Introduction
Puerperal hypocalcemia, more commonly known as “eclampsia,” is an acute, life-threatening condition in postpartum dogs that requires immediate medical treatment. While most commonly seen in small-breed bitches within a few weeks of whelping, it can happen to any size or breed of dog with a nursing litter. With prompt and proper treatment, the prognosis is excellent.
Treating Eclampsia (Puerperal Hypocalcemia)
Treatment of puerperal hypocalcemia by a veterinarian should start immediately based upon clinical signs, history and physical examination findings. A dog’s response to treatment is the most reliable diagnostic tool. The goal of treatment is to return blood calcium levels to normal through intravenous therapy. The type and amount of calcium to be administered will be determined by your veterinarian. It should be given slowly, over a period of 10 to 30 minutes, with close heart monitoring. Unmonitored or overly rapid administration of intravenous calcium can be as bad as (if not worse than) the hypocalcemia itself and can cause severe heart abnormalities, low blood pressure and even death. Careful monitoring of the heart during intravenous calcium therapy is therefore essential to its success. The dog’s temperature should also be checked regularly. The clinical signs of eclampsia should start to resolve dramatically once treatment begins and, if the condition is caught early and treated swiftly, the animal’s prognosis is excellent.
After an episode of eclampsia occurs, the puppies should be removed from the mother and kept from nursing for 12 to 36 hours, to decrease the mother’s loss of calcium through lactation. During this time, the puppies can be fed an appropriate milk substitute through a bottle. If the mother suffers a recurrence of eclampsia, the puppies probably should be removed from her permanently and be hand-fed until they can transition to solid food. If the puppies are close to weaning age when the hypocalcemic episode happens, it may be appropriate to wean them from their mother completely at that time. If the puppies are very young, the mother can be given oral calcium replacement for the remainder of the nursing period. Some veterinarians recommend Vitamin D supplementation as well, but this is somewhat controversial because excessive amounts of Vitamin D can promote hypercalcemia (too much calcium in the blood), which has its own set of problems.
It is important to note that oral calcium will not resolve a puerperal hypocalcemic crisis, because it takes up to 24 hours for the body to absorb an oral source of calcium and affected animals will not have that long to wait for absorption to take place. Finally, giving oral calcium to pregnant bitches before they whelp (during their pregnancy) is not recommended under current veterinary protocols. In fact, oral calcium supplementation during pregnancy has been shown to promote rather than prevent the development of eclampsia postpartum.