Veterinary Techniques in Llamas and Alpacas [2 ed.] 111986061X, 9781119860617

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Veterinary Techniques in Llamas and Alpacas

Veterinary Techniques in Llamas and Alpacas Edited by David E. Anderson, DVM, MS, DACVS

Professor and Associate Dean for Research and Graduate Studies College of Veterinary Medicine University of Tennessee Knoxville, Tennessee

Matt Miesner, DVM, MS, DACVIM

Clinical Professor and Section Head Livestock Services College of Veterinary Medicine Kansas State University Manhattan, Kansas

Meredyth Jones, DVM, MS, DACVIM

Associate Professor, Farm Animal Medicine and Surgery College of Veterinary Medicine Oklahoma State University Stillwater, Oklahoma

Second Edition

ffirs.indd 3

13-05-2023 20:16:49

This edition first published 2023 © 2023 John Wiley & Sons, Inc. Edition History First edition © 2013 by John Wiley and Sons, Inc. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/ permissions. The right of David E. Anderson, Matt Miesner, Meredyth Jones to be identified as the authors of this work has been asserted in accordance with law. Registered Office John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com. Wiley also publishes its books in a variety of electronic formats and by print-on-demand. Some content that appears in standard print versions of this book may not be available in other formats. Trademarks: Wiley and the Wiley logo are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or its affiliates in the United States and other countries and may not be used without written permission. All other trademarks are the property of their respective owners. John Wiley & Sons, Inc. is not associated with any product or vendor mentioned in this book. Limit of Liability/Disclaimer of Warranty The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages. A catalogue record for this book is available from the Library of Congress Paperback: 9781119860617; epub: 9781119860785; ePDF: 9781119860778; Obook: 9781119860792 Cover image: © Meredyth Jones; Courtesy of Meredyth Jones Cover design by Wiley Set in 9.5/12.5pt STIXTwoText by Integra Software Services Pvt. Ltd, Pondicherry, India

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Contents Preface  xi Section I  Behavior and Capture Techniques  1 1 Behavior and Capture Techniques  3 David E. Anderson Section II  Physical Restraint and Injection Sites  9 2 Haltering  11 Meredyth L. Jones 3 Manual Restraint  14 David E. Anderson 4 Chute Restraint  21 Meredyth L. Jones 5 Ear Squeeze (Ear Twitch)  24 Meredyth L. Jones 6 Injections—Subcutaneous (SC), Intramuscular (IM), Intradermal (ID), Intravenous (IV)  26 Meredyth L. Jones Section III  Chemical Restraint and Anesthesia  31 7 Sedation and Tranquilization  33 David E. Anderson 8 Injectable Anesthesia  37 David E. Anderson 9 Orotracheal Intubation  41 David E. Anderson

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10 Nasotracheal Intubation  45 David E. Anderson 11 Percutaneous Tracheal Intubation (Also Referred to as Retrograde Tracheal Intubation)  48 Matt D. Miesner Section IV  Catheterization  53 12 Vascular Catheterization—Jugular Vein  55 Meredyth L. Jones 13 Vascular Catheterization—Cephalic Vein  61 Meredyth L. Jones 14 Vascular Catheterization—Saphenous Vein  63 Meredyth L. Jones 15 Vascular Catheterization—Lateral Thoracic Vein  65 Meredyth L. Jones 16 Vascular Catheterization—Auricular Artery and Vein  67 Meredyth L. Jones 17 Vascular Catheterization—Femoral Artery  69 Meredyth L. Jones 18 Intramedullary Cannulation of the Femur for Administration of Parenteral Fluids  71 David E. Anderson 19 Intraperitoneal Cannula for Plasma or Fluid Administration  75 David E. Anderson 20 Caudal (Sacro-coccygeal) Epidural Anesthesia  78 Matt D. Miesner 21 Epidural Catheterization  80 Matt D. Miesner 22 Lumbo-Sacral Epidural Anesthesia  85 Matt D. Miesner Section V  Head and Neck  89 23 Anatomical Features of the Head and Neck  91 David E. Anderson

Contents

24 Dental Examination and Trimming  95 Meredyth L. Jones 25 Tooth Extraction—Oral Approach  100 David E. Anderson 26 Tooth Extraction—Lateral Approach to Premolars and Molars  105 David E. Anderson 27 Examination of the Ear  110 Matt D. Miesner Section VI  Skin  115 28 Anatomical Comments on the Skin  117 Matt D. Miesner 29 Skin Scraping  121 Meredyth L. Jones and Patricia Payne 30 Skin Biopsy  124 Meredyth L. Jones 31 Toenail Trimming  128 Meredyth L. Jones Section VII Respiratory  131 32 Thorax Anatomy and Auscultation  133 Matt D. Miesner 33 Tracheotomy/Tracheostomy  135 Matt D. Miesner 34 Field Diagnosis of Choanal Atresia  139 David E. Anderson 35 Transtracheal Wash  143 Matt D. Miesner Section VIII  Abdomen  147 36 Anatomical Comments on the Camelid Abdomen  149 Matt D. Miesner 37 Abdominal Ultrasound  152 Matt D. Miesner

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38 Abdominocentesis  157 Matt D. Miesner 39 Liver Biopsy  161 Meredyth L. Jones 40 First Compartment Paracentesis (Rumenocentesis) and Fluid Evaluation  165 Meredyth L. Jones 41 Intubation of the First Forestomach Compartment (“C1” or “Pseudorumen”)  169 David E. Anderson 42 Laparotomy—Lateral Approach  173 David E. Anderson 43 Laparotomy—Ventral Midline  180 David E. Anderson 44 Laparoscopy  186 David E. Anderson 45 Creation of Stoma into First Forestomach Compartment (“Rumenostomy”)  191 David E. Anderson Section IX  Musculoskeletal  195 46 Musculoskeletal Anatomy and Ambulation  197 David E. Anderson 47 Regional Intravenous Drug Perfusion  200 Meredyth L. Jones Section X  Urinary System  203 48 Urinary Tract Examination and Anatomy  205 Meredyth L. Jones 49 Urethral Catheterization  208 Meredyth L. Jones 50 Ultrasound of the Urinary System  212 Matt D. Miesner 51 Cystocentesis  217 Meredyth L. Jones

Contents

Section XI  Female Genital Anatomy  221 52 Comments Regarding Female Genital Anatomy  223 David E. Anderson 53 Pregnancy Diagnosis  226 David E. Anderson 54 Procedure: Vaginoscopy and Uterine Culture  232 David E. Anderson 55 Teat and Udder Examination  236 David E. Anderson 56 Mastectomy (Udder Amputation)  239 Matt D. Miesner 57 Cesarean Section  243 David E. Anderson 58 Diagnosis and Management of Uterine Torsion  247 David E. Anderson Section XII  Male Genital Anatomy  253 59 Male Genitalia Anatomical Comments and Breeding Behavior and Soundness  255 David E. Anderson 60 Examination of the Penis and Prepuce  258 David E. Anderson 61 Examination of Accessory Sex Glands  261 David E. Anderson 62 Examination of the Scrotum and Testicles  264 David E. Anderson 63 Semen Collection and Evaluation  267 David E. Anderson 64 Castration  272 Meredyth L. Jones

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Section XIII  Nervous System  277 65 Neurological Examination and Anatomy  279 Meredyth L. Jones and Matt D. Miesner 66 Cerebrospinal Fluid Collection and Interpretation  283 Meredyth L. Jones Section XIV  Ophthalmology  287 67 Eye Exam  289 Tracy Miesner and Matt Miesner 68 Nasolacrimal Duct Cannulation  293 Meredyth L. Jones 69 Conjunctivorhinostomy for Alleviation of Nasolacrimal Duct Obstruction  295 David E. Anderson 70 Ocular Extirpation  298 David E. Anderson 71 Subpalpebral Lavage System  301 Tracy Miesner 72 Conjunctival Pedicle Graft  305 Tracy Miesner and Matt Miesner Section XV Miscellaneous  309 73 Blood Transfusion  311 Meredyth L. Jones 74 Plasma Transfusion  315 Meredyth L. Jones Index  317

