Clinical signs for milk fever what divided into and how change/vary
Three (progressive non -discrete) stages described
- Stage 1
- stage 2
- stage 3
but:
1. They are overlapping
2. They are interfered with by farmer treatment - COMMON
- Most milk fever cows I have seen have already had some calcium
- Generally you tell farmers
3. Cows may have more than a single disease concurrently
4. Response to i/v calcium is often used as the basis for diagnosis!
What are the clinical signs in stage I and 2 of milk fever - EXAM
What are the clinical signs in stage 3 of milk fever - EXAM
○ Lateral recumbency - EMERGENCY
○ Flaccid paresis
○ Tachycardia (heart very quiet)
○ Bloat (regurgitate contents)
○ Hypothermia
○ Often look dead and inhalation pneumonia is common
§ Therefore any cow in lateral recumbency - ANTIBIOTICS
What are 5 other differentials for a cow that is milk fever
1. Acute toxic mastitis ○ They have mastitis 2. Calving paralysis ○ Been up since calving, musculoskeletal exam 3. Grain overload ○ Smell of faeces, rumen pH 3. Other infections (uterine, peritonitis …) ○ History and clinical exam 4. Grass Tetany ○ Mentation - hyperactive 5. Fat cow syndrome ○ Ketones
Milk fever how what are the 6 steps in treatment and what recommend for different outcomes
1) Check to make sure no mastitis or other causes then quickly give:
2) Calcium borogluconate - IV
3) NSAIDS if the animal has been down or it’s very cold
§ Makes the more likely to try and get up THEREFORE MORE LIKELY TO LIVE
4) antibiotics if the cow has signs of other disease or if she has been in lateral recumbency
5) Then …Wait 5 -10 minutes (while you pack up your things)
6) Try to get the cow up. +/ -hip lifters.
§ If the cow does not get up, suggest re -treat/assess in 6 hours and treat as a “downer cow”.
§ If she does get up, recommend no or partial milking for 24 hours, and possibly a treatment of s/c or oral calcium at milking time to prevent relapse.
Calcium borogluconate when give, main types, properties and the 2 main ways to administer
- any down cow ○ Types - 4 in 1 or just calcium ○ Soluble in water - (relatively) non-irritant 1) Subcutaneous Calcium - most common farmer treatment 2) IV - do as the vet
Giving subcutaneous calcium to a down cow who generally does this, how to do and general advice
§ probably most common “farmer treatment” of milk fever
§ best to warm calcium to body temp (if cold vasoconstriction occurs) - just put in a hot bucket of water
§ ideally <125mls per site but most ignore this
§ over ribs is better than over shoulder
□ Tissue reaction won’t cause lameness
§ farmers expect vets to give calcium IV!
§ general advice “Give 2 packs, and 2 hours and call me if she is not up”
Giving IV calcium how give, requirement, how long over, safe rate and when reach point how give remainder
§ Give IV slowly, whilst listening to the heart - slows and gets louder
□ If hear ectopic beats -> stop for a minute
□ Do again until more ectopic beats -> STOP NOW FOR GOOD
§ Typical requirement is 1-1.5 mls per kg
§ Ideally give over 15 -20 minutes.
§ The “safe” rate of infusion is less than what flows through a 14g needle!
§ Give the remainder s/c
Individual level prevention for hypocalcaemia
Non-parturient hypocalcaemia what also called, when occurs
Transit tetany”
How to transition feed appropriately to prevent metabolic conditions after parturition
○ Restrict green pasture in the 2 weeks before calving
○ Feed to appetite good quality hay low in K (lowers the DCAD)
○ Supplement with Mg
○ feed anionic salts/concentrate pellet combination for 10 days prior to calving
○ Anionic salts in water
○ Ensure that sufficient dietary calcium after calving
§ Grain is low in calcium
§ Most farmers who feed >4kg grain per day add 30g MgO and 1% to 2% limestone to the ration.
Grass tetany what is the issue, characterised by and pathogenesis/cause
HYPOMAGNASAEMIA
- Grass tetany, grass staggers
- Characterised by - hyperexcitable -> tetany & convulsions –death
○ Can occur in clumps -> come out one morning to 5 cows dead
- Combination of nutritional deficiency & metabolic factors ⇒reduced magnesium availability or increased loss
○ Fresh, rapidly growing pasture heavily fertilised N and/or K
○ Low Mg in CSF (not blood) causes convulsions
§ Blood brain barrier slows diffusion of Mg so CSF lags behind blood
○ Usually low Ca++ as well
○ Mg is not under hormonal control –bone resorption better in young animals
§ Cows very reliant on dietary absorption of Mg
What are the some common risk factors for grass tetany
Grass tetany clinical signs what are the 3 main forms and signs within
Grass tetany diagnosis what normally just do and what additional testing is available
Diagnosis
- Clinical signs (& history)
- Response to treatment
But also:
- Blood sample
- Serum levels Mg below 1.2mg/dl (Normal levels 1.8 –2.4 mg/dl)
○ Tetany generally only below 1.2mg/dl (some animals normal with levels this low)
○ Level of Mg in CSF critical to diagnosis (low CSF ⇒clinical -lasts 48 hrs. –use vitreous humour (in dead animals obviously!)
- Urine Mg levels used as herd guide 43
- Post mortem - look at evidence that they died after struggle
○ Moving around
Treatment for grass tetany
Restore serum Mg concentration ASAP (early)
- Slow IV of Ca & Mg solutions (“4 in 1”) although in extreme case give 50 to 100ml 20% Mg sulphate IV (Slowly & must monitor)
○ Must monitor for cardiac arrhythmias & slow or stop infusion if occurs
- Subcut Mg sulphate (500ml 20% solution) after IV
○ May need to sedate convulsing cow prior to IV
- Oral therapy (100g/cow/day) of MgOfor 2 days then 50g/day for 5 days
○ They respond slowly to treatment (raise CSF level)
prevention of grass tetany options, when start and what can also prevent
Disorders of energy metabolism what are the 4 main ones and what are they essentially
What occurs with not enough propionate in the energy metabolism
Low oxaloacetate due to low propionate means the cow is unable to do krebs cycle -> more acetyl CoA that isn’t oxidised -> converted to ketones (Eventually)
- Ketones can be used and oxidised as energy for heart, kidney, skeletal muscle but if too much they can accumulate and excreted mainly in urine and milk
Hepatic lipidosis what are the 5 steps in the pathogenesis and the 3 main diagnostics used
Pregnancy toxaemia what is it apart of and general presentation/history
part of hepatic lipidosis syndrome
What is the treatment of pregnancy toxaemia
Protein energy malnutrition what is it apart of, presentation, cause and prognosis
part of hepatic lipidosis syndrome
- Late pregnant dairy cows being fed low quality feed (often carrying twins)
- “Thin late pregnant cows that can’t get up
○ Once you lift up though will stay up as take a lot of energy
- ” No other clinical signs to speak of
- “Starvation ketosis”
○ Commonly poor quality feeds rather than failure to provide feed
○ Imbalance between intake and requirement
○ Insidious weight loss then sudden recumbency
○ Serum metabolites often “normal” -insufficient to sustain defensible “starvation” diagnosis
- Prognosis depends on severity, time, treatment and nursing care
Protein energy malnutrition treatment