Calcium Borogluconate
Calcium borogluconate is a soluble calcium preparation used predominantly in large-animal practice for rapid correction of hypocalcemia. Its principal application is parturient paresis, or milk fever, in dairy cattle. Veterinary products may combine it with magnesium, phosphorus-related compounds or glucose; those combinations have additional properties determined by their ingredients.
Group
Calcium supplement
Mechanism of Action
The preparation supplies readily available calcium ions, raising extracellular ionized calcium. Restoring calcium availability re-establishes excitation–contraction coupling in skeletal, smooth and cardiac muscle and supports normal neurotransmitter release. In hypocalcemic cattle, these effects improve muscle strength, gastrointestinal motility and cardiovascular function, helping reverse recumbency and other manifestations of milk fever.
Dose Rates
Cattle
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hypocalcemia | Reference only | IV | 5–12 g diluted in 500 mL and infused slowly intravenously. Salt-versus-elemental mass is not explicit. | |
| Dairy cow hypocalcemia | Reference only | IV | 2 g per 100 kg slowly at 1 g/minute; salt-versus-elemental mass is not explicit. | |
| Parturient paresis | Reference only | IV | For a recumbent adult dairy cow: 500 mL of the specified 23% calcium gluconate/borogluconate solution IV once, containing approximately 10.7 g ELEMENTAL calcium. Infuse over 10–20 minutes with cardiac monitoring. Product elemental content varies; do not infer it from the percentage alone. | |
| Subcutaneous calcium support | Reference only | SC | A suitable 23% gluconate/borogluconate solution 500 mL SC once can be used in selected standing cows or relapse prevention. Divide among at least two sites with asepsis; avoid products containing irritating dextrose or formaldehyde. Follow with oral calcium after 4–8 hours when indicated. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hypocalcemia | Reference only | IV | 5–12 g diluted in 500 mL and infused slowly intravenously. Salt-versus-elemental mass is not explicit. | |
| Alternative hypocalcemia regimen | Reference only | IV | 50–70 mg/kg diluted in 5% dextrose and infused slowly intravenously; salt-versus-elemental mass is not explicit. |
Pigs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hypocalcemia | Reference only | IV | 20 mg/kg intravenously slowly; salt-versus-elemental mass is not explicit. |
Sheep
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Hypocalcemia | Reference only | IV | 20 mg/kg intravenously slowly; salt-versus-elemental mass is not explicit. |
Indications
- Treatment of clinical hypocalcemia and parturient paresis in dairy cattle.
- Calcium replacement for hypocalcemic weakness or paresis in sheep and goats, including periparturient hypocalcemia.
- Treatment of other clinically significant calcium deficits in livestock when hypocalcemia contributes to neuromuscular dysfunction.
Contraindications
- Hypercalcemia.
- Hypercalcemia; use particular caution with cardiac disease, renal disease or concurrent digitalis glycosides.
Interactions
- Oral calcium can impair absorption of iron, tetracyclines and fluoroquinolones.
- Avoid mixing injectable calcium with bicarbonate, phosphate, sulfate or tartrate solutions.
- Digitalis glycosides increase sensitivity to calcium-associated arrhythmias.
Adverse effects
- Hypercalcemia
- Constipation with oral supplementation
- Arrhythmias with rapid intravenous calcium
Toxicity
Excess calcium can cause hypercalcemia, cardiac instability and tissue mineralization.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Calcium borogluconate 23% injection Calcium borogluconate salt mass; described elemental calcium content 19.14 mg/mL. | Injection | 230 mg / mL | IV |
Monitoring and Administration
Monitor ionized calcium and clinical response; phosphate monitoring is needed when used as a binder. Monitor heart rate and ECG during intravenous treatment.
Give intravenous calcium slowly. Avoid extravasation; injectable calcium can cause severe tissue injury. Route suitability is product-specific.
The described 23% borogluconate solution contains 230 mg salt/mL and 19.14 mg elemental calcium/mL. Large-animal dose passages do not clearly assign salt versus elemental mass; do not calculate volumes from those passages.
When indicated, monitor magnesium, phosphorus, potassium, renal function and urinary calcium as well as serum calcium. Do not infer compatibility of an admixture from compatibility with a different diluent or concentration.
Calcium gluconate solubilized with boric acid may be labelled calcium borogluconate. Some 23% products provide 10.7 g elemental calcium per 500 mL, while other products have different stated elemental content; retain the exact product denominator.
Do not use IV calcium routinely as prophylaxis in a normal standing cow. Oral calcium requires an alert animal able to swallow. Relapse can occur 12–24 hours after an initially successful infusion.