ABSTRACT
Three dogs that presented to the emergency service in severely emaciated body conditions were admitted to the hospital for monitoring and refeeding. During their hospitalization, all three dogs developed electrolyte derangements or required supplementation to prevent hypophosphatemia and hypomagnesemia. Additionally, all dogs developed hyperlactatemia, which was suspected to be secondary to thiamine deficiency. Two dogs were reported to have cardiac abnormalities, including cardiac arrhythmias, systolic dysfunction, and spontaneous echogenic contrast. These cases highlight the complexity of refeeding syndrome and its associated complications that extend beyond electrolyte deficiencies.
Subject(s)
Dog Diseases , Hyperlactatemia , Hypophosphatemia , Refeeding Syndrome , Animals , Dog Diseases/etiology , Dogs , Electrolytes , Hyperlactatemia/etiology , Hyperlactatemia/veterinary , Hypophosphatemia/etiology , Hypophosphatemia/veterinary , Refeeding Syndrome/complications , Refeeding Syndrome/veterinaryABSTRACT
OBJECTIVE: To describe refeeding syndrome in an equid without a history of recognized risk factors. CASE SUMMARY: Refeeding syndrome with marked hypophosphatemia developed in an aged miniature donkey gelding during treatment of suspected enterocolitis. Hypophosphatemia (manifested clinically as ileus and neuromuscular weakness) developed despite a short (3 day) history of hyporexia, increased body condition (7/9), and adherence to nutritional recommendations for critically ill equids. Nutritional support included nasogastric enteral feeding with a commercial equine nutrition product claiming to provide 100% of the National Research Council's daily recommended protein, vitamin, and mineral requirements for equids. Hypophosphatemia developed despite this enteral supplementation and was ultimately corrected by intravenous administration of sodium phosphate solution. NEW OR UNIQUE INFORMATION PROVIDED: This case report suggests that risk factors for refeeding syndrome in equids may be broader than previously recognized. Specifically, critically ill equids at risk for insulin dysregulation may have unique nutritional co-morbidities and requirements. This report highlights the need for both broader recognition of risk factors for refeeding syndrome, and revised best-practice nutritional guidelines and supplementation products to improve equine critical care.
Subject(s)
Horse Diseases , Hypophosphatemia , Refeeding Syndrome , Animals , Critical Illness , Enteral Nutrition/veterinary , Equidae , Horses , Hypophosphatemia/veterinary , Male , Refeeding Syndrome/veterinaryABSTRACT
Layer fatigue syndrome caused by the lack of calcium and phosphorus can cause fracture in laying hens. The effect of phosphorus deficiency on the femur of laying hens with layer fatigue syndrome has not been studied. In this study, sixty 22-week-old Roman white layers were randomly divided into control group (group C) and low phosphorus group (group P), 30 individuals in each group. The available phosphorus content of group P was 0.18%. At the age of 26, 30 and 34 weeks, the production performance, biomechanical index, protein expression, histopathological change of femur and serological index were detected. The results showed that the laying rate, egg quality and body weight of laying hens, bone density, cortical bone thickness, rigidity, flexural modulus, flexural rigidity, the maximum load of femur and expression of osteocalcin (OCN), receptor activator of nuclear factor kappa-Β (RANK) and receptor activator of nuclear factor kappa-Β ligand (RANKL) decreased of group P. The number of osteocytes was decreased, and the voids was increased. However, cell lacunae were not obvious. The levels of phosphorus, calcium and OCN were increased, and the content of estradiol (E2), OPG and calcitonin (CT) were decreased in serum. In conclusion, the low phosphorus diet can induce layer fatigue syndrome and affect the content of OPG and E2 in serum and the expression of OCN, OPG, RANK and RANKL in femur protein, which leads to the imbalance of bone homeostasis, the thinning of femur cortex bone and the decrease of bone density.
