Down cow: Bags vs oral

Bag versus oral metabolics

So, you have a down cow, do you reach for a bag or an oral treatment?

If she’s down and not looking in a great state and you think she is down due to milk fever, grass staggers or ketosis, reach for a bag and ideally give it to her in the vein for the quickest results (but do not give yellow bags/mag 20 IV). Be careful when giving bags containing calcium in the vein as calcium given too fast can stop the heart. Avoid putting pressure on the bag and allow it to slowly flow into the vein.

If you’ve picked the right bag to cover her metabolic deficit/s you should see a response within minutes, and she should start looking brighter, chewing her cud, and starting to sit up. Avoid the temptation to give another bag in the vein as this may lead to an overdose. If she’s not responding, there is probably something else keeping her off her feet and calling the clinic and asking for advice is the next step.

If she’s down and you are unable to get a vein, a bag under the skin is an alternative. Expect results to take much longer, (up to 30+ minutes) as the body takes significantly longer to absorb a bag via this route, especially in down cows. It should be administered across several different regions to improve uptake and reduce the risk of a skin reaction. Generally, oral treatments are not the best to give to cows that are down as their swallowing reflex is impaired, and you risk her inhaling the drench which can lead to pneumonia. It also takes longer for drenches to take effect than bags given in the vein or under the skin.

The role of oral drenches comes into play when considering the duration of effect of the bags, which typically only sustains the cow for around 4-6 hours, after which levels of calcium drop and she can go down again. Around 25%+ of down cows go down again after receiving only 1 treatment in the vein. You therefore want to give another bag under the skin around 4 hours later or give an oral treatment once she is looking bright and able to safely swallow the drench. Oral formulations can provide a more sustained
source of metabolic support while cows are in their post-calving metabolic slump.

Calpro boluses for example provide a sustained release of calcium over 12 hours, which helps prevent a relapse. Oral treatments are also a great option in cows that have recently gone down and are still relatively bright and alert and still swallowing and may be used instead of bags.

If you have any questions on which products to use, please contact your local clinic for advice.

Dr Connor Hughes-Love BVSc (Dist.) - Farm Vet, Pukekohe


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