| The postpartum period is a pivotal time in the production   cycle of the cow, determining both production and reproduction performance.   Early diagnosis and treatment of sick cows may be even more important than   the type of treatment administered. Different health monitoring strategies,   which parameters to use and how to interpret the results are discussed.   Summarized by Milkproduction.com from Proceedings 3rd Florida & Georgia   Dairy Road Show (2006) Introduction Early diagnosis and treatment of sick cows may be even   more important than the type of treatment administered. In lactating dairy   cows, this concept cannot be overemphasized. A delay in treating a sick cow   not only reduces chances for a full recovery but results in milk production   loss and may impair reproductive performance, especially if the disease   occurs early post partum. There are different opinions on health monitoring   strategies, which parameters to use and how to interpret them. This paper   reviews parameters that can be used to monitor postpartum health and   discusses clinical signs to look for in sick cows. Monitoring Postpartum Health The postpartum period is a pivotal time in the production   cycle of the cow, determining both production and reproduction performance.   During the postpartum period, dairy cows are at risk of developing   calving-related diseases, such as; hypocalcaemia, metritis, ketosis and   displacement of the abomasum (Curtis et al, 1983). These are costly disorders   with estimated economic losses ranging from 200 to 400 dollars per case per   lactation (Bartlett et al, 1986). Monitoring postpartum health allows the opportunity to   identify sick cows early and provide supportive therapy. Furthermore, it can   help prevent diseases. For example, a cow treated early for a uterine   infection is less likely to develop secondary disorders such as displaced   abomasum and ketosis. Another example would be a cow diagnosed with   sub-clinical ketosis: if treated a loss in milk production can be prevented. Monitoring postpartum health requires examination of all   cows early postpartum (7 to 10 days in milk) by trained farm personnel.   Parameters that can be used to evaluate health status of cows include rectal   temperature, attitude, milk production, uterine discharge and urine ketones.   In the authors’ opinion, a common problem for many farms monitoring   postpartum health is that too much emphasis is given to one or two of these   parameters. It is important to understand that the combination of these   parameters must be considered when making a decision whether or not a cow is   sick and requires treatment. Rectal Temperature The premise for evaluating rectal temperature post partum   is that an elevated temperature indicates an abnormal health status. More   specifically, in postpartum dairy cows, it most likely indicates a uterine   infection or metritis. Monitoring rectal temperatures will result in a wide   range of values from individual cows. The normal rectal temperature range for   cattle can be from 101.5 to 103° F, where a fever is diagnosed when the   temperature is > 103.0 F. The variation in rectal temperature is   influenced by factors such as health status, age, season of year, and time of   day. Although an individual cow’s body temperature will vary, a   healthy cow maintains a narrow range. A Pennsylvania study (Kristula et al,   2001) reported that cows experiencing no clinical problems at calving or   during early post partum, had an average rectal temperature below 102° F for   each day during the first 10 days postpartum. However, cows with metritis may have rectal temperatures   within the normal range and may not necessarily develop fever. A recent   Florida study (Benzaquen et al, 2004) found that over half of the cows   diagnosed with metritis during the first week post partum did not have a   fever. Cows with an abnormal parturition had rectal temperatures   greater than 103.1 F related to metritis for significantly more days than   cows that calved normally (Kristula and Smith, 2001). Furthermore, cows with   an abnormal calving had a higher incidence of metritis when compared to cows   with a normal calving (Benzaquen et al 2004). From these studies, it can be   concluded that cows with an abnormal calving (dystocia, retained placenta or   twins) should be monitored carefully early post partum. Dairy cows diagnosed with fevers due to metritis during   the postpartum period respond positively to antimicrobial treatment. The   challenge when using monitoring programs is to decide when to treat   cows.Research findings suggest that the majority of cows develop fever within   one week after calving (Benzaquen et al 2004; Kristula and Smith, 2001).   Therefore, monitoring programs using rectal temperature should be put in   place for at least 7 days after calving. Attitude Some people are better than others at identifying sick   cows based on their general attitude or appearance. Farm employees with this   ability must be identified and trained properly. They should be taught to   look at the eyes, ears, presence of uterine discharge and overall demeanor.   Positioning and appearance of the eyes within the socket to access level of   dehydration or pain can be observed and scored. A scoring system such as 1   (minimal), 2 (mild), 3 (moderate), or 4 (severe) can be used (Smith and   Risco, 2005). A cow with a score of 1 usually will have bright eyes that are   positioned normally within the eye socket. A score of 2 will have dull eyes   that are slightly sunken (1-2mm) within the eye socket. A score of 3 will   have glazed eyes that are moderately sunken (2-4 mm) where as a score of 4   will have dry eyes that are severely sunken (>5mm) within the eye socket. Positioning of the cow’s ears is also a good indicator of   a cow’s attitude. Sick cows usually have ears that droop down due to   depression, pain, or fever. Healthy cows on the other hand appear bright,   alert and are curious about their environment. Upon being approached by   someone, a healthy cow will often try to make contact with her nose and   tongue. In those farms that have locking stanchions, the attitude   of the cow can be observed after feeding to evaluate appetite. A cow that is   sick will not eat conversely; a healthy cow aggressively goes after her feed.   In our clinical service we evaluate a cow’s appetite according to these   scoring system; 1) cows that lock and eat, 2) cows that lock but appear dull   and do not eat, and 3) cows that do not lock to eat and appear dull or sick.   