Subject(s)
Chickens , Femur/pathology , Hypophosphatemia/veterinary , Poultry Diseases/pathology , Animals , Body Weight , Calcium , Diet , Female , Femur/metabolism , Hypophosphatemia/metabolism , Hypophosphatemia/pathology , Phosphorus/blood , Poultry Diseases/metabolismABSTRACT
BACKGROUND: Small ruminants presented to tertiary care facilities commonly suffer from severe protein-calorie malnutrition. Some of these patients require parenteral nutrition (PN; amino acids and dextrose with or without lipids) during hospitalization. Refeeding syndrome, a potentially fatal shift of electrolytes seen in malnourished patients during refeeding, may occur. OBJECTIVE: (a) To report the prevalence of refeeding syndrome in small ruminants receiving PN and (b) to determine risk factors for the development of refeeding syndrome. ANIMALS: Hospitalized small ruminants (n = 20) that received PN from 2010 to 2018 and that had serial (≥2) monitoring of serum electrolyte concentrations after initiation of PN. METHODS: Retrospective case series. Refeeding syndrome was defined as the presence of at least 2 of the following electrolyte abnormalities after initiation of PN: hypophosphatemia, hypokalemia, hypomagnesemia, or some combination of these. Data was analyzed using Fisher's exact test, followed by univariate logistic regression. RESULTS: Eleven of 20 (55%) animals met the definition of refeeding syndrome. Mean minimum serum phosphorus concentration in animals with refeeding syndrome was 1.96 ± 0.69 mg/dL (reference range, 4.2-7.6 mg/dL). Eleven of 20 animals survived to discharge. Survival rate did not differ significantly between refeeding cases (4/11, 36.3%) and nonrefeeding cases (7/9, 77.8%; P = .09). Mean serum phosphorus concentration was significantly lower in nonsurvivors than in survivors (1.88 ± 0.10 mg/dL vs 4.32 ± 0.70 mg/dL, P = .006). CONCLUSIONS AND CLINICAL IMPORTANCE: We report the prevalence of refeeding syndrome in small ruminants receiving PN. Clinicians should anticipate refeeding syndrome after initiation of PN and consider pre-emptive supplementation with phosphorus, potassium, magnesium, or some combination of these.
Subject(s)
Goat Diseases/metabolism , Parenteral Nutrition/veterinary , Refeeding Syndrome/veterinary , Sheep Diseases/metabolism , Animals , Electrolytes/blood , Female , Goats , Hypokalemia/epidemiology , Hypokalemia/veterinary , Hypophosphatemia/epidemiology , Hypophosphatemia/veterinary , Magnesium/blood , Male , Parenteral Nutrition/adverse effects , Prevalence , Refeeding Syndrome/blood , Refeeding Syndrome/epidemiology , Retrospective Studies , Risk Factors , SheepABSTRACT
Case history: Two commercial pasture-based farms within the North Canterbury district of New Zealand were feeding fodder beet (Beta vulgaris vulgaris L.) as a large proportion of the diet to cows during the dry period. On each farm 25 multiparous cows were blood sampled up to six times from 28 days before, to 21 days after calving (Day 0). Plasma samples were analysed for concentrations of ß-hydroxybutyrate (BHBA), non-esterified fatty acid (NEFA), Ca, Mg and P, and aspartate aminotransferase (AST) activity. The first sampling visit was performed when cows were being fed their maximum intake of fodder beet. Clinical findings: The mean body condition score (BCS) of cows on Farm 1 was 5.4 (95% CI = 5.3-5.6) and on Farm 2, 5.4 (95% CI = 5.3-5.6) at first sampling. Mean concentrations of BHBA increased between Days -15 and Day -8 then decreased postpartum on Day 2 before increasing again on Day 21. On Farm 2, concentrations remained low (<1.2â mmol/L) on all days of sampling. Mean concentrations of NEFA in plasma remained low during the periparturient period on Farm 1, then increased on Day 2. On Farm 2, concentrations were elevated above 0.3â mmol/L between Days -28 and -17 then decreased on Day -10, before increasing on Day 2. Mean concentrations of Ca, Mg and P were higher than threshold values on both farms prepartum. However on Day 2, there were 8/23 (35%) cows on Farm 1 and 6/23 (26%) cows on Farm 2 with concentrations of Ca in plasma <2.0â mmol/L, and 10/23 (44%) cows on Farm 1 and 8/23 (35%) cows on Farm 2 with concentrations of P in plasma <1.3â mmol/L. Mean AST activities remained relatively constant and below 130 IU/L on both farms at all sampling times. Clinical relevance: On both farms, post-partum hypocalcaemia and hypophosphataemia were common after calving despite differing fodder beet feeding and mineral supplementation regimes. There was more variation in energy status, especially prior to calving. More research is required on factors affecting mineral and energy status in dry cows fed fodder beet.
