A fifth-lactation Holstein cow presents with paresis 2 days after calving. History reports a BCS of 2.75 before calving, administration of two oral Ca boluses, and a 25% glucose solution + methionine IV immediately after calving.
The animal is apathetic/depressed, with generalized weakness that manifests intermittently, with the head resting on the ground or prolonged lateral recumbency, aggravated by ruminal bloat.
Ruminal stasis, refusing food and water. Rectal temperature 99.5°F. Retained placenta. Dehydration estimated at 5-6%.
No ketosis: BHB 0.4 mmol/L
With mastitis, musculoskeletal trauma, and severe metritis ruled out, a complex metabolic imbalance is suspected, prompting a blood gas analysis (BGA).
