Medical Care

Disclaimers

[LEGAL DISCLAIMER: Neither of us are veterinarians. Any advice listed here as medical care is to be taken at your own risk. We neither guarantee or make any expressed warranties of the health information anywhere on our website. Double check anything here with a camelid experienced veterinarian before employing it. If you find something that we have posted with which your regular veterinarian has a disagreement, first notify us. Then get another veterinarian’s opinion as we have seen vets that continue to promulgate out of date information.]

[PRACTICAL DISCLAIMER: We do not expect to cover every aspect of Medical Care for your Alpacas in this relatively brief section. We have learned a lot since we started. And we are continuing to learn more. We would urge you to do the same!]

Do These Things First

Observe your Alpacas behavior closely on a daily basis.  They have often been described as being stoic animals.  They seem to handle problems without displaying a visible negative reaction.  So if they seem even the slightest bit off, monitor that issue to see if continues.  Then consult your vet or another knowledgeable camelid source for input. (See our section about Social Media & Internet before acting on advice you receive.)  Speaking of vets…

Seek out a camelid knowledgeable vet and establish a relationship with them before an emergency occurs. Search for someone that is up to date on camelid medical care, easy to work with, available, reasonably priced, communicates well, and most importantly willing to listen to you and others in the camelid industry without being defensive about their knowledge base. Since Alpacas were only introduced into the US in 1984 we are all still learning and developing our facts. Don’t be afraid to change vets or utilize more than one if you have to.

Your number one most important item to have on hand is a digital thermometer. It should be regularly tested to ensure that it is reading properly. Their normal temperature is 100°-102° (approx.) Write it on the thermometer so you don’t forget!

Many, many medicines are dosed based upon an accurate weight. Be sure to have an appropriate small animal scale installed and properly calibrated. Guessing about weights and resulting dosages can lead to deleterious side effects up to and including sudden death.

Initial Illness Assessment

If you have an Alpaca go down quickly check several things immediately before you contact your veterinarian. These pieces of information will help a camelid experienced vet quickly help your Alpaca with appropriate medical care.

  • What is the rectal temperature? (100°-102° is normal. Higher temperatures indicate a possible infection. Lower temperatures indicate susceptibility to colder air temperatures. Really young crias don’t have the ability to regulate their temperature as more mature animals do. Older or ill-thrift Alpacas also are susceptible to cold temperatures. Alpacas cannot digest their food intake when their body temperature falls below 98°.)
  • Have you performed a FAMACHA conjunctiva eyelid score?  (This is an observational test for anemia. A score of 1-2 is acceptable. 3 is borderline. 4-5 should be treated immediately. The problem is two fold: they need to have an acceptable iron product to help their blood, and the source of the anemia—which can be bloodsucking Barberpole stomach worms—should be treated as well.)
  • How long has the animal been down? (The longer an animal has been down the harder it is to save it.)
  • If it is a female is it pregnant and in labor? (Some females labor in a cushed position. That is many times normal, but in some instances are indicative of a mis-presentation such as a breach which requires human intervention.)
  • How old is it? (A new cria may be septic as a result of failure to passively receive antibodies through its dam’s milk.)
  • Is it in a pen with other same sex Alpacas? (Female Alpacas kept in a pen with males can be overbred and damaged, especially if they are small. Smaller males can be mounted by mature males and also damaged.)
  • What is the body score on a 9 point scale? (If the Alpaca is 1-2—extremely skinny, or 8-9—it could have corresponding health issues. 5 is ideal.)
  • Is it chewing cud? (Alpacas that are still chewing cud are processing their intake and gaining strength and energy. It is also indicative of a good rumen health.)
  • When was the last time it ate hay and/or grazed? (Monitoring intake on your Alpaca is an important factor in a proper diagnosis.)
  • Was that grazing on a newly greened up pasture. (A fresh pasture can cause bloat or a belly ache. Treating with probiotics could be helpful.)
  • Is the belly distended or overly firm?  (Bloat or gas can cause this condition. Treating with an anti-gas medicine could be helpful.)
  • Has it experienced any choke episodes? (Repeated choke episodes can lead to a damaged esophagus and may eventually lead to the Alpaca not being able to consume their grass, hay or feed.)
  • Before your Alpaca went down was your Alpaca exhibiting unusual neurological symptoms? (Stargazing, leaning neck or head, unsteady gait, neck arch, rear leg weakness, etc. These are signs that can help the vet diagnose the issue which may be PEM, Meningeal worm, Listeriosis, West Nile Virus, EEE, trauma, or botulism, or other possibilities. I have read that a cancer diagnosis is usually done by eliminating all other possible causes.)
  • Do you give monthly Ivermectin shots to your herd if you live in an affected Meningeal Worm area? (M-Worm treatment has one preventative protocol every 30 days—an Ivermectin injection. After approximately 35-45 days the M-worm can pass the blood-brain barrier ascend through the spinal cord to the brain. Death usually follows quickly. There is a separate and totally different treatment protocol for this stage of infection—banamine and fenbendazole injections.)

