teeth at this time.
9. Flay the skin from the front leg rostrally up 18. Examine the lungs, having cut down the
to the head so the teeth and mandible are trachea. Sample the heart blood and examine
exposed. the heart.
10. At the xiphisternum carefully open the 19. After tying off the rectum the three com-
abdomen with a pair of blunt-nosed scissors partments of the stomach C1, C2 and C3, the
and make an incision along the midline cau- intestines, the spleen and the liver can be
dally to the pelvis. removed.
11. Make a second incision through the body 20. Examine the whole of the gastroenteric
wall from the xiphisternum along the line of tract and the lymph nodes from the outside.
the last rib to the backbone, so that the abdom- 21. Take samples after examining the liver
inal muscles can be reflected. and spleen.
174 Chapter 15

22. Away from the carcass open up the gas- nasal bone just caudal to the eye sockets join-
troenteric tract after taking samples and even ing the two lateral cuts. A final fourth saw cut
milking out the small and large intestines is made across the caudal aspect of the cra-
separately for parasite examination. Examine nium linking the caudal ends of the two lat-
the contents and the mucosal surface. eral saw cuts. The skull can then be lifted off,
23. The bladder can be examined and a urine revealing the brain underneath. This should
sample can be taken. be examined for gross pathology and then
24. The female or male genital organs can be examined under fluorescent light to diagnose
examined. CCN. The brain can then be removed to take
25. The kidneys can be removed and examined. histological samples after any bacterial sam-
26. After this the head can be removed from ples have been collected.
the neck and the brain can be removed.
27. The brain should be examined for CCN.
If there is a proper post-mortem table availa- Post-mortem examinations of neonatal
ble the post-mortem can be performed with crias and aborted fetuses
the SAC in dorsal recumbency.
1. It should be remembered that mummified
fetuses are useless for diagnostic purposes.
Removal of the brain 2. The placenta as well as the aborted cria can
be sent to a referral laboratory if possible.
3. If a fetus cannot be sent then fresh perito-
This is not an easy procedure. Clinicians
neal fluid, pleural fluid and C3 contents
should take special care for health and safety
should be sent on ice if possible, together with
reasons. Goggles and face masks should be
fresh liver. A totally separate small piece of
worn. Rubber gloves should be worn as for
liver in formalin should be sent.
all post-mortem examinations. The skin over
the head including the ears should be flayed They will look for Brucella, but as practition-
away from the bones of the skull. Using a ers you will be aware it does not occur in the
meat saw two parallel cuts are made through UK. They will also look for Toxoplasma,
the skull in a rostral-caudal direction laterally Chlamydophila, Listeria and Salmonella as well
to the eyes. A third saw cut is made across the as doing general bacteriology.
16
Poisons

Introduction signs and the poison is unknown, a drip of


normal isotonic saline with a 16G catheter
The first problem with poisoning cases is should be set up. Clinicians should remember
establishing a diagnosis. If the poison is defi- that the saline must be warm. Efforts should
nitely known, that is obviously very helpful. be made to make sure that the animal itself
However, owners in the UK are often very is warmed up by being not only in a warm
keen to wrongly blame farmers for suspected place but also having hot water bottles around
poisonous sprays, so any history needs to be it. There are commercial coats available for
taken with caution. If there has definitely crias, alpacas and llamas. Obviously if the
been a spilt chemical, then the clinician should poison is known and there is a specific treat-
make sure this fact is used immediately so ment available, this should be given as a pri-
that any antidote can be obtained while the ority. Otherwise the clinician should carry out
patient is being brought in. Equally if a plant symptomatic treatment. The practitioner
has been eaten, the clinician should make needs to make a careful clinical judgement if
sure the owners pass on the name of the plant the animal is in extremis. Welfare must be con-
so the toxicity can be checked and treatment sidered. Euthanasia must be considered. If
can be readied while the animal is being there are several animals affected it may be
brought in. If a plant has definitely been eaten kinder to put the really badly affected animals
but they do not know what it is, the clinician to sleep and concentrate on treating the ani-
should make sure the owners bring some of mals that could possibly survive.
the plant in with them. It needs to stressed Notes should be taken as poisoning cases
that the leaves and the fruit and maybe even often lead to litigation or to insurance claims.
the roots are required to help identification. It is likely that any animals that have died
Also clinicians should remember to tell the or are put to sleep will have to be post-
owner to remove any other animals away mortemed. Careful notes once again should
from the toxic plant or substance. be taken with a full identification. Obviously
If the alpaca or llama is seriously ill a full carefully labelled samples will need to be
clinical examination should be carried out. collected (see Chapter 15).
Clinicians must not base a diagnosis exclu- With animals that are found dead, it is
sively on the history of exposure to the important to try to establish a time of death.
poison. If there are no helpful diagnostic The owner may be convinced that it has been

G.R. Duncanson 2012. Veterinary Treatment of Llamas and Alpacas (G.R. Duncanson) 175
176 Chapter 16

sudden but in reality it may be that they have Gastroenteric: anorexia, polyphagia,
not looked at the animals for a length of time polydipsia, colic, vomiting, diarrhoea,
(see Chapter 15). melena, icterus, tenesmus;
Respiratory: dyspnoea, tachypnoea;
Cardiovascular: arrhythmia, bradycardia,
Information Required from a Suspected tachycardia, anaemia, oedema, haemor-
Poisoning Case rhage, haematuria, icterus, haemoglobinu-
ria, fever, weakness;
Urino-genital: anuria, polyuria, haematuria,
Owner (manager if different);
anoestrus, hyperoestrogenism, agalactia,
Address;
abortion, stillbirth.
Contact phone numbers plus fax plus
email address;
Illness in previous 12 months;
Exposure to other animals in last 21 Clinical and Post-Mortem Specimens
days; for Toxicology
Vaccination history with other medica-
tions, including wormers and topical
Blood: 10 ml in EDTA (purple top vac-
medicines;
cutainer) chill and submit on ice if
Location, e.g. pasture, wood, waste
possible;
ground, garden, pond and housing;
Serum: 10 ml (red top vaccutainer) before
Recent change of location, e.g. transport
death or from heart blood after death.
to shows, access to waste, old construc-
Spin remove clot; submit chilled or
tion materials, mining, dredging;
frozen;
Recent deaths;
Brain: send half frozen and half in formal
Age, sex, pregnancy, weight loss;
saline;
Size of total herd and size of group
CSF: 4 ml if possible, chilled;
(shared feed or water between groups);
Ocular fluid: 4 ml chilled or frozen;
Morbidity and mortality;
Contents of C1, C2, C3 and intestines;
Date of first animal to be seen sick or
1 kg from each should be taken and
dead;
frozen;
Onset and progression of signs;
Injection site: 100 g frozen for drug
Malicious threats or new staff;
residues;
Recent changes in feed or pasture;
Liver: 200 g frozen;
Weeds or moulds;
Kidney: 200 g frozen;
Insecticides, acaricides, anthelmintics,
Urine: 100 ml, half chilled, half frozen.
herbicides and rodenticides;
Outside services, e.g. tree planting, pas-
ture seeding, fertilizing, burning, build-
ing construction; Plant Collection
Changes of diet, including new hay, hard
feed, spoilt feed etc.;
The ideal method of preserving a suspected
Pasture type e.g. bare, lush, weeds
toxic plant is to freeze it. If this is not possible,
present.
it should be partially dried and then placed in
a paper bag. This should then be placed in an
oven at 150F (65C) for 12 h to totally dry the
Clinical Sign Checklist plant. Plants should not be microwaved or
refrigerated.
Neurological: ataxia, salivation, blindness, It is very difficult to find plants in hay as
impaired vision, depression, excitement, they will not be evenly distributed. If is better
seizures, head pressing, cerebellar signs, to examine the area from which the hay or
weakness, dysphonia; silage was cut.
Poisons 177

Diagnostic Criteria allowed to escape they are in danger of gaining


access to toxic plants. Tethered animals or
History; animals on a trek are at risk if they are short of
Clinical signs; food and only have access to a plant that they
Clinical laboratory evaluation; normally would not eat, but which is toxic.
Post-mortem picture; Llamas and alpacas are at risk from access to
Chemical evaluation. garden rubbish or indeed being fed cut toxic
plants. Such plants may be presented by mis-
take as browse or dried in hay or haylage.
SACs will find it particularly difficult to reject
Evaluation of Water Drunk by Possible
plants in silage. It is very important to remem-
Poisoned Animals ber that it is a complete myth that llamas and
alpacas will not eat plants that are bad for
Salt content; them. SACs originate on the altiplano in
Sulfate content; South America which is remarkably free of
Nitrite/nitrate content; toxic plants. SACs are therefore particularly
Algae; prone to ingesting poisonous plants with
Hardness; which they are unfamiliar.
Minerals;
pH;
Bacteria;
Temperature. Abrus precatorius (Gidee-gidee)

This vine with pink flowers, which turn into


Treatment curled pods containing red and black seeds, is
found throughout the tropical parts of
Australia and in the tropical islands to the
The first effort must be to try to prevent further
north of Australia. It is also called the rosary
absorption of the toxin. The clinician should
pea or the precatory bean. The seeds are toxic
consider trying to empty C1. If the animal is
and cause acute enteric signs. The only treat-
very ill and a specific treatment is not being
ment is supportive.
given, the practitioner has very little to lose.
A general anaesthetic is not given as a local
block is going to be used in the left paralumbar
fossa. Entry into C1 may well make a diagno- Acacia berlanderi (Guajillo)
sis by finding the plant in the organ. It is
advisable to stitch C1 to the peritoneum of the This shrub causes poisoning under drought
abdomen so there will be very little contami- conditions in Mexico. The animals become
nation. Any remaining plant toxins can be recumbent but retain their appetite. They will
removed by removing the ingesta and flushing recover with good nursing and a toxin-free diet.
C1. The animal can be rehydrated by half Obviously the rest of the flock or herd should be
filling C1 with electrolytes. A proprietary ant- given supplementary feed immediately.
acid preparation containing some bicarbonate
can be used. If there is a specific treatment then
that must be carried out. Also symptomatic
treatment in all cases will be useful. Acer rubrum (Red maple)

This tree is found in eastern parts of the USA.


It is rarely eaten by SACs except llamas on the
Plant Poisons trek. It contains an oxidant that will cause
haemoglobinuria. If the animals are very
Plant poisoning is liable to occur under a variety anaemic they will need to be given whole
of circumstances. Obviously if animals are blood as a transfusion.
178 Chapter 16

Aconitum napellus (Aconite) and is grown in gardens in the UK. All of the
plant is toxic as it contains a cardiac glyco-
This flowering plant of the ranunculus family side. Animals will be found dead. The remain-
occurs throughout the world. It is called der should be given oral activated charcoal at
monkshood in the UK. It takes its name from 5 g/kg with an electrolyte solution by mouth.
the dark blue helmet-shaped flowers. It is one In theory the cardiac arrhythmias can be con-
of the most poisonous plants in the UK. All trolled by atropine. However, this requires
parts of the plant are poisonous and contain very careful monitoring.
an alkaloid that causes neurological signs,
e.g. recumbency and dilated pupils. These
signs lead on to acute depression and death. Aesculus hippocastanum (Horse chestnut)
Treatment including stimulants is ineffective.
This is a very common large tree found in the
UK and originated in the Balkans. It contains a
Adenium obesum (Desert rose) saponic glycoside termed aesculin. Harwood
et al. (2010) reported poisoning in a Cashmere
This plant is found worldwide in hot dry goat. There have been no reports in SACs. The
locations. It is sometimes called mock or goat showed severe tachycardia and tachyp-
desert azalea. It is a succulent shrub or small noea. There was profuse salivation and cyano-
tree with red flowers. It contains cardiac gly- sis. The main post-mortem signs were respiratory
cosides, but is rarely a problem as it causes and circulatory. There is no known antidote.
vomiting and is not palatable to SACs. The
treatment is symptomatic.
Aesculus spp. (Buckeye)

Adonis aestivalis (Adonis) This is a large shrub, which can even grow
into a tree, and is found throughout North
America. The young shoots and seeds are
There are approximately 35 species of this
particularly poisonous. It causes neurological
plant found in Europe and temperate Asia.
depression and inflammation of the mucous
Adonis aestivalis is found in North America.
membranes. Treatment is symptomatic and
It was thought to be cardiotoxic and could be
normally successful.
ingested in hay. Authors in the USA carried
out careful evaluation of its toxicity in sheep
(Woods et al., 2011). They concluded that
Aethusa cynapium (Fools parsley)
sheep were resistant to intoxication. It is sug-
gested that SACs may also be immune.
This herbaceous weed with white flowers
occurs in Europe and North America. In the
UK it is also known as lesser hemlock. It has a
Adonis annua (Pheasants eye)
repulsive smell, making it a rare cause of tox-
icity. It causes recumbency and inappetence.
This plant is found in the UK. It should not be The latter sign aids recovery as normally
confused with Adonis microcarpa, which has the insufficient amounts of the plant are con-
same local name in Australia. There has been sumed to cause death. There is no specific
no record of A. annua causing signs of toxicity. antidote and treatment is symptomatic.

