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CASE DESCRIPTION A 14-month-old female alpaca presented with a 3-week history of acute left hind limb lameness and swelling of the left tarsal region. CLINICAL FINDINGS Radiography revealed intermittent dorsal rotation of the talus with tibiotarsal, talocalcaneal, and proximal intertarsal joint subluxation. TREATMENT AND OUTCOME In an attempt to stabilize the talus, screws were placed in the distomedial aspect of the talus and the plantaromedial aspect of the central tarsal bone, and a stainless-steel wire was placed around the screws in a figure-eight pattern. The screw head of the proximal screw broke within 4 weeks after surgery, but subluxation did not recur, and the lameness resolved. Seven months later, the same condition was diagnosed in the opposite hind limb and was treated similarly. Implants remained intact on this side, but the animal started to show signs of pain and inability to flex the tarsal joint, prompting removal of the distal screw. Subsequently, the animal became sound and produced 2 healthy crias, but was euthanatized 4 years after the second surgery because of coccidiosis. CLINICAL RELEVANCE Dorsal rotation of the talus with tibiotarsal, talocalcaneal, and proximal intertarsal joint subluxation is a sporadic condition in New World camelids. This report provides the first account of successful treatment by surgical stabilization of the medial aspect of the proximal intertarsal joint.

CASE DESCRIPTION A 2.5-month-old 17.5-kg female alpaca cria was presented for evaluation and treatment of severe bilateral carpal varus deformities. CLINICAL FINDINGS No lameness was evident at a walk, and neither carpal varus deformity could be corrected by means of manipulation. Radiography revealed severe varus of the left (27°) and right (21°) carpal regions. No additional conformational abnormalities were detected. TREATMENT AND OUTCOME A single 2.7-mm transphyseal cortical screw was placed in the distolateral aspect of the radius in each limb. On reexamination 8 weeks after screw placement, the left carpal varus deformity had corrected from 27° to 2.6°, and the left transphyseal screw was removed. The right carpal varus deformity had improved but was still present (18°), and hemicircumferential periosteal transection and elevation was performed on the mediodistal aspect of the right radius. Five weeks after the second surgery, the right carpal varus deformity had corrected to 2.4°, and the right transphyseal screw was removed. Six months after the second screw removal, both thoracic limbs remained straight, the cria had a normal gait, and the owner was happy with the cosmetic result. CLINICAL RELEVANCE Placement of a single transphyseal cortical screw with or without the addition of hemicircumferential periosteal transection and elevation can provide a favorable outcome in skeletally immature alpacas with severe carpal varus deformities.

CASE DESCRIPTION 4 alpacas and 2 llamas (11 months to 11 years old) from 2 properties were examined for lethargy (6/6), salivation and regurgitation (4/6), and recumbency (3/6). Signs developed approximately 48 to 72 hours after accidental access to black oil sunflower seeds. CLINICAL FINDINGS 3 alpacas died suddenly prior to treatment and were necropsied. One llama survived, and 1 alpaca and 1 llama died after days of medical treatment. All 3 treated animals had systemic inflammatory signs including tachycardia, fever, and hematologic changes. Biochemical anomalies included azotemia, hyperglycemia, hyponatremia, hypochloremia, and hypoalbuminemia. Necropsy identified numerous sunflower seeds in the gastrointestinal tract of all 5 animals that died, with pulmonary congestion (5/5 animals), mild centrilobular vacuolar hepatic degeneration (4/5), and erosions of the esophagus (3/5) and first (3/5) and third (1/5) compartments of the forestomach. Renal tubular necrosis was found in the 2 animals that died on day 4 of treatment. TREATMENT AND OUTCOME One llama responded successfully to intensive medical management including supplemented IV fluid therapy, oral and partial parenteral nutrition, and administration of antimicrobials, furosemide, and insulin and was clinically normal with plasma biochemical analysis values within reference range 12 weeks later. Vitamin D, oxalates, heavy metals, and mycotoxins were excluded as the cause of clinical signs on the basis of screening of uneaten seeds and tissue samples and gastric content from the treated llama that died. CLINICAL RELEVANCE Inadvertent large volume black oil sunflower seed ingestion resulted in a high mortality rate in camelids. A specific toxic principle was not identified. Feeding this product to camelids is not recommended to avoid the risk of accidental overingestion and subsequent disease. (J Am Vet Med Assoc 2021;259:406–414)

CASE DESCRIPTION A 2-month-old 12.0-kg (26.4-lb) sexually intact male alpaca was evaluated for a 1-week history of progressive forelimb lameness with no known history of trauma. CLINICAL FINDINGS The cria had toe-touching lameness in the right forelimb with a firm swelling at the distal dorsomedial metacarpal region. Signs of pain were elicited on palpation of the swollen region. There was no associated wound or draining tract. Radiographic examination revealed soft tissue swelling and osteomyelitis of the distal portion of the third metacarpal bone with a possible medial cortical sequestrum. TREATMENT AND OUTCOME The cria was hospitalized and treated with meloxicam (1 mg/kg [0.45 mg/lb], PO, q 72 h) and ceftiofur sodium administered SC (2.2 mg/kg [1 mg/lb], q 12 h for 8 days) and by means of regional limb perfusion (1.25 mg/kg [0.57 mg/lb], IV, q 48 h for 8 days). Lameness and swelling improved, and the cria was discharged from the hospital with meloxicam (1 mg/kg, PO, q 72 h for 2 weeks) and ceftiofur crystalline free acid (1.5 mg/kg [0.68 mg/kg], SC, q 5 d for 2 weeks). At a recheck examination 17 days later, there was radiographic evidence of a well-defined 3.4 × 0.3-cm osseous sequestrum in the distal aspect of the affected third metacarpal bone. The owner declined further treatment and elected to monitor the cria at home. One year later, radiographic examination revealed nearly complete resolution of the sequestrum. CLINICAL RELEVANCE Results for this patient suggested that osseous sequestra in some camelids may resolve following medical treatment without surgical intervention.

