Veterinary World 2011, Vol.4 (1):45-47 REVIEW Eclampsia in the Dog: An Overview

Eclampsia is an acute, life-threatening disease caused by low blood calcium levels (hypocalcaemia) in dogs and more rarely in cats. The causes of Eclampsia are poor nutrition, low blood level of albumin, excessive milk production and disease of parathyroid gland. Imbalance between the rates of in flow and out flow from the extra cellular fluid calcium because of the increased loss into the milk appears to be an important factor in the pathogenesis of puerperal tetany in the bitches. Normally the condition is diagnosed by careful investigation, recording proper history, correlating the clinical signs, response to therapy in most cases and confirming the condition with laboratory diagnosis. Generally, 5-10 ml of 10% calcium gluconate will provide sufficient calcium for a bitch weighing between five and ten Kg. Dietary supplements of calcium and vitamin D are useful in preventing relapse of the disease after treatment and prevention of the disease.


Introduction
are more prone to the disease as compared to the larger breeds.The disease has been reported to be more Eclampsia is an acute, life-threatening disease frequently observed in small, hyper excitable breeds caused by low blood calcium levels (hypocalcaemia) of dogs.Eclampsia may not be necessarily associated in dogs and more rarely in cats.There is lesser with large litter size.documentation of hypocalcaemia in dogs and cats as compared to cattle (Rowland et al., 1972).Canine Etiology Eclampsia more correctly called Puerperal Tetany is a This disease condition can be produced by startling and dangerous condition brought on by hypocalcaemia (low blood calcium), which can be extremely low levels of calcium in the blood stream.It brought on by the following: is sometimes erroneously called as milk fever.Low 1. Poor Nutrition -In most of the cases the dog blood calcium is the result of reduction of calcium owners are not aware of the nutritional requirements of levels outside the cells of the bitch's body.The disease their dog and may either feed diet deficient in nutrients most commonly occurs in bitches 1-3 weeks after or feed nutrients in excess."Home brewed" diets are giving birth but the cases are also sometimes observed usually common predisposing factor for this disease.during gestation.As the demand for milk increases, The owner innocently may be adding too much the likelihood of eclampsia escalates.Normally, by 40 unbalanced meat to the bitch's diet, thinking that the days after whelping, the danger of eclampsia has extra protein is beneficial.This normally disturbs the passed.The pups of the affected bitches may not be calcium to phosphorus ratio because the amount of usually affected as the affected bitches usually useful calcium in the food is actually reduced.The produce milk with normal calcium level.Lctating ideal diet for a dog should have calcium: phosphorus animals are especially susceptible to blood calcium ratio of 1.2 to 1.Many organ meats such as liver have depletion because of milk production.The body of calcium to phosphorus ratio of 1 to 15. Liver is great some lactating dogs and cats simply cannot keep up for dogs but if it comprises a large part of the diet, the with the increased demands for calcium.Animals with Puerperal Tetany lack the ability to quickly move calcium/phosphorus ratio of the diet will be improper.calcium into their milk without depleting their own 2. Low Blood Levels of Albumen -Dietary protein deficiency or excessive loss of albumen from the body blood levels of this mineral.Smaller breeds of dogs will cause low levels of calcium.This happens in some calcium diet to dairy cows in the prepartum period also kidney diseases.
has provocative effect on development of 3. Excessive Milk Production -When pups require hypocalcaemia due to decreased responsiveness of large amounts of milk (10 to 30 days post whelping) PTH-mediated bone resorption.The resulting the bitch's ability to maintain proper amounts of decreased availability of calcium from skeletal calcium in her blood stream becomes stressed.As pups sources leads to increased reliance on intestinal grow their total daily intake of milk increases which calcium absorption.puts a greater and greater demand on bitch's milk Symptoms production.Interestingly, even with small litters, some Eclampsia is a very serious disorder but bitches produce so much milk so rapidly that their fortunately the signs are fairly easy to recognize, blood calcium levels cannot be maintained.Milk especially when it is coupled with late term pregnancy production has priority over the blood stream for and/or milk production.Initially, the affected dog will calcium.Since calcium ions in the blood have a be restless and nervous.Within a short time, she will dynamic impact on nerve transmission and muscle walk with a stiff gait and may even wobble or appear contractility, all sorts of physiologic dysfunction will disoriented.Eventually, the bitch may be unable to arise if blood calcium levels are too low.
walk and her legs may become stiff or rigid.Muscle 4. Disease of the Parathyroid Glands -The tremors, eye twitching, panting, in coordination may diseases of the parathyroid glands are also believed to also be observed.The bitch may have fever; with body cause hypocalcaemia in dogs and cats.This condition temperature even over 105º F. Temperature up to 107º F is quite rare.
is also not uncommon (Ettinger, 1983).This rise of

