“Meg” freshened two weeks ago with
twins. The first calf had
to be pulled with a calf-jack. Two
days ago, she was observed to be weak in her hind end and then down on
the following day. There is
also an unclear history of the owner giving several doses of
isoflupredone acetate (Predef) in the past couple days.
Isoflupredone is a glucocorticoid with some mineralocorticoid
effects. At this time, the
owners called their veterinarian.
The referring veterinarian found “Meg” to
be down for the past 1 or 2 hours but bright, alert, chewing her cud,
eating, and drinking. The
producer had started antibiotic therapy with Naxcel the day before.
The referring veterinarian gave a 50% dextrose combination (with
isoflupredone and B-12), 500 mL calcium gluconate, and 500 mL cal-dex.
“Meg” attempted to stand but was unable to raise her
that evening, bloodwork was drawn and “Meg” was given additional
calcium gluconate, 500 mL CMPK, and intravenous banamine.
She was referred to NBC for further treatment. Bloodwork from the referring veterinarian revealed hypophosphatemia (2.4, ref 4.1-9.2), elevated
AST (340), and slightly elevated calcium (9.8). Mg, BUN, TP, GGT
and Albumin were all normal. K+ was not done.
here to conduct your physical exam.