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Preface Traditional farm animal species are routinely included in veterinary curricula, have immense volumes of published information, and most large animal veterinarians and veterinary technicians possess experience and a general understanding of procedures to be performed on these species. This wealth of resources greatly outweighs that available regarding South American camelids for most veterinarians. South American camelids are increasingly ingrained in modern veterinary culture, but this experience is relatively new—measured in decades versus centuries for that of traditional species. Early on, medical and surgical care was directed toward specialty clinics and veterinarians with special interest. This was largely due to the extreme monetary value of animals and veterinarians’ apprehension to treat animals in which they have little to no experience. Also, many practitioners have limited direct practice experience with llamas and alpacas. Many methods for common procedures as well as specialized investigative procedures have been developed through trial and error. The general acceptance of South American camelids as a

common component of mixed animal veterinary practice has led to veterinarians finding themselves performing examinations, diagnostic testing, and medical and surgical procedures on llamas and alpacas. Comfort working with the species has grown as graduating veterinarians receive more formal training and experience during their education. We receive and address many calls from the field and from other academic institutions on how to perform varying procedures. Our goal with this text is to synthesize our combined experience with procedures from routine maintenance to advanced procedures into a single, organized, concise, visually descriptive volume for veterinary reference. This manual is intended to serve as a reference and patient-side guide for veterinarians and veterinary technicians to facilitate performance of these procedures. We gratefully acknowledge the input of our fellow veterinary practitioners who have contributed to the advancement of knowledge about these species and to increasing the standard of care provided to llamas and alpacas.

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Section I Behavior and Capture Techniques

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1 Behavior and Capture Techniques David E. Anderson

Behavior Llamas and alpacas are intensely herd oriented. Each group of animals has a distinct social structure including a command hierarchy. Interestingly, group hierarchy often changes when the makeup of the group is altered. When herds are moved to a different location, a member of the group is removed, or members of different groups in different pastures are mixed, a period of reorganization occurs. These dynamics are important when llamas and alpacas are maintained in involuntary groupings based on management decisions (e.g., breeding groups, weaning groups, etc.). Involuntary grouping refers to the fact that small groups are assembled by humans for the purpose of management structure, pasture availability, or other matters of convenience or necessity relative to the working of the farm. Thus, the llamas and alpacas are forced to create stable groups that may not be ideal and, in rare cases, are incompatible. The likelihood of establishing an integrated and stable group can be reduced by limited space. High stocking density creates social stress that is often not perceptible to farm personnel or veterinarians. When regulations are developed for minimum space needs for various species of animals, these guidelines most commonly refer to critical self-care needs to lay down, stand up, turn

around, eat, drink, etc. With llamas and alpacas, we have found that these animals seem to have a need for “psychological space.” Thus, when herd groups are assembled, space requirements should take into account the need for llamas and alpacas to have the freedom to lay down, eat, move, and so on without disruption of this individual space. Any assessment of llama and alpaca herds should include an analysis of the herd structure, group compatibility, and space limitations. Occasionally, llamas and alpacas that are losing weight, suffering early embryonic losses, or failing to produce hair or fleece optimally are manifesting these problems as a reflection of herd stress or social stress. This may be present in a herd as a whole or with specific individuals. For example, a herd of 200 alpacas was examined because of a history of weight loss and sudden death. Diagnostic testing suggested deaths were associated with Clostridium perfringens Type A overgrowth in the small intestine. Upon inspection of the herd, the 200 alpacas were found to be residing in a rectangular barn of 80 feet by 60 feet square and a 10-acre pasture, and were being fed a daily ration of hay and commercial pelleted supplement. The hay was of good quality (TDN 55%; crude protein 16%) and the grain supplement was appropriate for alpacas and included trace minerals. Observation of hay and supplement feeding revealed that, hay

Veterinary Techniques in Llamas and Alpacas, Second Edition. Edited by David E. Anderson, Matt Miesner, and Meredyth Jones. © 2023 John Wiley & Sons, Inc. Published 2023 by John Wiley & Sons, Inc.

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was fed based on expected intake with the desire to minimize waste in a feeding trough 60 feet long. The hierarchy of the herd created a dynamic of limited feed access for subordinate members of the herd. Feeding space was inadequate (desired bunk space >18 inches per alpaca; actual bunk space 50% of corneal thickness), nonhealing ulcers, and corneal stromal abscesses (Figure 72.1).

Equipment Needed The following equipment is needed: eyelid speculum, Steven’s tenotomy scissors, Colibri or tying forceps, ophthalmic needle holders, 6–0 to 8–0 polyglactin 910 suture (smaller is better), and magnifying lens (Gelatt 2007).

Restraint/Position General anesthesia is used.

Technical Description of Procedure/Method This technique has been described by multiple people in multiple species. A single case report in published in an alpaca (Rodriquez-Alvaro et al 2005). This technical description was made using Gellat’s Veterinary Ophthalmology text as a reference and with personal consultation with Dr. Anne Metzler, DVM, MS, ACVO.

Specific location and size of flap is determined by the corneal defect being covered. The conjunctiva is incised at a position that will allow undermining and transposition to the corneal lesion. The initial incision should be perpendicular to the cornea and undermined parallel to the corneal edge with more width than the abnormal corneal tissue to allow for some contracture (Figure 72.2). Careful dissection is done to remove the conjunctiva from Tenon’s capsule without putting holes in the conjunctiva. The pedicle is created by making two long incisions in the undermined conjunctiva at and parallel to the limbus and at a parallel line distal to the limbus creating a flap that is 1–2 mm wider than the defect to be covered and wider at the base than at the tip (Figure 72.2). This creates a pedicle that is roughly rectangular in shape with three sides cut free and one edge attached. Final graft material should be thin enough that the scissors can be seen through it, large enough to more than cover the defect, loose enough to have no tension when sutured in place, and the base should be wider than the tip of the graft. The conjunctival flap will not adhere to corneal epithelium, necrotic, or collagenolytic corneal stroma. Therefore, preparation of the cornea for graft placement should be done to carefully remove all melting or dead tissue and the corneal epithelium needs to be removed for graft adhesion. The pedicle is rotated to

Veterinary Techniques in Llamas and Alpacas, Second Edition. Edited by David E. Anderson, Matt Miesner, and Meredyth Jones. © 2023 John Wiley & Sons, Inc. Published 2023 by John Wiley & Sons, Inc.

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Figure 72.1  Stromal abscess in a llama. (Photo courtesy of Anne Metzler, DVM, MS, ACVO).

Figure 72.2  Schematic drawing of camelid eye with corneal lesion and conjunctival flap harvest. Initial incision is perpendicular to the cornea at A and undermined toward B and C. The location of A is determined by measuring from a location nearest to the lesion, which will be the base of the pedicle at B to 1–2 mm beyond the lesions distal edge (light green dotted line). The width of the flap is determined by the size of the lesion (dark green dotted line). The base of the pedicle must be wider than the tip. After elevation of the conjunctiva, the pedicle is severed from A to B along the limbus, then from A to C. (Illustration courtesy of Matt Miesner.)

the lesion and sutured in place. Other techniques may be used such as bridge flaps that are attached at both short ends of the rectangle and the loosened conjunctiva spans the corneal surface and is sutured at the lesion site. Suturing is done using a simple interrupted pattern with the first suture being at the distal most portion of the flap and then progressing around the lesion at 1–1.5 mm apart until sufficient sutures have been placed to keep the flap secured (Figure 72.3). Some authors described placing an additional holding suture on either side of the base of the pedicle, and some

Figure 72.3  After the lesion is cleaned and prepped and a recipient bed of corneal stroma is exposed to accept the graft, then the pedicle is rotated into place and sutured with 6–0 to 7–0 absorbable, monofilament suture in a simple interrupted pattern (open arrow). Additional sutures are placed around the lesion 1–1.5 mm apart. Some authors place one additional vertical suture at the apex of the lesion and at the limbus on either side of the pedicle for additional support (arrows) (illustration courtesy of Matt Miesner).

