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Recent Diagnosis and Treatment
                of Milk Fever in Animals
IAAS


  Institute of Agriculture and Animal Science
 Department of Veterinary Medicine and Public
                     Health

                               Tara Nath Gaire
        MVSc( vet. medicine and public health)
                          gaire.tn@gmail.com

                  tara nath gaire,iaas,Nepal
Introduction

• Milk fever or parturient paresis is a metabolic
  disease of cattle, sheep and goat .
• occurring around the time of parturition and caused
  by hypocalcaemia .
• characterized by weakness, recumbency and
  ultimately shock and death. (Radostits et al., 2000)
• estimated to occur at the rate of 5-10% nationwide
  (Horst, 1986).


                     tara nath gaire,iaas,Nepal
Etio-Pathogenesis
Calcium level:
   Normal level: 9-10 mg %
   Milk fever: 2-6 mg %
Alteration in calcium homeostasis by :
• Excessive loss of calcium in the colostrums
• impairment of absorption of calcium :
    – deficiency of Vitamin D.1,25 dihydroxycholecaciferol is
      the activated from of Vitamin D3.
    – acts on the gut cells and helps in the absorption of ca++
      from the intestine and resorption of ca++ from bone
    – less acidic pH in gut.


                         tara nath gaire,iaas,Nepal
Etio-Pathogenesis

• Failure to mobilize skeletal calcium
   – Parathormone (P.T.H) insufficiency.
   – Excessive calcitonin level
   – Effect of estrogen
• “Milk fever syndrome”: milk fever is associated with
   – hypocalcaemia
   – hypophosphtaemia
   – and hypomagnesaemia

                      tara nath gaire,iaas,Nepal
Epidemiology

• Cattle
   – In high producing adult lactating dairy cattle
   – 5-10 year age group.
   – Jerseys are most susceptible
   – Stress :distant transport , forced exercised, etc
     predisposes the condition
   – Drugs
   – estrus
• Sheep and goats
   – 6 weeks before to 10 weeks after lambing.
                     tara nath gaire,iaas,Nepal
Clinical signs and symptoms

• Cattle
   – Stage I
   – Stage II/ sternal recumbency
   – Stage III/ lateral recumbency
• Sheep and goats
   – loss of anal reflex, constipation, tachycardia
   – hyposensitivity, ruminal stasis and tympany,
   – salivation and tachypnea.


                       tara nath gaire,iaas,Nepal
Forms of milk fever




 tara nath gaire,iaas,Nepal
Diagnosis




tara nath gaire,iaas,Nepal
Diagnosis




tara nath gaire,iaas,Nepal
Differential diagnosis




  tara nath gaire,iaas,Nepal
Line of Treatment:
         General management and clinical procedure

• Treatment
  – first stage of the disease, before the cow is
    recumbent, is the ideal situation.
  – Cows found in lateral recumbency (third stage)
    should be placed in sternal recumbency which
    reduce the chances of aspiration if the cow
    regurgitate.
  – Avoidance of this complication necessitates the
    placement of rubber or other mats under the cow

                   tara nath gaire,iaas,Nepal
Treatment
                       Replacement Therapy

• Calcium borogluconate:
   – milk fever can be treated successfully with 8-10 g of
     calcium (calcium borogluconate is 8.3% calcium) in cow.
   – solutions available vary from 18 to 40% calcium
     borogluconate.
   – 800-1000 mL of a 25% solution: an initial dose a large cow
     (540-590 kg)
   – 400-500 mL: small cow (320-360 kg)
• standard rate of administration :
   – rapid intravenous administration of the calculated dose
     of calcium borogluconate (often supplemented with
     phosphorus,magnesium, and glucose) over a period of
     15 min.
                        tara nath gaire,iaas,Nepal
Treatment
                       Dietary anion –cation balance diet

