the causes and implications of subclinical hypocalcemia
DESCRIPTION
Dr. Jesse Goff presented this for DAIReXNET on November 11, 2014. The recorded webinar is available at http://www.extension.org/pages/15830/archived-dairy-cattle-webinarsTRANSCRIPT
Hypocalcemia!
It’s Not Just Milk Fever Anymore!!!
Jesse Goff
Iowa State University
Lactation #
Ca
(mg/
dl)
0
2
4
6
8
10
12
0 1 2 ≥3
Normal
Sub-clinical
Milk Fever
25%
0.7%
54%
2%
53%
5%
Incidence of hypocalcemia in USA confinement herds
0.50
0.55
0.60
0.65
0.70
0.75
0.80
0.85
0.90
1st 2nd ≥3rdLactation
NE
FA
(m
M)
Ca < 8.0 mg/dl
Ca 8.0 mg/dl≥
Mastitis
Retained FetalMembranes and Metritis
Ketosis/Fatty Liver
Milk Fever
Displaced Abomasum
Lameness
Decreasing DMIDecreasing DMI
Around Calving Calving
Insufficient Vitamins, Trace Minerals, or Anti-Oxidants
High DCAD or
Low Mg diets
Negative Energy + Protein Balance Increasing NEFA
Immune Suppression Hypocalcemia Lost Muscle Tone
Insufficient Dietary Effective Fiber
Rumen acidosis
Normal Blood Calcium Concentration= 9-10 mg/100ml
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Urine Ca0.2 - 6 g *
Endogenous Fecal Loss
5-8 g Ca
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Urine Ca0.2 - 6 g *
Lactation- 20-30 g Ca
Colostrum –2.3 g Ca/ LMilk – 1.1 g Ca / L
Endogenous Fecal Loss
5-8 g Ca
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Bone ~ 8 Kg Ca
Bone Fluid ~ 9 -15 g Ca *
Osteoclast recruitment &
activation
Urine Ca0.2 - 6 g *
Lactation- 20-30 g Ca
Colostrum –2.3 g Ca/ LMilk – 1.1 g Ca / L
PTH Endogenous Fecal Loss
5-8 g Ca
Parathyroid Hormone
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Bone ~ 8 Kg Ca
Bone Fluid ~ 9 -15 g Ca *
Osteoclast recruitment &
activation
Urine Ca0.2 - 6 g *
Lactation- 20-30 g Ca
Colostrum –2.3 g Ca/ LMilk – 1.1 g Ca / L
PTH Endogenous Fecal Loss
5-8 g Ca
Trabecular
Co
mp
act
Co
mp
act
A B
Figure 50.5
OCLOb
ObOcyte
Blood vessel
Marrow Cavity
H
Bone spicule Figure 50.4
Parathyroid Hormone
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Bone ~ 8 Kg Ca
Bone Fluid ~ 9 -15 g Ca *
Osteoclast recruitment &
activation
Urine Ca0.2 - 6 g *
Lactation- 20-30 g Ca
Colostrum –2.3 g Ca/ LMilk – 1.1 g Ca / L
PTH Endogenous Fecal Loss
5-8 g Ca
Section thru compact Bone
Ca++
Osteocytic Osteolysis Ca in bone fluid surrounding each cell pumped into blood
Parathyroid Hormone
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Bone ~ 8 Kg Ca
Bone Fluid ~ 9 -15 g Ca *
Osteoclast recruitment &
activation
Urine Ca0.2 - 6 g *
Diet Ca = 45- 150 g**Passive Ca Transport
Lactation- 20-30 g Ca
Colostrum –2.3 g Ca/ LMilk – 1.1 g Ca / L
PTH Endogenous Fecal Loss
