F338
Hypocalcemia (Milk Fever)

Most cases can be identified by physical examination and the appearance of the common clinical signs during the last part of gestation or during lactation. Blood work specifically looking at calcium can also be done.

1. Begin by administering an oral glucose supplement such as Nutri-Drench or propylene glycol. These will help to prevent ketosis (see page F650). Nutri-Drench should be dosed according to the label, while giving about 60 mLs of propylene glycol is recommended. These products should be given 2-3 times a day until the animal has fully recovered.
   
   
2. An intravenous (IV) source of calcium should be given. CMPK is probably the best source of calcium because it also contains potassium. In general, give 50-100 mLs of CMPK or another IV solution that contains calcium borogluconate (21.6 mg/mL). This amount should be repeated frequently (every 2-3 hours) and the doses should be given SLOWLY. During administration, heart rate and rhythm should be monitored. If at any point during the calcium administration the heart skips beats, becomes irregular, or speeds up over 80 beats per minute, discontinue the IV immediately! Death can occur if calcium is given too quickly. Repeat these doses until a significant change is noted and the animal begins eating.
   
   
3. Daily IV CMPK doses may need to be given until the ewe/doe gives birth.
   
   
4. Oral calcium can also be given for continued calcium supplementation.
   
   
5. As the animal begins to eat, offer alfalfa and/or alfalfa pellets. These are usually high in calcium.
   
   
6. If the ewe/doe has been down for extended amounts of time, efforts should be made to frequently move the animal. This will help prevent muscle shrinking and sores from developing.
   
   In some cases, a homemade sling can be made that can be hung from beams or rafters in the barn. This can be made from two long poles that rest on either side of the animal, with some type of soft netting or canvas material used to support the animal’s chest and abdomen. The animal should be hoisted in the sling on a regular basis (2-3 times a day) for 30-60 minutes. The animal should be lifted off the ground to where the feet are touching and some weight bearing can be done. Use of the sling should be done with caution and the animal should not be left unattended.

Prevention: The best way to prevent hypocalcemia is to provide a balanced and nutritious diet during the last part of gestation and through lactation. Realize that during the first 3 months of gestation, the fetus does not require excessive amounts of calcium; however, after 90 days of gestation and during lactation, the calcium requirements increase dramatically. This means that during the first few months of gestation, a diet of grass hay (generally low in calcium) may be sufficient. If this same diet, however, is fed later in gestation, problems will occur. To over come this, it is recommended that small amounts of alfalfa hay and/or pellets (high in calcium) be added into the diet around day 90 of gestation. The alfalfa being fed should gradually replace all the grass hay by the time the ewe/doe gives birth. Supplemental grain (high in phosphorus and low in calcium) should also be fed at this same time to keep up with the increased energy demands on the mother. Start feeding a small amount of grain (1-2 cups) in the morning and evening. This should be increased when she begins lactating to approximately 0.5-1.0 pound per every 1-3 pounds of milk she is producing. Because of the low calcium levels in grains (concentrates), it is important to not over-feed the grain and neglect the necessary alfalfa hay. This diet can be fed until the dry-off period.