Calcium gluconate is also available as 10% and 23% solutions in water. Calcium gluconate is used as mineral supplement and medication when there is insufficient calcium in the diet. Cautions: Consult your veterinarian for re-evaluation of diagnosis and therapeutic plan if there is no improvement in 24 hours. Giant breed dogs: 6 to 10 grams orally per day. Used as a calcium supplement at a dose of 300 mg/kg given in divided doses over a 24 hour period. Medium dogs that weigh between 20 to 45 pounds should get 500 mg a day. Calcium gluconate. In dogs with hypocalcemia, unlike cows, excitation-secretion coupling is maintained at the neuromuscular junction. Katharine F. Lunn, . Calcium gluconate is the calcium salt of gluconic acid, an intravenous medication used to treat conditions arising from calcium deficiencies such as hypocalcemic tetany, hypocalcemia related to hypoparathyrodism, and hypocalcemia due to rapid growth or pregnancy. Hyperkalemia is a known complication of ACEi usage in human patients with kidney disease; a similar effect in animal patients may restrict or preclude their use. Once the animal is stable, the dose of calcium gluconate needed for initial control of tetany may be diluted in an equal volume of normal (0.9%) saline and given subcutaneously every 8 hours to control clinical signs. Treatment of hypercalcemia associated with Addison's disease is not necessary. The treatment steps will be contingent on the severity of the toxicosis. INDICATION: As an aid in the treatment of hypocalcemic conditions, such as milk fever, in cattle, horses, sheep, swine, dogs and cats. is 13% calcium, and 1 g yields 6.5 mEq. Pregnant and lactating dogs use high amounts of calcium to maintain the growing fetuses and produce enough milk to sustain the litter. Once the cardiotoxicity has been controlled, transient lowering of serum potassium can be achieved by promoting its translocation from the extracellular to the intracellular fluid compartment with sodium bicarbonate or insulin and glucose administration. In this Vet Minute, Dr. Marty Greer will talk about the importance of calcium a. Blood markers, electrolyte levels, and kidney and liver function will be monitored because all must be normal before your pet can be released from the hospital. Still, hypervitaminosis D is a rare cause of hypercalcemia. Hypocalcemia most likely results from loss of calcium into the milk and from inadequate dietary calcium intake. Common calcium supplements may be labeled as: Calcium carbonate (40% elemental calcium) Calcium citrate (21% elemental calcium) Calcium gluconate (9% elemental calcium) Calcium lactate (13% elemental calcium) The two main forms of calcium supplements are carbonate and citrate. The link you have selected will take you to a third-party website. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with calcium gluconate. The animal's urine and feces may Potassium balance is typically preserved in patients with chronic kidney disease, but hyperkalemia can develop in response to acute decompensation of stable I.R.I.S. Gender. It must be noted that every animal is different, and the return of normal parathyroid gland function is impossible to predict. Calcium gluconate will treat or prevent the deleterious effects of hypocalcemia. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Usual maximum total daily dose is 15 g calcium gluconate (= 1350 mg Ca ++) Dose may be administered as a continuous infusion or in divided doses. Give an additional dose if labor stalls more than an hour. Most cases of vitamin D toxicity are iatrogenic, and occur following parathyroidectomy. Ether . Hypocalcemia (dose depends on clinical condition and serum calcium level): Hypocalcemia may also occur during parturition and may precipitate dystocia. Giant breeds will need 2000 mg. Calcium should only be offered after labor has begun. Ohio Veterinarian of the Year awarded, and new president named, News wrap-up: This weeks headlines, plus Virox and NAVTA announce infection prevention program, Hypoadrenocorticism in the emergency setting, Point-of-care thyroid diagnostic device is shaking up the endocrinology world. Most simple cases of calcium supplement ingestion will end in a positive way as long as the situation was treated as needed. This imbalance in calcium metabolism occurs because calcium mobilization from bone into the serum pool is insufficient to compensate for the efflux