Eclampsia, aka "Milk Fever", aka Post-partum hypocalcemia

The phone rang at 3:00AM.  This is never good: I am not pretty and I need my beauty sleep. "Do you make house-calls?"  It turns out the guy got up to use the bathroom and found his dog stiff and twitching uncontrollably. "Is this a female dog?" Yes.  "Has she had puppies recently?" Two weeks ago. "What kind of dog is it?" Part Rat-terrier and part Feist [I thought those were two different names for the same breed. In fact, I still think that.]  She needs an intravenous calcium injection, and I'm going to work... at three o'clock in the morning.  I'll be discombobulated for days.

So here she is.  You can't see her rigidity, her shaking, her fever. 

What you can see are the hardest-working glands in show-business.  This gal is running a do-it-yourself dairy, but she failed to read that little disclaimer about "professional driver, closed course, do not attempt".   She didn't see the asterisk: "Results not typical".

This dog is actually not the typical eclampsia sufferer.  While I have seen Beagles and even larger dogs with the condition, the typical patient is a very small dog like a Chihuahua.  She's milking heavily.  While it might occur even before birth, or at any time during nursing, seven to fourteen days after birth is pretty typical.  The bitch cannot cope with the demands of putting so much calcium in the mammary pipelines, and her blood calcium levels get low.  When this happens, the nerve-muscle electrical function gets screwy, resulting in uncontrollable muscle contractions.  This, like shivering, causes a rise in temperature (though to much higher, even dangerous levels, as high as 107 degrees).  Convulsions result and the combination of seizures and high temperature will prove fatal if not treated.

The longer this goes on, the more difficult it is to treat.  In early stages, one can almost always achieve a rapid reversal of signs by giving a slow intravenous injection of calcium gluconate.  It is miraculous to see the dog return to normal.  In more advanced and severe cases, intravenous fluids may be needed to support and cool the patient, and anti-convulsant sedatives may be needed for the seizures, but most can be saved.

We used to think these dogs didn't have enough calcium in their diets (which certainly wouldn't help anything).  Breeders used to give the bitches calcium supplements.  This turns out to be of little help.  It is a good idea to feed a high-quality puppy food during the last half of pregnancy and nursing.  This provides the extra protein, calories, vitamins and minerals needed for gestation and nursing.  However, there are plenty of dogs who have crummy diets and they don't get eclampsia.  The dogs that get it just can't handle the metabolic stress of nursing, and it doesn't seem to matter what you feed them. 

Since being "milked out" is what stimulates more milk production, you have to quit milking the dog.  In other words, the puppies get moved from the mama to the bottle -- no more nursing.  Since this condition appears to stem from a flaw in mama's metabolism, she needs to get out of the mommy business.  If she has another litter, you can count on another emergency call.

This is really my least favorite emergency, as I can't be self-righteous about it.  It's not due to neglect or bad judgment.  It's not like letting the dog run loose, or feeding it garbage, or forgetting that you left rat-poison behind the couch.  It is a true emergency, in that it just emerges, springing out like Athena from the head of Zeus.  Not only that, if I don't go treat it, the dog will die.  It really can't wait.  The only thing the owner could really do to prepare would be to get informed about the problem when the dog gets pregnant, and keep some Calsorb on hand (a rapidly absorbed oral calcium supplement) for emergency treatment at home.  Speaking of getting informed, here's a link to a great article on birthing puppies from Veterinary Partner.

Comments

[ballerinamoose]

So if this is your least favorite emergency, do you have a favorite...? :)

[Doc]

That is a tough question. Flipping a bone chip out of a distressed dog's mouth isn't bad, as emergencies go. Mostly I like the ones that aren't in the middle of the night, aren't too much work, and the pet gets well.

Thanks for reading and writing.

[libby haver]