Subject(s)
3-Hydroxybutyric Acid/blood , Cattle Diseases/blood , Hypocalcemia/veterinary , Hypophosphatemia/veterinary , Animal Feed , Animals , Aspartate Aminotransferases/blood , Beta vulgaris , Calcium/blood , Cattle/blood , Dairying , Fatty Acids, Nonesterified/blood , Female , Hypocalcemia/blood , Hypophosphatemia/blood , Magnesium/blood , New Zealand , Phosphorus/blood , Postpartum Period/blood , Pregnancy/bloodABSTRACT
Phosphorus (P) deficiency and hypophosphatemia are believed to be associated with muscle function disturbances in dairy cows, particularly around parturition. The objective of this study was to determine the effect of dietary P deprivation during late gestation and early lactation on muscle P homeostasis and muscle function in periparturient dairy cows. Thirty-six multiparous dairy cows in late gestation were randomly assigned either to undergo dietary P depletion or to be offered a diet with adequate P content from 4 wk before to 4 wk after parturition. Phosphorus-deficient rations for dry and lactating cows contained 0.15 and 0.20% P on a dry matter basis, respectively. Blood and muscle tissue for biopsy were obtained and electromyographic examinations were conducted on biceps femoris and intercostal muscles in regular intervals throughout the study. Muscle tissue was analyzed for the total P, adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, creatine phosphate, and tissue water content. Dietary P deprivation resulted in a pronounced and sustained decline of the plasma phosphate concentration, reaching a nadir at calving with mean values below 1.5 mg/dL and remaining below 2.0 mg/dL during the first 4 wk of lactation. Hypophosphatemia was not associated with signs of clinically apparent muscle weakness or disturbed muscle function and was not associated with a decline in the content of any of the studied P-containing compounds in muscle tissue. Accordingly, no association between plasma phosphate concentration and muscle tissue P content was found. Electromyographic examination identified subclinical effects on motor unit action potentials that are indicative of disturbed neuromuscular functionality. Increasing occurrence of pathologic spontaneous activity possibly resulting from membrane instability of nerve or muscle cells and suggestive of myopathy was also recorded as P deprivation progressed. These effects were predominantly observed in intercostal and to a lesser degree biceps femoris muscles. Electromyographic parameters affected by P deprivation were found to be associated primarily with the plasma phosphate and to a lesser extent with the amounts of energy storing P-containing compounds contained in muscle tissue. These results indicate that prolonged and pronounced dietary P deprivation in transition dairy cows leads to marked sustained hypophosphatemia without altering the muscle tissue P homeostasis or causing clinically apparent muscle function disturbances.
Subject(s)
Diet/veterinary , Muscle, Skeletal/metabolism , Phosphorus, Dietary/administration & dosage , Phosphorus/metabolism , Animals , Cattle , Cattle Diseases/metabolism , Female , Homeostasis , Hypophosphatemia/veterinary , Lactation/physiology , Milk , Parturition , Phosphates/blood , Phosphorus/deficiency , PregnancyABSTRACT
BACKGROUND: Hypophosphatemia is commonly associated with disease and decreased productivity in dairy cows particularly in early lactation. Oral supplementation with phosphate salts is recognized as suitable for the rapid correction of hypophosphatemia. Little information is available about the differences in efficacy between salts used for oral phosphorus supplementation. OBJECTIVES: Comparison of efficacy of oral administration of NaH2 PO4 , Na2 HPO4 , and MgHPO4 in treating hypophosphatemia in cattle. ANIMALS: 12 healthy dairy cows in the fourth week of lactation in their second to fifth lactation. METHODS: Randomized clinical study. Phosphorus deficient, hypophosphatemic cows underwent a sham treatment and were afterwards assigned to 1 of 3 treatments-NaH2 PO4 , Na2 HPO4 , or MgHPO4 (each provided the equivalent of 60 g of phosphorus). Blood samples were obtained immediately before and repeatedly after treatment. RESULTS: Treatment with NaH2 PO4 and Na2 HPO4 resulted in rapid and sustained increases of plasma phosphate concentrations ([Pi]). Significant effects were apparent within 1 hour (NaH2 PO4 : P = .0044; Na2 HPO4 : P = .0077). Peak increments of plasma [Pi] of 5.33 mg/dL [5.26-5.36] and 4.30 mg/dL [3.59-4.68] (median and interquartile range) were reached after 7 and 6 hours in animals treated with NaPH2 PO4 and Na2 HPO4 , respectively, whereas treatment with MgHPO4 led to peak increments 14 hours after treatment (3.19 mg/dL [2.11-4.04]). CONCLUSIONS AND CLINICAL IMPORTANCE: NaH2 PO4 and Na2 HPO4 are suitable to rapidly correct hypophosphatemia in cattle. Because of the protracted and weaker effect, MgHPO4 cannot be recommended for this purpose. Despite important differences in solubility of NaH2 PO4 and Na2 HPO4 only small plasma [Pi] differences were observed after treatment.