of calcium via the mammary glands during lactation. During administration of calcium, heart rate should be carefully monitored by auscultation or ECG for bradycardia or arrhythmias. Clinical signs like frequent urination, information provided by you as to your pets history (previous illnesses, current medications, or knowledge of intake of supplements), and a physical examination will all add to the quick diagnosis by the veterinarian. The legacy of this great resource continues in the online and mobile app versions today. Comes in a powdered form. calcium-lactate gluconate are more easily absorbed than calcium carbonate, but all of these forms of calcium can be used to increase dietary . In: Hall JE, ed. It is employed to treat hypocalcemia and conditions in which the physiological effects of increasing the plasma calcium level are likely to be beneficial to the animal. Calcium gluconate works best if you take it with food. Easy for your pet to digest and make use of. Therapeutic effects begin within 10 minutes and may persist for 1 to 2 hours. Some cats require post-operative supplementation for up to 6 months, but eventually normal parathyroid gland function returns. Five conditioned dogs under halothane anesthesia received calcium chloride (4, 8, 12 mg/kg) and calcium gluconate (14, 28, 42 mg/kg) intravenously. The phosphonate drug pamidronate can also be used to decrease bone resorption, so it is a logical choice in the treatment of hypercalcemia of malignancy. Fever usually resolves rapidly with control of tetany, and specific treatment for fever may result in hypothermia. A commercially available human intact-PTH assay has been validated in both cats and dogs; PTH-calcium curves are also similar in cats and dogs. IV: (Dose expressed in mg of calcium gluconate): If a diuresis cannot be established or serum potassium cannot be controlled with fluid or diuretic administration, all potassium containing fluid should be replaced with solutions devoid of potassium, and sodium bicarbonate given to correct any existing bicarbonate deficit. Dosage may be repeated after several hours if required, or as recommended by your veterinarian. Correction:This paper has been updated to correct the calcitriol dose units, which should have been mcg/kg/day (ng/kg/day), not mg/kg/day. There are also several different delivery methods available for glucosamine. A pretreatment total serum calcium concentration of <7 mg/dL in dogs or < 6 mg/dL in cats confirms the diagnosis; noting that reference values vary between laboratories. Sodium polystyrene sulfonate resin (Kayexalate) may be given orally at 2 g/kg in 3 to 4 divided doses daily as a suspension in 20% sorbitol (to prevent constipation). The small osteoclast pool results from feeding a high concentration of dietary calcium during the nonlactating period, which suppresses secretion of PTH by the parathyroid gland and stimulates secretion of calcitonin by parafollicular C cells. Doses of calcium gluconate vary widely depending on the reason for prescribing and response top initial doses. Hemodialysis eliminates potassium from both extracellular and intracellular pools and provides the most effective way to alleviate excessive potassium loads. Administer by intravenous, subcutaneous or intraperitoneal injection using proper aseptic techniques. Rarely, mastitis is seen in lactating read more , should also be excluded. Calcium gluconate is preferred to calcium chloride because . Guyton and Hall Textbook of Medical Physiology, 14th ed. However, this recommendation is supported by a low level of evidence and is anecdotal. Calcium can make it harder for your body to absorb certain medicines. Sodium bicarbonate is contraindicated in animals with metabolic alkalosis and potentially is risky in overhydrated animals. Ionized calcium is the physiologically available fraction of calcium; it is affected by protein concentration, acid-base status (alkalosis favors protein binding of serum calcium and will decrease blood concentrations of the biologically important ionized calcium, thus exacerbating hypocalcemia), and other electrolyte imbalances. Roughly 40% of hypercalcemic dogs with lymphoma has mediastinal masses, but hypercalcemia is common in other types of lymphoma as well. PetPartners, Inc. is an indirect corporate affiliate of PetPlace.com. Calcium chloride is not appropriate because of its potency, acidifying tendency, and