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Metabolic Diseases: Milk fever

Prepared by
Dr. Ali H. Sadiek
Prof. of Internal Veterinary Medicine
and Clinical Laboratory Diagnosis
Faculty of Veterinary Medicine, Assiut University
E-mail: Sadiek59@yahoo.com
 Metabolic diseases
6 Metabolic disease or diseases of
Intensive production occurs in highly
lactating cows and preg. ewes.
6 It occurs usually around parturition.
6 It could be defined as disturb. of
Internal homeostasis as a result of
sudden change in one or more of
intermediate metabolites.
 Metabolic disorders
• Metab. disorders occur primarily in early lactation
– Period of great stress and drastic changes in
nutritional requirement
– Energy metabolism disorders (ketosis, pregnancy
toxemia, fatty liver, rumen acidosis)
– Minerals and vitamin metabolism disorders (milk
fever, metritis, udder edema, retained placenta)
• Metab. disorders are correlated with each other:
– A cow with milk fever is 4 x more likely to also
suffer from retained placenta and 16 x more likely
to develop ketosis than a cow with no milk fever.
• Early detection and prevention is far better than
treatment
 Causes of metabolic Diseases
• Severe, sudden change in fluids,
electrolytes, soluble organic elements
during early lactation.
• Animal become unable to withstand such
changes led to change in the concentration
of these elements in blood e.g. Na, K, Ca,
P, Mg, Glucose, as a result of their
secretion in Milk.
• Stress of pregnancy, parturition, decreased
feed intake, increased M. production.
 1-Stress of
pregnancy
& parturition

Metabolic
Disorders

3-Stress of
2-Decreased
milk
feed intake
production
Examples of Metab. diseases
1. Milk Fever.
2. Hypomagnesaemia.
3. Downer Cow Syndrome.
4. Post Parturient Hemoglobinurea.
5. Azoturia
6. Metritis, udder edema, retained
placenta.
7. Ketosis.
8. Pregnancy toxemia of ewes.
9. Fat Cow Syndrome.
 Diseases characterized by recumbency.

1- Milk Fever.
2- Hypomagnesemia.
3- Downer cow syndrome.
4- Hypophosphatemia.
5- Ketosis.
6- Pregnancy toxemia.
7- Fatty liver syndrome.
8- Azoturia of equines.
 What are the disease associted
with ketonuria
1. Bovine Ketosis.
2. Pregnant toxemia of
ewes.
3. Downer cow syndrome.
4. Fatty Liver in cows.
5. Displacement of
Abomasum.
6. Ruminal acidosis.
7. Azoturia of equine.
 Milk fever
• It is an acute to peracute, afebrile, flaccid
paralysis of mature dairy cows that
occurs most commonly at or soon after
parturition.
• It is manifest by changes in mentation,
generalized paresis, and circulatory
collapse.
• In ewes it occurs before or after
parturition.
• It is called pregnancy toxemia in mares.
 Etiology
• At or near the time of parturition, the
onset of lactation results in the sudden
loss of calcium into milk.
• Serum calcium levels decline from a
normal of 10-12 mg/dL to 2-7 mg/dL.
• Commonly, serum magnesium is
increased, serum phosphorus is
decreased, and cows are
hyperglycemic.
 Blood Ca: 10 mg/ 100 ml
Ca intake Ca Pool: 3 g
Dry period: 50 g/d
Lactation: 100 g/d Body reserve:
Total: 6000 g
Mobilizable:15-20 g/d

Each cow need 30 gm ca daily, at parturition

•10 L colostr. need 23 gm Ca (9 folds serum
Ca).
 Causes
• Drop of Ionized Ca in blood and tissues
beyond the capability of PTH to withstand
such drop.
• PTH increased to mobilize ca from bone to the
blood to withstand such dramatic needs.
• In 5-20 % of cows PTH unable to mobilize
sufficient ca leading to its sharp drop in blood.
• Role of anaerobes in udder.
• Role of adrenal gland.
• Brain ischemia and anemia may have a role
after parturition
Serum Ca level after parturition
10
9
Seru m Ca (m g/dl)

8
7 Normal
6 Hypocalcemia
5 Milk Fever
4
3
2
-8
-6
-4
-2

0
2
4
6
8
10
Days from Parturition
 Occurrence of the disease
• Mainly in adult high lactating cows.
• Gersy cows is the more affected ones.
• Complete milking just after parturition may
help occurrence of the dis.
• It may occurs at late days of pregnancy or
during parturition.
• Most cases occurs just after parturition
and extending to 10 days after.
• 28 % of cases occurs afer the 1st week of
parution extending to 2 Months after.
•Parturient paresis usually occurs within 72 hr of parturition.
The disease may be seen in cows of any age but is most
common in high-producing dairy cows >5 yr old.
Incidence is higher in the Jersey breed.

% of Time of occurrence relative

cases to calving
3 Before calving
6 After calving
75 1-25 h after calving
12 25-48 h after calving
4 > 48 h after calving
 Signs of Milk Fever
Three clinical stages could be recognized:
1- First stage: (Stage of anorexia, ataxia, & hind limb stiffness).

