Calcium Borogluconate (IV Calcium): veterinary dose and monograph

At a glance

Drug class

Veterinary drug

Also known as

Cal-Mag Plus, Calbo, Calcium Magnesium Plus, Calcimust IV

Species with doses

Dogs, Cats, Cattle, Horses, Goats and Sheep

Routes

IV, SC

Last reviewed

1 October 2026

Indications

• Bovine / buffalo milk fever (parturient hypocalcaemia)
• Ewe pregnancy toxaemia with hypocalcaemia component
• Goat hypocalcaemia (peri-kidding)
• Equine lactational tetany (rare)
• Canine eclampsia (post-whelping hypocalcaemia)
• Hypocalcaemic seizures

Calcium Borogluconate (IV Calcium) dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Eclampsia (puerperal tetany): Uses 10% CALCIUM GLUCONATE, not the 23% borogluconate pack. Papich 5e: 0.5–1.6 mL/kg of the 10% solution slowly IV (5–15 mg/kg elemental calcium over 10–30 min) for severe hypocalcaemia with tetany or seizures. Monitor ECG — stop if bradycardia or arrhythmia. Then oral calcium; wean or rest the pups.

Cats

• Severe hypocalcaemia (tetany / seizures): Uses 10% CALCIUM GLUCONATE. Papich 5e (dogs and cats): 0.5–1.6 mL/kg of the 10% solution slowly IV (5–15 mg/kg elemental calcium over 10–30 min). Monitor ECG throughout.

Cattle

• Milk fever — slow IV: Papich 5e: cattle 5–12 g calcium diluted in 500 mL, slowly IV; dairy cows 2 g/100 kg at no more than 1 g/min. Auscultate throughout — STOP if arrhythmia or bradycardia develops.
• Milk fever — SC alternative: Slower absorption than IV; used when IV access is impossible or as follow-up after IV therapy. Massage the sites to disperse. Not covered by a Papich 5e or Plumb’s dose — standard product practice.

Horses

• Lactational tetany (rare): 250–500 mL of 23% calcium borogluconate slow IV over about 20 min in an adult horse. Papich 5e: cattle and horses 5–12 g calcium diluted in 500 mL slowly IV, or 50–70 mg/kg diluted in 5% dextrose, infused slowly. Auscultate throughout.

Goats

• Goat hypocalcaemia: Plumb’s 10e p.176 (sheep/goats, extra-label): calcium borogluconate 23% ≈50–75 mL per 45 kg (100 lb) body weight (NOT mL/kg) IV slowly — an immediate clinical response should follow; may also be given SC (next row). Papich 5e gives sheep and pigs 20 mg/kg calcium slowly IV. Give slowly over 10–15 min while auscultating; stop for bradycardia or arrhythmia.
• Hypocalcaemia — per body weight (Plumb’s 10e): Plumb’s 10e p.176 (sheep/goats, extra-label): ≈50–75 mL per 45 kg (100 lb) — NOT per kg — IV slowly; may also be given SC. Auscultate during IV administration.

Sheep

• Hypocalcaemia: 50–100 mL of 23% solution slow IV in an adult ewe. Plumb’s 10e p.176 (sheep/goats): 23% calcium borogluconate ≈50–75 mL per 45 kg (NOT mL/kg) IV slowly, or SC; sheep — calcium gluconate 150–250 mg/kg IV slowly to effect (intraperitoneal also possible). Papich 5e: pigs and sheep 20 mg/kg (calcium) IV slowly — about 60 mL of 23% calcium borogluconate for a 60 kg ewe. Auscultate throughout.

Buffalo

No buffalo-specific doses are on file, so buffalo are dosed as cattle.

• Milk fever — slow IV: Papich 5e: cattle 5–12 g calcium diluted in 500 mL, slowly IV; dairy cows 2 g/100 kg at no more than 1 g/min. Auscultate throughout — STOP if arrhythmia or bradycardia develops.
• Milk fever — SC alternative: Slower absorption than IV; used when IV access is impossible or as follow-up after IV therapy. Massage the sites to disperse. Not covered by a Papich 5e or Plumb’s dose — standard product practice.