Adonis microcarpa (Pheasants eye) Agapanthus orientalis (African blue lily)

This annual herb with glossy scarlet flowers This is a tall perennial herb found in gardens
is found in the temperate parts of Australia worldwide. It is the rhizome that is liable to
Poisons 179

cause problems in SACs. It causes intense irrita- New Zealand, New Guinea and on many
tion of the tongue and pharynx. The toxin is self Pacific islands. There is a complex toxicologi-
limiting and not dangerous as the symptoms cal process, which results in convulsions and
regress in 30 min. Treatment is symptomatic. death, called floodplain staggers. The toxic
principle is a corynetoxin, which is produced
by Rathayibacter toxicus, a bacterium in the
Agave americana (American aloe) seed head nematode galls on the grass. There
is a hope to develop cyclodextrin, a toxin
binding agent, to be an antidote, but as yet
This garden plant is found worldwide and
trials have not been successful.
may also be called the century plant. Poisoning
is self limiting in SACs as the plant contains
irritant oxalates that cause pain and inflam-
mation of the lips, tongue and pharynx. Aleurites fordii (Tung oil tree)
Treatment is symptomatic.
This tree used to be grown for its oil on farms
in the south-eastern USA. It is now found
Agave lechuguilla (Lechuguilla) wild in woods and is also grown in gardens.
All parts of the tree are toxic. It causes acute
bloody diarrhoea, dehydration and death.
This perennial desert plant is found in the
There is no specific treatment but supportive
south-west of North America. Large quanti-
fluids should be tried.
ties need to be consumed over a few weeks to
cause toxicity. This is likely to occur in drought
conditions. The plant contains an unidentified
liver toxin, which causes photosensitization. Allamanda cathartica (Golden trumpet)
The animals need to be brought in out of the
sunlight and put on a low protein diet. Vitamin This is a climbing perennial found in tropical
B injections may be helpful. The plant also areas of the Americas. It contains lethal alkyl-
contains toxic saponins that can cause abor- iridoid terpenoids. Luckily it is very irritant
tions. There is no preventative treatment. and SACs will not eat sufficient to cause major
toxic signs. A llama would require 2 kg to
cause major signs and possible death.
Agrostemma githago (Corn cockle)

This annual plant is seen in cornfields Allium spp. (Onions)


throughout the world. However, it is rapidly
disappearing thanks to improved agricultural In theory onions should be toxic to SACs as
methods. The growing plant is avoided by they are to cattle in large quantities. SACs do
SACs. The only possibility of poisoning is not seem to be able to ingest a sufficient quan-
when the seeds are mixed in with grain, tity to cause toxicity. Wild onions are found
which is then fed to llamas or alpacas. in woodlands but do not seem to be eaten
The saponins in the seeds cause haemoglob- by SACs. The species are Allium ursinim,
inuria, acute diarrhoea, tachypnoea and A. vineale and A. oleraceum. They are actually
death. Blood transfusions are indicated. There garlics and do not appear to be toxic.
is no specific antidote.

Aloe barbadensis (Curacao aloe)


Agrostis avenacea (Blow-away grass)
This succulent herb is also called the Barbados
This grass occurs in subtropical and temper- aloe. It is found in the tropical and semitropical
ate areas of Australia. It also found in parts of the Americas. The young succulent
180 Chapter 16

leaves are the most dangerous to SACs as photosensitization shown on the faces of
they are attractive and contain high levels of white-faced llamas as crusty lesions. All ani-
an anthraquinone glycoside, which causes mals will show raised liver enzymes. The
severe diarrhoea. Treatment is symptomatic. diagnosis is made by collecting the algae for
the laboratory. The treatment is supportive,
obviously removing the animal from the con-
Alstonia constricta (Quinine tree) taminated water and providing clean water
is vital.
This tree is found in Queensland and northern
parts of New South Wales. The leaves and the
fruit are toxic to SACs. They contain indole Amaranthus retroflexus (Redroot pigweed)
alkaloids. These cause titanic spasms of the
skeletal muscles. Treatment consists of heavy This plant occurs in North America. SACs
sedation with alpha2 agonists. will eat it if there is no other food available.
It causes hindleg paralysis and eventual
death. There is no antidote.
Amianthium muscaetoxicum (Stagger grass)

This is a perennial herb found in acid soils on Apocynum spp. (Dogbane)


the eastern seaboard of North America. It is
not normally touched by SACs unless there is This is a large perennial herb found in open
absolutely no other food available. Such an woods throughout North America. The toxic
occasion might be a on a trek. It causes death glycoside, which it contains, causes dilated
by respiratory depression. There is no anti- pupils and congested mucous membranes.
dote. The animal should be destroyed if Symptomatic treatment with intravenous
in extremis. warm isotonic saline may be successful.

Ammi majus (Bishops weed) Arachis hypogaea (Peanut hay)

This herb is found in the temperate areas of This should not be fed to SACs as it will cause
Australia, where it causes problems. It origi- an acute respiratory syndrome, similar to fog
nated in the Nile valley. It contains furano- fever in cattle. There is a specific antidote,
coumarins, which cause photosensitization which is methylene blue at 10 mg/kg given
and the more serious corneal oedema. The slowly intravenously. The best approach is to
animals should be brought in to the dark. set up an intravenous drip of warm isotonic
NSAIDs should be injected and put as drops saline and then slowly add the methylene
into the eyes. blue. The prognosis is poor.

Anabena spp., Aphanizomenon spp. Arctotheca calendula (Cape weed)


and Microcystis spp. (Algae)
This annual herb originated in Cape Province
Algae cause poisoning by high concentra- in South Africa, hence its name. It is now
tions of specific species of blue-green algae in found in California and southern parts of
the drinking water. It is often a problem in Australia, not only in gardens but in the wild.
still inland lakes, e.g. the Norfolk Broads in It causes nitrate poisoning if large amounts
the UK. The acute form of toxicity will kill are consumed rapidly. There is vasodilatation
the animals within 1 h. The presenting sign is and shock. The antidote is intravenous 1%
cyanosis. In more chronic cases there is methylene blue at the rate of 5 mg/kg.
Poisons 181

Argemone spp. (Mexican poppies) be controlled with diazepam. Intravenous


fluids are helpful.
These are found in all areas of North America,
throughout Australia and in gardens in
Europe. They are an ornamental thistle-like Atropa belladonna (Deadly nightshade)
plant with yellow flowers. The seeds, which
contain isoquinoline alkaloids, are toxic. The
This plant, which is found in hedgerows in
toxic signs are cardiovascular with ventral
the UK, is also found throughout Europe.
and submandibular oedema, collapse and
It now is also found in North America. It is
death. There is no known antidote. The seeds
often confused with the more common woody
if crushed are detoxified by sunlight.
nightshade. Woody nightshade is not nearly
as toxic as deadly nightshade. Normally ani-
mals will not touch deadly nightshade when
Arum maculatum (Cuckoo-pint) it is growing. The only cases reported have
been when it has been included in hay (Hubbs,
This plant is found in hedgerows in the UK 1947). As the name suggests the plant con-
and in northern Europe. It is also called lords tains some atropine that gives the signs of
and ladies. It is very bitter and therefore poisoning, i.e. enlarged pupils and ileus.
extremely rarely eaten by SACs. Crias are However, the more toxic principle is an alka-
attracted to the bright red berries, which are loid hyoscamine. The specific antidote is
extremely poisonous. They cause acute gas- neostigmine at 0.01 mg/kg given subcutane-
tritis and violent diarrhoea. Poisoning is likely ously. The ileus should be treated with isot-
to be fatal unless intravenous fluids can be onic saline and flunixin intravenously. More
given immediately. old fashioned treatments include strong black
coffee and alcohol per os.

Asclepias spp. (Milkweed)


Baptisia spp. (Wild indigo)
This is a well documented poisonous plant
for rabbits. It is found in North America. There are several species of these herbaceous
SACs will only eat it when it is dried and hid- perennials, e.g. false indigo and yellow
den in hay. It is rare for animals to ingest indigo. They grow in the north-eastern areas
enough to cause problems. Initially there is of the USA and are dangerous in the spring
gut stasis followed by diarrhoea. There is no when they are green. They contain various
specific antidote but NSAIDs are helpful. alkaloids that cause neurological signs and
acute diarrhoea. SACs rarely eat enough to
cause severe symptoms. Treatment is symp-
tomatic and deaths are unlikely.
Astragalus spp. (Locoweed)

This plant is found in the western states of the


USA. It is called milk vetch in the UK. It is a Beta vulgaris (Sugarbeet)
perennial leguminous herb. It contains the
toxic alkaloid swainsonine, which causes The tops of this crop are often fed in the UK
tetanic convulsions, dilated pupils, dyspnoea, quite safely. However, toxic signs of acute diar-
coma and death. It is a cumulative poison so rhoea and recumbency may be seen in alpacas
that unless large quantities are available, SACs that are suddenly given large quantities. The
are rarely poisoned. The first appearance of treatment that is often successful is vitamin B
toxicity is that the animal will appear to have preparations and 20% calcium borogluconate,
very dull eyes. It will cause abortions. There is both given slowly intravenously. The dose of
no specific antidote. The convulsions should the 20% calcium borogluconate is 80 ml.
182 Chapter 16

Brachiaria spp. (Signal grass) Brunfelsia pauciflora floribunda


(Lady-of-the-night)
This grass is found in tropical areas in Asia
and Australia. It contains steroidal saponins This is an evergreen shrub or small tree
and causes abortion and photosensitization. found in gardens worldwide. It is not palat-
Animals will recover if brought in, but abor- able but contains a lethal cocktail of atropine,
tion is rarely prevented. scopolamine and hyoscyamine, which causes
ataxia and dilated pupils. The specific anti-
dote is neostigmine at 0.01 mg/kg given
subcutaneously.
Brachyachne spp. (Native couch grass)

This grass found in the interior in Australia


causes cyanide poisoning when large amounts Bryonia dioica (White bryony)
of the grass are consumed rapidly. Animals
are likely to be found dead. The remainder This plant, like black bryony, is a hedge climb-
should be dosed with 5 g of sodium thiosul- ing plant; however, it comes from a totally
fate by mouth. different plant family. The toxin is a violent
purgative. SACs rarely eat enough to cause
real toxicity, unless the roots are dug up and
fed. The roots, like the berries, are highly toxic
Brassica napus (Rape) as they contain large amounts of a glycoside
called bryonin. Intravenous fluids are the
This brassica is grown as a field crop world- only realistic treatment available.
wide. It can cause haemoglobinuria in SACs
but the actual trigger factor is not fully
understood except that normally it occurs
Buxus sempervirens (Box)
soon after the animals have ingested large
quantities. The animals will be anaemic,
similar to Haemonchus contortus infestation. This cultivated ornamental evergreen shrub
Normally they will survive if taken off is common on chalky limestone soils. It is
the rape. usually trimmed as a hedge but can grow to
more than 6 m. It is used for topiary in the
UK and Europe and also in Northern
America. It originated in North Africa and
Brassica oleracea (Marrowstem kale) western Asia. Like so many poisons, it was
historically used in small amounts as a
This is grown worldwide as a fodder plant for medicine to bring down fever. SACs will not
cattle. Toxicity in SACs is extremely rare. The touch the growing plant but may ingest
toxicity signs are haemoglobinuria and result- hedge clippings. Box contains a toxic alka-
ing anaemia. Animals will survive if taken off loid, which causes intense bowel irritation.
the kale. There is no specific antidote. Bowel protect-
ants may be helpful.

