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Alpaca Neonatology

Claire Whitehead

Camelid Neonatology

Most llama and alpaca crias will be born without complication. However, it is important to be able to recognise what is normal and which crias are likely to be at risk of complications so that you are best able to know when to seek help and take the correct course of action if required.

Newborn llamas and alpacas should be standing within 30-60 minutes and nursing within 2-4hrs but often this will occur within 30-60 minutes. The dam should also normally pass the placenta within 2-4 hours. Meconium (first faeces) should be passed within 24-36 hours. Normal alpaca crias should weigh at least 6 kg and llama crias 7 kg ? though average weights are probably closer to 7.5 and 8.5 kg respectively for alpaca and llama crias. They will normally lose 0.25 kg or so during the first 24hours but then should gain 0.1-0.45 kg in body weight daily (average 0.25kg). Dams and crias should ideally be left alone as much as possible to begin with so that bonding can occur, but it is best to step in early in inclement weather or if a new mother is being crowded out by curious ?aunties?! Once bonding has occurred, the cria should be weighed and the navel dipped in 2-3% iodine tincture (which also helps dry the navel). At this point, it is also a good idea to perform a quick congenital defect check ? check for anus, normal genitalia (with openings!), cleft palate and check for nasal airflow if the cria is having any difficulty breathing. Common defects include choanal atresia, vulva aplasia/hypoplasia and wry-face (see later for details). Some defects will be immediately obvious whereas other defects may take a day or two to become apparent. Identify any signs of prematurity/dysmaturity as these crias will be considered high risk for problems: tendon laxity, low birth-weight, unerupted incisors, ears bent backwards, poor suckle reflex, silky coats etc. Also always check the dam?s udder for milk ? make sure that you check that all the teats are open and functioning normally. If milk production looks poor, as may be the case in a premature delivery or with maiden females, the dam may need to be given products to improve her lactation ? e.g. oxytocin in the early stages, Dr Pollard?s Herbal Lactation Stimulator (US), domperidone. Furthermore, the cria will probably need supplementation. Note also that overweight females (especially maidens) may have udders that look full but are mostly useless fatty tissue.

Ensuring adequate colostrum intake (10-20% of body weight in 24hrs) is vital in order to protect crias from infections during the first few months of life (passive immunity). There is only a narrow window of opportunity: after about 8 hours of life, the gut will start to lose its ability to absorb antibodies from the colostrum and after 24 hours, virtually nothing will be absorbed. Note that premature crias may have delayed absorption meaning that their gut may not be ready to absorb nutrients/antibodies from milk for a few days after which time the quality of colostrum may be much less. Failure to ensure colostrum intake may result in failure of passive transfer of immunity (FPT) and, unless this is addressed, may result in potentially fatal infections. If a dam has insufficient milk, then frozen camelid colostrum can be used, or goat, cow or sheep colostrum as alternatives ? goat is best since it is the closest to Camelid milk in composition. This can be either fresh or frozen. Frozen colostrum keeps for up to 1 year in the freezer. [NB Don?t microwave-thaw!!] It is best to have this in stock BEFORE you have a problem cria!!! Avoid powdered colostrum supplements which are not designed to be substitutes for colostrum. These really only provide energy. Aim to feed 10-15% of the cria?s bodyweight over 24 hours, divided into feedings every 2-4 hours. Preferably feed by bottle, though tube-feeding may be necessary initially ? avoid repeated tube-feedings which can cause oesophagitis (inflammation of the oesophagus). If you have to tube-feed more than twice, there is probably a reason why the cria is not getting up and nursing for itself and you should seek veterinary attention.

Over the first 2-3 weeks, it is advisable to weigh the cria on a daily basis. Often the first sign of problems is pre-empted by either a failure to gain weight for a day or two, or a loss of weight. Recognising this early will give your vet the best chance to correct the problem before it is too late. The next indication that something is wrong is often a ?crashing cria?. Monitor nursing behaviour. If a cria is seen constantly nursing this may suggest that the dam does not have sufficient milk. Also, make sure that you actually see the cria latched on to a teat and that its head is not just in the right place. Watch the cria?s activity level. Most crias will be running around playing, especially at dusk, once they are a few days old. If this is not happening, there may be a problem.


