Puerperal Tetany in a 2-year-old Chihuahua
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Case Description: A 2-year-old intact female Chihuahua was evaluated because of an acute onset of trembling, weakness, restlessness and panting. The patient had whelped 5 pups 17 days prior. Clinical Findings: Initial examination revealed generalized weakness, inability to stand, episodes of shaking, hyperthermia, dull mentation and mild vaginal discharge. Point of care bloodwork revealed severe ionized hypocalcemia (0.74 mEq/L). Electrocardiographic examination showed normal sinus rhythm. Abdominal ultrasound was unremarkable. Vaginal cytology revealed normal epithelial cells and no evidence of infection. Treatment and Outcome: Initial treatment consisted of a bolus of intravenous calcium gluconate and intravenous fluid administration. Shortly after treatment, the patient was able to stand and was no longer trembling. Repeat bloodwork showed improved, but still low, ionized calcium (0.94 mEq/L). A second bolus of calcium gluconate was administered. Hospitalization was recommended, but declined and the patient was discharged with oral calcium supplementation, husbandry changes and follow up with the primary veterinarian. Clinical Relevance: Puerperal tetany, or eclampsia, is an acute condition of severe hypocalcemia secondary to gestation or lactation that requires immediate intervention. The objective of this case study is to discuss the presentation, pathogenesis and treatment of eclampsia in dogs.