™ Ch. by excitation, violence,

nervousness.
™ Decreased movement,
convulsions, reluctant to
move, may be falling.
™ Increased rate and strength
of heart rate
™ Body temp:37 to 38.5°C
™ Serum Ca: 5.5-7.5 mg/dl
2-Second stage (Stage of recumbency and Depression)

• Cow became calm, weak.

• Lay down on sternum in a
deep sleep, complete
muscular relaxation.
• Exhausted, dehydrated,
dryness of nose and
muzzle.
• Mild hypothermia “35 to
37°C” , mydriasis
™ Weak , rapid heart rate
™ Ruminal atony and dry
feces.
™Serum Ca:3-6.5 mg/dl
3-The Third stage: (Stage of pariesis and comatose)

• Signs of circulatory failure.

• Lateral recumbency with
loss of consciousness.
• Loss of muscle tone and
paresis and inability to
stand.
• Weak rapid pulse and heart
sound may be difficulty
audible
• Body temp: < 35 C
• Serum ca: < 2.0 mg/dl
 Milk fever in sheep
1. It is not common.
2. It occurs after parturition in
ewes exposed for forceful
exhaustion, long transport,
deprivation of food and
water.
3. Signs: Stilted and proppy
gait, alert and struggling
when approached, muscle
tremors, staggers and Lay
down, often with legs
stretched out behind the
body
4. It is misdiagnosed as
pregnancy toxemia

A ewe showing signs

of milk fever.
Problems that closely related to milk fever
1. Dystocia due to muscular weakness that
prevents proper labor.
2. Retained placentas and Uterine prolapse.
3. Mastitis and Metritis
4. Decreased reproductive performance.
5. Bloat due to rumen atony.
6. Abomasal displacements and Ketosis.
7. Greater risk of other infectious disease.
8. Decreased milk production.
9. Reduced total productive life in the herd.
 Diagnosis of Milk fever
•Case history:
Just after parturit. in a high lactat. cows.
•Signs: Recumbency, paresis, coma,
hypothermia
•Lab.: Serum Ca < 7 mg/dl
• serum Mg is increased, serum P is decreased,
and cows are hyperglycemic.

•Rapid response for IV Calcium

therapy
 Differential diagnoses
It includes:
1. Acute coliform Toxic mastitis.
2. Toxic metritis.
3. Traumatic injury (eg, stifle injury,
coxofemoral luxation, fractured pelvis,
spinal compression),
4. Calving paralysis syndrome (damage to the
L6 lumbar roots of sciatic and obturator
nerves), or compartment syndrome.
• Some of these diseases, in addition to
aspiration pneumonia, may also occur
concurrently with parturient paresis or as
complications.
Treatment of Milk fever
Restoring normal serum calcium levels:
– Ca gluconate 20-25 % (400-800 ml IV and repeated
after 6 hrs. I.V./I.M & /S.C
– Ca carbonate or Ca chloride orally (2-4 gm daily for
3-5 days.
– Ca, P, Mg preparation may be injected to maintain
their equilibrium.
– Calcium propionate (0.5 kg dissolved in 8-16 L water
administered as a drench.
– Calcium is cardiotoxic; therefore, it should be given
slowly (10-20 min) with cardiac auscultation
– Cases which not treated with sufficient doses may
relapse again with complications ending in downer
cows.
 Signs of response to Ca-therapy
• Tremors are seen as neuromuscular function returns,
• Stronger heart sounds and decreased heart rate
• Return of smooth muscle function results in eructation,
defecation, and urination once the cow rises
• Approximately 75% of cows stand within 2 hr of
treatment.
• Animals not responding by 4-8 hr should be reevaluated
and re-treated if necessary.
• Of cows that respond initially, 25-30% relapse within 24-
48 hr and require additional therapy.
• Incomplete milking has been advised to reduce the
incidence of relapse.
Intravenous calcium therapy
 I/V & S/C calcium therapy

Sucutaneous injection of ca gluconate

 Prevention of Milk fever
1. Feeding low-calcium diets during the dry
period to stimulate intestinal absorption and
enhance skeletal resorption prior to the
sudden onset of lactation.
Total calcium requirement for a 500 kg dry cow
is approx. 40 gm/day. Try not to feed in excess
of 0.40 % Ca (% of ration DM) to dry cows
2. Delayed or incomplete milking after calving,
which maintains pressure within the udder
and decreases milk production.
3. Prophylactic treatment of susceptible cows at
calving may help reduce parturient paresis.
Cows are administered either SC calcium on
the day of calving or oral calcium gels at
calving and 12 hr later
 Prevention of Milk fever
4. The DCAD approach :Use the dietary cation-
anion difference (DCAD), which decreases the
blood pH of cows prior and just afetr calving.
- Adding excess anions to the diet is believed
to enhance calcium resorption from bone and
absorption from the GI tract
- Reducing the K content of the diet: by feeding
corn silage as a major portion of the dry cow’s
diet to decrease bl. pH
5. Administration of vitamin D3 and its
metabolites is effective in preventing
parturient paresis (20-30 million U, sid), given
in the feed for 5-7 days before parturition,
reduces the incidence
Thank You