OBJECTIVE To assess signalment, clinical findings, and treatments for New World camelids (NWCs) hospitalized for evaluation and treatment of neonatal disorders and investigate associations between these factors and death during and after hospitalization. ANIMALS 267 NWCs ≤ 30 days of age. PROCEDURES Medical records of a veterinary teaching hospital were retrospectively reviewed to identify NWCs admitted for evaluation and treatment of neonatal disorders between 2000 and 2010. Signalment, physical examination data, diagnostic findings, treatments, and outcomes were recorded. Factors were examined for association with death during hospitalization and the overall hazard of death by use of multivariable logistic regression and Cox proportional hazards analysis, respectively. RESULTS The sample comprised alpacas (n = 255) and llamas (12). Median age at admission was 3 days, and median hospitalization time was 2 days; 208 of the 267 (77.9%) neonatal NWCs survived to hospital discharge. Factors associated with increased odds of death during hospitalization included prematurity or dysmaturity, hypothermia, sepsis, toxic changes in neutrophils, and undergoing surgery. The odds of death during hospitalization also increased as anion gap increased. After discharge, 151 of 176 (85.8%) animals had follow-up information available (median follow-up time, 2,932 days); 126 (83%) were alive and 25 (17%) had died. Prematurity or dysmaturity, congenital defects, sepsis, oxygen administration, and undergoing surgery as a neonate were associated with an increased hazard of death; the hazard of death also increased as serum chloride concentration at the time of hospitalization increased. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested the prognosis for survival during and after hospitalization is good for most NWCs hospitalized because of neonatal disorders.

CASE DESCRIPTION A 4-hour-old 6.3-kg (13.9-lb) female alpaca cria was evaluated because of severe respiratory distress and difficulty nursing since birth. CLINICAL FINDINGS The cria had open-mouth breathing and cyanotic membranes, with no airflow evident from either nostril. Supplemental oxygen was delivered, and the patient was anesthetized and intubated orotracheally; a CT evaluation of the head confirmed bilateral membranous obstruction of the nasal cavities, consistent with complete bilateral choanal atresia. TREATMENT AND OUTCOME Choanal atresia was treated with an endoscopically assisted balloon-dilation technique, and temporary tracheostomy was performed. Stenosis recurred, requiring revision of the repair and intranasal stent placement 3 days after the first surgery. The tracheostomy tube was removed the next day. Complications during hospitalization included mucoid obstruction of the tracheostomy tube, granulation tissue development in the trachea near the tracheostomy site, mucoid stent obstruction, aspiration pneumonia, and presumed partial failure of passive transfer of immunity. The stents were removed 2 weeks after admission, and the cria was discharged 3 days later. The owner was advised that the animal should not be bred. At last follow-up 3 years later, the alpaca was doing well. CLINICAL RELEVANCE Surgical treatment with a balloon-dilation technique and placement of nasal stents with endoscopic guidance were curative in this neonatal alpaca with bilateral membranous choanal atresia. Computed tomography was useful to determine the nature of the atresia and aid surgical planning. Because a genetic component is likely, owners should be advised to prevent affected animals from breeding.

Objective—To estimate seroprevalence of antibodies against bovine viral diarrhea virus (BVDV) and incidence of seroconversion in alpacas in the United States during 2006 to 2007 and to evaluate associations between BVDV seropositive status and potential risk factors for exposure to BVDV. Design—Cross-sectional and longitudinal cohort study. Sample—Blood samples from 192 alpacas > 6 months old in 39 herds from 20 states; 40 owners who completed questionnaires. Procedures—550 US alpaca owners, stratified by state and randomly selected from a list of approximately 4,300 owners, were mailed a study description, voluntary participation request, and questionnaire. Thirty-nine owners submitted blood samples from up to 6 alpacas > 6 months old; 27 of 39 owners submitted another blood sample from the same alpacas > 1 month later. Samples were tested for serum virus-neutralizing antibodies against BVDV. Seropositive status was used to indicate BVDV exposure. Associations between seropositive status and potential risk factors for BVDV exposure described in questionnaires were evaluated by use of a Fisher exact test. Results—8 of 192 (4.2%) alpacas in 3 of 39 (7.7%) herds were seropositive. Larger herds had a greater percentage of seropositive alpacas than did smaller herds. No alpaca from which a second blood sample was obtained seroconverted during 292 to 1,460 alpaca-days (mean, 740 alpaca-days) of potential exposure. Conclusions and Clinical Relevance—Results contributed to information on assessment of BVDV prevalence, risk factors for exposure, and alpaca industry practices in 2006 to 2007 during the emergence of BVDV as a major disease in alpacas.

Objective—To describe clinical findings, treatments, and outcome in camelids treated for osseous sequestration. Design—Retrospective case series. Animals—27 alpacas and 9 llamas with osseous sequestration. Procedures—Medical records of 2 veterinary teaching hospitals were reviewed to identify camelids evaluated because of osseous sequestration between January 1, 1999, and December 31, 2010. Data on history, signalment, physical examination and medical imaging findings, treatment, and complications were collected. Results—Records of 36 camelids were included, of which there were 22 sexually intact males, 11 females, and 2 castrated males with a median age of 7. 5 months, 3.9 months, and 8.5 years, respectively (age and sex were not available for 1 camelid). The most common clinical signs were lameness, swelling over the affected bone, and associated draining sinus. Sequestra were associated with trauma in 7 (19%) camelids. Camelids with sequestra not associated with trauma (n = 29 [81%]) were significantly younger than those with sequestra attributed to trauma. Thirty-four camelids underwent sequestrectomy, and all survived to hospital discharge (median duration of hospitalization, 6.5 days). Recurrence of a sequestrum occurred twice in 1 (3%) camelid. Long-term follow-up (≥ 12 months) information was available on 24 camelids, of which 20 (83%) recovered without long-term complications. Conclusions and Clinical Relevance—Unlike in other livestock, trauma was not a primary cause of osseous sequestration in camelids. Sequestra should be considered in the differential diagnostic process in camelids with lameness, a draining sinus, or a firm swelling over a bony prominence. Sequestrectomy is a successful treatment option.

