Camelid Clinical Procedures
After completing this chapter, you will be able to
• Set up and prepare the patient for each procedure, perform the procedure (when appropriate), or assist the clinician in performing diagnostic sampling and medication procedures
• Properly insert and maintain an intravenous catheter and monitor the catheter for complications
• Explain the rationale and indications for each of the clinical procedures described
• Set up materials and equipment and prepare the patient as needed for the procedure
• Provide assistance to the veterinarian when performing the procedure or perform the procedure when it may be appropriate for a veterinary technician to do so
• Perform or assist necropsy and sample collection procedures and maintain a safe environment during these procedures
Diagnostic Sampling
Venous Blood Sampling
Blood draws for camelids typically are performed in stocks. If stocks are not available, a wall or fence can be used to help decrease movement of the animal. If a wall or fence is used for venous blood sampling, it is important that the camelid be halter broke.
The hair can be clipped to help gain access to the vein; however, this should be avoided because the wool may take up to 18 months to regrow. The wool should be clipped only with the owner’s permission because some animals are used for show purposes.
Two techniques can be used to draw blood from a camelid: high neck jugular and low neck jugular. Use of the high neck jugular technique decreases the chance of arterial blood collection because the jugular vein is more superficial in this location than in the low venipuncture site.
High Neck Jugular Technique
The skin in the cervical vertebrae region can be almost 
thick, which can make the procedure more difficult. However, the more challenging aspect is the location’s protection provided by the transverse processes of the cervical vertebrae. To begin drawing blood from the high neck location, place the head of the animal so that the nose is completely perpendicular to the cervical vertebrae. The nose should not be tipped up or down. Palpate the sternomandibularis tendon. From this anatomical landmark, draw a line along the tendon and insert the needle at the location just dorsal and caudal. Insert the needle where the two lines connect.
Distension of the vein is not common and should not be relied upon as confirmation of vein location. However, flicking of the vein may lead to waves of blood felt in the occluding fingers. The technician then should insert an 18- to 20-gauge (ga) × 
-inch-long needle. Digital pressure should be applied following needle withdrawal to help prevent hematoma formation. Hematoma formation is more common in camelids than in other species, especially neonates, so care should be taken to prevent hematoma formation.
Low Neck Jugular Technique
The low neck jugular venipuncture should be performed with the animal in stocks or performed against a fence or wall if the camelid is halter broke. To begin, elevate the camelid’s head. The anatomical location of interest for this method of collection is the enlarged transverse process of the sixth cervical vertebrae. The jugular vein lies just medial to this process. Care should be taken to avoid the carotid artery, which is also located just medial to the process and can be identified by its pulsating. The technician should begin by occluding the vein. Confirmation of the jugular can be identified visually by observation of its filling when it is occluded between the fifth and sixth cervical vertebrae (Fig. 19-1). The needle then can be inserted. Use of an 18- to 20-ga × 
needle is recommended.
Arterial Blood Sampling
Arterial blood sampling can readily be performed from the low neck jugular venipuncture location, which allows for readily palpatable pulsing, as in the low neck venipuncture location. Tables 19-1 and 19-2 list normal blood chemistry values for llamas and alpacas, respectively.
TABLE 19-1
Llama’s Complete Blood Count Normal Values
| COMPLETE BLOOD COUNT | |
| Packed cell volume | 29%–39% |
| Hemoglobin | 12.8–17.6 g/dl |
| Red blood cells | 11.3–17.5 × 106 µl |
| Total protein | 5.8–7 g/dl |
| White blood cells | 7.5–21.5 × 103/µl |
| Platelets | × 105/µl |
| Mean corpuscular volume | 21–28 fl |
| Mean corpuscular hemoglobin | 43.2–46.6 pg |
| Mean corpuscular hemoglobin concentration | g/gl |
| Bone marrow | Myeloid-to-erythroid ratio |
| DIFFERENTIAL, ABSOLUTE | |
| Segs | 4.6–16 |
| Bands | 0–0.35 |
| Lymphocytes | 1–7.5 |
| Monocytes | 0.05–0.8 |
| Eosinophils | 0–3.3 |
| Basophils | 0–0.4 |
TABLE 19-2
Normal Blood Chemistry Values for Llamas
| Blood urea nitrogen | 13–32 mg/dl |
| Creatinine | 1.5–2.9 mg/dl |
| Glucose | 90–140 mg/dl |
| Albumin | 3–5 g/dl |
| Total bilirubin | 0–0.1 mg/dl |
| Aspartate aminotransferase | 110–250 µ/L |
| γ-Glutamyl transferase | 5–29 µ/L |
| Creatine kinase | 30–400 µ/L |
| Alkaline phosphatase | 30–780 µ/L |
| Lactate dehydrogenase | 50–300 µ/L |
| Sodium | 147–158 mEq/L |
| Potassium | 4.3–5.6 mEq/L |
| Chloride | 106–118 mEq/L |
| Calcium | 7.7–9.4 mg/dl |
| Phosphorus | 4.6–9.8 mg/dl |
| Magnesium | 1.5–3 mg/dl |
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