7 minute read
Unpacking caesareans
from Alpaca Issue 87
by KELSEY Media
Ami Sawran, Westpoint Farm Vets, off ers an overview of decision making in obstetrical emergencies – being informed can help deliver the best outcome in a diffi cult situation.
There is a certain amount of worry surrounding caesarean
sections in alpacas compared to species such as sheep or cattle. Indeed, there are several particular quirks of alpacas that every vet and owner should keep in mind, but they are not necessarily great barriers to performing the surgery if indicated.
When you are in the situation where you must opt for or against a caesarean, it pays to be informed about potential risks, and factors we can mitigate, to aim for the best outcome.
In the UK, alpacas are generally thought of as a farmed species, and are therefore under the care of farm practitioners (of course, there are exceptions!). Farm vets have experience of caesareans in cattle, sheep and even goats, and the fundamental aspects of the surgery do not really diff er between species. If a vet can perform the surgery on a sheep, for example, it is no great departure from an alpaca, however there are several key aspects that we must all be mindful of.
Are we at term?
In some species, it is accepted that when the dam is very ill or injured, we can induce birth. This is not a safe practice in alpaca, due to their varying gestation lengths, and the safety of the usual medications. If a live cria is a priority, elective (planned) caesarean would not be advised unless the dam is severely compromised, and continuing gestation would be fatal to her and/or the cria.
Safe restraint
Alpacas are less tolerant of local anaesthesia than other farm species, necessitating a lower dose or dilution of our usual medication, and careful monitoring of their demeanour post operatively. Your vet is also going to need time to clip, clean, prepare, anaesthetise and sterilise the operation side (usually the left fl ank). You can assist by providing clean, warm water.
Secure restraint is of paramount importance, so whether the operation is undertaken standing or lying down (depending on surgeon preference – either is permissible) it must be done with the safety of the animal, yourselves and the surgeon in mind. When there are behavioural issues preventing safe working, your vet may wish to sedate the dam.
Sedation is not necessarily without risk, however, surgery cannot be safely completed on an out of control animal. Take a look at your sheltered facilities – would you be able to ready them at short notice for a safe restraint?
About the author
Dr Ami Sawran graduated from the University of Liverpool in 2011 and works for Westpoint Farm Vets. Liverpool in 2011 and works for Westpoint Farm Vets. She is head of the small ruminant and camelid working She is head of the small ruminant and camelid working group, and head of the camelid specialist interest group for VetPartners. Ami’s certifi cate in advanced veterinary practice focussed on camelid medicine.
Consultancy service Westpoint Farm Vets has launched a camelid consultancy service where owners can enquire about second opinion work, further education and courses. Owners can also book health planning visits in cooperation with their usual private veterinary surgeon. The service also off ers continuing professional development (CPD) and training to veterinary surgeons. Westpoint Consultancy’s camelid team includes: Ami Sawran based in Chelmsford, Ashley Marshall in York and Laura Gibson.
Potential complications
A recognised complication of any surgery is post-operative infection. Cattle can cope well with a degree of contamination, but alpacas are not as adept at walling off infection in the abdominal cavity and are more prone to peritonitis. This means that the area in which surgery is performed should be as clean as possible, and your vet should let you know what you can and can’t touch or assist with during surgery.
With the best will in the world, the environment will never be sterile on farm, but you are giving your animals their best chance at survival if you can provide clean, warm, lit, dry, dust-free facilities in which to operate. A post-operative dam will also need TLC (tender loving care), monitoring and ongoing injectable treatments depending on your veterinarian’s plan.
Alpacas have relatively weak abdominal musculature compared to other species, and this can very easily break down after surgery. Their thin muscles also mean we must be extra careful when making incisions, so as not to catch internal organs. To give them their best chance, I recommend abdominal bandaging post surgery, but breakdown or herniation of tissues is unfortunately a risk of abdominal surgery that your vet will do their best to mitigate.
Will she be fi t to breed again?
Any dam that has had a degree of diffi culty during birthing could have fertility issues in future. Bruising and tearing during ‘normal’ or assisted delivery can cause adhesions and scarring in the uterus. It follows that surgery on the uterus can also cause scarring and adhesions. There are reports of returns to productive fertility post caesarean, but it may not be something you wish to risk a second time, which is a personal decision. It is recommended that a dam that has had any form of obstetrical intervention undergoes a pre-breeding examination with a veterinary surgeon prior to remating.
Making diffi cult decisions
During an obstetrical emergency, your vet may ask if you are open to a caesarean, but they may also ask you whether the dam or cria is your priority – particularly if the dam is unwell, and possibly unable to cope with much more intervention. This is not because they’re going to stop trying to save both dam and cria, but it can help determine a course of action that is more likely to preserve the life of that which you have identifi ed as your priority.
This decision could be economical or emotional – or both, as they often are - and though it may come across as blunt, it is an important question to ask, so please be prepared to answer it honestly. It’s also worth pointing out that in situations where the cria cannot be delivered naturally, and the dam is a poor surgical candidate – or the environment is not conducive to a safe surgery- you may be asked to consider euthanasia. Remember, choosing to euthanise an animal in distress is not a sign of failure – it is, after all, the prevention of further suff ering, and ability to care for the dam intensively after surgery will rightly come into this decision.
It is worth remembering that cria born by caesarean section are at higher risk of developing failure of passive transfer and may benefi t from monitoring and potential plasma transfusion. It’s not too late to bank plasma ready for unforeseen circumstances – please contact your veterinary practice for more information.
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