Beyond fertility to udder health, fresh pen, foot health (Proceedings)

We have talked about supervision and finding treatment failures and conditions that have low odds of successful treatment in an efficient manner that is cost efficient for the dairy, good welfare for the cow and work we'd like to do. These are hollow words unless it can be delivered to the cows in need on a timely basis.

Times have been hard on dairies economically for several years. How can we expect to expand our work in this economic climate regardless of the legalities of AMDUCA, the need for a valid VCPR, or the introduction of a welfare program?

The 1 defined condition / 1 treatment / 1 recording plan we build into the written protocol is exactly the tool to accomplish this and our fertility work schedules allow a modest expansion of work that has huge opportunities for improved the welfare of the cow and clinical effectiveness of the treatments. We can accomplish this in a cost effective way and more importantly we pay for it ourselves by improving the dairies profitability. We have the perfect vehicle already set up on our dairies.

The record system initiated allows us to make a list of all the cows currently under treatment for each management group, check on the accuracy of the record keeping, and compliance with the written protocol at the same time. Additional information can be integrated into the list that identifies cows that the protocols don't cover and need professional care.

Logistically, this works best when we arrive early and initiate the herd check by looking at the lists of the animals being treated for any condition that is of interest. Consider:

     • A summary command of the fresh cow

           o Now we are measuring prevalence rates not incidence rates as a vertical assessment

           o Problem cows are visible as individual animals and are identified before we start

     • A summary command of clinical mastitis cows

           o Prevalence rate and the pattern of scenarios is visible

           o Problem cows are visible as individual animals and are identified before we start

     • Cow or calves treated for diarrhea or pneumonia

           o Problem cows are visible as individual animals and are identified before we start

We consider sufficient knowledge to be knowledge of the herd patterns of conditions and outcomes before we considered the plan for supervision because it is important to have an understanding of them first so that the supervision has value for the herd as well as the individual. Changes in current patterns from historic patterns are the basis for deciding if the recent change should trigger a more in depth investigation.

We know the herds' history:

     • The written treatment definitions, drug protocols, and recording plan

     • The herd's policy toward detection sensitivity and management of mild cases

     • The recent trends in KPI's

     • The production medicine risk factors that are imbedded into the management plan

     • The pattern of conditions and treatment outcomes routinely experienced by the dairy

We can step out of the past into the present with a list of animals currently under treatment for every management group we want to have input into. Arriving early for this portion of the herd check was not said by accident. Since our cows have been released from stanchions and moved into covered yards the commitment of not interfering with the cows resting schedule has become a major factor in the scheduling of herd checks and the time commitment by both the workers and ourselves is usually predictable.

Supervision of the cows under treatment is also reasonably predictable from week to week as to the time commitment for examinations or potential diagnostics. However it is not as predictable as the number of palpations in a pen. It is elective work so the reason to start our assessment of supervision with the treatment records is so we can triage the work that is urgent from work that could be delayed. There will probably be animals that require an examination and there may be animals that only need a visual examination and could be accomplished easy if some is watching for the cow.

The commitment to efficiency of time utilization for all three principles, people, cows, and ourselves is the key to establishing routine supervision efficiently during the herd check. There may be herds where the scheduling of time must be arranged at a separate trip, but the talking portion of the supervision can still be done if we schedule time to do paper portion of the supervision before the herd check.

The value to the producer is evident first by your commitment and then by the recognition of cows that you can instantly spot that you want to make input for or that you may want to examine yourself. (The greatest proof of VCPR is for all three of you to be in the same pen at the same time.)

Table 1 -cows currently in the mastitis pen

The columns can be visualized for the pattern of infections, but when listed by days since mastitis we have the advantage of knowing what stage of convalescence you expect them to be in. Some cows of "interest" that can be seen on this list are:

     • 6124- Primary case in all quarters of a young low cell count cow that is giving 127# milk 1 day since a severe case was detected. – (What should we find today?) (Want a visual or a complete exam?)

     • 5054- Primary case 4 days old in a high producing gram- cow. - (What should we find today?) (Do you want to check to see if the Gram negative is Klebsiella?)

     • 4552- Primary case that is mild in a 4th lactation fresh cow only giving 70# of 5,000,000 SCC milk - (What duration of therapy do you want?)(What outcomes do you expect?)

     • 6357 is still in the treatment pen 14 days after the mastitis - (Why is she there?)

These don't fit a written treatment plan and don't need to because they can efficiently receive the individual care they need whether it is a recommendation, an examination, or diagnostics. Whatever they need the veterinarian, client, and patient are all represented.

The advantage of computerized records for being able to integrate additional information into the summary commands but integration of significant information into a paper record system is equally possible; it merely requires planning how to retrieving the information that has value.

There is one additional aspect to supervision that is a little more difficult to frame into words, but can be very visible in the summary commands which goes beyond epidemiology and medical science. That variable is watching the application of the protocols by the people especially when there is more than one person is involved.

Different people favor different conditions as the cause of a problem. Identifying these tendencies among the workers is part of our back ground knowledge and serves to schedule one on one training cow side, which is exactly the place you have put yourself in at that time.

The foot is the difficult organ system for supervision and it is only second to the udder in the need for a sound plan. While the changes in our housing of putting a roof over the cow yard and replacing the stanchion with a free stall and lock-up has improved comfort. The disadvantage has been the foot needs regular trimming to maintain the proper walking platform for the cow. Addressing the disadvantage to the foot from these facility changes has created a new team member; the hoof trimmer and the need for accurate records and KPI's for all team members because the foot health impacts performance at all other levels. Our fertility schedule is such a natural time to be involved in foot care. We can:

     • Locomotion score (LMS) fertility cows as they are released and it offers the perfect opportunity to assess both the standing posture (LMS3 - arched back standing, no clinically lame foot) and the clinically lame cows (LMS4-5 – arched back standing, clinically lame foot identifiable).

     • Assess convalescence of lame cows by having list of cows in appropriate windows to sort and check LMS at the time other cows are pregnancy checked

     • Recording a locomotion score dry for the cows receiving a pregnancy confirmation pre dry (Key measure of both sensitivity of detection and evaluating outcomes).

     • Monitoring the level of subclinical LMS 3 cows in the herd for planning compliance with the new Farmers Assuring Responsible Management of Animal Care Certification Program.

Incorporating the dairies preparation for the FARM certification program is a natural extension of supervision of drug use and treatment supervision. This program is designed to certify the care and encouraging the discovery of management areas to improve. The manual is long and the assessment questions include all aspects of the dairies management. The dairies are going to need to address the aspects of their plan in the smaller bite size pieces that was build into the supervision of drug usage and identifiable risk factors in management.

It is logical that we become very familiar with the certification requirements so that they become part of the supervision program and actions are taken with the risk factors as their presence is demonstrated by condition patterns and outcomes. This plan is going to be easier to handle a management group at a time not the entire herd.

Conclusion

     • The fertility program is a natural time to supervise all animals under treatment for mastitis, fresh cow problem, pneumonia, and diarrhea.

     • Information can be integrated into the lists of cows under treatment that makes identification of treatment failures and problem cows possible at the time they are under therapy.

     • The pattern of current conditions may identify a change requiring diagnostics.

     • The accuracy of recording can be identified on current cases.

     • All three principles from the VCPR are together which also makes it a time for 1-on-1 training.

     • Identifying the aspects of managements predisposing risk factor and proposing modifications is better done at the teachable moment when the cows are demonstrating the effect.

     • We have early detection of protocol drift.