Lack of calcium in the body in dogs, symptoms, treatment

Causes of the disease, its description

Pathology appears against the background of a lack of calcium in the body. It should be taken into account that eclampsia belongs to the category of serious diseases. In the absence of timely effective treatment, death cannot be ruled out. Often, symptoms of illness go unnoticed during pregnancy and after birth. Dog owners believe that the signs are features of these periods, so they do not contact veterinarians. Only a specialist can determine eclampsia using tests. If the calcium content is reduced to 1.6 mmol per liter, this indicates a mineral deficiency and the presence of a disease.

The causes of calcium deficiency are:

unbalanced diet;
decreased albumin levels;
dysfunction of the thyroid gland;
excessive lactation.

Eclampsia is formed not only due to deficiency, but also due to excess calcium. An excess is observed in animals whose menu includes only meat products. A decrease in albumin levels is caused by an insufficient amount of protein in food, kidney diseases, in which protein is not absorbed and is actively removed from the body. Calcium deficiency occurs with increased production of thyroid hormones. This element is often lacking in lactating bitches with large litters. A lot of milk is produced, most of the calcium goes to the babies.

Symptoms (signs)

Clinical picture

• Latent tetany (mild hypocalcemia) •• Muscle fatigue, weakness, twitching of individual muscle groups, numbness and tingling around the mouth, hands and feet •• Positive Chvostek’s sign, but it is also observed in 10% of healthy individuals •• Positive Trousseau’s sign • • Positive Lyust sign.

• Obvious tetany (severe hypocalcemia) •• Muscle hypertonicity before the development of cramps •• Spasm of smooth muscles (laryngospasm) • Long-term effects of hypocalcemia •• Atrophy, fragility of the nail plates; dryness and flaking of the skin; enamel defects and dental hypoplasia •• Calcification of the basal ganglia, in some cases in combination with signs of parkinsonism •• Calcification of the lens often leads to cataracts.

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Treatment is etiotropic and pathogenetic • Calcium preparations: for acute hypocalcemia - 10 ml of 10% r - ra calcium gluconate intravenously for 15–30 minutes, followed by repeating the injection and/or intravenous infusion of 20–30 ml in 1 liter of 5% r — radextrose for 12–24 hours; for chronic hypocalcemia - 1-2 g/day of calcium orally, for example calcium gluconate (in 1 g - 90 mg of calcium) or calcium carbonate (in 1 g - 400 mg of calcium) in combination with ergocalciferol • Magnesium and potassium preparations - potassium and magnesium aspartate • Enzyme preparations for malabsorption syndromes • Administration of albumin intravenously for hypoalbuminemia • Ergocalciferol • To bind phosphates in the gastrointestinal tract - algedrate.

Age characteristics • Early childhood. In young children (6–18 months), latent and overt tetany, pathogenetically associated with rickets, is designated by the term spasmophilia •• Latent tetany. In children, in addition to the listed symptoms of mild hypocalcemia, respiratory arrhythmia is also noted, caused by hypertonicity of the accessory respiratory muscles and diaphragm against the background of physiological sympathicotonia •• Overt tetany. There are 3 leading syndromes. The presence of one syndrome or a combination of them is possible ••• Laryngospasm is a sudden narrowing of the glottis. In the clinic - pallor, difficulty breathing, possible apnea attack. A few seconds after a noisy inhalation, breathing is restored. ••• Carpopedal spasm is a tonic contraction of the muscles of the hands and feet. In the clinic - the limbs are bent at the large joints, the shoulders are pressed to the body, the hand is in the “obstetrician’s hand” position; the foot is in a state of plantar flexion. The duration of the spasm is variable - from a few seconds to several hours or days. Possible combination with hypertonicity of other muscle groups ••• Eclampsia - an attack of clonicotonic convulsions, covering all voluntary and involuntary muscles against the background of loss of consciousness. Very dangerous due to possible cardiac and respiratory arrest •• Treatment – calcium supplements, anticonvulsant therapy, ergocalciferol • Newborns – neonatal hypocalcemia •• Early hypocalcemia (serum Ca2+ content below 7 mg%, or 0.07 g/l) manifests itself in first 24–48 hours of life; usually associated with prematurity ••• Cause - functional insufficiency of the parathyroid glands (impaired response of the glands to the normal decrease in serum calcium after birth) ••• Predisposing factors - fetal asphyxia during childbirth; Diabetes in the mother ••• Treatment - administration of calcium preparations orally or intravenously in combination with anticonvulsants (for convulsive syndrome) •• Late hypocalcemic tetany can occur in the first few weeks of an infant's life ••• Cause - hyperphosphatemia (usually of nutritional origin ) ••• Treatment - calcium supplements.

