Objective To describe the use of therapeutic plasma exchange (TPE) in treatment flunixin meglumine overdose a cria. Case Summary A 3-day-old alpaca cria was diagnosed with ureteral obstruction and agenesis resulting severe bilateral hydronephrosis. During hospitalization, inadvertently received >65 mg/kg. Here, we report lipid emulsion TPE to mitigate toxicosis. appeared prevent any flunixin-in...