Brodiaea spp. (Brodiaea, Cluster lilies)


Caesalpinia spp. (Grey nicker bean)
This erect flowering plant has purple flow-
ers and is found on the west coast of the This tree is found in the tropical areas of
USA. It only causes poisoning if eaten by the south-west of the USA. It contains tan-
starving SACs. There is no antidote but nins, which cause acute diarrhoea.
symptomatic treatment for the diarrhoea is Treatment is symptomatic and normally
helpful. successful.
Poisons 183

Camassia quamash (Camas) species contains enough anthraquinone to


cause toxic signs. The plants often cause prob-
This plant is found in the wild in western lems after the first frost when they are wilted,
parts of the USA. It is rarely eaten by SACs. which seems to make them more palatable.
It will cause a transitory diarrhoea. No treat- Diarrhoea is followed by recumbency. The
ment is required. chance of recovery after recumbency is very
unlikely. As there is no specific antidote,
euthanasia is indicated. It should be noted
that the use of vitamin E and selenium is con-
Cannabis sativa (Marijuana)
tra-indicated in treatment as they increase
myodegeneration.
This plant, known as cannabis, which is
grown illegally as a recreational drug for
humans, may be eaten by SACs. They become
depressed, ataxic and will vocalize. They Cenchrus ciliaris (Buffel grass)
should be given supportive care, with intra-
venous fluids. They are often cold, so this This grass is found in tropical areas of
hypothermia should be addressed. The prog- Australia, the Far East, North and South
nosis is good unless seizures are seen. These America, and is a native of Africa. It is an
can be controlled with diazepam but the out- extremely invasive plant. It is only eaten by
come then is rarely good. SACs if there is no other forage or food avail-
able, e.g. in tethered llamas. It contains
oxalates and causes milk fever-like symp-
Capsicum annuum (Chili pepper) toms of hypocalcaemia. Treatment, which is
normally successful, is with 20% calcium
borogluconate given slowly intravenously.
This annual shrub is grown as a crop through-
The dose is 80 ml for a SAC.
out the world. It is very irritant to the bowel
and causes diarrhoea. It is not life threatening
to SACs. Treatment should be symptomatic.
Cestrum parquet (Green cestrum)

Cassia occidentalis (Coffee weed) This is a cultivated garden shrub with yellow
flowers. It is a native of Central and South
This annual leguminous shrub is found in America and has become wild in New South
eastern areas of North America. It is also Wales. Diterpenoid glycosides are found in
called wild coffee or septic weed. It causes the black berries, which are consumed by
recumbency as it contains an anthraquinone inquisitive SACs. They cause acute liver dam-
alkaloid. There is no specific antidote. age and resulting encephalopathy. Once neu-
Recovery is unlikely after the animal has gone rological signs have developed death is
down. There is a plant of the same genus, cof- inevitable and euthanasia is indicated. If the
feepod (Cassia obtusifolia), which causes less toxicity is caught early enough, vitamin B
severe symptoms. The animals are usually injections and a low protein diet can be tried.
found to be ataxic. If treated symptomatically,
they normally recover.
Cheilanthes sieberi (Mulga fern)

Cassia spp. (Senna) This small fern is found in all subtropical and
temperate areas of Australia. It is not readily
These plants of the legume family are com- eaten by SACs unless there is no other food
mon in North America. The seeds are the available. It is cumulative and causes irre-
most toxic but the green plant of many of the versible progressive retinal atrophy.
184 Chapter 16

Chenopodium album (Fat hen) Colchicum autumnale (Autumn crocus)

This weed grows on waste ground and in cul- This is also called meadow saffron when
tivated areas between fruit trees throughout found outside of gardens. It is found in
Europe. It is not normally eaten in sufficient gardens throughout the world. The toxin is
quantities by SACs to cause toxicity unless colchicine. The signs in SACs are gastroen-
they are starving, e.g. a neglected animal. It teric. There is no specific antidote but
contains high levels of oxalates and so causes demulcents are helpful and survival rates
hypocalcaemia. Treatment is 20% calcium are very good.
borogluconate given slowly intravenously.
The dose is 80 ml. Treatment is normally
successful.
Conium maculatum (Hemlock)

This herbaceous plant, with white flowers,


Cicuta virosa (Water hemlock) found in ditches, is rarely eaten by SACs
except after ditch clearance. It can be distin-
This is commonly called cowbane for obvious guished from other members of the
reasons as it is poisonous to all livestock. It is Umbelliferae family, which include carrots,
the roots, which look like parsnips, that are parsnips, celery and parsley, by a smooth,
normally eaten after dredging of ditches. spotted stem and the distinct smell of mice. It
They are still toxic when dry. A piece the size is a native of Europe, North Africa, West
of a walnut is sufficient to kill a cow (Stratton, Africa and South Africa. It has spread to
1919). The species Cicuta douglasii found in North America, Australia and New Zealand.
North America is also poisonous. It contains a very potent alkaloid. Ingestion
causes severe nervous signs, staggering and
dilated pupils. Death occurs from respiratory
Claviceps purpurea (Ergot) depression. There is no specific antidote.
However, like all alkaloids some authors
report success with tannic acid or acetic acid
This parasitic plant fungus produces a toxin
(Copithorne, 1937).
that causes the well known ergot poisoning.
It grows on various grain crops worldwide.
The main sign of toxicity is gangrene of the
extremities. This is only seen in cold climates. Convallaria majalis (Lily-of-the-valley)
Abortion will also be seen. There is no spe-
cific treatment. Normally if the condition is This is a herbaceous perennial found in gar-
noticed early enough for the diet to be cor- dens worldwide. It has small bell-like flow-
rected, the animals will then recover from the ers. It contains potent cardiac glycosides.
gangrene but pregnant females will invaria- As it is irritant adult SACs do not normally
bly abort. touch the plant. Crias will show trembling
and an A-V block. They should be put on
fluids intravenously and be given very
Clematis vitalba (Wild clematis) small doses of atropine (e.g. 100 mg) very
slowly intravenously while monitoring the
heart.
This is often called old mans beard as the
fruits resemble a white silky beard. It origi-
nated in the UK, but has spread and become a
very invasive plant in New Zealand. It has an Crotalaria spp. (Rattlebox)
acid taste and is very irritant so is not attrac-
tive to SACs. However, if ingested it can cause This perennial legume with yellow flowers is
violent diarrhoea and death. found throughout North America. It is called
Poisons 185

rattlepods in Australia. This should not be Cynoglossum officinale (Hounds tongue)


confused with Daubentonia punicea, which is
also called rattlebox. It causes a cumulative This biennial plant is common on waste ground
poisoning when fed dried in hay. SACs will throughout North America. SACs will not eat
not touch the growing plant. The toxic princi- the growing plant on account of its unpleasant
ple is a pyrrolizidine alkaloid, which causes smell; however, it becomes palatable when dry
jaundice, oedema and ataxia. There is no in hay. Luckily it is not found on hay fields.
treatment. Poisoning only occurs when hay is made on
waste ground. It contains two alkaloids, helio-
supine and echinatine. These cause dysentery
Cycas spp. (Cycad palm) and necrotic liver damage. It is invariably fatal
once jaundice is seen. There is no antidote.
Euthanasia is indicated. All the other animals
Poisoning has been reported in many sub-
must be given hay not containing the plant and
tropical and tropical areas throughout the
vitamin B injections together with antibiotics.
world. These trees originated in the Far East.
The signs reported are neurological and
appear to be irreversible. Euthanasia is
indicated. Dactyloctenium radulans (Button grass)

This grass is not widespread in Australia, but


Cynodon dactylon (Bermuda grass) restricted to New South Wales. It causes nitrate
poisoning if large amounts are consumed rap-
idly. There is vasodilatation and shock. The
This fodder crop grown in semitropical areas
antidote is intravenous 1% methylene blue at
can become toxic in the late summer and
the rate of 5 mg/kg. Alpaca owners should
autumn. Animals will shake and become
avoid heavy nitrogen fertilization.
ataxic. The ataxia is made worse by move-
ment. The animals should be coaxed very
slowly off the pasture with the promise of
hard feed. If they are driven they will stagger Datura stramonium (Thorn-apple)
and become recumbent. The prognosis is then
very poor. If the grass is cut for hay it will This weed is only found in southern England,
remain toxic for over 2 years. The specific not in the rest of the UK. It is called jimson-
antidote is sodium thiosulfate. This should be weed in the USA. It is rarely eaten in the fresh
given intravenously at the rate of 20 mg/kg, state but can be ingested in hay. All parts of
well diluted in warm normal saline. this annual plant are toxic. The plant contains
the alkaloids atropine, hyoscamine and hyos-
cine. It causes symptoms similar to deadly
nightshade. The specific antidote is neostig-
Cynodon nlemfuensis (African star grass)
mine, which should be given at the rate of
0.01 mg/kg subcutaneously.
This grass is grown as a forage crop in tropi-
cal and semitropical areas, particularly the
south-eastern parts of the USA. It is really
only toxic when the plant is young, particu- Daubentonia punicea (Purple sesbane)
larly if it suffers physical damage from the
frost when grown in higher areas. The toxin This is a flowering shrub cultivated in gar-
produced is cyanide. The animals will show dens in North America and the UK. It is also
ataxia and collapse. The specific antidote is found wild in northern America, where it is
sodium thiosulfate. This should be given called rattlebox. It should not be confused
intravenously at the rate of 20 mg/kg, well with Crotalaria spp., which is also called
diluted in warm normal saline. Rattlebox. It has legume pods that are
186 Chapter 16

poisonous. These are not normally eaten but Drymaria pachyphyllia (Inkweed)
if ingested by curious llamas will cause circu-
latory signs and death if sufficient is ingested. This creeping annual plant is found in the
There is no specific antidote. Treatment has to south-west of North America. It is only con-
be supportive and is often successful if suffi- sumed by SACs in drought conditions. The
cient has not been eaten. toxin is unknown but is thought to be a
saponin. It causes depression, coma and death.
There is no antidote. Animals should be fed
Delphinium nuttallii (Larkspur) quality roughage immediately.

This herbaceous plant has purple flowers.


The first sign of poisoning will be generalized Dryopteris filix-mas (Male fern)
muscular weakness and trembling. Alpacas
seem to be unable to defaecate completely. This is one of the most common ferns found in
the northern hemisphere. It is doubtful if a
SAC could ingest enough of this plant to cause
Delphinium spp. (Delphinium) toxicity. However, if the roots are eaten then it
will cause progressive retinal atrophy and
This common blue garden flower in the UK is irreversible blindness. There is no antidote.
rarely a problem when growing. However,
animals may eat the dried young plants on
garden compost heaps. It is called larkspur in Duboisia hopwoodii (Pituri)
North America. The toxic alkaloids cause ini-
tial gastroenteric signs and then neurological This large shrub is found in arid regions in
signs. There is no specific treatment. Australia. It has black berries. It is not normally
consumed if other food is available. It contains
nicotine, which causes neurological signs. There
Dieffenbachia seguine (Dumbcane) is no antidote but if the animals are left alone
and not stimulated they will often recover. This
One author (Johnson, 1989) reported some shrub is in the same genus as corkwoods, which
mild toxicity signs were shown by a llama contain an alkaloid, tropane, not nicotine.
when this weed was fed dry. The llama recov-
ered in 30 min.
Duboisia leichhardtii (Corkwood)

Digitalis purpurea (Foxglove) These small trees have small white flowers,
which become green berries. They are found
in tropical areas of the USA. They contain an
This erect herb with purple flowers is a native
alkaloid, tropane, which is not unlike nico-
of Europe but is now found throughout the
tine. The signs shown by tropane and nicotine
world. The signs of poisoning are those of
toxicity are similar. They both show marked
digitalis overdose as the Latin name of the
dilation of the pupils and other neurological
plant would suggest, i.e. bradycardia, cyano-
signs. There is a specific antidote, physostig-
sis and collapse. Animals will not eat the
mine. This should be given at the rate of
fresh plant but may ingest small amounts in
0.06 mg/kg by slow intravenous injection.
hay. In the event of collapse a SAC should be
given lidocaine intravenously at the rate of
3 mg/min until the bradycardia improves. In
the event of ingestion of a limited amount of Duboisia myoporoides (Corkwood)
foxglove causing bradycardia a SAC should
be given 5 g of potassium chloride by These small trees are of the same genus as
mouth. pituri. They have small white flowers and are
Poisons 187

mainly found in the east of Australia and Eremophila deserti (Turkey bush)
New Caledonia. They contain an alkaloid,
tropane, which is not unlike nicotine. The This small tree with white, bell-shaped
signs shown by tropane and nicotine toxicity flowers grows in the central areas of Australia.
are similar. They both show marked dilation Some plants but not all contain furanosequit-
of the pupils and other neurological signs. erpenes. These cause acute liver toxicity.
There is a specific antidote, physostigmine. There is no antidote.
This should be given at the rate of 0.06 mg/kg
by slow intravenous injection.
Eremophila maculata (Spotted emu bush)

Echium plantagineum (Pattersons curse) This shrub has red tubular flowers and is
found throughout the centre of Australia. The
This annual herb with blue flowers is found young leaves, which are attractive to SACs in
in the UK and Europe, particularly around drought conditions, contain cyanogenic gly-
the Mediterranean and Black Seas. It is also cosides. These cause rapid death if large
found in southern regions of Australia. The amounts are ingested. Treatment is with
toxic principles are pyrrolizidine alkaloids. 30 mg/kg of sodium thiosulfate given as a
These cause chronic weight loss as they dam- warm solution intravenously twice daily for 3
age the liver over a length of time. There is no days. All in-contact animals should be given
specific antidote. However, if the animals are 5 g sodium thiosulfate by mouth. This should
removed from the weed their livers will be repeated 24 h later as relapses can occur.
regenerate on a low protein diet. Vitamin B
injections may be helpful.
Erythrophleum chlorostachys (Camel poison)