Failure of Passive Transfer of Immunity (FPT)

At risk crias:
- Low birth weight (≤6kg alpaca, ≤7kg llama)
- Prematurity/dysmaturity
- Dystocia/ c-section birth
- Maternal factors (Born to maiden dam, poor mothering, poor milk, mastitis, overweight dam  poor milk)
- Extremes of environment  e.g. hypothermia
- Congenital defects

Identifying high-risk crias is the first step in ensuring cria viability. Then it is necessary to check for FPT. There is no point in checking for FPT until the cria is at least 24hrs old ie once the gut has had a chance to absorb the antibodies out of the colostrum (immunoglobulins) and once no more is likely to be absorbed. This can be done in one of several ways, as listed in the table below:












Method Results Comments
Serum Total Protein >55 g/l Adequate
50-55 g/l Partial FPT
<50 g/l FPT Easy, minimal kit required.
[Centrifuge/refractometer]
Not species-specific
Affected by hydration status
Globulins >20 g/l Adequate
<20 g/l FPT Need laboratory analyser
Not species-specific
Affected by hydration status
Camelid-specific IgG >800 mg/dl Adequate
600-800 Partial FPT
<600 FPT RID plates
Cheap, easy test
Takes 24hrs to run
Difficult to interpret after 7 days
Won?t detect cow/goat antibodies if other species? colostrum has been given

Once FPT has been diagnosed, the only way to remedy the situation is by plasma transfusion. Crias with partial-FPT may not need plasma: the decision whether to transfuse or not should be based on the animal?s clinical condition +/- CBC results. Plasma can be collected from adult animals (preferably those >3 years old as these have better immunity) on the same farm ideally or can be obtained commercially in some countries. Ideally plasma should be given intravenously through an IV catheter and this will obviously need to be done by your veterinarian. I am personally not in favour of intraperitoneal transfusion as the procedure has the following disadvantages:
- if given rapidly causes abdominal pain
- peritonitis if aseptic technique used or non-sterile plasma
- abdominal discomfort alone may cause a cria to be ill-thrifty for several days to a week or more
- adhesions  colic later (possibly up to 2 years).
Bottom line, in my opinion, I see far fewer complications when the transfusion is given intravenously. For crias that are hospitalised, they will be receiving intravenous fluids and antibiotics, therefore an intravenous catheter is likely to be required in any case. Crias that are already starting to show early signs of sepsis (failure to gain weight, weight loss, lethargy, reddened mucous membranes around the eyes etc) should never be given plasma intraperitoneally as these crias are far more likely to develop peritonitis in my experience.



Neonatal Diseases

1) Hypothermia and Hypoglycaemia
Newborns mostly, especially those born in Autumn/Winter. Treatment: warming. Heat lamps, towels/blankets, hot water bottles, warm water bathing etc. Also warmed oral/IV fluids. Hypoglycaemia may be treated initially with any concentrated sugar solution orally until IV fluid therapy can be initiated. You can use anything sweet and concentrated in an emergency smeared in the cria?s mouth: this will be absorbed fairly quickly. Always have cria coats available for young crias in bad/cold weather. It is also worthwhile having a heat lamp available so that you can set this up in the corner of a stall. Hot water bottles, even hot-water-filled latex gloves are useful for warming cold crias. There are also heating discs available now that can be placed in the microwave for up to 8 minutes depending on the temperature required, and these stay warm for up to 8 hours. I usually wrap these in tea-towels so that they are not too hot next to the cria?s body. Also, you do not want to draw blood to the skin (ie away from the essential organs) because the hot water bottles are too hot.

2) Cerebral hypoxia
?Dummy cria? syndrome. Often these crias have a history of difficult or prolonged birthing. Crias have difficulty nursing and may be weak or unable to stand. Normally TLC +/- IV fluid support will help these crias get through their first few days of life until they are able to fend for themselves. Prime candidates for FPT due to inability to get up and nurse sufficiently and obtain enough colostrum.

3) Septicaemia
This can result from FPT. It is serious and requires aggressive management. If your vet does not have hospital facilities/care available at their clinic for alpaca patients, referral should be considered as these babies require a lot of time and intensive therapy. Clinical signs include weakness, depression, failure to nurse, weight loss (or failure to gain weight), dehydration, hypo-/hyper-thermia and very red membranes around the eyes. It is important to run bloodwork on a cria showing these signs as there may be severe alterations in white cell count, blood glucose, kidney parameters or electrolytes that will need addressing with IV fluid therapy and antibiotics, and probably at least one plasma transfusion. Serial monitoring of bloodwork and close attention to body temperature and weight changes are important in management. If the cria is able to hold up its head, don?t forget to get the cria up to nurse and/or bottle feed as well. This can be a very expensive problem! Therefore, it is best to prevent it by ensuring adequate colostrum intake in the first place. The first sign is often a drop in weight or failure to gain weight, possibly together with a cria that ?just doesn?t look right?. If action is taken at this time, much expense can be saved, and also highlights just how important daily weighing of crias can be during the risky neonatal period (up to 2/3 weeks of age).