ICD-10 • P71 Transient neonatal disorders of calcium and magnesium metabolism • E58 Nutritional calcium deficiency • E83.5 Disorders of calcium metabolism • M11.1 Hereditary chondrocalcinosis • M11.2 Other chondrocalcinosis

Clinical picture

Picture of the development of the disease

Eclampsia has several stages. Each of them has specific characteristics. At the first stage you may experience:

increased breathing;
excessive excitement;
aggression in behavior.

As the pathology develops, the following appear:

difficulty moving;
copious secretion of saliva;
convulsions that appear during sharp sounds or touches;
tachycardia;
constriction of the pupils;
increase in body temperature.

The last stage is accompanied by high temperature, breathing is difficult. The formation of edema in the brain is possible. Therapeutic treatment at this stage is ineffective, and there is a high risk of death of the animal. It should be taken into account that eclampsia during pregnancy can provoke uterine contractions and premature birth.

Providing emergency assistance

During the period when you suspect eclampsia, you must immediately provide first aid before going to a specialist.

It is advisable that you are prepared in advance for possible problems and can quickly make an intravenous injection. If you notice that the animal’s condition has deteriorated significantly and is accompanied by convulsions, you need to take active action, otherwise the dog may not wait for the veterinarian. First of all, you need to remember: panic in this case is completely inappropriate, since the animal will feel your confusion, which can frighten a weakened pet.

Symptoms of the disease

The dog owner needs to know at least the main signs of eclampsia, which are signals for an urgent visit to a veterinary clinic. These symptoms include:

Aggression, fearfulness, inappropriate behavior;
Signs of anxiety, restlessness, expressed in causeless barking, darting around the apartment, frequent carrying of puppies;
Increased temperature, which can cross 39°C;
Rapid breathing, shortness of breath, occurring due to fever, heart failure;
Dry mouth and eyes, which appear due to a critical decrease in the volume of fluid in the body, are accompanied by a deterioration in the condition of the coat;
Muscle weakness leading to poor coordination of movements. Formed as a result of an acid-base imbalance or insufficient blood supply to the brain;
Spasms of smooth muscles as a reaction to pain in the abdominal area;
Convulsions in certain parts or throughout the body can occur in a similar way to epileptic seizures;
A critical decrease in pressure observed when blood circulation is disrupted. Urgent assistance from a veterinarian is required, otherwise a severe stress reaction of the body will occur and the dog will die.

Prevention

Any disease is easier to prevent than to treat. To avoid such a terrible disease, it is necessary to follow some preventive measures.

A few simple tips to help avoid eclampsia:

It is advisable to be registered with a veterinarian throughout pregnancy and regularly undergo biochemical blood tests.
10-15 days before the puppies are born, reduce protein (meat) intake, because... it slows down the absorption of calcium.
Give your dog more water because... on the contrary, it helps calcium not to transit through the body.
In the last two weeks of pregnancy, give the female more milk porridges and fermented milk products.
Agree with your doctor on a set of additional mineral supplements containing calcium and vitamin D
Before mating, be sure to carry out prophylaxis against helminths.
Monitor your dog's weight; obesity is a bad thing for your animal's health.
Before mating, take tests for viruses and inflammatory processes in the body; reduced immunity is susceptible to any ailments, hypocalcemia is no exception.
If a dog eats ready-made dry food, during pregnancy it is worth switching it to “holistic” or “super premium” food.

Diagnosis of the disease, examination

When visiting a veterinarian, it is necessary to tell in detail about all the existing symptoms, their intensity, frequency of manifestation, vitamins, supplements included in the pet’s menu, and diet. After studying the symptoms and examining the dog, the specialist prescribes tests to determine the state of internal systems and organs, and assess the effectiveness of metabolic processes.

An important indicator is the calcium content in the bloodstream. When the indicator is determined to be 7 mg per 100 ml or lower, a diagnosis of “eclampsia” is made. During this disease, magnesium and glucose deficiency are often observed. The veterinarian prescribes medications to restore the balance of these microelements.

Hypocalcemia - symptoms and treatment of hypocalcemia

Hypocalcemia is a decrease in the content of ionized calcium in the blood serum.
This syndrome is manifested primarily by disturbances in electrophysiological processes on cell membranes, since calcium ions are involved in the formation of action potentials. The disease can occur in acute and chronic forms. Hypocalcemic syndrome occurs:

In the absence or deficiency of parathyrocrinine (hypoparathyroidism, absolute parathyrocrinine deficiency).
With a normal or increased amount of parathyrocrinine (ineffective action of parathyrocrinine on the target, peripheral parathyrocrinine resistance).
With a rapid loss of extracellular calcium with overlap of the functional reserves of the parathyroid glands and decompensation against the background of a maximum increase in the secretion of parathyrocrinine (relative parathyrocrinine insufficiency). The etiology and pathogenesis of hypocalcemia is in one way or another always associated with an absolute or relative failure of parathyroid regulation.

