Tuesday, November 23, 2010

Hands On Birthing Wet Lab: Dystocias in Alpacas & Llamas with Dr. Missi Cooper, VMD at GALA 2010

Dr. Cooper, left, behind the box
The Wet Lab rotations were filmed and appear at the end of this post, along with Dr. Cooper's PowerPoint.

Not every GALA Conference offers a Wet Lab, so when the three-hour session was offered by Carol Reigh's veterinary, Missi Cooper, VMD, I enrolled. Please note that while I filmed the manipulation rotations, you may be sensitive to the film. That having been said, I will tell you that what you can learn just may save a cria's life. The interventions are designed to rescue a difficult birth, should you vet be too far away and time be of the essence.

Our session began in a conference room, with an amazing overview of birthing at large, and what could go wrong. Cooper began with surveying her audience to determine experience levels with birthing; our audience is split with half having experience and the other half not.

Cooper began with a classic Wiggins and McTighe Understanding by Design approach, beginning with her end point resources. Getting us out of the dark, Cooper asked what are the signs a llama is going to deliver. The mucus string is ejected about 2 weeks before she delivers; the size is variable for the plug, but sometimes you will see it and sometimes not. Sometimes it is whitish-yellow hanging from her, and other times you see it on the ground. The vulva elongates and sometimes swelling and pouching out begins as the cria pushes out. Sometimes she is unsteady on the hind end, but unfortunately there are no reliable indicators of impending delivery. Occasionally, a mother will stop eating a day before.

What is the normal positioning of the cria, and how long does birth take? The answers vary, again depending on the dam and size of pelvis and cria. Normal position, front feet first and then the nose.

The first stage can take 24 hours; second stage is going to the dung pile often, the beginning of labor. Amniotic sack breaks, then feet usually protrude from the dam. Time should be 15 minutes, but can last an hour. The last stage is the placenta, and that passing should occur within 4-6 hours. Best indicator: write down the time you saw the first feet. The sooner you help your mother, the better of she/they will be. Mid-morning is the time they deliver; later PM delivery usually indicates the cria is malformed or there is a delivery problem.

A normal delivery often begins with the anionic sack breaking. Mother tries to reposition the cria to make it easier to deliver by lying down. Mother sometimes delivers the head and shoulders and then stands up to complete the delivery. Some mothers hum and others scream during delivery; the screaming is not an indication of an abnormal delivery but just the vocalization of a female. Nose and front feet first; humans should let the llamas deliver so long as the delivery is going fine. If you need to pull, do so gently and in an arc toward the mother’s head. Do not put too much force or traction on the mother. The following video of an unassisted birth comes from Twin Lakes Llama Ranch.

Find more videos like this on Great Pyrenees Community GPC

Very little is known about what initiates labor. Cup feet.
Passing the placenta is the same procedure for birth; often they go to the dung pile. If the mother does not release the placenta within a normal time range, give a dose of Oxytocin. Do not interfere with the bonding; the mother and cria need to bond. After birth, confine them to a stall for 24-48 hours so the cria can get to nursing quickly. Bring in a buddy to keep company, but know your animals so you make a correct choice. Mother’s position in the herd makes a difference for the release to the herd. It’s better to have more than one cria at the same time birthing. [My note: I so heartily agree; I have a sole cria with a lot of aunts and mother doting on him, but it is just not the same.]

On dystocias or difficult births, what do I do when I know there is something wrong? Time is a good indicator—how long and when during the day. Five percent of deliveries are dystocias. The mother could be ill, the cria too big, the mother bred too young, malposition, or the cria could kick the umbilical cord a few hours before birth and consequently be stillborn. Alpacas normal weight at birth is 14 - 17; llamas 17-20 pounds. But weights vary and depend on genetics and size of parents, as well as age.

Some problems r easy 2 solve; others need a vet.
Early intervention is the key to success when you suspect a difficult birth. Each cria matures at different rate; calling the vet is your option, but I always opt for calling. A bloody discharge is not normal; call your vet. Uterine torsion can occur and can be corrected by a vet. This could occur at 7 months or thereabouts. If the cria is present and protruding with 2 front legs and head but 30 minutes later, still no delivery. The shoulder could be locked and sometimes the mother cannot reposition herself. You need to push the cria back in and rotate it 45 degrees either way. In order to reposition, you MUST push the cria back into the uterus. If you hear or feel a popping, that is normal as the cria passes through the uterus. 
Most dystocias require 2 small hands/arms 2 correct.

If you only see one front leg and head of the cria and she has been trying to deliver for 45 minutes—you need to push the cria back slightly then find the other leg. You need to do this gently because you could tear the mother’s uterus. The size of your arm can make a difference on how you push everything back in. Most of these manipulations are two handed, and often you have to do them yourself because of the time it may take for the vet to arrive. Clear the airways gently with a towel.

If the dam has been up and down frequently for 15 minutes and there appears to be a cria at the vulva, but you do not see any legs or head, clean the vulva and check to see what parts are present. You will only feel the tail and backbone, so you need to reverse the cria because it is backwards. If you see feet with pads upward, then the cria is also reversed and you need to reposition it.

Examination supplies include clean warm water, disinfectant like betadine, sterile lubricant, a tail wrap, towels, and an exam gloves. KY jelly or big tubes of lubricant can be found online or at farm stores. To manage dystocias, call the vet, clean vulvar area, clean hands and arms (no nails or jewelry). Put long gloves on and use liberal amounts of lubrication. Determine the fetal position. There is usually so much dilation that if you are gentle you will not do damage.
Care of the dam post-dystocia begins with monitoring her closely. If there has been a long dystocia, an antibiotic treatment should be administered. 1cc subcutaneously. If you see a red velvet membrane, tear open the placenta and pull out the cria fast because it is already compromised. Don’t cut; tear.

In addition to the conference session, which lasted approximately 1 hour and provided excellent preparation, the Wet Lab session followed and lasted for 2 hours with each person in the class going through 6 rotations. Dr. Cooper allowed filming of the rotations, and graciously shared her resources.

Dr. Missi Cooper on Dystocias GALA 2010

GALA 2010 Dr. Missi Cooper's Wet Lab: How To Save a Cria's Life from RJ Stangherlin on Vimeo.

GALA 2010 Dr. Missi Cooper's Wet Lab: Identifying Cria Body Parts from RJ Stangherlin on Vimeo.

GALA 2010 Dr. Missi Cooper's Wet Lab: Finding a Cria's Head from RJ Stangherlin on Vimeo.

GALA 2010 Dr. Missi Cooper's Wet Lab: Finding A Cria's Head, Neck & Managing Feet from RJ Stangherlin on Vimeo.

GALA 2010 Dr. Missi Cooper's Wet Lab: Dealing With A Breech Birth from RJ Stangherlin on Vimeo.

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