Title Water intoxication in adult cattle

Author(s) Kawahara, Naoya; Ofuji, Sosuke; Abe, Sakae; Tanaka, Ai; Uematsu, Masami; Ogata, Yoshimi

Citation Japanese Journal of Veterinary Research, 64(2), 159-164

Issue Date 2016-05

DOI 10.14943/jjvr.64.2.159

Doc URL http://hdl.handle.net/2115/62211

Type bulletin (article)

File Information 061.p159-164 NOTE KAWAHARA.pdf

Instructions for use

Hokkaido University Collection of Scholarly and Academic Papers : HUSCAP

Japanese Journal of Veterinary Research 64(2): 159-164, 2016

NOTE

Water intoxication in adult cattle

Naoya Kawahara＊), Sosuke Ofuji, Sakae Abe, Ai Tanaka,
Masami Uematsu and Yoshimi Ogata

Central Veterinary Clinic, Yamagata Prefectural Federation of Agricultural Mutual Aid Associations,
286-1, Kitagawara, Nanaura, Yamagata-shi, Yamagata 990-2171, JAPAN

Received for publication, December 8, 2015; accepted, March 11, 2016

ABSTRACT
Water intoxication is a common disorder in calves and is usually characterized by transient
hemoglobinuria. In contrast, the condition is very rare in adult cattle, with few reports on
naturally occurring cases. In the present report, four female Japanese Black cattle, aged
16-25 months, showed neurological signs when they drank water following a water outage.
Hemoglobinuria was not grossly observed, while severe hyponatremia was revealed by
laboratory tests. Autopsy indicated cerebral edema with accumulation of serous fluid in
expanded Virchow-Robin spaces. These results indicate the possibility of water intoxication
associated with cerebral edema due to severe dilutional hyponatremia in adult cattle.

Key Words: cattle, cerebral edema, water intoxication

　　Water intoxication is a relatively well-known calves2,3,5,14), while there are few reports of this
disorder in calves, which occurs when calves are condition in adult cattle4). Recently, we experienced
exposed to ad libitum access to water after a a case of water intoxication characterized by
certain period of restriction9). The condition is neurological signs in adult cattle that drank their
characterized by transient hemoglobinuria and fill after a relatively short period of water outage.
hemoglobinemia. It is considered that excessive
water ingestion causes a temporary extreme drop 　　The case described in the present report
in plasma osmotic pressure in the capillary veins occurred on a fattening farm in Yamagata, Japan,
of the intestinal wall, where intravascular in which about 850 Japanese Black cattle, aged
hemolysis may occur11). In addition, depending on 7-32 months, were raised in groups of two or
the amount of absorbed water, hemodilution in three animals. This farm consisted of four cow
systemic veins may also occur, and consequently, houses. Two of them used tap water as drinking
various degrees of hyponatremia are observed8,9). water, and the others used well water.
There have been many reports on naturally
occurring cases of water intoxication in 　　In 2013, on July 18, the Yamagata prefecture

*Corresponding author: Naoya Kawahara, Central Veterinary Clinic, Yamagata Prefectural Federation of
Agricultural Mutual Aid Associations, 286-1, Kitagawara, Nanaura, Yamagata-shi, Yamagata 990-2171, JAPAN
Phone: +81-23-684-5531. Fax: +81-23-684-5538. E-mail: [email protected]
doi: 10.14943/jjvr.64.2.159
160 Water intoxication in adult cattle

sustained torrential rain, and around noon on Serum osmolality (mOsm/kg) ＝ 2[Na] ＋ [Glu]/18 

