Calcium Deficiency In Sugar Gliders: Symptoms, Treatment, and Prevention

Calcium deficiency or nutritional Secondary Hyperparathyroidism (NSHP) is a common condition in pet sugar gliders that can be painful and lead to stunted growth and brittle bones, prone to fractures.

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Calcium deficiency is a common disorder in pet sugar gliders, especially in young and growing sugar gliders. This is primarily a result of the difficulty of replicating a sugar glider’s natural diet (Eshar, 2016). An improper sugar glider diet deficient in calcium will lead to nutritional secondary hyperparathyroidism (NSHP).

Treating calcium deficiency in sugar gliders is achieved through the administration of 100-150mg/kg of
Calcium Gluconate is 23% intravenously, intramuscularly, or subcutaneously (Lennox, 2007). The
prevention of this condition is focused on formulating their diet as accurately as possible to mimic
that which they would live on in their natural habitat, including appropriate calcium supplementation.

In this article, we will look at the causes and symptoms of calcium deficiency as well as how it can be treated by a vet, and what you can do at home to help. We also look at how nutritional secondary hyperparathyroidism can be prevented through diet and supplementation.

Causes Of Calcium Deficiency In Sugar Gliders

While all causes of calcium deficiency are diet related, not all the causes of nutritional secondary hyperparathyroidism are directly related to low dietary calcium intake. A diet that is too high in phosphorus relative to calcium or that does not contain enough vitamin D3 can also lead to NSHP.

Nutritional secondary hyperparathyroidism occurs when low levels of blood calcium cause the parathyroid gland to produce a high amount of parathyroid hormone, this, in turn, leads calcium to be leached from the bone, causing the bones to become brittle and prone to fractures.

Calcium and phosphorus are in constant interaction in the body. High phosphorus in the diet will cause reduced calcium absorption in the intestinal tract due to the formation of Ca-P salts. The ideal dietary calcium to phosphorus ratio is 1-2:1 calcium to phosphorus. This can be hard to predict unless you exclusively feed a formulated diet.

In addition, parathyroid hormone can increase due to low vitamin D3. In sugar gliders, low vitamin D3 is relatively uncommon but usually diet related. Exposure to sunlight or UV light will also increase vitamin D.

It is also important to remember that certain medical conditions can mimic calcium deficiency by affecting the way calcium is absorbed or excreted by the body. Diseases that could mimic a dietary calcium deficiency include kidney disease and parathyroid conditions.

Symptoms Of Calcium Deficiency In Sugar Gliders

Not only does calcium play an essential part in the normal growth and development of bones, but it also plays an important part in normal muscle and nerve functioning.

1. Weakness And Difficulty Climbing

Difficulty climbing or jumping is often the first symptom seen in sugar gliders suffering from calcium deficiency.

2. Hind Limb Paresis Or Paralysis

The most common symptom of calcium deficiency is pain and hindlimb paresis or paralysis as a result of nutritional osteodystrophy, also known as metabolic bone disease due to nutritional secondary hyperparathyroidism.

3. Bone Deformities In Young And Growing Sugar Gliders

In young and growing sugar gliders, it may cause permanently stunted or abnormal growth of front and hind limbs.

Sugar gliders that are fed an improper or calcium deficient diet from a young age will also have overall stunted growth and may appear small for their age.

4. Bone Fractures

In severe cases, bone loss can be severe enough for the bones to fracture under a relatively low load.

5. Seizures or Convulsion

In acute cases, sugar gliders may present with neurological symptoms such as seizures (Sirois, 2022). This is because calcium is important in the normal physiological functioning of muscles and nerves.

If you would like to read more on causes for shaking or trembling in sugar gliders, have a look at this article.

Diagnosis Of Calcium Deficiency (NSHP and Hypocalcemia)

If you notice any of the symptoms above, it is imperative to have your sugar glider evaluated by a vet familiar with exotic pets and not delay treatment.

Blood Biochemistry

The diagnosis can be made by drawing blood for biochemistry to measure the blood calcium levels. This will most likely be performed before proceeding with treatment to ensure the correct therapy is
initiated.

Radiographs

A radiograph or X-ray is another helpful diagnostic modality that will help to visualize loss of bone density as well as check for possible fractures due to severe bone thinning.

Treatment For Hypocalcemia and NSHP In Sugar Gliders

In the case of an acute onset of hypocalcemia symptoms, your vet will need to sedate your sugar glider in order to administer Calcium Gluconate 23% at 100-150mg/kg. This is for the safety of the animal as well as to ensure that maximum therapeutic efficacy is achieved.

Your vet may monitor your sugar glider during therapy using an electrocardiogram to check for a slowing heart rate (bradycardia). Bradycardia is a normal effect of calcium administration in cases of hypocalcemia; however, a dangerously low heart rate should be avoided.

If the sugar glider presents with seizures and does not respond to calcium administration, then anti-convulsant medication may also be given (Lennox, 2007).

Your vet may also prescribe an oral calcium supplement to be given daily for some time or may recommend that your glider be seen for follow-up calcium injections.

