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540 (cow class) > Parturient Paresis > Flashcards

Parturient Paresis Flashcards

1
Q

what is a transition cow?

A

when a cow is in late gestation and is preparing to calve and “transitions” from being a dry cow to a fresh cow

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2
Q

what are the 4 components of parturient paresis? which one is most important?

A

hypocalcemia
hypomagnesemia
Hypophosphatemia
Hypokalemia

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3
Q

tell me the other names of parturient paresis

A

Clinical or subclinical hypocalcemia
milk fever

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4
Q

tell me about normal calcium mobilization during calving/lactation.
how much Ca in colostrum per day?
when is [Ca] lowest in blood?

A

pre calving –> Ca leaves blood and is sequestered w/i mammary gland during colostrum formation

20-30g Ca per day

day 1 after calving

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5
Q

what does hypocalcemia cause?

A
  • paresis
  • increase risk of metritis
  • increase risk for fatty liver development
  • increase risk of mastitis
  • reduce fertility
  • increase risk of DA
  • higher blood NEFA
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6
Q

Why does hypocalcemia cause paresis?

A

Ca is required for muscle contractions, so low Ca = impaired muscle contractions

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7
Q

why does hypocalcemia increase risk of metritis?

A

Hypocalcemia impairs immune cell response, including neutrophil function

lower Ca in mitochondria decreases its use as a secondary messenger and decreases release of cytokines and impaired neutrophil function

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8
Q

Why does hypocalcemia increase risk for fatty liver development?

A

due to increased NEFAs bc body fat is being mobilized more

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9
Q

why does hypocalcemia increase risk of mastitis?

A

Ca required for muscle contraction, so hypocalcemia reduces contraction of teat sphincter –> lil gremlins can get up in there more easily

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10
Q

why does hypocalcemia reduce fertility?

A

because of the other diseases it causes/increases risk for

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11
Q

why does hypocalcemia increase a risk for DA?

A

Ca required for muscle contraction, so it reduces rumen and abomasal contraction and reduces rumen and abomasum motiliy.

it also mobilizes more body fat causing increase NEFAs

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12
Q

why does hypocalcemia increase NEFAs?

A

mobilizes more body fat

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13
Q

tell me the relationship b/t Ca, parathyroid gland, PTH, and Vitamin D?

A

low Ca –> parathyroid detects –> PTH released –> renal reabsorption of Ca from proximal renal tubules & resorption of bone collagen to release Ca

Vit D absorbed in diet or synthesized by skin –> absorption of Ca from small intestine & resorption of bone collagen to release Ca

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14
Q

what are the risk factors for parturient paresis?

A

fresh dairy cow >3 lactation
Jerseys & Guernseys
Hypomagnesemia

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15
Q

why are fresh dairy cows >3 lactations more at risk for parturient paresis?

A

they have less osteoclasts, so they are less able to utilize the Ca from their bones

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16
Q

why are Jerseys and Guernseys more at risk for parturient paresis?

A

they have fewer receptors for Vit D

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17
Q

Why is hypomagnesemia a risk factor for parturient paresis?

A

interferes with PTH action on tissues

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18
Q

what are the cut offs for clinical and subclinical hypocalcemia?

A

clinical: <5 mg/dL or < 1.25 mmol
subclinical: <8-8.4 mg/dL or <2.1 mmol

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19
Q

is subclinical hypocalcemia more likely to occur in primiparous or multiparous cows?

A

multiparous (50% of them get subclinical hypocalcemia, 25% of primiparous)

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20
Q

describe stage 1 of clinical hypocalcemia

A

standing and ambulatory
hypersensitivity and excitability
mildly ataxic, tremors

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21
Q

describe stage 2 of clinical hypocalcemia

A

cannot stand, sternal recumency w/ s-shaped curve to neck, obtunded

cold body temp and extremities

decrease PLR & dilated pupils

tachycardia, weak pulse, anorectic

bloat

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22
Q

describe stage 3 of clinical hypocalcemia

A

lose consciousness
unable to maintain sternal recumbency
extreme muscle flaccidity
severe bloat

23
Q

how can you diagnose hypocalcemia?

A

total calcium (calcium split trehalase assay)
ionized calcium (ISTAT, HORIBA)

bench top in-clinic analyzers

24
Q

compare and contrast using total Ca vs ionized Ca to diagnose hypocalcemia

A

tCa: less expensive, less affected by sampling conditions

iCa: more accurate measurement of available Ca, few thresholds est., affected by hydration and albumin status

25
Q

how do you treat a cow with stage 1 hypocalcemia?

A

oral Ca bolus
1st bolus immediately after calving
2nd bolus 12-24 h later

26
Q

tell me about postpartum Ca supplementation, like who to give it to, how to, etc

A

1 oral tx = 4g Ca IV
tx of standing multiparous cows only! (not for blanket tx, not for primiparous cows)
provides oral Ca absorption for immediate use to cover time b/t when cows can become normocalcemic after calving

27
Q

how do you treat a cow with stage 2 or 3 hypocalcemia?

A

500 mL 23% Ca gluconate IV
- 1g/45kg BW (0.022223g/kg)
- 1 bottle = 10g Ca/500mL
- give slowly! (10-20 mins)
- do not use milk vein

oral Ca bolus

28
Q

when should you NOT give calcium gluconate to tx hypocalcemia?

