canis - Articles
Puerperal tetany
Synonym(s): Eclampsia
Introduction
- Cause: neurological condition due to hypocalcemia.
- Signs: apprehension, ataxia, muscular tremors, spasms, panting and then tetany and convulsions. Tachycardia and fever in lactating female.
- Diagnosis: signs, biochemistry.
- Treatment: intravenous calcium.
- Prognosis: good if treated promptly.
Presenting signs
- Apprehension, whining, rapid panting.
- Muscular tremors, ataxia.
- Stiffness then recumbency, tetany then convulsions.
- Pyrexia (>205°C) as a result of tetany and convulsions.
- Excessive salivation.
Acute presentation
- Tetany, seizures and sudden death.
Breed/Species predisposition
- Small breeds.
Cost considerations
- Inexpensive if treated promptly.
Special risks
- Animals should be monitored closely by auscultation or ECG during calcium infusion for development of bradycardia or other dysrhythmias. If dysrhythmia or vomiting occurs, stop infusion. When normal rhythm returns, start infusion at slower rate.
Pathogenesis
Etiology
- Hypocalcemia causing panting, restlessness, ataxia and muscle tremors that can rapidly progress to tetany, convusions, hyperthermia and death.
Specific
- Heavy lactation.
- Large litters.
- Small breeds.
Pathophysiology
- A potentially life-threatening condition resulting from hypocalcemia during the periparturient period.
- Not well understood.
- Onset of lactation promotes calcium loss which is too great for homeostatic mechanisms to replace.
- Previous calcium loss to fetuses may be significant.
- Imbalance between the calcium utilization by the dam to support pregnancy and lactation and calcium absorption from gut and reabsorption from kidney and bone, resulting in hypocalcemia. Therefore, the clinical signs develop most often during peak lactation, in small bitches nursing large litters.
- It can occur in any size dog with any size litter, at any time during lactation. Rarely it occurs during late gestation.
Timecourse
- Within 3 weeks of whelping.
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.
- Drobatz K J & Casey K K (2000) Eclampsia in dogs - 31 cases (1995-1998). JAVMA 217 (2), 216-219 PubMed.
- Aroch I, Srebro H & Shpigel N Y (1999) Serum electrolyte concentrations in bitches with eclampsia. Vet Rec 145 (11), 318-320 PubMed.
- Frascetti A A & Hickman M A (1999) Preparturient hypocalcaemia in four cats. JAVMA 215 (8), 1127-1129 PubMed.
- Wallace M S (1994) Management of parturition and problems of the periparturient period of dogs and cats. Semin Vet Med Surg (Small Anim) 9 (1), 28-37 PubMed.