Common Fresh Cow Disorders Causes, Treatment, and Prevention. Travis Thayer DVM UCCE Dairy Management Seminars December 2012



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Common Fresh Cow Disorders Causes, Treatment, and Prevention Travis Thayer DVM UCCE Dairy Management Seminars December 2012

Why Are We Here?

Fresh Cows Need Special Care Calving and sudden milk production demands are extremely stressful for the cow Many things can go wrong Problems as a fresh cow will negatively affect milk production and reproduction for the whole lactation Prevention is best Early treatment is essential

Overview General comments on fresh cow programs Communication and working together Benefits of monitoring/recordkeeping Herd level Individual Animals Importance of following protocols

Overview 2 Review of Common Fresh Cow Problems Hypocalcemia Retained Placenta/Uterine Infections Ketosis Displaced Abomasum Other disorders of high risk (mastitis, pneumonia, digestive upset) Drug Residue Avoidance Vaccination Programs

Communication and Teamwork The Dairy Team Owner/Herdsman/Manager Employee(s) in charge of fresh cows Veterinarian Nutritionist Communication between team members is essential to the dairy s success

Monitoring Know what normal/acceptable rates of diseases are for your dairy Keep records so that you can detect when something is going wrong Be consistent and vigilant Communicate deviations to others on the team owner/manager, veterinarian, nutritionist - so problem can be addressed

The Value of Protocols Even the best protocol will fail if it is not followed properly Are the protocols for your dairy: Written down and accessible? Reviewed with new employees that have fresh cow responsibility? Available in English and Spanish? Reviewed and updated regularly?

Fresh Cow Treatment Equipment Checklist Is the fresh cow area/cart clean and well organized? Do you have all the tools you need to implement the protocols? Equipment in good repair? Equipment sanitized between uses?(between cows is ideal but may not always be practical/possible). Disease spread can happen from equipment!

Supportive Therapy General therapy that helps the cow to feel better and recover from illness Will vary according to preferences and opinions of dairy manager/owner and veterinarian, as well as specific needs of the dairy

Supportive Treatment May Include: Replace Calcium +/- Phosphorous IV for clinical Oral for subclinical/other disease Replace Fluid/Electrolytes Oral fluids/drench Hypertonic saline (cow MUST drink water or be given oral fluids) Energy Dextrose/propylene glycol Probiotic/prebiotic to help restore rumen function Providing a clean, comfortable place for the cows is also key Don t forget food and water!

Common Routes of Administration of Medications IV Intravenous In the vein SC Subcutaneous Under the Skin Oral Via the mouth IM Intramuscular In the Muscle Intramammary in the udder

General Risk Factors for Fresh Cow Overcrowded closeup and fresh pens Inconsistent/inaccurat e feed delivery to close-up cows Heat Stress Dystocia/Calving Problems Diseases Abortion/Stillbirth Body Condition too high or too low (too fat or too thin) Heifers grouped with adult (lact 2+) cows

Hypocalcemia Low blood level of calcium Two main forms Clinical Subclinical Calcium metabolism is closely related to phosphorous Proper ratio in the diet is important Cows with clinical hypocalcemia often need phosphorous as well work with vet on specific protocols

Calcium Functions in the Body Structure of bone and teeth Muscular contractions Skeletal and cardiac muscle Heart beating and movement Smooth Muscle Intestine Peristalsis (gut movement), rumen contractions Uterus Expulsion of fetal membranes (Placenta) Uterine involution (return to normal size)

Hypocalcemia: Clinical vs Subclinical Clinical Hypocalcemia milk fever Cow appears weak, often unable to stand Extremities cold, especially ears May see muscle twitching If left untreated, cow can die Subclinical hypocalcemia Cow not visibly ill, but blood calcium is low Shows up as other diseases (metritis, RP, DA, etc)

Clinical Treatment of Hypocalcemia Usually IV Calcium Go slow! Too fast can kill the cow! May put additional calcium SC (Ca only! Not Dextrose!) Oral calcium and energy sources to follow up Observe cow closely for other diseases Subclinical since hard to tell if cow is having other problems due to calcium, usually oral Ca is part of supportive care for all diseases.

Oral Calcium Many forms of delivery available Bolus, Gel, Drench Follow the protocol for your dairy

Prevention of Hypocalcemia Fresh cow disorders usually go back to the transition cow diet DCAD Dietary cation-anion difference Proper balance between different minerals is important for cow to maintain proper blood levels of diet If we have problems with fresh cows go back and look at dry/closeup cows.