A

when there is subclinical hypocalcemia or those w/o C/S

29
Q

when should you NOT give oral Ca bolus to tx hypocalcemia?

A

when stage 2 or 3 cow does not response to IV Ca

30
Q

what is hypocalcemic relapse, why does it happen, and how to prevent it?

A

12-24 h after IV Ca to subclinical hypocalcemic cows immediately postpartum

rapid increase in [Ca] removes stimulation of PTH secretion and slows homeostatic response

oral Ca bolus

31
Q

why should you give IV Ca slowly?

A

fatal cardiac arrhythmia if given too fast

32
Q

using Ca borogluconate sub q:
1. what does it require?
2. what is the pro?
3. how many mL per site?
4. what is the con?

A
  1. adequate perfusion and hydration to absorb
  2. blood Ca increased for at least 12 h after SQ admin
  3. no more than 75mL per site
  4. little effect on minimizing risk of subsequent dz development, milk prod., repro performance
33
Q

DO NOT ADMIN CA PRODUCT WITH ______ UNDER THE SKIN!

A

glucose

34
Q

how can you prevent hypocalcemia?

A
  • DCAD diet
  • dietary Ca manipulation
  • Vit D supplementation
35
Q

What is DCAD diet? how does it help prevent hypocalcemia? what is the recommended “dosage”?

A

dietary cation-anion difference

diets high in alkalinity leads to clinical hypocalcemia, so DCAD creates metabolic acidosis by lowering alkalinizing cations (Na, K, Ca, Mg) and increasing anions (S, Cl, P)

add anionic salts to diet to balance and create more acidic state

100-200 mEq/kg [ (Na + K) - (S + Cl) mEq/kg ]

36
Q

how can you monitor cows on DCAD?

A

test “close up” cows’ urine pH
pH = 6.0-6.5 holsteins
pH = 5.5-6.0 jerseys

37
Q

how can you manipulate dietary Ca to prevent hypocalcemia? why does this work?

A

Low Ca diet prior to parturition
High Ca diet after parturition
Feed Ca binder in dry period

Low Ca diet puts cow in negative Ca balance –> stimulating PTH secretion –> stimulate osteoclastic bone resorption & renal production

feed less than 20g Ca per cow per day

38
Q

tell me pros and cons of supplementing Vit D to prevent hypocalcemia

what is the dose of Vit D supplementation and when?

A

30,000-50,000 IU added to prepartum diet

pros: when fed with DCAD decreases subclinical hypocalcemia, doesn’t affect postpartum Ca levels

cons: injectable causes negative feedback loop that leads to down reg of Ca, doesn’t affect postpartum Ca levels

39
Q

why is phosphorus important during pregnancy?

A

required for fetal skeletal development in last trimester of pregnancy

40
Q

what are the risk factors for hypophosphatemia?

A

hypocalcemia
PTH increases renal and salivary excretion of P
lost through colostrum and milk in fresh cows

41
Q

what are the C/S of hypophosphatemia?

A

typical downer cow
not as responsive to Ca
plasma P <1 mg/dl

42
Q

how do you tx hypophosphatemia?

A

6-23g monosodium phosphate dissolved in 1L of saline IV

oral supplementation 50-500g monosodium phosphate

Cal Mag Plus/Phos

43
Q

what are the C/S of hypokalemia?

A

flaccid paralysis, recumbency, s-shaped neck, cardiac arrhythmias (ventricular tachycardia)

serum K < 2.5 mmol/L

44
Q

what are the causes of hypokalemia?

A
  • parturient paresis syndrome
  • chronic anorexia or GI stasis
  • repeated admin of isoflupredone acetate
45
Q

how do you tx hypokalemia?

A

nursing care for downer cows

oral KCl 50g/100kg BW

46
Q

Mg is absorbed from _____.

A

rumen

47
Q

what causes hypomagnesemia?

A
  • beef cows on lush pastures high in K & N, low in Mg & Na
  • inadequate Mg in forages (cool season grasses, green cereal crops)
  • bad weather
48
Q

what are the risk factors for hypomagnesemia?

A

high producing cows
mid-lactation dairy cows w/ milk fever C/S

49
Q

what are the C/S of hypomagnesemia?

A
  • Mg > 1.1 mg/dL
  • twitching of face
  • tetanic spasms of muscles
  • staggering
  • clonic convulsions
  • chomping of jaws/frothy salivation
  • paddling
  • tachycardia >120
  • tachypnea >60
  • high RT > 40
50
Q

how do you dx hypomagnesemia?

A

serum???

PM: vitreous humor Mg >1mg/dL up to 48h after death, CSF Mg remains low up to 12 h after death

51
Q

why should you not use blood to test for hypomagnesemia post mortem?

A

blood samples shortly after death may be normal Mg due to rupture of muscles and release of Mg

52
Q

how to you tx hypomagnesemia?

A

1.5-2.25g Mg IV (milk fever supplements 1.5-4g)

oral Mg salts 100g Mg oxide drench

200-400mL 50% Mg sulfate solution enema

53
Q

what is important to know about using Mg IV to tx hypomagnesemia?

A

can take up to 1 h to recover and stand (CSF Mg to return to normal)

many will relapse in 12 h

54
Q

what are the top down cow ddx?

A
  • parturient paresis
  • toxic mastitis
  • toxic metritis
  • MSK injury (stifle injury, pelvic fx)
  • coxofemoral luxation
  • calving paralysis

540 (cow class) (32 decks)

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