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Stomach Ulcers in Alpacas and Llamas

Stomach Ulcers in Alpacas and Llamas
By Stephen R. Purdy, DVM

Normal Stomach Anatomy

  • 3 compartments:
    • C1- 83% by volume of stomach contents (15- 25 liters)
    • C2- 6% by volume (1- 2 liters)
      • C1 and C2 contents freely intermix
      • bicarbonate secreted in ventral saccules of C1 and C2 to buffer pH in C1
    • C3- a tubular structure
      • first 3/4 is glandular ~ saccules of C1 and C2
      • last 1/4 has acid-secreting glands- ph 1.4- 2.0
  • peristaltic contractions mix stomach contents with secreted acid
  • very little is known about the control of acid secretion in camelids
  • protective mechanisms preventing autodigestion of the stomach lining are thought to be similar to other species
  • ulcers occur mostly in acid-secreting zone of C3 and upper duodenum

Clinical Signs Of Ulcers: alpacas and llamas are very stoic animals!

  • depression/ lack of appetite
  • ~1/3 of cases show colic- shifting weight, grinding teeth, frothing at the mouth, rolling, getting up and dow
  • not often feveris
  • decreased manure production
  • may be obscured by other disease conditions which might be the cause of the ulcers

Proposed Mechanisms of Ulcer Formation in Camelids

  • stress- serious or chronic diseases increase the incidence of ulcers
    • high incidence with colic cases at referral hospitals
    • found in animals dying of any cause with no premortem signs of ulcers
    • complicated orthopedic problems- pain may predispose to major trauma, e.g. dog bites
    • overcrowding
    • travel- long distance, hot weather, and nervous temperament animals
    • weaning- delay if cria has health problems
    • isolation from other animals- have to see other camelids ( they are herd animals)
  • glucocorticoids- cortisones- topical, oral or injectable can cause ulcer formation
  • non-steroidal anti-inflammatory drugs such as Bute and Banamine
    • not as often as in horses, but don’t use a long time
  • bacteria- not isolated in lamas as in people
  • excessive acid secretion- no evidence either way that this contributes to ulcer formation in camelids
  • dietary causes?
    • high grain diets?? – seen in cattle
    • low incidence in S. America where little grain is fed
    • small particle size pellets?? – causes ulcers in pigs

Diagnosis of Ulcers

  • clinical signs
  • no specific blood tests
  • abdominal exploratory surgery- A bad idea in an already stressed animal
  • dark stools indicating the presence of digested blood are not seen
  • decreased bacteria and protozoa in C1 contents sample from stomach tube
  • C1 pH < 4.0 on stomach tube sample
  • abdominal tap is usually normal unless perforation has occurred

Differential Diagnoses:

  • intestinal torsions- rare
  • uterine torsion- last 60 days of gestation
  • impactions- should see significant dehydration
    • enemas in newborn crias could prevent
  • abdominal tumors- rare
  • intussusception- rare
  • peritonitis- uncommon, except with perforating ulcers
  • urinary tract problems- males- ruptured bladder/urethral stones-uncommon
  • intra-abdominal abscesses- uncommon- abdominal tap shows increased WBCs, or possibly increased serum globulin level
  • toxic plants- Rhododendron
  • C1 stasis (lack of stomach motility)
    • in adults off feed greater than 3- 4 days
    • in crias with repeated tubing
  • lactic acidosis- overeating grain- C1 stasis- low C1 pH

Management of Ulcers

  • Oregon State University Vet School- most occur as secondary problems (this has also been my experience)
  • some cases at Colorado State University Vet School have resulted in secondary pneumonia
  • ulcers in newborns in New England

relatively high mortality, so treat aggressively!!!

  • suppress acid production
    • antihistamines (H2 blockers)
      • Zantac (ranitidine)- perhaps the best drug for treatment of ulcers
        • 0.75 mg/lb IM, subQ, or IV two times daily (once daily for prevention)
        • not effective orally
      • Prilosec (omeprazole)- good orally at 0.5 mg/lb PO BID (once daily for prevention)
        • open capsule into 12 ml syringe (with tip end cut off) with KY and squirt into mouth
  • nonspecific C3 protection- sucralfate (Carafate)- 10 mg/lb orally four times a day- not very effective in adults
  • stress reduction!!!!!
    • resolve the primary problem
    • cohousing with herdmates
  • IV fluids/ prophylactic antibiotics
  • preventative treatment when a severe primary disease is present
    • Zantac or Prilosec once daily
    • do not let the treatment worsen the disease

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