Surgical correction of metacarpophalangeal valgus deformity in an alpaca

A 1-month-old alpaca cria presented with a 13 degree valgus deformity of the left metacarpophalangeal joint. The angular limb deformity was centered on the distal metacarpal physes. Transphyseal bridging of the physes was recommended. Two 2.7 mm cortical bone screws were placed either side of the distal metacarpal physes and a figure of eight wire was placed medially around the screw heads. The screws extended through the medial metacarpus into the axial cortex of the lateral metacarpus. Seven weeks after surgery the limb was straight and the screws and wire were removed. Transphyseal bridging of the distal metacarpal physes can be effectively used for the treatment of metacarpophalangeal valgus in crias with open physes.     

Arthrotomy,curettage and medical management of septic arthritis and osteomyelitis of the temporomandibular joint in a horse

Osteomyelitis and/or bone sequestra are commonly reported in equids following traumatic wounds. This report describes the clinical management and outcome following an arthrotomy of the temporomandibular joint of a 1-year-old Quarter Horse gelding with septic osteomyelitis and arthritis. Computed tomography was used for further assessment of the lesions within the temporomandibular joint and helped guide surgical planning.     

The diagnosis and treatment of a thoracic abscess in an alpaca

A 6-month-old alpaca presented for lethargy, failure to thrive and leucocytosis. Diagnostic procedures, including thoracic ultrasound, radiographs and a computed tomography scan, were used to document a thoracic mass. Based on appearance and ultrasound-guided aspiration of purulent material, the mass was determined to be a large abscess. The abscess was treated with surgical drainage and long-term antibiotic therapy. The origin of this thoracic abscess was felt to be the caudal mediastinum, secondary to bacterial seeding of the caudal mediastinal lymph nodes. Although an aetiological agent was not definitively determined, the most likely was Actinomyces spp or Arcanobacterium pyogenes. The alpaca made a complete recovery following treatment.     

Surgical treatment of scapulohumeral subluxation in an alpaca (Vicugna pacos) using osteotomy of the acromion,open reduction and extracapsular tension sutures

CASE HISTORY AND CLINICAL FINDINGS: A 3.3-year-old male alpaca, weighing 60?kg was referred for investigation of a severe left forelimb lameness of 4 weeks duration. A scapulohumeral subluxation had been diagnosed radiographically by the referring veterinarian.

CLINICAL FINDINGS AND DIAGNOSIS: Based on clinical, ultrasonographic and radiographic findings the diagnosis of cranio-lateral subluxation of the left humeral head was confirmed. In addition, a full thickness lesion (approximately 1?×?1?cm) of the articular cartilage on the caudomedial aspect of the humeral head was diagnosed by arthroscopy.

TREATMENT AND OUTCOME: Treatment included open reduction with internal fixation. Severe muscle contraction and local tissue fibrosis around the scapulohumeral joint (SHJ) required osteotomy of the acromion 3?cm proximal to the distal acromial edge, to allow adequate access. Internal stabilisation was achieved by placing tension band sutures between one cortical screw in the scapular neck and two cortical screws, with washers, craniolaterally on the greater tubercle of the humerus. Post-surgery, a carpal flexion sling was applied with the carpus maintained in 70° flexion for 4 weeks to avoid postoperative weight-bearing. An exercise programme was started 8 days after surgery and continued for 12 weeks. The alpaca had an uneventful postsurgical recovery and showed no lameness after 8 weeks. The long-term outcome was excellent; 21 months after surgery the alpaca was sound and the range of movement of the left SHJ was equal to the right SHJ.

CLINICAL RELEVANCE: Even in this chronic case of subluxation of the SHJ of 4 weeks duration, surgical treatment using osteotomy of the acromion, open reduction and internal fixation with extracapsular scapulohumeral tension sutures resulted in an excellent long-term outcome in this alpaca, despite the presence of a cartilage lesion.     