Contraindications

Concurrent calcium-containing IV solutions like ceftriaxone reconstituted in calcium fluids — precipitation embolism. Severe renal failure. Cardiac glycoside (digoxin) therapy. Hypercalcaemia. Severe metabolic alkalosis. Rapid IV bolus on its own is contraindicated — must be slow IV.

Species-specific warnings

Cattle: SLOW IV ONLY (15–20 min) with cardiac auscultation. Pair with oral calcium gel for relapse prevention. NEVER co-infuse with ceftriaxone.

Dogs: Eclampsia emergency — 10 % calcium gluconate 1 mL/kg slow IV. Remove pups from nursing once stable.

Adverse effects

• Cardiac arrhythmia / arrest with rapid IV (most serious)
• Bradycardia (vagally-mediated) during infusion
• SC perivascular reaction → tissue sloughing if leaked
• Local tissue irritation at injection site

Drug interactions

• Ceftriaxone in IV fluids: FATAL calcium-ceftriaxone precipitation — flush IV line thoroughly between drugs
• Digoxin: additive cardiac toxicity — avoid in digitalised patients
• Diuretics (thiazides): may worsen hypercalcaemia
• Magnesium-containing IV fluids: usually safe but should be considered

Pregnancy and lactation

Indicated in pregnancy for hypocalcaemia — safe and necessary.

Monitoring

• Continuous cardiac auscultation during entire IV infusion — DO NOT walk away
• Heart rhythm: bradycardia is the first warning to slow / pause infusion
• Clinical response: cow rises within 30 min to 2 h if going to respond
• Repeat dose at 12 h if no response or relapse signs
• Pair oral calcium gel for relapse prevention (see [[calcimust-bolus]])

Toxicity and overdose

Rapid IV bolus is the chief life-threat — cardiac arrest. Always slow IV with continuous cardiac auscultation. Magnesium-containing combinations can cause flaccid paresis if too rapid. SC perivascular leakage → tissue sloughing.

Management: STOP infusion immediately. If cardiac arrest — CPR. Bradycardia → atropine 0.04 mg/kg IV. Severe hypercalcaemia → fluid diuresis, furosemide, monitor ECG. Tissue sloughing from SC leak — local saline infiltration to dilute, NSAIDs, supportive wound care.

Clinical pearls

• Down cow with milk fever — slow IV 450 mL pack over 15–20 min with cardiac auscultation is the standard emergency therapy. Cow usually rises within 2 h
• Auscultate THROUGHOUT infusion — bradycardia / extrasystoles = SLOW DOWN; arrhythmia = STOP
• Pair IV calcium with Tonophosphan 10–20 mL IV — phosphorus is the #2 deficit in milk fever
• After IV calcium, give Calcimust Gel oral immediately + at 24 h + at 48 h to prevent relapse (~70 % of relapses are within 48 h)
• NEVER co-infuse with ceftriaxone — calcium-ceftriaxone precipitate causes fatal lung / kidney emboli
• Canine eclampsia: 1 mL/kg of 10 % calcium gluconate slow IV; remove pups from dam after stabilisation
• Refer cow that does NOT rise within 4 h of 2 calcium treatments — likely complicated downer (sciatic injury, hypoP, hypoMg, displaced abomasum)

Mechanism of action

Direct replacement of ionised calcium — the deficient cation in milk fever / hypocalcaemic states. Restoration of plasma Ca²⁺ → restoration of neuromuscular function, vascular smooth muscle tone, and myocardial contractility. Borogluconate complex is less irritating than calcium chloride / calcium gluconate alone, hence preferred for the large IV volumes needed.

Formulations and products

• Calcium borogluconate 23 % + Magnesium hypophosphite IV solution 450 mL pack (typical large-animal pack)
• Cal-C-Sure (Assure Biotech, Jagadhri (HR)) — Calcium gluconolactobionate 137.5 mg + Cholecalciferol 5000 IU + Vitamin B12 50 mcg per mL, Injection - IM or IV

Storage

15–25 °C. Warm to body temperature before SC use. Inspect for crystallisation — discard if visible.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other hormones, emergency drugs, supplements and other drugs

• Buspirone
• Butaphosphan + Cyanocobalamin
• Cabergoline
• Calcitriol
• Calcium EDTA (Calcium Disodium Edetate)
• Carbimazole
• Carboplatin
• Cetirizine

Frequently asked questions