Severe bone density loss can be painful, so your vet might prescribe pain medication for your sugar glider as well.

What Can Be Done At Home For A Hypocalcemic Sugar Glider?

Cage Rest In A ‘Hospital’ Cage or Enclosure

The bones of a sugar glider with hypocalcemia will be weak, and therefore it is recommended to put
them on cage rest while the deficiency is being corrected (Booth, 2003).

Move them into a smaller enclosure where they will be at little risk of injuring themselves and ensure that the bottom of the cage is padded as sugar gliders suffering from hypocalcemia are prone to falling due to weakness and potentially fracturing fragile bones.

The ideal hospital cage for an NSHP sugar glider will be an enclosure with smooth edges to avoid your sugar glider being able to climb and potentially fall and injure themselves. A terrarium or large plastic contained with smooth edges will work well for a sugar glider with severe calcium deficiency.

Prescription Medication

Depending on the severity of your sugar glider’s condition, your vet may prescribe a daily calcium supplement and pain medication to give orally while he is recovering.

Calcium and Vitamin D3 Supplementation

Many protein-rich foods are naturally high in phosphorus. To counter-balance this, it is best to supplement with calcium. We use Rep-Cal Calcium Supplement with Vitamin D3 in the Leadbeater’s mixture (Sirois,2022).

Insects are naturally low in calcium, but feeding insects such as crickets fed a high calcium diet before feeding them to your gliders (gut-loaded insects) as treats have been shown to be a very effective way to supplement calcium (Finke et al., 2005).

You can buy a high calcium cricket diet such as Fluker‘s High Calcium Cricket Diet and feed that to live crickets before offering them as treats to your sugar gliders.

How Long Will a Sugar Glider Take To Recover From Calcium Deficiency?

The course of treatment of hypocalcaemia in your sugar glider will depend on many factors and the veterinarian will adapt therapy according to regular check-ups. According to Arizona State Exotic Animal Hospital, recovery from hypocalcaemia can take anywhere between three and six months depending on the severity and clinical presentation of the condition (azeah.com).  

It is important to manage other aspects such as housing and activity to prevent any unwanted injury during this time.  It is also essential that you manage the sugar glider’s diet going forward and treatment from the veterinarian should not be seen as a ‘magic bullet’ so to speak.  By managing these additional aspects you will aid the success of your pet’s recovery.

Prevention Of Calcium Deficiency in Sugar Gliders

To prevent calcium deficiency in sugar gliders, the true natural diet of a sugar glider should be replicated in captivity to the best of our ability. This means that live insects should, as far as possible, constitute the predominant protein source while sap and nectar form a smaller percentage of the nutritional consumption.

A typical, natural diet would include some of the following: (Eshar, 2016)
 Invertebrates – insects are the main protein source of sugar gliders
 Nectar
 Tree sap

Supplementation Options for your sugar glider’s natural dietary components can be seen in table 1
below (Booth, 2003).

Dietary constituent
in the wild
Supplementation options
Insect– Small omnivore mix 
– Insectivore mix 
– Dry cat food 
Nectar– 1½  cups brown sugar + ½ cup glucose made up to 2L with warm wate
– Dry nectar mix: 1 cup rolled oats + 14 cups wheat germ + 14 cups brown sugar + 1 tbsp glucose powder + 1 tbsp raisins  
Tree Sap– Maple Syrup mixed with water in a 1:1 ratio
– Gum Arabic

The quantity of food should be 15-20% of the animal’s body weight and should not be more than
this to avoid obesity which may cause other metabolic issues in your sugar glider (Booth, 2003).

For more information on sugar glider nutrition, as well as examples of daily feeding plans, please have a look at the Sugar Glider Diet Guide.

Do All Sugar Gliders Need To Take a Calcium Supplement?

If you offer your sugar glider a variety of choice in terms of their dietary constituents, they have been known to select particular foods such as meat and fruit in higher quantities compared to other options.

Despite this ability to select food items, most captive diets have been shown to have an inadequate calcium to phosphorous ratio (Ca:P) where the target value is deemed 1:1-2:1 (Dierenfeld, 2009).  It is a good idea, therefore, to supplement your sugar glider’s nutrition with using the above-mentioned options.

In order to prevent calcium deficiency in sugar gliders, a species appropriate diet that resembles a wild sugar glider’s diet as closely as possible should be followe

Conclusion

Sugar Gliders are prone to low calcium levels, leading to low bone density. Low calcium can cause hindquarter weakness, lameness, and dental disease in the long run. Sugar gliders should therefore be supplemented with calcium. As sugar glider owners, it is our responsibility to provide our gliders with a diet as close to their wild diet as possible.

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References

Dr. Annerien de Villiers

Dr. Annerien de Villiers graduated as a veterinarian from the University of Pretoria in 2018. She has since worked full-time in clinical practice tending to all kinds of companion animals in general practice. Serving the human-animal bond with care and compassion and making accurate information accessible to pet owners is at the heart of her driving force as a veterinarian.

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