Clinical Signs:

• Divided into 3 stages:
  • Stage I- Stage of excitement
  • Stage II- Stage of sternal Recumbency
  • Stage III- Stage of lateral Recumbency

Stage I (Stage of Excitement):

• Grinding of teeth
• Short period of excitement
• Often go unnoticed
• Protrusion of tongue
• Temperature may be normal or subnormal.

Stage II (Stage of Sternal Recumbency):

• Cow lies down and cannot get up.
• Animal rests on sternum with head turned upwards shoulder or flank (S-shaped posture)
• Cold skin and extremities
• Suspended rumination, defecation and urination
• Secondary bloat and constipation

Stage III (Stage of Lateral Recumbency):

• Cow lies on its side with legs stretched out.
• Cow loses consciousness; progressively to coma
• Complete muscle flaccidity, unresponsive to stimuli
• Severe bloat, lowered body temperature
• If left untreated, animal dies due to cardio-respiratory failure.

Diagnosis:

• Based on history and clinical signs
• Based on response to Ca therapy
• Based on serum biochemistry; decreased serum Ca level

Treatment:

• Calcium borogluconate (Thiacal) @ 500 ml; 250 ml slow IV and remaining dose by S/C.
• Normal rule of Ca dosing is 1g/45 kg b.wt.
• Dexamethasone injection; 5-7 ml, IM or IV
• Vitamin-B complex; 10-15 ml, IM or IV
• In case of bloat; Afanil or tympanil is given
• 1 complete Ca dose along with 1 oz. of sodium acid phosphate and 4 oz. glucose IV
• Antihistamine: Avil or Phenergan- 10-15 ml, IM
• D therapy: 8 mg single dose 3-10 days before calving IM
• For prevention of milk fever; oral dosing of calcium
  • Prior to calving- 1 dose
  • At calving- 1 dose
  • 12-hour post calving- 1 dose
  • 24-hour post calving- 1 dose