HYPOCALCEMIA. THE LINK BETWEEN CALCIUM and PHOSPHORUS in the DIET

(And the link between Hypocalcemia and Ketosis as well!) By Sue Reith (4/23/05)

As we goat owners sometimes painfully discover thru the unnecessary loss of a doe in late gestation, the nutrients we
provide for them during that period are more important than at any other time in their lives. Remember, it's not just the
mother we're feeding, but all her fetuses as well. Two minerals especially critical now are calcium and phosphorus. If
not available in sufficient amounts and balanced in relationship to each other, in the areas of bone development and
muscle tone the physical needs of the mother and her fast-growing fetuses cannot be met.

This is no simple task! The tricky part is that for her to handle those functions the doe must get a ration containing lots
of calcium-rich foods* along with a lesser amount of phosphorus-rich foods*. By the fourth month a properly balanced
calcium to phosphorus ratio must be available since that's when those developing fetuses start rapidly draining calcium
and phosphorus from her system for their bone development. Mom gets only "left-overs" for herself, and absent that
mineral balance, thus with nothing left for her own muscle tone, she'll be facing a deficiency that, if severe enough, will
cause her pregnancy to falter. Too weak to perform her normal body functions, she'll be unable even to eat! No
appetite, along with wobbly legs, will be the first clues that she's in trouble.** If this situation isn't corrected fast she'll be
faced with starvation, her body left with no option but to rely on its own fat reserves to stay alive. As the fat reserves
are processed in the liver, ketones get released into her bloodstream, setting off a secondary crisis, a metabolic
condition known as Ketosis. Failure to fix the new problem right away will allow excess ketones to build up, quickly
overwhelming the liver. Sadly, once it's 70% damaged it can't be saved. But if intervention starts before that happens,
with lots of TLC there's still a chance for survival.

Intervention involves two essential steps:

First, provide outside energy to stop further damage to the liver (propylene glycol can do this), or even better, provide
her with a source of energy plus nutrition. (Nutridrench is good for that.)

And Second, restore her body's calcium to phosphorus ratio ASAP to fix the problem that started all this and get her
back up on her own, functioning normally again.

Emergency Repair Info: If you have a 500ml bottle of injectable CMPK¹ (an Rx item) on hand, dose her SQ with 30cc of
it every 2 hours day and night, warmed to body temperature until she's normal again. If you have oral CMPK or MFO
(not Rx) instead, dispense it orally at the same rate as the injectable form, taking care that she swallows one mouthful
before you give her another.

If neither of those products are handy, you can re-create a 30 cc CMPK dose (650 mg calcium; 500mg potassium; 150
mg phosphorus; and 96 mg magnesium) in your kitchen by going to the Supplements department of any large
chain-type drugstore and buying bottles of Posture D tablets (600 mg calcium, 266 mg phosphorus, 125 units Vitamin
D), Citracal tablets (315mg calcium and 200 IU of Vitamin D), Potassium tablets (500 mg), and Magnesium tablets (150
mg). Crush up the amount of each pill needed to recreate one 30cc dose of CMPK above. (To assist the reader,
helpful owners have calculated the following: "½ of a 600mg tablet of Posture-D, a 315mg tablet of CitraCal, a 500mg
tablet of Potassium, and ½ of a 150mg tablet of Magnesium). Serve it in a little yogurt, or add water and drench it with
a syringe.

Once she's normal again, along with her corrected ration she'll need a 30cc dose of this CMPK replacement daily until
she freshens.

Prevention: In the future you can avoid this trauma by feeding the bred doe a "non-working" ² diet of grass or timothy
hay during the first 3 months. But as she enters her 4th month of gestation when the fetuses really start growing fast,
switch her to a "working diet" ², feeding her the needed calcium-foods and phosphorus-foods in a ratio that provides
her with at least 2 parts of calcium to every 1 part of phosphorus. This is quite critical, because if a doe in late
gestation eats plenty of alfalfa, but NO grain, there'll be a phosphorus deficiency. And if she eats straight grass hay
and lots of grain, there'll be a calcium deficiency. Feeding any way other than to provide that balance of calcium to
phosphorus will leave her deficient in the essential dietary calcium and phosphorus. Only a doe that isn't 'working'
(growing, pregnant or lactating) can survive on a diet like that.