• Recent concept of treatment and prevention of disease.
• Results are more reassuring and currently appears to be the best way
  to prevent.
• increased incidence of milk fever with
   – Prepartum diets high in cations such as sodium and potassium
   – Most forage such as legumes and grasses are high in potassium and are
     alkaline. Metabolic alkalosis predisposes cows to milk fever.
• incidence of the disease decrease with
   – diets high in anions, especially chloride and sulfur.
   – The addition of anions to the diet of dairy cows prior to parturition
     effectively reduced the incidence of milk fever by inducing a metabolic
     acidosis which facilitates bone resorption of calcium.(Radostits et al.,2000)
• The DCAD is expressed using the equation. (Radostits et al., 2000)

                  DCAD in mEq/kg DM = (Na +K) - (CI + S)

                               tara nath gaire,iaas,Nepal
Treatment
Dietary anion –cation balance diet




     tara nath gaire,iaas,Nepal
Preventive measures
• Limiting Ca intake
   – less than 80-100g/day;
• Limiting P consumption
   – less than 45g/day;
• Holding Ca:P ratio
   – less than 2:1 without exceeding P limits.
• These methods directly sitmulate the intestinal Ca absorption or
  mobilize bone Ca prior to parturition or do both to avoid
  hypocalcemia when intestinal Ca demand is suddenly increased after
  the calving.
• More recently Goff et al., (1992), have studied the effects of
  recombinant bovine interleukin- 1 β(IL-1β) has been shown to be
  homologus to osteoclast-activating factor and is capable of
  stimulating increased osteoclastic bone resorption.
• Administration of Vit D3
• Besides dietary and hormonal treatments, good housing is also very
  important for the prevention. nath gaire,iaas,Nepal
                             tara
Summary
• The basis principal to prevent milk fever is to maintain a high plasma Ca
  level at the time of parturition to overcome the sudden high demand
  for Ca.
• hormonal therapy and dietary manipulations are successful in this
  regard.
• The dietary manipulation may be the best and easiest way to prevent
  milk fever in field condition.
• The supplementation of anionic diet salts brings about a mild acidosis
  thus increasing the rapid absorption of Ca through intestine and bone
  resorption.
• Thus the extracellular level of Ca increases which helps in coping with
  the demand of Ca particularly in the early lactation.
• Among the anionic salts, MgSo4 may be used commonly used.
• A useful tool is to measure the urine pH i.e. pH 5.5-6.5 to monitor
  anion cation balance in diet.


                             tara nath gaire,iaas,Nepal
IAAS




Thank you.
       tara nath gaire,iaas,Nepal

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Recent diagnosis and treatment of milk fever in

