Phosphorus deficiency hemoglobinuria, also known as red water disease, is a hemolytic disease affecting dairy cattle around calving. It is characterized by intravascular hemolysis and severe anemia, which can lead to death. Clinical signs include hemoglobinuria, weakness, inappetence, and reduced milk yield. Diagnosis is based on dark red-brown urine despite the absence of red blood cells, along with anemia and hypophosphatemia. Treatment involves intravenous and oral phosphorus supplementation along with fluid therapy. Prevention focuses on ensuring adequate phosphorus intake in early lactation and correcting copper deficiencies.

1. DR ANITA SEWAG
MVSc MEDICINE
1ST YEAR

2. Dietary phosphorus deficiency, feeding
cruciferous plants or sugar beet
byproducts, high dietary molybdenum
content, and copper deficiency have
been incriminated.

3. The feeding of cruciferous plants and
plants containing potential hemolysins
such as saponins (e.g., alfalfa or sugar
beet byproducts) has been associated with
the disease.
The ingestion of cold water or exposure to
extremely cold weather may precipitate an
episode of hemoglobinuria.

4. It is characterized by development of
peracute intravascular hemolysis and
anemia with potentially fatal outcome. Beef
and nonlactating cattle are rarely affected.

7. Hypophosphatemia
results in a decrease in red
blood cell glycolysis and adenosine
triphosphate (ATP) synthesis.
an increase in osmotic fragility and
hemolysis.

8. Hemoglobinuria, inappetence, and
weakness develop suddenly, and there is a
severe depression of the milk yield,
although in some less acute cases, the
cow continues to eat and milk normally for
24 hours after discoloration of the urine is
evident.

9. Dehydration develops quickly, the mucous
membranes are pale, and the cardiac
impulse and jugular pulse are much
augmented.
A moderate temperature rise (40° C;
103.5° F) often occurs.
In fatal cases, death results from anemic
anoxia.

10. Babesiosis
Leptospirosis
Chronic copper poisoning
Rape and kale poisoning
Bacillary hemoglobinuria
Enzootic hematuria (bracken fern
poisoning)

11. The urine is dark-reddish-brown to black in
color and usually moderately turbid.
No red cells are present in the urine.
the packed cell volume, erythrocyte
counts, and hemoglobin levels are also
greatly reduced.
Heinz bodies may be present in
erythrocytes.

12. Marked hypophosphatemia is a common
result of the serum chemical analysis.
In advanced stages serum
hyperbilirubinemia and icterus resulting
from hemoglobin breakdown are
commonly seen.

13. Diagnosis is usually made by recognition
of clinical signs, particularly dark urine and
anemia during the characteristic stage of
lactation.
Hemoglobinuria may best be diagnosed by
noting failure of the urine to clear with
centrifugation (excluding hematuria) and
presence of concurrent severe anemia.

14.  Hematologically, PPH has the features of an
acute intravascular haemolytic anemia.
 Morphologically, the anemia is characterized
by evidence of intensified erythrogenesis.
polychromasia, anisocytosis, macrocytosis,
basophilic stippling, reticulocytosis and
increased numbers of metarubricytes are
commonly seen on stained blood films
(Macwillims et al., 1982).

15. The blood is thin, and icterus is
widespread throughout the body.
The liver is swollen, and fatty infiltration
and degeneration are evident. Discolored
urine is present in the bladder.

16. The disease has also got economic
importance due to decrease in milk yield,
cost of treatment and high case fatality
rates (Sharma et al., 2014).

17. Treatment Intravenous administration of
60g of sodium hydrogen ortho phosphate
(NaH2PO42H2O) dissolved in 5%
dextrose solution through intravenous
route followed by oral administration of
same dose twice daily for three days.

18. Following successful blood transfusions,
fluid therapy is recommended as both
supportive therapy and to minimize the
danger of hemoglobinuric nephrosis.

19. Copper glycinate (1.5 mg /Kg body weight
dissolved in 500 ml NSS intravenously as
single dose) has been recommended in
cases where copper deficiency is
suspected as the underlying cause.

20. Ketosis is a common complication of the
disease, and additional treatment for it
may be required.

21. An adequate intake of phosphorus
according to the requirements for
maintenance and milk production should
be ensured, particularly in early lactation.
 A decrease in the incidence of the disease
is reported after copper supplementation of
cattle in a copper-deficient area.

22. Reference from
Veterinary medicine by D.C. Blood and J.A.
Henderson
https://www.researchgate.net/publication/31
7658619