Objective—To describe clinical signs and treatment outcomes for juvenile alpacas with spiral colon impaction (SCI). Design—Retrospective case series. Animals—12 juvenile (< 6 months old) camelids with SCI. Procedures—Crias with SCI were identified by searching the medical records database of the Cornell University Equine and Farm Animal Hospital. A keyword-based search method was used. Inclusion required confirmation of SCI on the basis of surgical or necropsy findings. History, signalment, examination findings, diagnostic test results, medical treatments, and surgical reports as well as short- and long-term outcomes were reviewed. Peritoneal fluid parameters were compared with those of age-matched comparison crias in which SCI was suspected but ruled out at necropsy or exploratory celiotomy. Results—12 crias with confirmed SCI were identified. Common clinical signs included lethargy and diarrhea. Abdominal distention was observed in 9 crias. In 3 crias, a mass in the region of the spiral colon was palpated. Seven crias underwent peritoneal fluid analysis; compared with age-matched comparison crias, SCI-affected crias had higher peritoneal fluid nucleated cell counts and nucleated cell count-to-total protein concentration ratios. A ventral midline celiotomy was performed in 9 crias; 7 underwent an enterotomy, and 2 underwent transmural infusion of saline (0.9% NaCl) solution with manual breakdown of ingesta; 3 of these crias survived for at least 6 months. Conclusions and Clinical Relevance—Crias with SCI that were not resolved by medical management had a poor prognosis. During celiotomy, transmural infusion of saline solution with manual breakdown of ingesta provided a less invasive alternative to enterotomy.

Objective—To determine indications for cesarean section in alpacas and llamas, and clinical management and outcome of alpacas and llamas undergoing cesarean section. Design—Retrospective case series. Animals—27 alpacas and 7 llamas. Procedures—Medical records were reviewed and information gathered on signalment, anamnesis including reproductive history, physical examination findings, indication for cesarean section, anesthetic protocol, surgical technique, number of crias delivered (alive or dead), additional treatment, duration of hospitalization, and postoperative complications. Follow-up information was gathered via email or telephone interview with owners. Results—Uterine torsion (13/34 [38%]) was the most common reason for cesarean section. The most common surgical approach was the left proximal lateral abdominal approach (21/34 [62%]). Thirty-four crias were delivered via cesarean section. Twenty (59%) were born alive and discharged from the hospital. Retained placenta was the most common complication observed after surgery. A significant association was found between prolonged dystocia and fetal death. Of the 34 dams that underwent cesarean section, 21 were rebred, and 19 of the 21 (90.5%) dams that were rebred became pregnant. Fifteen of 19 dams were confirmed to have ≥ 1 normal vaginal delivery with a live cria following cesarean section. Conclusions and Clinical Relevance—The results of the present study indicated that cesarean section was an effective method of resolving dystocia in camelids without negatively affecting future fertility or parturition by the dam. Prompt referral of patients with dystocia is advised to improve fetal viability. Retained fetal membranes seemed to be a common complication of cesarean section in camelids but was not associated with negative outcomes.

CASE DESCRIPTION A female alpaca, kept at pasture with 12 other female alpacas, 2 crias, and 5 goats, was evaluated because of clinical signs of aggression. CLINICAL FINDINGS The clinical signs of aggression progressed to include biting at other animals as well as disorientation. Three days later, the alpaca was euthanized because of suspicion of rabies virus infection. TREATMENT AND OUTCOME No physical injuries were found at necropsy. Brain tissue specimens were confirmed positive for rabies on the basis of direct fluorescent antibody test results. Molecular typing identified the rabies virus variant as one that is enzootic in raccoons. The farm was placed under quarantine, restricting movement of animals on and off the property for 6 months. To prevent further rabies cases, 14 alpacas (12 adults and 2 crias) were vaccinated by extralabel use of a large animal rabies vaccine. Of the 14 vaccinated alpacas, 8 had paired serum samples obtained immediately before and 21 days after vaccination; all 8 alpacas had adequate serum antirabies antibody production in response to rabies vaccination. As a result of an adequate serologic response, the quarantine was reduced to 3 months. In the year after the index rabies case, no other animals on the farm developed rabies. CLINICAL RELEVANCE Extralabel use of rabies vaccines in camelids was used in the face of a public health investigation. This report provides an example of handling of a rabies case for future public health investigations, which will undoubtedly need to develop ad-hoc rabies vaccination recommendations on the basis of the unique characteristics of the event.

Case Description—Primary hypoaldosteronism without concurrent hypoadrenocorticism was diagnosed in an 8-year-old female alpaca with acute onset of weakness progressing to recumbency within 6 hours after onset. Clinical Findings—Hematologic testing at admission revealed profound hyponatremia, hypochloremia, and acidemia with a normal blood potassium concentration. Further diagnostic testing, including an ACTH stimulation test, led to a diagnosis of hypoaldosteronism in conjunction with normal cortisol production. Treatment and Outcome—The hembra responded well to IV polyionic fluid therapy with sodium supplementation and was managed successfully long term with free access to saline (0.9% NaCl) solution in addition to water ad libitum. Clinical Relevance—To our knowledge, this is the first reported case of hypoaldosteronism in an alpaca. Hypoaldosteronism should be considered in alpacas as a possible differential diagnosis for refractory hyponatremia or for hyponatremia in which an underlying etiology is not determined.

Objective—To compare the performance of 3 point-of-care glucose meters in adult and juvenile alpacas with that of a laboratory-based analyzer. Design—Evaluation study. Animals—35 adult alpacas and 21 juvenile alpacas. Procedures—Whole blood samples obtained via jugular venipuncture were tested with all 3 point-of-care glucose meters; plasma samples were also tested with 1 of those meters. Glucose concentrations determined by use of the point-of-care meters were compared with results from the laboratory-based analyzer. Results—Plasma glucose concentrations determined by use of the laboratory-based analyzer ranged from 36 to 693 mg/dL. Over the entire range of glucose concentrations tested, the Lin concordance correlation coefficient (agreement) was significant and excellent for all comparisons. Concordance decreased for 1 glucometer when testing whole blood samples over a narrower range of glucose concentrations (50 to 200 mg/dL). Bias was typically small (< 10 mg/dL) for 3 of the 4 comparisons but considerable for 1 meter with the use of whole blood. The limits of agreement were wide for all comparisons over the entire range of glucose concentrations tested but decreased to within acceptable limits when the narrower glucose range (50 to 200 mg/dL) was analyzed for 3 of the comparisons. For samples with a PCV < 25%, bias and the limits of agreement were greater for one of the meters tested. Conclusions and Clinical Relevance—Discrepancies between point-of-care glucose meters and reference techniques can be considerable in alpacas, emphasizing the importance of assessing individual meter performance in a target population.