Subject(s)
Cattle Diseases/drug therapy , Hypophosphatemia/veterinary , Magnesium Compounds/therapeutic use , Phosphates/therapeutic use , Administration, Oral , Animals , Cattle , Cattle Diseases/blood , Cattle Diseases/metabolism , Female , Hypophosphatemia/blood , Hypophosphatemia/drug therapy , Hypophosphatemia/metabolism , Lactation/metabolism , Magnesium Compounds/administration & dosage , Phosphates/administration & dosage , Phosphorus/bloodABSTRACT
BACKGROUND: Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soy-blends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified product (CSB+) and a product further fortified with skim milk powder (CBS++). METHODS: Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia. Pigs were weaned at 4 weeks of age and undernutrition was induced with a nutritionally inadequate pure maize diet for 7 weeks, after which they were refed for 3 weeks with either CSB+ (n = 10), CSB++ (n = 10) or CSB+/wp (n = 10). For reference, a fourth group continued on the maize diet (REF, n = 10). RESULTS: Following induction of undernutrition, body weight and length were 29±5% and 67±4% (means±SD) of values in age-matched pigs fed a nutritionally adequate diet, and the mean serum P level was 1.77±0.34 mmol/l. During the first week of refeeding, P levels in the CSB+ pigs decreased to 55% of values before refeeding (P < 0.05) while values in the CSB++ and CSB+/wp pigs were able to maintain their plasma phosphate at a similar level as before refeeding. CONCLUSION: We conclude that fortification of CSB with only monocalcium-phosphate does not prevent hypophosphatemia. Dairy products like skim milk powder or whey permeate may represent relevant sources of phosphorus during refeeding. The content and form of phosphorus in such diets need to be carefully evaluated, and the undernourished piglet may be used to test the efficacy of such diets.
Subject(s)
Diet/veterinary , Glycine max/chemistry , Hypophosphatemia/veterinary , Malnutrition/veterinary , Phosphorus/chemistry , Zea mays/chemistry , Animals , Body Size , Body Weight , Calcium/urine , Female , Food, Fortified , Hypophosphatemia/pathology , Hypophosphatemia/prevention & control , Magnesium/blood , Malnutrition/complications , Malnutrition/pathology , Phosphorus/blood , Phosphorus/urine , Serum Albumin/analysis , Glycine max/metabolism , Swine , Zea mays/metabolismABSTRACT
Hypohosphataemia is a frequent finding in early lactating and anorectic dairy cows. Sodium phosphate is commonly used for oral phosphorus (P) supplementation, although other phosphate salts may present useful treatment alternatives. Objectives of this study were to compare the efficacy of monopotassium phosphate (KH2PO4) and monocalcium phosphate (Ca(H2PO4)2) to monosodium phosphate (NaH2PO4) in P-depleted cows. Furthermore, the effect of concentrated NaH2PO4 on the reticular groove reflex was studied. Six healthy but P-depleted dairy cows underwent four treatments in randomised order. Treatments consisted of intraruminal administration of NaH2PO4, KH2PO4 and Ca(H2PO4)2 providing the equivalent of 60â g P. A fourth treatment consisting of concentrated NaH2PO4 combined with acetaminophen as a marker substance was administered orally to determine whether the reticular groove reflex could be induced. Intraruminal administration of NaH2PO4 and KH2PO4 resulted in similar increases in plasma Pi concentrations ([Pi]) while intraruminal Ca(H2PO4)2 resulted in lower increases in plasma [Pi]. Oral and intraruminal administration of NaH2PO4 resulted in similar times to peak plasma [Pi] and acetaminophen concentration, indicating that concentrated NaH2PO4 administered orally did not trigger the reticular groove reflex. These results suggest that oral administration of KH2PO4 is equally effective as NaH2PO4. Oral administration of Ca(H2PO4)2 in contrast has a less pronounced effect on the plasma [Pi].