4) Premature lungs
Apart from FPT and neonatal septicaemia, the next biggest problem with premature crias is premature lungs. These have inadequate surfactant and show a tendency to collapse. Crias that are more than 2-3 weeks premature are most susceptible to this and these can be identified as they have unerupted incisors. Once the lung collapse situation has started, it is very difficult to reverse. Bronchodilator therapy can be used to try and prevent lung collapse. At present it is extremely expensive to treat with surfactant (about US$1000-1500 per dose in the US with multiple doses required). Ventilation therapy could be considered.

5) Retained Meconium
Crias should pass their first faeces within the first 24-36 hours. This is normally gooey in texture and orange-coloured, but sometimes it will look like small pellets coated in orange-coloured mucus. After the first 24 hours, if a cria is observed straining and meconium has not been seen, this might indicate that the meconium is retained. Crias will also strain to urinate in the case of vulvar aplasia/hypoplasia (see below) or with urinary tract problems. If retained meconium is suspected, giving an enema may resolve the problem. This can be done by passing a lubricated red rubber catheter or feeding tube about 10cm into the rectum and then infusing about 20ml warm soapy water from a catheter-tipped syringe. [Don?t use the same one you use for tube feeding!] This should only be done once or twice since performing more often may result in colitis. If the cria continues to strain following an enema, it may be that there is a different problem and you should seek veterinary attention.

6) Diarrhoea
Common pathogens to be considered are:
- E coli, common in conjunction with FPT/septicaemia
- Viral (e.g. rotavirus/coronavirus)
- Cryptosporidium
- Giardia
- Clostridium perfringens
- Coccidia
- Salmonella
General approach to the cria with diarrhoea:
a) Isolate the affected cria with her dam to reduce environmental contamination.
a) If mild diarrhoea only, oral fluids, probiotics/live yoghurt (transfaunation best), pepto-bismol, possibly antibiotics or specific therapy based on diagnostics.
b) If diarrhoea is watery, neonates will deteriorate rapidly and early IV fluid support may be useful.
c) Get a DIAGNOSIS! Try not to ?blanket treat? with everything you can get your hands on which may make things worse. This will also help you to control the problem.
- faecal parasite identification (especially coccidia), viral electron microscopy
- Crypto/giardia (membrane antigen assay)
- Faecal culture, mainly for Salmonella.
d) Treat specifically if possible
e) Devise a herd prevention strategy in consultation with your vet (e.g. hygiene, vaccination, water management etc).

It is possible for more than one type of pathogen to be involved simultaneously: often one type will cause damage to the intestinal mucosa allowing other types of pathogens to proliferate and take advantage of impaired defences. E.g. crypto + giardia or crypto and coronavirus.

Chronic diarrhoea is common in crias and is often due to a failure to diagnose an underlying cause and to treat it appropriately. Secondary renal complications from chronic dehydration can be a major cause of mortality.

E.coli
Crias will inevitably be exposed to E coli in their environment. E coli diarrhoea is often associated with FPT and neonatal septicaemia and affected crias are often less than 5 days old. Prevention involves farm hygiene (clean birthing areas), dipping the navels and ensuring adequate colostrum intake.

Cryptosporidiosis
NB Zoonotic! (This means that the disease can also affect humans.) Crias can be affected at any time from 7-10 days old but most will be under 2 months of age. Mostly larger farms will be affected. No specific treatment is available. Treatment is mainly supportive. The worst problem associated with crypto diarrhoea is chronic dehydration  organ failure if fluid therapy is inadequate until diarrhoea resolves. Crypto is also often an opportunistic invader and may be found in combination with another agent, compounding the severity of disease.

Giardiasis
NB Zoonotic! Crias affected are normally affected at any time after 7-10 days old.

Salmonellosis
NB Zoonotic! Any age affected: rare in camelids. Causes severe diarrhoea +/- blood with shreds of mucosa, septicaemia.