Alpaca Anatomy

It’s always good to know how your Alpacas are constructed. We saved this anatomical diagram link on Pinterest for you.

Vaccinations

In Texas vets must vaccinate annually for rabies. In Oklahoma the vaccine is available over the counter and can be administered by owners. Crias should receive their first dose at 6 months.  Thereafter t’s an annual vaccination, but can also be certified as a 3-5 year vaccination. Other states will have their own regulations—check yours out!

Be sure not to vaccinate during pregnancy because there have been some cases of pregnancy loss shortly after vaccination. Also, it is best to separate vaccinations from shearing days as the stress factor releases cortisols which can interfere with vaccine effectiveness. Be sure to also separate the rabies vaccine from your CDT vaccine. The “attention” that the immune system responds to can be divided by giving more than one vaccine at the same time. Especially since stress, infection, parasites and other unknown factors can compromise any given Alpaca.

The CDT vaccine is an important vaccine to have on hand. In a study by Dr. Walter Bravo it was shown that giving the CDT to late pregnant female alpacas does not increase the IgG of the cria.  Since there is a small chance of inducing abortion it is no longer recommended to dams that are late in pregnancy. However we give it on the second day after birth. 

Camelid Medicine Cabinet

Drugs are always best dispensed with a veterinarian’s instruction, especially because most all drugs for Alpacas are used off label. And you definitely don’t want to have everything on hand all the time.  Drugs have expiration dates and when they get old they must not be used and should be properly disposed.

That being said, it is important to know about them. You should become familiar with the different types of meds, their applications, their dosages and the appropriate method of injection, etc.

You can find a great resource on the Ohio State University website at:

https://icinfo.vet.ohio-state.edu/sites/camelid-sta.osumc.edu/files/documents/Camelid_Medicine_Cabinet.pdf

Charles has this link on the Favorites home page of his iPhone.

Another resource for Alpaca medicines is:

https://www.elzorrocolorado.com/pacahealth/html/drugdoses.html

Some “Must-Have” Drugs

The following is what *we* try to have on hand so that we can treat appropriate medical care issues quickly with the vet’s OK. Your needs, experiences, and vet considerations may very.

  • Banamine is anon-steroidal anti-inflammatory drug, and can be considered to be a pain reliever similar to Advil for humans. BAnamine is teh brand name for injectable flunixin meglumine. It is typically given as a subcutaneous injection with a 20 minute effective time. However, a vet can use it orally as it is absorbed through the gums and becomes effective almost instantly. In Texas it is available from your vet, and probably the same in other states. It does not cause ulcers in alpacas like it can in equines. Some vets are not up to date on this information. Keep in mind that this is a prescription drug and your vet may not agree to let you have it on your ranch without them being involved in the diagnosis and application of this pain reliever.  Nonetheless we consider it a must have drug.

Plan to keep pure thiamine that is only available from your vet on hand. Do not use the standard  B-Complex as a substitute as it does not have enough thiamine to be effective for PEM. It has a lot of other false applications. Facebook is replete with them. But it is the only thing that works for PEM, and when you need it, you need it fast.

  • Safeguard is a standard drug with multiple applications so it is good to have the liquid on hand.  FYI the dosing rates are:
    • 20 mg/kg for gut worms
    • 50 mg/kg for barberpole
    • 100 mg/kg to treat Meningeal worm (with Banamine)
  • Vitamins A&D or AD&E are good to have on hand. They are given by injection in mid to late pregnancy.
  • Depending upon your state’s regulations, rabies and CDT vaccines can be kept on hand.

