Just today I was heading back to home, when the phone rang. A worried voice was at the other end of the line…
\”My little dog is really unwell, we think she has milk fever,\” she said. \”She\’s panting, and all stiff, and shaking, and her heart is racing. She had two puppies about 3 days ago.\”
\”Certainly she has all the symptoms of milk fever, from what you\’re describing. I\’ll just turn my van around, and I\’ll be there as soon as I can!\”
\”It\’s great that you can come so quickly,\” she said (and I could hear the relief in her voice).
I turned around and wended my way through a back road, the car thumping over potholes, embraced in the cool green shadows of trees. Then rolling cleared hill, all green, and the cool clear glint of a creek beside the road. I was running through what I would need in my head – milk fever happens most commonly at the peak of milk production. The body suddenly goes out of whack from all the calcium needed to make the milk, and the levels in the blood plummet. It is a genuine medical emergency – if untreated, the disease progresses to a raging fever, convulsions, and death. So I was driving as quickly as I could without endangering life and limb.
I followed the magic trail of the iphone\’s map to their door, and pulled up at the road side. A worried face was standing in the doorway. I bustled out of the car, and got a box, making sure I had everything that I needed. Intravenous catheters, tape, clippers, syringes, needles, a bung with an injection site, and most importantly of all, vials of calcium gluconate. I went in, to find her sitting on the floor, her little dog on her lap.
\”She\’s gotten worse so quickly!\” she told me.
\”They do, it a very sudden onset,\” I replied, as I laid out everything I needed. I could see that she was distressed- panting, stiff, shaking, eyes wide and looking very frantic. \”Ok – It\’s milk fever for sure – the first thing I need to do is to get an IV catheter into the vein on her front leg. Just before that though, I\’ll give her a drop of these homeopathics.\”
She held the little one firmly while I clipped up a front leg, then a friend held the little dog (she was tiny, all of about 2kg) gently while I slipped the catheter through the skin, and saw the blood pop into the hub. I let go a breath and relaxed as I used one careful finger nail to push the catheter off the needle, right into the vein and flush with the skin. It\’s a delicate skill, and doesn\’t always work first time! Then I popped the plug with the injection site into the hub of the catheter, and taped it all securely onto her leg.
\”Right!\” I said as I drew up 3 ml of the calcium solution into a syringe. \”Here, I just need to get the stethoscope so it\’s sitting over her heart, and I can hear it while I very slowly inject the calcium into her bloodstream. You can hold it, and cradle her, while I ever so gently inject it in. I have to go very slowly, and I need to listen to her heart rate while I do, because too much of this is as bad as not enough. And before that I\’ll just give her another dose of homeopathics.\”
I eased a tiny bit in, waited, then another 0.1 of a ml, and so it went, with 30 seconds or a minute between each microdose. I knew she would need between 1-3ml of the calcium solution, but if I gave her too much, she could develop a severe bradycardia (the heart rate slowing down too much) or an arrhythmia, where the hearts timing gets disrupted. I watched her start to slowly respond. After a 1 & 1/2 ml, she had settled enough to close her mouth and actually lick some of the drool from her chops.
\”I think she\’s responding a bit,\”I said, with a smile.
\”Yes, I can see that…\”
I kept on easing the calcium in, little by little, and then suddenly heard the rhythm falter ever so slightly. Time to stop with that. The next step was to give her the same dose once again, diluted in saline solution, and injected under the skin, from where it is absorbed more slowly. She relaxed more and more, and even started to look around at what was happening outside… She gave a little woof, and sat up. The frantic look dissolved out of her gaze, and she started to look more herself.
\”It\’s almost like magic, isn\’t it?\” I said. \”
Yes – it\’s amazing. I\’m so happy to see her looking better!\”
\”You\’ll have to keep her from feeding the puppies for 12-24 hours, so you\’ll need some puppy formula. I have some oral calcium syrup here, too, which she will need twice a day. It shouldn\’t recur, but if it does, you\’ll have to wean the pups early, and feed them.\” Her daughter looked very excited at the thought of feeding the puppies. I wondered what she\’d think of it in the deep dark hours of the early morning! They need feeding every two hours. By now the little dog was bright as a button, completely back to herself except for still being a bit hot and feverish. It is one of the most wonderful things to treat, because they get better so quickly. And I got to hold some puppies, which is enough to brighten any day!
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