Saturday, March 14, 2015

Eclampsia

Eclampsia is a sudden onset of potentially life-threatening symptoms resulting from low blood calcium (hypocalcemia) in the female dog (bitch) or female cat (queen) that has given birth in the preceding 3 weeks. In the bitch, eclampsia can occur at any time during lactation (nursing), but it is most likely to occur during the first 3 weeks of lactation, which begins within minutes after birth. Eclampsia occurs most commonly in small dogs with large litters, but it can occur in any bitch after whelping (giving birth). Symptoms of eclampsia include panting, pacing, restlessness, muscle stiffness and trembling, inability to rise, seizures, and coma. If eclampsia progresses to produce severe symptoms such as seizures and coma and is not treated immediately, death is possible. Eclampsia does not occur during pregnancy (before giving birth). Eclampsia is a well-known disorder in dogs, but it occurs very rarely in cats. Timing (postpartum) and symptoms are the telltale features that lead a veterinarian to suspect eclampsia.


There is no relation between eclampsia in dogs and cats and preeclampsia in humans, which is a disorder involving blood pressure and proteinuria in women during –not after- pregnancy.

The cause of eclampsia is a sudden transfer of circulating calcium from the mother’s bloodstream into the milk; while this is beneficial to the puppies, the mother may experience such a sudden drop in blood calcium levels that eclampsia and the symptoms described above occur. There are many additional factors that contribute to this disorder. Maternal calcium is sacrificed for growth of the fetuses during pregnancy, and additional factors such as poor diet during gestation and lactation or excessive calcium supplementation during gestation can upset calcium balance and predispose to eclampsia. Offering reasonable amounts of a regular balanced diet and avoiding calcium supplementation during pregnancy (because these discourage the body from absorbing much ingested calcium, leaving it totally unprepared for the massive calcium absorption needed once milk production and nursing begin) are important preventive measures that can be taken to reduce the risk of eclampsia.

Diagnosis

Eclampsia is usually diagnosed based on the onset of symptoms hours, days, or a few weeks after giving birth, and the positive response to treatment with calcium gluconate injections in a lactating bitch or queen. Although hypocalcemia confirms the diagnosis on a blood sample, the time and equipment necessary for performing this blood test are not always available in the short time frame (minutes) during which treatment with calcium gluconate is often necessary.
Eclampsia is a serious, potentially life-threatening condition, but it is a temporary condition that leaves no permanent after effects and requires no ongoing treatment if the initial stages are detected early and if adequate treatment (usually only needed for a few weeks at most) is provided. If your dog or cat has been diagnosed and treated for eclampsia, give medication at home exactly as your veterinarian prescribes it, even when symptoms are completely gone. This is because the course of treatment (typically days to a few weeks) is what keeps the symptoms away, and stopping treatment prematurely can cause eclampsia to return very quickly. Follow your veterinarian’s instructions regarding hand-feeding the puppies or kittens if necessary, as a reduction in nursing may lessen the burden of milk production and decrease the amount of calcium being transferred from the mother’s body into milk. 
Eclampsia can recur if nursing resumes and the mother’s calcium level is not regulated. Eclampsia can recur with subsequent litters. To prevent this disorder, it is important that the bitch or queen has a nutritionally balanced diet during pregnancy and lactation. To ensure that this diet is consumed, the puppies or kittens can be removed from the mother for a short period of time several times daily while she eats. Solid food can be gradually offered to the puppies and kittens(beginning the weaning process) beginning at approximately 3 weeks while they are still nursing. Calcium should NEVER be given to the mother during pregnancy because it can disrupt the normal balance of calcium in the body and, counter productively, it actually makes eclampsia more likely.

Treatment

Eclampsia may worsen quickly and can be fatal if it is not treated. Therefore, treatment should begin immediately when symptoms begin to be visible. Calcium (gluconate) is administered intravenously by a veterinarian, very slowly and with careful monitoring because intravenous calcium excess is also potentially very dangerous, until symptoms resolve. Low blood glucose (hypoglycemia)can occur simultaneously and if present, it can produce similar or identical symptoms; hypoglycemia is treated with dextrose, which can be given by mouth or intravenously. If tremors, muscle twitching, or seizures do not respond to this treatment, an anticonvulsant medication may also be needed. Depending on their age, kittens or puppies may need to be weaned and hand-fed to lessen the calcium drain of milk production.When the bitch or queen is recovering from eclampsia and is stable, calcium should be supplemented at home. A carefully calculated and monitored dose of oral vitamin D may be needed to help the body absorb calcium. A well-balanced diet is important and may eliminate the need for vitamin D supplementation. Several commercial diets are available.

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