July 21, due to a troubled water filtration plant, ＋ [BUN]/2.8
the water supply was discontinued in the area
around the farm. On the afternoon of July 22, the where Na ＝ sodium (mM), Glu ＝ glucose (mg/dl),
water in the tanks of two cow houses, in which and BUN ＝ blood urea nitrogen (mg/dl).
about 700 cattle were housed, was depleted.
Therefore, on the morning of July 23, the rancher 　　Hyponatremia, hypochloremia, and low serum
switched the water source from tap water to well osmolality were revealed in three of the four
water, and let the cattle drink it until they were animals, and all four cows had increased blood
satisfied. However, about 10 hours after giving levels of glucose (Glu), creatine kinase (CK), and
well water, the rancher found two animals (Cases aspartate aminotransferase (AST). A urine test
1 and 2) lying down with neurological signs. On was performed only in Case 4. The specific
July 24, all animals were allowed to drink well gravity of the urine was 1.013, and the urine
water ad libitum, except during the night time, sodium concentration was 1 mM. Although the
but on July 25, after the resumption of water urine color was grossly normal, a slight occult
supply, another two cows (Cases 3 and 4) were blood reaction was observed.
observed having similar clinical signs. The feed
given to the cattle consisted of rice straw and 　　The major diseases of adult cattle which
commercial compound feeds which contained no cause neurological abnormalities include infectious
salt. The daily ration was not changed even after thromboembolic meningoencephalitis, listeriosis,
water outage, but it was reduced to two-thirds polioencephalomalacia, salt poisoning, and ruminal
after the occurrence of Cases 1 and 2. acidosis. In this case, the infections were ruled
out based on the absence of fever, and
　　All four affected animals were female and polioencephalomalacia was ruled out because a
their ages (Cases 1 to 4) were 25, 22, 16, and 17 number of animals developed neurological signs
months, respectively. On the first day, Cases 1 suddenly and for a short time. Salt poisoning was
and 4 were in recumbent positions with muscle ruled out, based on the absence of salt in the
twitches and coma and were unable to get up. feed. Therefore, we initially made a tentative
Cases 2 and 3 were able to stand up but diagnosis of acute ruminal acidosis in Cases 1
showed depression, staggering, and disturbed and 2. However, the results of the laboratory
consciousness during which they kept moving tests revealed hyponatremia with a low serum
against the bars of the stall and were unable to osmolality and suggested the possibility of water
drink or eat by themselves. All of them showed intoxication. In Case 4, we tried to classify the
symptoms of dehydration such as enophthalmus hyponatremia according to the diagnostic criteria
and skin hardening, and Case 1 exhibited applied in humans6) to confirm the diagnosis of
frequent urination. Their rectal temperature water intoxication. Firstly, the specific gravity of
were within normal ranges, and hemoglobinuria, urine should be lower than 1.003 in euvolemic
which is one of the most common manifestations patients with hyponatremia and hypo-osmolality.
of water intoxication in calves3,8-11,14), was grossly However, that of Case 4 was inappropriately
unnoticeable in all cases. high (1.013), suggesting disturbance of free water
excretion caused by volume overload, volume
　　The results of laboratory tests are presented contraction, or syndrome of inappropriate
in Table 1. Serum osmolality was estimated antidiuretic hormone secretion. In this case,
according to the following formula6): volume contraction was suspected on the basis of
the history and the symptoms of dehydration. In
 Naoya Kawahara et al. 161

Table 1.  Results of the laboratory tests on the first day

Case 1 Case 2 Case 3 Case 4 Normal range
Peripheral blood cell count
WBC (×102/μl) 178 94 220 103 40-120
RBC (×104/μl) 646 1024 1007 784 500-1000
Hematocrit (%) 33.7 46.5 45.0 35.9 24-46
Blood biochemistry
Total protein (g/dl) 7.2 7.0 7.8 6.6 5.7-8.1
Albumin (g/dl) 3.2 3.5 3.9 3.5 2.1-3.6
CK (IU/l) 870 465 7389 1768 35-280
AST (IU/l) 198 358 154 144 41-109
Sodium (mM) 128 117 139 117 132-152
Potassium (mM) 2.5 3.7 3.6 4.5 3.9-5.8
Chloride (mM) 91 78 98 80 95-110
Calcium (mg/dl) 9.2 8.3 9.3 8.3 8.5-12.4
Total cholesterol (mg/dl) 98 101 78 207 65-220
Glucose (mg/dl) 176 239 99 91 45-75
BUN (mg/dl) 7.1 6.7 8.1 10.2 6.0-27
Serum osmolality (mOsm/kg) 268 250 286 243 270-306
Urine test
Specific gravity 1.013
Occult blood test ＋
Urine biochemistry
Sodium (mM) 1
Potassium (mM) 34.2
Chloride (mM) 12
WBC: White blood cell count, RBC: Red blood cell count, CK: Creatine kinase, AST: aspartate
aminotransferase, BUN: Blood urea nitrogen.

patients with hypovolemic hyponatremia and the volume contraction was subsequently
normal renal function, the urine sodium resolved by drinking a large amount of well
concentration should be lower than 20 mM. water. However, its sodium concentration was
Therefore, the remarkably low urine sodium later revealed to be only 2.3 mM, and severe
concentration of Case 4 (1 mM) suggested its dilutional hyponatremia was suspected.
normal renal function and the existence of
extrarenal fluid losses, causing volume contraction. 　　On the first day, we treated Cases 1 and 2
Extrarenal fluid losses may occur as a consequence using a slightly hypotonic solution (sodium
of protracted vomiting, severe diarrhea, or concentration, 106 mM and 76 mM, respectively)
sequestration of fluids in a third space. In this including sodium bicarbonate for suspected
case, such symptoms were not present, so the ruminal acidosis and Cases 3 and 4 using a
volume contraction was assumed to be due to the hypertonic solution (sodium concentration,
failure of water supply. It is known that these 420 mM and 355 mM respectively). Intravenous
fluid losses can typically cause hyponatremia administration of hypertonic saline has been
when losses are replaced by ingesting plain recommended for water intoxication in calves8,9);
water or liquids low in sodium6,9). In this case, however, in these cases, neither hypotonic nor
162 Water intoxication in adult cattle

hypertonic solution was effective, and the final

outcomes appeared to depend on the severity of
the neurological signs observed on the first day.

