mostely for medical students ,this disease is important

1. 11
(Equine Metabolic disease)(Equine Metabolic disease)
LACTATION TETANY OF MARESLACTATION TETANY OF MARES
Transit tetany of mares,Transit tetany of mares,
Eclampsia of maresEclampsia of mares

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DefinitionDefinition::
 It is a metabolic neurotic disease of lactatingIt is a metabolic neurotic disease of lactating
mares characterized clinically by stiffness inmares characterized clinically by stiffness in
gait and tetany and biochemically bygait and tetany and biochemically by
hypocalcaemia.hypocalcaemia.
(Tetany:(Tetany: a condition marked by intermittent
muscular spasms, caused by malfunction of the
parathyroid glands and a consequent
deficiency of calcium)

3. 33
Incidence, occurrence andIncidence, occurrence and
predisposing factor:predisposing factor:
1- Most cases occur in1- Most cases occur in lactating mareslactating mares, either at, either at
about theabout the l0th day after foalingl0th day after foaling or 1-2 daysor 1-2 days
after weaning.after weaning.
2-Mares have a2-Mares have a heavy flow of milkheavy flow of milk..
3-Pregnant mares subjected to hard physical3-Pregnant mares subjected to hard physical
work or exercise (work or exercise (stress of workstress of work).).
4-Pregnant mares during or after prolonged4-Pregnant mares during or after prolonged
transport (transport (stress of transportstress of transport).).

4. 44
Etiology and pathogenesisEtiology and pathogenesis
 1- The basic constant biochemical1- The basic constant biochemical
finding isfinding is lowlow serum calcium levelserum calcium level
((hypocalcemiahypocalcemia) in which serum) in which serum
calcium level ranges between 4-8 mgcalcium level ranges between 4-8 mg
%%
 2- Hypo- or Hypermagnesemia have2- Hypo- or Hypermagnesemia have

5. 55
Clinical signsClinical signs
Clinical signs are related to the degree ofClinical signs are related to the degree of
hypocalcaemia, because:hypocalcaemia, because:
1- When serum calcium level is1- When serum calcium level is higher thanhigher than
8 mg%,8 mg%, the only clinical sign isthe only clinical sign is increasedincreased
excitability.excitability.
2- At levels of2- At levels of 4-8 mg4-8 mg %, there are%, there are tetanictetanic
spasms.spasms.
3- At levels less than3- At levels less than 4 mg%,4 mg%, there arethere are
recumbency and stupor (recumbency and stupor (state of unconsciousnessstate of unconsciousness).).

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The clinical signs proceed asThe clinical signs proceed as
follow:follow:
1-Profuse sweating1-Profuse sweating
2-Muscular fibrillation particularly of the2-Muscular fibrillation particularly of the
masseter and shoulder regionmasseter and shoulder region
3-3-TrismusTrismus (spasmodic contraction of(spasmodic contraction of
Muscles of mastication)Muscles of mastication)
4-Normal pulse in early stages, but later4-Normal pulse in early stages, but later
becomesbecomes rapid and irregularrapid and irregular..

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5-Rapid, violent respiration accompanied
with wide dilation of nostrils.
6-Normal temp. or6-Normal temp. or slightly elevatedslightly elevated..
7-7-DysphagiaDysphagia (unable to swallow)(unable to swallow)
8-8- OLiguriaOLiguria or even anuria and constipation.or even anuria and constipation.

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9-9- Difficulty in movingDifficulty in moving, stiffness in gait and, stiffness in gait and
incoordination.incoordination.
10-Within 24 hours, the animal goes down10-Within 24 hours, the animal goes down
thenthen tetanic convulsionstetanic convulsions develop anddevelop and deathdeath
may occur about 48hrs. after onset ofmay occur about 48hrs. after onset of
illness due toillness due to respiratory failurerespiratory failure..

9. 99
Profuse sweatingProfuse sweating

10. 1010
Tetanic spasmTetanic spasm

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StiffnessStiffness

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DiagnosisDiagnosis
 I- HistoryI- History
 II- Clinical signs.II- Clinical signs.
 III- Laboratory diagnosisIII- Laboratory diagnosis ::
 Estimation serum calcium level usuallyEstimation serum calcium level usually
between 4-8 mg% (normal around 10 mg%)between 4-8 mg% (normal around 10 mg%)
 IV-Therapeutic diagnosisIV-Therapeutic diagnosis
 Response to treatment withResponse to treatment with calciumcalcium
preparationspreparations
 Differential diagnosis:Differential diagnosis: Tetanus andTetanus and

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Laminitis & TetanusLaminitis & Tetanus
Tetanus

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Treatment and preventionTreatment and prevention
 I/V administration ofI/V administration of calcium solutionscalcium solutions , such as 20, such as 20
% C.B.G (calcium boro gluconate ) usually results in% C.B.G (calcium boro gluconate ) usually results in
full recovery.full recovery.
Administered slowly (over 20 min) at 250- 500 mL/500Administered slowly (over 20 min) at 250- 500 mL/500
kg, diluted at least 1: 4 in saline or dextrose, and thekg, diluted at least 1: 4 in saline or dextrose, and the
cardiovascular responsecardiovascular response should be closely monitored.should be closely monitored.
If arrhythmias or brady-cardia develop, I/V treatmentIf arrhythmias or brady-cardia develop, I/V treatment
should be discontinued immediately.should be discontinued immediately.

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 Once the heart rate has returned to normal, theOnce the heart rate has returned to normal, the
infusion may be resumedinfusion may be resumed at a slower rateat a slower rate..
 If the horse does not improve withinIf the horse does not improve within 1-2 hours of the1-2 hours of the
initial infusioninitial infusion, a second dose may be given., a second dose may be given.
 Some horses require repeated treatments overSome horses require repeated treatments over
several days to recover from hypocalcemic tetany.several days to recover from hypocalcemic tetany.
N.B:N.B:
One of the earliest signs of recovery is the usuallyOne of the earliest signs of recovery is the usually
followed by offollowed by of large volume of urinelarge volume of urine..

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Prevention:Prevention:
Single IV or S/C. 10 millions I.U.Single IV or S/C. 10 millions I.U. crystalline vit. Dcrystalline vit. D
immediately after foaling and repeated at weaning timeimmediately after foaling and repeated at weaning time
for lactating mares.for lactating mares.
AA balanced feed rationbalanced feed ration should be provided to supplyshould be provided to supply
adequate amounts and rations of calcium andadequate amounts and rations of calcium and
phosphorus throughout gestationphosphorus throughout gestation
In times of increased calcium demand such asIn times of increased calcium demand such as
lactating, fasting should be avoidedlactating, fasting should be avoided and high qualityand high quality
forage asforage as Alfa AlfaAlfa Alfa oror calciumcalcium –containing mineral mixes–containing mineral mixes
should be provided.should be provided.
Stress and fasting during transportStress and fasting during transport should beshould be
minimized.minimized.

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 InIn endurance horsesendurance horses water and electrolyte deficitswater and electrolyte deficits
associated with porolonged exercise and sweatingassociated with porolonged exercise and sweating
may be prevented by provision of amay be prevented by provision of a sufficient watersufficient water
supply and electrolyte supplementationsupply and electrolyte supplementation