Sedation of Camelids!

Question 1

The external jugular vein lies deep to what muscles? and other structures?

Answer 1

lie deep to
the sternomandibularisand brachicephalicusmuscles,
ventral to the cervical vertebral transverse processes,
and superficial to the carotid artery and vagosympathetic trunk within the carotid sheath for
most of their length

Question 2

Acepromazine helps facilitate?

Answer 2

Handling

Question 3

What camelids would you use ace in?

Answer 3

Used commonly in Bactrian and
Dromedary
Not very useful in SAC

Question 4

What are the sedation signs of acepromazine?

Answer 4

Droop of eyelid and lower lip

Question 5

What are the effects of alpha-2s in camelids?

Answer 5

Sensitive species (half-way between bovine and
horses)
 Alpaca may require higher dose than llama
 Cause hypoxemia and hypoventilation in llamas
and alpacas

Question 6

What reversals can you use for alpha-2s in camelids and which one should you be most careful with?

Answer 6

 Yohimbine 0.12 mg/kg IV/IM (Riebold, 1996)
 Atipemazole – 0.03-0.06 mg/kg IM/IV (Waldridge,
1997)
 Tolazoline (Read, 2000) – 1 mg/kg GIVEN SLOWLY IV
or IM to effect
 Tolazoline toxicity >2 mg/kg IV
 Anxiety, convulsions, salivation, hypotension,
diarrhea, cardiac arrest

Question 7

Why would you use butorphanol?

Answer 7

Adjunct to increase degree of
sedation
 Insufficient data on analgesic
properties
 Minimal cardiovascular effects in
alpacas

Question 8

What is morphine used for?

Answer 8

Reliable analgesia inconsistent among
individuals

Question 9

Why is important to dose morphine correctly?

Answer 9

Muscle tremors observed with 0.5
mg/kg, so a regimen of 0.25 mg/kg
q4h is recommended

Question 10

What is the ketamine stun combo?

Answer 10

BKX - butorphanol, ketamine and xylaxine

Question 11

BKX will cause

Answer 11

RECUMBENCY - Sternal (cushed) or
lateral

Question 12

WHat are some common induction agents in camelids?

Answer 12

Xyla+ket
Xyla+ket with a benzo
Guaifenesin + ket
Propofol
Alfaxolone

Question 13

In terms of duration and recovery how does Alfaxalone effect these in camelids?

Answer 13

• Longer duration of anesthesia with Alfaxalone
• VERY poor recovery (paddling, twitching, uncoordinated rolling over)

Question 14

How do you intubate alpacas?

Answer 14

• Nasal – Blind (Riebold, 1994)
• Oral – Direct Visualization
  –> Same technique as small ruminants
  –> Laryngoscope and stylet

ALPACAS ARE OBLIGATE NASAL breathers

Question 15

How do you intubate llamas?

Answer 15

• Depends on size
• Nasal – Blind (Riebold, 1994)
• Oral – Direct Visualization
  –> Laryngoscope and stylet
• Oral – Palpation
  –> Same technique as bovine

Question 16

Anesthesia is maintained on injectables?

Answer 16

Triple Drip
 Guaifenesin 5%, 50 mg/mL +
 Ketamine 0.1%, 1 mg/mL +
 Xylazine 0.02%, 0.2 mg/mL
 Mixed together and given
at 2.2 mL/kg/hr IV

Question 17

How is anesthesia maintained on inhalants?

Answer 17

Isoflurane
 MAC: 1.1%
Sevoflurane
 MAC: 2.3%
Desflurane
 MAC: 8%

These are a little lower than other spp.

Question 18

How do you monitor anesthetic depth in camelids?

Answer 18

• Slow palpebral reflex of the upper
  eyelid if elicited
  –> Surgical plane of anesthesia
• Spontaneous blinking
  –> Insufficient depth
• Spontaneous/stimulated closure of lower eyelid (aka “crinkling”)
  –>Insufficient depth
• Jaw tone –As in small ruminants
• All other parameters are monitored as
  in other species

Question 19

How should you position them while they recover?

Answer 19

Sternal recumbency with elevated
head
IV catheter STAYS in place
throughout recovery

Question 20

What are some potential complicatiosn during recovery?

Answer 20

UPPER AIRWAY
OBSTRUCTION
Keep intubation equipment with
you
May need temporary tracheostomy

Question 21

What are some other techniques for recovery?

Answer 21

• Draining liquid and cleaning mouth from any foreign
  material
  Observing patient closely during recovery
• Keeping IV access

Question 22

When should you extubate?

Answer 22

Extubation only when signs of FULL RECOVERY:
- Swallowing & jaw movements
- Coughing & shivering
Extubation with ETT cuff semi-inflated if regurgitation
Noisy breathing after extubation MUST be investigated
immediately

Question 23

What are some common post-anesthetic complications?

Answer 23

• Airway Obstruction
• Regurgitation (leads to aspiration
  pneumonia)
• Prolonged recovery (reversal?)
• Ruminal tympany (impeded
  eructation)
• Neuropathies (nerve damage)
• Myopathy (rare)
• Hypothermia

Question 24

Which two muscles make it difficult to place a jugular catheter in an alpaca?

Answer 24

sternomandibularis and brachiocephalicus

Question 25

In adaptation to living at high altitudes, all of the following are true of llamas and alpacas EXCEPT:
- Eliptical shape of RBCs to exhance oxygen exchange
- High red blood cell count
- Lower oxygen requirements
- Increased capillary density in tissues to make utilization more efficient

Answer 25

• Eliptical shape of RBCs to exhance oxygen exchange
• High red blood cell count
• **Lower oxygen requirements **
• Increased capillary density in tissues to make utilization more efficient

Question 26

Which of the followings is the most practical regimen for general anesthesia of 20 minutes duration in the llama?

Answer 26

Inject xylazine and ketamine IM in combination

Question 27

While drug combinations are often better, which of the following drugs used alone can be used to successfully sedate a camelid?

Answer 27

dexmedetomidine