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Eclampsia 281

PROGNOSIS & OUTCOME • Prepartum abdominal radiography to Client Education
estimate fetal number and relative size in Discuss proper perinatal husbandry, accurate
VetBooks.ir appropriate monitoring Technician Tips ovulation timing, and prompt recognition of Diseases and Diseases and Disorders Disorders
comparison to the dam (best after 55 days’
gestational length interpretation based on
Fair to good with timely intervention and
gestation)
dystocia.
PEARLS & CONSIDERATIONS
• Hospitalization in a secluded but closely SUGGESTED READING
Comments monitored area of the clinic during labor Davidson AP: Clinical conditions of the bitch and
Obstruction of the birth canal, regardless of is ideal, decreasing stress to the dam. queen. In Nelson RW, et al, editors: Small animal
cause (fetal malposition, fetal-dam size mis- • Neonates should be allowed to nurse imme- internal medicine, ed 5, St. Louis, 2014, Elsevier,
match, or anatomic defects of dam), must be diately after delivery; direct supervision of pp 915-950.
ruled out by vaginal palpation or vaginoscopy. new or postanesthesia dams is important to AUTHOR: Autumn P. Davidson, DVM, MS, DACVIM
Obstruction of the birth canal is an indication ensure normal maternal instincts are present EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
for cesarean section and an absolute contrain- and smothering of neonates is prevented.
dication for treatment with oxytocin. Neonates should then be moved into a warm
box until the next nursing or discharge to
Prevention the owner. Weigh neonates before and
• Complete prebreeding evaluation of the after nursing to ensure colostrum has been
bitch, including a vaginal exam ingested.

Eclampsia Client Education
Sheet

BASIC INFORMATION PHYSICAL EXAM FINDINGS • Peripheral nerve cells are more permeable
• Clinical signs are related to hypocalcemia and to sodium when extracellular calcium levels
Definition progress rapidly if left untreated (p. 515). are low.
Acute onset hypocalcemia occurring during late • Early signs include anorexia, depression, and • Calcium ions are also important for micro-
pregnancy or early lactation agitation. vascular tone and maintenance of arterial
• Signs progress to include facial pruritus, pressure.
Synonyms panting, weakness, and muscle fasciculation. • Eclampsia is thought to occur due to
Milk fever, puerperal tetany • Later signs are more severe and include the metabolic imbalance between the
salivation, stiffness, and tonic-clonic muscle high calcium demands of fetal skeletal
Epidemiology spasms, which may progress to epileptiform development and lactation and the intake
SPECIES, AGE, SEX seizures in the bitch. from diet, intestinal absorption, and bone
• Dogs: younger bitches ○ Flaccid paralysis may be seen in the queen. resorption.
• Cats: rare in queens • Hyperthermia and dysrhythmias may also • Exogenous calcium supplementation may
be seen in the bitch. contribute to hypocalcemia due to para-
GENETICS, BREED PREDISPOSITION • Hypothermia may occur in the queen. thyroid atrophy.
More frequent in toy and small breed dogs • Alkalosis may decrease ionized calcium
Etiology and Pathophysiology levels and cause signs of eclampsia even
RISK FACTORS • Eclampsia occurs when serum ionized when serum total calcium concentrations
• Young dogs of low parity (parity and age do calcium is < 0.8 nmol/L or total serum are normal.
not seem to be risk factors for the queen) calcium concentration is < 7 mg/dL.
• Poor perinatal nutrition DIAGNOSIS
• Calcium supplementation during pregnancy
• Large litter size Diagnostic Overview
A provisional diagnosis of eclampsia is based
ASSOCIATED DISORDERS on the presenting clinical signs of hypocalcemia
• Hypomagnesemia during late pregnancy or early lactation and a
• Hypoglycemia rapid response to intravenous calcium supple-
• Hyperthermia mentation. Low serum calcium concentration
confirms the diagnosis.
Clinical Presentation
DISEASE FORMS/SUBTYPES Differential Diagnosis
Queens may be more prone to hypothermia • Hypocalcemia of other cause (p. 1239)
and exhibit a flaccid paralysis rather than • Neuromuscular disease (e.g., tetanus, rabies)
hyperexcitability. • Hypoglycemia
HISTORY, CHIEF COMPLAINT Initial Database
• Bitches typically present during the first 3 • Total serum calcium concentration < 7 mg/
weeks of lactation but they may also be seen dL (<1.74 mmol/L) or ionized serum calcium
during late pregnancy or parturition. ECLAMPSIA Aberrant behavior in a Brittany bitch ≤ 0.8 mmol/L is the biochemical finding of
• Queens typically present in late pregnancy. with eclampsia. (Courtesy www.PetPlace.com.) eclampsia.

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