Subject(s)
Calcium Phosphates/administration & dosage , Cattle Diseases/therapy , Enteral Nutrition/veterinary , Hypophosphatemia/veterinary , Phosphates/administration & dosage , Potassium Compounds/administration & dosage , Animals , Calcium Phosphates/chemistry , Cattle , Female , Hypophosphatemia/therapy , Lactation , Phosphates/chemistry , Potassium Compounds/chemistry , Treatment OutcomeABSTRACT
Phosphorus depletion and hypophosphatemia have been described to interfere with immune function in rats and humans. In dairy cows, hypophosphatemia has been associated with muscle weakness and recumbency as well as with intravascular hemolysis resulting from increased osmotic fragility of erythrocytes, but so far, the influence of P depletion and hypophosphatemia on immune function has not been studied. Therefore, the aim of this study was to investigate whether P depletion and ensuing hypophosphatemia are associated with impaired granulocyte and lymphocyte function. Eight mid-lactation dairy cows were fed a P-deficient ration (0.2% P/kg of DM) for a period of 4wk. The depletion phase was preceded by a 2-wk acclimatization period and followed by a 2-wk repletion phase, during which the same ration was supplemented with P to meet or exceed daily requirements. Blood samples were collected at the end of the acclimatization period, after 2 and 4wk of P depletion, and at the end of the repletion phase. Plasma phosphate concentrations ([Pi]) were determined and white blood cells were counted and isolated. General immune function was investigated by performing a phagocytosis assay with Staphylococcus aureus and a lymphocyte stimulation test (LST) with concanavalin A and pokeweed mitogen. The plasma [Pi] decreased significantly, with the lowest values (mean 0.7±0.2mmol/L) occurring after 2wk of depletion, although depletion was continued for another 2wk. During repletion, plasma [Pi] increased above baseline concentrations. Granulocyte counts changed in parallel with plasma [Pi] over time, decreasing significantly at 2wk after P depletion and increasing again thereafter. Granulocyte survival after phagocytosis was lowest after 4wk of P depletion. Phagocytosis activity of surviving granulocytes determined by mean fluorescence intensity was higher, indicating that phagocytosis was not negatively influenced by P depletion. Lymphocyte stimulation showed a similar trend, with a decreasing stimulation index at the end of P depletion, but differences were not statistically significant. Data presented in this study indicate that hypophosphatemia leads to a decrease in granulocyte counts. Chronic P depletion impairs granulocyte survival during phagocytosis but not phagocytosis activity. Lymphocyte function is not influenced by P depletion.
Subject(s)
Cattle/physiology , Diet/veterinary , Hypophosphatemia/veterinary , Leukocytes/physiology , Phosphorus/blood , Animals , Dietary Supplements , Female , Lactation , Leukocyte Count/veterinary , Lymphocyte Activation , Phagocytosis , Phosphorus/administration & dosage , Rats , Staphylococcus aureus/physiologyABSTRACT
BACKGROUND: Proximal renal tubulopathy was reported in Australian dogs with markedly increased frequency from September 2007. METHODS: Two veterinarian-completed surveys were launched in response to an increased incidence of acquired proximal renal tubulopathy in dogs. The selection criterion for inclusion was glucosuria with blood glucose < 10 mmol/L. Data collected included signalment, presenting signs, history of feeding treats, results of urinalysis and blood tests, treatment and time to resolution of clinical signs. RESULTS: A total of 108 affected dogs were studied. All had been fed the same brand of dried chicken treats, made in China, for a median of 12 weeks (range, 0.3-78 weeks). Small breeds (< 10 kg) accounted for 88% of cases. Common presenting signs included polyuria/polydipsia (76%), lethargy (73%), inappetence (65%) and vomiting (54%). Common biochemical findings included euglycaemia (74%; 71/96), hypoglycaemia (23%; 22/96), acidosis (77%; 20/26), hypokalaemia (45%; 38/84), hypophosphataemia (37%; 28/75) and azotaemia (27%; 23/85). In addition to discontinuation of treats, 64 dogs received medical treatment, including intravenous fluids (52%) and oral electrolyte, amino acid or vitamin supplements. Six dogs died or were euthanased. Two dogs were necropsied. Histopathological findings consisted of proximal tubular necrosis accompanied by regeneration. Time to resolution of clinical signs in 35 survivors available for follow-up was < 2 weeks (n = 8), 2-4 weeks (n = 2), 5-7 weeks (n = 5) and 2-6 months (n = 10). CONCLUSION: Of the 108 dogs with acquired proximal renal tubulopathy contemporaneous with chicken treat consumption, most survived but many required aggressive supportive care. The treats likely contained a toxin targeting the proximal renal tubules. Diet history and urinalysis were vital for diagnosis.
