Treatment of cows with parturient paresis using intravenous calcium and oral sodium phosphate

Abstract

The goal of this study was to investigate whether intravenous infusion of 1000 ml 40% calcium borogluconate combined with the oral adminstration of 500 g sodium phosphate leads to a better cure rate and longer-lasting normocalcaemia and normophosphataemia than standard intravenous treatment with 500 ml calcium borogluconate in cows with parturient paresis. Forty recumbent cows with hypocalcaemia and hypophosphataemia were alternately allocated to group A or B. Cows of both groups were treated intravenously with 500 ml 40% calcium borogluconate, and cows of group B additionally received another 500 ml calcium borogluconate via slow intravenous infusion and 500 g sodium phosphate administered via an orogastric tube. Thirty-two cows stood within 8 hours after the start of treatment and 8 did not; of the 32 cows that stood, 18 belonged to group A and 14 to group B (90% of group A vs. 70% of group B; P = 0.23). Seven cows relapsed; of these and the 8 that did not respond to initial treatment, 10 stood after two standard intravenous treatments. Downer cow syndrome occurred in 5 cows, 3 of which recovered after aggressive therapy. The overall cure rate did not differ significantly between groups A and B. Twelve (60%) cows of group A and 14 (70%) cows of group B were cured after a single treatment and of the remaining 14, 11 were cured after two or more treatments. Two downer cows were euthanized and one other died of heart failure during treatment. Serum calcium concentrations during the first eight hours after the start of treatment were significantly higher in group B than in group A, and oral sodium phosphate caused a significant and lasting increase in inorganic phosphate. More cows of group B than group A were cured after a single treatment (P > 0.05). These findings, although not statistically significant, are promising and should be verified using a larger number of cows. DOI: https://doi.org/10.17236/sat00081Other titles: Behandlung der Gebärparese von Kühen mit Kalzium intravenös und Natriumphosphat per os Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-130508 Veröffentlichte Version Originally published at: Braun, Ueli; Grob, Daniela; Hässig, Michael (2016). Treatment of cows with parturient paresis using intravenous calcium and oral sodium phosphate. Schweizer Archiv für Tierheilkunde, 158(9):615-622.

A scoping review of the analytical literature concerning nonambulatory dairy cattle

“…Of the studies that investigated treatment of nonambulatory conditions, almost all used calcium compounds. A contributing factor could be that in addition to calcium being used to treat hypocalcemia (Sasaki et al, 2013;Braun et al, 2016), nonresponse to calcium therapy is often used as a diagnostic criterion for causes of recumbency other than hypocalcemia (Björkman et al, 1994;Oikawa and Katoh, 2002;Labonté et al, 2018). There is also prognostic value in nonresponse to calcium therapy in a clinical setting, as this could indicate that secondary muscular damage has occurred, which affects likelihood of recovery (Cox, 1988;Poulton et al, 2016a).…”

Lifting techniques in bovine recumbency

“…Eine gleichzeitig auftretende Hypophosphatämie kann die Therapie der Hypokalzämie erschweren. 18,19 Die Erfolgsrate in der Therapie von kombinierter Hypokalzämie-und Hypophosphatämie liegt bei 30%. 20 Die klassische Erstbehandlung einer Gebärparese besteht aus einer intravenösen Kalziumgluconat-Infusion als Monopräparat oder in Kombination mit unterschiedlichen Komponenten.…”

Diagnosis, therapy and prophylactic measures of parturient paresis in dairy cattle: results of an online survey for Swiss veterinarians

“…Postpartal festliegende Kühe zeigen in der Regel nicht nur eine Hypokalzämie, sondern auch eine Hypophosphatämie sowie eine Tendenz zur Hypermagnesämie (Martig 2002). Die orale oder intravenöse Supplementierung von Phosphaten scheint jedoch bei der Behandlung einer Gebärparese keine signifikante Verbesserung des Therapieerfolgs nach sich zu ziehen (Gelfert et al, 2004; Braun et al, 2009, Braun, 2016. Es wird daher empfohlen, Tiere nur bei einer deutlichen Hypophosphatämie zu supplementieren (Forrester und Moreland, 1989;Cheng et al, 1998;Visser't Hooft et al, 2005).…”

“…Die Rolle von Phosphat in der Behandlung der Gebärparese wird kontrovers diskutiert. Obwohl die Ergänzung mit phosphathaltigen Präparaten die Phosphatkonzentration im Blut erhöht und längerfristig stabilisiert, konnte klinisch keine signifikante Verbesserung der Heilungsrate festgestellt werden (Braun et al, 2016). Die Therapien werden durch die Verabreichung von oralen Kalziumpräparaten ergänzt.…”