Cows that fall in categories 2 or 3 should be monitored or examined   carefully. Milk Production Daily milk production is monitored on many farms. As   mentioned earlier, a sick does not eat and consequently her milk production   drops. Dairy cows with a normal postpartum period have a steady progressive   day-to-day increase in milk production. Determining the deviation value to   identify these sick cows varies between farms. Some managers create a list of   all cows that deviate from a value equal to or more than a preset value. In   most dairies, a 10 pound drop in production is frequently used. Trained   employees will use this deviation list to identify these cows and perform a   thorough physical examination. One goal for cows is a 10% daily milk increase   during the first 14 days post partum (Overton, 2001). Heifers should have an   8% daily increase In addition, a cow should be producing close to 100 pounds   of milk per day by 20 days post partum and heifers 70 pounds per day. Cows   and heifers that do not meet these criteria should be identified and examined   by trained farm personnel. Uterine Discharge A common disorder during post partum and commonly   identified with a health monitoring program is metritis. Although, there is   much debate on the diagnosis of metritis, in our clinical service, cows that   appear sick and have a malodorous discharge from the uterus, regardless of   rectal temperature, are considered to have metritis and require treatment.   Therefore, we feel that evaluation of uterine discharge is important for the   correct diagnosis of metritis. Particularly, as mentioned earlier, some cows   affected with metritis do not develop fever. Discharges that are red-brown, contain   mucus or pus, and are not malodorous should be considered normal. A watery,   foul smelling discharge more often indicates a severe form of metritis that   needs therapy as opposed to a mucoid discharge that more often indicates a   recovery situation. A common method used to evaluate uterine discharge is   palpation of the uterus and visual inspection of the vulva for a malodorous   brownish color discharge. However, this method of diagnosis has the drawback   that it does not always produce discharge outside of the cow. Consequently,   the use of vaginoscopy or the insertion of a gloved clean hand into the   vagina and extending it to the cervix can be used to evaluate discharge. Ketones in Milk or Urine Ketone bodies in urine or milk can be used to diagnose   ketosis in lactating dairy cattle. In our opinion, evaluation of ketosis in   postpartum dairy cows is under used is valuable in diagnosing sick cows. The   cost of subclinical ketosis per cow is estimated to be $78 (Geishauser et al,   2001). Ketosis has been associated with an increased risk to develop   metritis, (Markusfeld, 1984; Markusfeld, 1987; and Reist et al, 2003)   displaced abomasums (Geishauser et al, 1997) and mastitis (Syvajarvi et al,   1986). A negative impact on milk production may also occur and it has been   reported that cows that produce a positive milk ketone test produce 1.0 to   1.4 kg less milk per day for the lactation (Geishauser et al, 1997).   Identification and treatment of cattle suffering from subclinical ketosis in   the immediate postpartum period could reduce the negative side effects of   ketosis. Identification of post partum cows suffering from ketosis is   accomplished either by analyzing urine or milk ketone levels using cowside   tests. These cowside tests are available as powders (commonly used in milk)   and as urinalysis strips. Measuring urine ketone levels is most common   because obtaining a urine sample is uncomplicated, repeatable, and cost   effective. A recent study (Carrier et al, 2004) evaluated the   performance of 3 cowside tests for detection of subclinical ketosis. The   tests were: 1) a commonly used powder for detecting milk acetoacetate   (KetoCheck, Great States Animal Health, St. Joseph MO), 2) a urine strip   detecting ketones (acetoacetate) in urine (Ketostix, Bayer Corporation,   Elkhart, IN), and 3) a milk test strip for ketone bodies (BHBA). The study   concluded that either the Ketostix or milk ketome test strips would provide   acceptable results for screening individual cows on commercial dairies to   detect ketosis, but the KetoCheck would have limited application. Putting It All Together Disorders such as metritis, displaced abomasum and ketosis   can be evaluated by monitoring temperature, attitude, milk production and   urine ketone levels early post partum. A postpartum health monitoring program   assures early identification of cows that are sick. Employing a post partum   health monitoring program, Benzaquen et al (2004) reported that early   treatment of cows with metritis resulted in pregnancy rates comparable to   cows without metritis. This suggests that identification of cows with   metritis early and prompt treatment may ameliorate the effects of metritis on   reproduction. The following are key points to consider in the application of   a post partum health monitoring program. 
                Identify        key farm employees that have the interest to work with and treat sick        cows. Train and work with them on a periodic basis. Have your        veterinarian work with them side by side routinely. The basic premise in        looking for sick cows is that the cow should be evaluated as a whole        considering attitude, rectal temperature, milk production and urine        evaluation for ketone bodies.Create        Standard Operation Practices (SOP’s) for detecting sick cows, physical        examination and treatment procedures for individual diseases. Review        these practices frequently.Based        on farm facilities and employee abilities; you and your veterinarian        should decide which program works best for your herd.It        is important that health monitoring takes place for at least the first        week post partum. Days 3 to 7 appear to be the most critical.Evaluate        attitude, rectal temperature and urine sample for presence of ketone        bodies daily for 10 days post partum.Examine        cows for metritis, displaced abomasum and mastitis if they have fever        (Temp > 103. F) or appear sick, regardless of temperature.Cows        that test positive on a urine ketone sick should be treated for ketosis.Consider        an evaluation of uterine discharge on days 3, 5 and 7 to make sure that        cows with metritis that do not have fever are not missed.Evaluation        of changes in daily milk production for the first 20 days post partum is        a valuable tool that can be used effectively to evaluate health.Look        for sick cows beyond the postpartum period. It is important to recognize        that sick cow monitoring must be performed for all cows. Farm personnel        involved in moving, feeding, milking or breeding cows should be aware        that they play a major role in the identification of sick cows.        Consequently, they too should be trained in how to look for sick cows.        Milkers should also be well trained in how to identify cows with        mastitis. Literature Cited 
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