Describe etio-pathogenesis, clinical signs and management of post parturient haemoglobinurea in buffaloes.

Etiology and Pathogenesis

The etiology of PPHU is multifactorial, with nutritional deficiencies playing a central role. The primary cause is a deficiency of glucose-6-phosphate dehydrogenase (G6PD), an enzyme critical for red blood cell metabolism. Other contributing factors include:

• Nutritional Deficiencies: Severe deficiencies of Vitamin A, B Vitamins (especially B1 and B2), and trace minerals like copper and selenium exacerbate the condition. A diet low in energy and protein also contributes.
• Stress: The physiological stress of parturition, combined with inadequate feed and water, weakens the animal's immune system and metabolic resilience.
• Haemolytic Anaemia: The deficiency in G6PD makes red blood cells vulnerable to oxidative damage. This leads to intravascular haemolysis (destruction of red blood cells within blood vessels), releasing haemoglobin into the bloodstream.
• Liver Dysfunction: The liver's inability to efficiently process and excrete the released haemoglobin results in its excretion in urine, causing the characteristic haemoglobinuria. The kidneys become overloaded and damaged.

The pathogenesis can be summarized as follows:

1. Nutritional deficiency/stress weakens the animal.
2. G6PD deficiency leads to increased oxidative stress on red blood cells.
3. Intravascular haemolysis releases haemoglobin.
4. Liver fails to efficiently process haemoglobin.
5. Haemoglobin is excreted in urine, leading to haemoglobinuria and anaemia.

Clinical Signs

Clinical signs of PPHU can be categorized into early and late stages:

• Early Signs (2-7 days postpartum): These are often subtle and easily missed.
  • Loss of appetite and depression
  • Reduced milk yield
  • Mild ketosis (acetone smell in breath)
• Late Signs (7-14 days postpartum): These become more pronounced and indicate severe disease.
  • Dark red or brown urine (haemoglobinuria)
  • Severe weakness and lethargy
  • Pale mucous membranes (anaemia)
  • Dehydration
  • Coma and death (in severe cases)

The severity of the clinical signs correlates with the degree of haemoglobinuria and anaemia.

Management

Management of PPHU involves both preventive and curative measures. A comprehensive approach is crucial for successful treatment.

Preventive Measures

• Balanced Ration: Provide a balanced ration containing adequate energy (1.5-2.0 Mcal/kg DM), protein (12-16%), and minerals (calcium, phosphorus, copper, selenium, zinc).
• Vitamin Supplementation: Supplement with Vitamin A (25,000-50,000 IU/day), Vitamin B complex (50-100mg/day), and Vitamin E (20-40 IU/day) during late gestation and early lactation.
• Mineral Mixtures: Provide mineral mixtures containing trace elements like copper and selenium.
• Clean Water: Ensure access to clean and adequate water at all times.
• Reduce Stress: Minimize stress during calving by providing a comfortable calving environment and adequate assistance.

Curative Measures

• Fluid Therapy: Administer intravenous fluids (Ringer’s lactate) to correct dehydration and electrolyte imbalances.
• Glucose Administration: Provide glucose intravenously or orally to stabilize blood sugar levels and reduce ketosis.
• Vitamin and Mineral Supplementation: Continue vitamin and mineral supplementation as mentioned in preventive measures.
• Blood Transfusion: In severe cases of anaemia, blood transfusion may be necessary to improve oxygen-carrying capacity.
• Liver Protectants: Administer liver protectants like silymarin to support liver function.
• Antibiotics: Use antibiotics to prevent secondary infections.

Management Approach	Description	Advantages	Disadvantages
Nutritional Correction	Providing a balanced diet with adequate vitamins and minerals.	Relatively inexpensive, preventive.	Requires consistent feed supply, slow to show results.
Fluid Therapy & Glucose	Intravenous fluids and glucose administration.	Rapid correction of dehydration and ketosis.	Requires veterinary expertise, can be costly.
Blood Transfusion	Transfusion of donor blood.	Rapidly corrects severe anaemia.	Requires blood typing, risk of transfusion reactions, costly.

definition G6PD Deficiency A genetic disorder characterized by a deficiency of the enzyme glucose-6-phosphate dehydrogenase, leading to increased susceptibility to oxidative stress and haemolysis. statistic Prevalence of PPHU ranges from 5% to 30% in affected regions of India, Pakistan, and Bangladesh. National Dairy Development Board (NDDB) reports example In Saharanpur, UP, a village experienced a PPHU outbreak affecting 15% of the buffalo population in 2022. A survey revealed widespread nutritional deficiencies, particularly in Vitamin A and copper. A targeted intervention program involving vitamin supplementation and improved feeding practices reduced the incidence to below 5% within six months. faq Can PPHU be prevented in all buffaloes? While complete prevention is challenging due to genetic predisposition and environmental factors, implementing preventive measures like balanced nutrition and stress reduction significantly reduces the risk. scheme National Animal Disease Control Programme (NADCP) The NADCP aims to control major animal diseases including those impacting livestock productivity. It includes components for improving animal nutrition and health management, indirectly addressing factors contributing to PPHU. 2019 case-study Gujarat state has implemented a proactive approach by establishing village-level animal health workers who conduct regular nutritional assessments and provide vitamin supplementation. This has resulted in a significant decline in PPHU incidence compared to other states. Reduced PPHU incidence, improved buffalo productivity. definition Haemoglobinurea A condition characterized by the presence of haemoglobin in the urine, indicating haemolysis and often associated with metabolic disorders in livestock. statistic The economic losses due to PPHU in India are estimated to be around INR 500 crore annually. Knowledge cutoff - estimates based on agricultural economics reports. Post-Partum Haemoglobinurea represents a significant challenge to buffalo farming in many regions. A multifaceted approach encompassing preventative nutritional strategies, prompt curative interventions, and proactive veterinary care is crucial for mitigating its impact. Continuous monitoring of animal health, coupled with community-level awareness programs, are essential for ensuring the sustainable productivity of buffalo farming and improving the livelihoods of farmers. Further research into the genetic basis of G6PD deficiency and the development of more effective diagnostic tools remain critical priorities.