Bacillary hemoglobinuria in a cow
By Andrés de la Concha-Bermejillo, DVM, MS, PhD
The carcass of a female, 913 pound, 7-year-old Angus cow was submitted to the Texas A&M Veterinary Medical Diagnostic Laboratory (TVMDL) for necropsy. History noted the owner had observed red discoloration of the urine shortly before death. The cow had not been vaccinated recently.
At necropsy, the body was freshandin good nutritional condition.The anterior ventral areas of the lung were dark red (atelectasis). Portions of the lung placed in formalin floated. There were extensive areas of severe hemorrhage in the epicardium and peritoneum. The rumen, reticulum, and omasum were full of ingesta consisting of grass.
The liver had a large, ill-defined area of pale and red discoloration in the left lobe. On the cut section, there were multifocal to coalescing areas of pallor and reddening interpreted to be necrosis and hemorrhage, respectively. There were large areas of severe hemorrhage in the right perirenal adipose tissue. The kidneys were dark red. The urinary bladder contained approximately 15 cc of dark red urine (“Port wine” urine– hemoglobinuria).
Fluorescent antibody test for 5 histotoxic clostridial specieswas positive for Clostridium novyi/hemolyticum. AqPCR test forLeptospirawas negative. Microscopic lesions in the liver consisted ofmultifocal to confluent areasof severe, acute coagulation necrosis characterized by hepatocyte swelling, cytoplasmic hypereosinophilia, karryorhexis,and pyknosis. The areas of hepatic necrosis were surrounded by a thick rim of degenerate neutrophils and necrotic debris. The gross and microscopic lesions and the positive fluorescent antibody test for Clostridium novyi/hemolyticumwere consistent with bacillary hemoglobinuria.
Bacillary hemoglobinuria (BH) is a disease of cattle and occasionally sheep that was first described in 1916. BH hemoglobinuria is often referred to as red water, but this term is also used for leptospirosis and other causes of hemoglobinuria.
BH is caused by Clostridium haemolyticum (previously known as Clostridium novyi type D), which is an anaerobic, motile, sporulating, rod shaped bacterium, found in soil of areas with poorly drained pastures and alkaline pH, where viable spores of the microorganism can survive for many years.
In the case reported here, lesions suggestive of, or parasites consistent with Fasciola hepaticaor F.magnawere not found; however, BH is more common in areas with high prevalence of liver flukes.Clinical signs are variable and may include sudden death.Animals that survive for 12 to 48 hours may show fever, depression, hemoglobinuria, jaundice, inappetence, fever, lethargy, reduction in milk production, and blood-stained feces. In endemic areas, death losses may be as high as 25%.
The differential diagnosis includes leptospirosis, anaplasmosis, babesiosis, hypophosphatemic hemolytic anemia (postparturient hemoglobinuria), hemolytic anemia associated with Brassicasp., Bracken fern toxicosis (enzootic hematuria), chronic copper poisoning, and other causes of hemolytic anemia.
Rapid diagnosis can be made by demonstrating the organism in fresh liver or formalin-fixed deparaffinizedsections by a fluorescent antibody test. However, C. hemolyticum may be a normal inhabitant in the liver and a positive result has to be interpreted in conjunction with characteristic microscopic lesions in the liver.
Prevention is done by vaccination with a C. haemolyticum bacterin prepared from whole cultures, which usually confers immunity for approximately 6 months. In areas where the disease is seasonal, one preseasonal dose is usually adequate and in areas where the disease occurs throughout the year, semiannual vaccination is necessary.
Navarro MA, Dutra F, Briano C, A. Romero A, M. Persiani M, Freedman JC, Morrell E, Beingesser J, Uzal FA. Pathology of Naturally Occurring Bacillary Hemoglobinuria in Cattle. Vet Pathol54:457-466, 2017
For questions about this article, please contact Dr. Andres de la Concha at (979) 845-3414.