Subject(s)
Dog Diseases/pathology , Kidney Tubules, Proximal/pathology , Animal Feed/adverse effects , Animals , Blood Glucose/analysis , Dog Diseases/etiology , Dogs , Female , Hypokalemia/veterinary , Hyponatremia/veterinary , Hypophosphatemia/veterinary , Male , Retrospective Studies , Surveys and QuestionnairesABSTRACT
The aim of the presented study was the estimation of optimal Ca and P levels applied before calving together with anionic salt addition, as an element of hypocalcaemia and hypophosphataemia prevention. The experiment was carried out during the dry period on 48 cows with similar milk yield in the previous lactation. Cows were divided into four groups. In group I (control) the amount of minerals was in accordance to NRC standards. In experimental groups (groups II-IV), two weeks before calving, cows received 140 g/day/head of hydrated magnesium sulphate to achieve dietary cation-anion difference at the level of about 50 mEq/kg DM. In groups II and III cows received calcium carbonate (100 g/day) 10 days a.p. (antepartum) (group II), or 5 days a.p. (group III), while cows in IV group received dicalcium phosphate (100 g/day) for 5 days a.p. Application of MgSO4 x 7H20 significantly affected the urine pH of cows from group III and IV 4-5 d. before calving - 6.45 and 6.81, respectively. The acidification of urine was observed after calving in group IV (7.13). In cows from group II (100 CaCO3 10 days a.p.) urine pH decline was not found (7.97-7.75). In that group the incidences of hypophosphatemia were noted (blood serum inorganic P level 1.41-1.46 mmol/1). Addition of magnesium sulphate prevented hypocalcaemia occurrence -- 4-5 d. before calving the concentration of ionized Ca in blood serum was 1.11, 1.13 and 1.16 mmol/1 (respectively for group II, III and IV). Reproductive functions were significantly improved after the application of CaCO3 and CaHPO4 for 5 days a.p. in comparison with control and group II -- progesterone concentration in the blood serum on the 45th day of lactation was 1.396 - 1.409 versus 0.799 - 0.401. The correlation between progesterone and inorganic P level in serum was almost significant. Based on the obtained results a treatment optimal in prevention of hypocalcaemia and hypophosphataemia is the application of 50 g CaCO3 and 50 g of CaHPO4 for the last 5 days of the dry period together with MgSO4 x 7H20 given for 14 days a.p.
Subject(s)
Calcium/pharmacology , Cattle Diseases/prevention & control , Hypocalcemia/veterinary , Hypophosphatemia/veterinary , Magnesium Sulfate/pharmacology , Phosphorus/pharmacology , Animal Feed , Animal Nutritional Physiological Phenomena , Animals , Calcium/administration & dosage , Cattle , Diet/veterinary , Dietary Supplements , Female , Hypocalcemia/prevention & control , Hypophosphatemia/prevention & control , Lactation/physiology , Magnesium Sulfate/administration & dosage , Phosphorus/administration & dosageABSTRACT
Thirty cows with parturient paresis were divided into three groups of 10. All the cows were given 500 ml of a 40 per cent calcium borogluconate solution intravenously over a period of 10 minutes, and 20 were also given 500 ml of a 10 per cent solution of sodium phosphate intravenously; in 10 of the cows this solution was administered over a period of 10 minutes immediately after the calcium borogluconate solution, and in the other 10 cows 200 ml of the solution was administered rapidly and the remaining 300 ml was added to 10 litres of sodium chloride and glucose solution and infused slowly over six hours. There were no significant differences between the groups with respect to the outcome of the treatments; six or seven of the cows in each group stood within eight hours of the treatment. There were no significant differences between the changes in serum calcium concentrations among the groups. The mean concentrations of inorganic phosphorus in the groups given sodium phosphate were increased above the normal range initially, but after eight hours there were no significant differences between the groups in terms of the numbers of cows that were hypophosphataemic. There were no significant differences between the three groups with respect to changes after treatment in the serum concentrations of magnesium or parathyroid hormone.