　　Only Case 2 gradually recovered and was

able to feed spontaneously four days after the
onset. Cases 1, 3, and 4 finally died 3, 4, and 1
days after the onset, respectively, and were
immediately subjected to autopsy. During the
autopsies of Cases 1 and 4, a softening and a
wetness of the brain and an increase in the
cerebrospinal fluid were observed grossly.
Moreover, histological examination revealed that
Fig. 1.  Accumulation of serous fluid in expanded
all cases had accumulation of serous fluid in Virchow-Robin spaces (Case 4).  Hematoxylin and
expanded Virchow-Robin spaces (Fig. 1). These eosin. Scale bar ＝ 100 μm.
results indicated the existence of cerebral
edema7), which was considered to be the cause of being lowest around the age of 4 to 5 months10).
the neurological abnormalities. Case 4, the most This is considered to be the primary reason why
severe case, had a hemorrhagic lesion in the brain the manifestations of water intoxication differ
parenchyma and diffuse congestion and edema of between calves and adult cattle.
the lung. Cases 1 and 3 had moderate fibrinous
bronchopneumonia, which was suspected to 　　A case of water intoxication in adult range
contribute to the clinical exacerbation. Additional cattle has been reported previously; however,
autopsy findings typically included mild partial detailed laboratory tests and autopsies were not
myoedema around the chest wall, thinning and performed4). Furthermore, in that report, the
fragility of the mucosa of the rumina, and animals had suffered severe dehydration before
congested mucosa of the abomasum and a portion water intake, and some of them had already died.
of the small intestine. Case 4 showed enlargement Therefore, the animals might have developed
and fragility of the liver. In humans, rapid serious hemoconcentration and hypernatremia
correction of hyponatremia is known to increase and might have been in a condition of salt
the risk of developing osmotic demyelination poisoning. In salt poisoning, sodium ions are
syndrome6). In the present report, although the accumulated in tissues, including the brain, and
affected animals were not to be treated with when water is made available, it migrates to the
sufficient care regarding the rate of correction, tissues according to the concentration gradient9).
examples of demyelination were not observed. In the previous report, some of the cattle died
soon after drinking a small amount of water. The
　　Evidence from laboratory tests and autopsies cause of their death is supposed to have been
indicated that water intoxication might occur exacerbation of salt poisoning. On the other
in adult cattle as well as in calves. In cases of hand, the affected cattle in the present case did
water intoxication in calves, the most common not show serious dehydration before water
manifestations is transient, uncomplicated intake, because the temperature at the time of
hemoglobinuria3,11,14). However, in these adult cattle, the incident was lower (the daily maximum
obvious hemoglobinuria was not observed. It has temperature was between 25 and 30°C), and the
been reported that the osmotic tolerance of period of water restriction was shorter (about 1
bovine red blood cells changes according to age, day) than that of the previous report4). In addition,
 Naoya Kawahara et al. 163

there were no symptoms suggestive of salt overhydration due to the relatively small amount
poisoning, such as diarrhea or neurological signs, of water ingested3,8,9). The mechanism by which
and no salt was contained in the feed. Therefore, salt deprivation increases the risk of water
it was unlikely that the animals in this case were intoxication is still unclear, but the feed without
in a condition of salt poisoning. salt might have contributed to decreased total
body sodium content. In addition, the continued
　　Hyponatremia was considered to be one of feeding of the cattle during the water outage might
the most important findings in diagnosis of water have increased their desire to drink and might
intoxication in adult cattle. However, hyponatremia have predisposed them to water intoxication.
shown in Case 1 was rather mild, and Case 3 did
not have hyponatremia. In humans, it is known 　　In conclusion, this report has demonstrated
that mild dilutional hyponatremia with normal that water intoxication may occur in adult cattle
renal function can be treated only by restriction even in the absence of serious dehydration.
of water intake because the kidneys produce large Therefore, veterinarians should always bear this
quantities of dilute urine and excrete excessive disorder in mind when failure or irregularities of
free water6). In the present report, Cases 1 and 3, water supply to cattle is suspected.
which did not have serious hyponatremia, were
unable to drink water spontaneously, and Case 1
showed frequent urination. Hence, it was possible Acknowledgments
that the two cows had developed water intoxication
shortly before, and that hyponatremia had been 　　We would like to thank Dr. Mitsutaka
already resolved by production of dilute urine Ikezawa and Dr. Yoshiyuki Takano for their
when the rancher found their abnormalities. An advice on the pathological findings, and Dr.
increase in AST has been also encountered in the Naoki Fujita for revising the manuscript.
cases of water intoxication in calves3). In the
present case, increased CK was also observed,
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