HELP NEEDED Hypocalcemia episode-shopping list help

[ayd]

Hello and good morning wise ones. I need assistance in the must haves of a medicine cabinet for my Jersey please.

my Jersey first calf heifer calved on 12/16. Text book birth and peachy two weeks, until yesterday.

she came in to be milked as always. Alert, happy and hungry.. however she did not want to finish her grain. After milking I pulled the wet grain figuring she was being picky, replaced it with dry and no supplements except for the addition of her beat pulp. She ate that. She did not want her alfalfa hay. Cleaned machine and let her out, that’s when I noticed some missed steps. She was a little wobbly and off balance when I had to move her hip to close the door. 

I called my vet who primarily is an equine vet. No promises from the office lady, but said she’d talk to him. In the mean time I drenched her with bottle CMPK and gave a shot of multimin. By this time she was low headed, sleepy and not moving around. I waited for a call back from the vet. After two hours of no word I posted on the local farm page for recommendation on another large animal vet who would see a cow. As I was waiting I called local vet offices and found no help.

I have a dear goat friend who saw my post on fb and notified a local rancher who then called me. Suggested oral calcium gluconate, one whole bottle oral drench. As well as offering great support and confidence. Tractor supply had one bottle which I purchased and drenched. I also drenched her with vegetable glycerin. 

she never went down and by 5 pm she was alert and eating again. I checked on her over night on the barn cam and she was recumbent resting but did not notice her cuddling. This morning she is again eating. She has drank good, peeing and pooping. 

questions. Can you kind folks suggest medication to have on hand for another episode please. And if not to much trouble, why and what it does for the cow. I am a researcher so no need for great length and trouble.

my short list
I want to get a good calcium bolus 
more calcium gluconate
CMPK
IV supplies
dextrose
anything else?

also, do I continue milking as normal?

thanks a million! 






Edited to add feed

free choice teff hay, 1 flake of alfalfa but I’m upping that after yesterday. Also adding Orchard hay now.
kelp, lose minerals (TSC minerals) I’d like to order a dairy cow brand.

at milking

5 lbs. bulk grain mix (almond hulls, oat pellets, cracked corn, distillers grain, barley, cotton seed, molasses)
1 lb. beat pulp
2 ounces wheat germ oil
1 ounce ACV
1/2 C vegetable glycerine
1/2 C DE bentonite mix
herbs
Hand full of respberry leaves
hand full of dandelion leaves
2 tsp milk thistle powder
2 tsp nettle powder
2 tsp ascorbic acid
1 tsp. Magnesium / calcium powder

[Shawn]

yes, continue milking, but only if you can do so safely - without her falling over on you.

Take her temp. Monitor that TAD and post it here for more help. I'm saying this in case she's not fully over whatever it is.

Sorry I can't think of anything else to add to your list except probiotics. Always good to have that. Maybe Vit. B if you need it for appetite stimulation.

Hope she continues to improve.

[ayd]

Dec 31, 2020 10:14:03 GMT -5 Shawn said:

yes, continue milking, but only if you can do so safely - without her falling over on you.

Take her temp. Monitor that TAD and post it here for more help. I'm saying this in case she's not fully over whatever it is.

Sorry I can't think of anything else to add to your list except probiotics. Always good to have that. Maybe Vit. B if you need it for appetite stimulation.

Hope she continues to improve.

Thank you, I forgot to mention temp. Yesterday it was 99.9 

[Kelsey]

Have you checked for ketosis? Grab some ketones strips from the pharmacy and test her urine.
Glad she turned around for you. I suspect ketosis might be a big part of the issue because MF is uncommon in heifers, particularly 2 weeks out. But it's the most common time for ketosis to occur.
There can definitely be overlap of symptoms. If it was truly milk fever her rumen would have shut down and she would not have recovered without an IV. Going off of that, I would say it was the glycerin drench that made the biggest impact (and the Vit B in the shot).

For future reference, never drench a cow that is showing MF signs - no oral products, definitely no drenching. (And I personally won't drench ever, as it's too easy to get a tiny bit in the lungs which is a death sentence for cows - small lung size relative to the body).

You'll want to go for the CMPK administered through IV, and failing that, Calcium Glucose through SubQ.