Be sure to consider drug expiration dates, and how well you observe aseptic techniques at every step when you choose what to have “on hand” versus what you are able to obtain quickly or as needed. It is more important to use fresh, sterile drugs than to use an old drug that you have one hand. These considerations can save you money or cost the life of your Alpaca depending upon your choices so make these decisions wisely!

Alpacas and Parasites

Alpacas will always have parasites. You just really want them to have reasonable numbers. Be sure to do regular fecal tests with a camelid knowledgeable lab. They should be using a sugar float test with centrifuge.  Always reserve deworming treatments for those Alpacas that:

1) show negative health indications: anemia (per a FAMACHA eyelid test, unexplained weight loss, or lethargy/lack of normal grazing, etc.,
2) in combination with those that have high fecal oocyte (egg) counts.

Some parasites always survive treatment. This is called a refugia. And repeated exposure to the medicines we use to CONTROL them will breed resistance. There are only a few classes of drugs that we can use, so only use one until it doesn’t work effectively to significantly reduce egg counts. Please do not rotate various drugs between treatments. When one stops having any effect that’s when you have to move on.

If you try to eradicate every parasite oocyte (egg) you encounter you will actually be setting up your herd for major trouble. Seasonal deworming for your entire herd will create parasites that are resistant to your drugs. And some parasites, like Barber Pole, mutates faster than any other parasite we know. Even using the same dewormer across your entire herd  twice in a year can create resistance per research by Dr. Lisa Williamson at the University of Georgia. Generally speaking 20% of your herd spread 80% of your parasites. So concentrate on those animals rather than the rest of your herd. Yes, some gut parasites are more dangerous and require more aggressive treatment, but that is the exception.

Fecals

This is the best place to start your medical care. Plan on submitting fecals to a lab/vet periodically. Some prefer annual, semiannual or quarterly. Be sure that your lab uses a sugar float process with centrifuge.
We have chosen to utilize a mail order lab—MidAmerica Ag Research. They use a sliding scale to process: $10-$8-$6. Their instructions are online—  http://midamericaagresearch.net/instructions.php
Not everyone in the Alpaca industry will agree that this laboratory is your best choice. But we have found them to experienced, timely and consistent. Mailing the samples takes careful timing and preparation as well as a freezer bag designed for transport. You don’t want to let your samples sit in transport over a weekend. Smaller herds may choose to utilize their local camelid knowledgeable veterinarian.

After you have treated appropriate animals from initial test results, it is imperative that you perform a subsequent test. You are documenting a Fecal Egg Count Reduction Test (FECRT) with this second test.

Just a side note here. Fecal testing for your own herd is OK with the proper training. But doing fecal tests for other ranches is actually practicing medicine without a license!

Fecal Collection Process

We plan on a day when we can spend the necessary time outdoors with them. Since they tend to go one after the other when gathered together in a smaller area it’s not too bad—1-3 hours usually. Get a box of inexpensive zippered plastic sandwich sized baggies. Have a Sharpie permanent marker with you. The cheapest way is to use your hand to turn the baggie inside out, then use it to pick up 15-20 beans.  If you have an Alpaca with a looser stool then just grab what you need.  Invert the baggie, zip to seal and put a number and name on it. We use inexpensive, disposable rubber gloves to pick up our poop samples—one glove per animal. The fewer the vegetation and dirt contaminants the better.

You will need an appropriate freezer pack and sealable bags to ship to them. We use USPS Click-N-Ship and their free Priority Mail boxes/envelopes. A simple digital postal scale, shipping labels and shipping tape and their easy online website at

https://www.usps.com/ship/online-shipping.htm

means all I have to do is walk in the post office and drop it off. (Alternatively you can print shipping labels on plain paper and tape it to the box.)

If you choose to learn how to do your own fecals, take at least one class and then take refresher courses to keep your knowledge up to date. Ruthanne McCaslin in Ohio offers them periodically. We have attended a class at TXOLAN presented by a veterinarian from Texas A&M who teaches classes about parasites and how to identify them. Her recommendation is, if you do your own labs, go ahead and submit them to a laboratory (or your local vet) to compare your findings. She almost guaranteed that there will be differences!