Bovine xenograft application for treatment of a metatarsal nonunion fracture in an alpaca (Vicugna pacos)

CASE HISTORY: A 15-year-old female huacaya alpaca (Vicugna pacos) was referred because of a non-weight-bearing lameness (4/4) in the left pelvic limb caused by a grade three open metatarsal fracture. The referring veterinarian treated the fracture with conservative management using bandages, but it progressively evolved to a non-union.

CLINICAL FINDINGS AND DIAGNOSIS: Clinical examination revealed external wounds on the medial and lateral surfaces of the metatarsus. Radiographs confirmed an open, nonarticular, displaced, diaphyseal fracture of the left metatarsus.

TREATMENT AND OUTCOME: Cancellous bone was sourced from bovine proximal and distal femur epiphyses, followed by a thermal shock procedure to achieve decellularisation, to produce a xenograft. Open reduction and internal fixation of the fracture using locking plates was performed. Alignment of the fracture fragments was corrected and the xenograft was placed at the debrided fracture site to stimulate and harness osteogenesis in situ. Clinical and radiographic follow-up was performed up to 40 weeks postoperatively. Clinical evaluations revealed that the alpaca gradually increased weight bearing following bandage removal 10 days after surgery. Serial radiographs showed correct alignment of the left metatarsus, progressive bone modelling and, complete bone union at 12 weeks. Ten months postoperatively the alpaca showed no signs of lameness and resumed normal activity.

CLINICAL RELEVANCE: For management of a metatarsal non-union, a combination of bovine xenograft application and angular stable internal fixation progressed toward an excellent long-term recovery.     

Septic arthritis of the first and second cervical vertebral articulations with vertebral osteomyelitis in a foal caused by Salmonella

A case of infectious arthritis of a cervical vertebral articulation and vertebral osteomyelitis in a foal caused by Salmonella is described. Ultrasound images of the cervical facet joints were suggestive of septic arthritis and ultrasound facilitated needle placement for arthrocentesis and joint lavage. Due to the uncommon location of the infection, diagnosis of septic arthritis was not immediate and, despite aggressive intra‐articular lavage and instillation of appropriate intra‐articular antibiotics after hospitalisation, we were unable to resolve the infection in this foal. Radiographs did not show evidence of osseous involvement until later in the course of the infection. Septic arthritis should be suspected in cases with similar clinical and laboratory findings and radiographic changes may not be present early in the course of infection. Ultrasound imaging provided the most useful diagnostic information regarding infection of the cervical joints, facilitating both diagnosis and treatment.     

Diffuse osteomyelitis of the fourth metacarpal bone in a horse caused by Clostridium perfringens

Osteomyelitis in adult horses, often associated with trauma or iatrogenic infection following surgery, usually presents as a focal area of infected bone. Diffuse osteomyelitis, affecting both the cortex and medulla, along the full length of a bone is encountered less frequently and treatment of such infections is not well reported in horses. The 2-year-old Warmblood mare in this case was diagnosed with diffuse osteomyelitis affecting the 4th metacarpal bone with concurrent unicortical fracture of the third metacarpal bone following traumatic injury. Computed tomography (CT) aided diagnosis in this case, providing critical additional detail to that obtained with radiography and ultrasound. This case highlights the value of CT in the diagnosis of diffuse osteomyelitis. This is the first reported case of diffuse osteomyelitis caused by Clostridium perfringens in horses. Successful treatment in this case consisted of surgical debridement of the associated abscess, followed by systemic and locoregional antimicrobial therapies.     