Case Description—A 3-day-old 9.5-kg (21-lb) female alpaca cria was examined because of lethargy and anorexia. Clinical Findings—Physical examination revealed hyperthermia, muscle fasciculations, and tremors of the head. Seizures were also observed, which indicated CNS dysfunction. Hyperosmolar syndrome (HOS) was diagnosed on the basis of hyperglycemia, hypernatremia, azotemia, high plasma osmolarity, and metabolic acidosis. Treatment and Outcome—A constant rate infusion of regular insulin was administered with hypo-osmolar fluids to treat HOS, and blood glucose and sodium concentrations were successfully lowered. Neurologic deficits resolved with treatment, and the cria was discharged 11 days after admission. Clinical Relevance—Administration of insulin as a bolus in addition to hypo-osmolar fluids has been advocated in the management of neonatal camelids with HOS. Administration of regular insulin via a constant rate IV infusion was used to successfully manage a neonatal camelid with HOS. This form of insulin administration may allow more control of glucose kinetics in these patients.

Objective—To determine humoral responses to an equine encephalitis vaccine in healthy alpacas. Design—Clinical trial. Animals—39 healthy alpacas on 1 farm and 86 healthy alpacas on a second farm. Procedures—All alpacas were given 3 doses IM of a bivalent, killed-virus equine encephalitis vaccine, with 4 weeks between doses. Eastern equine encephalitis (EEE) virus neutralizing antibody responses were determined with a plaque reduction neutralization assay every 14 days in alpacas on the first farm and 70 days after the first dose of vaccine on the second farm. Results—For alpacas on the first farm, geometric mean virus neutralizing antibody titer peaked 2 weeks after the third vaccine dose was given (ie, day 70). At this time, 29 of 38 (76%) animals were seropositive for antibodies against EEE virus, and percentage of animals ≤ 2 years old that were seropositive (16/17) was significantly higher than percentage of animals > 6 years old that were seropositive (1/5). For alpacas on the second farm, 76 (88%) were seropositive on day 70, and percentage of animals ≤ 2 years old that were seropositive (24/24) was significantly higher than percentage of animals > 6 years old that were seropositive (27/33). For both farms, geometric mean titer on day 70 was significantly higher in animals < 2 years old than in animals > 6 years old. Conclusions and Clinical Relevance—Results suggested that inoculation of alpacas with 3 doses of a bivalent, killed-virus equine encephalitis vaccine induced a humoral antibody response against EEE virus.

Case Description—20 alpaca crias (13 females and 7 males) were examined for diarrhea (n = 20), weight loss (15), and poor appetite (5). Fourteen crias were between 8 and 18 days of age at time of admission. Clinical Findings—Cryptosporidiosis was diagnosed in all crias. Common biochemical abnormalities included acidemia, hyperlactemia, azotemia, and hyperglycemia and increases in aspartate transaminase and γ-glutamyltransferase activities. Serum sodium and chloride concentrations were high or low. Other potential gastrointestinal tract pathogens were identified in only 7 crias. Treatment and Outcome—Supportive care was instituted, including IV administration of fluids with partial parenteral administration of nutrients (n = 19 crias), antimicrobials (19), supplemental orally administered nutrients (11), administration of plasma (10), and insulin treatment (9). Other palliative treatments used by attending clinicians were sucralfate, flunixin meglumine, vitamin A/D/E/B complex, antiparasitic agents, antidiarrheal agents, and azithromycin. Three crias with inadequate urine production and severe azotemia were treated with furosemide administered IV as a bolus or as a constant-rate infusion. Treatment resulted in a successful outcome in 16 of 20 crias. Weight loss and refractory azotemia were common in nonsurvivors but not in surviving crias. Clinical Relevance—Findings suggested that Cryptosporidium spp may be a diarrheal pathogen of unweaned alpaca crias that may be more widespread than has been recognized and can become endemic on some farms. Metabolic derangements were unpredictable and should be determined by biochemical analysis before fluid and electrolyte replacement is initiated. Cryptosporidiosis has zoonotic potential, and the infection can be self-limiting in alpacas receiving supportive treatment.

Case Description—An 11-year-old 72-kg (158-lb) sexually intact female alpaca was examined for diagnosis and treatment of hematuria of 4 months' duration. Clinical Findings—Pigmenturia was detected by the owner when the alpaca was 8 months pregnant. Radiographic, ultrasonographic, vaginal speculum, and cystoscopic evaluation of the urinary tract revealed normal vaginal and urethral epithelia and increased bladder vessel tortuosity, with pulses of hemorrhage from the left ureter. Regenerative anemia and mild leukopenia were detected and serum urea nitrogen and creatinine concentrations were within reference ranges. Treatment and Outcome—Chronic hematuria resolved after unilateral nephrectomy of the left kidney, and no dysfunction was detected in the remaining kidney. Histologic evaluation of the kidney revealed a transitional cell tumor in the renal pelvis. Clinical Relevance—Although anemia is common in South American camelids, hematuria is an uncommon sign of this condition. Chronic urinary tract infection, toxin ingestion, and neoplasia causing hematuria or hemoglobinuria should be considered in South American camelids with pigmenturia. Thorough and systematic evaluation of the urinary tract should be performed to locate the site of hemorrhage to treat hematuria appropriately.