Equisetum spp. (Mares tails) This substantial tree has yellow-green flow-
ers, which become dry brown flat seed pods.
It is restricted to the north of Western Australia.
This plant, which is seen on some pastures
It contains diterpenoid alkaloids, which cause
worldwide, is very toxic. However, it is not
sudden death. Luckily SACs rarely touch the
palatable and is only eaten by animals that
plant. There is no effective antidote.
are starving. It causes ataxia and convulsions.
The specific antidote is thiamine (vitamin
B1). Care should be taken on the administra-
tion of this vitamin intravenously as deaths Eucalyptus cladocalyx (Sugar gum)
have been reported. Normally it is given in a
solution with other B vitamins. It should be This tall tree is found in the south-eastern states
given intramuscularly at the rate of 1 mg/kg of Australia, in East Africa in areas over 1500 m
daily. above sea level and in gardens in the UK. It has
white flowers and barrel-shaped fruit. It con-
tains cyanogenic glycosides, which cause sud-
Eremophila accuminatum (Boobialla) den death. The young leaves are the most toxic.
Poisoning only occurs after a high wind early in
the growing season. All in-contact SACs should
This small tree with white, bell-shaped flow-
be given 5 g sodium thiosulfate by mouth.
ers, grows in the central areas of Australia. It
has red fruit and is also called the wild
peach. The author has eaten them cooked in
a pie with no ill effects. Some plants but not Euonymus europaeus (Spindle tree)
all contain furanosequiterpenes. These cause
acute or chronic liver toxicity. There is no This shrub, whose leaves are most toxic in the
antidote. spring, is rarely eaten by SACs as it is bitter
188 Chapter 16

and gives off an unpleasant odour. It is a Galega officinalis (Goats rue)


purgative. Treatment is symptomatic. It has
small yellowish green flowers. It is found As the name indicates this legume is toxic
throughout Europe up to the Caucasus. in large quantities to goats and also to SACs.
It is a herb with purple flowers and is
native to Europe, the Middle East and
Eupatorium rugosum (White snakeroot) western Asia. It was used in the USA,
South America and New Zealand as a for-
age crop. It has now become a weed in all
This is a North American tall perennial herb.
these areas. It causes inappetence, so after
Poisoned llamas become ketotic with fatty
the initial gorging the plant poisoning is
degeneration of the liver with chronic poison-
self limiting. Animals should be removed
ing. Although the heart is affected, the clini-
from the plant and fed good grass. Liver
cian has a dilemma as corticosteroids are
toxicity is extremely rare and recovery rates
normally helpful for the liver but risky with
are good.
the cardiac signs.

Gastrolobium spp.
Euphorbia pulcherrima (Poinsettia)
(Poison bushes)

This is a very common pot plant found


These bushes are found throughout Australia
worldwide. It causes acute diarrhoea in
and there are over 30 different species. They
alpacas. It is not life threatening. Treatment
contain fluoroacetate, which causes sudden
is symptomatic.
death. They are not readily eaten by SACs.
There is no antidote.

Euphorbia spp. (Spurges)

Gelsemium sempervirens
These plants occur worldwide. Poisoning has
(Evening trumpet flower)
been reported in North America, Australia,
New Zealand and Europe. The seeds look like
small capers and indeed there is a species This trailing plant is found in open woods
called the caper spurge in North America. in the south-east of North America and in
The plant produces a very irritant juice, which Latin America. It has yellow trumpet-like
burns the mouth of alpacas, giving an Orf flowers. It contains alkaloids related to
like appearance. The treatment is the applica- strychnine. The signs are dilated pupils,
tion of topical oily creams. Fly control is also convulsions, coma and death. It is only eaten
important. by tethered llamas. Immediate treatment
with sedatives and relaxants is required to
control the convulsions. There is no specific
treatment.
Festuca arundinacea (Fescue)

This is a common pasture grass in North


America. Like ryegrass, it can harbour a Glyceria maxima (Reed sweet grass)
fungus. The normal culprit is Epichloe typhina.
The mycotoxicosis has been reported in This semi-aquatic grass is found in all the
llamas to cause ill-thrift and general malaise. temperate areas of Australia. It causes sudden
This latter condition will resolve if the animals death as it contains cyanogenic glycosides.
are removed from the pasture. An endophyte- It is only eaten by very hungry animals. All
free strain of fescue grass has been developed in-contact animals should be given 5 g sodium
in the USA. thiosulfate by mouth.
Poisons 189

Gutierrezia microcephala (Snakeweed) H. hoopesii. Both cause a cumulative poison-


ing and so are rarely fatal. Owners will notice
This perennial shrub is found throughout the stiff gait, weakness and emaciation. If the
North America. The toxin is unknown. It animals are removed from access to the plant
causes abortion and haematuria. The animals they will recover.
can normally be saved if put on to good for-
age but the abortions cannot be prevented.
Heliotropium amplexicaule
(Blue heliotrope)
Halogeton glomeratus (Halogeton)
This annual herb with blue flowers is found
This annual herb is found in desert areas in throughout the UK, Europe and southern
the western part of North America. It contains areas of Australia. It is not normally eaten by
high levels of oxalic acid, which makes it SACs unless they are starving. It contains
unpalatable. However, if it is eaten by starv- pyrrolizidine alkaloids, which cause chronic
ing SACs it causes peracute hypocalcaemia. liver damage. Animals should be removed
Unless given intravenous calcium borogluco- from access to the plant and fed on a low pro-
nate immediately the animals will die. A 20% tein diet, e.g. cereals or sugarbeet pulp.
calcium borogluconate solution should be
given slowly. The dose is 80 ml.
Heliotropium europaeum
(Common heliotrope)
Haplopappus heterophyllius (Goldenrod)
This annual herb with white flowers is found
This perennial bush found in gardens in the
throughout the UK, Europe and southern
UK grows wild in North America, where it is
areas of Australia. It is not normally eaten by
called burroweed. It does not affect adults but
SACs unless they are starving. It contains
only suckling crias, which will be weak and
pyrrolizidine alkaloids, which cause chronic
tremble. The nursing mother should immedi-
liver damage. Animals should be removed
ately be taken away from the goldenrod and
from access to the plant and fed on a low pro-
given other feed. If possible it should be
tein diet, e.g. cereals or sugarbeet pulp.
milked out every 12 h. The young cria should
be given warm electrolytes for 48 h before
being returned to its mother.
Heliotrope spp. (Vipers bugloss)

Helenium hoopesii (Western sneezeweed) This plant, which is found in Texas, contains a
toxic alkaloid that will cause acute diarrhoea
This perennial herb is found in North America in SACs. It is not normally fatal but there is no
and is often called orange sneezeweed after specific treatment. Demulcents and NSAIDs
the colour of the flowers. It is a cumulative are helpful. Not all species are toxic. Heliotrope
poison and so is rarely fatal. Owners will europaeum was used in the Middle Ages to
notice the stiff gait, weakness and emaciation. colour food and is still used in modern French
If the animals are removed from access to the cuisine.
plant they will recover.

Helleborus niger (Christmas rose)


Helenium microcephalum
(Smallheaded sneezeweed) This garden flower is found throughout
Europe. The toxic principle is a cardiac glyco-
This annual herb is found in North America, side. The plant is very bitter so is not eaten by
as is its near relative orange sneezeweed, SACs when it is growing. However, it may be
190 Chapter 16

consumed when cut and dried on garden Hymenoxys richardsonii


rubbish tips. It causes acute bloody diarrhoea. (Colorado rubberweed)
Treatment is symptomatic and is normally
successful. This North American perennial herb with
yellow flowers is also called pinque. It is a
cumulative poison causing depression and
Heterodendron oleifolium colic. Immediate removal from the plant will
(Rosewood) normally solve the problem.

This small tree with flaky bark has linear


leaves and is found in central areas of Hyoscyamus niger (Henbane)
Australia. It contains cyanogenic glycosides
and causes sudden death. All in-contact SACs This is an extremely poisonous herbaceous
should be given 5 g of sodium thiosulfate by plant with pale yellow flowers. All parts are
mouth. toxic. It has the same alkaloids as deadly night-
shade and gives the same signs if eaten. It orig-
inated in Europe and Asia and is now global.
Homeria spp. (Cape tulip)

This tulip is found in the UK, Europe, North Hypericum perforatum


America and Australia. It originated in South (St Johns wort)
Africa. There are two species: the one-leaf
cape tulip H. flaccida; and the two-leaf cape This marshland plant rarely causes problems
tulip H. miniata. They both contain cardiac in temperate climates. It causes chronic liver
glycosides. The growing plant is not touched damage. The first sign will be photosensitiza-
by SACs. However, they may ingest it in hay. tion. It is therefore much more serious in sub-
Even a small amount will cause rapid death. tropical areas. Any affected animals should
be brought in out of the sun. Vitamin B injec-
tions are helpful. The animals should be put
Hoya australis (Wax flower) on a low protein diet.

This is a vine with bunches of waxy white


flowers and is found in subtropical areas of Ipomoea batatus (Sweet potato)
eastern Australia. It contains an unidentified
neurotoxin, which causes convulsions. There These potatoes will cause poisoning world-
is no effective treatment and so euthanasia is wide if they are fed mouldy to animals. They
recommended. contain pneumotoxic furanoterpenes, which
cause respiratory signs. Animals will recover
if the mouldy tubers are removed.
Hymenoxys odorata
(Bitterweed)
Ipomoea calobra
This plant is found in North America, mainly (Weir vine)
in the south-west. It prefers wet areas. It has
bright yellow flowers. It has an unpleasant This vine has trumpet-shaped pink flowers
smell and so is not normally a problem except and is found in localized areas of Queensland.
if there is no other food available. It causes It is a chronic poison. Animals develop a crav-
anorexia and depression. As it is a cumulative ing for the plant. If access is denied, less
poison the symptoms regress when animals severely affected animals will recover. There
are moved on to good fresh pastures. is no known antidote.
Poisons 191

Ipomoea muelleri (Poison morning glory) highly toxic but SACs tend to give it a wide
berth. It contains grayano-toxins and gives
This is a vine with trumpet-shaped pink flow- similar toxic signs as Rhododendron spp., i.e.
ers, found in gardens in the UK and Europe. projectile vomiting and abdominal pain. The
It is found wild in central and north-west only treatment is a mixture of morphine and
areas of Australia. It contains an unknown atropine. The dose is 2 ml twice daily of a 5%
neurotoxin. There is no known antidote. It is wt/vol solution of morphine sulfate injected
rare for SACs to eat the vines. intramuscularly. Atropine will aid recovery
by reducing the massive amount of saliva
produced. A SAC should be given 2 ml of a
0.5% wt/vol solution of atropine sulfate
Isotropis spp. (Lamb poisons)
intramuscularly.
These herbs have pea-type flowers of many col-
ours and are found in gardens in the UK. Distinct
species are found in south-western Australia Kalmia spp. (Kalmia)
and another in central Australia. They contain a
heterocyclic alkaloid, which causes nephrosis in This flowering plant found in gardens in the
older crias. There is no known antidote. UK causes acute gastritis and abdominal
pain. The pain should be controlled with
morphine 2 ml twice daily of a 5% wt/vol
Kallstroemia hirsutissima (Carpetweed) solution of morphine sulfate injected intra-
muscularly. Atropine will aid recovery by
reducing the massive amount of saliva pro-
This weed is not readily eaten by livestock
duced. A dose of 2 ml of a 0.5% wt/vol solu-
except under drought conditions. It is found in
tion of atropine sulfate should be given twice
the south-west of North America. It causes
daily intramuscularly.
paresis in single animals but does not affect the
majority of the others. The toxin is unknown
and hence any treatment is only supportive.
Karwinskia humboldtiana
(Coyotillo)
Kalmia angustifolia (Lambkill)
This woody shrub is common in the south-
This member of the Ericaceae family found in ern areas of North America. It has small
the south-east parts of the USA will kill SACs. black berries. It is the fruit that is toxic,
It contains grayano-toxins and gives similar causing generalized neurological signs.
toxic signs as Rhododendron spp., i.e. projectile There is no specific antidote. If the animals
vomiting and abdominal pain. The only treat- are removed from the plant early enough
ment is a mixture of morphine and atropine. recovery is possible. However, when the
The dose is 2 ml twice daily of a 5% wt/vol nervous signs are advanced euthanasia is
solution of morphine sulfate injected intramus- indicated.
cularly. Atropine will aid recovery by reducing
the massive amount of saliva produced. A SAC
should be given 2 ml of a 0.5% wt/vol solution Kochia scoparia
of atropine sulfate intramuscularly. (Mexican fireweed)