If this is a ketosis issue, consider her milk volume and how much grain she's getting. Most classic nutritional ketosis cases (too much milk, too little feed) pop up at around 2 weeks post-calving because the metabolism really ramps up and milk production is increasing.

How much milk is she giving?

[ayd]

Kelsey thank you. I am calf sharing with her calf. Morning milking 1 to 1/2 gallons. Evening milking one gallon. I get an excellent cream line, I dont think she is holding back a lot.

I'll search for the items mentioned.

[Kelsey]

Dec 31, 2020 13:06:45 GMT -5 ayd said:

Kelsey thank you. I am calf sharing with her calf. Morning milking 1 to 1/2 gallons. Evening milking one gallon. I get an excellent cream line, I dont think she is holding back a lot.

I'll search for the items mentioned.

Is the calf with her all the time? What quantity do you estimate the calf is drinking? At two weeks most calves will be drinking 2-3 gallons, so she may be giving 5+ gallons and increasing.

[ayd]

Dec 31, 2020 13:11:12 GMT -5 Kelsey said:

Dec 31, 2020 13:06:45 GMT -5 ayd said:

Kelsey thank you. I am calf sharing with her calf. Morning milking 1 to 1/2 gallons. Evening milking one gallon. I get an excellent cream line, I dont think she is holding back a lot.

I'll search for the items mentioned.

Is the calf with her all the time? What quantity do you estimate the calf is drinking? At two weeks most calves will be drinking 2-3 gallons, so she may be giving 5+ gallons and increasing.

Yes, calf on full time. Bull calf (steer) bulky and eating very well. I'd estimate he's on the upper end of 2 -3 gallons easily. She is registered and I know of some of her sires daughters in dairies on robots are producing 90+ lbs. a day as FF. How should I modify her diet? She picked at her grain this morning but ate her alfalfa hay very well and is really chowing down on the orchard now. 

She gave an honest 1 1/2 gallons this am with a little left over after bottling. 

[Kelsey]

If she's at 10# grain per day and slipping into ketosis and still increasing in milk, then I would slowly work up to 15-18# grain per day.
What protein % is your grain?
I would offer free choice of all three hays so she can choose what she needs.

Eating hay but reluctantly eating grain is usually the first sign of ketosis.
Try to get those ketone strips today so that you can confirm it's ketosis. If not we can troubleshoot further.

[ayd]

Dec 31, 2020 13:38:44 GMT -5 Kelsey said:

If she's at 10# grain per day and slipping into ketosis and still increasing in milk, then I would slowly work up to 15-18# grain per day.
What protein % is your grain?
I would offer free choice of all three hays so she can choose what she needs.

Eating hay but reluctantly eating grain is usually the first sign of ketosis.
Try to get those ketone strips today so that you can confirm it's ketosis. If not we can troubleshoot further.

WOW! That's a lot of grain! But I'm good with that.. whatever it takes to keep her healthy. Grain is low in protein.. I was told about 13% protein. If she needs more protein I can add Calf Manna?

Minerals.. I want to get her on a good dairy cow mineral. If you've the time and at your convenience, could you suggest a good mineral and/or recommend one from this site? www.wickslivestocknutrition.com/minerals.html

I'll hunt down some keto strips

And thank you again, very very much

[Kelsey]

A Jersey giving 90# of milk per day is going to be taking in 50+ pounds of dry matter per day, which is 60+ pounds of actual feed. On a commercial dairy, that likely means 25+ pounds of grain. You won't need to go that high as you aren't pushing for further production, but it illustrates how a higher production cow usually needs a fairly high quantity of grain. 18# is on the higher end, but in my opinion, a fairly reasonable amount that will not cause issues. Staying under 2% of her body weight per day is a good limit.

[rosalind]

IV Dextrose is the treatment for ketosis. Both Dextrose and IV kit should be available at your feed store.

Her going downhill even though she's getting a fair amount of grain and hay is worrisome...

[Meadow Creek Mama]

For hypocalcemia (milk fever), after several rounds of it over the years, I will now only give IV CMPK as my primary weapon. Hopefully you have a vet who can do it for you and teach you to do it yourself. The IV CMPK is prescription so you'll need a vet anyway in order to get it. It has dextrose in it so you get the bonus of that for energy to get them eating again. When the cow is treated via IV with CMPK, you can also give a bolus of Bovicalc which is a slow release as she should begin eating again soon after the IV. One bottle should get her going again although it may need to be repeated.

