Treatment and Prognosis of Eclampsia in Dogs
Goals of Treating Eclampsia
Eclampsia is an emergency. It can rapidly become life-threatening in postpartum dogs and requires immediate medical attention. While eclampsia is most commonly seen in small-breed bitches within a few weeks of whelping a relatively large litter, it can happen to any size or breed of dog with nursing puppies. The goal of treatment is to return blood calcium levels to normal through intravenous calcium supplementation.
Treatment of eclampsia should start immediately based upon clinical signs, history and physical examination findings. A bitch’s response to intravenous calcium is the most reliable diagnostic tool. The type and amount of calcium to be administered will be determined by the veterinarian based upon his assessment of the patient’s condition. Calcium should be given slowly, over a period of 10 to 30 minutes, with constant monitoring of heart rate, rhythm and blood pressure. Careful monitoring of the heart during slow intravenous calcium therapy is essential to its success. Unmonitored or overly rapid administration of intravenous calcium can cause severe cardiac abnormalities, including critically low blood pressure and possibly death. The bitch’s temperature should also be checked regularly. In most cases, the symptoms of eclampsia start to resolve dramatically a short time after treatment begins.
The puppies of a bitch with eclampsia should be removed from their mother for 24 to 36 hours, or until the dam has returned completely to normal, to reduce the mother’s loss of calcium through lactation and nursing. During this time, the puppies can be fed an appropriate milk replacer through a baby bottle or a bottle designed for nursing pups. If the mother recovers but then suffers a recurrence of eclampsia, the puppies probably should be removed from her permanently and bottle-fed until they can transition to solid food. If the puppies are close to weaning age when the hypocalcemic event happens, it may be best to wean them from their mother completely at that time.
If the puppies are very young, the mother can be given calcium supplements orally for the remainder of the nursing period. Some veterinarians recommend Vitamin D supplementation as well, to promote calcium absorption from food in the gastrointestinal tract. However, exessive intake of Vitamin D can cause an overabundance of calcium in circulation. Hypercalcemia has its own set of problems.
It is important for owners to note that calcium given orally will not help a bitch suffering a hypocalcemic crisis. It takes up to 24 hours for the body to absorb an oral source of calcium, and affected animals simply do not have that long to wait for circulating calcium levels to be restored. The only viable therapy for eclampsia is intravenous calcium administration. Finally, giving calcium to a bitch during her pregnancy is not recommended under current veterinary protocols. In fact, calcium supplementation during gestation has been shown to promote rather than prevent the development of postpartum eclampsia.
With prompt treatment of eclampsia, the prognosis is usually excellent for a complete recovery. However, bitches that develop this disorder once tend to develop it again in connection with subsequent litters.