A 2-year-old female Alpaca presented to Cornell’s Equine and Nemo Farm Animal Hospital for hematuria and straining for twelve days. Bloodwork from the referring veterinarian found anemia, eosinophilia and hyperglobulinemia. On presentation, the problem list included a bladder mass, anemia, straining, and hematuria. Differential diagnoses included neoplasia, coagulopathy, hemorrhagic cystitis, pyelonephritis, and idiopathic hematuria. Ultrasonography and radiographs on the patient found additional lung lesions. Surgery was considered but she was euthanized due to poor prognosis. Necropsy found multi-organ lesions due to disseminated bacterial thromboembolism, likely with an original insult to the liver. Further investigation found the patient’s companion also had anemia, hyperglobulinemia, and eosinophilia, with liver lesions consistent with parasite migration tracts. Multiple other members of the herd were also discovered to have anemia and hyperproteinemia. This suggests a herd issue, with differentials including subacute ruminal acidosis, liver flukes, and bacterial infection.