We've recently had a 2 month fresh cow have problems, never quite figured it out, but she was slow, on and off going off feed, not ruminating much. We treated her with IV CMPK even though it wasn't MF and it helped for a while (eventually she bounced back overall). It got her eating again when for whatever reason she wouldn't on her own. We've given a bottle of dextrose to a very MF cow (along with the bottle of CMPK) and all the sugar made her body shake. So if you give a full bottle of dextrose IV, be prepared for that response. It does pass but is a little unsettling to see at the moment.

[Kelsey]

Dec 31, 2020 13:57:14 GMT -5 ayd said:

Dec 31, 2020 13:38:44 GMT -5 Kelsey said:

If she's at 10# grain per day and slipping into ketosis and still increasing in milk, then I would slowly work up to 15-18# grain per day.
What protein % is your grain?
I would offer free choice of all three hays so she can choose what she needs.

Eating hay but reluctantly eating grain is usually the first sign of ketosis.
Try to get those ketone strips today so that you can confirm it's ketosis. If not we can troubleshoot further.

WOW! That's a lot of grain! But I'm good with that.. whatever it takes to keep her healthy. Grain is low in protein.. I was told about 13% protein. If she needs more protein I can add Calf Manna?

Minerals.. I want to get her on a good dairy cow mineral. If you've the time and at your convenience, could you suggest a good mineral and/or recommend one from this site? www.wickslivestocknutrition.com/minerals.html

I'll hunt down some keto strips

And thank you again, very very much

I want to back up a little...
First, the higher grain amount was under the assumption that ketosis is her primary issue. The ketone strips will answer that.
Make sure you are weighing her grain.

The foundation for every dairy cow diet should be high quality forage. I believe you are in a desert area/no grazing (yes?) so your hay needs to be top quality (same goes for anyone in the non-grazing season). If her hay quality or intake is not sufficient, she is going to have issues and simply adding more grain is not the answer.

My recommendations to up her grain are dependant on her needing it (actually being in ketosis, or losing weight too rapidly) and knowing that she is eating hay optimally (50+ pounds per day of very good hay).
If she has nutritional ketosis and she is still eating relatively well, increasing carbs (I like molasses in water or on the grain) and enticing her with different grains will hopefully be sufficient. I would also give a Vit B shot daily for 3 days. If she backtracks, doesn't want to eat grain, etc then treat with Dextrose IV. But it sounds like you may have caught it early and hopefully changes to her diet will be enough to turn her around.

Edit: 13-14% protein is great for grain, if her hay average is higher (total diet should come into around 16.5% protein).

[Kelsey]

ayd How's she doing today?

[ayd]

Kelsey Okay I am back.. Sorry for the delay. I picked up the test strips and attaching a picture. It is dark... I'll also attach a picture of what I was able to get from TSC. Stock is low on everything. I purchased gel instead of drench, thought perhaps safer. Tomorrow things should open back up and I can find an IV set if need be. 

as of this AM Temp is holding at 99.9

She was a pain to milk this morning. Didn't want her grain and was fidgety and held back on me. 

She wanted alfalfa and ate that good. Wouldn't touch her grain UNTIL I offered it on her alfalfa then she ate I'd guess to be about 3 lbs. Last night she ate about 4 lbs. of grain after I added Molasses to it. This morning she wouldn't touch the grain after I added the Molasses. 

She only wants to eat alfalfa hay now (and a little Orchard) and I am concerned about the protein and that it will push more production? I wanted to pick up some 3-way hay (barley/oat/wheat) for her but nothing is open. I will tomorrow if this sounds like a good idea?   

edited: Yes, correct, no pasture. Bailed hay only

[ayd]

Dec 31, 2020 13:06:45 GMT -5 ayd said:

Kelsey thank you. I am calf sharing with her calf. Morning milking 1 to 1/2 gallons. Evening milking one gallon. I get an excellent cream line, I dont think she is holding back a lot.

I'll search for the items mentioned.

I don't know where my head was at when I wrote that above about her production.. She gives 1 - 1 1/2 gallons in the morning and a half gallon in the evening. I have cut out the evening milking for now.


an hour ago I gave her one tube of the CAL-MAG-CO GEL and a dose of the Probios. within 10 minutes she went in and ate some alfalfa and Orchard hay. 

