Medical management of an osseous sequestrum in an alpaca cria

A 2-month-old 12.0-kg (26.4-lb) sexually intact male alpaca was evaluated for a 1-week history of progressive forelimb lameness with no known history of trauma.

The cria had toe-touching lameness in the right forelimb with a firm swelling at the distal dorsomedial metacarpal region. Signs of pain were elicited on palpation of the swollen region. There was no associated wound or draining tract. Radiographic examination revealed soft tissue swelling and osteomyelitis of the distal portion of the third metacarpal bone with a possible medial cortical sequestrum.

The cria was hospitalized and treated with meloxicam (1 mg/kg [0.45 mg/lb], PO, q 72 h) and ceftiofur sodium administered SC (2.2 mg/kg [1 mg/lb], q 12 h for 8 days) and by means of regional limb perfusion (1.25 mg/kg [0.57 mg/lb], IV, q 48 h for 8 days). Lameness and swelling improved, and the cria was discharged from the hospital with meloxicam (1 mg/kg, PO, q 72 h for 2 weeks) and ceftiofur crystalline free acid (1.5 mg/kg [0.68 mg/kg], SC, q 5 d for 2 weeks). At a recheck examination 17 days later, there was radiographic evidence of a well-defined 3.4 × 0.3-cm osseous sequestrum in the distal aspect of the affected third metacarpal bone. The owner declined further treatment and elected to monitor the cria at home. One year later, radiographic examination revealed nearly complete resolution of the sequestrum.

Results for this patient suggested that osseous sequestra in some camelids may resolve following medical treatment without surgical intervention.