Absolute or relative deficiency of parathyroid hormone leads to hyperphosphatemia (increased reabsorption of phosphorus in the kidney tubules) and hypocalcemia (loss of calcium in the urine, impaired absorption in the intestine, decreased mobilization from the bones). Reduced synthesis of active vitamin D (calcitriol) in the kidneys also contributes to the development of the disease. In general, the alkaline acid balance is disturbed, the level of potassium in the blood serum increases, the excitability of striated and smooth muscles increases with a tendency to tonic convulsions, less often to clonic ones. Thus, the essence of convulsive syndrome is an increase in the concentration of potassium in muscle cells.

Symptoms of hypocalcemia

Acute hypocalcemia is a dangerous disease, briefly characterized by the following features. First of all, this is the syndrome of massive cytolysis in almost all its forms. With hepatolysis, hemolysis, the use of cytostatics that cause massive death of neoplastic cells, with prolonged crush syndrome, severe traumatic and burn shock, phosphate, potassium and, to a lesser extent, magnesium are released from the cells. Ionized calcium leaves the blood. If, as is often observed, cytolysis is accompanied by acute renal failure, then hyperphosphatemic hypocalcemia can be very significant.

Acute hypocalcemia can occur with nitrate blood transfusion, the action of a number of calcium-binding drugs (heparin, EDTA, protamine), as well as medications that interfere with the absorption of calcium and magnesium in the intestines and kidneys (loop diuretics, aminoglycoside antibiotics, cis-platinum, amphotericin B) , drugs that affect the release of calcium in bones (bisphosphonates, plicamycin). It is observed in the polyuric stage of acute renal failure, during sepsis (due to the blocking effect of cytokines on the effects of parathyroid hormone), as well as during acute pancreatitis. In the latter case, its mechanism is not entirely clear. Most likely, the deficiency of calcium and magnesium absorption in pancreatic steatorrhea is important, when these cations remain in the composition of fecal soaps. There is evidence of the formation of calcium-containing soap-like compounds in retroperitoneal fatty tissue due to necrosis of the pancreas and the release of its hydrolases. A decrease in the secretion of parathyrocrinine and resistance to it has also been reported due to a lack of some unidentified factors of pancreatic origin.

Transient hypocalcemia is typical for newborns due to the insufficient calcium content in human milk and their high need for this cation. Massive release of phosphates during rhabdomyolysis and destruction of tumor tissue can also be associated with acute hypocalcemia. During liver transplantation, hypercitrateemia develops as a complication, since the transplant is not able to effectively metabolize citric acid for some time. This also leads to acute hypocalcemia. Acute hypocalcemia is dangerous due to seizures and arrhythmia if it is severe, but in many cases it is transient and asymptomatic.

Chronic hypocalcemia always develops into a characteristic clinical picture. The cause of the chronic form of the disease is most often hypoparathyroidism, pseudohypoparathyroidism, chronic renal failure, rickets, and hypomagnesemia. Characterized by increased neuromuscular excitability with tetany. With tetany, the patient experiences peripheral and perioral paresthesia, and there is carpedal spasm. Sometimes convulsions, bronchospasm and laryngospasm develop. Convulsions are provoked by alkalosis, including respiratory alkalosis (with hyperventilation), as well as hypomagnesemia and hyperkalemia. At the same time, acidosis and hypokalemia nonspecifically reduce convulsive readiness.

The most common symptoms of chronic hypocalcemia are neuromuscular or neurological in nature. Patients may experience facial grimaces, muscle spasms of the hands and feet, and in severe cases, laryngeal spasms and general cramps. Respiratory arrest may occur. Other central nervous system symptoms include irritability, depression, and psychosis.

Treatment of hypocalcemia

The main treatment for hypocalcemia is the administration of calcium or vitamin D supplements. When treating hypoparathyroidism, it is important to eliminate hypocalcemia without allowing the development of hypercalcemia. The goal of treatment is to maintain the level of total calcium in the blood serum within the range of 2.1-2.4 mmol/l with calcium excretion less than 10 mmol/day.

If calcium absorption in the small intestine is not impaired, then calcium supplements are effective even in severe forms of hypocalcemia. They are prescribed at 3-7 g/day in terms of calcium, in several doses. Calcium supplements without vitamin D supplements are usually prescribed for a short term, although in some cases calcium monotherapy can maintain normal serum calcium levels for a long time.

