azoturia, paralytic myoglobinuria of equine

Ali sadiekAli sadiek 11

جامعة أسيوط

كلية الطب البيطري

AZOTURIA, AZOTURIA, paralytic paralytic rnyoglobinuriarnyoglobinuria , ,

Black water DiseaseBlack water Disease

bybyDr. Ali H. Dr. Ali H. SadiekSadiek

Prof. of Internal Veterinary Medicine Prof. of Internal Veterinary Medicine and Clinical Laboratory Diagnosisand Clinical Laboratory Diagnosis

Faculty of Veterinary Medicine, Faculty of Veterinary Medicine, AssiutAssiut UniversityUniversityEE--mail: mail: [email protected]@yahoo.com


AZOTURIA, AZOTURIA, paralytic rnyoglobinuria , paralytic rnyoglobinuria ,

Black water Disease,Black water Disease,RhabdomyolysisRhabdomyolysis

Monday Morning diseaseMonday Morning diseaseTying Up Syndrome, Tying Up Syndrome,

SetfastSetfast diseasediseaseSporadic acute disease affecting adult draft Sporadic acute disease affecting adult draft horses , mules and donkeys. horses , mules and donkeys. The byproducts of abnormal energy The byproducts of abnormal energy metabolism cause inflammation of muscle metabolism cause inflammation of muscle cells, which leads to painful spasms of the cells, which leads to painful spasms of the large muscles of the back and hindquarters. large muscles of the back and hindquarters.


AZOTURIA, AZOTURIA, paralytic paralytic rnyoglobinuriarnyoglobinuria , ,

Black water Disease,Black water Disease,RhabdomyolysisRhabdomyolysis

Monday Morning diseaseMonday Morning diseaseTying Up Syndrome, Tying Up Syndrome,

SetfastSetfast diseasediseaseIt is It is chch. By:. By:1.1. Functional and morphological changes of the Functional and morphological changes of the

muscles.muscles.2.2. Liberation of myoglobin in urine, Liberation of myoglobin in urine, 3.3. Lameness ending with paralysis esp. after sudden Lameness ending with paralysis esp. after sudden

excessive work or training following days of rest.excessive work or training following days of rest.


Causes & Pathogenesis of Azoturia.Causes & Pathogenesis of Azoturia.

Feeding of highly concentrated ration to draft Feeding of highly concentrated ration to draft horses at rest resulted inhorses at rest resulted in

Formation of large stores of glycogen in Formation of large stores of glycogen in muscles. muscles.

At work, this glycogen is converted to energy At work, this glycogen is converted to energy and lactic acid.and lactic acid.

The rate of removal of lactic acid from the The rate of removal of lactic acid from the blood stream does not equal to its production blood stream does not equal to its production and the disease ensues. and the disease ensues.


Pathogenesis of Azoturia.Pathogenesis of Azoturia.Or. ration deficient in vitamins A, B,C. Or. ration deficient in vitamins A, B,C. and E., minerals as Ca, P, Na, CU, Mg, and E., minerals as Ca, P, Na, CU, Mg, MnMn, Fe, Co and I) leads to , Fe, Co and I) leads to

MetabMetab. disturb., improper function and . disturb., improper function and dystrophic changes in the central and dystrophic changes in the central and prepheralprepheral NS, endocrine glands and NS, endocrine glands and

skeletal muscles, skeletal muscles,

Lowering resistance of the animal body Lowering resistance of the animal body that leads to streptococcal sepsis. that leads to streptococcal sepsis.


Pathogenesis of Azoturia.Pathogenesis of Azoturia.AccumAccum. Of lactic acid in muscles. Of lactic acid in muscles

coagulativecoagulative necrosis of muscles, followed necrosis of muscles, followed by liberation of its Mb and its secretion in by liberation of its Mb and its secretion in

urine.urine.The lesions may press on sciatic and other The lesions may press on sciatic and other

cruralcrural nerves nerves

2ndry 2ndry neuropathicneuropathic degeneration of the degeneration of the rectusrectus femorisfemoris muscle. muscle.


Cause of Death in AzoturiaCause of Death in Azoturia

Death may occurs from: Death may occurs from: MyoglobinemicMyoglobinemic nephrosisnephrosis..UraemiaUraemia. . Myocardial degeneration.Myocardial degeneration.Septicemia. Septicemia.