Monitoring Close-up Cow Urine ph to Help Prevent Hypocalcemia Many farms check close-up cow urine ph to detect risk of hypocalcemia (DCAD Balance) Urine ph is affected by DCAD Mineral mix added to closeup ration Composition of minerals in feed (e.g. high potassium hay) Can monitor with a ph meter or paper to check range

Checking Urine ph Can use paper or handheld meter Check 8-10 close-up cows (2 nd lact or greater) Desired ph range is 6-7 If out of range Investigate reason

Metritis Infection of the uterus Uterine Discharge Endometritis, metritis varying degrees of disease We will use metritis to describe both. Severity ranges from mild discharge to toxic with systemic illness Photo:http://www.msd-animal-health.co.uk

Risk Factors for Metritis Dystocia (hard calving that needed correction) Twins Retained Placenta Abortion/Stillbirth Fat Cows/Heifers Heat Stress Overcrowded Pens Contamination from unclean: Calving area Calving equipment Calving procedure Cows and heifers housed together

Diagnosis of Metritis Use Your Eyes and Nose! Covered in depth by Dr. Silva-del-Rio Recap: Vaginal discharge Dark brown/pus Foul smelling +/- fever Cow may be noticeably sick/off feed

Pyometra Pyo = Pus Metra =Uterus Sometimes called chronic endometritis Cow not ill Fluid filled uterus (Pus) Discharge is white and does not smell bad like metritis Antibiotics, supportive care not needed Prostaglandin (see treatment of metritis)

Treatment of Metritis Supportive care as needed Anti-inflammatory if fever Aspirin oral Flunixin meglumine (IV only! Review why) Systemic Antibiotics Depending on severity Follow label instructions! Route/dose/withdrawal time IMPORTANT!

Treatment of Metritis (cont) Prostaglandin Works to lyse corpus luteum on ovary and allow cervix to open, promoting drainage Protocols vary - most effective after 14 days fresh

Intrauterine Treatment? Uterine infusion with an AI pipette or uterine boluses Antibiotics (usually oxytetracycline) Scientific studies have not shown benefit, and many vets feel there is potential to make things worse Increased risk of antibiotic residues! Some vets/producers feel benefit Follow the protocol on your farm!

Metritis Prevention Clean calving facilities and equipment Use of proper (gentle and clean!) technique when assisting calving Practice excellent hygiene and use lots of lube! Proper care of cow after calving Follow protocol! Observe cow extra carefully for early signs of problems

Metritis Prevention (cont) Avoid overcrowding close-up and fresh cows Make sure fresh cows always have fresh, well mixed feed available When possible, group cows and heifers separately

Retained Placenta (RP) Placenta/fetal membranes normally expelled within 12 hr If not, this is called retained placenta Same risk factors/causes as metritis Photo Credit: http://www.nadis.org.uk

Managing RPs Follow the dairy protocol for treatment! Manual removal may do more harm than good be careful and check with vet on how/when to do this Treatment involves supportive therapy +/- antibiotics. (Follow the label on the medicine for dose/route and the protocol for withdrawals!) IMPORTANT!

Ketosis Ketosis is a sign that cow is not getting enough energy from the diet Overall energy demand exceeding intake Intake may be depressed because of other illness Ketones are fat breakdown products, and are also a product of fermentation in the rumen Too many ketones makes the cow sick

Diagnosis of Ketosis See description by Dr. Silva-del-Rio Physical appearance Depressed, dull, off feed Milk production may be down Smell breath>>acetone (fingernail polish) Tests: Blood, milk, and urine tests Advantages and disadvantages to each test Work with vet on protocol/follow protocol

Testing Multiple Animals If many cases of ketosis and other fresh cow problems are happening, the vet and nutritionist may run blood tests on a number of cows to see what is going on NEFA BHBA These tests results can help target where the problem is and aid in management changes to stop it.

Treatment of Ketosis Severe Ketosis IV Dextrose (Never put dextrose SC! Can cause problems) Examples large on urine/milk Blood level above specified cutoff (protocol) Glucose precursor Propylene glycol Processed by rumen and liver into VFA and glucose Delivered orally, often in a drench

Corticosteroids and Ketosis Corticosteroids Not used in all protocols Can help the liver produce and save more glucose so the cow has more energy available Examples include Predef/dexamethasone Need to be done very carefully and according to protocol FOLLOW THE PROTOCOL! Too much or too long duration of treatment can make things worse, especially in fatty liver

Fatty Liver Syndrome Often associated with ketosis Liver cannot process fatty acids and ketones as fast as they are delivered Fatty deposits in liver interfere with normal liver cell function, making the problem worse. Treatment is supportive, same as with ketosis

Prevention of Ketosis and Fatty Liver Avoid overcrowding in close-up pens Cows in proper body condition at calving 5 point system (1-very thin; 5= super fat) Ideal score at calving is 3.5-3.75 Proper feed management Adequate amount of feed available to all cows Delivered and pushed up consistently Diet supplements/additives may be helpful

Displaced Abomasum (DA) Abomasum usually situated below and to the right of the rumen Under certain conditions when the cow is ill, it inflates with air and moves up to the left or the right At a minimum, requires medical treatment, but usually some level of surgical correction.

