POSTPARTURIENT HAEMOGLOBINURIA IN CATTLE AND BUFFALO Learning objectives • To understand the etio-pathogeneis and clinical signs of nutritional haemoglobinuria in postparturient dairy animals. • To study the diagnosis, treatment, control and prevention of nutritional haemoglobinuria in postparturient cows. DEFINITION OF NUTRITIONAL HAEMOGLOBINURIA • A disease of high producing dairy cows occurring soon after calving. It is also called postparturient haemoglobinuria and is characterised by intravascular hemolysis, haemoglobinuria and anemia. ETIOLOGY AND EPIDEMIOLOGY NUTRITIONAL HAEMOGLOBINURIA Etiology • Ration low in P, hay and grass from low P area, draught • Cu deficiency (incidence reduced when supplemented) Precipitating factor • Grazing Brassica sp. plants, rape and turnip and other cruciferous plants, large quantity of beet pulp, sugar cane top (low in p). • Exposure to cold weather, cold water - erythrocytes becomes more sensitive to hemolysis when there is hypophosphatemia & hypocupremia Epidemiology • Prolonged hypophosphatemia is an important predisposing factor • 'P' deficient soil and drought condition act as precipitating factors • 50% mortality and 40% morbidity • Adult cow & she buffalo 3-6 weeks after delivery are more prone. • Animals in 3-6th Lactation are more prone • Geographical distribution: Throughout the world including India • In India: It is very common in North India – Punjab, Haryana, M.P, Rajasthan, Western part of Maharashtra. • In Europe & North America the diseases is more common during prolonged period of housing. Acute cases • Rapid onset after 2-4 weeks of calving, course is 3-5 days, red coloured urine, anorexia, weakness, severe depression of milk yield. Less acute cases • Eats and gives milk for 24 hours after red coloured urine. • Dehydration occurs quickly. • Haemoglobinuria, inappetence, severe depression of milk yield. • Heart rate is increased and bounding. • Augmented irregular pulse. • Temperature – Normal or raised (40º C). • Mucous membrane – pallor, later yellow. • Dyspnoea is obvious. • Diarrhoea; sometimes constipation. • Mastitis. • Gangrenous necrosis of tail, feet, pastern, ear and teeth (occasionally). • Milk yield reduced. • Suffer for 2-3 days and then recumbent followed by death in few hours /days. If survive • Weakness and Pica only during convalescence. • There may be additional sign of 'P' deficiency is recumbency. • Affects ruminal digestion. • Lame and bone disease • Infertility. • Pica. • Fall of milk yield. • Retarded growth and unthriftiness. • Weakness and convalescence In marginal deficiency- general condition of the herd is normal CLINICO PATHOLOGICAL CHANGES IN NUTRITIONAL HAEMOGLOBINURIA • Non-lactating animals of the affected herd in marginal 'P' deficiency area may have normal range of inorganic P (4-7 mg %).But, lactating animal my have moderately low levels of 2-3 mg. Affected animal may also have extremely low levels of 0.4 to 1.5mg. • R.B.C decreased – Heinz body seen. • Urine: Dark red brown to black, moderately turbid, No R.B.C. • Low Cu in blood & liver. PM changes • Jaundiced carcass • Blood: Dark and thin • Swelling of spleen • Liver: Fatty infiltration, swollen • Dropsy in lower part of the body • Discolored urine in bladder DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF NUTRITIONAL HEMOGLOBINURIA IN ANIMALS • Characteristic clinical signs like hemolytic anemia, haemoglobinuria within 4 weeks of parturition. • Deficiency of P Differential diagnosis • Parasite – Babesia, Theileria • High altitudes • Copper Poisoning • Plant – Rape • Bacteria: Anthrax, Leptospira, Bacillary Haemoglobinuria • Virus – Rinderpest • Cold water • Enzootic nutritional muscular dystrophy • Drug induced Eg. Phenothiazine • Enzootic haematuria • Myoglobinuria • Chronic hill haematuria • Blood transfusion • Metabolic ketosis • Pyelonephritis TREATMENT FOR NUTRITIONAL HAEMOGLOBINURIA Treatment • Keep in quiet and warm place. • Avoid laxatives and purgatives. • Blood Transfusion (5 to 10 liters) → followed by fluid therapy to prevent haemoglobinuric nephrosis. • Acid sodium phosphate 60 gm in 300 ml i/v very slow+ same dose s/c . Further s/c inj at 12 hours interval for 3 times. • Orally drench 30 gm Sodium acid Po4 BID. • Copper glycinate 500mg i/v in copper deficiency cases • Haematinics during convalescence. • Bone meal 120 g BID / Dicalcium Po4.– orally for 5 days Prevention • Copper gluconate 120 mg s/c. • Remove the cruciferous plants. • Adequate intake of 'P' during early lactation.