Subject(s)
Boric Acids/administration & dosage , Cattle Diseases/drug therapy , Parturient Paresis/drug therapy , Phosphates/administration & dosage , Phosphorus/blood , Animals , Cattle , Cattle Diseases/blood , Cattle Diseases/urine , Drug Therapy, Combination , Female , Hypophosphatemia/blood , Hypophosphatemia/complications , Hypophosphatemia/drug therapy , Hypophosphatemia/veterinary , Infusions, Intravenous/veterinary , Magnesium/blood , Parathyroid Hormone/blood , Parturient Paresis/blood , Parturient Paresis/complications , Parturient Paresis/urine , Pregnancy , Treatment OutcomeABSTRACT
The purpose of this prospective cohort study was to identify factors that place a dairy cow with uncomplicated milk fever (MF) at significant risk of becoming an alert downer cow (ADC) and to verify if these factors could be used to predict treatment outcome. Recumbent MF cows were examined before treatment and 52 were excluded due to complications. In all, histories and pretreatment serum samples were taken and the serum of 86 cows was analyzed for electrolyte levels (calcium, phosphorus, magnesium, and potassium). In total, 36 of the 86 samples were from ADCs and 50 from animals that responded to MF treatment (MFT). A binary-two-factor logistic model determined that a MF cow with a phosphorus pretreatment level of > or = 0.9 mmol/L was 12 times more likely not to become an ADC than one with a phosphorus level < 0.9 mmol/L (CI: 6.3,23.1). Also, a binary multivariable logistic regression analysis showed that a MF cow with a pretreatment calcium level > or = 1.7 mmol/L was 14 times more likely to become an ADC than one with a serum level < 1.7 mmol/L (CI: 2.0,98). Age and the other serum electrolytes were not statistically significant risk factors at the 0.05 level. The rigorous pretreatment examination and stringent adherence to protocol reduced ADC misclassification and fostered the strong association between single factor serum phosphorus levels and ADCs. By using a cutoff level of serum phosphorus at > or = 0.9 mmol/L, a practitioner could correctly predict that 95% of the MFs would not become ADCs and, therefore, this level would be a useful pretreatment predictor.
Subject(s)
Calcium/blood , Cattle Diseases/drug therapy , Hypophosphatemia/veterinary , Parturient Paresis/drug therapy , Phosphorus/blood , Animals , Arousal/physiology , Calcium/therapeutic use , Cattle , Cattle Diseases/blood , Cohort Studies , Electrolytes/blood , Female , Hypophosphatemia/complications , Hypophosphatemia/drug therapy , Logistic Models , Parturient Paresis/blood , Phosphorus/therapeutic use , Pregnancy , Prospective Studies , Risk Factors , Treatment OutcomeABSTRACT
Our objective was to compare the effects of different prepartum dietary phosphorus concentrations on periparturient metabolism and performance. Forty-two late pregnant multiparous Holstein cows were fed 0.21, 0.31, or 0.44% P (dry basis) for 4 wk before expected calving. After parturition, all cows were fed a common lactation diet (0.40% P). In the prepartum period, cows fed 0.21% P had lower blood serum P concentrations compared with cows fed 0.31 or 0.44% P. However, serum P concentrations of all cows were within the normal range (4 to 8 mg/dL) until the day of calving when average concentrations dropped below 4 mg/dL. From 3 to 14 d postpartum, serum P of cows fed 0.21% P was greater than that of cows fed 0.31 or 0.44% P. No cows presented with or were treated for clinical hypophosphatemia in the periparturient period. Total serum Ca was lower before calving through 2 d postpartum for cows fed 0.44% P compared with those fed 0.21 or 0.31%. Prepartum dietary P treatments did not alter blood osteocalcin, hydroxyproline, and deoxypyridinoline, indicators of bone metabolism, or concentrations of parathyroid hormone or 1,25-dihydroxyvitamin D3. Energy-corrected milk yield and milk composition (first 28 d of lactation) were not affected by prepartum dietary P concentrations. It is concluded that feeding 0.21% P (34 g of P/cow daily) prepartum is adequate for periparturient multiparous Holstein cows with high metabolic demands and genetic potential for milk production. No adverse effects on periparturient health, dry matter intake, or 28-d lactation performance resulted.
Subject(s)
Cattle/physiology , Parity , Parturition/physiology , Phosphorus, Dietary/administration & dosage , Animals , Body Composition , Body Weight , Calcitriol/blood , Calcium/blood , Cattle Diseases/epidemiology , Cell Count , Diet , Eating , Energy Metabolism , Female , Hypocalcemia/epidemiology , Hypocalcemia/veterinary , Hypophosphatemia/epidemiology , Hypophosphatemia/veterinary , Lactation/physiology , Least-Squares Analysis , Magnesium/blood , Milk/chemistry , Milk/cytology , Nutritional Requirements , Parathyroid Hormone/blood , Phosphorus/blood , PregnancySubject(s)
Animal Nutritional Physiological Phenomena , Hemoglobinuria/veterinary , Hypophosphatemia/veterinary , Phosphorus/therapeutic use , Sheep Diseases/diagnosis , Animal Feed/standards , Animals , Animals, Newborn , Hemoglobinuria/etiology , Hypophosphatemia/complications , Hypophosphatemia/drug therapy , Sheep , Sheep Diseases/blood , Sheep Diseases/drug therapy , Sheep Diseases/urine , Treatment OutcomeABSTRACT
Two juvenile male Speke's gazelles (Gazella spekei) at the St. Louis Zoo showed poor body condition, slowed growth, hunched stance, rough hair coat, and profound hypophosphatemia. The first gazelle was treated with parenteral phosphorous supplements but continued to deteriorate clinically and was euthanatized. The second gazelle had serum 25-hydroxyvitamin D levels of 0 nmol/L and was treated with i.m. injections of vitamin D. It died shortly after starting therapy. The only significant necropsy finding was multiple rib fractures in various stages of healing. Hypovitaminosis D has been confirmed in multiple Speke's gazelles in this collection, indicating possible deficiencies in the diet or in the amount of ultraviolet light available to the gazelles.