This plant is found in many southern areas of


Kalmia latifolia (Mountain laurel) North America and of course in Mexico.
It causes neurological signs. Recovery rates
This evergreen shrub of the Ericaceae family are good if there is good nursing. NSAIDs are
is found in the south-east of the USA. It is helpful.
192 Chapter 16

Laburnum anagyroides (Laburnum) has small white to cream flowers. It causes


colic and paresis. There is no specific antidote
After yew this is the most poisonous tree in the but recovery can be expected with pain con-
UK. It is a native tree of Europe but is found in trol and good nursing. The toxin is denatured
gardens throughout the world. The most poi- by boiling, so the plant can be boiled to make
sonous parts of the tree are the seeds, which a tea-like drink.
form from yellow flowers, but the whole tree is
in fact poisonous. Alpacas will be poisoned by
grazing under the tree and picking up the Leiocarpa brevicompta (Flat Billy buttons)
seeds. The main toxin is an alkaloid called
cytosine, which gives similar signs as nicotine. This shrub is also called plains plover daisy. It
These are incoordination, convulsions and grows in the heavy clay soils of the flood-
death from asphyxia. There is no antidote. plains of the Darling River system in
Queensland and New South Wales. It has
dense yellow flower heads. These develop
Lamium amplexicaule (Dead nettle) into seed heads, which cause toxicity if eaten
in quantity. They contain crepenynic acid and
This is an herb with pinkish tubular flowers. other fatty acids, which cause striated muscle
It is found as a weed after cultivation through- degeneration. The main sign is recumbency.
out Australia. It contains an unknown neuro- There is no specific antidote but with careful
toxin causing incoordination. There is no nursing most animals will recover.
known treatment but removal from the toxic
plants will normally result in a recovery.
Leucothoe davisiae (Black laurel)

Lantana camara (Lantana) This is a shrub found in North America and


Asia around lakes and along the banks of
This flowering shrub may be found in the streams. It is not found in Africa except in
wild as well as in gardens. It is a native of Madagascar. It has white flowers. It causes
tropical Africa and America. It causes chronic colic and recumbency. There is no specific
liver damage with resulting jaundice and treatment. The colic signs should be control-
photosensitization. The treatment is vitamin led with NSAIDs. Provided only a little has
B injections to help the liver and the animal been ingested, which is likely as it also causes
should be kept out of direct sunlight. anorexia, there is a good chance of survival.

Laurus spp. (Laurel) Ligustrum spp. (Privet)

This plant is rarely eaten in sufficient quanti- This hedge plant is found worldwide. Large
ties to cause toxicity. Quite large amounts quantities have to be eaten by SACs to cause
need to be ingested. It is still toxic when dry toxicity. The main sign is diarrhoea. Treatment
so it can be eaten by animals on garden waste is symptomatic.
tips. It causes severe symptoms of cyanide
poisoning.
Linum spp. (Linseed)

Ledum glandulosum (Labrador tea) This is often included as an oil in food. It causes
diarrhoea and its use should be avoided. There
This North American herb, which grows in is no specific antidote. One species L. catharticum
wettish areas, contains andromedotoxin and is actually called purging flax.
Poisons 193

Lolium spp. (Ryegrass) jaundice has been reported (Brash, 1943).


Animals will recover but it is slow.
There are two main types of poisoning. The
first poisoning is caused by an endophyte
fungus, Claviceps purpurea, which causes gan- Lythrum hyssopifolia (Lesser loosestrife)
grene of the extremities like ergot. The second
is caused by another endophyte fungus, This herb has single pink or purple tubular
Acremonium lolii, which causes neurological flowers and is found in pastures in temperate
signs, mainly stiffness. The condition seen in areas of Australia. It contains an unidentified
sheep and SACs is called ryegrass staggers. toxin that causes kidney and liver damage.
It has been reported in the UK, New Zealand Poisoning only occurs when this plant
and in several states of Australia. Exercise becomes very dominant in stubbles. There is
will make the condition much worse. The no known treatment.
SACs should be quietly walked off the offend-
ing pasture. Improvement will be quite rapid
(i.e. 3 or 4 days) without any treatment.
Malva parviflora (Marsh mallow)
A third very rare condition of facial eczema
has been reported in alpacas caused by the
fungus Pithomyces chartarum in both New This is found on waste ground in the UK and
Zealand and Australia. It is a photosensitivity in North America where it is known as
and the animals will recover if brought inside. cheeseweed. It is also found as a widespread
weed throughout Australia. It seems to cause
poisoning in suckling young with the moth-
ers being unaffected. The crias will show con-
Lotus corniculatus (Birds-foot-trefoil)
vulsions, or be found dead. The post-mortem
will reveal dark haemorrhages in many inter-
The toxic substance found in this plant, which nal organs. There will be high nitrate/nitrite
is common in cleared woodland in the UK, levels in the aqueous humor. There is a spe-
Europe and Australasia, is a cyanogenic gly- cific antidote, which is methylene blue at
coside. It will cause acute diarrhoea, which is 10 mg/kg given slowly intravenously. The
followed by ataxia and collapse, when it is best approach is to set up an intravenous drip
invariably fatal. However, if others are less of warm isotonic saline and then slowly add
affected they should be given the specific the methylene blue.
antidote, sodium thiosulfate, which should
be given i/v at the rate of 20 mg/kg well
diluted in warm normal saline.
Marsilea drummondii (Common nardoo)

Lupinus spp. (Lupines) This aquatic fern is widespread in both eastern


and Western Australia. It looks like a four-
leafed clover. It is eaten locally by man and
These plants are found in hedgerows and gar-
does not appear to be toxic. However, it con-
dens. They also are grown commercially as
tains a thiaminase enzyme, which causes
nitrogen fixing plants, to improve the fertility
cerebro-cortico-necrosis (CCN). Prompt injec-
of the soil in Europe, central Asia, Australasia
tions of thiamine hopefully given intrave-
and the USA. Alpacas can eat the green young
nously bring about a recovery.
plants without any problems. However, the
seeds contain a poisonous alkaloid. The main
sign is inappetence and so the poisoning is
self-limiting. The animals should be moved Melia azedarach (Chinaberry)
quietly on to a grass pasture. This will avoid
the acute neurological symptoms that have The yellow fruit of this tree found in the
been described. There is liver damage and south-east of North America contains several
194 Chapter 16

alkaloids that cause gastroenteritis. It is a Australia and are found cultivated in gardens
native of India and is also now found in throughout the world. They contain oxalates,
southern China and Australia. Recovery is which cause hypocalcaemia. Treatment, which
spontaneous provided not too large amounts is normally successful, is with 20% calcium
are eaten. There is no specific antidote. borogluconate given slowly intravenously. The
dose is 80 ml.

Melilotus officinalis (Sweet clover)


Nandina domestica (Chinese sacred bamboo)
This only causes poisoning when the plant
has been spoilt or made into hay, haylage or This evergreen shrub has cyanogenic glyco-
silage. Fungal spores then convert the natural sides in its foliage. As the name suggests it is
harmless coumarins into dicumarol. This a native of China. It is also called heavenly
interferes with the clotting mechanism. bamboo. It is found wild in Japan and else-
Haemorrhages are seen on the mucous mem- where in gardens and parks throughout the
branes. Haematomas are rare but have been world. The treatment is specific: 30 mg/kg of
reported in alpacas. They should be removed sodium thiosulfate should be given intrave-
from the pasture and given an injection of nously. At the same time 35 g/h should be
3 mg/kg of vitamin K1 intramuscularly. given by mouth to detoxify any remaining
HCN in C1. Affected animals show dyspnoea
and tachycardia.
Menziesia pilosa (Minniebush)

This member of the Ericaceae family found in Narcissus spp. (Daffodil)


the south-eastern parts of the USA is very
toxic to SACs. It contains grayano-toxins and The growing flowers are rarely eaten by
gives similar toxic signs as Rhododendron spp., SACs. Llamas have been reported to eat the
i.e. projectile vomiting and abdominal pain. bulbs, which caused mild diarrhoea.
The only treatment is a mixture of morphine
and atropine. The dose is 2 ml twice daily of a
5% wt/vol solution of morphine sulfate Narthecium ossifragum (Bog asphodel)
injected intramuscularly. Atropine will aid
recovery by reducing the massive amount of
This plant is found growing in marshes in the
saliva produced. A SAC should be given 2 ml
UK and Scandinavia. It is not normally eaten
of a 0.5% wt/vol solution of atropine sulfate
fresh by SACs. However, it may be ingested in
intramuscularly.
hay from rough pastures. It causes photosen-
sitization on the white areas of llamas faces.
It is thought that the toxic effect is caused by
Mercurialis perennis (Dogs mercury) microfungi that live on the plant. It may cause
jaundice. Affected animals should be housed
This is said to be toxic. However, the only and treated with vitamin B injections.
documented reported incident was in lambs
that developed diarrhoea but the toxicity was
not serious.
Neobassia proceriflora (Soda bush)

This small shrub grows in central Australia.


Mesembryanthemum spp. (Ice plants) It contains oxalates and so causes hypocalcae-
mia. Treatment, which is normally successful,
These succulent prostrate herbs originated in is with 20% calcium borogluconate given
South Africa and now grow wild in south-western slowly intravenously. The dose is 80 ml.
Poisons 195

Nerium oleander (Oleander) Approximately 50% will recover from the


convulsions and get diarrhoea for 48 h and
This is a very toxic garden plant with pink then recover. There is no specific antidote.
flowers, which originated in Morocco. The plant occurs worldwide. The leaves are
Animals will not eat it except in cut prunings. not toxic.
It causes sudden death. There is no treatment.
As it is so toxic if any animal has eaten some,
immediate gastrotomy should be carried out. Osteospermum echionis
(South African daisy)

Nicotiana tabacum (Tobacco) This annual garden plant may be eaten


by escaping SACs. It contains cyanogenic
Nicotine historically was used as a drench to glycosides. Animals may be found dead.
control bowel worms in sheep. It had an All in-contact animals should be given 5 g
extremely narrow safety margin. Deaths sodium thiosulfate by mouth.
following convulsions were common. If SACs
eat dried tobacco they will die. There is no
antidote. Oxalis corniculata (Wood sorrel)

As the Latin name implies this herb contains


Nolina texana (Sacahuista beargrass) oxalates and so causes toxicity in SACs as it
causes hypocalcaemia. It occurs in temperate
This perennial North American plant contains areas of North America. It is most dangerous
a heptatoxin in its flowers and fruit. The toxin in the spring and autumn. Treatment, which
causes photosensitization. SACs should be is normally successful, is with 20% calcium
kept off the plant in the spring and early sum- borogluconate given slowly intravenously.
mer. If signs develop the animals should be The dose is 80 ml.
kept out of the sunlight. Vitamin B injections
may be helpful.
Oxalis pes-caprae (Soursob)

Notholaena sinuata cochisensis As the Latin name implies this herb contains
(Jimmy fern) oxalates and so causes toxicity in SACs as it
causes hypocalcaemia. It occurs in temperate
This evergreen perennial fern is found in the areas of Australia. Treatment, which is nor-
south-west of North America. Its ingestion is mally successful, is with 20% calcium boro-
rare. It causes nervous signs, which are more gluconate given slowly intravenously. The
apparent when llamas are on the trek. dose is 80 ml.
Dehydration appears also to bring on the
signs. With rest and fresh water the animals
normally recover. Oxytenia acerosa (Copperweed)

This herb is found wild in North America,


Oenanthe crocata (Water dropwort) mainly in the south-western states of the USA,
where it is called sagebud. It has been imported
The roots of this plant, which are called dead into gardens in the UK. The cause of the toxicity
mens fingers, are eaten by livestock after is unknown. It is not palatable so the only likely
dredging of ditches (Forsyth, 1954). They are poisoning is curious SACs. It causes anorexia so
still toxic when dry. The signs shown are con- poisoning is normally self limited. Survival
vulsions, salivation, dilated pupils and death. depends on changing the diet.
196 Chapter 16

Panicum spp. (Panicum grass) Persea americana (Avocado)

These grasses are grown worldwide as fodder The toxic principle of this tree is persin, which
crops. They may contain steroidal saponins, is mainly found in the leaves and skin of the
which cause liver damage that results in fruit. Individual animals may become
photosensitization. Affected animals need to addicted to this fruit and ingest toxic doses of
be brought in out of the sunlight and put on a the skin of the fruit. It will cause diarrhoea,
low protein diet. Vitamin B injections are which should be treated symptomatically.
helpful.