Doses of vitamin D preparations are selected depending on the cause of hypocalcemia:

For disorders of bone tissue mineralization, the maximum tolerated dose of vitamin D is prescribed. After achieving a therapeutic effect, the dose is reduced so as not to cause hypercalcemia.
When using active forms of vitamin D (calcitriol, alfacalcidol), the need for calcium supplements is reduced. In these cases, a diet high in calcium may be sufficient. Treatment with ergocalciferol or cholecalciferol usually requires calcium supplements.
Because calcitriol is a highly active drug, it can sometimes be difficult to adjust the dose when combined with calcium supplements.
When choosing a vitamin D preparation, one must take into account its activity, the time of onset and cessation of action, as well as the duration of treatment necessary to normalize calcium levels.

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The article uses materials from Yu.I. Stroeva and L.P. Churilova

The main treatment for hypocalcemia is the administration of calcium or vitamin D supplements. When treating hypoparathyroidism, it is important to eliminate hypocalcemia without allowing the development of hypercalcemia. The goal of treatment is to maintain the level of total calcium in the blood serum within the range of 2.1-2.4 mmol/l with calcium excretion less than 10 mmol/day.

Treatment methods

If convulsions and other obvious symptoms of eclampsia occur, specialists give a potassium injection. If the case is severe, a drip with calcium gluconate or glucose is required. The dose is selected according to the age of the animal. The condition improves quickly after this procedure.

After the exacerbation is relieved, medications are prescribed to regulate the functions of the central nervous system. They are administered in the form of intramuscular injections. A decrease in the intensity of symptoms does not indicate a complete cure. A course of taking capsules containing calcium is required. The course lasts about a month. The dog should not feed the puppies during injections or oral medications.

Subacute hypocalcemia in cats and dogs: treatment

An initial bolus of elemental calcium usually reduces signs of hypocalcemia for a limited time (at least 1 hour and at most 12 hours) if the original cause of hypocalcemia remains. Vitamin D metabolites should be started as soon as possible, as they require at least a few days to maximally accelerate calcium transfer in the intestine. Supplementation with parenteral calcium salts is necessary to maintain adequate calcium levels until treatment with vitamin D metabolites remains effective in maintaining serum calcium within acceptable levels.

Multiple intermittent intravenous injections of calcium salts can be given to control clinical signs, but this method is not recommended because large fluctuations in serum calcium concentrations may occur. The remaining two options are continuous administration of calcium salts or their intermediate subcutaneous injection.

For continuous intravenous calcium administration, the recommended dose is 60-90 mg/kg basal calcium per day (2.5-3.75 mg/kg per hour) until the required calcium level can be achieved with oral medications. Initial doses in the higher range are given to patients with more severe hypocalcemia, and then the dose is reduced according to the calcium level achieved. The dose of intravenous calcium is also reduced in the future as calcium salts and oral vitamin D become more effective.

10 ml of 10% calcium gluconate solution contains 93 mg of basic calcium. A convenient method of administering calcium is to administer an intravenous solution in a volume of 60 ml/kg per day (2.5 ml/kg per hour). Approximately 1 mg/kg per hour, 2 mg/kg/hour and 3 mg/kg per hour of basal calcium are provided by adding 10, 20 and 30 ml of 10% calcium gluconate solution, respectively, to each 250 ml liquid bottle. Apparently, the same degree of calcium delivery can be achieved by adding 20, 40 or 60 ml of 10% calcium gluconate solution to each 500 ml liquid bottle to administer the desired dose.

Calcium salts should not be added to liquid medicinal preparations that contain lactate, acetate, bicarbonate and phosphate, as the calcium salts may precipitate. Treatment with alkalinizing fluids containing sodium bicarbonate reduces the amount of ionized calcium and produces clinical signs of hypocalcemia in animals with borderline hypocalcemia and should therefore not be used.

Options for subcutaneous administration of solutions containing calcium are possible. Calcium gluconate should be diluted before subcutaneous injection in a ratio of at least 1:1; Calcium chloride should not be used as it causes severe tissue irritation. An initial dose of calcium to combat tetany can be given 3-4 times a day or a dose of 60-90 mg/kg divided and administered subcutaneously several times a day. Doses for subcutaneous calcium administration should be reduced as with continuous calcium administration.

Calcium salts should not be added to liquid medicinal preparations that contain lactate, acetate, bicarbonate and phosphate, as the calcium salts may precipitate. Treatment with alkalinizing fluids containing sodium bicarbonate reduces the amount of ionized calcium and produces clinical signs of hypocalcemia in animals with borderline hypocalcemia and should therefore not be used.