irritation if injected extravascularly. The brand most pet owners may be aware of is Caltrate; other brands are Viactiv and Nature Made. In one survey (253 whelpings, 1,671 pups born), a high frequency . Oral: Use OR to account for alternate terms 10-50 mL. Class of drug. Panting and restlessness are early clinical signs of eclampsia. How does calcium benefit pregnant dogs and cats? Resistant: 10 mg/kg IM/PO q 24h. Options for the acute management of hyperkalemia are to antagonize the increased resting membrane potential in cardiac myocytes, redistribute potassium from the extracellular to the intracellular fluid compartments, and to eliminate the potassium load from the body. Calcium carbonate . Please confirm that you are a health care professional. Capsicum . Prolongation of the QT interval and ventricular premature contractions may be evident on an ECG. animals are especially susceptible to blood calcium ideal diet for a dog should have calcium: phosphorus depletion because of milk production. Ionized Calcium . All information is peer reviewed. About Us. It is important to base the dosage of calcium on a calculation of elemental (available) calcium because different products vary in the amount of calcium available. Compare top pet insurance plans. Version: 6.01. Intravenous: Capsicum, fluid extract of . Find custom compounded calcium gluconate medication for animals and articles with calcium gluconate information from Wedgewood Pharmacy, a leading veterinary pharmacy. 22 mg/kg PO q 12-24 h. Ineffective unless used with aminoglycosides (such as Amikacin) Baytril (enrofloxacin) Lizards and snakes: Routine: 5 mg/kg IM/PO q 24h. 48(4):663681. Common calcium gluconate side effects may include: warmth, tingling, or a heavy feeling; a chalky taste in your mouth; upset stomach, gas; or. 250-500 mL. In cats, the dosage of calcium is ~0.51 g/day, in divided doses. To immediately resolve these threats, calcium gluconate (10% solution) is administered at 0.5-1.0 ml/kg as a slow intravenous bolus over 10-15 minutes to increase the threshold potential for cardiac excitation. Other causes of hypercalcemia of malignancy include apocrine gland adenocarcinoma of the anal sac, and any tumor that has osteolytic activity. They will be able to tell you if you need to worry or what actions may need to be taken. For this reason, calcium must be monitored frequently, and owners should be made aware of the clinical signs of hypocalcemia. Inadequate production of parathyroid hormone (PTH) during the hypocalcemic crisis is not responsible for eclampsia in dogs. Small breed dogs: 1250 mg per day. Daily maintenance calcium: In the past, vitamin D-containing rodenticides were used and were a more common cause of hypervitaminosis D, but those products are no longer marketed. Because calcium carbonate contains 40% elemental calcium, one 750 tablet contains 300 mg of calcium, so a cat would need approximately 3 tablets daily for calcium supplementation. IV: 3 to 4 mEq/kg/day The dose is 0.03 to 0.06 mcg/kg/day (30 to 60 ng/kg/day) divided BID. Here are some final tips for choosing and taking calcium supplements as found in the Harvard Special Health Report Osteoporosis: A guide to prevention and treatment: Avoid products made from unrefined oyster shell, bone meal, dolomite, or coral, as they may contain lead or other toxic metals. Hypercalcemia is much less common in feline lymphoma than in its canine counterpart. In some cases, when the litter is large, or if the new mom belongs to a toy breed, calcium may become scarce, causing a serious condition called eclampsia, also known as Canine Hypocalcemia or . The acceptability of these preparations is low due to persistent side effects including nausea, constipation, gastrointestinal ulceration and necrosis. Calcium gluconate is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian. IV, IO: (Dosage expressed in mg of calcium gluconate): Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when this medicine is injected. Granular dosage forms containing . IV Fluids - 1x: Maintenance (30cc x kg) + 70cc IV: . Clinical signs of primary hyperparathyroidism are usually related to the effects of prolonged hypercalcemia rather than to the PTH-secreting mass itself. Rapid injection of calcium solutions may cause hypotension and cardiac arrhythmias; therefore, arterial blood pressure and ECG monitoring should be established during calcium administration. Post-operative