Treatment
Treatment generally involves calcium injection by intravenous, intramuscular or subcutaneous routes. Before calcium injection was employed, treatment comprised inflation of the udder using a pneumatic pump. Inflation of the udder worked because the increased pressure created in the udder pushed the calcium in the udder back into the bloodstream of the cow.
Intravenous calcium, though indicated in many cases, is potentially fatal through "heart blockade", or transient high calcium levels stopping the heart, so should be administered with care.
In unclear cases of downer cows, intravenous calcium injection can lead to diagnosis. The typical reaction will be a generalized tremor of the skeletal muscles, and sometimes cardiac arrhythmia. Defecation, urination and eructation are frequent during the treatment, due to pharmacological effect of calcium on the smooth muscles. In stages 1 and 2, the cow can stand up approximately 10 minutes after the end of the intravenous injection. But in stage 3, it may take two or three hours. If the cow is in stage 3 and lying on its side, it is important to put the cow in a sternal position or else risk aspiration.
The prognosis is generally good, even in advanced cases. However, some cows can relapse the following day, and even a third time the day after.
Read more about this topic: Milk Fever
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