Recommended Reading and References

describe placing an additional stay suture on the flap at the top edge of the corneal lesion through the center of the flap tissue. This additional suture must be placed vertical to the flap orientation to prevent vascular constriction (Figure 72.3). After the pedicle is sutured to the cornea, the scleral conjunctiva is re-apposed and sutured together. This can be done with either a simple interrupted or a continuous pattern (Figure 72.3). Some authors consider re-suturing to be an optional step. Suture ends should be short. The corneal lesion should be covered with semitranslucent conjunctival tissue (Figure 72.4). Topical and/or systemic antibiotics and other appropriate medications should be used while the conjunctival flap is supporting the corneal lesion. After the flap has secured to the corneal lesion and when the lesion is stable and the underlying ­problem has resolved, the graft can be severed from the rest of the conjunctiva using sedation and topical anesthetic. Blunt scissors are slipped under the nonadherent section of the graft and the normal cornea to snip the conjunctival tissue free from the vascular supply of the donor site. The result will be an island of conjunctival tissue. This step is optional, but it leads to a more cosmetic appearance long term. This step must be postponed until the veterinary surgeon is confident

Figure 72.4  Conjunctival flap used to treat stromal abscess in llama ( photo courtesy of Anne Metzler, DVM, MS, ACVO).

that the underlying corneal problem has been resolved. This step can be postponed as long as is needed or never performed at all. Practice Tip to Facilitate Procedure General anesthesia is used.

Potential Complications If the flap is sutured in place under tension, the vascular supply will be compromised and the flap will necrose and dehisce. If Tenon’s capsule is not adequately removed from the conjunctival flap, the graft will contract and dehisce.

Patient Monitoring/Aftercare Routine monitoring for recovery from general anesthesia and routine monitoring of corneal lesions should be performed.

Recommended Reading and References Gelatt K. 2007. Veterinary Ophthalmology, 4th Edition. Blackwell, pp. 671–675 and 707–711. LoPinto AJ, Pirie CG, Bedenice D, et al. 2017. Corneal thickness of eyes of healthy goats, sheep, and alpacas manually measured by use of a protable spectral-domain optical coherence tomography device. Ajvr; 78(1):80–84. Metzler A 2010. The Ohio State University Veterinary Teaching Hospital Ophthalmology Department. Personal communication. Rodriquez-Alvaro A, Gonzalez-Alonso-Alegre EM, Delclaux-real Del Asua M, et al. 2005. Surgical correction of a corneal perforation. J Zoo Wldlf Med; 36(2):336–339.

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Section XV Miscellaneous

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73 Blood Transfusion Meredyth L. Jones

Purpose or Indication for Procedure

Technical Description of Procedure/Method

This procedure is performed to provide volume, protein, and oxygen-carrying support in cases of hypovolemia, hypoproteinemia, or anemia associated with signs of hypoxemia.

The donor is selected based on good general health, a packed cell volume (PCV) and total protein within the reference ranges, and a body weight similar to or greater than the recipient. Both donor and recipient should have jugular intravenous catheters placed aseptically. Calculations should be made as to the amount of whole blood that will be administered. In the case of anemia, an ideal blood volume to be administered can be calculated when the PCV of the donor and recipient are known.

Equipment Needed The following equipment is needed: intravenous (jugular) catheters (16-  ×  or 14-gauge 15-cm catheter) secured in place in donor and recipient animal, acid citrate dextrose (ACD) blood collection bag, filtered administration set, and whole blood and serum from the donor and recipient for crossmatch, if desired (performed at reference laboratories). Where commercial blood bags are not available, sodium citrate (2.5–4%) and a sterile receptacle may be used.

Restraint/Position Standing, haltered, and chute restraint may be used.

Administration volume (L) =  desired − PCV (recipient )×   PCV  BW of recipient (kg )× 0.1 L / kg PCV (donor )

Donated blood should not exceed 20% of the blood volume of the donor, which equates to about 1.5% of the donor’s body weight. It is often encountered that the donor is unable to give the volume of blood that is required to achieve the desired PCV using the above formula. In these cases, if a donor of greater body weight cannot be obtained, the safe donor volume must be administered and a lower PCV achieved.

Veterinary Techniques in Llamas and Alpacas, Second Edition. Edited by David E. Anderson, Matt Miesner, and Meredyth Jones. © 2023 John Wiley & Sons, Inc. Published 2023 by John Wiley & Sons, Inc.

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In the case of hypoproteinemia caused by hypoalbuminemia, hypoglobulinemia, or ­panhypoproteinemia, whole blood may also be administered where plasma is unavailable using the following formula (using albumin as the target protein): Administration volume (L ) = desired − Alb (recipient )× BW of   Alb  recipient (kg )× 0.06 L / kg  Alb(donor ) When the collection and administration volumes are calculated, the donor is restrained in the standing position (preferably in a chute) and the catheter connected to the appropriate receptacle containing anticoagulant. The container is lowered to the ground and filled by gravity flow. In the case of commercial blood collection bags (Figure 73.1), they should be filled until turgid and rocked to assure proper

Figure 73.1  Acid citrate dextrose blood collection bags. These commercially available bags come as a set of three for separating blood components, but only one of the bags is used for whole blood collection.

mixing of the blood and anticoagulant. Where these bags are not available, any sterile receptacle may be used. Sodium citrate is added to the receptacle at a volume to create a 1:9 ratio of sodium citrate: whole blood. After the desired volume is collected, the bag is attached to a filtered administration set (Figure 73.2) and administration to the donor initiated. The transfusion should begin at a slow rate of 5 mL/kg/hour for the first 15 to 20 minutes and the recipient monitored for signs of transfusion reaction (see Patient Monitoring below). After this time, if no abnormalities are noted, the rate may be increased to 10 mL/kg/ hour for the remainder of the transfusion. In cases where acute hemorrhage is the cause of anemia, the bleeding must be stopped prior to or during the transfusion, because the volume expansion will worsen the losses. In the case of hemolytic disease, efforts should be made to identify the cause and minimize ongoing hemolysis, as the average lifespan of transfused red blood cells is limited to 3 to 5 days. Severe anemia may be recognized during the physical examination by inspection of the mucous membranes. Extreme anemia causes a pale appearance (Figure 73.3). Assessment of the anemic patient should include examination of peripheral blood. This may allow identification of Mycoplasma haemolamae infection of red blood cells (Figure 73.4).

Figure 73.2  Filtered blood transfusion administration set. These should be used to prevent microscopic clots from being transfused.

Patient Monitoring/Aftercare

Figure 73.3  The mucous membranes of an alpaca presented for weakness and lethargy. Note the extreme pallor. This animal had a packed cell volume of 9%, was tachycardic, tachypneic, and recumbent.

Glass bottles from injectable medications may be cleaned, the mouth covered in aluminum foil or pack wrap sealed with autoclave tape and sterilized in a steam autoclave for blood transfusion. The appropriate amount of anticoagulant is added and a Bell IV (simplex) set attached with the metal injection port removed and the tubing attached to a filtered administration set. In general, when treating for failure of passive transfer of immunoglobulin, 40 mL/kg of whole blood are administered when plasma is unavailable. Although crossmatch is desirable in all cases of blood transfusion, it is not performed in most veterinary practices, but it is available through most reference laboratories. The time delay for laboratory testing, as well as the difficulty interpreting the test in camelid species, makes this test impractical in most situations.

Potential Complications

Figure 73.4  Peripheral blood smear (WrightGiemsa) of an alpaca infected with Candidatus Mycoplasma haemolamae, which can result in severe hemolytic episodes. Note the blue organisms in the background of the blood film.

Practice Tip to Facilitate Procedure It is useful to place the largest gauge catheter possible in the donor animal to facilitate rapid donation of blood. Where sodium citrate is not readily available, heparin may be used as a substitute anticoagulant at 4.5 to 5 units heparin per 1.0 mL blood, but should be avoided in cases of hemorrhage.

Blood donation is generally a very safe procedure for the donor, and few complications are seen. Hematoma or other catheter complications may occur and, rarely, the donor may show signs of hypovolemia (weakness). This appears to occur in animals that are very stressed during donation. Where there is concern for the vascular volume of the donor, a liter of a balanced intravenous fluid can be administered prior to removal of the catheter. For the recipient, the primary concern during and after blood transfusion is that of a transfusion reaction. Transfusion reactions can range from minor urticaria to life-threatening anaphylaxis.

Patient Monitoring/Aftercare The donor should be monitored for 2 to 3 days after blood donation for general health and appetite.

