Treating Milk Fever

Contributed by Dr. A. Samad - (Reproduced from the article titled Myths about Hypocalcaemia & its
Treatment - Journal of Bombay Veterinary College Vol:7 (1&2)

The Approach
Replacement of calcium by parenteral administration is the most important initial
step, which should not be delayed in severely hypocalcaemic animals.

Nowadays two different types of parenteral calcium preparations are available in the
market;

1. Ionic calcium for intravenous or subcutaneous administration and,

2. Dicationic calcium preparation suitable for intramuscular administration.

The choice of drug should be rational. The thumb rule is: when the animal is
showing signs of peripheral vascular failure, hypothermia and cold
extremities, calcium borogluconate should be administered intravenously. In
such case intramuscular administration of dicationic calcium may not be reliable as
due to impaired blood supply to peripheral organs, absorption of calcium from the
injection site is likely to be delayed. The results have shown that , after
intramuscular injection of dicationic calcium, blood calcium levels are increased
within 3 hours, which remain consistently high up to 24 hours. Thus, administration
for 3 consecutive days would ensure high blood calcium during the entire high risk
period.

The Strategy
The treatment strategy in milk fever should be

1. To administer calcium as early as possible.

2. Ensure sustained absorption of calcium.

As a matter of fact even herdsman with little experience can diagnose milk fever, but
usually the problem is intimation to veterinarian and thus the time lag in
administration of calcium.It is well known that if calcium is administered early the
likelihood of relapses and complication arising out of recumbancy can be minimized.
Unlike intravenous, many herdsman are able to administer intramuscular injection.
An intramuscular dicationic calcium therefore can be recommended as a strategic
treatment before the arrival of the Veterinarian for intravenous administration. It is
now emphasized that after onset of first sign of milk fever calcium should be
administered within one hour, otherwise the chance that the animal may turn
Downer Cow is significantly high. There is an urgent need in India to implement this
strategic approach.

The second important issue is to maintain the level of calcium in blood for a longer
period of time to avoid relapses. Since calcium administered intravenously is not
retained for a long time, for sustained absorption and maintenance of the level,
administration of calcium borogluconate subcutaneously is also practiced. But this is
not without danger and in hypothermic cases the absorption may be delayed
considerably. In any case, it is recommended that waiting for more than one hour for
the response after subcutaneous injection is improper. In all such cases,
administration of intrmuscular dicationic calcium as starting and follow up to
intravenous calcium borogluconate is by far the most rational approach.

The dose of intravenous calcium in cows and buffaloes:

The dose of intravenous calcium should be calculated rationally and arbitrary dose
may be risky and expensive. Various workers have found that an ARD system of
dose fixation is convenient. The word A denotes "appetite", R denotes "ruminal
activity" and D denotes "ability to defecate". The animal with normal ARD are slightly
hypocalcaemic for which 2g calcium (110 ml of calcium borogluconate) is sufficient.
Animal lacking in one or two functions of ARD are judged moderately hypocalcaemic
and should be given 4 g calcium (225 ml calcium borogluconate), whereas, those
having severely depressed ARD must be given 6g calcium (330ml calcium
borogluconate) intravenously.

Wish to Know the answer to the following FAQ's from Dr.Samad?

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1. What are the physiological functions of Calcium in an animal's body?

2. What is the daily requirement of calcium in the feeds for cows and buffaloes?
3. Why does an adult animal which has enough calcium deposited in bones, etc.
need calcium daily in the diet?
4. Why milk fever is recorded only in few animals?
5. Why few animals can not mobilize calcium effectively?
6. Can milk fever occur at any time of the lactation?
7. Can hypocalcaemia occur in non lactating animals?
8. How to diagnose hypocalcaemia?

9. Can hypocalcaemia be controlled?