5-8 g Ca
Ca++
Ca++
Passive Transport of Ca Across Intestine
Ca++Ca++
Ca++Ca++
Ca++Ca++
Ca++
Ca++
Passive Transport of Ca
Ca++Ca++
Ca++Ca++
Ca++
Ca++
Ca++
Ca++
Passive Transport of Ca
Ca++Ca++
Ca++
Ca++
Ca++
Ca++
Ca++
Ca++
Passive Transport of Ca
Ca++Ca++
Ca++
Ca++
Ca++ Ca++
Parathyroid Hormone
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Bone ~ 8 Kg Ca
Bone Fluid ~ 9 -15 g Ca *
Osteoclast recruitment &
activation
Urine Ca0.2 - 6 g *
Kidney 25-OH vit D
Diet Ca = 45- 150 g**
1,25(OH)2D
Active Ca Transport
Passive Ca Transport
Lactation- 20-30 g Ca
Colostrum –2.3 g Ca/ LMilk – 1.1 g Ca / L
PTH Endogenous Fecal Loss
5-8 g Ca
Ca++
Ca++ 1,25-vitD
VDR
Vitamin D-dependent Active Transport of Ca
Ca++ Ca++
Ca++
Ca++1,25-vitD
VDR-1,25-vitD
Vitamin D-dependent Active Transport of Ca
Ca++ Ca++
Ca++
CaBP
Ca++
Vitamin D-dependent Active Transport of Ca
Ca-ATPase pump
Ca++ Ca++
VDR-1,25-vitD
TRPV-6
Ca++
CaBP
Ca++
-CaBP
Vitamin D-dependent Active Transport of Ca
Ca++
Ca ATPase pump
Ca++ Ca++
Ca++
Ca++-CaBP
Ca -ATPase Pump
Vitamin D-dependent Active Transport of Ca
Ca++
Ca++ Ca++
Ca++
CaBP
Ca -ATPase Pump
Vitamin D-dependent Active Transport of Ca
Ca++
Ca++ Ca++
Ca++
Parathyroid Hormone
Extracellular Ca Pool ~11 g
Serum Ca pool ~ 3.5 g
Bone ~ 8 Kg Ca
Bone Fluid ~ 9 -15 g Ca *
Osteoclast recruitment &
activation
Urine Ca0.2 - 6 g *
Kidney 25-OH vit D
Diet Ca = 45- 150 g**
1,25(OH)2D
Active Ca Transport
Passive Ca Transport
Lactation- 20-30 g Ca
Colostrum –2.3 g Ca/ LMilk – 1.1 g Ca / L
PTH Endogenous Fecal Loss
5-8 g Ca
A. pH=7.35 Normal Mg
Cyclic AMP
PTH
Receptor
C. pH=7.35 Hypomagnesemia
PTH
Receptor
B. pH=7.45 Normal Mg
Receptor
PTH
Adenyl cyclase complex
Adenyl cyclase complex
Adenyl cyclase complex
Mg++
Cyclic AMP Cyclic AMP
Mg++
2 Eq of each anion source fed
5.5
6.0
6.5
7.0
7.5
8.0
8.5
HC
lN
H4 c
hlor
ide
Ca
chlo
ride
Ca
sulf
ate
Mg
sulf
ate
Ele
men
tal S
ulfu
r
Uri
ne p
H
H2S
O4
Minerals/DCAD for Close-up Diets
Phos at .30-.37%Mg at .4% to use passive absorption!!S between .22 and .4%Ca at .85-1.3% ??Na at .1-.15%K as close to 1% as possibleEnough Chloride to urine pH.
Na, K, and Cl for the close-up dry cow.
Keep diet Na at .10-.15%
Keep diet K as close to 1.0% as you can get.
THIS IS ALL YOU NEED TO DO TO PREVENT MILK FEVER IN HOLSTEINS!!!!
TO REDUCE SUBCLINICAL HYPOCALCEMIA YOU WILL NEED TO ADD CHLORIDE TO COUNTERACT K.
HOW MUCH Chloride do I add to the diet?
Enough to bring urine pH between 6.2 and 6.8 the week before calving. (Jersey target= 5.8-6.2)
When urine pH is below 5.3 in the cows you may have caused an uncompensated metabolic acidosis = trouble!!!!!