Persicaria spp. (Smart weeds)


Peganum harmala (African rue)
These pink-flowered herbs are found near
This is a leafy perennial found in semi-desert water in eastern areas of Australia. They con-
areas, worldwide. It originated in the eastern tain an unknown toxin, which causes photo-
Mediterranean area but is now also found in sensitization. Animals need to be brought in.
India, where it is used to make red dye for car- Vitamin B injections may be helpful.
pets. It is found in North America. It is unpal-
atable so is very rarely eaten unless there is
absolutely no other food available. It causes Phalaris aquatica (Australian phalaris)
anorexia and so is really self limiting. Survival
is likely if other food is provided. This grass grown in temperate areas through-
out Australia is also called Toowoomba
canary grass. It can contain indole alkaloids,
Pennisetum clandestinum (Kikuyu grass) which cause convulsions and recumbency,
looking very like hypomagnesaemia; in fact
This forage grass originated in the highlands the condition is called phalaris staggers.
of Kenya but is grown in tropical and sub- There is no specific antidote.
tropical areas throughout the world. The
leaves have very small spines, which cause
alimentary irritation in certain animals. Phoradendron flavescens (Mistletoe)
Normally the diarrhoea is short lived.
However, in unvaccinated SACs pathogenic This is a parasitic perennial evergreen plant
clostridial bacteria may multiply and release with white berries. It is eaten by SACs on rub-
toxins causing death. bish dumps after it has been discarded after
Christmas. It contains acetylcholine, and
causes acute diarrhoea and dilated pupils.
Perilla frutescens (Perilla mint) Treatment is symptomatic. Physostigmine
should not be injected as that is liable to make
the symptoms worse.
This herb originates in India, Pakistan and
central Asia. It is also called purple mint.
It has been imported into the UK, Europe and
North America. It has an unpleasant smell. Photinia fraseri (Chinese photinia)
It may be eaten by tethered llamas but it needs
a considerable amount to cause toxicity. The This evergreen shrub is used as a hedge in
main signs are respiratory and result in North America and is also seen in gardens in
mouth-breathing, which is very serious. Europe and the UK. It is a native of China.
Treatment with either steroids, diuretics or It contains a cyanogenic glycoside in its foli-
NSAIDs is rarely successful after the animal age. Affected animals show dyspnoea and
is recumbent. tachycardia. There is a specific treatment
Poisons 197

available: 30 mg/kg of sodium thiosulfate Polypogon monspeliensis


should be given intravenously. At the same (Annual beard grass)
time, 35 g/h should be given by mouth to
detoxify any remaining HCN in C1. Treatment This grass is found in seasonally flooded areas
may often be successful. of subtropical and temperate regions of
Australia. It is also found throughout North
America, except it is absent from the mid-
Phytolacca americana west. In northern America it is called rabbits
(Poke weed) foot grass. There is a complex toxicological
process, which results in convulsions and
death, called Stewart range syndrome. The
This North American weed is found on waste
toxic principle is a corynetoxin, which is pro-
ground in the eastern states, and has been
duced by Rathayibacter toxicus, a bacterium in
introduced to gardens in the UK. The whole
the seed-head nematode galls on the grass.
plant is toxic but poisoning seems to occur
There is a hope to develop cyclodextrin, a
when the roots have been dug up and left on
toxin binding agent, to be an antidote, but as
the ground. The main signs are violent colic
yet trials have not been successful.
and diarrhoea. There is no specific antidote
but gastro-protectants are helpful plus intra-
venous fluids.
Portulaca oleracea (Pigweed)

Pieris japonica variegated (Pieris) This weed is found throughout Australia,


particularly in stockyards. It is often con-
sumed when SACs are left penned in a stock-
As the Latin name suggests, this flower
yard with nothing else to eat. It contains
grows wild in Japan and has been intro-
oxalates, which cause hypocalcaemia.
duced into European gardens. It is extremely
Treatment, which is normally successful, is
toxic to SACs. It is a member of the Ericaceae
with 20% calcium borogluconate given slowly
family and causes a similar toxicity to rho-
intravenously. The dose is 80 ml.
dodendron. It contains a grayano-toxin,
which acts on the autonomic nervous
system via the vagal nerve stimulating the
vomiting centre; only a very small dose is Prosopis glandulosa (Mesquite)
required. The only treatment is a mixture of
morphine and atropine. The dose is 2 ml This small leguminous tree found in the
twice daily of a 5% wt/vol solution of mor- south-west of North America has a long pod
phine sulfate injected intramuscularly. containing an unknown toxin, which causes
Atropine will aid recovery by reducing the partial paralysis of the tongue and atony of
massive amount of saliva produced. The C1. The affected animals appear similar to
twice daily dose is 2 ml of a 0.5% wt/vol animals that have been given oral antibiot-
solution of atropine sulfate intramuscularly. ics. They seem to have improper digestion.
The prognosis is good. Probiotics and good grass seem to affect
a cure.

Pinus spp. (Pine needles)


Prunus caroliniana (Cherry laurel)
Several different species found in many coun-
tries will cause poisoning. The signs shown This tree is found worldwide and is also
are depression, anorexia, C1 stasis, dyspnoea called laurel cherry. It contains a cyanogenic
and even death. Pregnant animals will abort. glycoside, which causes convulsions and
There is no specific treatment. rapid death. Once the animal is convulsing
198 Chapter 16

euthanasia should be carried out as the prog- the diet is supplemented with sodium sulfate
nosis is hopeless. However, if others are and large amounts of protein.
affected they should be given the specific
antidote, sodium thiosulfate, which should
be given i/v at the rate of 30 mg/kg well Pteridium aquilinum (Bracken)
diluted in warm normal saline.
This common plant is not toxic in small quan-
tities. However, if other food is not available
Prunus serotina (Black cherry) SACs will ingest toxic doses. It causes a spe-
cific symptom of progressive retinal atrophy.
This tree is found in Europe and North This is called bright blindness and is irrevers-
America. Like other Prunus spp. it contains ible. Bright blindness should not be confused
a cyanogenic glycoside, which causes con- with cerebral-cortico-necrosis (CCN). This
vulsions and rapid death. Once the animal also causes blindness in SACs. CCN can be
is convulsing euthanasia should be carried brought on by eating bracken. This blindness
out as the prognosis is hopeless. However, caused by CCN is reversible with treatment
if others are affected they should be given with thiamine at 10 mg/kg, ideally given by
the specific antidote, sodium thiosulfate, intravenous injection for 3 days. Some clini-
which should be given i/v at the rate of cians consider it worthwhile to inject thia-
30 mg/kg well diluted in warm normal mine every 6 h for the first 24 h. If thiamine is
saline. not available on its own, a suitable multivita-
min preparation may be given. The clinician
must ensure that in so doing the same dose of
thiamine is given. Cumulative bracken poi-
Prunus virginiana (Choke cherry) soning can also cause the development of
cancerous changes in the wall of the bladder
This tree is found in the south-east of the in SACs. This can be recognized by the clini-
USA and in gardens in the UK. It contains a cian as haemoglobinuria. It is irreversible.
cyanogenic glycoside. SACs will show neu-
rological signs. The specific antidote is
sodium thiosulfate. This should be given i/v
Quercus spp. (Acorns)
at the rate of 20 mg/kg well diluted in warm
normal saline. If animals are having convul-
sions they should be destroyed as the prog- Llamas and alpacas require quite large quan-
nosis is hopeless. tities of acorns to be poisoned. Poisoning can
occur on a poor pasture in the early autumn
in the UK after a high wind. Certain animals
get a craving for green acorns. The toxin is
Psilostrophe spp. (Paperflowers) tannin. The animals will be inappetent with
lack of movement in C1. The faeces will be
This small erect, woody perennial is found on very dry. The animals will be dull. Animals
the range in the south-west of North America. may show colic pains. The colic should be
Only poisoning in sheep has been reported. controlled with NSAIDs. Liquid paraffin
However, it is reasonable to suspect SACs should be given by mouth, carefully to avoid
will be affected by the sesquiterpene lactone, inhalation. The animals should be given elec-
which the plant contains. The signs apart trolytes in their drinking water. They should
from general weakness are respiratory. be moved off the contaminated area, ideally
Aspiration pneumonia is a possibility, so great on to fresh grass. Ingestion can be prevented
care should be taken drenching animals. The by rolling the area to push the acorns into the
animals should be kept away from the plant ground to make it hard for the animals to eat
and stabilized. The toxic substance upsets the them. Areas around oak trees can be fenced
microflora in C1, so it is recommended that off during the danger period.
Poisons 199

Ranunculus spp. (Buttercups) alpacas and llamas as other Rhododendron spp.


and other members of the Ericaceae family.
These are very common but are not normally All these plants contain a grayano-toxin,
eaten by SACs and do not seem to be toxic which acts on the autonomic nervous system
in hay. They do contain a gastrointestinal via the vagal nerve and stimulates the vomit-
irritant toxin and so in theory could cause ing centre. A very small dose is required.
diarrhoea in llamas and alpacas. It will cause projectile vomiting, as it causes
acute gastritis and excess salivation. The only
treatment is a mixture of morphine and atro-
pine. The dose is 2 ml twice daily of a 5% wt/
Raphanus raphanistrum (Wild radish)
vol solution of morphine sulfate injected
intramuscularly. Atropine will aid recovery
This herb is widespread throughout the tem- by reducing the massive amount of saliva
perate regions of the world. It is not palatable produced. An adult alpaca should be given
so SACs need to be starving to eat it. It con- 2 ml of a 0.5% wt/vol solution of atropine sul-
tains S-methylcysteine sulfoxide (SMCO). fate intramuscularly. With an early diagnosis
This causes haemolysis. There is no effective and treatment the prognosis is good.
treatment. Euthanasia should be carried out
without delay.

Rhododendron ponticum (Rhododendron)


Rapistrum rugosum (Turnip weed)
This is the most common cause of plant poison-
ing in animals in the UK. It is found throughout
This herb is widespread throughout the tem- the northern hemisphere, South-east Asia and
perate regions of the world. It is not palatable northern Australia. Rhododendrons are very
so animals need to be starving to eat it. It con- rare in Africa and South America. They may
tains S-methylcysteine sulfoxide (SMCO). have originated in Nepal, where they are the
This causes haemolysis. It may also cause national flower. It is one of the few causes of
polioencephalomalacia. There is no sympto- projectile vomiting in SACs. They have acute
matic effective treatment. Thiamine injections gastritis and excess salivation. It is a member of
are not helpful. Euthanasia should be carried the Ericaceae family, which includes Pieris and
out without delay. Azaleas. These plants contain a grayano-toxin,
acting on the autonomic nervous system via
the vagal nerve stimulating the vomiting cen-
Rheum rhaponticum (Rhubarb) tre, and a very small dose is required.
The only treatment is a mixture of mor-
The stems of this plant have been cooked and phine and atropine. The dose is 2 ml twice
eaten by humans for hundreds of years. It origi- daily of a 5% wt/vol solution of morphine
nated in Europe but is now worldwide. It is sulfate injected intramuscularly. Atropine will
ingestion of the leaves by SACs that cause poi- aid recovery by reducing the massive amount
soning. They contain oxalates, which cause of saliva produced. A SAC should be given
hypocalcaemia. The signs are anorexia, C1 stasis 2 ml of a 0.5% wt/vol solution of atropine sul-
and recumbency. Treatment, which is normally fate intramuscularly. The prognosis is good.
successful, is with 20% calcium borogluconate
given slowly intravenously. The dose is 80 ml.
Rhodomyrtus macrocarpa (Finger cherry)

Rhododendron occidentale (Azalea) This small tree is also called native loquat or
Wannakai. It is found in the rainforests of
This flower found in gardens and ornamental eastern Queensland. It has white flowers,
woods is very toxic but is not as attractive to which are followed by fleshy cylindrical red
200 Chapter 16

fruit. Both the leaves and the fruit are poison- SAC over a short period of time they become
ous to SACs. They contain an unidentified hypocalcaemic. The main signs are recum-
toxin that causes permanent blindness. There bency, inappetence and gut stasis. The treat-
is no effective treatment. ment, which is normally successful, is with
20% calcium borogluconate solution given
slowly intravenously. The dose is 80 ml.
Ricinus communis (Castor bean)

These may be included in animal feed and are Salvia reflexa (Mint weed)
not a problem in small quantities. However, it
will cause diarrhoea and dysentery in alpacas This herb is widespread in inland areas of
if fed in large amounts. Queensland and New South Wales. It has pale
blue tubular flowers. It will not be eaten by
SACs fresh as it is not palatable. However, if it is
Robinia pseudoacacia (Black locust) cut and baled in hay then there are dangers.
A large quantity consumed quickly would
cause nitrate poisoning. The main sign is meth-
This large tree found in North America can
aemoglobinaemia. There is a specific antidote,
cause diarrhoea and even collapse but it is rarely
which is methylene blue at 10 mg/kg given
eaten by SACs unless they are tethered and there
slowly intravenously. The best approach is to
is no other food available. It has white flowers
set up an intravenous drip of warm isotonic
and is also found in southern Europe, central
saline and then slowly add the methylene blue.
Asia and South Africa. There is no specific anti-
dote so treatment should be symptomatic.

