Milk fever is a disease of increasing importance. In dairy herds its incidence has doubled since 1950; today about 8 per cent of parturitions in Swedish dairy cattle are complicated by milk fever. At the same time, the clinical picture has changed and the effectiveness of calcium therapy has been markedly reduced. Thirty to 40 per cent of cows with milk fever need more than one treatment. These trends are obvious in Sweden and Norway and have been reported from many other parts of the world. However, there are also geographical and breed differences so that these figures might not be applicable under British conditions.
Summary Clinical, clinico‐chemical and patho‐anatomical investigations were made on 129 downers, i. e. cows which were unable to rise after two treatments for parturient paresis. Of this number 74 had to be slaughtered. The results may be summarized as follows: 1. At the primary onset the downers had no other changes in blood‐chemistry than those found in uncomplicated parturient paresis. The downer syndrome is therefore most often a complication of this disease. Exceptions are a few cases of, inter alia, nerve injuries arising in conjunction with calving. 2. The most prominent blood‐chemistry change in the course of the disease was a rise in GOT. This was usually due to muscle injuries, which were the most common cause of the downer syndrome. Muscle injuries were found in 53% of the slaughtered cows. The injuries were localized chiefly to the medial thigh musculature and are usually regarded as caused by spreadeagling. Pressure injuries of the musculature also occurred. No generalized waxy muscular degeneration was observed. 3. The impaired liver function (elevated serum bilirubin and BSP) and/or the histologically demonstrated liver abnormalities are usually interpreted as a consequence of a state of relative starvation. The injuries were so grave, however, in 5% of the cows that they were considered the main cause of the downer condition. 4. Lesions were common in the sacro‐iliac joint. These were, however, considered to be caused by hormonal action in conjunction with calving and were in no case considered to be the main cause of the cows' inability to rise. 5. In 7% of the cows the downer condition was judged to be caused by persistent hypocalcaemia. 6. Six of the cows had no other abnormality than persistent hypophosphataemia. These cows had no specific symptoms but, apart from an inability to rise, showed a manifest general tieredness. All recovered. 7. Myocardosis was found in half of the slaughtered cows. A certain, but not constant, relation was found between pathoanatomical and clinical observations (tachycardia, arrhythmia). Myocardosis was considered the main cause of the downer condition in 8% of the cows. 8. As traumatic muscular injuries predominated in the material, this points to the diagnostic and prognostic value of GOT determinations. The detection of myoglobinuria at an early stage of the disease is also of diagnostic and prognostic value. 9. The significance of a good delivery environment in order to diminish the risk of traumatic injury is emphasized. Excess fatness appears to be an important predisposing factor for these injuries and should be avoided. No relation was found between the downer syndrome and different environmental conditions. Zusammenfassung Studien über das Festliegen („downer”‐Syndrom) bei Milchkühen 129 “downers” wurden klinisch, klinisch‐chemisch und pathologisch‐anatomisch untersucht. Als “downers” werden Kühe bezeichnet, die nach zwei Behandlungen gegen Paresis puerperalis, sich nicht zu erheben vermögen. Von diesen wurden 74 notgeschlachtet. Die Ergebnisse lassen sic...
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