care following a parathyroidectomy is critical because of the very high likelihood of post-operative hypocalcemia (iatrogenic hypoparathyroidism) even when normal parathyroid glands are left in place during surgery. When expressed at the sinus node and on myocardial cells these perturbations cause classic electrocardiographic abnormalities associated with the severity of hyperkalemia. Learn about the foods that contain calcium. . Membrane potentials and action potentials. The pathogenesis of hypercalcemia in hypoadrenocorticism is not completely understood either, but total calcium is probably elevated due to hemoconcentration. Hypocalcemia may also occur during parturition and may precipitate dystocia. IV: Neonatal: Mild to moderate elevations Mild to moderate elevations exist when the serum potassium concentration is between 5.5mmol/L and 6.5mmol/L. Intestinal Tract Disease (Lymphangiectasia), Food Sensitivity and Allergies in French Bulldogs, Calcium absorbed in the chewable supplements is increased when Vitamin D3 is added, Chews and other forms of supplementation can contain both vitamins D and K, Pet owners who feel calcium addition is needed must speak to their veterinary caregiver for advice and verification of the need, Calcium chews are often chocolate flavored; chocolate can be poisonous though most chews contain only enough chocolate to make your dog very sick, Excessive calcium causes electrolyte changes, Kidney damage can be acute but can lead to chronic kidney disease, Puppies and dogs with previous or concurrent kidney issues will be predisposed to poisoning, The heart and gastrointestinal tract can be affected, Vitamin D3 is absorbed by the gastrointestinal tract increasing serum calcium levels and the kidney cannot eliminate or regulate it, If a dog eats a lot of calcium chew wrappers there is a chance of obstruction. Complicating things even more, iron, phosphorus and calcium can lower the absorption of manganese. Calcium Gluconate Injection is a clear, colorless to slightly yellow, solution available in the following: Single dose vial: 1,000 mg per 10 mL (100 mg per mL) Single dose vial: 5,000 mg per 50 . puerperal tetany). Novocal. IV: (Dose expressed in mg of calcium gluconate): To get that amount from beef muscle meat you'd have to give your dog 10,000g - that's 22 lbs. Deficiency of PTH results in an inability to adequately read more . Fluid therapy via intravenous could be needed; this may also include medications to promote a bowel movement, increase urine production, ease nausea, and stabilize blood calcium levels. Mineral. Other causes of irritability and hyperthermia, such as metritis Metritis in Small Animals Metritis is postpartem infection of the uterus. 500 to 3000 mg (5 to 30 mL) IV one time at a rate not to exceed 0.5 to 2 mL/min. However, to avoid acute problems of hypocalcemic tetany, oral calcium supplementation should continue throughout lactation. 7 to 12 months: 270 mg/day . This occurs in roughly 10 percent of cats undergoing thyroidectomy, but it is largely dependent upon the skill of the surgeon performing the procedure. Mild tremors, twitching, muscle spasms, and gait changes (stiffness and ataxia) result from increased neuromuscular excitability. It is a positive inotrope and has variable effect on systemic vascular resistance. Medium dogs: 2 grams to 4 grams per day. Cardiac arrest in the presence of hyperkalemia or hypocalcemia, magnesium toxicity, or calcium antagonist toxicity: Dosage expressed in mg of calcium gluconate: IV or intraosseous IO: Calcium Gluconate Injection 10ml is a super-saturated solution containing calcium gluconate 95.3 mg/mL in water for injections. Medically reviewed by Philip Thornton, DipPharm. Calcium gluconate does not affect potassium levels but instead antagonizes potassium's effect on cardiomyocytes. The dosage of 1,25-dihydroxyvitamin D3 (calcitriol) is 0.030.06 mcg/kg per day. Signalment is key to the diagnosis of eclampsia; typically a small-breed dog nursing a large litter at peak lactation. 60 to 100 mg/kg/dose; may repeat in 10 minutes if necessary. Take this medication by mouth with food. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Large-sized dogs will require 1000 to 2000 mg. . Hyperkalemia is the most common electrolyte imbalance encountered in animals with acute uremia and can cause severe cardiovascular instability and death. For animals manifesting hyperkalemia associated with oral or enteral feeding of commercial renal diets, it is necessary to have a home-cooked diet formulated by a veterinary clinical nutritionist that contains a reduced potassium content. The dosage of calcium can be gradually tapered to avoid unnecessary treatment; commercial pet food usually contains sufficient calcium to meet the needs of dogs and cats. Dose should be expressed as 'mmol' IV: Urgent correction: Generic name: calcium gluconate (oral/injection) [KAL-see-um-GLUE-koe-nate]. Treatment and prevention of hyperkalemia in adults. It is associated with varying degrees of hyponatremia and metabolic acidosis, and its prevalence is associated with the duration of dialytic support, degree of azotemia, ultrafiltration requirements, and the intensity of dialysis. In hypercalcemia of any cause, treatment of hypercalcemia is needed if the product of calcium x phosphorus exceeds 75. Severe tremors, tetany, generalized seizure activity, and finally coma and death may occur. Vitamin D supplementation is used to increase calcium absorption from the intestines. Slow intravenous administration of 10% calcium gluconate0.51.5 mL/kg over 1030 minutes (520 mL is a typical dose)is an effective treatment for eclampsia, usually resulting in clinical improvement within 15 minutes. Adverse effects resulting from too rapid administration of calcium include bradycardia, shortening of the QT interval, and premature ventricular complexes. dose: 9 g/24 hr. Treatment depends on the severity of neurologic signs but usually requires IV administration of calcium gluconate. Clinical signs of hypocalcemia include tetany, ataxia, facial twitches, seizures, arrhythmia, facial pruritus, PU/PD, anorexia, vomiting, diarrhea, and posterior lenticular cataracts. The level of toxicity will depend on the age and size of the dog (in comparison to the amount ingested), as well as the state of the kidneys at time of exposure. Objectives: Intravenous (IV) calcium salts are routinely recommended as a cardio-protective therapy in the emergency treatment of severe hyperkalemia. Calcium gluconate is approved for use in humans and cattle, horses, swine, sheep, cats, and dogs (depending on the product). Natural calcified seaweed sourced from Iceland. Powder for oral suspension is available as a 346.7 mg elemental calcium/15mL. Some pet owners also choose to supplement their pets diet with calcium; this is generally not necessary if proper food is the mainstay of the diet. Hyperthermia may occur in severe cases. If you suspect that your pet has consumed a large number of your calcium supplement chews or tablets, or if you have been adding supplements to his diet and notice that he is drinking excessively, is lethargic, or seems depressed, these signs along with other behavioral changes indicate that your dog should be seen by the veterinarian. Infants and Children: 100 to 200 mg/kg/dose; over 5 to 10 minutes; may repeat after 6 hours or follow with an infusion with a maximum dose of 500 mg/kg/day. Hyperkalemia may be associated with the increasing use of ACEi for the management of hypertension and proteinuria now recognized as risk factors for progression of chronic kidney disease. Development of hyperkalemia in a hemodialysis dependent dog with chronic kidney disease in response to feeding a commercial renal diet via an esophageal feeding tube (dashed insert) and its resolution with a potassium restricted formulated diet. As chronic kidney disease progresses to an advanced state (less than 5% to 10% of normal renal function) compensatory adjustments for potassium homeostasis become ineffective and potassium retention and hyperkalemia may develop. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Oral: (Dosage expressed in mg of elemental calcium): Calcium chloride is not appropriate because of its potency, acidifying tendency, and irritation if injected extravascularly. 