Patho-physiology
temperature is often associated with increased muscular activity.The respiration rate will also Imbalance between the rates of in flow and out increase.At this point, death can occur if no treatment flow from the extra cellular fluid calcium because of is given.The clinical course of the disease is very rapid the increased loss into the milk appears to be an and the bitch may proceed from the initial symptoms important factor in the pathogenesis of puerperal of restlessness, panting and nervousness to ataxia, tetany in the bitches.Severe hypocalcaemia and often trembling, muscle tetany and convulsive seizures hypophosphatemia develop near the time of peak within 12 hours (Resnik, 1972).lactation (approximately one to three weeks postpartum); probably as the result of an imbalance Diagnosis between the rates of inflow and outflow from the Normally the condition is diagnosed by careful extracellular calcium pool (Ettinger, 1983).There is investigation, recording proper history, correlating the excessive loss of stabilizing membrane bound calcium clinical signs, response to therapy in most cases and resulting in increased permeability of nerve confirming the condition with laboratory diagnosis.membranes to ions.These membranes, therefore, The bitches suffering of eclampsia have a history of require stimulus of lesser magnitude to depolarize.whelping one to two weeks ago, sudden start of pacing Functional disturbances associated with hypocalcaand hesitation to nurse.The animal may show the signs emia in the bitch are due to neuromuscular tetany. of panting, shaking all over, and it may not be able to Tetany occurs in bitches as a result of spontaneous even stand up.Laboratory examination may be repetitive firing of motor nerve fibers.
performed for the diagnosis of Eclampsia by The addition of calcium supplements or diets estimation of Serum calcium, Serum phosphorus and excessively high in calcium may exert a negative Blood glucose levels.In canines affected with biofeedback on the secretion of hormones by the eclampsia, the serum calcium level is less than 7 parathyroid glands that control calcium metabolism.mg/dl.The Serum phosphorus levels are often This effect can cause a decrease in both the body's lowered.The Blood glucose levels are in the low capabilities to mobilize calcium stores from bone and normal range or decreased due to severely increased its ability to increase calcium absorption in the muscular activity as a result of tetany.Eclampsia is intestine.When calcium is suddenly needed for generally associated with proteinuria (Vigue, 1953).lactation, the body's regulatory mechanisms are Treatment unable to adapt quickly enough to the sudden calcium loss.Since calcium is diverted to milk production, the Eclampsia can be treated by a slow and careful bitch's blood calcium levels decrease.Feeding high intravenous injection of a calcium solution under the d close supervision of the veterinarian.Generally, 5-10 suitable preventive measures need to be taken to ml of 10% calcium gluconate will provide sufficient prevent this disease.The following preventive calcium for a bitch weighing between five and ten Kg. measures can be taken for prevention of Eclampsia: Calcium should be administered slowly to avoid 1.
Provide balanced diet with proper Calcium ventricular fibrillation and cardiac arrest.Often a Phosphorus ratio during gestation.High quality meat-based balanced food may be provided.patient needs to be monitored through ECG or other Don't over supplement with all sorts of calcium, device to record heart rate and blood pressure.After vitamins or meat products.only a few minutes of seizure and even continuous 2.
Give only small amount of a balanced source of tremors or spasms, the patient's temperature will rise calcium, phosphorus, and Vitamin D to the to dangerously high values.It isn't uncommon for a bitch's diet beginning about mid-term.Milk dog, whose normal body temperature is generally near makes a good "supplement" as long as the 101 and 102 º F, to have a body temperature of 107 º F.
lactose does not create loose stool.Do not add Any higher values will surely lead to irreversible brain calcium alone, it must be used with phosphorus damage.Cool bath should be given, in such cases, to and Vitamin D. Remember that optimum ratio of lower body temperature to normal.After only a few calcium to phosphorus is 1.2 to 1. minutes of muscle spasms the bitch will be thoroughly 3.
Cortisone supplement prior to whelping are exhausted and rapidly available glycogen (glucose) helpful in preventing Canine Eclampsia.stored in the liver and muscles can be depleted.Low 4. Supplement the puppies' with a milk replacer as blood sugar can trigger seizure activity, too.soon as possible to decrease the milk demands Therefore, intravenous injection of dextrose for quick on the bitch.Preferably, the pups of the energy should be given to eclampsia patients.If the susceptible bitches should be removed from the tremors are severe mild sedation or use of bitch for 24 hours and fed on milk substitute or phenobarbitone may be beneficial to assist in relaxing other suitable diet.Commercial milk replacers the muscles.are also available.Dietary supplements of calcium and vitamin D 5.
Wean the pups as soon as possible.are useful in preventing relapse of the disease after treatment.Some clinicians prefer using cortico-References steroids in addition to calcium and vitamin D. 1.