Treatment consisted of 1 dose of ivermectin (Merial) 0.2 mg/kg BW, SQ, fenbendazole (Hoechst Roussel Vet, Somerville, New Jersey, USA), 15 mg/kg PO, q24h, dexamethasone (Hoechst Roussel Vet), 0.05 mg/kg, IV, q24h, and flunixin meglumine (Fort Dodge Animal Health, Overland Park, Kansas, USA), 0.5 mg/kg, IV, q12h. tenuis antigen were considered but not pursued in light of the low diagnostic yield of the flotation and limited availability of the antigen test. Further diagnostic tests, including a Baerman flotation and CSF analysis for P. Based on these findings, the presumptive diagnosis of intraocular and meningeal nematodiasis, most likely due to Parelaphostrongylus tenuis was established.

The nucleated cell population was comprised predominantly of eosinophils with few mononuclear cells. The red blood cell count was 20 × 10 6 cells/L. Analysis of the CSF showed an increased nucleated cell count (26 × 10 6 cells/L) and increased total protein concentration (0.94 g/L) ( 1). Based on the neurological examination, multifocal or diffuse disease of the spinal cord and brain was suspected.įunduscopic picture of parasite within the posterior segment of the right eye.Ī complete blood (cell) count and serum chemistry yielded no significant abnormal findings therefore, cerebrospinal fluid (CSF) was obtained from the lumbosacral space. The llama was able to rise without assistance and stood for short periods. Spinal reflexes were intact, but muscular tone in all 4 limbs was decreased. No further cranial nerve deficits were detected. The remainder of the neuro-ophthalmic examination was unremarkable. Intraocular pressure measurements and Schirmer tear tests were not performed as an increased intraocular pressure or decreased tear production were considered unlikely. Ocular changes in the left eye were attributed to trauma sustained during recumbency leading to corneal ulceration and anterior uveitis. Fluorescein staining identified a central superficial corneal ulcer approximately 0.5 cm in diameter and a small amount of fibrin within the anterior chamber no abnormalities of the posterior segment or fundus were observed. The left eye had an intact menace response, the pupil was miotic, but direct and indirect PLR could be elicited. Ophthalmologic examination of the right eye using direct and indirect ophthalmoscopy before and after pharmacologic dilation of the pupil yielded an actively moving, approximately 2-cm long helminth within the vitreous, close to the retinal surface ( Figure 1).

Direct and indirect pupillary light responses (PLR) were intact, but the eye was deemed non-visual. Neuro-ophthalmic evaluation revealed an absent menace and dazzle response in the right eye. Several abrasions were present over the left side of the face the left eye showed marked blepharospasm. Upon presentation, the llama was bright and alert, and vital parameters were within normal limits. On the day of presentation, the llama was found down on her left side, apparently unable to stand and was referred to the Widener Hospital for Large Animals at New Bolton Center, University of Pennsylvania.

The camelids had been last dewormed with ivermectin (Merial, Athens, Georgia, USA) 0.2 mg/kg body weight (BW), SQ, 5 mo before presentation. The field was kept under loose observation. The llama was kept in a field that had another llama and 1 alpaca and was frequently visited by the local deer population. A 12-year-old female llama was presented with a history of acute onset of recumbency.

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