Case Description—15 llamas and 34 alpacas between 3 weeks and 18 years old with fecal oocysts or intestinal coccidial stages morphologically consistent with Eimeria macusaniensis were examined. Nineteen of the camelids were admitted dead, and 30 were admitted alive. Camelids admitted alive accounted for 5.5% of all camelid admissions during this period. Clinical Findings—Many severely affected camelids had signs of lethargy, weight loss, decreased appetite, and diarrhea. Camelids with clinical infection also commonly had evidence of circulatory shock, fat mobilization, and protein loss. Nonsurviving camelids also had evidence of shock, edema, bile stasis, renal insufficiency, hepatic lipidosis, muscle damage, relative hemoconcentration, and sepsis. Postmortem examination frequently re-vealed complete, segmental replacement of the mucosa of the distal portion of the jejunum with coccidial meronts and gamonts. For 17 of 42 camelids, results of initial fecal examinations for E macusaniensis were negative. Treatment and Outcome—Most camelids admitted alive were treated with amprolium hydrochloride, plasma, and various supportive treatments. Fifteen of the 30 treated camelids died or were euthanized. Clinical Relevance—Findings suggest that E macusaniensis may be an important gastrointestinal tract pathogen in camelids of all ages. Clinical signs were frequently nonspecific and were often evident before results of fecal examinations for the parasite were positive. As with other coccidia, severity of disease was probably related to ingested dose, host immunity, and other factors. The clinical and herd relevance of positive fecal examination results must be determined.

Case Description—An 11-year-old male breeding alpaca was evaluated for a 2-day history of lowered head carriage and lethargy. Clinical Findings—On initial examination, the alpaca had signs of lethargy and lowered carriage of the head and neck, but no specific neurologic deficits. Medical management improved the clinical signs, but 8 months later, the alpaca developed acute, progressive general proprioceptive ataxia affecting all 4 limbs and was referred for further evaluation and treatment. Magnetic resonance imaging and CT identified disruption of the normal osseous architecture of C7 and T1. Medical management was attempted, but because of a lack of improvement, the patient underwent surgery 14 months after initial examination. Treatment and Outcome—A dorsal laminectomy of C7 and T1 via a dorsal midline approach was performed, and the spinous processes of both vertebrae were removed prior to removal of the overlying lamina. Free dorsal expansion of the spinal cord was ensured by resection of the ligamentum flavum. Six months after surgery, the alpaca had returned to successful breeding with 7 hembra bred in the first year after surgery, producing 6 crias, and 4 crias in the second year. The patient was eventually euthanized 28 months after surgery because of neurologic deterioration but was still ambulatory at that time. Conclusions and Clinical Relevance—A good outcome with adequate alleviation of clinical signs and breeding soundness for > 2 years following dorsal laminectomy was achieved in this camelid patient. The surgical approach was similar to that in other species and was associated with mild postoperative morbidity. Veterinarians treating camelids should be aware of the initial clinical signs and treatment options for cervical vertebral stenotic myelopathy. In acute cases, the signs of reduced cervical mobility and pain on manipulation should prompt investigation including appropriate diagnostic imaging. Timely surgical intervention should be considered in patients that respond poorly to medical treatment to avoid irreversible spinal cord injury and optimize outcome.

Among the population of an alpaca breeding farm, 5 alpacas (22 days to 14 months old) developed focal swellings in the subcutaneous tissues of the head or neck. Infection with Corynebacterium pseudotuberculosis was confirmed on the basis of results of microbial culture of abscess material and a serum hemolysis inhibition assay to detect C. pseudotuberculosis toxin. The dams of the affected alpacas were seronegative for C. pseudotuberculosis toxin. The affected alpacas underwent surgical excision of the abscesses and were isolated from herdmates for 90 days; treatment was successful, and no other alpacas in the herd became infected. Common risk factors for sources of infection in the affected alpacas included housing in a maternity barn and a pasture. Also, the infection potentially originated from new alpacas introduced into the herd during the preceding 3 months. Infection with C. pseudotuberculosis should be considered as a differential diagnosis for camelids with peripheral lymphadenopathy or abscesses in subcutaneous tissues.

Two adult female alpacas were evaluated for acute onset of weakness, pale mucous membranes, and signs of depression of unknown etiology. Both alpacas had intravascular hemolysis, anemia, and Heinz body formation and had been fed wilted red maple leaves. Clinical signs developed several days after ingestion of the leaves. No other toxin exposure was reported, and no parasites were detected. Dietary copper and nitrate-nitrite concentrations were evaluated and determined to be within reference limits. Both alpacas continued to become profoundly anemic with continued hemolysis. This necessitated blood transfusion as a life-saving intervention; however, prior to whole blood being available, transfusion with bovine hemoglobin glutamer was necessary. Both alpacas recovered without complications.

JAVMA, Vol 224, No. 4, February 15, 2004 F the purpose of this FARAD Digest, small ruminants are considered to include sheep, goats, deer, and camelids. In the United States, the small ruminant population is low, and they are all considered minor species under the Food, Drug, and Cosmetics Act (Table 1). Minor species are defined by exclusion from major species (ie, cats, dogs, horses, swine, cattle, chickens, and turkeys). In the United States, sheep were only considered to be minor species in regard to efficacy and target animal safety requirements and remained a major species when human food safety was being evaluated. This exception was attributed to the high consumption of lamb and mutton at the time of the original classification in 1983. It was not until August 2002 that the sheep drug approval process was amended so that sheep were reclassified as a minor species with regard to human food safety requirements. Classification as a minor species allows the FDA flexibility in permitting new drug applications when FARAD Digest

Objective—To determine the effect of experimental infection with bovine viral diarrhea virus (BVDV) on llamas and their fetuses, evaluate seroprevalence of BVDV in llamas and alpacas, and genetically characterize BVDV isolates from llamas.Design—Prospective study.Animals—4 pregnant llamas for the experimental infection study and 223 llamas and alpacas for the seroprevalence study.Procedure—Llamas (seronegative to BVDV) were experimentally infected with a llama isolate of BVDV via nasal aerosolization. After inoculation, blood samples were collected every other day for 2 weeks; blood samples were obtained from crias at birth and monthly thereafter. For the seroprevalence study, blood was collected from a convenience sample of 223 camelids. Isolates of BVDV were characterized by reverse transcription- polymerase chain reaction assay.Results—Viremia and BVDV-specific antibody response were detected in the experimentally infected llamas, but no signs of disease were observed. No virus was detected in the crias or aborted fetus, although antibodies were evident in crias after colostrum consumption. Seroprevalence to BVDV was 0.9% in llamas and alpacas. Sequences of the llama BVDV isolates were comparable to known bovine isolates.Conclusions and Clinical Relevance—Findings suggest that llamas may be infected with BVDV but have few or no clinical signs. Inoculation of llamas during gestation did not result in fetal infection or persistent BVDV infection of crias. Seroprevalence to BVDV in llamas and alpacas is apparently low. The most likely source for BVDV infection in camelids may be cattle. (J Am Vet Med Assoc2003;223:223–228)