Sambucus ebulus (Ground elder)


Rumex acetosa (Sorrel)
This herb has white flowers, which become
clusters of black berries. It is a native of
This weed normally called common sorrel and
Europe and south-west Asia. It is reported to
its relative sheeps sorrel Rumex acetosella are
be a purgative but no specific poisoning
common in pastures in Europe, Australia and
instances have been recorded.
New Zealand. Their relative curly dock Rumex
crispus occurs in North America. All the sorrels
are extremely acid and so are not readily eaten
by livestock. In fact small quantities are not Sambucus nigra (Common elder)
toxic but if animals eat small quantities over
long periods of time they become hypocalcae- This large shrub is a native of Europe. It is
mic. This will then give a picture after stress of also found in north-west Africa and south-
a sudden onset. The main signs are recum- west Asia. It has been reported in western
bency, inappetence and gut stasis. The treat- areas of northern Australia. It has pink flow-
ment, which is normally successful, is with ers, which mature to dark red berries. This
20% calcium borogluconate solution given plant is said to be poisonous. However, there
slowly intravenously. The dose is 80 ml. have never been any cases reported. Most
animals do not seem to like the smell and
therefore do not eat it.
Salsola kali (Soft roly-poly)

An annual herb that originated in Eurasia. Sapium sebiferum (Chinese tallow tree)
It is now a very invasive weed found all over
Australia and North America. It contains This tree found in the tropical parts of south-
oxalates. If a large amount is consumed by a eastern USA originated in China. Llamas will
Poisons 201

browse it with little toxic effects as it causes Senecio jacobea (Ragwort)


anorexia and therefore the danger is self lim-
iting. On recovery the llamas will have a brief This plant is found throughout Europe. It was
period of diarrhoea. thought not to be toxic to SACs. Workers at
Oregon maintain that llamas will not eat the
plant and do not show signs of toxicity when
Sarcobatus vermiculatus (Grease-wood) they are given the plant as a slurry by stom-
ach tube.
This large deciduous North American shrub
is toxic in large quantities. It is also found in
Mexico. It contains oxalates, which bind up Senna obtusifolia (Sicklepod)
blood calcium. It therefore causes hypocal-
caemia. The signs are anorexia, lack of C1 This annual shrub is found in the wild in the
movement and recumbency. Treatment is 20% eastern USA. The plant is rarely eaten by
calcium borogluconate given slowly intrave- SACs even on the trek. It contains anthraqui-
nously. The dose is 80 ml. Treatment is nor- nones, which cause neurological signs. If
mally successful. these are severe treatment is hopeless and
euthanasia is advised.

Sarcostemma brevipedicellatum
(Caustic vine) Senna occidentalis (Coffee senna)

This vine has small bunches of waxy white This small shrub has yellow flowers. There is
flowers, which develop into long pods. another plant of the same genus, Senna obtusi-
It grows in tropical areas of Australia and in folia. They look alike and are both found in
the nearby islands. It is not palatable so it tropical parts of Australia and on the nearby
really is only a problem with starving ani- islands. They are also found in the south-eastern
mals, e.g. tethered llamas. It contains an states of the USA. The pods, which would
unidentified neurotoxin, which causes con- only be eaten by starving animals, contain an
vulsions and death. There is no known unidentified toxin that causes striated muscle
antidote. degeneration and necrosis. This results in
myoglobinuria. There is no known antidote.
Intravenous fluids may be successful.
Sarothamnus scoparius (Broom)

There is another species, Spanish broom Sesbania herbacea (Dangle pod)


Sarothamnus junceum. They are both very
mildly poisonous. It would be unlikely that This used to be called Sesbania exaltata. It is
any SAC could ingest enough to cause toxic also wrongly called coffee weed, which is
signs. really Cassia occidentalis. SACs will eat this
weed and get transitory diarrhoea. Treatment
is unnecessary.
Schoenus asperocarpus (Poison sedge)

This grass grows in south-western Australia. Sesbania vesicara (Bladder pod)


It is avoided by grazing alpacas. However, it
can cause problems when cut and baled in This is a tall annual legume with yellow flow-
hay. It contains galegine, an alkaloid, which ers. It is also called sesbane. It grows wild in
causes acute pulmonary oedema. There is no the south-east of the USA. It can be consumed
known antidote and euthanasia is advised. by SACs. The toxic principle is unknown but
202 Chapter 16

the signs are mainly gastroenteric. Treatment appear to be as toxic as deadly nightshade.
is with intravenous fluids, which is normally It is a trailing type of plant and does not seem
successful. attractive to SACs.

Setaria sphacelata (Setaria grass) Solanum esuriale (Solly weed)

This grass is found in pastures throughout the This plant causes neurological signs in alpacas
tropics. It very rarely causes poisoning. The in Australia. The animals show a characteris-
animals need to be starving and then to be tic hump-back appearance. Treatment is non-
offered a large amount of this grass, which specific with B vitamins and NSAIDs.
contains oxalates. These cause hypocalcaemia,
which normally results in recumbency. The
treatment, which is normally successful, is Solanum nigrum (Black nightshade)
with 20% calcium borogluconate solution
given slowly intravenously. The dose is 80 ml.
This is a weed commonly found in gardens
worldwide. It grows up to 30 cm high. It con-
tains solanine and other allied alkaloids but
Silybum marianum (Variegated thistle) does not seem as toxic as deadly nightshade.
There have been few cases of toxicity reported.
This herb originates in southern and eastern However, it will grow in maize and then can
regions of Australia on land that has been cul- be cut and be made into silage. Maize silage is
tivated. It has been imported in to the UK and unlikely to be fed to SACs but clinicians
Europe as a garden plant. Rapid intake by should be aware that black nightshade will
tethered animals can lead to nitrate poison- cause severe enteritis and maybe even death.
ing, shown as methaemoglobinaemia. There There is no specific antidote. Fluids and
is a specific antidote, which is methylene blue NSAIDs will be helpful.
at 10 mg/kg given slowly intravenously. The
best approach is to set up an intravenous drip
of warm isotonic saline and then slowly add
Solanum pseudocapsicum
the methylene blue.
(Jerusalem cherry)

This shrub, which has bright red cherry-like


Sinapis arvensis (Charlock) fruit, is found in gardens worldwide. It con-
tains solanocapsine and other alkaloids.
This common weed is a brassica with bright It causes abdominal pain and anorexia, so that
yellow flowers. It is commonly seen in corn- it is self-limiting. Treatment is symptomatic.
fields, particularly on organic farms. It is a
native of Europe but is also now found through-
out northern America. It is only poisonous
Solanum tuberosum (Potatoes)
when the pods have formed. It causes acute
gastroenteritis in SACs, with violent colic.
Survival is unlikely. Oil of camphor is the rec- These can safely be fed to SACs but only in
ommended antidote. NSAIDs are supportive. small quantities. If they are allowed to gorge
on them they will get a toxic acidosis. They
will have violent diarrhoea. Treatment should
be symptomatic. Green potatoes should never
Solanum dulcamara (Woody nightshade) be fed as they are very toxic. Also there is a
bad reaction when potatoes and either pea
Like the other nightshades it contains straw or pea silage are fed together. Animals
solanine, but like black nightshade it does not will die rapidly. Both feeds are acceptable in
Poisons 203

moderation separately but they should never Australia. The toxic principle is unknown but as
be fed together. the name suggests it causes incoordination.
There is no specific treatment but animals nor-
mally get better on their own if they are not
Sophora secundiflora (Mescal bean) chased or stressed.

The beans from this tree found in Mexico,


Texas and New Mexico contains a quinolizi- Stemodia kingii (Woolly twintip)
dine alkaloid. If large quantities are consumed
quickly by SACs they will show nervous This herb has blue tubular flowers and grows
signs and fall over but remain alert. They will in the inland regions of Western Australia.
continue to eat. If they are prevented from A very similar species is found in more arid
eating more beans and given good quality areas of North America. It contains cucur-
forage they will recover in a few minutes. bitacins, which cause peracute irritation to
the gastroenteric tract. The resulting severe
diarrhoea can cause death unless the animal
Sorghum halepense (Johnson grass) is rehydrated immediately by intravenous
normal saline. There is no specific antidote.
This is very similar to Sudan grass. It causes
the same toxicities of cyanide and nitrate
poisoning. Stypandra glauca (Blind grass)

This is not really a grass but a perennial herb


Sorghum vulgare (Sudan grass) with blue flowers. It is found in the temperate
areas of Australia. It is also found in gardens,
This forage grass, which originated in Africa, is where it is called the nodding blue lily. It
now grown throughout North America and is contains stypandrol. This causes irreversible
safe when cut as hay from a hydrocyanic acid blindness by retinal and optic nerve degen-
poisoning perspective. However, when it is fed eration. There is no effective treatment.
fresh in drought conditions or when it has been Toxicity is rare as SACs rarely eat the growing
damaged by trampling or frost then it is toxic. plant. Ingestion can occur in hay.
The toxicity is that of cyanide poisoning. The
pathognomic sign shown is the blood is bright
red. Sudan grass can cause another problem if Swainsona spp. (Darling or Swainson peas)
it has been heavily fertilized with nitrogen. It
can cause nitrate poisoning. This can be avoided
These herbs can have a variety of colours of
by not top-dressing with large quantities of
flower. They originate in subtropical regions
nitrogen and accepting the lower yields. An
of Australia. However, they now can be
alternative is to get the crop tested for nitrates
found in gardens throughout the world.
and feed accordingly. The pathognomic sign
They contain an indolizidine alkaloid, which
for nitrate poisoning is when the blood is choc-
primarily causes incoordination but may
olate brown. Sudan grass toxicity is primarily a
also cause abortion. SACs need over 4 weeks
problem for cattle farmers. It is rarely grown to
of exposure before there are signs of toxicity.
be the sole feed for SACs.
Poisoning is therefore only likely in sub-
tropical areas of Australia. There is no anti-
dote. However, if the animals are denied
Stachys arvensis (Stagger weed) access to the plant they will recover except
abortions cannot be prevented. It is reputed
This herb with pink tubular flowers is a wide- that certain animals develop a craving for
spread weed of cultivation throughout the plant.
204 Chapter 16

Tamus communis (Black bryony) Terminalia oblongata (Yellow wood)

This common hedge climbing plant, with This deciduous tree has small white flowers.
greenish white flowers, is found in England It is only found in the McKenzie River basin
but not in Scotland. SACs can eat the leaves of north-eastern Queensland. SACs are
without ill effects. The author has eaten it as a poisoned by large intakes of fallen branches.
boiled vegetable served with butter in Algeria. The tannins cause convulsions. There is no
It is found throughout Africa north of the antidote. Euthanasia is indicated.
Sahara, where it originated. However, the
bright red berries contain a glycoside, which
is irritant but more importantly is a strong Tetradymia spp. (Horsebrush)
narcotic. It causes colic, paralysis and rapid
death. Treatment is unlikely to be successful.
This is a shrub found in arid areas of western
Demulcents (e.g. egg whites) have been
North America. It causes photosensitization
recommended.
of the non-woolly white areas of llamas faces.
Affected animals should be brought in and
treated with vitamin B injections.
Taxus baccata (Yew)

