Post-Parturient Hemoglobinuria (PPH):

Syn: Hypophosphatemia, Metabolic or Nutritional Hemoglobinuria

• It is metabolic disease of high producing dairy cows and buffaloes characterized by intravascular hemolysis, hemoglobinuria and anemia.

Etiology:

• Deficiency of P in diet
  • Soil deficient in P
  • Hay, straws and plant rich in oxalate are naturally deficient in P
  • Drought, stress reduces P content in forage
• Impaired absorption of P
  • Excess Ca and Fe in diet
  • Vitamin D deficiency
  • Improper Ca: P ratio
• Increased requirement of P
  • Heavy loss through milk
  • For development of fetuses
• Feeding of cruciferous plants like cabbage, turnip, kales, rape, rye
• Forage low in Cu, Se and Mo
• Plant rich in saponin, oxalate

Epidemiology:

• Cattle and buffaloes are more susceptible. Buffaloes are more susceptible than cattle
• More common during 3^rd lactation-6^th lactation, 5-10 years of age
• Mostly occur between 2-4 weeks after calving
• Advanced pregnant animal is more prone
• Heavy milker, cold weather and malnutrition.

Clinical Findings:

• Affected animals voids “dark-red brown” to almost “black” urine.
• Milk is yellowish or reddish in color
• Drop in milk production
• Anorexia, lethargy
• Pale mucus membrane and icteric mucus membrane
• Tachycardia, tachypnea
• Extremities and teats are cold to touch.
• Passage of pasty feces with straining
• Death occur due to anemic anoxia.

Diagnosis:

• Based on history
• Based on clinical findings
• Based on blood report; serum level of P; 0.5-1.5 mg/dL (Normal 4-7 mg/dL)

Treatment:

• Transfusion of 4-6 litre of blood is the only known treatment consistently reported effective.
• Blood transfusion is indicated only, if PCV < 15%
• Affected cows should be placed in warm and calm environment allowing easy access to feed and water.
• Oral drenches with fluid to maintain hydration may be needed in depressed animals.
• Oral treatment of 200-300 g of sodium phosphate salt every 12 hr which may be preceded by IV infusion of monosodium dihydrogen phosphate @60g in 300 mL of sterile water.
• In case of Cu deficiency, copper glycinate @120 mg IV has been recommended.
• Ferritas injection, Tonophosphan- 10-15 ml IV or IM for 4-5 days
• Vitamin C @ 15-20 mg/kg, IV daily for 3-4 days
• Liver extract with vitamin B complex
• Mineral mixture @ 30-40 gm/animal/day