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The recipient should be monitored for any evidence of transfusion reaction during and after the transfusion. Prior to initiation of the transfusion, basal temperature, pulse, and respiratory rate findings should be recorded. Signs that should be monitored for include ­trembling, hives, pruritis, hemoglobinuria, edema, tachypnea, tachycardia, increased rectal temperature, and collapse. If a mild reaction is noted, the transfusion should be stopped and ­antihistamines administered. If more severe signs occur that indicate anaphylaxis, the transfusion should be stopped and ­supportive therapy, perhaps including epinephrine, should be initiated.

Recommended Reading DeWitt SF, Bedenice D, Mazan MR. 2004. Hemolysis and Heinz body formation associated with ingestion of red maple leaves in two alpacas. J Am Vet Med Assoc; 225(4):578–583.

Divers TJ. 2005. Blood component transfusions. Vet Clin N Am Food Anim Pract; 21:615–622. Miesner MD, Anderson DE. 2006. Factor-VII deficiency in a newborn alpaca. J Vet Intern Med; 20:1248–1250. Tornquist SJ. 2009. Clinical pathology of llamas and alpacas. Vet Clin N Am Food Anim Pract; 25(2):311–322. Tornquist SJ, Boeder LJ, Cebra CK, et al. 2009. Use of a polymerase chain reaction assay to study response to oxytetracycline treatment in experimental Candidatus Mycoplasma haemolamae infection in alpacas. Am J Vet Res; 70:1102–1107.

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74 Plasma Transfusion Meredyth L. Jones

Purpose or Indication for Procedure This procedure is to provide intravascular ­volume and protein in cases of hypovolemia, hypoalbuminemia, hypoglobulinemia, or panhypoproteinemia.

Equipment Needed Intravenous (jugular) catheter in place in the recipient, commercial frozen plasma, and filtered administration set are needed.

Restraint/Position Standing (chute) or cushed positions may be used.

Technical Description of Procedure/Method Commercial llama plasma is available for use in transfusions (Figure 74.1). Volume to be thawed may be calculated by providing 20–40 mL plasma per kg of body weight. The plasma should be thawed slowly by immersion in warm water. Active heating by microwave

or other means must be avoided to prevent denaturing of proteins. The recipient should have a jugular intravenous catheter placed aseptically. The thawed plasma should be attached to a filtered administration set (Figure 74.2) and administration to the recipient initiated. The transfusion should begin at a slow rate of 5 mL/kg/hour for the first 15 to 20 minutes and the recipient monitored for signs of transfusion reaction. After this time, if no abnormalities are noted, the rate may be increased to 10 mL/kg/hour for the remainder of the transfusion. Practice Tip to Facilitate Procedure In sick crias, it has been shown that 2 or more units of plasma may be needed to achieve IgG levels over 1,000 mg/dL (Gerspach et al. 2007).

Potential Complications The primary concern during and after plasma transfusion is a transfusion reaction. Transfusion reactions can range from minor urticaria to lifethreatening anaphylaxis. Plasma components may be absorbed across the peritoneum, leading many to administer plasma via abdominal catheter rather than intravenously. This technique may result in

Veterinary Techniques in Llamas and Alpacas, Second Edition. Edited by David E. Anderson, Matt Miesner, and Meredyth Jones. © 2023 John Wiley & Sons, Inc. Published 2023 by John Wiley & Sons, Inc.

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signs of colic in crias and provides a ready media for bacterial growth. The author elects to avoid this method of administration and if it is chosen, strict asepsis must be practiced.

Patient Monitoring/Aftercare The recipient should be monitored for any evidence of transfusion reaction during and after the transfusion. Prior to initiation of the transfusion, basal temperature, pulse, and respiratory rate findings should be recorded. Signs that should be monitored for include trembling, hives, pruritis, hemoglobinuria, edema, tachypnea, tachycardia, increased rectal temperature, and collapse. If a mild reaction is noted, the transfusion should be stopped and antihistamines administered. If more severe signs occur that indicate anaphylaxis, the transfusion should be stopped and supportive therapy, perhaps including epinephrine, should be initiated.

Recommended Reading Figure 74.1  Commercially available frozen llama plasma. The total volume of plasma in each bag varies but is generally around 250–300 mL. The IgG concentration is recorded on each bag.

Figure 74.2  Filtered blood transfusion administration set. These should be used to prevent microscopic clots and fibrin from being transfused.

Divers TJ. 2005. Blood component transfusions. Vet Clin N Am Food Anim Pract; 21:615–622. Dolente BA, Lindborg S, Palmer JE, et al. 2007. Culturepositive sepsis in neonatal camelids: 21 cases. J Vet Intern Med; 21:519–525. Gerspach C, Varga A, Niehaus A, et al. 2007. Serum IgG Concentrations in crias: how much is enough? In: Proceedings of the American College of Veterinary Internal Medicine Forum, Seattle, WA. Sharpe MS, Lord LK, Wittum TE, et al. 2009. Pre-weaning morbidity and mortality of llamas and alpacas. Aust Vet J; 87:56–60. Tornquist SJ. 2009. Clinical pathology of llamas and alpacas. Vet Clin N Am Food Anim Pract; 25(2):311–322. Whitehead CE. 2009a. Management of neonatal llamas and alpacas. Vet Clin N Am Food Anim Pract; 25(2):353–356. Whitehead CE. 2009b. Neonatal diseases in llamas and alpacas. Vet Clin N Am Food Anim Pract; 25(2):367–384.

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Index Note: Page numbers followed by “f” refer to figures and “t” refer to tables.

a

abdominal ultrasound: C-3 proximal portion  153, 153f duodenum  153, 154f equipment  152 flank and intercostal muscles  152, 153f glandular and nonglandular regions  153 hyperechoic lesions  155, 155f hypoechoic intraluminal ingesta  154 intercostal imaging  153 intraluminal obstructions  154 liver/kidney disease  152 lumbar vertebrae  154, 154f probe positioning  155, 155f procedure  152–155 pyloric antrum  153, 153f restraint/position  152 smooth capsular appearance  154, 155f splenic vasculature  155, 155f tenth intercostal space  153, 153f xyphoid  154f abdominocentesis: complications  160 equipment  157 fluid accumulation  159 18-gauge hypodermic needle  159, 159f linea alba  159, 159f paracostal aspiration  157, 157f patient monitoring  160 peritoneal fluid  158, 158f, 159, 159f procedure  157–159

restraint/position  157 #15 scalpel blade  158, 158f teat cannula  158, 158f umbilicus, linea alba  157–158, 158f accessory sex glands: bilobed prostate  263, 263f bulbourethral and prostate  256, 261–263, 262f, 262t complications  263 equipment  261 patient monitoring  263 procedure  261–263 restraint/position  261 subfertile males  261 acepromazine  33, 35 adjunctive therapy  80 aggressive movements  5 ambulation  197–198, 202 aminoglycosides  201 analgesics  80 anaphylaxis  28, 29, 313–316 anesthetics  33, 37, 39, 80 antibiotic therapy  105, 300 anti-inflammatory therapy  300 antimicrobial therapy  164, 201, 242, 245, 272 artificial breeding technologies  267 artificial vaginas (AV)  269, 269f arytenoids  44 atipamezole  36, 40 atropine sulfate  39

Veterinary Techniques in Llamas and Alpacas, Second Edition. Edited by David E. Anderson, Matt Miesner, and Meredyth Jones. © 2023 John Wiley & Sons, Inc. Published 2023 by John Wiley & Sons, Inc.

