What is eclampsia?

Eclampsia, also referred to as hypocalcemia or puerperal tetany, is an emergency medical condition associated with a life-threatening drop in blood calcium levels that occurs in nursing mothers. Eclampsia most often occurs when the puppies are one to four weeks of age and the mother is producing the most milk. It can also occur before giving birth.

What causes eclampsia in dogs?

The cause of eclampsia is often undetermined, but may be due to:

• Excessive loss of calcium from the mother to the developing fetal skeletons
• Calcium supplementation during pregnancy
• Producing milk after birth
• Not receiving a balanced, premium growth and development diet while pregnant and nursing
• A hormonal problem with the parathyroid gland

Mothers that are especially attentive to their puppies seem to be more likely to develop eclampsia. Small-breed dogs are at an increased risk (e.g., chihuahuas, pomeranians, toy poodles, miniature pinschers, and shih tzus).

What are the clinical signs of eclampsia in dogs?

The signs of eclampsia are initially subtle. The female may be restless or panting, and you may notice she is moving stiffly, which may progress to an inability to walk. This soon progresses to muscle spasms (tetany), affecting the whole body, which can progress to convulsing. Some affected dogs may have a fever, and may become disoriented, aggressive, restless, and pace excessively. They may rub their face, have constricted (small) pupils, or have prominent third eyelids. (The third eyelid is a small cartilage flap that normally sits just inside the lower eyelid, at the inside corner of the eye; it comes up to cover the eye when the eye is retracted or sunken.)

Eclampsia is a true medical emergency. If you suspect eclampsia is developing, prevent the pups from suckling and contact your veterinarian immediately.

How is eclampsia treated?

Treatment involves intravenous fluids and injections of calcium and other medications, depending on physical examination and laboratory test results. Intravenous calcium must be administered very carefully and slowly or it can cause severe lowering of the heart rate and arrhythmias. Some dogs require anti-seizure drugs such as diazepam (Valium®) to control seizures and tetany.

Follow-up care typically involves oral calcium supplements (something as simple as Tums® may be recommended) and weaning the puppies as quickly as possible. If eclampsia is diagnosed and treated promptly, recovery is usually rapid and complete.

Can eclampsia be prevented?

To help prevent eclampsia, all pregnant dogs should be fed a high-quality diet formulated for pregnant and nursing mothers that is rich in essential vitamins and minerals. If the mother is at risk, the puppies may need to be separated from her a few times per day, allowing her to eat. The puppies can be supplemented with a milk replacer and transitioned to puppy food at three to four weeks of age.

Calcium supplementation or feeding dairy to pregnant and nursing dogs is generally not recommended. Excessive calcium intake during pregnancy or nursing can suppress parathyroid hormone production and increase the risk of developing eclampsia. Your veterinarian can help you determine if your dog needs supplementation.