Veterinary Guide to Canine Hypocalcemia (2025) 🐶🩺

By Dr. Duncan Houston BVSc

🧬 What Is Hypocalcemia?

Hypocalcemia occurs when blood calcium falls below normal (<7 mg/dL total or ionized <0.8 mmol/L), disrupting neuromuscular, cardiovascular, and neurologic function.

👥 Which Dogs Are Affected?

• Nursing females (eclampsia/puerperal tetany), especially small breeds & large litters.
• Any dog with kidney disease, pancreatitis, alkalosis, oxalate poisoning, or following thyroid/parathyroid removal.
• Dogs with hypoparathyroidism—immune‑mediated or post‑surgical.
• Critical illness, transfusions with citrate, or nutritional imbalances may also trigger hypocalcemia.

⚠️ Clinical Signs

• Early: panting, agitation, facial rubbing, stiffness.
• Neuromuscular: tremors, twitching, stiff gait, ataxia.
• Severe: seizures, tetany, collapse.
• Cardiovascular: hypotension, arrhythmias, bradycardia.
• Other signs: vomiting, weakness, fever, increased thirst/urination.

🔍 Diagnostic Work-Up

1. Clinical exam & history: focus on breeding status, recent surgery, toxicoses, nutrition.
2. Blood tests: measure total & ionized calcium, kidney/liver panels, phosphorus, magnesium, albumin.
3. PTH & vitamin D levels: essential to diagnose hypoparathyroidism.
4. EKG & ECG: monitor for arrhythmias and changes due to calcium deficit.
5. Further tests: ethylene glycol, oxalate panel, acid-base status, imaging for pancreatitis or renal disease.
6. Repeat testing: confirm low calcium, rule out lab error.

🛠️ Emergency Treatment

• IV calcium gluconate: slow infusion under monitoring to reverse life‑threatening signs.
• Supportive care: IV fluids, manage electrolytes, control seizure activity, regulate temperature.
• Monitor: EKG, blood pressure, and calcium levels during acute management.

🔄 Long-Term Management

• Eclampsia: taper to oral calcium + vitamin D, wean puppies, repeat breeding caution.
• Hypoparathyroidism: lifelong calcitriol & calcium supplementation, monitor serum monthly.
• Kidney/pancreatitis: treat underlying condition, correct Ca with diet & Ph control.
• Toxin-related (ethylene glycol, citrate): treat the toxin and supplement until resolved.
• Nutrition-based: ensure dietary calcium and vitamin D balance.

📈 Prognosis

• Good to excellent when promptly treated—most canine hypocalcemia recover fully.
• Eclampsia cases recover quickly, but may recur with future pregnancies.
• Hypoparathyroidism requires lifelong therapy; renal or chronic conditions carry more guarded prognosis.
• Critical illness-related cases may need extended ICU stay but often recover.

📱 Ask A Vet Telehealth Integration

• 📸 Rapid upload of labs, EKGs, and clinical signs for specialist consultation.
• 🔔 Treatment reminders: calcium dosing, vitamin D, and rechecks.
• 🩺 Virtual vitals check-ins and seizure monitoring.

🎓 Case Spotlight: “Molly” the Chihuahua Mum

Molly, a nursing Chihuahua with a six‑pup litter, became restless, trembled, and collapsed at 3 weeks post-whelping. Labs showed ionized Ca 0.6 mmol/L. She received IV calcium gluconate, then transitioned to oral calcium + vitamin D; puppies were pup‑reared temporarily. Ask A Vet coordinated dosing reminders, supplement delivery, and telehealth monitoring. Molly’s calcium normalized in 48 hours, and she fully recovered 🐾.

🔚 Key Takeaways

1. Hypocalcemia can result from eclampsia, hypoparathyroidism, renal disease, toxins, or nutritional imbalances.
2. Watch for tremors, stiff gait, seizures, arrhythmias, especially in at‑risk dogs.
3. Diagnosis relies on ionized calcium, PTH, kidney/pancreas/toxin evaluation.
4. Emergency treatment includes IV calcium and supportive care; long‑term management tailored to cause.
5. Ask A Vet telehealth offers rapid assessment, treatment coordination, remote monitoring, and supplement delivery for optimal outcomes 📲🐕

Dr Duncan Houston BVSc, founder of Ask A Vet. Download the Ask A Vet app to protect your dog from hypocalcemia—offering lab reviews, emergency guidance, dosing reminders, supplement delivery, and long-term calcium monitoring 🐶📲