Objective—To determine the apparent prevalence of shedding of Cryptosporidium spp in healthy alpaca crias and their dams on 14 farms in New York and 1 farm in Pennsylvania. Design—Cross-sectional study. Animals—110 alpaca crias and their 110 dams. Procedures—Fecal samples were obtained from 220 alpacas at 14 alpaca farms in New York and 1 farm in Pennsylvania. For each animal, age, sex, and health condition were recorded. A fecal score (1 = normally formed; 2 = soft or loose; 3 = diarrhetic) was recorded for each cria. Cryptosporidium oocysts were identified in fecal samples by a direct immunofluorescence assay. Results—Apparent prevalence of fecal shedding of Cryptosporidium oocysts was 8% (95% confidence interval, 4% to 15%) in dams and was 7% (95% confidence interval, 3% to 13%) in crias. There was no significant difference in age between dams with positive fecal test results for Cryptosporidium oocysts (median age, 4 years; range, 3 to 8 years) and dams with negative results (median age, 4 years; range, 2.5 to 19 years). No significant difference was found in age between crias with positive fecal test results (median age, 20 days; range, 7 to 53 days) and those with negative results (median, 36 days; range, 2 to 111 days). No significant difference in fecal scores was found between crias with positive versus negative fecal test results. Conclusions and Clinical Relevance—A higher than previously reported apparent prevalence of fecal shedding of Cryptosporidium oocysts in healthy alpacas was found. A zoonotic risk should be considered, especially for Cryptosporidium parvum.

A 5-month-old alpaca cria was examined for chronic poor growth and repeated episodes of diarrhea. Examination of feces for parasites yielded negative results. Serum bile acid and blood ammonia concentrations were high. Subsequent examination by ultrasonography, percutaneous splenic portography, and colonic scintigraphy did not reveal evidence of a portosystemic vascular anomaly. Exploratory celiotomy with mesenteric vein portography revealed a colonic vein shunt in the caudal portion of the abdomen from the caudal vena cava to the portal vein. The shunt vessel was ligated without incident. Following surgery, the cria began to gain weight and was more alert. Eighteen months after surgery, the cria was doing well, although it had loose feces and was slightly small for its age. Portosystemic shunts are rare in cattle and horses but should be considered in alpacas with chronic poor growth when parasitism has been ruled out.

A 7-month-old female llama was examined because of chronic otitis media and externa of 7 months' duration. Radiographically, the tympanic bullae appeared thicker than normal, and the ventral borders were poorly defined; the left external acoustic meatus (ear canal) appeared to be narrower than the right. The llama was treated with penicillin, and the ear canals were lavaged daily. Contrast radiography was performed on day 15 to determine the shape and size of the ear canals and evaluate the integrity of the tympanic membranes. Contrast medium was visible radiographically in the left tympanic bulla, indicating that the left tympanic membrane was ruptured, but the right tympanic membrane appeared to be intact. The left ear canal was narrower than the right, and the bony ear canals had a well-defined sigmoid shape. The right ear improved with medial treatment alone, but the left ear did not. Therefore, lateral ear canal resection was performed. After surgery, however, exudate was still evident in the left ear canal, and the llama became more lethargic and more reluctant to eat. Lateral bulla osteotomy was attempted, but no purulent material was obtained, and curettage of the bulla resulted in hemorrhage. Because of this and because of the llama's poor physical condition, a decision was made to euthanatize the llama. The sigmoid shape of the bony ear canal and the multicompartmental nature of the tympanic bulla make surgical treatment of otitis media and externa in llamas difficult. Further study of surgical treatments for otitis media in llamas is needed.

Objective—To determine clinical, clinicopathologic, and postmortem abnormalities in New World camelids with pancreatic necrosis. Design—Retrospective study. Animals—10 llamas and 1 alpaca. Procedures—Medical records of animals in which a diagnosis of pancreatic necrosis had been made on the basis of histologic examination of necropsy specimens or on the basis of clinical signs and results of clinicopathologic testing were reviewed. Results—The initial owner complaint varied, and various other conditions were diagnosed. Clinical and clinicopathologic abnormalities were vague. Amylase activity was higher in abdominal fluid than in serum in 5 of 7 animals, and lipase activity was higher in abdominal fluid than in serum in all 7. Four animals survived, and 7 died or were euthanatized. Only 1 of the animals that died had marked inflammation of the pancreatic parenchyma. All 7 had necrosis and saponification of fat in and surrounding the pancreas. Conclusions and Clinical Relevance—Results suggest that pancreatic necrosis may develop in New World camelids, but clinical signs are vague, and the condition may easily be confused with other diseases. The only laboratory test that appeared to be helpful in the antemortem diagnosis of pancreatic necrosis was comparison of amylase and lipase activities in abdominal fluid and serum. (J Am Vet Med Assoc 2000;217:241–244)