Thumbrule
% Chloride needed = % K - 0.5
Example -If diet K is 1.3% then bring diet to 0.8 % Cl and check urine pH to fine tune diet
Interpreting urine pHCollect ten samplesScenario 1- average pH = 6.3 + .6
- good shape, compensated metabolic acidosisScenario 2-average pH= 7.4 + .5
Add more anion – 0.25 lb incrementsScenario 3 – average pH 5.2 + 0.5
-reduce anion by 0.5 lbScenario 4 – 4 cows at 5.2, 6 cows at 7.8
-reduce anion by 0.5 lbs and start increasing back in after 4-5 days by 0.25 lb increments
150
200
250
300
350
400
DC
AD
0.0
0.5
1.0
1.5
2.0
2.5%
of
DM
Con
trol 50
100
150
Chloride (lbs/acre)
Potassium
Calcium
Chloride
DCAD
A. pH=7.35 Normal Mg
Cyclic AMP
PTH
Receptor
C. pH=7.35 Hypomagnesemia
PTH
Receptor
B. pH=7.45 Normal Mg
Receptor
PTH
Adenyl cyclase complex
Adenyl cyclase complex
Adenyl cyclase complex
Mg++
Cyclic AMP Cyclic AMP
Mg++
Hypomagnesemia
Blood Mg < 1.9 mg/dl within 12 hrs of calving indicates inadequate dietary absorption of Mg.
-secondary hypocalcemia
-Depressed feed intake, depressed rumen fermentation (Ammerman, et.al., 1971)
-Tetany in grazing dairy ( below 1.2 mg/dl).
MagnesiumAdult Ruminants absorb Mg across rumen wall ! Mg insoluble at rumen pH is NOT available.
- Active transport process efficient with low diet Mg BUT EASILY POISONED BY DIET K AND NITROGEN
- Second passive transport system exists, but requires high concentration of ionized Mg in rumen fluid to work
Keep diet Mg at 0.4% prepartum and early post-partum to take advantage of passive transport of Mg across rumen wall
MAKE SURE Mg Source is AVAILABLE to the cow. Finely ground, not overly calcined!
Magnesium sources
Pre-calving - using MgSO4 or MgCl2 as “anions” also supplies readily available, soluble Mg.
-The better anion supplements on the market include Mg in this form to remove Mg worries pre-calving.
Post-calvingMagnesium Oxide – supply Mg and act as rumen alkalinizer.
- my experience low Mg = primary cause of mid-lactation milk fevers
Testing Magnesium Oxide Availability
Weigh out 3 g MgO into large vessel.
Add 40 ml of 5% acetic acid (white vinegar) slowly!!
Cap container and shake well and let sit 30 minutes. Check the pH.
Vinegar will be pH 2.6-2.8!
The best MgO will bring the pH up to 8.2.
The worst to just 3.8.
pH is a log scale so this represents >10,000 fold difference in buffering action.
Milk Fever PreventionMilk Fever Prevention1. Avoid very high potassium forages for
close-up cows; practiced by most dairies in US.
2. Add anions (Cl or Sulfate) to diet to reduce blood and urine pH; various forms practiced.
3. Diet Mg = 0.4% and available
4. Reduce diet Ca to stimulate parathyroid hormone release well before calving.
Milk Fever PreventionMilk Fever Prevention1. Avoid very high potassium forages for
close-up cows; practiced by most dairies in US.
2. Add anions (Cl or Sulfate) to diet to reduce blood and urine pH; various forms practiced.
3. Diet Mg = 0.4% and available
4. Reduce diet Ca to stimulate parathyroid hormone release well before calving.
-zeolite makes this possible!!??
Milk Fever - UnknownsMilk Fever - Unknowns
1. Is it necessary to raise diet Ca when using ‘anionic” diets?
2. Is there any advantage to combining preventatives? Low K + Low Ca + Anions, + IV or oral Ca?
3. Is partial acidification better than no acidification?