World Veterinarian Prize Quiz - 2

 

Post parturient hemoglobinuria(PPH)

SYNONYM:-

1.      ⇒ Nutritional haemoglobinuria

2.       ⇒ Hypophosphataemia

4.       ⇒ Lahu- mutna

DEFINITION:-

«  ⇒ It is metabolic disease of high producing dairy cow occurring soon after calving is characterised by intravascular haemolysis, hemoglobinuria and profound anaemia

ETIOLOGY:-

(1)Dietary factor:-

§      ⇒ Cabbage,turnip,kale,cruciferous plant,Ryegrass and alpha alpha

§      ⇒ Saponin content of the plant

§      ⇒ Copper, molybdenum poisoning

§      ⇒ Plant rich in oxylates

(2) high drainage of the phosphorus from the milk

 

Two factor are responsible for the increase fragility of R.B.C

(1) Hypophosphataemia and hemolytic effect of saponin

(2) hypophosphataemia and hemolytic factor in cruciferous plant

§     Kale contain thiocyanate,nitrate and sulphoxide

§     Cabbage contain thiouracil which is goitrogenic

Pathogenesis:-

(1)Toxin:-

  Toxin cause irreversible oxidative changes in the haemoglobin lead to formation of the Heinz body

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So that R.B.C become foreign body for the system

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This foreign R.B.C  carriers to the spleen where it is phagocytosed by the spleen and R.E system.

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(2) the wall of the R.B.C made up of the phospholipid which maintain integrity of the wall

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      But due to deficiency of the phosphorus

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     Lost of the integrity of the cell wall

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     Increase fragility of R.B.C.

 

Clinical finding:-

(1) phase of I/V haemolysis:-

ü           ⇒ It is rapid process

ü          ⇒ Dullness, depression, weakness and Anorexia seen

ü          ⇒ Due to haemolysis of R.B.C, urine vary from light brown to dark red color (hemoglobinuria)

ü          ⇒ Depression in milk yield

(2) Phase of jaundice:-

         ⇒ Dehydration develops quickly and markely

v         ⇒ Mucous membrane become pale

v         ⇒ Hemolytic jaundice may be seen in last stage

v         ⇒ Passage of bloody urine

v         ⇒ Develpes anaemia

(3)phase of respiratory distress:-

Ø    ⇒ Respiratory distress and shortness of breathing

Ø    ⇒ Rapid breathing

Ø    ⇒ Cardiac impulse and jugular pulse are increase

Ø    ⇒ Thumping of heart beat occur

Ø    ⇒ Elevation of the base of the tail

Ø    ⇒ Feces usually dry and firm

Ø    ⇒ Death occur within few hours due to anorexic anaemia

Clinical pathology:-

    ⇒  Normal level of Phosphorus:- 4 to 7 mg /dl

   ⇒  In PPH  phosphorus level down from:-0.5 to 3 mg/dl

«  ⇒  Urine is dark ,red-brown to black

   ⇒  Heinz bodies may present in erythrocyte

«  ⇒  Calcium level normal

«  ⇒ But increase Blood -urea-nitrogen (BUN) level . 

Diagnosis:-

           ⇒  Based on History:- like recently calving

         ⇒  Based on clinical sign:- haemoglobinuria , jaundice , dehydration, weakness etc.

         ⇒  Estimation of Phosphorus level for diagnosis

          ⇒ Replacement therapy:- means give phosphorus supplement, animal will respond on it

 

Differential diagnosis:-

     1.  Babesiosis:-

            ⇒  history for tick infection

          ⇒  Haemoglobinuria

         ⇒  Jaundice

         ⇒  High fever

         ⇒  Identification of the organism in blood smear

     2. Bacillary hemoglobinuria :-

         ⇒  Acute fever

        ⇒ Abdominal pain

        ⇒  Organisms (cl. Haemolyticum ) found in culture examination

    3. Anaplasmosis:-

          ⇒  Commonly seen in summer season

         ⇒  No haemoglobinuria

         ⇒  Jaundice is common

          ⇒  Fever

         ⇒  Organisms found in blood smear

  4. leptospirosis:-

       ⇒ No haemoglobinuria

      ⇒  Fever

      ⇒  Red color milk

      ⇒  Abortion

       ⇒  Leucopenia

        ⇒  Animal will be die within 24 to 48 hr

  5. Myoglobinuria:-

          ⇒  Animal affect with enzootic nutritional muscular dystrophy

         ⇒ History for grain feed

Treatment

A.  Immediate therapy:-

       Correction of anaemia:-

       ⇒  Transfusion of large quantities of the blood i.e minimum 5 litre to 450 kg animal required

       Supportive therapy:-

      ⇒  Haematinic drug give for increase production of the haemoglobin( ini. Imfero)

      ⇒   Liver extracts like liv 52 ,liggen etc.

       Specific therapy:-

        ⇒  Na- acid phosphate (80 gm dissolving i 400 ml of distilled water i/v slowly)

        ⇒  Ini. Tonophosphan give for correct hyphhyphypophoaphataem(  Dose :- 10 to15  ml i/m per day for4-5 day)

       ⇒  Bone meal supplement give for correct phosphorus level

      ⇒  Ascorbic acid( vitamin -C ) @5 gm pet animal i/v