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. For that hormonal therapy and dietary manipulations are successful. Among them, hormonal therapy does not seem to work in the field as it needs an accurate prediction of the date of parturition for the administration of hormones. The dietary manipulation may be the best and easiest way to prevent milk fever in this regard. The supplementation of anionic diet salts brings about a mild acidosis in the body 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. To be more sure of prevention of the disease, anionic salts should be supplemented with high Ca diet so that sufficient amount of Ca is absorbed through intestine. Among the anionic salts, MgSo4 may be used commonly as it is more palatable to the animals and cheap. However, ammonium salts such as NH4Cl and NH4SO4 although effective are less palatable. A useful tool is to measure the urine pH i.e. pH 5.5-6.5 to monitor anion cation balance in diet.

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).
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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.
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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
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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.
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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.
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7. Forms of milk fever
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8. Diagnosis
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9. Diagnosis
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10. Differential diagnosis
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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
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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.
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