Objective—To evaluate several practice-adapted assays for determination of passive transfer status in crias. Animals—24 llama and 9 alpaca crias. Design—Prospective study. Procedure—Serum IgG concentration was measured by use of a radial immunodiffusion assay when crias were 45 to 51 hours old. Results were compared with serum γ-glutamyltransferase (GGT) activity, serum total protein, albumin, globulin, and total solids concentrations, and results of commercially available and traditional sodium sulfite turbidity (SST) tests. Results—Mean (± SD) serum IgG concentration was 1,762 ± 1,153 mg/dl. On the basis of a threshold value of 1,000 mg of IgG/dl at 48 hours of age, 5 of 33 (15.15%) crias had failure of passive transfer. Serum total solids, protein, and globulin concentrations were significantly associated with serum IgG concentration, whereas serum GGT activity and serum albumin concentration were not. Serum IgG concentrations were significantly different among crias with negative, 2+, and 3+ scores on the traditional SST test. Serum IgG concentrations were not significantly different between crias with negative and 100 mg/dl scores or 100 and 300 mg/dl scores on the commercially available SST test. However, all other comparisons between crias with different scores revealed significant differences. Sensitivity and specificity ranged between 0 and 1, depending on the test and endpoint selected. Conclusion and Clinical Relevance—The commercially available SST test and determination of serum total protein and globulin concentrations are suitable methods for assessing passive transfer status in llama and alpaca crias. (J Am Vet Med Assoc 2000;216:559–563)

Objective—To describe clinical, microbiological, in vivo confocal microscopic, and histopathologic features of fungal keratitis in alpacas and to estimate prevalence of the disease in a population of alpacas from the northeastern United States. Design—Retrospective case series. Animals—11 alpacas. Procedures—Medical records of alpacas evaluated by the ophthalmology service of a veterinary teaching hospital were searched to identify animals with a clinical diagnosis of fungal keratitis and positive results for fungal culture of a corneal sample between 2003 and 2012. Signalment and historical, clinical, and microbiological details were recorded. Results of cytologic, histopathologic, and in vivo confocal microscopic corneal examinations were collected when available. Results—Fungal keratitis was diagnosed in 11 of 169 (6.5%) alpacas that underwent ophthalmologic examination by the ophthalmology service during the study period. Ten of the 11 alpacas were evaluated in the summer or fall months. Corneal lesions included stromal ulcer, stromal abscess, corneal perforation, and nonulcerative keratitis. Aspergillus fumigatus and Fusarium solani were the most frequently cultured fungi. Fungi were also identified through corneal cytologic examination, histologic examination, or in vivo confocal microscopy in 9 alpacas. Historically, 2 alpacas were evaluated following external ocular trauma and 1 following corneal foreign body removal. Nine alpacas had received topical treatment with antimicrobials and 2 had antimicrobial-corticosteroid combinations administered topically prior to referral. Nine of 10 alpacas for which follow-up information was available were successfully treated, with globe and vision retention. Conclusions and Clinical Relevance—Fungal keratitis was a relatively common ocular disease in this population of alpacas and appeared to share several clinical features with keratomycosis in horses.

Case Description—A 2-year-old male Suri alpaca was referred for evaluation of severe right forelimb lameness of 2 weeks' duration following a traumatic episode. Clinical Findings—Examination of the distal aspect of the metacarpus revealed 4 wounds exuding purulent material. On weight bearing, the metacarpophalangeal joint was severely hyperextended with the palmar surface touching the ground. Ultrasonography of the palmar surface of the metacarpus revealed desmitis of the proximal suspensory ligament, a large core lesion of the deep digital flexor tendon at mid-metacarpus, and complete loss of fiber pattern within the deep digital flexor tendon and lateral aspect of the superficial digital flexor tendon distally. Treatment and Outcome—The alpaca was treated systemically with antimicrobials and anti-inflammatory drugs and underwent repeated antimicrobial intraosseous regional limb perfusion. A bandage and splint were applied to stabilize the affected forelimb in an anatomically correct position, and the alpaca underwent prolonged stall confinement. At the time of hospital discharge 5 days after initial evaluation, clinical evidence of infection at the wound sites was absent. Three months following treatment, the alpaca was moving freely in a small paddock and had moderate hyperextension of the metacarpophalangeal joint. Clinical Relevance—Treatment of septic flexor tendonitis and suspensory desmitis with antimicrobial intraosseous regional limb perfusion in combination with systemic treatment with antimicrobials and orthopedic support resulted in an excellent outcome in this alpaca. Antimicrobial intraosseous regional limb perfusion is simple to perform and has the potential to be beneficial in the treatment of infections in the distal portion of a limb in camelids.

Objective—To assess the feasibility and usefulness of CT enterography to evaluate the gastrointestinal tract in clinically normal llamas and alpacas. Design—Prospective observational study. Animals—7 clinically normal alpacas and 8 clinically normal llamas. Procedures—The imaging protocol included orogastric administration of iodinated contrast material mixed with water. Three hours later, helical CT scanning was performed of the entire abdomen with transverse and multiplanar sagittal and dorsal projections before and after IV iodinated contrast agent injection. Results—Both oral and IV contrast agents were well tolerated, and no adverse reactions were observed. Transverse images depicted the gastrointestinal tract and pancreas in the short axis; however, dorsal and sagittal projections aided in localizing and differentiating the various gastrointestinal segments, including the pancreas. In all camelids, the wall of the gastrointestinal tract was well differentiated. In all but 2 camelids, all gastrointestinal segments were well visualized and differentiated. In those 2 animals, the cecum was difficult to identify. Good distention of the small intestine was achieved by use of the oral contrast agent. The dorsal projections were useful to identify the pancreas in its entire length. Conclusions and Clinical Relevance—The present study supplied new information about gastrointestinal wall thickness, intestinal diameter, and location of the pancreas and ileocecocolic junction in alpacas and llamas. Multiplanar contrast-enhanced CT was useful to reveal the various segments of the gastrointestinal tract, pancreas, and abdominal lymph nodes. The shorter time delay before imaging, compared with the delay with conventional barium studies, makes this technique complementary or superior to conventional radiographic or ultrasonographic studies for evaluation of the gastrointestinal tract.