Established veterinary opinion is that this is Trachyandra divaricata


an extremely poisonous plant. In theory (Branched onion weed)
SACs need very little of the foliage or the
berries to die. However, they do not eat the This herb originated in south-west Australia
live tree. The danger is clippings from yew and is found throughout the world. It has
hedges. The toxicity is normally peracute white flowers and a rhizome, which contains
and the animal is found either dead or an unknown toxin, which causes ataxia and
totally collapsed. There is no realistic treat- recumbency. There is no known antidote.
ment. However, one author (Angus, 2010) If the llamas or alpacas are recumbent but still
reported after heavy snow in early January eating they will normally recover. If they have
2009 that three adult roe deer (Capreolus stopped eating euthanasia is indicated.
capreolus) ate large quantities of yew
branches. A second author (Scott, 2010) con-
firms seeing muntjac deer (Muntiacus reevesi) Trema tomentosa (Poison peach)
and Soay sheep browsing yew branches on
trees during snowy periods with no ill
This small tree has small white flowers, which
effects. The tolerance to yew is confirmed by
develop into small black fruit. The trees are
a third author (Stevenson, 2010), having
found in northern and north-eastern areas of
seen his own Lleyn sheep eating the
Australia and on tropical islands nearby.
branches. A fourth author (Swarbrick, 2010)
Llamas are not normally poisoned unless the
confirms resistance to yew by roe deer and
branches are broken or cut for browse. The
muntjac deer. This author considers that the
unidentified toxin affects the liver and can
profession should be prepared to review its
cause death from hepatoencephalopathy.
views on the toxicity of yew in at least sheep.
There is no known treatment.
There is no doubt that the berries are more
toxic. It is still prudent to deny access to yew
to SACs as yew is definitely extremely toxic
to cattle in the authors own experience. It is Trianthema spp. (Red spinach)
reasonable to expect it to be toxic to SACs.
Other yew species (e.g. Japanese yew Taxus This succulent prostrate herb is found in the
cuspidate) appear to be more toxic to SACs in arid and semi-arid areas of northern
the authors experience. Australia. It requires rapid intake by SACs
Poisons 205

so poisoning is only likely when the animals Veratrum californicum (False hellebore)
are starving. Toxicity therefore is extremely
rare. The plant contains oxalates, which This plant is also called the corn lily. It is an
cause hypocalcaemia and result in recum- erect herb with white flowers. It is found
bency. Treatment, which is normally success- throughout North America. The signs of
ful, is 80 ml of 20% calcium borogluconate poisoning are vomiting, convulsions and a fast
given slowly intravenously. irregular heart beat. There is no specific anti-
dote and symptomatic treatment is unlikely to
be successful. It is not normally eaten by SACs.
Tribulus terrestris (Caltrop)

This prostate creeping herb originated in Verbesina encelioides (Crownbeard)


southern Europe and is found throughout
the world. It has small yellow flowers. The This herb has daisy-like yellow flowers. It
plant contains steroidal saponins, which are causes problems in sandy soils in eastern
enhanced by wilting. Toxicity is only seen Australia. It is also found in gardens in the
if this plant is the main part of the diet of UK and wild in parts of southern Europe, the
llamas for several weeks. The main sign Middle East and central Asia. The toxic prin-
is photosensitization. The affected animals ciple galegine causes acute pulmonary
should be brought in. Vitamin B injections oedema. There is no treatment and euthana-
and a low protein diet will help the affected sia is indicated. However, large intakes are
liver to regenerate. Like so many poisonous required to cause toxicity. These are unlikely
plants, this herb may have medicinal except with starved or tethered animals.
effects. It may stimulate sexual behaviour
in male SACs.
Viburnum spp. (Viburnum)

Triglochin maritima (Arrowgrass) There are over 150 species of this garden
shrub, bush or small tree. They are all toxic to
This plant contains a cyanogenic glycoside, SACs to varying extents. The symptoms are
which causes not only neurotoxic signs but the same as poisoning with rhododendron,
also dyspnoea with bright red blood. The i.e. a gastritis making the animal vomit. The
plant is found worldwide. The specific anti- treatment is the same as for rhododendron
dote is sodium thiosulfate, which should be poisoning, i.e. morphine and atropine.
given intravenously at the rate of 30 mg/kg,
well diluted in warm normal saline twice
daily for 3 days. Wedelia asperrima (Yellow daisy)

This herb is a native of northern Australia.


Urochloa panicoides (Liverseed grass) It is also called the sunflower daisy. Toxicity is
rare as large intakes are required. It contains
kaurene, which causes acute liver toxicity
This grass grows throughout the tropics and
with a resulting encephalopathy. There is no
originated in southern Africa. If consumed
effective treatment known.
lush and in large quantities it can cause nitrate
poisoning in SACs. The specific antidote is
methylene blue, which should be given at
10 mg/kg slowly intravenously. The best Wikstroemia indica (Tie bush)
approach is to set up an intravenous drip of
warm isotonic saline and then slowly add the This shrub is a native of the coastal areas of
methylene blue. eastern Australia. It is liable to cause acute
206 Chapter 16

diarrhoea in SACs that have been tethered. Zea mays (Maize)


There is no specific treatment. However,
warm intravenous fluids and other support- This cultivated crop grown for maize or for
ive treatments are worthwhile. silage is highly palatable. On non-inorganic
farms it is normally top-dressed with large
amounts of nitrogen fertilizer. This is what
Xanthium occidentale (Noogoora burr) causes the problem for alpacas if they are
allowed to gorge on the young green growing
This upright annual herb is found in eastern plants. They develop nitrate poisoning. The
Australia. As the name implies it has burrs, specific antidote is methylene blue, which
which contain the active toxin, kaurene. It is should be given at 10 mg/kg slowly intrave-
an acute liver toxin, which leads to an enceph- nously. The best approach is to set up an
alopathy. There is no effective treatment and intravenous drip of warm isotonic saline and
euthanasia is indicated. Trekking llamas are at then slowly add the methylene blue.
risk but otherwise toxicity is extremely rare.

Zephyranthes atamasco (Rain lily)


Xanthium spp. (Cocklebur)
This woodland plant is also called the Easter
This plant found in the south-east of the USA lily. It is at that time that it is most toxic to
causes liver damage. It is a cumulative poison llamas on the trek. It contains alkaloids with
and so is unlikely to cause problems in alpacas anticholinergic properties, mainly vomiting
or llamas. In theory it might cause photosen- and excessive salivation. It is self limiting and
sitization of the white areas of the faces of the effects although violent only last for an
individual llamas. hour or so. Treatment is symptomatic but
hardly required.

Zamia pumila (Coontie)


Zigadenus venenosus (Death camas)
This cycad palm is found in gardens in many
subtropical and tropical areas throughout the This poisonous plant is found in North
world. These trees originated in the Far East. America and has star-shaped white flowers.
SACs are unlikely to eat it unless it is on rub- It is often called snakeroot. It is also found
bish dumps. It causes neurological signs, in Asia. It will not normally be eaten by
which appear to be irreversible. Euthanasia is llamas except when they are tethered on a
indicated. trek with little else to eat. The alkaloid will
cause ataxia. There is no specific antidote.
Recovery is likely unless large quantities
have been eaten.
Zantedeschia aethiopica (Arum lily)

These striking large white lilies are found


throughout the world as well as in gardens. Fungus Poisoning
They are also called calla lilies. They contain
actual oxalate crystals, which irritate the buc- Psilocybe cyanesciens (Wavy caps)
cal mucosa. The animals will froth at the
mouth and even get laryngeal oedema with This fungus found in the UK normally grows
dyspnoea. There is little need for any anti- on dry bark, e.g. under swings in childrens
inflammatory treatment as the condition soon playgrounds. It will grow in paddocks
resolves. It normally occurs when animals normally in the autumn. The fungi are attrac-
escape into gardens. tive to alpacas. The toxic signs shown are
Poisons 207

swollen lips, dyspnoea and slight tremors. toxic dose from massive fleece contamina-
Consumption of large amounts will cause tion. It normally causes C1 atony and consti-
ataxia and death. There is no antidote so pation, with resulting colic. Treatment is
treatment must be supportive. NSAIDs and oral liquid paraffin. Obviously
the animal should be bathed to remove fur-
ther chemical.
Amanita spp.

These fungi found in the UK are very toxic to Antimony


humans and to other mammals but have not
been implicated in toxicity in SACs. They are This metal is not found free in nature but may
Amanita muscaria the fly agaric, Amanita pan- cause toxicity from wastes associated with
therina the panther cap, Amanita phalloides the mining or indeed by discarded alloys con-
death cap and Amanita verna the destroying taining antimony. Acute poisoning causes
angel. The most toxic is the death cap. There diarrhoea. Treatment is with oral magnesium
is no antidote. Clinicians faced with a possi- oxide to precipitate the antimony and other
ble poisoning should set up a fluid line and demulcents to protect the mucous mem-
carry out an emergency emptying of C1. branes. Chronic poisoning causes liver dam-
Dexamethasone and glucose should be given age. The animals should be removed from
intravenously. Morphine may help as the ani- further ingestion and treated with B vitamins
mals will suffer severe cramping pain. The by injection.
prognosis is very poor and euthanasia must
always be considered.
Arsenic

Chemical Poisons Poisoning from arsenic can be in two ways,


as an inorganic source, or as an organic
Alphachloralose source. The source for inorganic poisoning is
from rat bait, or acaricides. The principle
Alphachloralose is the active ingredient of sign is severe dysentery. The diagnosis can
mouse bait. It causes death in mice by coma be confirmed by analysis of the ingesta, liver
and hypothermia. SACs are unlikely to con- or kidney. Low doses of arsenic were
sume enough to cause problems. It is possible included in tonics for horses to improve their
that crias might be affected. They should be coats. These should not be given to SACs.
warmed in a hot box to raise their core tem- The specific treatment for toxicity is sodium
perature. There are no references in the litera- thiosulfate at the rate of 30 mg/kg twice
ture of incidents of toxicity. daily. Ideally this should be given by very
slow intravenous injection. If a very dilute
solution is used it can be given subcutane-
ously. It may cause a severe reaction and
Aluminium
damage the fleece in alpacas. Oral adminis-
tration is not effective.
Although this metal is potentially toxic Historically, arsenic used to be included
because it binds up phosphorus, it does not in pig food to prevent swine dysentery and as
appear to be toxic to SACs. a growth promoter. This is the source of
organic arsenic. Organic poisoning has a
slower onset compared with the acute inor-
Amitraz ganic poisoning and shows neurological signs.
There may also be diarrhoea. This should be
This acaricide used for dipping and spraying controlled symptomatically as there is no
cattle is toxic to SACs. Alpacas may absorb a specific treatment.
208 Chapter 16

Battery acid Closantel

If animals lick the acid from batteries they Closantel is a salicylanilide drug used for the
will get ulcers on their tongues reminiscent of treatment and control of fasciolosis in sheep.
foot-and-mouth disease lesions. The condi- It is also active against Haemonchus contortus
tion is not life threatening. and the nasal bot, Oestrus ovis (Barlow et al.,
2002). When it was given at four times the rec-
ommended dose rate it caused blindness
Cadmium 2 weeks later on account of retinal degenera-
tion. This drug should not be used in SACs if
possible as it has a very narrow safety
Direct toxicity in SACs has not been recorded.
margin.

Caesium
Copper
Radioactive caesium was recorded in sheep
in the UK after the Chernobyl disaster in 1986. There is a very fine margin of safety with
However, no toxic effects were observed. copper in SACs. They all require some cop-
per, particularly on copper deficient land,
which is rare. What is more likely is land
that is high in molybdenum or sulfur. These
Cantharidin
two elements bind up the copper so it is
not available for the animal. Copper sup-
Blister beetles of Epicauta sp. swarm on to plementation is then required. However,
lucerne during harvesting. The beetles con- copper is very toxic to SACs and so
tain cantharidin, which is very toxic to all supplementation has to be carried out with
animals. Cantharidin causes acute abdomi- care. Copper ingestion can be cumulative.
nal pain with diarrhoea. Shreds of mucosa Historically, pigs used to be fed diets high
will be seen in the faeces. It also causes in copper to act as a growth promoter. If
haematuria. Animals will die unless stabi- such pig food is fed to SACs it will cause
lized by an isotonic saline drip. The toxicity copper toxicity. The main sign is jaundice.
of cantharidin does not diminish in This will be mirrored in the increase in liver
stored hay. enzymes, e.g. GLDH, AST and GGT. The
SAC will be ataxic. If this is evident then the
outcome is death. For a definitive diagnosis
Carbamate at post-mortem liver copper levels need to
be above 8000 mmols/kg DM or kidney lev-
These substances, which are herbicides and els higher than 650 mmols/kg DM. Kidney
insecticides, will cause poisoning in all ani- samples are more reliable as there is not the
mals. The signs and treatment are the same as same interference by iron as in the liver.
for organophosphorous poisoning. There is no reliable antidote when the dis-
ease has developed that far. However, a sub-
cutaneous injection of 3.4 mg/kg ammonium
tetrathiomolbdate on 3 alternate days has
Chlorinated hydrocarbons been successfully used for treatment of cop-
per poisoning in sheep (Sargison, 2001). This
These insecticides and acaricides are very author suggests treating the entire in-contact
potent poisons in all animals. They cause group. Young animals of all species are more
nervous signs from over-stimulation of the susceptible to toxicity and deficiency. Soil
CNS. There are no specific antidotes and sup- ingestion may account for up to 30% of DM
portive treatment is rarely effective. intake of copper.
Poisons