318

Index

auricular artery/vein: butterfly taping  67, 68f complications  68 equipment  67 location, rubber band tourniquet  67, 68f patient monitoring  68 procedure  67–68 restraint/position  67

b

behavior techniques  3–4 beta-lactam antimicrobials  201 blood-borne pathogens  26 blood transfusion: acid citrate dextrose  312, 312f complications  313 donor and recipient PCV  311 equipment  311 filtered administration set  312, 312f formula, administration volume  312 mucous membranes  312, 313f patient monitoring  313–314 peripheral blood smear  312, 313f procedure  311–313 restraint/position  311 steam autoclave  313 body condition score (BCS)  4, 33, 37, 237 body weight  28, 37, 79, 202, 244, 311, 315 bone sequestra  103, 105, 108 brainstem  279, 281, 283 bulbourethral glands  256, 261–262, 262f, 262t butorphanol  33, 35, 38, 39 butorphanol/xylazine/ketamine (BXK)  39

c

C1/pseudorumen intubation: complications  172 equipment  169 esophagus  170f infusing air  171f oral speculum  171f patient monitoring  172 procedure  169–172 restraint/position  169

camelid abdomen: C-3 and duodenum orientation  150, 150f cranial and caudal sacs  149, 149f diagnostic procedures  149 forestomachs  149 glandular saccules  149 ileocecal/ceco-colic junction  150 liver margin  150, 151f nonlobulated kidneys  150 right and left kidneys  151, 151f stomach compartments  149 viscera orientation  150, 150f capture techniques: animal’s movement  6, 6f arms around neck  6, 6f bony bridge of nose  6, 7f cartilaginous bridge of nose  6–7, 7f flight zones  4, 5 halter below jawline  6, 6f herd group  4 lead rope  5–7, 6f, 7f mobile barrier  5, 5f movable barrier  5, 5f rope barriers  5 stress-induced problems  4 uncooperative patients  5, 6f vaccination and deworming  4 wandering off  4 cardiac contractility  230 cardiopulmonary instability  40 carotid artery  27, 35, 40, 55, 60, 91 castration  37 absorbable suture material  273, 274f anesthetic options  272–273 cautionary statements  275 complications  275 equipment  272 injectable field anesthesia  273, 273f intradermal pattern, absorbable suture  273, 274f isolated spermatic cord  273, 274f patient monitoring  275 preoperative preparation  272 prescrotal approach  273, 273f, 275f

Index

procedure  272–275 restraint/position  272 scrotal approach  273–275 scrotal vs. prescrotal techniques  275 single prescrotal incision  273, 274f testicle pressure  273, 273f testicle, tunic and scrotal fat  273, 274f cattle  4, 139, 162, 165, 171, 202, 267 caudal (sacro-coccygeal) epidural anesthesia: anatomical angles and narrow  79 coccygeal vertebrae  78, 79f complications  79 dorsal and ventral motion  78, 78f equipment  78 patient monitoring  79 procedure  78–79 restraint/position  78 ceftiofur sodium  202, 243 central vestibular system  279, 281 cephalic vein  200 complications  61 equipment  61 extension set attached  61, 62f forelimb preparation  61, 62f over-the-needle catheter  61, 62f patient monitoring  62 procedure  61 restraint/position  61 cerebellum  279 cerebrospinal fluid (CSF): AO joint  283, 284f complications  286 equipment  283 intracranial and spinal disease  284 LS junction  283 lumbosacral tap  284, 284f meningitis  285, 285f neutrophilic pleocytosis  286, 286t patient monitoring  286 procedure  283–286 reference ranges  285, 285t restraint/position  283 spinal needle  284, 284f

sterile syringe  284, 285f subarachnoid space  283, 284, 285f cerebrum  279 cervical epaxial musculature  27f cervical injuries  13, 91, 92f cervical rings  223 cervico-thoracic spine  21 cesarean section: complications  245 costochondral junction  244 equipment  243 non-adhesive bandaging tape/roll gauze  245 patient monitoring  245 procedure  243–245 restraint/position  243 uterus  244 ventral midline celiotomy  244 ventral midline laparotomy  244 CHARGE syndrome  139 choanal atresia  135 atretic tissue  139, 139f, 141, 141f breathing patterns, nasopharynx results  140, 140f clinical tests  140–142 congenital and heritable defects  139 equipment  140 nasopharynx and pharynx  139 patient monitoring  142 procedure  139–142 respiratory rate  140 restraint/position  140 temporary tracheostomy  141, 142f unilateral, endoscopic image  141, 141f ventral midline incision  141, 142f Chorioptes sp. mites  121 chronic malnutrition  4 chute restraint: alpaca chute  21, 22f alpaca chute with straps  21, 22f complications  23 equipment  21 llama chute  21, 22f patient monitoring  23 procedure  21

319

320

Index

quick-release hardware/knots  21, 22f quick release snaps  21, 22f restraint/position  21 closprostenol  245 clostridial vaccines  164 Clostridium perfringens  3 Cochet-Bonnet anesthesiometer  290 congenital defects  139 conjunctival pedicle graft: complications  307 corneal epithelium  305 corneal lesion and conjunctival flap harvest  305, 306f corneal stroma  306, 306f equipment  305 patient monitoring  307 procedure  305–307 restraint/position  305 stromal abscess  305, 306f, 307, 307f Tenon’s capsule  305 topical/systemic antibiotics  307 conjunctivorhinostomy: complications  296 equipment  295 nasolacrimal duct  295 nested trochar assembly  296 patient monitoring  296 pigmented and nonpigmented epithelium  296 procedure  295–296 pulsate operator  296 restraint/position  295 corpus cavernosus penis (CCP)  255 corpus luteum (CL)  223 corpus spongiosus penis (CSP)  255, 258 creatine kinase (CK)  286 cryptorchidism  225, 264 cushed posture  17 cystocentesis: caudal abdomen  217, 218f complications  218 equipment  217 18-gauge spinal needle  217, 218f patient monitoring  218 procedure  217–218

restraint/position  217 urinary bladder  217, 218f

d

Demodex  121 dental disease  100 dental examination/trimming: alpaca mandibles  96, 96f, 97f alpaca skull  96, 96f complications  99 dental formula  95 electric rotary tool  97, 97f equipment  95 incisor conformation  96, 97f mandibular incisors  96, 96f oral evaluation  95, 96f overgrown incisors  97–98, 98f patient monitoring  99 procedure  95–98 restraint/position  95 rotary tool, fighting teeth  98, 98f swine oral speculum  97, 98f 60-mL syringe barrel  97, 97f teeth trimming  97–98 dermatologic diseases  117 diazepam  35, 38 dietary deficiencies  118 domperidone  238 dorsal common digital vein  200 dysphagia/malocclusion  103, 108 dystocia  243–245 dysuria/hematuria  210

e

ear examination: acute external otitis  112, 112f alpaca skull  112, 112f equipment  110–111 external, middle and inner right ear  110, 111f newborn cria, prematurity  111, 111f otitis media/interna  110, 111f otoscopic exam, external canal  111–112, 112f procedure  110–112

Index

restraint/position  111 right-sided otitis interna  112, 112f ear squeeze/twitch: applied ear base  24, 25f aural cartilage fracture/hematoma  24, 25f complications  25 crook of assistant’s arm  24, 24f equipment  24 procedure  24 restraint/position  24 ectoparasites  118 ejaculating thrusts  223, 257 electroejaculation (EEJ)  269, 270, 270f endotracheal intubation  48 enterotomy  177–178 enucleation  298, 299 epidural catheterization: adhesive flexible bandage material  83, 83f complications  83 equipment  80–83 length cut off and injection port setup  82, 82f lumbar-sacral space approach  80, 81f materials, sterile field  80, 81f patient monitoring  83 procedure  80–83 restraint/position  80 saline solution  81, 82f second strip of bandage material  83, 83f stapling the bandage  83, 83f subcutaneous tissues  80, 81f testing methods  81 tissue stapler  82, 82f Tuohy needle  80, 81f, 82, 82f equine chestnuts  117, 119f esophageal obstruction  28, 35, 40 esophageal puncture  91 esophagus  35, 40, 46, 55, 60, 136, 140, 143, 170–172 ethylenediaminetetraacetic acid (EDTA)  144, 157 exuberant granulation  138

eye exam: anterior segment anatomical structures  290 atropine  289 binocular ophthalmoscopy  289 complications  291 cortical lenticular sclerosis  291, 291f direct/indirect ophthalmoscopy  289 equipment  289 nasolacrimal duct patency and corneal integrity  290 patient monitoring  291 posterior segment anatomical structures  291 procedure  289–291 pupillary light reflexes  289 restraint/position  289 topical anesthesia  289–290 transilluminator  289

f

facial artery  106 facial nerve  106 feeding space  4 female genital anatomy: congenital defects  224, 225 embryotaxis  224 external and internal genitalia  223 follicle development  223, 224f heritable defects  224 muscular papilla  223 neurohormonal stimuli  224 orgling  223 oviductal papilla  223 progesterone concentration  223 femoral artery: arterial blood gas determination  69, 69f arterial blood sample  69, 69f complications  70 equipment  69 patient monitoring  70 procedure  69 restraint/position  69 systemic blood pressure monitoring  69, 69f

