Bovis ISSN 2398-2993

Water intoxication

Synonym(s): cold water hemoglobinuria, acute dilutional hyponatremia

Contributor(s): Nicola Bates , Alessandro Seguino

VPIS logo Royal Dick School Veterinary Studies logo

Introduction

  • Cause: rapid ingestion of water following a period of water deprivation.
  • Signs: hemoglobinuria and neurological signs.
  • Diagnosis: history (water deprivation followed by unlimited access to water) and neurological signs.
  • Treatment: usually no intervention for mild to moderate cases. Intravenous hypertonic saline and furosemide can be given in severe cases.
  • Prognosis: good for mild cases; guarded in animals with pronounced neurological signs.

Pathogenesis

Etiology

  • Dilutional hyponatremia can occur after ingestion of water at a rate in excess of the maximal excretory capacity of the kidney, or by ingestion of lesser amounts of water with impaired water excretion by the kidney.  
  • Water intoxication occurs following rapid ingestion of water and may occur under several circumstances:
    • Following a period of water deprivation.
    • Following strenuous exercise.
    • During periods of high environmental temperatures.

Predisposing factors

Calves

  • Water intoxication can occur in calves offered free access to water for the first time.
  • Bucket-fed calves usually drink excessive water if it is offered in the manner in which they normally receive their milk.
  • The volume ingested is limited by the capacity of the gut not by satiety and the rumen can hold a large volume of water compared with total body size.
  • Chronic subclinical dehydration with increased environmental temperature, excess of fluid loss due to diarrhea or fever may predispose to water intoxication.
  • Calves with oliguria or calves that fail to develop diuresis soon after water overload at are also at risk.
  • Failure to provide both water and salt before weaning also predisposes to water intoxication.

Adult cattle

  • Free access to water following a period of water deprivation. Even a short period of water deprivation (eg 1 day) followed by free access to water can result in water intoxication.

Pathophysiology

  • Ingestion of too much water results in a positive water balance which leads to hemodilution.
  • Water retention causes a dilution of body solutes and a reduction in osmolality.
  • There is a rapid fall in serum sodium which results in increased water uptake by cells. This has multiple effects:
    • Edema in the brain resulting in neurological signs.
    • Hypotonicity of erythrocytes causes lysis resulting in hemoglobinuria and anemia.

Timecourse

  • Onset is often rapid (<30 minutes) but can be longer (eg several hours).
  • In mild cases recovery may occur in 3-4 hours, particularly if there is rapid diuresis after ingestion of excess water.
  • In more severe cases recovery can take 2-5 days.
  • Death generally occurs within 24-72 hours, but can occur within a few hours.

Epidemiology

  • Water intoxication is a particular risk in hot weather when drinking water is limited or absent and then freely available.
  • Water intoxication also occurs following a long transport period without access to water followed by rapid ingestion of water on reaching the final destination.

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Aitra S, Berisso R & Quiroga M A (2017) Intoxicación hídrica en Bovinos. [Water intoxication in cattle]. [online]. Thesis, Faculty of Veterinary Sciences, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Argentina. Available at: www.ridaa.unicen.edu.ar.
  • Kawahara N, Ofuji S, Abe S, Tanaka A, Uematsu M & Ogata Y (2016) Water intoxication in adult cattle. Japanese journal of vet research 64 (2),159-64 PubMed.
  • Njoroge E M, Maribei J M, Mbugua P N & Njiru S M (1999) Water intoxication in cattle. Journal south african vet 70 (4), 177-9.
  • Maribei J M, Njoroge E M & Mbungua P N (1998) Clinical manifestation of experimental water intoxication in calvesIndian journal animal sci 68 (6), 531-2 VetMedResource.
  • Njoroge E M, Maribei J M & Mbugua P N (1997) Pathological changes in calves that died from experimental water intoxication. Onderstepoort journal vet res 64, 111-114 PubMed.
  • Gilchrist F (1996) Water intoxication in weaned beef calves. Canadian vet journal 37 (8), 490-1 PubMed.
  • Shimizu Y, Naito Y & Murakami D (1979) Experimental study on the mechanism of hemolysis on paroxysmal hemoglobinemia and hemoglobinuria in calves due to excessive water intake. Japanese journal vet sci 41 (6), 583-592 PubMed.
  • Gray T C (1970) Dehydration and water intoxication of range cattle. AVMA 157 (11), 1549-56 VetMedResource.
  • Kirkbride C A & Frey R A (1967) Experimental water intoxication in calves. AVMA 151 (6), 742-6 PubMed.
  • Lawrence J A (1965) Water intoxication in calves. SAVA 36, 277-278.

Organisation(s)


ADDED