Clostridial enteritis
Caused by Clostridium perfringens toxins A,C or D. Type A seems to have high significance in the US ? currently no vaccine available in the US for this. I am not aware of any major outbreaks of clostridial enteritis in camelids in Europe. It is possible to vaccinate neonates against C and D (at 2-3 days old and 2-3 weeks later ? use ?Lambivac? vaccine ? note not licensed in camelids). The diarrhoea in this disease is profuse and watery and often rapidly fatal.

Viral
Rotavirus or coronavirus. Coronavirus is more common in the US while rotavirus appears to have been more of a problem in South America. Diagnosis is achieved by electron microscopy and is only offered at certain labs. Supportive treatment is the only treatment for viral causes of diarrhoea. When viral diarrhoea occurs on a farm, it may be worth treating all remaining crias born that season with monoclonal antibody oral vaccine: this may offer protection but has not been tested in camelids and is of unknown efficacy in these species.

Coccidiosis
Normally at least 3 weeks of age before coccidia can be detected in faecal samples. Diarrhoea can be severe and may be bloody. However, often the crias are active with loose stool only but losing weight. Coccidiosis in crias is often the tip of the iceberg and finding it suggests a herd management problem. Often animals are too densely stocked or visiting animals (also show animals) are being moved on and off the farm without adequate quarantine precautions. Affected crias and their dams should be isolated from those not having diarrhoea to reduce the spread of contaminated faeces. All in-contact crias, and preferably dams should be treated also as they are likely to be harbouring prepatent infections. Check remainder of herd to see how extensive the problem is. Devise a herd prevention/containment strategy in consultation with your veterinarian. Periodic use of prophylactic drugs may be introduced. This strategic anticoccidial use is best used at times of stress such as weaning and mixing large groups of crias, and shearing.


7) Congenital Problems
It is important to look for congenital defects in any cria experiencing problems. Camelids do tend to have a higher incidence of defects than some other domestic species. This is partly due to the culling of Camelids during the Spanish invasion in the 1500s as this reduced the population drastically in South America, and partly due to the line-breeding in certain lines of alpacas for their superior fleece characteristics. Of particular importance:
? CHOANAL ATRESIA: This causes respiratory difficulty. Some crias compensate for this relatively well while others show respiratory difficulty fairly shortly after birth. Often crias will puff out cheeks while breathing and may struggle to nurse because they get out of breath. Diagnosis is fairly simple: pass a red rubber catheter up nostril ? there will be a blockage at the level of the eye. It is not usually necessary to perform further diagnostic procedures such as contrast radiography and endoscopy. Secondary aspiration pneumonia is common. Surgery is possible but the prognosis is not great and should only be considered in animals that are stable clinically or in cases with only unilateral atresia. These latter cases may not present with difficulties until they are weaned since they are able to breathe normally through one side.
? IMPERFORATE VULVA: The cria strains to urinate. Sometimes completely imperforate (ie no hole) or may be incomplete (ie small hole). The vulva pouches out below the anus and appears to be fluid-filled. This is an easy problem to correct by the vet by making an incision in the midline to make a normal sized vulva opening. No suturing is required.
? CLEFT PALATE: Affected crias normally have nasal discharge and may develop aspiration pneumonia easily. The defect is usually severe involving the entire hard/soft palate. This condition carries a poor prognosis.
? UMBILICAL HERNIA: If the umbilical hernia is small and reducible, then a belly-band may be used ? this is an elasticon wrap with 4x4 gauze swabs over the defect to push the contents of the hernial sac back into the abdomen. This may be left on for 1-2 weeks but it is important to make sure it doesn?t get too tight as the cria is growing. If it is still not reduced after this time, and the defect is more than one finger-tip in diameter, surgical correction can be done to help prevent this from being a problem in later life. Animals with good-size hernias requiring surgical correction should not be used for breeding.
? HEART DEFECTS: May cause a cria to be weak in the first few days of life if the defect prevents the heart from being able to pump blood efficiently around the circulation. The cria may be weak and floppy, stand with its head down, or get easily out of breath: it is important to differentiate especially weak/floppy cria presentations from problems caused by hypoglycaemia, hypothermia or sepsis as a result of FPT. A good physical examination by your vet should detect a significant heart murmur: an echocardiogram (cardiac ultrasound) is required to determine the cause of the murmur. Crias that have murmurs do not necessarily have defective hearts since other problems may cause murmurs: however, the murmurs of non-cardiac origin are typically quieter.
It is important to realise that, even if these animals? defects are surgically corrected, they should be excluded from the breeding programme.