Hemoglobinuria:

• It is a condition in animals characterized by presence of hemoglobin in urine.
• It typically occurs when red blood cells are damaged or destroyed, leading to the release of hemoglobin into the bloodstream, which is then filtered by the kidneys and excreted in the urine.
• It is sign of underlying health issues in animals and should be addressed quickly.

Etiology:

• Hemolytic anemia; as in immune-mediated hemolytic anemia or infections
• Toxins: exposure to certain toxins or chemical such as onion, garlic, zinc, copper,
• Bacterial infection: Leptospirosis, Clostridium haemolyticum infection causes bacillary hemoglobinuria in cattle
• Protozoal infection: Babesiosis also causes hemoglobinuria
• Phosphorus deficiency in cattle after parturition results in post-parturient hemoglobinuria
• Animals with inherited disorder affecting red blood cell integrity results in hemoglobinuria

Clinical Signs:

• Dark or discolored urine; often brown or red
• Lethargy and weakness
• Pale mucus membrane due to anemia
• Elevated heart rate and respiratory rate
• Abdominal pain or discomfort
• Swelling of regional lymphnodes in case of infection
• In case of post-parturient hemoglobinuria, animal shows signs of pica such as chewing of inanimate objects, woods, soils
• Dehydration develops quickly due to loss of blood
• Feces becomes dry and firm
• In case of bacillary hemoglobinuria;
  • Cattle may be found dead without any clinical signs
  • Onset of severe depression, fever, abdominal pain
  • Dyspnea, severe diarrhoea
  • Edema of sternum
  • Dehydration and anemia

Diagnosis:

• On basis of history of parturition, feeding
• On basis of clinical findings
• On basis of laboratory findings:
  • CBC: reduced Hb levels, anemia
  • Blood chemistry: to evaluate liver and kidney function for signs of toxicity
  • Urinalysis: to confirm presence of hemoglobin in urine and assess its color and specific gravity
  • Coagulation profile: To check any bleeding disorder
  • Serology and PCR testing
• Radiographic examination and ultrasonographic examination

Differential diagnosis:

• Hemoglobinuria should be differentiated from other causes of hemoglobinuria
• Hematuria
• Myoglobinuria

Treatment:

• Treatment of hemoglobinuria is based on underlying causes
• Animals are often dehydrated, so intravenous fluid therapy is administered to correct dehydration in animals
• In severe cases of anemia, whole blood transfusion or plasma extender is used
• In case of bacterial infection, antibiotics should be administered intravenously or intramuscularly or orally depending on situation of animals. Streptomycin @ 12mg/kg, BID, for 3-5 days is effective against leptospirosis
• In case of clostridium infection, penicillin @ 20000-30000 units/kg, or tetracycline @ 10-15 mg/kg, is recommended.
• NSAID; meloxicam, paracetamol, diclofenac, firocoxib may be used to reduce inflammation and pain in animals
• Immune-suppressive drugs or corticosteroids such as prednisone, dexamethasone should be administered to suppress immune reactions as well as inflammatory conditions
• In case of toxicity, toxin should be removed as soon as possible through gastric lavage or induction of emesis or through administration of activated charcoal
• In case of babesiosis, Imidocarb dipropionate @1mg/kg, b.wt., SC or berenil (Diminazene aceturate) @ 3.5mg/kg, deep IM
• In case of phosphorus deficiency, intravenous administration of 60g of sodium hydrogen orthophosphate dissolved in 5% dextrose solution.
• Dicalcium phosphate or mineral mixture @ 30-60 g should be given in feed or as paste until recovery
• Intravenous administration of 40-50 ml of 10% ascorbic acid also reduces recovery period.
• Intravenous administration of ascorbic acid @ 3-7 ml daily for 3-5 days in case of plant toxicities reduces recovery period.
• In case of bovine enzootic hematuria, sodium acid phosphate @ 60g/300 ml water through IV or SC and dose repeated after 12 hours.
• Acidified CuSO_4­­ @ 1-2 g, PO, daily for 10-15 days helps in hemopoiesis.