321

322

Index

fetal development in utero  224 fetal heart rate (FHR)  230 fighting teeth  91, 95, 98, 99 fine needle aspiration  164, 265 first-compartment fluid: chloride concentration  167 complications  168 equipment  165 Gram staining  166, 167f iodine-stained protozoa  166, 167f last rib and stifle  165, 166f methylene blue reduction time  166, 167f patient monitoring  168 pH determination  165, 166 procedure  165–167 protozoa, lactic acidosis  166 restraint/position  165 sedimentation time  166 values in llamas  166, 166t fluid therapy  71 flunixin meglumine  77 foot anatomy  197 forward interlocking pattern. See interlocking pattern fundic pigmentation  291

g

gastrocnemius muscle  63, 64f gastrointestinal disease  167 Gellat’s veterinary ophthalmology  305 general anesthesia: after induction  41f complications  40, 179 equipment  37 intubation  179, 184 patient monitoring  40, 179 procedure  37–39 protocols  38t restraint/position  37–38 goats  4, 174, 192, 217, 256, 259, 267 granulation tissue  103, 108

h

Haemonchus contortus  289 haltering: cattle rope  12f

complications  13 equipment  11 individual handling, rope/conduit  12f muzzle portion  12f procedure  11 restraint/position  11 soft nasal cartilage  12f spitting/regurgitation behavior  12f head/neck, anatomical features: cervical injuries  91, 92f complications  93–94 dental pad  93, 93f long, dense hair/fiber  91, 91f mouth gags  92–93 muscle mass  91, 92f oral speculum  92, 93f PCV pipe with rubber tube  93, 93f premolars and molars (cheek teeth)  93, 94f procedure  91–93 restraint/position  92 sensitive gumline  93, 93f split upper lips (muzzle)  91, 92f ventral aspect  91, 92f hematology  37 hematoma  25, 28, 35, 40, 60, 67, 135, 202, 206, 313 hemodynamic stability  180 hepatobiliary diseases  161 herd stress  3 hyperprogesteronemia  227 hypoalbuminemia  312 hypoglobulinemia  312 hypoproteinemia  312 hypotension  71 hypothermia  71 hysterotomy. See cesarean section

i

IM anesthesia  39 inadequate nutrition  4 inadvertent carotid puncture  28, 135 inadvertent intravascular injection  28 infectious diseases  128, 283 injections: complications  28–29 equipment  26

Index

intracarotid  28 intradermal (ID)  27, 27f intramuscular (IM)  27, 27f, 28, 33, 37 intravenous (IV)  27, 28f, 33, 37 patient monitoring  29 perivascular  29 procedure  26–28 restraint/position  26 subcutaneous (SC)  26, 26f, 33 interlocking pattern  177, 184 intermammary groove  236 interrupted sutures  241 intestinal obstruction  160, 177–179, 184 intestinal resection  178–179 intracarotid injections  28 intradermal (ID) injections  27, 27f intradermal tuberculin skin testing  117 intraluminal obstruction  184 intramedullary cannulation: bone biopsy and aspiration needle  72, 72f cap and trocar removed  73, 73f complications  73–74 diaphysis of femur  72, 73f equipment  71 patient monitoring  74 procedure  71–73 restraint/position  71 trochanteric fossae  72, 72f trochanter of femur  71, 72f intramuscular (IM) injections  27, 27f, 28, 33, 37 intraperitoneal (IP) cannula: anecdotal evidence  75 complications  77 equipment  75 fluid/plasma infusion  76, 77f left lateral abdominal wall  76, 76f lengths of teat cannulas  76, 76f patient monitoring  77 peritoneal cavity  76, 77f procedure  75–77 restraint/position  75 sedation  75 skin tenting technique  76, 76f using No. 15 scalpel blade  76, 76f

intravenous (IV) injections  27, 28f, 33, 37 inverted clover leaf method  239 involuntary grouping  3 IV anesthesia  39

j

jugular groove  27, 28f, 35, 55 jugular vein: actual catheter into vein  57, 58f blood flash, stylette removal  57, 58f built-in extension port  57, 60f catheterization, 2% lidocaine  55, 56f catheter/stylette unit  56, 56f complications  60 ease of bandaging and fluid administration  56, 57f equipment  55 external catheter port  57, 59f insertion and actual catheters  57, 58f insertion catheter grasped and peeled  57, 58f insertion needle is placed  57, 59f J-wire catheters  55, 57, 58f–60f location, cervical vertebrae and trachea  55, 56f neck wrap  57, 57f patient monitoring  60 peel away catheters  55, 57, 57f procedure  55–60 restraint/position  55 stab incision, scalpel blade  55, 56f stylette and tabbed insertion catheter  57, 58f stylette removed  56, 57f tissue spreader  57, 59f withdrawn, insertion needle  57, 59f jugular venipuncture  38

k

ketamine  38, 39 ketamine-diazepam anesthesia  39 Ketamine-Stun protocol  35 kidney disease  152

l

laceration repair  37

323

324

Index

lactated Ringer’s solution (LRS)  29, 173, 180, 191, 243 laparoscopy: adjustable ports  189f, 190f complications  190 equipment  186 inflatable cuff and sliding lock washer  189f patient monitoring  190 procedure  186–190 restraint/position  186–187 laparotomy: lateral approach abdomen is exposed  174, 176f approach  174–175 duodenum  175, 177f equipment  173 intestinal obstruction  177–179 jejunum and ileum  175, 176f lateral abdominal wall  174, 174f muscle layers  174, 175f preparation  174 procedure  173–179 proximal loop, spiral colon  175, 176f pyloric fundus  175, 176f restraint/position  173–174 right kidney  175, 177f right lobe of pancreas  175, 177f skin incision  174, 175f sternolateral recumbency  173–174, 174f suture selection and patterns  178t visceral access  174, 175t wound closure  176–177 ventral midline  180–184 laryngospasm management  44, 47 lateral abdominal approach  186–188 lateral recumbency: camelid restraint chute  19, 19f firm pressure, head and neck  18, 19f hyperextended posture  18 lateral saphenous vein  200 lateral thoracic vein: complications  66 equipment  65 location  65, 66f

over-the-needle catheter  65, 66f patient monitoring  66 procedure  65–66 restraint/position  65 leg conformation  198 libido  257 lidocaine  44, 47, 55, 76, 79, 80, 83, 87, 101, 124, 126, 143, 158, 162, 170, 202, 244, 245, 248, 263, 273, 284, 301 life-threatening dehydration  71 liver biopsy: animal restraint and ultrasound placement  161–162, 162f automatic biopsy instrument  162, 163f bandage tape  163, 163f blind technique  162, 162f blood vessels  162, 162f chamber instrument  162, 163f coagulation abnormalities  163 complications  164 equipment  161 necropsy specimen  161, 161f patient monitoring  164 procedure  161–164 restraint/position  161 vasculature and intercostal nerve  162 liver disease  152, 155 liver tissue analysis  164 lower motor neuron (LMN)  281 lumbosacral epidural anesthesia  210 complications  86–87 equipment  85 patient monitoring  87 pelvis and dorsal spinous processes  85, 86f procedure  85–86 restraint/position  85 saline solution  85, 86f spinal fluid  85, 86f spinal needle  85, 86f subcutaneous tissues  85, 86f lumbosacral epidural catheterization  78 lymph nodes  97, 237

m

male genitalia anatomy/breeding soundness:

