Eperythrozoonosis, From the Archives

D. E. Larsen, DVM

Jack was at the corral gate when I pulled into his upper barnyard. He was opened the gate as I stepped out of the truck. There in the middle of the corral was a young llama lying down and obviously not feeling well.

“Jack, it’s good to see you. How are things going?” I said as I got out of the truck.

“We are doing well,” Jack said. “But this little gal is looking droopy this morning.”

Llama had a strong herding instinct and they rarely showed any sign of ill health until they were in very serious condition. For this little llama to be down in the middle of the morning was a sign she was likely very sick.

“How long has she been like this, Jack?” I asked.

“I guess I don’t know,” Jack said. “I looked at all of them yesterday. I can’t say for sure that I saw her, but I sure didn’t notice her being sick.”

I grabbed my stethoscope and a couple of blood tubes went in the corral with Jack. We had to coax Sugar to stand. I raised her lip and looked at her oral membranes. They were pale, in fact, they were almost white. 

Trying not to get ahead of myself, I took stuck a thermometer into her rectum and listened to her chest and abdomen while I was waiting on the thermometer. Everything was normal except for the obvious anemia.

“Jack, I am going to get some blood out of her. I might need to run it back to the lab before I treat her,” I said. 

I drew a couple of tubes of blood. The blood was almost like water. Obviously, red but it was thin enough that her anemia must have severe. I collected another small amount of blood with a syringe and made several blood smears so they would not have any artifacts from the additive in the purple top tube that keeps the blood from clotting.

“Jack, this is a severe anemia,” I said. “It might even be life threatening, this blood is very thin.”

“What can cause that to come on so fast?” Jack asked.

“I probably didn’t come on so fast,” I said. “These llamas will hold out until they are near death before they will show any signs of illness. It just got to the point where she could not cope with it any longer. I don’t know what it can be. I have seen anaplasmosis in cattle that were this anemic when I worked in the feedlots in Colorado. I haven’t seen anaplasmosis here, but I guess it is possible.”

“Do you think she is going to be okay while you run to the lab?” Jack asked.

“That’s a good question,” I said. “I think with how this blood looks that I should treat her with some tetracycline now. In cattle, prompt use of tetracycline will reduce mortality. Blood transfusions are sometimes necessary, but I need some supplies from the office to do that. I will be able to tell from the initial blood results if a transfusion is needed. I will be sending this blood to the diagnostic lab in Corvallis to check on the diagnosis, but I will look at it in my lab first.”

I gave Sugar a dose of intravenous tetracycline and also some dexamethasone. The dexamethasone was probably controversial, but I always remember Dr. Annes saying, “No patient should die without the benefits of steroids first.” I would at least help to slow the immune response if a blood parasite was the cause of this anemia.

“Jack, I have some time today,” I said. “I will run back to the lab and get this blood looked and also get it on the way to Corvallis and then I will come back here in an hour or two if Sugar needs any additional treatment today. Either way, I will give you a call.”

Back at the clinic, I ran a quick complete blood count. Sugar’s packed cell volume was eighteen percent. Values below fifteen percent were considered to require a transfusion.

My next step was to stain one of the blood smears I had prepared from the  blood collected with the syringe. Under the microscope it always took me a moment to adjust my thinking when looking a llama blood. All the red blood cells were elliptical. 

This slide showed a lot of basophilic strippling. This was indicative of an anemia and was often seen in anaplasmosis in cattle. There was no evidence of any anaplasma organisms on the red blood cells. But there was something there that I couldn’t identify. I would have to send the blood and the smears to the lab.

“Jack, I think the Sugar is okay for today with the treatment that I did earlier,” I said when I called Jack. “I am sending the blood to the lab with a currier, so they will get it this afternoon. She is anemic, but not bad enough to require a transfusion. There is a blood parasite there, or some infection on the red blood cells. We will have to wait for the lab results. I will drop by in the morning to give her another injection and to recheck her blood.”

“Are you sure about not needing a transfusion?” Jack asked. “These little gals are pretty valuable, you know.”

“Her blood is above the line that we draw,” I said. “That said, it’s man that draws the lines, in nature, everything is a continuum. But if we do a transfusion too soon, the bone marrow gets the message that it doesn’t have to work so hard. Sometimes a transfusion given too soon, does more harm than good.”

***

I was in the corral looking at Sugar when Jack came out of the house.

“I thought you said it would around nine when you got here this morning.” Jack said.

“I probably said that, but in this business, I have to to do things when the time becomes available,” I said. “I’m sorry if I hurried you. Sugar is looking better this morning.”

“I thought she was up and about when I watched her out the window this morning,” Jack said. “Did you get any results from the lab yet?”

“The diagnosis is eperythrozoonosis,” I said. “Does that help you out any?”

“Doesn’t do a thing for me,” Jack said. “Does it come with a common explanation.”

“This is an infection of the red blood cells,” I said. “A small organism, a mycoplasma, infects the blood cells and the body removes those cells because they infected. It is sort of a number’s game. If enough red cells are removed, the patient becomes very anemia.”

“How did she get it?” Jack asked. 

“I don’t know that we know for sure,” I said. “Biting insects and ticks can spread it. Also using non sterile needles and surgical instruments can spread it. I am not sure if she could have gotten it from her mother. But that is a possibility. This treatment will make her better and she will unlikely have any more problems, but it is unlikely to eliminate the bug from her system. You just need to remember that she could be carrier for the rest of her life.”

“Do I have to do anything more for her?” Jack asked.

“I am going to come by every morning for another few days, just to give her an injection,” I said. “If you leave her here, you don’t need to be here. I will just run by and give her an injection. After that I will repeat the blood, and if it looks like it is needed, I will fix you up with some oral medication for another week. That will be some powder to put in her water. I think the injections will clear things up her.”

Sugar recovered with no complications and became a part of Jack’s llama herd for the next several years. That was when the llama market collapsed and Jack sold his herd, twice. The final time, for pennies on the dollar.

Photo by Erik McLean on Pexels.