[Kelsey]

Wow... yes, definitely ketosis!
Glad to hear she's still interested in food.
Usually with ketotic cows I'll pretty much let them eat whatever they will - if she wants alfalfa, give it to her.

How does she normally do with her teff hay? I don't know a lot about it - is your source high quality, good protein levels, etc?

I always run out to the feed store and buy a couple bales of their primo hay when I have a picky/ketotic cow because they will eat one thing one hour and then turn up their nose at it the next. Good to have multiple hay and grain options to rotate through.

Because she's still eating decently and hasn't (that we know of) developed further complications like LDA, consider every hour that she's still eating a golden opportunity to pull her out of this. Once she stops eating, rumen shuts down, etc, things go downhill very fast and it is a long hard battle to pull them out.

With that said, I'd give her the Vitamin B ASAP (and again the next couple days) and a 1/2 or full (?? rosalind ?) bottle of IV Dextrose. Keep offering molasses water and various types of grain (separate offerings, as they cycle through preferences as I said).
You can also offer kale, carrots, cut apples, etc. In winter/early spring I'll even find areas that have grass and dandelions growing to cut for a sick cow.

[Kelsey]

Posted at the same time.
I'd still give the Vit B now but hold off on the Dextrose now that she's eating more from the gel. Calcium levels almost always dip a bit with ketosis so that can definitely help, though I'm generally not a fan of gels/pastes due to them causing sore mouths and throats on already reluctant eaters.

IV Dextrose will make their blood sugar jump but then they can crash afterwards if they don't start eating, which is why oral treatments are often preferable (as in, tempting her with feeds, molasses water, oral glycerin). So I think you can hold off for now if she continues to eat.

With a sudden case of ketosis like this (especially when milk production isn't particularly high - she's not a high producer unless calf is taking a ridiculous amount) you do need to consider an underlying issue like LDA or fatty liver. Hopefully not, but do keep it in mind if she backtracks again.

Rather than dropping a milking, I recommend limiting calf to twice daily nursing, at least while she recovers.

[rosalind]

Eek, yeah, whew, high ketones!!

I agree, at this point let her eat whatever she wants.

If she was my cow, she'd get a full bottle of IV Dextrose. Why? Because the gels, etc. can be caustic and can affect apoetite. By giving Dextrose, you get her eating immediately and you'll jump that temp right back up to 101.5, which will get her ruminating again and she should take off at maintain her body temp and apoetite afyer tgat. (If still sluggish, further IV or oral supplements may be needed for a day or two more).

Note: Dextrose = IV only.

[ayd]

Jan 1, 2021 18:03:10 GMT -5 Kelsey said:

Posted at the same time.
I'd still give the Vit B now but hold off on the Dextrose now that she's eating more from the gel. Calcium levels almost always dip a bit with ketosis so that can definitely help, though I'm generally not a fan of gels/pastes due to them causing sore mouths and throats on already reluctant eaters.

IV Dextrose will make their blood sugar jump but then they can crash afterwards if they don't start eating, which is why oral treatments are often preferable (as in, tempting her with feeds, molasses water, oral glycerin). So I think you can hold off for now if she continues to eat.

With a sudden case of ketosis like this (especially when milk production isn't particularly high - she's not a high producer unless calf is taking a ridiculous amount) you do need to consider an underlying issue like LDA or fatty liver. Hopefully not, but do keep it in mind if she backtracks again.

Rather than dropping a milking, I recommend limiting calf to twice daily nursing, at least while she recovers.

Fatty liver risk was mentioned on more than one occasion to me (on this board) to be watchful of. She is three and this is her first calf.. she was a bit on the plump side pre calving. 

Bottle of B says IM. should it be given in the neck only or can it go in the hip? 1-2 ML. would 2 be better than 1 right now? 

Also she ate more of the grain. 

I'm going to figure out a way to confine calf without upsetting her..  If she frets over him I am concerned she will not think about eating. 

She LOVED the Teff up until 4 or 5 days ago then started turning away from it. No idea on it's food value. No one tests hay around here and the feed stores rotate hay often. She's a PITA, only wanting fresh hay and I may have screwed up trying to "tuff love her". 
No arguing now, she can eat whatever she wants. She is cudding well and is alert.