1000 to 2000 mg (10 to 20 mL) IV one time at a rate not to exceed 0.5 to 2 mL/min. Idiopathic hypercalcemia has been described in cats, with Persians being over-represented. This is administered at the vets only. Generally, 5-10 ml of 10% calcium gluconate will provide sufficient calcium for a bitch weighing between five and ten Kg. IV: Mild hyperkalemia generally resolves with initial (potassium free) replacement fluids and administration of furosemide and/or sodium bicarbonate. My preference is to use calcitriol (trade name is Rocaltrol), which is active vitamin D3. Glucocorticoids can be useful to promote urinary calcium excretion and to inhibit absorption of calcium from the gut, but extreme care must be taken to ensure that a diagnosis of lymphoma has been excluded. Dosage may be repeated after several hours if required, or as recommended by your veterinarian. Small-breed bitches with large litters are most often affected. If given in a larger dose or too rapidly, the calcium may cause severe drop in the heart rate followed by a hard-to-control arrhythmia. https://doi.org/10.1016/j.cvsm.2018.02.010. A total serum calcium concentration < 7 mg/dL is confirmatory. The recommended dosage of calcium phosphate for dogs is 0.5 grams per 10 pounds (4.5 kg) of body weight daily. To treat the primary condition, surgical parathyroidectomy is indicated. Calcium gluconate may also be used for purposes not listed in this medication guide. To make sure calcium gluconate is safe for you, tell your doctor if you have ever had: Tell your doctor if you are pregnant or breastfeeding. Recurrence of hyperparathyroidism is extremely uncommon following surgery, and surgery is, therefore, almost always curative. Congenital and Inherited Cerebral Disorders in Animals, Meningitis, Encephalitis, and Encephalomyelitis in Animals, https://doi.org/10.1016/j.cvsm.2018.02.010. It is environmentally sustainable. The strength of this product is 2.2 millimoles of calcium ions in 10 mL. Hypocalcemic animals should, therefore, receive parenteral calcium support during the initial posttetany period. Worried about the cost of Calcium Supplements Poisoning treatment? 7 Calcium gluconate: hypocalcemia: 94-140 mg/kg slow IV. Calcium chloride contains about 3 times more elemental calcium than an equal volume of calcium gluconate: 1 g of calcium chloride has 270 mg (13.5 mEq) of elemental calcium, whereas 1 g of calcium gluconate has 90 mg (4.5 mEq). Calcium chloride contains three . In cats with hypocalcemia, 46 to 70 mg per . It does not require renal activation, has a quicker onset of activity, and the short half-life makes it much easier to manage iatrogenic vitamin D toxicity. It may be administered on an emergency basis at a dosage of 0.5 to 1.5 mL/kg, diluted and given over several minutes, or it is added to . Heavy lactational demands from large puppies or a large litter are often noted. Cats and dogs In a study previously reviewed by the Committee, five cats and three dogs received a daily dose of 1 g gluconic acid (10% solution) by stomach intubation for 14 days. Tetany occurs as a result of spontaneous repetitive firing of motor nerve fibers. In dogs with hypocalcemia, the usual dose is 25 to 75 mg per pound (50 to 150 mg/kg) of 10% calcium gluconate solution slowly by intravenous injection with careful monitoring of the heart rate. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Usual Adult Dose for Exchange Transfusion: 300 mg (3 mL) IV one time with each 100 mL of citrated blood at a rate not to exceed 0.5 to 2 mL/min. Hypoglycemia can occur concurrently. Dogs up to 20 lb, 2 mL initial dose; 1 mL per dose thereafter. The calcium would not cause harm at this low dose. Your dose needs may be different during pregnancy or while you are nursing. Rarely, it occurs during late gestation in bitches. The concentration of serum calcium should be monitored weekly. Calcium should be monitored closely following any thyroidectomy, and treatment of hypocalcemia is the same as for post-parathyroidectomy hypocalcemia. This includes prescription and over-the-counter medicines, vitamins, and herbal products. . In some cases, however, signs of hypercalcemia are present, and include polyuria/polydipsia (this is the most common sign), constipation, vomiting, anorexia, neurological signs, muscle wasting, fatigue, and, if calcium containing uroliths are present due to longstanding hypercalciuria, lower urinary tract signs can be present. The Veterinary Manual was first published in 1955 as a service to the community. Sacramento, CA, Hyperkalemia in Animals with Renal Disease. Diagnosing and managing canine dystocia (Proceedings) July 31, 2008. Follow all directions on your medicine label and package. Dosage Considerations - Should be Given as Follows: Calcium Supplementation . All rights reserved. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use calcium gluconate only for the indication prescribed.