Hypocalcemia and Ketosis

The following was posted on Nubian Talk and it is full of such good information! This basically explains what most likely happened to Maggie and Rio this year due to being unable to get good quality hay and no forage.

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Posted by: "(no author)" (no email address)
Sun Feb 22, 2009 12:04 am (PST)
Since there has been much discussion online regarding ketosis, the causes and whether or not to feed alfalfa, etc., I went online to several websites and copied the one below. It is lenthy, but very informative. Remember this info is on Hypocalcemia and Ketosis,
Hope this helps.

Ketosis is a metabolic disorder defined by increased levels of ketone bodies (acetone, betahydroxybutyric acid, and acetoacetic acid) in blood, milk, and urine, and is associated with elevated blood plasma nonesterified fatty acids (NEFA), which are precursors of ketone bodies.

The link between calcium and phosphorus in the diet (and the link between Hypocalcemia and Ketosis as well!)

As we goat owners sometimes painfully discover through the unnecessary loss of a doe in late gestation, the nutrients we provide for them during that period are more important than at any other time in their lives. Remember, it's not just the mother we're feeding, but all her fetuses as well. Two minerals especially critical now are calcium and phosphorus. If not available in sufficient amounts and balanced in relationship to each other, in the areas of bone development and muscle tone the physical needs of the mother and her fast-growing fetuses cannot be met

This is no simple task! The tricky part is that for her to handle those functions the doe must get a ration containing lots of calcium-rich foods* along with a lesser amount of phosphorus-rich foods*. By the fourth month a properly balanced calcium to phosphorus ratio must be available since that's when those developing fetuses start rapidly draining calcium and phosphorus from her system for their bone development. Mom gets only "left-overs" for herself, and absent that mineral balance, thus with nothing left for her own muscle tone, she'll be facing a deficiency that, if severe enough, will cause her pregnancy to falter. Too weak to perform her normal body functions, she'll be unable even to eat! No appetite, along with wobbly legs,will be the first clues that she's in trouble.** If this situation isn't corrected fast she'll be faced with starvation, her body left with no option but to rely on its own fat reserves to stay alive. As the fat reserves are processed in the liver, ketones get released into her bloodstream, setting off a secondary crisis, a metabolic condition known as Ketosis. Failure to fix the new problem right away will allow excess ketones to build up, quickly overwhelming the liver. Sadly, once it's 70% damaged it can't be saved. But if intervention starts before that happens, with lots of TLC there's still a chance for survival.

Symptoms: Most cases are seen in does that were getting a hefty grain ration along with their hay in the 1st 3 months of pregnancy, especially when that's largely grass hay instead of alfalfa. The first signs can show up as early as the beginning of the 4th month of gestation****, when she stops eating her grain. Soon after that she won't want her hay either. Without immediate intervention she'll become wobbly, lethargic and depressed. If still untreated by then she'll go down and be unwilling to get up again. If you're concerned enough to take her temperature when you first see these changes, it'll be normal (102.3), but soon after that it'll drop to sub-normal (below 102). Unless you start corrective measures right away you'll lose both the doe and her fetuses.

Treatment: Intervention involves two essential steps:

First, provide outside energy immediately, to prevent damage to her liver (propylene glycol can do this), or even better, provide her with a source of energy plus nutrition. (Nutridrench is good for that.)

And Second, restore her body's calcium to phosphorus ratio ASAP to fix the problem that started all this and get her back up on her own, functioning normally again.

Emergency Repair Info: If you have a 500ml bottle of injectable CMPK¹ (an Rx item) on hand, dose her SQ with 30cc of it every 2 hours day and night, warmed to body temperature until she's normal again. Because of its volume (2 tablespoons) it must be injected between the last rib and the front of the hip bones. If you have oral CMPK or MFO (not Rx) instead, dispense it orally at the same rate as the injectable form, taking care that she swallows one mouthful before you give her another.

If neither of those products are handy, you can re-create a 30cc CMPK dose (650 mg calcium; 500mg potassium; 150 mg phosphorus; and 96 mg magnesium) in your kitchen by going to the Supplements department ofany large chain-type drugstore and buying bottles of Posture D tablets (600 mg calcium, 266 mg phosphorus, 125 units Vitamin D), Citracal tablets (315mg calcium and 200 IU of Vitamin D), Potassium tablets (500 mg), and Magnesium tablets (150mg). Crush up the amount of each pill needed to recreate one 30cc dose of CMPK above. (To assist the reader, helpful owners have calculated the following: "½ of a 600mg tablet of Posture-D, a 315mg tablet of CitraCal, a 500mg tablet of Potassium, and ½ of a 150mg tablet of Magnesium). Serve it in a little yogurt, or add water and drench it with a syringe.