Localization of orexin B and receptor 2 for orexins in testicular cytotypes of the camelid alpaca (Vicugna pacos)

The orexins A (OxA) and B (OxB) are two hypothalamic peptides involved in many physiological functions of the mammalian body. They act through the binding of two G‐coupled receptors named receptor 1 (OX₁) and receptor 2 (OX₂) for orexins. The first receptor is specific for OxA, while the second binds both the substances with equal affinity. The orexins and the relative receptors have been traced by means of different techniques also at the periphery of the body and particularly in the adrenals, and in gastrointestinal and genital organs. Aim of this work was to investigate the presence of OxB and OX₂ by means of immunohistochemistry and Western blotting analysis in the testis of the South American camelid alpaca, a species primarily breed in Chile and Ecuador and recently diffused in Europe where the quality of its wool is particularly appreciated. OxB immunoreactivity (IR) was found in the tubular compartment of the testis where spermatogonia (resting), zygotene and pachytene spermatocytes, and spermatids clearly showed differently sized and shaped cytoplasmic positive structures. OX₂‐IR was found both in the interstitial and tubular compartments of the testis and particularly in Leydig cells and round and elongated spermatids. Western blotting analysis of testis lysates showed the presence of a protein band whose molecular weight corresponded to that currently assigned to OX₂. Such findings easily translate the hypothesis that OxB and its receptor 2 play a functional role both in the interstitial and tubular compartments of the alpaca testis.     

Diagnosis and treatment of torsion of the spiral colon in an alpaca

A 14-year-old 61.7-kg (136-lb) alpaca was examined for colic of 24 hours' duration. An exploratory celiotomy was performed because of lack of response to medical treatment and ultrasonography revealed an abnormally large amount of free fluid in the peritoneal cavity. Exploration of the abdomen revealed a 20-cm diameter mass, consisting of most of the ascending colon. The spiral colon was thick and edemetous, and it was decided to resect the spiral colon. Following a few complications, the alpaca was discharged 17 days after surgery. Colic in camelids is considered a severe problem because clinical signs are subtle and often not recognized until the condition is untreatable. Camelids are reported to be stoic animals, and may have few signs of pain despite severe abdominal disease. Alpacas with signs of abdominal pain should undergo early and complete physical, laboratory, and diagnostic imaging evaluations. Rapid identification of the need for surgery is vital for a successful outcome.     

Prevalence of Candidatus Mycoplasma haemolamae,bovine viral diarrhoea virus,and gastrointestinal parasitism in a sample of adult New Zealand alpaca (Vicugna pacos)

AIM: To determine the prevalence of infection with Candidatus Mycoplasma haemolamae (Mhl), antibodies to bovine viral diarrhoea virus (BVDV), and BVDV antigen, and the prevalence of animals with elevated faecal nematode egg counts (FEC) in a sample of adult New Zealand alpaca (Vicugna pacos).

METHODS: Blood samples were obtained from 175 alpaca, collected from 15 farms around New Zealand, and from 31 samples sent to a diagnostic laboratory for routine haematology. Blood smears (n=170) were examined microscopically for the presence of haemoplasma, and DNA was extracted from whole blood (n=206) for real-time PCR testing for Mhl. Packed cell volume (PCV) was determined for 193 samples. Serum samples (n=195) were tested for BVDV antibody using ELISA, and for BVDV antigen using a real-time PCR assay. Faecal samples were collected from 143 animals; FEC were measured, and samples pooled for larval culture.

RESULTS: No haemoplasma organisms were present on blood smear examination. Of the 206 blood samples, two (from the same farm) were positive for Mhl by real-time PCR testing, giving a prevalence of infection with Mhl of 0.97%. Of the 195 serum samples tested, four (2.1%) were positive for antibodies to BVDV; animals with BVDV antibodies were from 3/15 (20%) farms, none of which farmed cattle. None of the serum samples were positive by PCR for BVDV antigen. The median FEC was 50?epg (min 0, max 4,700), with 55/143 (38.5%) samples having 0?epg, and 33/143 (23.1%) having ≥250?epg. Haemonchus spp. were the most common nematodes present in faecal larval cultures from the North Island. Log₁₀ FEC was negatively associated with PCV (p=0.02), and was higher in males than females (p<0.001), and in animals that were positive compared with negative for Mhl (p=0.022).

