Sweden runs short of calcium for drips: what it means for cows after calving and how farmers can cut the risk of milk fever

What happened

On 26 October 2026 the Swedish veterinary journal VeterinärMagazinet, citing the Swedish Medical Products Agency (Läkemedelsverket), reported a risk of shortages of calcium solutions for intravenous drips. Both intravenous calcium products authorised for animals in Sweden — Calcibel and Infucal vet. — are on the list of supply disruptions.

Calcibel is authorised for cattle, sheep, goats, horses and pigs. If nothing changes, the country will for a time have no authorised calcium solution at all for these uses. The shortage affects several areas of farm-animal vets' work at once.

Why calcium is given by drip

The body needs calcium for muscles to work, including the heart, and for nerves. In a dairy cow, milk production starts suddenly in the first days after calving, and a great deal of calcium is lost in colostrum and milk. If the body can't adapt quickly enough to draw calcium from bone and feed, blood calcium falls. This is called hypocalcaemia, and its severe form in cows is known as milk fever (parturient paresis).

Severe hypocalcaemia can be fatal. In such cases the only quick way to raise blood calcium is to give a calcium solution into a vein. Without these products farm vets are in a difficult position, and any delay in treatment can cost a cow her life.

Milk fever is just the tip of the iceberg. In many cows after calving, blood calcium doesn't drop far enough for them to go down, but far enough for the muscles of the uterus and stomach to work less well. These cows more often have retained cleansings, displaced abomasums, mastitis and fertility problems. So prevention pays off not only in lives saved but in the health of the whole herd.

Which cows are at risk

Milk fever is most common in high-yielding dairy cows, especially from the third calving onwards: with age, the body finds it harder to mobilise calcium from bone quickly. The risk is higher in over-fat cows and in those fed too much calcium and potassium during the dry period. Most cases occur in the first two days after calving. There are breed differences too: Jersey cows, for example, are more prone to milk fever than Holsteins. And a cow that has had milk fever before is at higher risk at her next calving.

How to recognise milk fever

Vets describe three stages:

1. Early. The cow is restless or, conversely, dull, shifts her weight from foot to foot, has muscle tremors and eats poorly. Many owners miss this stage.
2. Middle. The cow is lying on her chest and can't get up, often turns her head to her flank so that her neck forms an S-shape. Her ears and legs are cold, she isn't cudding and the rumen has stopped.
3. Severe. The cow is lying flat on her side, barely responds and may go into a coma. Without treatment, the animal dies within a few hours at this stage.

If a cow doesn't get up after calving or behaves unusually, call the vet straight away. A downer cow is also at risk of damaging the muscles and nerves of her legs, so every minute counts. Only a vet can tell milk fever apart from other reasons a cow may be down after calving — calving injuries, severe mastitis, ketosis — so don't try to diagnose it yourself.

How it is treated

Severe cases are treated with a calcium solution that the vet gives slowly into a vein while monitoring the heart: giving it too fast is dangerous for the heart rhythm. After the drip, many cows are on their feet within a few hours. In mild cases and for prevention, calcium is given under the skin or as boluses and gels by mouth. But in severe milk fever this is no substitute for intravenous treatment: a cow in that state may not be able to swallow, and calcium is absorbed slowly from the gut.

After treatment the cow needs watching. Milk fever can come back within a day or two, and then treatment is repeated. While the cow is down, she should be kept on soft, non-slip bedding, helped to change position every few hours and not allowed to get up on a slippery floor: a fall can lead to injury.

What the agency suggests

The Medical Products Agency reminds vets that they can apply for a licence — special permission to use a medicine that isn't authorised in Sweden but is approved in another European country. Applications for replacement calcium products are already coming in. The application is usually made by a pharmacy at the vet's request, and the agency makes the decision; this takes time, so it's best to apply in advance rather than on the night a cow goes down.

But a licence doesn't guarantee the medicine will be available: the agency doesn't know how much will actually reach the Swedish market. Vets are advised to follow the agency's list of supply interruptions, which is updated daily, and to make arrangements with pharmacies and suppliers in advance.

When to expect supplies

According to manufacturers' forecasts, Infucal vet. should be back on sale on 30 November and Calcibel on 17 December. The agency warns that these dates may change. For farmers, this means getting through November and early December with minimal stocks and a focus on prevention. If the products return sooner, the agency will update its list; if later, vets will have to rely for longer on licensed products from other countries.

Why veterinary medicines run short

Shortages of veterinary medicines are not unusual in Europe. Many medicines for animals are made by just one or two manufacturers, the market is small, and if one plant has problems with raw materials, equipment or quality control, there is nothing to replace its output quickly. In small countries with few authorised products, such shortages are felt especially keenly. That is why, in the EU and the UK, medicines approved elsewhere may be used when there is a shortage — which is what the agency's advice relies on. But an imported product may differ from the usual one in strength, bottle size and a leaflet in another language, so the vet needs to check the dose carefully before starting treatment.

How farmers can cut the risk of milk fever

Prevention matters more than usual right now. Discuss with your vet and nutritionist:

• dry cow feeding. A diet lower in calcium and potassium in the last weeks before calving "trains" the cow's body to draw calcium from bone more quickly. Special feed additives — anionic salts — are often used too;
• body condition. Cows shouldn't be over-fat at calving;
• oral calcium for at-risk cows. Calcium boluses or gels straight after calving and again a few hours later help cows through the most dangerous first 24 hours;
• watching calvings. Check high-yielding and older cows more often in the first 48 hours after calving so you can spot the early stage;
• records. Note which cows have had milk fever before — they need prevention first;
• supplies. Ask your vet whether they have a licensed product available for severe cases, and keep their number to hand.

Not just cows

Hypocalcaemia occurs in other animals too. In sheep and goats it usually develops at the end of pregnancy, especially with twins and triplets, and also needs urgent treatment. It is less common in horses and pigs, but Calcibel is authorised for them as well, so the shortage affects those farms too. Owners of small flocks of sheep and goats should talk to their vet in advance about how hypocalcaemia would be treated if it happened in the coming weeks.

What about dogs and cats?

A similarly dangerous condition occurs in nursing bitches and, more rarely, in cats — it is called eclampsia (sometimes also "milk fever"). It usually develops in the first weeks after giving birth, especially in small breeds and dogs with large litters. Signs include restlessness, rapid breathing, trembling and an unsteady gait, followed by seizures and a high temperature. It's an emergency: the dog needs to go to the vet straight away to be given calcium. The current shortage concerns products for farm animals, but if your dog has just had puppies, it's worth knowing the signs of eclampsia anyway.

What happens next

Until the products are back, Swedish vets will work with licensed products from other countries and whatever stocks remain. The agency and vets have one piece of advice for farmers: don't wait for a cow to go down — cut the risk of milk fever in advance through correct dry cow feeding and close watching of calvings. A practical plan for the coming weeks: see which cows are due to calve in November and early December, check their diet with your vet, stock up on oral calcium and agree how quickly the vet can get to a downer cow.