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


agritourism barn and pasture management behavior Berserk Male Syndrome biocontainment and biosecurity birth book review bottle feeding breeding celiotomy cestodes choke climate change coccidia cold weather colic community outreach community outreach and public relations conformation COVID cria Cryptosporidium diarrea Diarrhea differences digestion disease distress calls driving dystocia ears ears and hearing Ear Ticks eating equipment Evacuation Plan events fairs & shows events shows and fairs eye eyes female anatomy fiber first aid giardia guarding guarding and predators halter fit haltering a llama or alpaca hay testing health hearing heat safety heat stress heat stress in alpacas heat stress in llamas herd behavior and management herd management hiking history history of camelids how to catch a llama or alpaca hydrotherapy hypothermia industry history infections intestinal intestines judging knitting labor and delivery leading lesions Lewis lice llama and alpaca behavior llama and alpaca training llama ear ticks loading male anatomy manure Meloxicam mental capability mentoring mouth nematodes neonatal nutrition obstruction older animals orgling outreach packing pain pandemic parasites performance Peru poisonous plants predators pregnancy protozoa purchasing purchasing considerations rabies Rescue RMLA History RMLA library Safety scent glands shade shearing showing soil spinning stomach stomach ulcers teeth trailer trailers training training expectations trichostrongylus uterine prolapse Vaccinations valley fever water weaving West Nile Virus Wry face young animals Youth youth program

Want to join RMLA?

RMLA is open to and welcomes all people interested in becoming members.