CONCLUSIONS AND CLINICAL RELEVANCE: The number of alpaca infected with Mhl was low, as was the seroprevalence of BVDV. Gastrointestinal parasitism was, however, a common finding in this sample of New Zealand alpaca.     

Tuberculosis in alpaca (Lama pacos) on a farm in Ireland. 2. Results of an epidemiological investigation

Tuberculosis (TB), due to infection with Mycobacterium bovis was diagnosed in a flock of alpaca in Ireland in 2004. An epidemiological investigation was conducted to identify the risk of TB for farmed alpaca where TB is endemic, the origin of the infection, the potential for alpaca-to-alpaca transmission and appropriate control measures. The investigation focused on the alpaca flock (including the farm, animal movements and breeding, feeding and flock health practice), the disease episode (including animal disease events and subsequent control measures) and TB infection risk in the locality. The TB risk to alpaca is high in areas where infection is endemic in cattle and badgers and where biosecurity is inadequate. It is most likely that the source of infection for the alpaca was a local strain of M. bovis, present in cattle in this area since at least 2001. Genotyping of isolates identified a single variable number tandem repeat (VNTR) profile in both cattle and alpaca in this region. Although a tuberculous badger was also removed from the vicinity, bacterial isolation was not attempted. On this farm, infection in alpaca was probably derived from a common source. Alpaca-to-alpaca transmission seems unlikely. Two broad control strategies were implemented, aimed at the rapid removal of infected (and potentially infectious) animals and the implementation of measures to limit transmission. Tests that proved useful in detecting potentially-infected animals included measurement of the albumin-to-globulin ratio and regular body condition scoring. Skin testing was time consuming and unproductive, and early detection of infected animals remains a challenge. The flock was managed as a series of separate groupings, based on perceived infection risk. No further TB cases have been detected.     

Surgical treatment of osteomyelitis in the metacarpal and metatarsal bones of the horse.

The case histories of four horses with osteomyelitis involving the metacarpal and metatarsal bones are reviewed and the surgical treatments discussed. The horses recovered after curettage of all infected tissue and post operative drainage. The role of antibiotics in treatment is considered and reference is made to the acute treatment of deep wounds to avoid osteomyelitis.     

Diagnosis and treatment of Eimeria macusaniensis in an adult alpaca with signs of colic

A young adult pregnant alpaca was presented with an acute episode of abdominal pain. Hematology revealed mild anemia, neutropenia with a degenerative left shift and moderate toxic changes in neutrophils, hyperfibrinogenemia, hypoproteinemia, and hypoalbuminemia. Abdominal ultrasound showed a small intestinal segment with severely increased wall thickness and collapsed lumen. Exploratory laparotomy revealed a markedly thickened 60 cm jejunal segment with reddened serosa from which a full-thickness biopsy and samples for bacterial culture were obtained. Histopathology revealed severe coccidian enteropathy with secondary bacterial enteritis. Anaerobic culture yielded Clostridium perfringens, while fecal sugar flotation yielded Eimeria macusaniensis and Eimeria punoensis. The alpaca was treated with broad-spectrum antimicrobial drugs, sulfadimethoxine, and anti-inflammatory drugs. The alpaca made a gradual recovery and had a term pregnancy. This communication demonstrates the potential pathogenicity of E. macusaniensis in adult alpacas. Coccidian enteropathy should be considered in adult alpacas with gastrointestinal signs including acute abdominal pain and hypoproteinemia.     

Treatment of temporary upward fixation of the patella in an alpaca by abrasion trochleoplasty and imbrication of the medial retinacular fascia

A two-year-old female alpaca suddenly became lame on its right hindlimb. Eight days later clinical and radiographic examinations showed that the patella had become temporarily fixed within the supratrochlear notch of the femur. Under general anaesthesia an abrasion trochleoplasty followed by fascial imbrication was carried out. After two weeks in supporting slings, the animal put full weight on the leg, and six months after the surgery it showed no signs of lameness or recurrence of the upward fixation.