Interestingly, it's generally does carrying three or more fetuses that have early-onset problems as the result of a
calcium and phosphorus-deficient diet. Those carrying just one or two fetuses usually won't show obvious signs of this
until much closer to parturition. Having fewer fetuses to support means less drain on their own calcium and phosphorus
levels, so while they may groan a bit and move slowly and uncomfortably in late gestation, the problem only becomes
apparent when they weaken to the point where their labor is slow, assistance is needed during birthing, and they can't
expel their afterbirth in a timely manner.

Long range consequences of nutritional imbalance: If a doe suffering from this imbalance during late gestation doesn't
die at some stage, a few more freshenings with the same diet will leave her heart muscle so weakened that it'll suffer
permanent damage, rendering it unable to circulate the body fluids efficiently thru the system. Fluids settle in the
body's lower extremities, causing a buildup in the abdominal area and feet that's indicative of Congestive Heart Failure.

Additional problems that appear when goat diets are consistently calcium or phosphorus deficient are: Urolithiasis in
wethers (crystalline deposits of excess calcium or phosphorus that block the male urethra), rickets in growing kids (soft,
bowed leg bones), and osteomalacia in mature animals (brittle, easily fractured bones). This imbalance also affects the
performance of other minerals such as copper, magnesium, zinc, manganese, iron and iodine, all of which play
important roles in maintaining healthy body function.

Additional options and info: Alfalfa is the only commonly available* forage that has a lot of calcium, grass hays
containing almost none. And all grains contain lots of phosphorus but almost no calcium. So ideally, does in late
gestation should get lots of alfalfa along with a small amount of grain to provide the proper balance. But if living in an
area where grass hay is fed because alfalfa isn't available, in lieu of grain it might be best to provide a loose mineral
supplement free choice that has in it the needed calcium to phosphorus ratio along with all of the other essential
minerals (ex: Sweetlix 16:8 Meatmaker # 987), perhaps including calf manna in the mixture for additional protein, and
powdered dicalcium phosphate as well.

After reading the above, the first question many will ask is, "But how can I provide the energy and protein needed in
late gestation if I don't pour on the grain?" Well, here's the answer!

Alfalfa, grasses and grains (barley, oats, corn) all contain similar levels (~1.54%) of digestible energy. So reducing the
amount of grain fed and increasing the doe's intake of alfalfa to make the proper calcium to phosphorus ratio available
will not change the energy level in the diet at all.

Alfalfa has more digestible protein (~12.5% on average) than do the common grains (oats, barley, corn) and grass
hays (~ 8.5% on average). Since late gestation calls for ~ 18% protein, a small amount of calf manna (~24% protein)
could either be added to a reduced grain ration, or in addition to the free-choice loose mineral source if feeding
straight grass hay. END.

* Other forage-type substances are known to be heavy in calcium as well as alfalfa, but for reasons that while unknown
to me no doubt make good sense, they aren't in general use. All grains contain lots of phosphorus.

**These are symptoms of "Hypocalcemia", a metabolic condition caused by a diet lacking enough calcium and
phosphorus to provide for both the mother's and the fetuses' physical needs. But the term is misleading, more
accurate choices being Hyperphosphemia or Hypophosphemia since Hypo(too little)calcemia doesn't happen all by
itself, but is actually caused by feeding either too much (Hyper = too much) or too little (Hypo = too little) phosphorus
relative to the calcium intake.

¹ CMPK is a carefully balanced blend of Calcium (1st part of essential dicalcium phosphate balance necessary for bone
development and muscle strength), Magnesium (increases calcium

effectiveness), Phosphorus (2nd part of essential dicalcium phosphate combination) and K, potassium (helps maintain
normal heartbeat while calcium level is being increased).

² A "working diet" is fed to goats that are growing, in late gestation, lactating, or (in the case of bucks) in breeding
season.