Barberpole Treatment (Haemonchus-Stomach Worm)

The medical care for this gut worm is critical. It has been described as the most economically devastating parasite in the world for small ruminant producers. The adult female lays 10 times more eggs than the net most fertile strongyle.  The larvae suck blood directly. Alpacas infected with these larvae stage parasites are able to do fatal damage before they are even before they are found in a fecal exam. And this parasite mutates faster than any other.

You can start with the liquid form of fenbendazole, i.e., Safe-Guard/Panacur (same medicine but different brands) at the rate of 1ml/5# body weight—and yes that is a lot. But it is the intial prescribed medical care for an Alpaca with a high oocyte count and/or weight loss or low FAMACHA score needs daily for five days. You *MUST* weigh your Alpaca as proper administration of fenbendazole is weight dependent.

After a few days check another fecal after you finish that treatment. Look for a sharp decline in the fecal egg count. In just a few days you may not get a significant drop (at least 50% but hopefully up to a 95% decrease) but it should show a sharp drop off.

The next drug of choice if you do not get good results from the first drug is Cydectin Drench (for sheep), but the safety margin of SafeGuard/Panacur is significantly better.

Finally, a third generation drug is another form of moxidectin which is Quest, an equine dewormer. You must be extremely accurate in dosing this medicine as it is 20 times more concentrated than Cydectin Drench. Keep in mind that a single small tube is meant to dose a 800-1200 pound horse! Moxidectin can be repeated in 10 days, but a fecal is always recommended in between.

Past that drug the last resort in cases of extreme resistance is Levamisol or Pyrantel. Be careful if a vet leads you to use Valbazen because of the many limitations on use, such as not for a cria under six months due to potential liver damage, or in pregnant females.

Barberpole Management

If you have repeated or significant issues with Barber Pole parasites you should probably look to examine your animal husbandry routine and consider some of the following changes:

  • Examine your stocking rates and try to limit to six Alpacas per acre.
  • Pasture rotation with some pastures lying fallow for 6-12 months should help.
  • Keep barn and pastures clean and dry. Scoop regularly (2x a day is best), and use of pine bedding pellets to keep those soppy pens dryer.
  • Allowing Alpacas to graze dewey pastures in the early morning enhances the chance of larvae ingestion. They crawl up to the  top of the grass then retreat as the sun dries the field.
  • Keep your grass longer at 3-4 inches when you mow.  This discourages the Alpacas from grazing down at the bottom where the larvae live for most of the day.
  • Some farms that own multiple species can consider rotating in monogastric species like horses, pigs or poultry as they do not share parasites and can safely eat those that the Alpacas leave. And when the Alpacas are brought back in after the foregoing are rotated back out the Alpacas can safely ingest the parasites they leave behind.

Meningeal Worm

Information about Meningeal worm in depth can be found several places, but the most complete explanation we have found is linked below. You should read it all the way soon.

http://www.bagendsuris.com/?page_id=269#treatment

PLEASE—if you raise Alpacas in an area with whitetail deer east of the Mississippi and in some other states west of it including some areas in Texas it is imperative that you should be administering Ivermectin monthly—every 30 days. There are several ways to express this but we have found that the formula “weight x 0.018 and administered subcutaneously” is the easiest to understand and put into your monthly herd health routine.

Injections must be every 30 days OR LESS! Do NOT extend the time frame.  If you’re going to be out of town on your regular day, do it a week early! This can be a life and death procedure so be absolutely sure that you are informed and implement monthly if appropriate.

If, for some reason, you still have an animal begin to exhibit symptoms of a Meningeal worm infection (detailed in the referenced article), please read the following two paragraphs carefully. The advice that you will read is sage—not to be ignored.

From a nationally known vet: “IF you suspect Meningeal worm START TREATMENT NOW!!!! The treatment is very safe and will do no harm if diagnosis turns out to be another neurological disease, etc. But, if it IS meningeal worm any delay will decrease your chances of success. DO still call your vet out for a diagnosis but also get an early start on treatment. This is a rare exception to my Diagnosis before treatment motto.” Quoted from a post in the closed Facebook group Alpaca Farm Life on April 5, 2020.