Objective—To identify potential pathogens in feces from llama and alpaca crias with diarrhea. Design—Prospective observational study. Animals—45 unweaned crias with diarrhea. Procedure—Fecal samples were evaluated for Eimeria spp, Giardia spp, Cryptosporidium spp, enteric viruses, and Salmonella spp. A questionnaire yielded information concerning herd management and presence of other affected camelids. Results—28 crias were ≤ 31 days old, 11 were 32 to 62 days old, and 6 were 63 to 210 days old. Potential pathogens were isolated from feces from 32 of the 45 crias. A total of 39 potential pathogens were obtained, including coronavirus (n = 19 crias; 42%), Giardia spp (8; 18%), Eimeria spp (6; 13%), Cryptosporidium spp (4; 9%), rotavirus (1; 2%), and nematode ova (1; 2%). Salmonella spp were not isolated. Most crias from which potential pathogens were isolated were identified during outbreaks of diarrhea involving other camelids, although only coronavirus was isolated from crias identified during outbreaks involving adult camelids. Coronavirus was detected throughout the year, whereas protozoa were most commonly isolated during the fall and winter. Conclusions and Clinical Relevance—Results suggest that a variety of potential pathogens may be isolated from young crias with diarrhea. Many crias shed coronavirus, which may also have been affecting older camelids. Protozoa were isolated most often during wetter months, suggesting that crias born during these months may have greater exposure to protozoal pathogens. (J Am Vet Med Assoc 2003;223: 1806–1808)

Case Description—A 7-day-old female alpaca was examined because of an acute onset of diffuse central neurologic deficits. Clinical Findings—Diagnostic imaging with CT and MRI identified an intracranial cyst occupying approximately one-third to one-half of the dorsal portion of the cranial cavity, markedly displacing the cerebral hemispheres bilaterally. Treatment and Outcome—Initial surgical management via trephination and needle drainage was only transiently effective at resolving the neurologic signs. Craniotomy and drainage and removal of the cyst lining resulted in a sustained improvement in neurologic status, and the cria remained clinically normal and well grown at follow-up 5 months after surgery. Clinical Relevance—This report represented the first description of the successful treatment of an intracranial cyst in a New World camelid.

Objective—To compare the effects of hetastarch and lactated Ringer's solution (LRS) on plasma colloid osmotic pressure (pCOP) and other hematologic variables in healthy llamas. Design—Prospective crossover study. Animals—6 healthy female llamas. Procedures—Llamas were administered LRS (45 mL/kg [20.5 mL/lb]) and, after a 3-day washout period, hetastarch (15 mL/kg [6.8 mL/lb]) during 60-minute IV infusions. Serum total protein, serum albumin, and hemoglobin concentrations and Hct were measured before each infusion (baseline), immediately after each infusion was completed (0 hours), and at 2, 4, 8, and 12 hours. The pCOP was measured at baseline and at 0, 2, 4, 8, 12, 24, 36, and 48 hours after each infusion was completed; additional measurements of pCOP were obtained 72 and 96 hours after hetastarch infusion. Results—Hetastarch administration significantly increased mean ± SEM pCOP from 23.5 ± 0.3 mm Hg (baseline) to a peak of 28.4 ± 0.6 mm Hg (12 hours); significant increases in pCOP persisted at 96 hours after hetastarch administration. Administration of LRS significantly decreased albumin and total protein concentrations; in addition, mean ± SEM pCOP decreased from 24.1 ± 0.4 mm Hg (baseline) to 18.0 ± 0.3 mm Hg (0 hours). Hetastarch administration caused more pronounced decreases in Hct (0 hours) and concentrations of hemoglobin (0 hours), albumin (all time points), and total protein (all time points) than did LRS administration. Conclusions and Clinical Relevance—Hetastarch administration increased pCOP in healthy llamas for 96 hours with no clinically important complications.

Objective—To describe the clinical findings, treatments, and outcome in alpacas treated for scapulohumeral joint luxation (SHJL). Design—Retrospective case series. Animals—10 alpacas. Procedures—Medical records of alpacas with SHJL that were treated at 2 referral hospitals were reviewed. History, signalment, physical examination results, radiographic findings, treatments, complications, and outcome were evaluated. Results—Records for 8 male and 2 female alpacas with 16 instances of SHJL were reviewed. Three male alpacas each had 2 recurrences of SHJL in the treated limb. The proportion of male alpacas treated for SHJL was significantly greater than the proportion of female alpacas treated for SHJL. Closed reduction was used in 2 female and 3 male alpacas; SHJL reccurred in the 3 males. Stabilization by use of a lateral extracapsular tension band suture technique was performed successfully in 4 male alpacas; in another male alpaca, reluxation caused by self-inflicted trauma occurred postoperatively. In 2 male alpacas, arthrodesis was performed but residual lameness remained 1 year after surgery. Conclusions and Clinical Relevance—SHJL should be considered as a differential diagnosis in alpacas with thoracic limb lameness. Luxation may occur more frequently in males. A closed reduction technique may be used successfully to treat acute luxations. Extracapsular stabilization by use of the lateral extracapsular tension band suture technique was successful for treatment of recurrent SHJL and SHJL that could not be reduced via closed reduction.

Case Description—3 alpaca crias and cadavers of an alpaca cria and a llama cria were evaluated for evidence of esophageal dysfunction. Clinical Findings—All 5 crias were between 3 and 5 months of age when clinical signs developed, and all had a thin body condition when examined. Clinical signs included coughing, regurgitation, and grossly visible esophageal peristaltic waves. A barium esophagram was used to diagnose esophageal obstruction, megaesophagus, and a vascular ring anomaly (VRA). Fluoroscopy was used to evaluate deglutition, esophageal peristalsis, and the extent of esophageal dilation in 1 alpaca cria. A persistent right aortic arch was identified in 1 alpaca cria, and a left aortic arch with right ductus arteriosus or ligamentum arteriosum and an aberrant right subclavian artery were identified in the 4 remaining crias. Treatment and Outcome—Surgical correction of the VRA was attempted in the 3 live alpaca crias. It was complicated by the conformation and location of each VRA and inaccurate anatomic diagnosis of the VRAs before surgery. Treatment was universally unsuccessful because of intraoperative complications and the persistence of clinical signs after surgery. Clinical Relevance—Megaesophagus is typically an idiopathic condition in camelids. However, these findings suggested that camelids with esophageal dysfunction during the neonatal period may have a VRA. The prognosis is grave for camelids with VRA, and accurate anatomic diagnosis of the VRA via the use of advanced imaging techniques (eg, angiography, computed tomography, or magnetic resonance imaging) may improve the success of surgical intervention.