Post Parturient Hemoglobinuria

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Metabolic Diseases: Post part. Hypo-phosphatemia Post-parturient Hemoglobinuria,

byDr. Ali H. Sadiek

Prof. of Internal Veterinary Medicine and Clinical Laboratory Diagnosis

Faculty of Veterinary Medicine, Assiut UniversityE-mail: Sadiek59@yahoo.com

Post part. Hypo-phosphatemia Post part. Hypo-phosphatemia Post-parturient Hemoglobinuria, Post-parturient Hemoglobinuria,

Puerperal Hemoglobinburia Puerperal Hemoglobinburia

• Affect high lact. cows 2-6 weeks after part.• May affect buff. cows before or after part.• It is widely distributed in Egypt esp. in winter. • Charct. clinically by hemolysis of RBCs,

Hemoglobonuria, anemia and loss of condition.

CausesCauses::

• Not really understood, but severe drop in serum P levels a result of its secretion in milk and intensive milk production may predispose to the condition.

• Heavy feeding on hemolytic or oxidative plant toxins (e.g Brassica spp , sugar beets, or green forage) and plants low in P (cruciferous plants & Barseem) may predispose to the case.

Phosphorus is essential for: Phosphorus is essential for: 1- Intracellular functions e.g: • Glycolysis, • Oxygen transport, • Muscle contraction.• Protection of cell memb. from oxidative

damage.

2-It is an important component of:Bones, milk, and ruminant saliva.

3- P deficiency is usually primary and results in organ and system dysfunction and finally progressive demineralization of bone.

Suggested Pathogenesis of PPHburiaSuggested Pathogenesis of PPHburia

1 -Heavy lactation

3- Cruciferous plant (Low P & saponin)

Hypophosphatemia

Increases osmotic fragility of RBCs

4-Cu , Se deficiency

2 -Oxidative plant toxins (brassica, Sugar beets)

Hemolysis of RBCs

Hemoglobinuria &Red urine

AnemiaJaundice

Oxidative injury of RBCs

Dehydration &Recumbency

Anemic anoxia Death

Cold rainy weather

Clinical signsClinical signs : :1. Inappetance2. Severe decrease in the milk yield. 3. Hemoglobinurea in the next day. 4. Affected cows may have fever, diarrhea, and

tachypnea5. Signs of anemia: Pale Mucous membranes, icterus later on. Cardiac impulse is seriously augmented. 6. Recumbency: Acute cases stays for 3-4 days then,

the cow becomes severely dehydrated, weak, 7. Cows may die later on from anemic anoxia. 8. Non-fatal cases, recovery occurs after 3 weeks with

case fatality rate of (10-30%).

Post-Parturient haemoglobinurea

Hemoglobinurea

Passage of red colored urine

Urine strip Dipstick is positive for Hb

Red colored bloody urine

DiagnosisDiagnosis1. Case history: Time of calving and time of

occurrence and plan of nutrition.

2. Clinical signs: - Sudden appearance of heamoglobinurea 4 weeks after calving, - Normal to moderately rise body temperature.

3. Laboratory: - Serum P < 4 mg/dl., - Low RBCs, Hb, PCV. - Excess urine Urobilinogin

Hematuria* Hemoglobinuria†

Urolithiasis Postparturient hemoglobinuria

Cystitis

Leptospirosis

Acute pyelonephritis

Water or salt poisoning

Enzootic hematuria

Brassica or onion intoxication

Oxalate poisoning (ethylene glycol)

Chronic copper intoxication

Babesiosis, Theileriosis Bacillary hemoglobinuria

TreatmentTreatment• I.V. injection of 60 gm Na hypophosphate in 300

ml DW, repeated s.c. for next 3 days• Tonophosphan 50 ml, I/M Twice/24 hr• Copper glycinate (120 mg copper) may halt

hemolysis. • Bone meal should be added to the ration of

cows.• Blood transfusion should be attempted in severe

anemia (PCV < 16 %) 4- 10 liter/cow• Control:

1. Pay attention to phosphorus content of the ration at beginning of lactation. 2. Phosphorus supplement or bone meal could be added.