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Hypokalemia in postparturient animals and its management--a clinical study in 18 cows.

Introduction

Hypokalemia occurs commonly in inappetant adult cattle, particularly in lactating dairy cows because of additional loss of potassium in milk. Hypokalemia in cattle is also encountered secondary to anorexia and many primary conditions of gastrointestinal and urinary systems. However, types of clinical signs seen with these conditions are rarely attributed specifically to hypokalemia, which is an electrolyte abnormality not typically associated with muscle weakness, recumbency and downer cow syndrome. Recently, a syndrome of severe muscle weakness, recumbency and hypokalemia was reported in association with ketosis and intramuscular administration of isoflupredone acetate to lactating dairy cattle. Hypokalemia also has been documented as a potential cause of muscle weakness in cattle of varying ages, independent of corticosteroid administration. Very little work has been done in relation to supplementation of potassium in hypokalaemia in cattle. The present article describes successful management of post-parturient recumbent cows with intravenous administration of potassium.

Materials and Methods

Post parturient cows (weighing between 325 to 350 kg b.wt.) that were admitted during the period of six months were taken for the study. These cows were subjected to detailed clinico-pathological examination to rule out musculo-skeletal abnormalities, toxaemia and peri-parturient diseases. The cow were weak, in sternal recumbent with flaccidity of limbs and inability to keep the head upright. Haematology and blood smear examination was done to rule out anaemia and blood protozoan diseases. The serum was collected without haemolysis and subjected to estimation of serum calcium, phosphorus, magnesium and potassium. Those cows that had serum potassium of less than 4.0 mg/dl were administered with potassium chloride (Isotonic 1.15% solution @ less than 3.2 ml/kg per hour so as not to exceed 0.5 mEq of potassium/kg per hour) as per Radostits et al. (2006).

Results

Out of 18 post parturient non ambulatory cows, three cows were found to be treated for ketosis while another eight cases were treated for acute carbohydrate engorgement based on anamnesis and previous treatment instituted by practicing Veterinarian before being referred. Four cow were reported to have had been treated for non specific diarrhoea and no specific etiology could be established for remaining cases. The average serum calcium, phosphorus, magnesium and potassium concentration in these cases were 6.82+0.13 mg/dl, 4.56+0.33 mg/dl, 3.1+0.11 mg/ dl and 2.13+0.24 mg/dl respectively. Following intravenous administration of potassium in normal saline, twelve animals showed clinical improvement and were able to stand following lifting and massage of limbs. Three animals continued to be recumbent and their serum values were found to be hypokalemic. These three cows also recovered following another dose of administration of potassium on the next day. Remaining three cows did not show any improvement in condition following even after second dose of potassium administration, they further deteriorated, developed decubitus ulcers and were subsequently discharged as per request by the owner.

Discussion

Hypokalemia in cattle may occur secondary to anorexia, diarrhoea upper gastrointestinal obstruction, right-sided displacement and torsion of abomasum impaction of abomasum. In most cases, the hypokalemia was not severe enough to cause weakness and recumbency (Radostits et al., 2006). Hypokalemia resulting in severe weakness and recumbency had occurred in dairy cattle treated with isoflupredone acetate for ketosis (Sielman et al., 1997). Affected cows were recumbent, profoundly weak, appeared flaccid and lay in sternal or lateral recumbency. They were unable to support weight of their heads off the ground and commonly hold them in their flanks. Profound weakness of lateral cervical muscles might occur (Johns et al., 2004). Most had been also treated with insulin, IV glucose and oral propylene glycol for ketosis. However, not all cases have been treated with corticosteroids (Peek et al., 2000). Hypokalemia causes muscle weakness by lowering the resting potential of membranes, resulting in decreased excitability of neuromuscular tissue. Thus, differential diagnosis of animal with muscle weakness should always include hypokalemia (Radostits et al., 2006). The history of anorexia, treatment for ketosis/acidosis in present case would have caused hypokalemia in animals as was supported by reports. Potassium should be administered intravenously or orally. The intravenous route is used only for initial treatment of recumbent ruminants with severe hypokalemia and rumen atony, as it is much more dangerous and expensive than oral treatment (Radostits et al., 2006).

References

Johns, I.C., Whitlock, R.H. and Sweeney, R.W. (2004). Hypokalaemia as a cause of recumbency in an adult dairy cow. Aust Vet J. 82:413-16.

Peek, S.F., Divers, T.J., Guard, C., Rath, A. Rebhun, W.C. (2000). Hypokalemia, muscle weakness, and recumbency in dairy cattle. Vet Ther. 1: 235

Radostitis,, O.M., Gay, C.C., Hinchcliff, K, W. Constable, P.D. (2006). Veterinary Medicine. A textbook of the diseases of cattle, horses, sheep, pigs and goats. Saunders Elsevier, Edinburgh.

Sielman, E.S., Sweeney, R.W., Whitlock, R.H. and Reams, R.Y. (1997). Hypokalemia syndrome in dairy cows: 10 cases (1992-1996). J Am Vet Med Assoc. 210: 240-43.

G. Vijayakumar (1), S. Sivaraman, E. Venkatesakumar, S. Jegaveera Pandian and M. Subramanian

Department of Veterinary Clinical Medicine, Ethics and Jurisprudence Veterinary College and Research Institute Tamil Nadu Veterinary and Animal Sciences University (TANUVAS) Namakkal--637001 (Tamil Nadu)

(1.) Professor and Corresponding author.' E-mail: drvijaymvc@gmail.com
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Title Annotation:Clinical Article
Author:Vijayakumar, G.; Sivaraman, S.; Venkatesakumar, E.; Pandian, S. Jegaveera; Subramanian, M.
Publication:Intas Polivet
Article Type:Report
Geographic Code:9INDI
Date:Jul 1, 2014
Words:875
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