  • 1. Recent Diagnosis and Treatment of Milk Fever in Animals IAAS Institute of Agriculture and Animal Science Department of Veterinary Medicine and Public Health Tara Nath Gaire MVSc( vet. medicine and public health) gaire.tn@gmail.com tara nath gaire,iaas,Nepal
  • 2. Introduction • Milk fever or parturient paresis is a metabolic disease of cattle, sheep and goat . • occurring around the time of parturition and caused by hypocalcaemia . • characterized by weakness, recumbency and ultimately shock and death. (Radostits et al., 2000) • estimated to occur at the rate of 5-10% nationwide (Horst, 1986). tara nath gaire,iaas,Nepal
  • 3. Etio-Pathogenesis Calcium level: Normal level: 9-10 mg % Milk fever: 2-6 mg % Alteration in calcium homeostasis by : • Excessive loss of calcium in the colostrums • impairment of absorption of calcium : – deficiency of Vitamin D.1,25 dihydroxycholecaciferol is the activated from of Vitamin D3. – acts on the gut cells and helps in the absorption of ca++ from the intestine and resorption of ca++ from bone – less acidic pH in gut. tara nath gaire,iaas,Nepal
  • 4. Etio-Pathogenesis • Failure to mobilize skeletal calcium – Parathormone (P.T.H) insufficiency. – Excessive calcitonin level – Effect of estrogen • “Milk fever syndrome”: milk fever is associated with – hypocalcaemia – hypophosphtaemia – and hypomagnesaemia tara nath gaire,iaas,Nepal
  • 5. Epidemiology • Cattle – In high producing adult lactating dairy cattle – 5-10 year age group. – Jerseys are most susceptible – Stress :distant transport , forced exercised, etc predisposes the condition – Drugs – estrus • Sheep and goats – 6 weeks before to 10 weeks after lambing. tara nath gaire,iaas,Nepal
  • 6. Clinical signs and symptoms • Cattle – Stage I – Stage II/ sternal recumbency – Stage III/ lateral recumbency • Sheep and goats – loss of anal reflex, constipation, tachycardia – hyposensitivity, ruminal stasis and tympany, – salivation and tachypnea. tara nath gaire,iaas,Nepal
  • 7. Forms of milk fever tara nath gaire,iaas,Nepal
  • 10. Differential diagnosis tara nath gaire,iaas,Nepal
  • 11. Line of Treatment: General management and clinical procedure • Treatment – first stage of the disease, before the cow is recumbent, is the ideal situation. – Cows found in lateral recumbency (third stage) should be placed in sternal recumbency which reduce the chances of aspiration if the cow regurgitate. – Avoidance of this complication necessitates the placement of rubber or other mats under the cow tara nath gaire,iaas,Nepal
  • 12. Treatment Replacement Therapy • Calcium borogluconate: – milk fever can be treated successfully with 8-10 g of calcium (calcium borogluconate is 8.3% calcium) in cow. – solutions available vary from 18 to 40% calcium borogluconate. – 800-1000 mL of a 25% solution: an initial dose a large cow (540-590 kg) – 400-500 mL: small cow (320-360 kg) • standard rate of administration : – rapid intravenous administration of the calculated dose of calcium borogluconate (often supplemented with phosphorus,magnesium, and glucose) over a period of 15 min. tara nath gaire,iaas,Nepal
  • 13. Treatment Dietary anion –cation balance diet • Recent concept of treatment and prevention of disease. • Results are more reassuring and currently appears to be the best way to prevent. • increased incidence of milk fever with – Prepartum diets high in cations such as sodium and potassium – Most forage such as legumes and grasses are high in potassium and are alkaline. Metabolic alkalosis predisposes cows to milk fever. • incidence of the disease decrease with – diets high in anions, especially chloride and sulfur. – The addition of anions to the diet of dairy cows prior to parturition effectively reduced the incidence of milk fever by inducing a metabolic acidosis which facilitates bone resorption of calcium.(Radostits et al.,2000) • The DCAD is expressed using the equation. (Radostits et al., 2000) DCAD in mEq/kg DM = (Na +K) - (CI + S) tara nath gaire,iaas,Nepal
  • 14. Treatment Dietary anion –cation balance diet tara nath gaire,iaas,Nepal
  • 15. Preventive measures • Limiting Ca intake – less than 80-100g/day; • Limiting P consumption – less than 45g/day; • Holding Ca:P ratio – less than 2:1 without exceeding P limits. • These methods directly sitmulate the intestinal Ca absorption or mobilize bone Ca prior to parturition or do both to avoid hypocalcemia when intestinal Ca demand is suddenly increased after the calving. • More recently Goff et al., (1992), have studied the effects of recombinant bovine interleukin- 1 β(IL-1β) has been shown to be homologus to osteoclast-activating factor and is capable of stimulating increased osteoclastic bone resorption. • Administration of Vit D3 • Besides dietary and hormonal treatments, good housing is also very important for the prevention. nath gaire,iaas,Nepal tara
  • 16. Summary • The basis principal to prevent milk fever is to maintain a high plasma Ca level at the time of parturition to overcome the sudden high demand for Ca. • hormonal therapy and dietary manipulations are successful in this regard. • The dietary manipulation may be the best and easiest way to prevent milk fever in field condition. • The supplementation of anionic diet salts brings about a mild acidosis thus increasing the rapid absorption of Ca through intestine and bone resorption. • Thus the extracellular level of Ca increases which helps in coping with the demand of Ca particularly in the early lactation. • Among the anionic salts, MgSo4 may be used commonly used. • A useful tool is to measure the urine pH i.e. pH 5.5-6.5 to monitor anion cation balance in diet. tara nath gaire,iaas,Nepal
  • 17. IAAS Thank you. tara nath gaire,iaas,Nepal