Hi,
Sorry to bother you on Father's Day but ....my boxer is pregnant and she was due yesterday but we bred her on the 7th day
of the cycle "just in case" per my vet, so we could be 3 days off or so. She tied the 12th of April and the 16th of April.
Her x-ray was done the 9th of this month and we saw 7 to 9 puppies. This is her first litter she turned 2 in May. I noticed the other day she seemed stiff when she got up, but she had slept in the same spot all night so I thought maybe from laying there for so long her front legs went to sleep. I have been monitoring her temp since Wed. It has fluctuated from 100.9 and for the past 2 nights it has gone down as low as 98.6 last night. This morning 99.6 at noon 98.6 at 2:42 99.8.
At about 10:00 this morning she started shivering but she had been out in the rain but she has been doing it all day now off and on. She has eaten a little bit, not much, yesterday or today but she was never a big eater. She has a small amount of whitish yellow discharge from her vulva.
Her gums are a pinkish white and she has had no more signs of being stiff since the other day.
I squeeve her nipples and a few of them oozed a yellowish fluid but did not seem painful to her.
She seems a little out of it. Has that far off look in her eyes but no panting and I can see the fetuses moving but have seen no contractions. She is not digging or licking her vulva but she does seem very tired and uncomfortable. I am concerned about milk fever, what do you think?
I do need to mention that I spotted tape worms in her stool 2 days ago, I called the vet upset because she was tested before I bred her and when the x-ray was done because she looks thin to me and the tests were negative. They informed me that the test does not pick up tapes???? I think someone should have told me that months ago!!!! She has lost all of her muscle tone and her backbone sticks way up. She has never had fleas but the vet sd that she could have eaten a mouse and could have gotten them that way. We live in the country and she has the run of 12 acres (when she is not pregnant)so it is very possible. Anyway, whatever expert advise you can give me will be so appreciated. I will def be taking her to the vet tomm and maybe tonight. I called te emerenc vet and theys se is probably just in early labor and to keep an eye on her, they sd shivering is a reponse to pain. They are 2 hours away and all of my whelping stuff is ready to go here. It would be terrible for her to deliver her babies in the truck on the way there.
Thanks,
Libby

[Doc]

Hello, Libby,

It is very unlikely that your dog has low blood calcium. It is virtually unheard of in large-breed dogs.

Unfortunately, our fecal exams for parasites look for microscopic parasite eggs. The tapeworms pass chunks of worm that are full of the eggs. You are much more likely to find the pieces of tapeworm passing than your veterinarian is to find anything in the microscopic exam. There just really isn't a good test, other than visual inspection of the stool, the dog, and the dog's bedding. Any type of raw meat can be a source, including rabbits and rodents, and fleas are also intermediate hosts (probably responsible for MOST of the tapeworm infestations that I see in my practice). The deworming will be safe for her, despite pregnancy and nursing.

The loss of condition and weight occurs because the mother will sacrifice her own body to keep building the puppies. Nine puppies is a BIG litter. It is very difficult for her to eat enough to satisfy all the demands of pregnancy, even if she is eating a good, high-quality puppy food. Once she delivers, she'll have more room in her stomach and should eat better.

Many mother dogs are uneasy, uncomfortable and restless for two days before the onset of active labor (contractions, pushing, water breaking, etc.). This is often referred to as the "first stage" of labor.

I hope that all goes well.

Thanks for reading and writing.

[fever symptoms]

A child with a high fever may have a febrile seizure. Symptoms of a seizure include shaking or jerking of the arms and legs, a fixed stare or the eyes rolling back, drooling, heavy breathing, and the skin turning blue. If your child has a febrile seizure, contact your doctor immediately.

[stacey]

how long do i keep my dog away from her pups after she has had milk fever?

[Doc]

Hello, Stacey,

Generally speaking, I recommend bottle-feeding the dogs and not allowing the mother to nurse them. Another episode of low blood calcium is very likely if she resumes nursing them.

My feeling is that these dogs are not physically well-equipped to nurse. Even with supplementation of their diet they can have a relapse of this life-threatening problem.

I am certainly not an expert on reproductive medicine. I am speaking only from my clinical experience.

Your best source of advice is the veterinarian who is treating your dog. Ask him/her what they think is appropriate for your particular case.

Good luck.

[Emmy]

Hello Dr., really nice post. This is the second post I have come across where a vet says that supplements are really of no use ,and the last post said they may actually work against calcium production in the body. Can you tell us a bit more about this. I would suggest people use a supplement such as osteo-form with pregnant, lactating or elderly dogs to help prevent calcium deficiency... do you feel this isn't a very good idea? I'd love to know more from you. Thanks!

[Doc]

Hello, Emmy,

I wish I had a lot more expertise to share with you, but I do not.

We rarely recognize osteoporosis even in older dog, provided that they are on a balanced diet. Dogs who are living on Vienna Sausages probably need some dietary supplements, though.

Metabolic disease that causes osteoporosis is unlikely to be improved by supplements. If you've got some hormone wackiness, that needs to be diagnosed.

I am certainly not a nutritionist, nor an internal medicine specialist. Thus, I'm about as far out on the limb as I intend to go.

If you have a specific case in mind, I would be happy to try to investigate further. Bear in mind that my advice could only be general, as I have not examined your pet.

Thanks for reading and writing.