Another comment from an extremely well-trusted source in the same post said, “DOSAGE SHOULD BE BY WEIGHT – yes, I *am* yelling. Give too little and your animal will die. Safeguard is very safe to round up if you have to guess on weight, so overestimate weight if you don’t have a scale. MINIMUM dosage is 2.5 ml per 10 pounds (50 mg/kg) body weight and many vets now recommend 5 ml per 10 pounds (100 mg/kg) body weight. This is once a day for five days and liquid is much preferred to paste.
Banamine is 1 cc per 100 pounds body weight every 12 hours for three days, then once a day for a minimum of three additional pounds.
BOTH are critical components of treatment.” Quoted from a post in the closed Facebook group Alpaca Farm Life on April 5, 2020.

PEM—Thiamine Deficiency

Information about Thiamine deficiency induced polioencephalomalacia (PEM) in depth can be found at the following link. Note: thiamine is often mentioned for multitudinous health issues in Alpacas. But PEM is the ONLY one that truly requires Thiamine. And when treating this condition you must have Thiamine on hand. The other applications for which people suggest thiamine are spurious and can be ignored.

http://www.bagendsuris.com/?page_id=735

Choke

Choke is primarily caused by competition for pellets. If you have an Alpaca that chokes on pellets remove them from the pellets for at least a couple of days at a bare minimum and up to a week. Repeated choke episodes of choke can damage the esophagus and lead to a failure to thrive or even death. Resting them from pellets gives their esophagus time to heal.

If you have an Alpaca that is choking, massage the esophagus in a downward motion—never upward. Don’t make them struggle as you do this. Many will instinctively know you are helping them.

Use of tennis balls/rocks in the feeder may slow them down and reduce choke occurrences. We have actuallly haltered and safety tied aggressive eaters so that they only eat what is in front of them.

It is very important to remove the Alpaca that has experienced choke from grain for a while. A week off grain won’t hurt them and will give the esophagus time to heal. Repeated choke episodes can lead to a condition called Megaesophagus where the esophagus loses motility. Food will accumulate there and is not moved downward to the stomach. Extreme conditions lead to ill thrift and death.

Bloat

If you have an animal that has bloat (distended stomach that feels hard to the touch) they will in all likelihood be cushed. The best way to help it is to do what it doesn’t want to do: walk, walk, walk!

Give some banamine to minimize their discomfort. We have tried a slurry with an antacid like GasX in it. Probiotics in a liquid form should also help. Miralax or Pedialyte also are good solutions.

When introducing Alpacas into a new field with fresh spring growth limit the time on it. We start with an hour or two. This should help them avoid tummy aches.

Diarrhea (Scours)

Proper Alpaca poop formation is directly tied to appropriate water intake. But sometimes you run into Diarrhea (sometimes called Scours in animals).  While it is important to determine the root cause (coccidia, protozoans like giardia or cryptosporidium, infection, etc.) through a fecal or other test your vet may prescribe. Yes, that means that you glove up catch it in a cup if you have to do so. Alpaca owners have effectively utilized other products such as Imodium, Spectogard, BioSpong and Toltrazaril. Note that giardia and cryptosporidium do not show up on a standard fecal test; they must have a separate test performed.

Diarrhea in a bottle baby cria can very quickly lead to dehydration. Pedialyte is a good way to combat dehydration in that age of Alpaca.

Mycoplama Haemolamae

There is a common blood bacterium called mycoplasma haemolamae that that can appear out of remission during a stressful period. (This was formerly known as EPE, or Eperythrozoon.) Telltale signs are:

  • weight loss even with a great appetite
  • not having an appetite, and
  • stalling on growth.

It is easy to treat once an diagnosis is obtained via a blood test available from Oregon State University. There is no other source for this test that is known to us as they came up with the test.

Recommended drugs used in treatment for this condition are Biomycin 200, Agrimycin 200, or Noromycin 300. We’ve read that they cause much less tissue damage than LA 200. A vet should be involved in the treatment.

Mites

Mites are the most common skin issue and can cause significant skin damage and loss of fiber coverage. The topic and the medical care is complex. Expert camelid assistance should be engaged.

