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Hypocalcemia as an Electrolyte Disturbance in Small Animals


Jean A. Hall

, DVM, PhD, DACVIM, Department of Biomedical Sciences, Carlson College of Veterinary Medicine, Oregon State University

Last full review/revision Jun 2015 | Content last modified Jun 2016

Hypocalcemia is also an important electrolyte disturbance in critically ill dogs and cats. The incidence of hypocalcemia is 16% in critically ill dogs and 24% in dogs with sepsis. Hypocalcemia is best detected by measuring ionized calcium (<2.5 mEq/L), which is the biologically active form, rather than total or corrected calcium. Hypocalcemia, hypovitaminosis D, and metabolic acidosis occur in dogs with induced endotoxemia. LPS may mediate a decrease in vitamin D–binding protein, with subsequent loss of vitamin D in the urine. Also, dogs with blunt and penetrating traumatic injuries, particularly abdominal trauma, are significantly more likely to have ionized hypocalcemia (16% incidence). These dogs spend longer time in the hospital and ICU, require more intensive therapies, and are less likely to survive (57% survival rate) than dogs with normocalcemia (89% survival rate). Hypocalcemia from critical illness or traumatic injury can cause clinical signs similar to those of puerperal hypocalcemia (hyperexcitability, including tremors, twitching, spasms, or seizures, or more subtle signs related to cardiovascular collapse).

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Parturient paresis, also called milk fever, can cause flaccid paralysis and circulatory collapse in dairy cows during or soon after parturition. Serum calcium levels must be corrected as soon as possible by administering intravenous calcium gluconate slowly over 10-20 minutes. Which of the following signs is most consistent with too-rapid administration of intravenous calcium administration? 
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