JPC SYSTEMIC PATHOLOGY
DIGESTIVE SYSTEM
August 2018
D-B17

Signalment:  Holstein cow

HISTORY (JPC #2370239):  This cow presented with acute icterus, tachycardia, hemoglobinuria, and fever.

HISTOPATHOLOGIC DESCRIPTION:  Liver, two sections:  Affecting 1% of hepatic parenchyma in both sections are random and multifocal areas of necrosis characterized by loss of hepatocytes and replacement by viable and degenerate neutrophils, eosinophils, and fewer macrophages, lymphocytes and plasma cells admixed with eosinophilic and karyorrhectic debris, hemorrhage, fibrin and edema (lytic necrosis), or characterized by regions of hepatocytes with loss of differential staining and retention of architecture (coagulative necrosis).  Adjacent hepatic cords are disorganized with hepatocytes that are separated or individualized, with shrunken with hypereosinophlic cytoplasm and pyknotic nuclei (necrosis).  Adjacent to regions of necrosis, sinusoids are mildly expanded by fibrin and cellular debris.  There are multifocal round to oval areas of clear space, up to 2mm diameter, which contain flocculent, eosinophilic material (emphysema).  Adjacent to areas of lytic necrosis are multifocal colonies of 1-7um bacilli, and necrosis occasionally incorporates vessel walls, disrupting mural architecture (vascular necrosis) and vessel walls are transmigrated by neutrophils in affected areas.  There are multifocal aggregates of neutrophils, and fewer eosinophils, macrophages and lymphocytes within periportal areas.  

MORPHOLOGIC DIAGNOSIS:  Liver:  Hepatitis, necrosuppurative, acute, multifocal-random, severe, with emphysema and colonies of bacilli, Holstein, bovine.

ETIOLOGIC DIAGNOSIS:  Clostridial hepatitis

CAUSE:  Clostridium haemolyticum

CONDITION:  Bacillary hemoglobinuria (BH)

SYNONYMS:  Red water disease, Infectious icterohemoglobinuria  

GENERAL DISCUSSION: 

PATHOGENESIS:

TYPICAL CLINICAL FINDINGS:

TYPICAL GROSS FINDINGS:

TYPICAL LIGHT MICROSCOPIC FINDINGS:

ADDITIONAL DIAGNOSTIC TESTS:

  Plasma color Urine clears on centrifugation Urine clears with NH4S04 RBC’s in urine

Myoglobinuria

Clear

No

No

No

Hemoglobinuria

Pink

No

Yes

No

Hematuria

Clear

Yes

na

Yes

DIFFERENTIAL DIAGNOSIS:

COMPARATIVE PATHOLOGY:

References:

  1. Diseases of the liver. In: Constable PD, Hinchcliff KW, Done SH, Grunberg W, eds. Veterinary Medicine, A Textbook of the Diseases of Cattle, Horses, Sheep, Pigs, and Goats. 11th ed. St. Louis, MO: Elsevier; 2017:635-637.
  2. Navarro MA, Durtra F, Briano C, et al. Pathology of naturally occurring bacillary hemoglobinura in cattle. Vet Pathol. 2017; 54(3): 457-466.
  3. Smith GW. Bacillary hemoglobinura (“red water”). In: Smith BP, ed. Large Animal Internal Medicine. 5th ed. St. Louis, MO: Elsevier Mosby; 2015:850-851.
  4. Uzal FA, Plattner BL, Hostetter JM. Alimentary system. In: Maxie MG, ed. Jubb, Kennedy, and Palmer’s Pathology of Domestic Animals. Vol 2. 6th ed. St. Louis, MO: Elsevier; 2016:316-317.
  5. Zachary JF. Mechanisms of microbial infections. In: McGavin MD, Zachary JF, eds. Pathologic Basis of Veterinary Disease. 6th ed. St. Louis, MO: Elsevier; 2017:167.


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