1. Separate the puppies from the mother and seek veterinary attention immediately as clinical signs can progress rapidly. Transport the puppies to the veterinarian in a separate, secure carrier.
  2. Minimise stress as this can worsen the condition. It may be helpful for the mother to be able to see her litter during transport.

WHAT IS IT?

Milk fever, also known as eclampsia or puerperal tetany, occurs when blood calcium is low after giving birth. It usually occurs within 2-4 weeks of whelping, but can also occur in the last weeks of gestation or pregnancy.

CLINICAL SIGNS

The most common signs are muscle tremors, seizures and fever.
Other signs include:

  • Itchy face, rubbing face on the ground
  • Panting
  • Increased heart rate (tachycardia)
  • Increased vocalisation/whining
  • Weakness
  • Uncoordinated gait (ataxia)
  • Muscle rigidity/tetany
  • An abnormal posture where the back is arched and head is thrown backwards with the limbs straight and rigidly outstretched (Opisthotonos). This is caused by severely strong muscle spasms.

CAUSES

  • Milk fever is caused by a depletion of calcium, usually when the body fails to replace calcium that is lost in the milk. In pregnant bitches, a large amount of calcium is lost not only in milk but also through the process of formation of the foetal bones during gestation.
  • It is also seen in animals with inadequate nutrition (pregnant animals have increased nutritional requirements), or secondary to over-supplementation of calcium which can cause atrophy of the parathyroid glands involved in calcium metabolism.
  • Toy breeds and small dogs are most commonly affected.

TREATMENT

Provide your veterinarian with a full history including dates of whelping, number of offspring born and the diet provided.

Diagnosis of milk fever is confirmed with a blood test.

Treatment involves administration of calcium gluconate, slowly and carefully, while the heart rate is being monitored (rapid administration or overdose may stop the heart). Oral calcium supplements may also be required. The litter will need to be fed with a milk replacer, until the mother’s blood calcium is normalised, and your veterinarian may recommend early weaning to reduce stress on the mother.

Seizures can be controlled with some anti-seizure medication and if brain swelling is suspected, there is a drug called mannitol which can be used as well.

In patients with a severely high fever, cooling methods like using cool intravenous fluids, wetting the hair coat or blowing a fan over the animal can be used to cool them down once they have been stabilised.

Intravenous calcium supplementation may be required every 6-8 hours until the mother is stable and well enough to receive oral calcium supplements.

It is useful to feed expectant mothers puppy food two to three weeks before whelping and continue this while the mother is lactating (at least four weeks).

REFERENCES

Davidson AP (2012) Reproductive causes of hypocalcaemia. Topics in Companion Animal Medicine. 27:165-166

Jutkowitz LA (2005) Reproductive emergencies. Veterinary Clinics of North America: Small Animal Practice. 35:397-420