Clinical signsClinical signsSigns appears Signs appears within one hour within one hour after beginning of the exerciseafter beginning of the exercise. . The horse being active, may be The horse being active, may be nervousnervousProfuse sweating, rise of body Profuse sweating, rise of body temp. and hyperpnoea.temp. and hyperpnoea.Stiffness and reluctance to move, Stiffness and reluctance to move, swinging of the hind legs. swinging of the hind legs. The animal then drops on the The animal then drops on the ground, tries to stand but it fails ground, tries to stand but it fails and takes the dog sitting position and takes the dog sitting position followed by lateral recumbencyfollowed by lateral recumbency. .

Coffee colored urineCoffee colored urine


Clinical signsClinical signs

Hard, enlarged & tense Hard, enlarged & tense Quadriceps Quadriceps femorisfemoris & & gluttealgluttealmuscles muscles Urination and defecation are Urination and defecation are difficult. difficult. Urine is of dark red brown Urine is of dark red brown color (coffee urine). color (coffee urine). In severe cases, tachycardia, In severe cases, tachycardia, weak cardiac impulses, weak weak cardiac impulses, weak heart sounds with heart sounds with extrasystolicextrasystolic arrhythmiaarrhythmia


Azoturia of equinesAzoturia of equines

MyoglobinuriaMyoglobinuriaCoffeCoffe colredcolred urineurine


Clinical pathologyClinical pathologyI. Blood changes: I. Blood changes:

Blood serum is highly discolored since the Blood serum is highly discolored since the renal threshold for renal threshold for myoglobinmyoglobin is very low. is very low. Increased levelsIncreased levels of sugars, lactic and of sugars, lactic and pyurvicpyurvicacids, cholesterol, N.P.N. and phosphorus.acids, cholesterol, N.P.N. and phosphorus.Decreased levelsDecreased levels of alkaline reserve, protein, of alkaline reserve, protein, calcium, vitamins A, B, and C. calcium, vitamins A, B, and C.

II. Muscle tissues: II. Muscle tissues: Increased levels of CPK and SGOT in blood Increased levels of CPK and SGOT in blood indicating muscle destruction.indicating muscle destruction.


Clinical pathologyClinical pathology

III. Urine changes: III. Urine changes: IT may be acidic in severe cases. IT may be acidic in severe cases. Specific gravity lies between Specific gravity lies between 1.010 1.010 —— 1.078. 1.078. Presence of myoglobin, protein.Presence of myoglobin, protein.increased level of increased level of creatinescreatines, , pyurvicpyurvic acid, sugar, acid, sugar, indicanindican and and urobilinurobilin..

myoglobinmyoglobinuriauriaand and hematuhematuriaria

MyoglobinuriaMyoglobinuriaand and hematuriahematuria


DiagnosisDiagnosisCase historyCase history: Sudden exercise : Sudden exercise after a period of rest.after a period of rest.Clinical signsClinical signs: stiffness, : stiffness, lameness, coffee colored urine, lameness, coffee colored urine, recumbency.recumbency.ClCl. . PatholgyPatholgy: Mb urea, uremia, : Mb urea, uremia, increased serum AST, CPKincreased serum AST, CPK..Diff. Diff. DiagDiag: All cases of trauma, : All cases of trauma, lameness, etclameness, etc


Treatment and preventionTreatment and preventionII-- General hygienic aids:General hygienic aids:Complete rest, trails to raise animals on legs or its Complete rest, trails to raise animals on legs or its hanging.hanging.Increase green fodders.Increase green fodders.Hot fomentations and massage of affected muscles.Hot fomentations and massage of affected muscles.

IIII--Medical Treatment.Medical Treatment.•• Analgesics (Analgesics (i.vi.v. . NovalginNovalgin or Chloral hydrate 30 gm or Chloral hydrate 30 gm

orally)orally)•• Antacids (Antacids (i.vi.v. of 200. of 200--400 ml Na bicarbonate 2400 ml Na bicarbonate 2--5 %).5 %).•• Normal saline.Normal saline.•• Vitamin B1 (0.5 gm Vitamin B1 (0.5 gm i.mi.m daily of daily of ThaimineThaimine ))•• Insulin 200Insulin 200--300 IU 300 IU imim..•• Cortisone.Cortisone.•• Antibiotics.Antibiotics.


PreventionPrevention1.1. Controlling the diet and Controlling the diet and

exerciseexercise2.2. Assuring high fiber diet Assuring high fiber diet

Regular exercise, Regular exercise, 3.3. Keeping the horse well hydrated Keeping the horse well hydrated

can also prevent potential damage can also prevent potential damage to the kidneysto the kidneys

azoturia, paralytic myoglobinuria of equine

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