Post parturient hemoglobinuria (PPH)

1. Hypophosphatemia Post parturient hemoglobinuria (PPH)

2. **it is common occur in highly producing dairy cows in the 1st 2-4 weeks after calving & in the 5th – 7th month of pregnancy in buffaloes . **age of susceptibility → 3rd – 6th calving. **It is caused by low phosphorus level in the blood resulting from low phosphorus intake either by ration or grazing on pasture for long period 3-4 months as barseem. **The diseases mainly occur in winter as the animals feeding mainly on barseem (Nov.- May.). Addition of bran and bone meal to the ration are necessary during barseem season.

3. Clinical signs -Hb uria (urine color → light brown or reddish or coffee) -anorexia , pica, severe decrease of milk yield , loss of b.wt & .weakness -secondary ketosis -dehydration -pale M.M → then jaundice with normal body temperature -the course of disease → 3-5 days in standing position → followed by weakness & sternal recumbancy for 3-5 days -in chronic case → ketosis & locomotors disturbance

4. Treatment 1- in severe anemia → blood transfusion (4-5 liter) 2-give source of phosphorus : a- Sod.dibasic phosphate or Sod.acid phosphate → 60 gm / 300 ml D.W filtred and given /I.V → followed by S/C dose after 12 hr for 3-5days . Also , oral dose (80 gm ) / daily / till 3 days after recovery b- give patent preparation as : -Catozal , cafozal, phosphozal → 50 cm / I.V/ daily / 3-5 days. -Tonophosphan → 50 cm / I.V / daily/ 3-5 days 3 -Arsinal 15 cc I/M daily / 3 days 4- fluid therapy (very very important) : 2 liter saline + 3 liter glucose 5 % / I.V

5. N.B: *addition of bran & bone meal to the ration during barseem season *if the cow recumbent before calving → give it phosphorus therapy as APROPHYLACTIC

6. D.D Urine sample Sedimentation (centrifugation) *presence of sediment: it is hematouria microscopical exam → intact RBCs Presence of homogenous & transparent fluid : It may be Hb uria Myoglobinuria

7. -If presence of homogenous & transparent fluid : you may take serum sample & see its color : *if it is of pink color → Hb uria *if it is of clear color → Myoglobin uria **Hb uria (caused by ) 1- Babesia → -tick infestation -young age more susceptible -profuse diarrhea (pipe steam diarrhea) , then constipation -M.M → congested → pale → jundice -blood film → parasite

8. 2-Bacillary Hb: -sudden death (every 3 days) -high fever -sudden drop in milk yield -blood stained feces -necrosis in liver ( p.m) - most common with liver fluke infestation &during summer 3-Leptospira: -calves & lambs are more susceptible than adult -pyrexia (41-42ºc) → abortion -high mortality rate in calves & lambs -bloody milk from all qurters -the udder is soft & flappy

9. 4-copper poisoning -no fever -severe jaundice 5-water intoxication -history of ingestion of large amount of cold water 6-hypophosphatemia ***Hematouria (caused by) 1-pyelonephritis -fever in acute -urine contain RBCs & pus cell -rectally → pain , enlargement of kidney , absence of its lobulation , cord like urter -frequent , painful urination -vaginal purulent discharge

10. 2-Cystitis -rectally is → thickening in wall of U.B & painful in acute -urine → has RBCs & pus cell -frequent , painful urination 3-Urolithiasis -in castrated male ruminant (fattening) -retention of urine (auria) -few drop of blood stained urine -rectally → distention of U.B 4-Enzootic hematouria (neoplasm in U.B) -affect old age only -persistent red urine for long period of time -presence of blood clots in urine

11. Thank you and Good luck