07/09/2026
Hypocalcemia (Milk Fever) in Cows
Hypocalcemia, commonly called milk fever, is a metabolic disorder caused by a sudden fall in blood calcium, most commonly around calving and the first few days of lactation.
Typical clinical signs
Stage Signs
Early Reduced appetite, weakness, restlessness, cold ears, decreased rumen motility
Moderate Staggering, muscle tremors, inability to stand, dry muzzle, reduced defecation
Severe Sternal/lateral recumbency, head turned toward flank, marked weakness, coma and death
Temperature Often normal to below normal; cold extremities are common
Treatment
1. Recumbent cow — emergency treatment
* Calcium borogluconate IV, given slowly while monitoring heart rate/rhythm. A commonly used adult-cattle dose is around 8–12 g elemental calcium, but the exact volume depends on the formulation.
* Warm the solution to approximately body temperature before IV administration.
* If the cow responds poorly or relapses, additional calcium may be required under veterinary supervision.
2. Oral calcium
Once the cow is alert and able to swallow:
* Give an oral calcium bolus/gel according to the product’s label.
* A second dose is commonly given 12–24 hours later in high-risk cows.
3. Subcutaneous calcium
* Can be useful when IV administration is not appropriate or as supplemental therapy.
* Divide the dose among several sites to reduce tissue irritation.
* Do not give concentrated calcium solutions IM.
Important differential diagnoses
A cow that is recumbent after calving should not automatically be assumed to have milk fever.