Index

accessory sex glands  256 breeding behavior and aggressiveness  257 cartilaginous process  256, 256f complications  257 equipment  255 patient monitoring  257 penis and prepuce  255, 256, 256f procedure  255–257 restraint/position  255 sigmoid flexure  255, 256f mandibular/maxillary bone infections  105 mandibular osteomyelitis  105 manual restraint: complications  19 equipment  14 patient monitoring  20 procedure  14–19 restraint/position  14 mastectomy: blood vessels, mammary gland  239, 240f complications  242 dorsal skin  239, 240f elliptical incision  239, 240f equipment  239 lateral incisions  241, 241f ligate and transect  241, 241f median suspensory ligament  241, 241f patient monitoring  242 postoperative seroma formation  242 procedure  239–242 pudendal artery and vein  240, 240f restraint/position  239 right craniolateral photograph  239, 240f subcutaneous abdominal veins  241 mastitis  236, 237, 239 maternal heart rate (MHR)  231 meticulous techniques  83 micro/macromineral disparities  117 milkability  237–238 milk production  236–238 monogastric species  174, 181 musculoskeletal structures: abnormalities  275 camelids walk with pacing gait  198, 198f

complications  199 equipment  198 foot pad/slipper  197, 198f heel region, foot pads of digit  197, 198f non-weight-bearing toenail  197, 198f patient monitoring  199 procedure  199 proximal phalanx  197, 197f restraint/position  198 splayed digits  197, 197f Mycoplasma haemolamae  26, 312

n

nasal mucosa  172 nasogastric intubation  169–170, 170f nasolacrimal duct cannulation: complications  294 equipment  293 5-French polypropylene catheter  293, 294f nasal punch  293, 294f patient monitoring  294 procedure  293–294 restraint/position  293 #15 scalpel blade/14-gauge needle  294 nasolacrimal duct obstruction  295–296 nasotracheal intubation: assessment, air movement  46, 47f complications  47 cuff of tube inflated  46, 47f equipment  45 head and neck, hyperextended  45, 45f mechanical/manual ventilation  46–47, 47f patient monitoring  47 procedure  45–47 restraint/position  45 retracted and placement reassessed  46, 46f ventral nasal meatus  45–46, 46f ventral placement of tube  46, 46f neurological system: brainstem and central vestibular system  279, 281 C5-C6 subluxation  281, 281f cerebellum  279

325

326

Index

cerebrum  279 differential diagnoses  279, 280t facial paralysis  279, 280f peripheral nerves  281 peripheral vestibular system  281 reflexes  281 sign-time graph  279, 280f spinal cord  281 newborn crias/snake-bite victims  45 nonsteroidal anti-inflammatory drugs  109, 145, 173, 180, 186, 243, 245, 300 nuchal ligament  91

o

ocular extirpation: appositional suture patterns  299 complications  299–300 en bloc removal  298–299 enucleation  298 equipment  298 optic nerve  299 patient monitoring  300 procedure  298–299 restraint/position  298 skin sutures  299 surgical site preparation  298 transpalpebral ablation technique  298 olecranon  33, 38, 133 operative laparoscopy  188–189 oral approach: angled molar/cheek tooth  102, 103f complications  103 dental anatomy and eruption times  100, 101t dental elevator  101, 102f equipment  100 mental nerve, anesthetic blockade  101, 101f mouth speculum/gag  101, 102f orotracheal/nasotracheal intubation  101 patient monitoring  103–104 procedure  100–103 restraint/position  100 retained deciduous third mandibular incisor  102, 103f

rostral mandible  101, 101f organogenesis  224 orgling  223, 257 orocutaneous fistulas  103, 107 orogastric intubation  170–171, 171f oronasopharynx  135 oropharyngeal procedures  48 orotracheal intubation: complications  44 endotracheal intubation  43f endotracheal tube  42, 42f, 43f equipment  41 laryngoscope light source  42f larynx, laryngoscope blade  41, 42f mechanical/manual ventilation  43f patient monitoring  44 procedure  41–42 restraint/position  41 tongue, laryngoscope blade  41, 42f volume-regulated ventilation  43f orotracheal/nasotracheal tube  40 otitis media/interna  110, 111f ovulation  223–224, 257 oxytocin  245

p

packed cell volume (PCV)  311 panhypoproteinemia  312 paracostal aspiration  157 parotid salivary duct  106 pelvic thrusts  223 penis/prepuce examination: cartilaginous process  258, 259f complications  260 equipment  258 fibrovascular penis  258, 259f patient monitoring  260 preputial orifice  258, 259f procedure  258–260 restraint/position  258 percutaneous tracheal intubation: cannula sleeve  49, 49f cartilaginous rings  49, 49f complications  51 endotracheal tube, guide wire is removed  50, 51f

Index

equipment  48 laryngoscope with long blade  50, 50f nasal passage and pharynx  50, 50f oral speculum  49, 49f patient monitoring  51 procedure  48–50 restraint/position  48 right naris  50, 50f stab skin incision  49, 49f stiff guide wire/catheter  50, 50f peripheral nerve system  281 peripheral vestibular system  281 perivascular injection  29 petrolatum-based ointment  138 plasma transfusion: complications  315–316 equipment  315 filtered administration set  315, 316f frozen llama plasma  315, 316f jugular intravenous catheter  315 patient monitoring  316 procedure  315 restraint/position  315 polymethylmethacrylate  107, 108f pregnancy diagnosis: behavior  226–230 complications  231 25-day pregnancy  229, 229f 292-day pregnancy  229, 229f, 230f 37 days of pregnancy  229, 229f 60 days of pregnancy  229, 229f 120 days of pregnancy  229, 229f equipment  226 heartbeat  229, 230f mature follicle  228, 228f nonpregnant uterus  228, 228f patient monitoring  231 procedure  226–230 progesterone  227 rectal examination  227 restraint/position  226 rigid extender  228, 228f rigid plastic/polymer tubing  228, 228f thorax  229, 230f ultrasonography  228–230

premolars/molars, lateral approach: after tooth extraction  107, 108f complications  107–108 computed tomography image  105, 106f dental anatomy and eruption times  105, 106t dental elevators (Wolf tooth) extractors  107, 108f dental punches and mallet  107 equipment  105 myoperiosteal elevation flap  106, 107f oblique radiographic image  105, 106f patient monitoring  108–109 periodontal elevator  107 pneumatic osteotome  107, 107f procedure  105–107 restraint/position  105 ventral approach, mandibular arcade  105–106, 106f prescrotal castration  273, 273f, 275f progesterone  223, 226, 227 prolactin  238 prostate glands  256, 261–263, 262f, 262t pseudohermaphroditism  225 Psoroptes  121 psychological space  3

r

rectal examination  227, 248 reflexes  281 regional intravenous (RIV) drug perfusion: butterfly catheter  200, 201f complications  202 dorsal forelimb preparation  200, 201f equipment  200 lateral saphenous vein  200, 201f over-the-needle catheter  200, 201f patient monitoring  202 procedure  200–202 restraint/position  200 respiratory distress  35, 40, 146 retrograde/normograde nasotracheal intubation  48 retrograde tracheal intubation. See percutaneous tracheal intubation

327

328

Index

reversal agents: injectable anesthesia  40 sedation and tranquilization  36 routine (normograde) orotracheal intubation  48 rumenostomy: Brown-Adson forceps  192 C1 vertical incision  193, 193f complications  194 elliptical skin incision  192, 192f equipment  191 left lateral abdominal wall  191, 192f patient monitoring  194 preparation  191 procedure  191–194 restraint/position  191 seromuscular layers  192, 193f simple continuous suture  192, 193f stay sutures  192, 193f using Metzenbaum scissors  192, 192f rumen tympany  169

s

salivary fistulas  107 saphenous vein: complications  64 equipment  63 gastrocnemius muscle, proximal tibia  63, 64f patient monitoring  64 procedure  63–64 restraint/position  63 Sarcocystis spp.  155 Sarcoptes  121 Schirmer tear test values  290 scrotal castration  273–275 scrotal vs. prescrotal techniques  275 scrotum/testicles examination: complications  265 cryptorchidism  264 epididymides  264, 265 equipment  264 germinal epithelium  265 hyperechoic/hypoechoic lesions  265 mean testicular size and testosterone  264, 265t

patient monitoring  265 procedure  264–265 restraint/position  264 ultrasonography  265 sedation/tranquilization: complications  35–36 equipment  33 patient monitoring  36 procedure  33–35 restraint/position  33 reversal protocols  34t segmental aplasia  225 semen collection/evaluation: adjacent warm water system  269, 269f artificial insemination  267 artificial vagina  269, 269f aspiration, seminal fluids  268, 268f breeding maturity  267 characteristics  270 complications  271 cranial vaginal vault and cervix  268, 268f EEJ  269, 270, 270f equipment  267 genetics  267 mannequins  269 motility  270 patient monitoring  271 procedure  267–270 restraint/position  267 sperm cells  270 in vitro fertilization  267 warm water blanket/heating system  269, 269f semimembranosus/semitendinosus muscles  28, 33, 37 septic peritonitis  77 serum biochemistry  37 sheep  4, 11, 102, 174, 209, 217, 256, 259, 267 skin anatomy: caudal abdomen and groin regions  117, 119f dorsal interdigital space  117, 120f intact males, thick cervical skin  117, 119f

