Eclampsia is the sudden onset of clinical signs associated with low blood calcium levels (hypocalcemia) that occur in lactating (nursing) bitches. It is caused by loss of calcium in the milk and is often combined with poor dietary calcium intake. This condition is different from eclampsia in women, which is related to blood pressure abnormalities prior to birth.
Predisposing Factors More common in dogs than cats
Toy and small breeds most commonly affected
Large litter size
Highest incidence with the first litter
Poor nutrition during pregnancy and lactation
Possibly worsened by use of calcium supplements during pregnancy
Seen most commonly two to three weeks after-birth, although can be seen as late as six weeks after whelping (giving birth)
What to Watch for
Restlessness, nervousness
Panting
Stiffness, difficulty walking
Muscle tremors or rigidity
Convulsions
High body temperature
Rapid respiratory rate
Possibly coma and death
Diagnosis
The history and clinical signs are generally very suspicious of eclampsia. A biochemical profile confirms the hypocalcemia. The total serum calcium is usually less than 7 mg/dl. Low blood sugar (hypoglycemia) may also be found. Rapid response to treatment with intravenous calcium helps to confirm the diagnosis.
Treatment
Dogs with eclampsia usually require immediate emergency care. The definitive treatment involves returning blood calcium levels to normal and decreasing calcium loss from the body, which may include weaning and hand feeding the puppies. Treatment usually includes:
Intravenous calcium (calcium gluconate) given very slowly
An intravenous or oral dextrose solution to increase blood sugar
Anti-seizure drugs (e.g. Valium®) if seizures are unresponsive to calcium and dextrose
Cooling of patients with severely elevated body temperatures
Removal and hand raising of all puppies
Oral calcium supplementation when the patient is stable
Oral vitamin D supplementation to increase the absorption of calcium in the intestines
Home Care
Administer all medications as prescribed by your veterinarian.
Unless told otherwise, do not allow newborns to nurse after an episode of eclampsia.
Follow your veterinarian's recommendations regarding feeding the newborns.
Return to your veterinarian to have calcium levels monitored as prescribed.
Preventative Care
The best way to prevent eclampsia is to avoid calcium supplementation during pregnancy and to feed the pregnant bitch a well-balanced, good quality food. Supplementation of the bitch with calcium may be helpful once the puppies are delivered and are beginning to nurse. Supplemental feeding of the puppies may also be beneficial, especially for large litters.
