4 Treatment

Transcript

Welcome to lesson-4 so before that, in the previous class we saw about

• What is a stage-3 milk fever,
• What are the classical clinical signs,
• the complication of Milk fever,
• How to diagnose the Milk fever based on laboratory techniques, as well as a field test, and
• What is the Differential diagnosis for Milk fever in cattle?

Now we are going to see about the lesson-4 which mainly comprises Treatment which is an important part of this section and this includes:

• How to manage Hypocalcemia by Intravenous therapy as well as subcutaneous and oral therapy
• What are all the favorable responses immediately after injection of IV calcium, as well as unfavorable responses or poor responses to Calcium supplementation?

So the main goal of Hypercalcemia Treatment is Intravenous administration of rapid administration of Calcium solution. So the IV route is the most preferable route and followed by the subcutaneous route.

Actually, commercially available solutions yield about 8 to10 grams of calcium per bottle. The general thumb rule for calculating the dose of calcium in Hypercalcemia animals is 1 gram per 45 kg body weight. So roughly 450 kg body weight cattle meal you can give 10-gram maximum, that is the main thumb rule, if the animal is 300 kg accordingly we need to reduce the calcium dose.

And sometimes there are 23% calcium is also available but most of the time it uses about 10 grams of calcium in this bottle. IV route is the preferred route for administering calcium to get a rapid response in a Hypocalcemia animal and a calculated dose can be given rapidly between 10 to 15 minutes you can give an IV injection.

And so the important part is we need to monitor the cardiac activity because you are giving a rapid rate of calcium it directly has an effect on the heart rate, so whenever there is severe bradycardia or tachycardia, then we need to manage the flow rate of calcium accordingly. Suppose a case there is a recurrent Hypocalcemia in a dairy cattle it’s called Calcium cyclers, in that case, we need to give the calculated dose, half the dose through the subcutaneous route to get a favorable response.

The challenge in the treatment of Hypercalcemia is you may get both relapses of Hypercalcemia after a Treatment or the animal diet during Treatment. So underdosing and overdosing is avoided, they may occur due to various reason.

After the Intravenous administration of calcium, the animal is in sternal recumbency, so the favorable response to the calcium therapy you can get immediately, within a few minutes. So the animal the all the flaccid muscles, they receive the neuro neuronal impulses, and it promotes skeletal and smooth muscle contraction. So there will immediately stimulate the adaptation reflex, the relief of bloat, and the animal cardiac activity increases. So heart rate increases, the intensity of cardiac sound improves, pulse quality improves, and the urination activity gets stimulated. So the animal will urinate immediately and profuse urination and then defecation the animal will stand and become recumbent to be converted to standing posture and there will be muscular fasciculation, the contractility improves or regained especially from the hindquarter towards the forelimb and later on the animals become normal and it will work normally.

Sometimes the challenge in the Treatment of Hypercalcemia is a poor response or the animal may die while giving calcium Treatment or immediately after treatment it may fall and die. So the reasons are many ;

• Suppose the calcium administered may overdose, so the animal may be thin and the calculated dose exceeds the normal causing severe bradycardia and animal death. and
• Another thing the animal suppose in a high, there is heat stress or it is the animal is recumbency near open space and the high temperature also may cause increase the sensitivity of calcium and the animal may die.
• Another thing most of the time at the field level what will happen in Hypercalcemia, the owner themselves or farmers will give multiple dosages of subcutaneous injection, so after the arrival of a veterinarian if you start giving IV or calcium at a calculated day immediately the peripheral circulation improves and whatever the dose given by the farmer by the subcutaneous route, that also adds on to your calculated dose. So immediately there is increased calcium overdose or toxicity and it compromises the cardia, causing the severe cardiac arrhythmia.
• Apart from that, there are toxic conditions like severe toxemia materials Mastitis, and Peritonitis and these conditions may increase the sensitivity of calcium. So thereby causes even a calculated dose may become toxic to animals.
• Apart from Hypokalemia, and in Hyperkalemia also the sensitivity of calcium to the cardiac muscle also increases.
• So sudden sometimes during treatment, the animal gets frightened or excited because of sudden adrenal release that also causes a sudden cardiac arrest. So always whenever you are going to treat a Hypercalcemia animal you should have an antidote with you that is the atropine sulphate, immediately you should give it intravenously to contract the cardiac arrhythmias.
• Whenever there is an unusual response, that is a relapse occurs in Hypercalcemia after IV administration. In those cases, the subcutaneous route is the best choice, so calculate a dose of 50% you can administer through a sufficient route. At your site usually, 50 to 75 ml you can give is especially on shoulder muscles and the subcutaneous route is suggested mainly for calcium cyclers.
• Apart from parental administration and supplementation, oral supplementation is also suggested. so there are various commercial preparations nowadays available in the form of gel or powder or liquid and these contain mainly calcium chloride or calcium propionate, so according to the manufacturer’s prescription, we need to administer carefully you need to drench the cattle for a one or two days in addition to the IV calcium.

In General management apart from drug therapy, since the animal is on a recumbent for a few hours then we need to avoid that is you should probe the animal from lateral to sternal recumbency, we should roll the animal from one side to another side, and then we should clean the udder, we should avoid mastitis, so regular milking is also important, always the required contact for feed and water should be adjacent to the animal, and we know the animal tries to get up then we should give assisted lifting to the animal.

Normal the Failure to Hypercalcemia is mainly due to the repeated occurrence of a Hypercalcemia in a multiparous dairy cattle, that is a calcium cycler and the other thing once the animal becomes recumbent it is predisposed to go for downer cow syndrome, so about 30- 40% of Hypercalcemia untreated cases, they will go for downer cow syndrome.

We have seen the :

• How to Treat Hypercalcemia by various routes, the most preferred route is Intravenous followed by subcutaneous injection,
• the favorable and unfavorable response to Hypercalcemia, and
• How to manage a recumbent cow also

Thank you!