• 1.

    Fowler ME, Zinkl JG. Reference ranges for hematologic and serum biochemical values in llamas (Lama glama). Am J Vet Res 1989;50:20492053.

    • Search Google Scholar
    • Export Citation
  • 2.

    Garry F. Clinical pathology of llamas. Vet Clin North Am Food Anim Pract 1989;5:5570.

  • 3.

    Cebra CK. Hyperglycemia, hypernatremia, and hyperosmolarity in 6 neonatal llamas and alpacas. J Am Vet Med Assoc 2000;217:17011704.

  • 4.

    Dolente BA, Lindborg S, Palmer JE, et al. Culture-positive sepsis in neonatal camelids: 21 cases. J Vet Intern Med 2007;21:519525.

  • 5.

    Welles EG, Pugh DG, Wenzel JGW, et al. Composition of cerebrospinal fluid in healthy adult llamas. Am J Vet Res 1994;55:10751079.

  • 6.

    McKenzie E. Management and diseases of neonatal camelids in the early post-partum period, in Proceedings. 26th Annu Vet Med Forum Am Coll Vet Intern Med 2008;228231.

    • Search Google Scholar
    • Export Citation
  • 7.

    Abutarbush SM, Petrie L. Treatment of hypernatremia in neonatal calves with diarrhea. Can Vet J 2007;48:184187.

  • 8.

    Griffel MI, Kaufman BS. Pharmacology of colloids and crystalloids. Crit Care Clin 1992;8:235253.

  • 9.

    Cebra CK, McKane SA, Tornquist SJ. Effects of exogenous insulin on glucose tolerance in alpacas. Am J Vet Res 2001;62:15441547.

  • 10.

    Cebra CK, Tornquist SJ, Van Saun RJ, et al. Glucose tolerance testing in llamas and alpacas. Am J Vet Res 2001;62:682686.

  • 11.

    Ueda J, Cebra CK, Tornquist SJ. Assessment of the effects of exogenous long-acting insulin on glucose tolerance in alpacas. Am J Vet Res 2004;65:16881691.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Cebra CK, Tornquist SJ. Evaluation of glucose tolerance and insulin sensitivity in llama crias. Am J Vet Res 2005;66:10131017.

  • 13.

    Middleton JR, Johnson GC, Pardo I, et al. Dysautonomia and salmonellosis in an 11-year-old female llama (Lama glama). J Vet Intern Med 2006;20:213216.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Anderson DE, Constable PD, Yvorchuk KE, et al. Hyperlipidemia and ketonuria in an alpaca and a llama. J Vet Intern Med 1994;8:207211.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Saulez MN, Cebra CK, Valentine BA. Necrotizing hepatitis associated with enteric salmonellosis in an alpaca. Can Vet J 2004;45:321323.

  • 16.

    Van Saun RJ, Callihan BR, Tornquist SJ. Nutritional support for treatment of hepatic lipidosis in a llama. J Am Vet Med Assoc 2000;217:15311535.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Waitt LH, Cebra CK. Characterization of hypertriglyceridemia and response to treatment with insulin in llamas and alpacas: 31 cases (1995–2005). J Am Vet Med Assoc 2008;232:13621367.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Waitt LH, Cebra CK, Firshman AM, et al. Cryptosporidiosis in 20 alpaca crias. J Am Vet Med Assoc 2008;233:294298.

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Use of a constant rate infusion of insulin for the treatment of hyperglycemic, hypernatremic, hyperosmolar syndrome in an alpaca cria

Teresa M. BuchheitDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Carla S. SommardahlDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Nicholas FrankDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Jerry R. RobersonDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Abstract

Case Description—A 3-day-old 9.5-kg (21-lb) female alpaca cria was examined because of lethargy and anorexia.

Clinical Findings—Physical examination revealed hyperthermia, muscle fasciculations, and tremors of the head. Seizures were also observed, which indicated CNS dysfunction. Hyperosmolar syndrome (HOS) was diagnosed on the basis of hyperglycemia, hypernatremia, azotemia, high plasma osmolarity, and metabolic acidosis.

Treatment and Outcome—A constant rate infusion of regular insulin was administered with hypo-osmolar fluids to treat HOS, and blood glucose and sodium concentrations were successfully lowered. Neurologic deficits resolved with treatment, and the cria was discharged 11 days after admission.

Clinical Relevance—Administration of insulin as a bolus in addition to hypo-osmolar fluids has been advocated in the management of neonatal camelids with HOS. Administration of regular insulin via a constant rate IV infusion was used to successfully manage a neonatal camelid with HOS. This form of insulin administration may allow more control of glucose kinetics in these patients.

Abstract

Case Description—A 3-day-old 9.5-kg (21-lb) female alpaca cria was examined because of lethargy and anorexia.

Clinical Findings—Physical examination revealed hyperthermia, muscle fasciculations, and tremors of the head. Seizures were also observed, which indicated CNS dysfunction. Hyperosmolar syndrome (HOS) was diagnosed on the basis of hyperglycemia, hypernatremia, azotemia, high plasma osmolarity, and metabolic acidosis.

Treatment and Outcome—A constant rate infusion of regular insulin was administered with hypo-osmolar fluids to treat HOS, and blood glucose and sodium concentrations were successfully lowered. Neurologic deficits resolved with treatment, and the cria was discharged 11 days after admission.

Clinical Relevance—Administration of insulin as a bolus in addition to hypo-osmolar fluids has been advocated in the management of neonatal camelids with HOS. Administration of regular insulin via a constant rate IV infusion was used to successfully manage a neonatal camelid with HOS. This form of insulin administration may allow more control of glucose kinetics in these patients.

Contributor Notes

Dr. Buchheit's present address is Countryside Veterinary Services, 2930 Little Dug Gap Rd, Louisville, TN 37777.

Address correspondence to Dr. Buchheit (tbuchheit@countrysidevetservices.com).