Once she's normal again, along with her corrected ration she'll need a 30cc dose of this CMPK replacement daily until she freshens or, if lactating, until the symptoms subside completely.

Prevention: In the future you can avoid this trauma by feeding the bred doe a "non-working" ² diet of grass or timothy hay during the first 3 months. But as she enters her 4th month of gestation when the fetuses really start growing fast, switch her to a "working diet" ², feeding her the needed calcium-foods and phosphorus-foods in a ratio that provides her with at least 2 parts of calcium to every 1 part of phosphorus. This is quite critical, because ifa doe in late gestation eats plenty of alfalfa, but NO grain, there'll be a phosphorus deficiency. And if she eats straight grass hay and lots of grain, there'll be a calcium deficiency. Feeding any way other than to provide that balance of calcium to phosphorus will leave her deficient in the essential dietary calcium and phosphorus. Only a doe that isn't 'working' (growing, pregnant or lactating) can survive on a diet like that.

Long range consequences of nutritional imbalance: If a doe suffering from this imbalance during late gestation doesn't die at some stage, a few more freshenings with the same diet will leave her heart muscle so weakened that it'll suffer permanent damage, rendering it unable to circulate the body fluids efficiently thru the system. Fluids settle in the body's lower extremities, causing a buildup in the abdominal area and feet that's indicative of Congestive Heart Failure.

Additional problems that appear when goat diets are consistently calcium or phosphorus deficient are: Urolithiasis in wethers (crystalline deposits of excess calcium or phosphorus that block the male urethra), rickets in growing kids (soft, bowed leg bones), and osteomalacia in mature animals (brittle, easily fractured bones). This imbalance also affects the performance of other minerals such as copper, magnesium, zinc, manganese, iron and iodine, all of which play important roles in maintaining healthy body function.

Additional options and info: Alfalfa is the only commonly available* forage that has a lot of calcium, grass hays containing almost none. And all grains contain lots of phosphorus but almost no calcium. So ideally, does in late gestation should get lots of alfalfa along with a small amount of grain to provide the proper balance.*** But if living in an area where grass hay is fed because alfalfa isn't available, in lieu of grain it might be best to provide a loose mineral supplement free choice that has in it the needed calcium to phosphorus ratio along with all of the other essential minerals (ex: Sweetlix 16:8 Meatmaker # 987), perhaps including calf manna in the mixture for additional protein, and powdered dicalcium phosphate as well.

After reading the above, the first question many will ask is, "But how can I provide the energy and protein needed in late gestation if I don't pour on the grain?" Well, here's the answer!

Alfalfa, grasses and grains (barley, oats, corn) all contain similar levels (~1.54%) of digestible energy. So reducing the amount of grain fed and increasing the doe's intake of alfalfa to make the proper calcium to phosphorus ratio available will not change the energy level in the diet at all.

Alfalfa has more digestible protein (~12.5% on average) than do the common grains (oats, barley, corn) and grass hays (~ 8.5%on average). Since late gestation calls for ~ 18% protein, a small amount of calf manna (~24% protein) could either be added to a reduced grain ration, or in addition to the free-choice loose mineral source if feeding straight grass hay.

END

* Other forage-type substances are known to be heavy in calcium as well as alfalfa, but for reasons that while unknown to me no doubt make good sense, they aren't in general use.

**These are symptoms of "Hypocalcemia", a metabolic condition caused by a diet lacking enough calcium and phosphorus to provide for both the mother's and the fetuses' physical needs. But the term is misleading, more accurate choices being Hyperphosphatemia or Hypophosphatemia since Hypo(too little) calcemia doesn't happen all by itself, but is caused by feeding either too much (Hyper = too much) or too little (Hypo = too little) phosphorus relative to the calcium intake.

*** My own regimen for feeding full sized does in the last 2 months of gestation, and that which I recommend to others as well, is 1 cup of grain 2X daily until she freshens, along with all the alfalfa she wants. This diet, In addition to providing the proper amount of calcium, also provides all the protein and energy she needs.

**** Milder and more easily repairable cases of hypocalcemia occasionally show up during lactation as well.

¹ CMPK is a carefully balanced blend of Calcium (1st part of essential dicalcium phosphate balance necessary for bone development and muscle strength), Magnesium (increases calcium effectiveness), Phosphorus (2nd part of essential dicalcium phosphate combination) and K, potassium (helps maintain normal heartbeat while calcium level is being increased).

² A "working diet" is fed to goats that are growing, in late gestation, lactating, or (in the case of bucks) in breeding season. A "non-working" diet, then, is a subsistence ration that's fed to healthy goats that are neither growing, in late gestation, lactating, nor (in the case of bucks) breeding.