Refractory or atypical milk fever
An acute form with little or no response to treatment. The cow may remain alert, eat, and milk but cannot regain her feet. She may become a creeping downer cow with flexed pasterns and posterior paralysis. Rupture of the large muscle or group of muscles in one or both hind legs may complicate the problem. Similar fracture or dislocation of a hind joint may have occurred when the cow went down initially or in struggling to rise.