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Milk Fever
Synonym(s): Hypocalcaemia
Introduction
- Cause:
- Milk fever is the common name used to describe hypocalcemia in cattle.
- It is a metabolic disease associated with low blood calcium levels.
- Signs: see below.
- Diagnosis: history, clinical signs, blood biochemistry and response to treatment.
- Treatment: intravenous calcium supplementation.
- Prognosis: good, in uncomplicated cases.
Breed/Species predisposition
- Channel Island breeds (eg Jersey Jersey) are more susceptible to milk fever, either due to genetic susceptibility or high production levels relative to body size.
Cost considerations
- The estimated direct cost of a single, uncomplicated case of milk fever in the UK has been calculated to be £130.89 from lost productivity, treatment and labor costs (Macrae and Esslemont 2015).
- However, milk fever may result in primary uterine inertia and secondary effects such as dystocia, uterine prolapse, retained fetal membranes and “downer cow” syndrome, as well as predisposing to the development of environmental mastitis.
- The average cost of a case of milk fever (UK 2018) has thus been calculated to be £420.63 (including re-treatments, veterinary costs etc.)
- Fatal cases have been estimated to cost £3,618.97 in treatments, labor, vet costs and replacement of the cow (UK 2018).
Pathogenesis
Pathophysiology
- Follow this link for details on the homeostatic mechanisms involved in calcium metabolism by the cow and the factors that can influence this process Calcium and phosphorus: overview.
- In summary, only 1% of the total body calcium is in a form which is immediately available to the cow. Thus the cow is heavily reliant on the homeostatic mechanisms involved in regulating blood calcium levels.
- Parathyroid hormone (PTH), 1,25-dihydroxycholecalciferol (calcitriol) and calcitonin are the key hormones involved in the regulation of blood calcium levels.
- Immediately after calving, these homeostatic mechanisms are under increased pressure to release calcium from the skeleton and/or increase gut absorption to meet the high calcium requirements of the cow to produce colostrum/milk.
- These processes take 2-3 days to become fully active, and if these processes fail to meet the cow’s calcium demands in time, hypocalcemia will occur.
- Hypocalcemia affects muscular contraction due to the requirement of calcium for membrane stabilization in peripheral nerves, release of acetylcholine at the neuromuscular junction and contraction of muscle cells.
- Thus hypocalcemia will lead to flaccid paralysis of skeletal muscles (resulting in recumbency), smooth muscle (resulting in gut stasis and bloat) and cardiac muscle (reduction in cardiac output).
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Goff J P (2000) Pathophysiology of calcium and phosphorous disorders. Vet Clin North Am Food Anim Pract 16 (2), 319-337 PubMed.
- Green M J & Bradley A J (2000) Managing the dry period to prevent hypocalcaemia in dairy cows. UK Vet 5 (1), 35-39.
Other sources of information
- Macrae A I & Esslemont R J (2015) The prevalence and cost of important endemic diseases and fertility in dairy herds in the UK. In: Bovine Medicine. 3rd edn. Ed: Cockcroft P D. Wiley Blackwell, UK. pp 325-337.