Bovine GI Structure

Photo Credit Mydairyvet.com DA What Happens

LDA vs RDA Left side = LDA; Right = RDA RDA True emergency can often result in a twist (volvulus) which can damage the blood supply and tissue of the abomasum and potentially kill the cow LDA Should be dealt with in a timely manner, but can be managed medically while waiting to do procedure

Cause of DA? Usually cow is sick from something else look for a cause when examining cow Cow feels sick, goes off feed Abomasum is empty, and fills up with gas Low Ca>>decreased motility Abomasum floats up to left or right

Diagnosis of DA? Dr. Silva-del-Rio will be covering this topic in depth Cow off feed, often down in milk Usually have concurrent illness Characteristic ping noise when checked with stethoscope Other organs can make ping noise know how to tell the difference

Treatment/Correction of DA? Prevention is best! If she doesn t get a DA, we don t have to treat it! First question: Is this cow worth treating/fixing? Milk production Past production/repro history Usually some type of correction is needed

Non Surgical Management of LDA In some cases, medical treatment of underlying condition and supportive care may resolve problem (LDA only) One other option Roll the cow, allowing LDA to replace; treat with supportive care In both cases, there is a significant chance that the DA will reoccur, so usually some type of surgical intervention is needed.

DA Treatment: Surgical Options Most include steps to deflate DA, replace, and sew in place Standing surgery either right or left approach Depends on vet preference, both work well if cow is appropriately treated afterward (underlying condition + supportive care) Cow lyingon her back Not very common in CA or overall. Done by some in the Northeast, Midwest.

Photo Credit: http://www.nadis.org.uk LDA Surgery

DA Treatment: Roll and Toggle This is a type of closed surgical technique. Success rates can be comparable with surgery Key is to early intervention: Find the DA and treat the cow as soon as possible Preference varies between dairy/vet

Photo Credit: www.ldatogglesuture.com DA: Roll and Toggle

Other Diseases of Importance Mastitis Pneumonia Enteritis/Diarrhea Lameness

Mastitis Infection of the mammary gland (udder) Fresh cows at increased risk Usually caught and treated during milking Check for mastitis during physical exam

Pneumonia Lung Infection Off feed, +/- fever, increase resp rate Many organisms can cause usually a combination of viruses and bacteria Treatment: Supportive and Antibiotic

Enteritis/Diarrhea Loose, watery diarrhea is not normal and should be investigated Infectious causes: e.g. Salmonella, Johnes Non Infectious Causes Include: Acidosis Digestive upset from feed change Toxin exposure

Lameness Very common Very painful Many other fresh cow problems result because cow does not get up and eat Don t let lame cows go untreated they will get worse! Photo: http://www.nadis.org.uk

Administering Medications and Drug Residues Many medications have a withdrawal time for meat, milk, or both Milk or meat from cow cannot be sold during this period Animals (at slaughter) or milk with drug residues = HUGE PENALTIES Loss of public confidence

Avoiding Drug Residues FOLLOW THE LABEL on the medication for proper dose, route, and withdrawal times! Sometimes vets may choose a dose that is different from the label follow the dose and withdrawal they recommend WRITE EVERYTHING DOWN!

Vaccinations We give dairy cows many vaccinations as part of the routine, to prevent disease Like with medications, follow all label instructions for dose and route Vaccines given incorrectly can result in tissue/meat damage, off feed (painful) cows, and even death to the cow Have epinephrine ready in case of allergic reaction

Vaccine Handling Even the best vaccine will not work if it is not handled properly by the person using it Temperature of storage Time after live vaccines mixed (<1hr) Don t leave in the sun Don t leave in extreme cold Use clean syringes Change needles when needed

Recap Fresh cows are at high risk for disease, which affects the whole lactation Fresh cows should be monitored daily as part of a program Any abnormal behaviors or symptoms should be investigated thoroughly Follow all protocols they are there for a reason COMMUNICATE!

Questions? THANK YOU!