1.
Topic - Milk fever, its etiology and treatment
● Submitted To = Dr .Randhir Dabur
● Submitted By = ANKITA
● ADM.NO= 2017V109B-IIVER

2.
• Introduction
• Pathogenesis
• Clinical signs - 3 stages (stage of excitement)
( Sternal recumbency)
( Lateral recumbency)
• Diagnosis
• Treatment
• Signs of recovery
• Causes of failure of therapy
• Dietary management.
POINTS TO BE INCLUDED

3.
Milk fever /parturient paresis
Introduction-
Milk fever is a production disease of dairy animals
(cows /buffalo) which occurs at parturition and is
characterized by hypocalcaemia, general muscular
weakness ,circulatory collapse and depression of
consciousness.
✓Incidence is higher in
● Jersey cows
● Animals in 5th -8th lactation

4.
Typical milk fever posture

5.
Etiology
● Main cause is decrease in level of ionised calcium in blood .
Note -In bovines ,normal blood calcium level ranges between 9-12
mg%.
● In diseased animals it is significantly low (<5.0>)mg.
Precipitating factors-1. High milk yield.
2.Decreased calcium absorption.
3.Decreased calcium resorption.

6.
Associated factors -
1) High calcium diet during pregnancy-makes parathyroid gland inactive .
2) Prolonged dry period
3) Oxalates in feed
4) Deficiency of vitamin D3.
5) Hypophosphatemia -calcium and phosphorus ratio in blood is 2.3:1which is
maintained in homeostasis.
6) Complete milking soon after parturition
7) High estrogen level soon after parturition.
8) Thyrocalcitonin(higher level).
9) Chronic subclinical hypomagnesemia can lead to : Decreased PTH production,
Decreased hydroxylation of vitamin D3, Decreased sensitivity of target organs of
these

7.
Pathogenesis
Calcium is responsible for maintenance of tone of
skeletal and smooth muscles.
low level leads to muscular atony,decreased stroke
volume, peripheral circulatory failure,ruminal and
abomasal hypomotility and decreased consciousness.

8.
Clinical signs -
a) Stage of excitement
- Brief stage - half to one hour only
-hyperaesthesia
-tetanic spasms and tremors of muscle of limbs and head
-anorexia ,shaking of head , protrusion of
tongue,grinding of teeth .
-Ataxia
-Prognosis is good.

9.
Stage of sternal recumbency-
● Animal sits with body resting on sternum .
● Drowsy appearance.
● Cold extremities
● Anal reflex absent .
● Dry muzzle
● Heart rate increases
with decreased
intensity of sounds .

10.
Stage of lateral recumbency
● Almost coma stage .
● Complete flaccidity of
muscles
● Bloat
● Subnormal body temp .

11.
Subnormal body temperature

12.
Diagnosis
● History of parturition
● High milk yield
● Typical clinical signs that are sternal (Head
turned towards flank region) or lateral
recumbencywith subnormal body temperature
● Clinical pathology (Low serum Ca level)
● Clinical response to calcium therapy

13.
Differential diagnosis -
1) Ephemeral fever -same course,fever is there .
2) Limb injury -when nerve of limb damaged ,animal is
alert but unable to getup.
3) Coliform mastitis -Recumbency due to toxemia
.(examine udder ,milk )
4) Septicemic Metritis

14.
Treatment-
Principles-
● Give as early as possible
● Ideal in first stage
● Recumbency >4hr may lead to complications.
● Educate owner to turn side of animal .
● Give antihistamine before start of therapy or keep
ready.

15.
Standard treatment-(supp.therapy)-
● Calcium borogluconate(25%),500 ml slow iv.
● One dose is sufficient, if partial response then give
2nd dose.
● In 2nd dose ,give half subcutaneous and half
intravenous.
● Never do fast administration -may cause cardiac
fibrillation.

16.
⮚ When hypocalcaemia is associated with
hypomagnesaemia & hypophosphatemia then use a
combination of these( Mifex 200-450 ml slow IV).
⮚Unusual reaction to calcium therapy can be treated with -
⮚Atropine sulphate can be used to overcome cardiac
arrhythmia
⮚Magnesium sulphate 10% solution @100-400ml IV to
antagonize cardio-excitatory effects of calcium

17.
Relapses-
1. Common in older and mature animals which have
diminished skeletal reserve of calcium .
2. Upto 5-6 relapses common in old Jersey cows .
3. Pre-partum cases of milk fever -relapses are common
Signs of recovery -
● Bellowing ,defaecation and the animal gets up.
● Heart rate increases in sound intensity .
● Twitching of muscle of flank and often whole body .

18.
Some situations-
a) Does not getup even after 2 nd dose .may be due to
hypophosphatemia then give 40-60 g sodium acid phosphate
,20% I/v
b)Recoverd but tetany persist(may be due to hypomagnesemia)
c) Doesn't getup even when everything is alright.then throw
bucket of water /frighten with a dog.
d) Gets up but animal is anorectic - then may be concurrent
ketosis with hypoglycemia 20-40% dextrose I/v 500 ml .

19.
Evaluation of response-
1. After first dose - if no improvement then reconfirm the
diagnosis.
2. Reinvestigate the cause of recumbency.
3. Only after reconfirmation of diagnosis give second dose
4. In no case more than 3 dose .
5. Third dose only if there is partial response to 2nd dose

20.
After recovery-

21.
Causes of failure of therapy-
1.Late treatment
2.Insufficient
3.Concurrent disease
4.If first dose is subcutaneous.

22.
Dietary management-
● During pregnancy- Dietary calcium ideal is
30g/day .
● If >100g/day - increase incidence .
● 2 week before parturition give 20 g/day .
● Dietary Cation / anion balance(DCAD) of feed
should be negative (-50 to -100 meq/kg of DM of
feed .
● On day of calving -250g calcium chloride+105g
tricalcium phosphate.(orally -repeat in 12 hr /24 hr .

23.
THANK YOU