Index

metatarsal glands  117, 119f perineum and medial thigh, thin hair distribution  117, 118f procedure  117–120 restraint/position  117 tuberculin skin testing, thin fiber coat  117, 118f ventral abdomen, thin fiber distribution  117, 118f skin biopsy: complications  126 cutting edge  124, 125f equipment  124 instrument  124, 125f palmar aspect, zinc responsive dermatosis  124, 125f patient monitoring  126 procedure  124–126 restraint/position  124 Sarcoptes  124, 125f scissors/scalpel  126, 126f slight skin stretching  124, 125f thumb forceps  124, 126f skin scraping  119 complications  122–123 dorsal interdigital space  121, 122f equipment  121 exfoliated skin cells and debris  121, 122f mineral oil immersion  121, 122f patient monitoring  123 procedure  121–122 restraint/position  121 sarcoptic mange  121, 122f superficial scrapings  121, 122f skin tenting technique  76, 76f social outcast  4 social stress  3 sodium citrate  312 spinal cord  281 standing restraint: cursory oral examination  14, 15f ear squeeze  14, 15f front feet and bracing knee, sternum  16, 16f front pastern  16, 16f grasping head and neck  14, 15f

head and neck brace  15, 16f inner thigh and stifle  16–17, 17f insert needle, jugular vein  15, 16f jawbones (mandibles)  14, 15f pastern, grasped firmly and leg lifted  17, 17f relaxation, circular motion  19f stationary post  16, 16f submission posture, jugular bleeding method  15, 15f tail grasped at base  19f toenails inspected and trimmed  16, 17, 17f Staphylococcus aureus  237 sterile lubricant  45 sternal recumbency: back ropes fiited  19, 20f cannon bones  19, 20f cushed posture, head and neck  17, 18f front limb is lifted  17, 18f halter and lead rope  17, 18f head is pulled tightly  17, 18f maintained, head and front limb  17, 18f ropes/cattle hobbles  19, 20f self-protection mechanism  17 stranguria  212, 214 Streptococcus zooepidemicus  154 stripping  237 subcutaneous emphysema  51 subcutaneous (SC) injections  26, 26f, 33 subpalpebral lavage system: blue cap retainer ring  303, 304f clip hair and prep, eyelashes  301, 302f complications  304 cornea with gloved finger  301, 303f equipment  301 local anesthesia, 2% lidocaine  301, 302f materials needed  301, 302f patient monitoring  304 procedure  301–304 proparacaine, topical anesthesia  301, 302f restraint/position  301 tubing and protect cornea  301, 303f white tape wings  302, 303f

329

330

Index

t

teat/udder examination: anatomy  236–237 complications  238 equipment  236 milk and mastitis  237 nonpregnant, nonlactating adult female alpaca  236, 237f poor milkability  237–238 procedure  236–238 teeth trimming  97–98 testicular biopsy  265 tetanus toxoid  272 thorax anatomy/auscultation: diaphragmatic reflection  133, 134f equipment  133 pleural reflection  133, 133f procedure  133–134 restraint/position  133 thoracic organs  133, 134f threatening gestures  5 thrombophlebitis  60 toenail trimming  16 animal’s back and abducts  128, 129f carpus and fetlock  128, 129f complications  130 equipment  128 instruments  128, 128f overgrown  128, 130f patient monitoring  130 procedure  128–130 pruning shears  128, 129f restraint/position  128 v-shaped nail  128, 129f tolazoline  36, 40, 244 TonoPen.5®  290 TonoVet.5®  290 tooth extraction: lateral approach, premolars and molars  105–109 oral approach  100–104 tooth root abscesses  100, 105 total-nucleated cell counts (TNCC)  285 total protein (TP)  285, 286, 311 trace minerals  3

tracheotomy/tracheostomy: cervical musculature  136, 136f complications  138 direct tracheal intubation  137, 137f equipment  135 esophagus and cervical vasculature  136, 136f nonabsorbable suture material  137, 137f patient monitoring  138 procedure  48, 135–138 restraint/position  135 routine cleaning vs. suturing  137, 137f sternohyoideous and sternothyroideus muscles  136, 136f tracheal incision  136, 137f transtracheal wash (TTW): complications  145 equipment  143 infused fluid  144, 145f nested trocar set  144, 144f patient monitoring  146 polyethylene tubing  144, 145f procedure  143–145 resistance, lower airway  144, 145f restraint/position  143 stab incision  144, 144f transverse vertebral processes  143, 144f traumatic jugular puncture  28 tube placement  171–172, 171f tuberculosis testing  26

u

udder amputation. See mastectomy ultrasonography  228–230 upper motor neuron (UMN)  281 urethral catheterization: complications  210 corkscrew cartilaginous process  209, 209f equipment  208 3.5Fr polypropylene catheter  210, 210f 8Fr polypropylene catheter  208, 209f full exteriorization, penis  209, 209f intravenous catheter guide wire  210, 210f

Index

patient monitoring  210 penis and prepuce manipulation  209, 209f procedure  208–210 restraint/position  208 sampling, aspiration  208, 209f urethral diverticulum  205, 209f, 210, 256, 261 urethral obstruction  160 urinalysis  206, 207t, 211t, 218, 219t urinary bladder  187, 188, 205, 208, 210, 217 urinary system: clippers  212 complications  215 equipment  212 idiopathic polypoid cystitis  214, 215f large mucosal polyp  214–215, 215f left kidney, ultrasound image  213, 213f lumbar vertebrae  213, 213f patient monitoring  215 probe positioning  213, 213f procedure  212–215 prostate gland  214, 214f pubic eminence  214, 214f restraint/position  212 right kidney, smooth capsular appearance  213, 213f transabdominal ultrasound image  214, 214f ultrasound probes  212 urinary tract: anatomy  205 evaluation  205–207 exteriorized penis  205, 206f external urethral orifice  205, 206f normal prepucial conformation  205, 206f uroperitoneum  218 uterine torsion  160 clockwise and counter-clockwise torsions  247, 248 complications  251 corrective rolling procedure  249, 250f diagnosis  248, 249

dorsal oblique  249, 250f dorsal recumbency  249, 250f equipment  248 gestation  247 halter and leg ropes  249, 249f left lateral oblique position  249, 250f ligaments  248, 249 nongravid uterus  247 nonsurgical correction  247, 249–250 patient monitoring  251 procedure  247–250 rectal palpation  248, 248f restraint/position  248 right lateral oblique position  249, 250f right lateral recumbency  249, 249f sigmoidoscope, vaginoscopic examinations  248 terminology  247 vaginal speculum/transvaginal palpation  248

v

vaginoscopy/uterine culture: complications  235 equipment  232 guarded uterine culture  234, 234f hydraulic lift  234, 235f light source adaptor  233, 234f magnifying lens  232, 233f patient monitoring  235 procedure  232–235 restraint chute  234, 234f restraint/position  232 rigid sigmoidoscope  232, 233f sigmoidoscope light adaptor  232, 233f swab position  234, 234f vascular catheterization: auricular artery and vein  67–68 cephalic vein  61–62 femoral artery  69–70 jugular vein  55–60 lateral thoracic vein  65–66 saphenous vein  63–64 vasovagal response  299 ventral abdominal laparoscopy  187, 188

331

332

Index

ventral midline laparotomy: abdomen and abdominal wall  181, 182f approach  181 bladder palpated  181, 183f complications  184 equipment  180 fundus of C  3, 181, 182f ileocecal ligament  181, 182f operative findings  181, 181f patient monitoring  184 preparation  181 procedure  180–184 proximal loop, spiral colon  181, 182f restraint/position  180 #10 scalpel blade  181, 181f suture selection and patterns  183t

ventral sacs of C  1, 181, 182f wound closure  183–184 vertebral spondylitis/arthritis  257

w

walking sutures  241 warm-blooded mammal  33 wolf tooth extractor  101, 102f

x

xylazine  33, 35, 38–40, 218, 290

y

yohimbine  36, 40, 244

z

zinc responsive dermatosis  124, 125f

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