Subject(s)
Antelopes , Hypophosphatemia/veterinary , Vitamin D Deficiency/veterinary , Vitamin D/analogs & derivatives , Animals , Animals, Zoo , Calcium/blood , Euthanasia, Animal , Failure to Thrive/etiology , Failure to Thrive/veterinary , Fatal Outcome , Fractures, Spontaneous/etiology , Fractures, Spontaneous/veterinary , Hypoalbuminemia/complications , Hypoalbuminemia/veterinary , Hypophosphatemia/complications , Male , Vitamin D/blood , Vitamin D Deficiency/complicationsABSTRACT
Hypocalcemia and hypophosphatemia are relatively common in periparturient cows. This article reviews the etiologic factors that contribute to the development of these conditions. The physiologic role of magnesium in calcium homeostasis and the physiologic effect of dietary cation-anion difference at the cellular level are discussed in depth. A theory to explain the development of periparturient hypophosphatemia is developed.
Subject(s)
Calcium/metabolism , Cattle Diseases/physiopathology , Hypocalcemia/veterinary , Hypophosphatemia/veterinary , Lactation , Phosphorus/metabolism , Animals , Cattle , Cattle Diseases/prevention & control , Dairying , Female , Homeostasis , Hypocalcemia/physiopathology , Hypocalcemia/prevention & control , Hypophosphatemia/physiopathology , Hypophosphatemia/prevention & control , Parathyroid Hormone/physiology , PregnancyABSTRACT
The goal of this article is to summarize key features of calcium, phosphorus, and magnesium pathophysiology and highlight some of the recent scientific accomplishments in these fields. The area of calcium physiology has been especially active due to the discovery of a new calcium-regulating hormone, parathyroid hormone-related protein, cloning of the parathyroid hormone receptor and identification of a cell membrane receptor for ionized calcium. Advances have also been made in understanding the role of phosphorus and the active form of vitamin D, 1,25-dihydroxyvitamin D in the pathogenesis of secondary hyperparathyroidism in patients with chronic renal failure. The role of magnesium in many pathologic processes, including cardiac disease, is gaining a heightened appreciation due to its function in many metabolic processes and the development of techniques to measure ionized magnesium concentrations.
Subject(s)
Calcium/metabolism , Dog Diseases/metabolism , Magnesium/metabolism , Phosphorus/metabolism , Animals , Dog Diseases/physiopathology , Dogs , Hypercalcemia/metabolism , Hypercalcemia/physiopathology , Hypercalcemia/veterinary , Hypocalcemia/metabolism , Hypocalcemia/physiopathology , Hypocalcemia/veterinary , Hypophosphatemia/metabolism , Hypophosphatemia/physiopathology , Hypophosphatemia/veterinaryABSTRACT
Hypophosphatemia is uncommon in cats, but it has been reported in association with diabetes mellitus and hepatic lipidosis, where it can cause hemolysis, rhabdomyopathy, depression, seizures, and coma. The purpose of this article is to describe 9 cats that developed low serum phosphorus concentrations (< 2.5 mg/dL) subsequent to enteral alimentation. Serum biochemical analyses from more than 6,000 cats were reviewed. The medical records of all cats with hypophosphatemia were examined for history of enteral alimentation; diabetic cats were excluded from the study. Nine cats, ranging in age from 3 to 17 years, were identified. All cats had normal serum phosphorus concentrations before tube feeding began. Onset of hypophosphatemia occurred 12 to 72 hours after initiation of enteral alimentation, and the nadir for phosphorus concentrations ranged from 0.4 to 2.4 mg/dL. Hemolysis occurred in 6 of the 9 cats. Hypophosphatemia secondary to enteral alimentation is an uncommon clinical finding in cats. Cats with high alanine aminotransferase activity, hyperbilirubinemia, and weight loss should be closely monitored for hypophosphatemia during the first 72 hours of enteral alimentation.