Eclampsia in the bitch: puerperal hypocalcaemia and treatment
3-year-old Chihuahua, 3 weeks after whelping, nursing 5 puppies. She presents with tremors, stiffness, heavy panting, restlessness and a temperature of 41.0 °C. She received calcium supplements during pregnancy.
| Parameter | Result | Reference |
|---|---|---|
| Ionised calcium | 0.68 mmol/L | 1.20–1.40 |
| Glucose | 72 mg/dL | 70–120 |
| Potassium | 4.0 mmol/L | 3.5–5.8 |
What is the most appropriate immediate treatment?
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A. Diazepam and active cooling; withhold calcium until further tests
The clinical picture and ionised calcium already confirm the diagnosis. The hyperthermia is due to muscle activity and resolves when calcium is corrected; aggressive cooling may cause hypothermia.
B. 10% calcium gluconate slowly IV (over 10–20 minutes) monitoring heart rate and ECG
Correct. Eclampsia is an emergency due to hypocalcaemic tetany. IV calcium resolves signs within minutes; it is given slowly and stopped if bradycardia or arrhythmias appear. Oral calcium follows and lactation is reduced.
C. Calcium chloride subcutaneously
Calcium chloride is highly irritant and causes tissue necrosis if it leaves the vein; it is never given subcutaneously. Even gluconate given perivascularly or SC can cause calcinosis cutis.
D. Oral calcium and separate the puppies; the IV route is not needed
With tetany and hyperthermia oral absorption is too slow and unreliable. Oral calcium is used afterwards as maintenance, together with partial or complete weaning.
lightbulb Key takeaway
Eclampsia mainly occurs in small bitches with large litters during the first weeks of lactation. Do not supplement calcium during pregnancy: it suppresses PTH and predisposes to eclampsia. Also measure glucose, which may be low.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.