A few important things to note are:

  • There are more than one type of mite.
  • The two that are often found in Alpacas are Sarcoptes and Choreoptes.
  • They are extremely contagious.
  • Your veterinarian may help diagnose and treat them.
  • Many lab techs have been led to believe (erroneously) that all alpaca mites are Sarcoptes.
  • One excellent source to help diagnose mites is Dr. Ed McCaslin who is the leading expert on alpaca mites in the US.
  • Burrowing mites (Sarcoptes) are treated with ivermectin injections.
  • Surface mites (Choreoptes) are addressed with frontline spray. This spray is only available through your veterinarian. The treatment time is extensive — four 21 day treatments for all of your herd.
  • Some ranchers use a “goop” mixture referred to as witches brew (see below.)
  • Skin scrapings neeed to done between the toes for greatest accuracy no matter where the lesions are located. Most untrained people are too timid to scrape deeply enough for good results.
  • Chorioptic mites can live for up to 70 days off the animal. Keeping ALL animals off a pasture for more than 70 days will allow any mites in that area to die.

Witches Brew

We found the following formula on social media. We have not made our own batch. You should determine for yourself if this is safe and appropriate medical care for your own Alpacas.

Witches Brew Recipe

Ingredients:

2/3 pint mineral oil

1/5 pint DMSO (dimethyl silfoxide)
[Be careful here—don’t confuse this with Dexamethasone which can cause abortions.]

8 ml Ivermectin

5 cc Gentamycin (50 mg per ml)

Directions

The one who posted this recipe said “the ‘brew’ should be applied to the affected area every three days for at least 15 days, maybe more. Make sure that you use rubber gloves when you are applying the mixture.”  They also indicated that a vet recommended an injection of Ivermectin followed by another 15 days later. However, we have also read information by a camelid vet that Ivermectin works well for sarcoptic mites but not choreoptic mites. The bottom line is to know what you are treating before throwing medicine and money at it. 

By the way, dark animals are usually the ones that are afflicted with fiber loss on their noses—but not always. At one point the only two Alpacas on our ranch so afflicted were both white! Either way, dermatitis in an Alpaca can have several causes, so as stated above diagnose before using Witches Brew or any other medication before you begin to throw money at it.

Injuries

Some injuries, like a lacerated cornea, should immediately have the attention of your vet.  If in doubt on eye problems, get the vet involved. We have experienced mucous and pinkeye from time to time and treated the issues ourselves. But we must see improvement with 12-24 hours or we get the vet involved. Animal corneas are not as sensitive as ours, but pain and sensitivity to light are factors. Sometimes your vet may isolate an injured Alpaca for a brief time to avoid fights or head bumps, especially in eye injuries.

We’ve had some large scrapes or sores that we have treated with water therapy by using a thumb-pressured hose to remove scabs which ensures that the wound heals from the inside out. But we usually get a vet involved.

Medical Supplies

While you can obtain syringes and needles from your local Tractor Supply or similar store, you can also consider ordering them in bulk from a mail order firm to save money. We use https://www.air-tite-shop.com

While many medical care items you need can be found at your local Feed Store, Tractor Supply Company, etc., you may want to consider specialty camelid mail order firms such as Light Livestock (https://www.lightlivestockequipment.com/) and Quality Llama Products (www.llamaproducts.com/). These are just two that we have utilized, but there are others you may prefer.

Another is Useful Llama Items Inc.: https://www.useful-items.com

Valley Vet is often mentioned as a source for Rx fulfillment if you choose not to utilize your local vet. We have never used them.

You will probably end up with a supply of various medical care items.  Some of our considerations have been:

    •  Cylence for Goats, a pour-on insecticide.  Draw it up in a needless syringe and dot their topline up to their head with it.
    • SWAT is a botanically-derived pyrethrin formula which repels house flies, stable flies, face flies, and horn flies. It stays effective for hours, and is ideal for use on the face and areas around cuts, wounds and irritated skin.
    • Banixx, an antifungal spray.
    •  Baking soda, put out as a free choice item.  Some animals will utilize this and others will ignore it.  It can help reduce stomach issues.  Too much can cause rumen PH issues though. GasX is prefered when you have an animal that foams at the mouth a lot.

Read next: Alpaca Manure