Records, records, records (Proceedings)

Everything we have discussed to this point is actually about establishing a records plan that will allow us to serve the dairy industry of the future using the records that are efficiently gathered so we are not spending all of our time keeping or organizing the records. As our herds get larger, as the number of animals examined at any one time increases, as we are examining groups of diverse animals at one time, and as we struggle to maintain a cow side presence, the organization of the records becomes more critical.

We have considered first very traditional treatment records that we used for tracking well defined conditions recognized as known parts of dairy management. In summary:

The written treatment protocols that included the record keeping instructions for 1 defined condition/ 1 treatment / 1 recording allows us to proactively manage health issues of the individual cow that are expected.

The records supplied medical history to use during the treatment decision

Presented a reference point for predicting and accessing a cows progress during therapy

They collate to allow supervision of all cows under treatment and for detection of treatment failure during the current treatment

The collated records were tabulated to identify the pattern of a condition

By age, by stage of lactation, by severity, by cause, by subclinical history, by clinical history

Successful treatment outcomes can be defined and the proportion successful tabulated for the various subsets of animals needing a treatment decision

This sets stage for arriving at medically appropriate drug plans

Clinical effectiveness can be defined and assessed

Predisposing risks imbedded in the care package can be identified and managed around

SOPS can be proactively modified to match predicable health challenges for each management group.

Management programs can be modified to remove the risk.

KPIs that have value for the variety of management team responsibilities can be developed

Every member of the herds' team can monitor and communicate about proposed modifications in the care plan using actual herd data as a sound foundation

Each management team member can include KPIs they want others to see

Records can demonstrate accountability of early detection policies, detection of mild case, and medically appropriate drug usage for all severities

Supervision of all current treatment can be incorporated into the fertility programs in place

Supervision presents the teachable moment for one on one coaching cow side

The Wisconsin state licensing board has listed some statements in the past about how they measured the VCPR including:

The veterinarian not client determine the need for Rx drugs

There is always the consideration of what is wanted versus what is needed. We started with what was wanted and then worked to what was needed.

Definitions and treatment plans would accomplish this

Plan for treatment of medical conditions and include all veterinary recommendations

Written treatment plan for responsible manager accomplished this and offered the opportunity to achieve the letter of the law not just the intent of the law

Maintain prescription records of drug usage on the dairy

Accomplished

The veterinarian record information about history, symptoms diagnose, and diagnostics

Supervision plan accomplished this

Be available for adverse reactions and timely examination

Accomplished with supervision and care of treatment failure at the herd check

Examining board tended to define adverse reaction as a drug anaphylactic reaction while the consumer is clearly more concerned about the treatment failures.

When the treatment plan is not working provide additional recommendations

Supervision reveals protocol drift and identifies treatment failures

Supervision allow groups under treatment to identify potential need for herd diagnostics

There is a tradition record which is not a treatment record that offers a lot opportunity to aid in the profitability of the dairy. Cull and death records are currently kept but the remark has not been organized to give the valuable management information that is possible on most dairies. As an example we defined a threshold of 60 days for retention in a herd as one of the measures of successful outcomes for a mastitis cow. In actuality those that are sold in less than 60 days after a case are in three categories:

Those that the mastitis case caused an untimely removal from the herd

Those the case was the tip point for a cow that would have been sold anyway

Those that the case had no effect, but just happened less than 60 days before being marketed.

The economic lose to the first category is really the information we are seeking. The foot, lung, and fresh cow culls all have similar considerations about their impacts on culling time and determining the actual economic and welfare affects of the systems. Clearly there needs to be a better recording plan for identifying the primary and secondary reasons if we want to manage the marketing of animals. Meat quality and profitability of when to harvest meat are future considerations that will be met.

Death losses are even more critical to us and the culling philosophy must be factored into the welfare consideration for a dairy relative to death rate not a predetermined threshold for the industry.

It is a fact that all animals are going to die or be marketed at some point in time for the dairy.

If a herd does not want to market animals the existing animals are aging and the risk of dead from the variety of final terminal health events is increasing.

The remark needs to reflect if this death is truly unexpected and a cause of death by post mortem examination was done to be able to manage the health aspects of the cows. Or was the animal maintained on the dairy so that it faced a "normal" "expected" terminal condition that does not reflect a herd condition that needs diagnostic consideration.

Clearly our recordings at death need to address our lack of knowledge currently on all dairies and just as record keeping was organized for traditional health events it can be simplified to a handful of meaningful recordings instead of the colorful recordings available currently.

Organizing the traditional treatment records into back bone of what we offer a dairy relative to the defined conditions can accomplish a high return for the dairy from our work but this traditional record keeping is not the end of our opportunity to learn and organize work on the dairy.

There are also some non-traditional uses of records that require a bit of thinking outside the box that may be as valuable as measuring epidemiology and outcomes. Our concentration has been on the cow, bugs, and drugs. There is another major player; people:

There is much to be learned by studying the patterns of the people that work cow side.

We can't change the fact that different people interpret words in their own manner but we can learn to recognize individual recording patterns.

Different people are at different levels of competency, compliance, and even in their ability to think independently. This sound threatening, but it doesn't need to be. It is merely recognizing what coaching needs to be done.

We routinely face animals that don't fit into the cubby holes defined by our treatment protocols

This concept of using non-traditional recordings that send our selves messages into future about situations that don't fit into the defined categories is one of the most challenging yet necessary record plans to establish on a dairy.

We routinely face:

Animals that appear to have a medical problem but cannot be diagnosed

Fresh cows that don't to have a medical problem but do not produce as expected

Cows that lack persistency of production but without a diagnosable reason.

Fresh cows that can be recognized as likely to leave the herd at less than 60 DIM

The undiagnosed medical problem represents and animal that needs to be watched in the future because we feel there something wrong but nothing that matches a defined condition.

Some have a minor issue that is going to spontaneous cure

Some were detected before symptoms have progressed to a point of being recognized

Some are obscure conditions requiring deep diagnostics to reach a diagnosis

We have recognized these categories in the past but the advent of the daily milk weight technology has made detection of these categories easier. Milk weights don't appear once a month, they appear every milking. Getting these undiagnosed cows recorded as watch cows prevents them from disappearing back into the herd and being forgotten or requiring our detection screens to find them again. That animal can then be monitored just as if she were under treatment by creating a list of these cows daily. From a practical standpoint some of these will spontaneously respond, so will deteriorate and an immediate re examination will be done, or some may just linger and need to be re examined in but as elective work.

A similar none traditional use of a cows records when there are multiple people involved in health care is how do we mark the record when a cow is detected that will either die or be marketed within 60 days for a medical reason. There are very few animals that are sold or die at <60 DIM that couldn't be recognized well before either event occurred. Management of these two categories of animals means that an opinion needs to reach the records for each animal that can be collated into herd information before they leave.

If they receive a recording into an event named "will" they can be professionally examined, their medical records examined and an opinion entered into their record that categorizes why. The recognition of these animals plus collated information from the herd allows as much management of this category of cows as possible.

A final non-traditional use of records that are gathered for individual animals with the intention of collating the results into categories of animals that can lead to prevention is the fresh cow that does not milk up to the expectations of the herd. These cows' milk below a threshold of production set by the dairy and just fail to peak. Again most don't have a definable condition that can be treated. As with the other non- traditional categories they need to be examined and their history examined and an opinion entered into their records about why they didn't peak. Certainly the history is an important consideration because it is unlikely that the reason is recent. This information is usually not about doing something for the individual in question. It may include a prognosis for that individual that has value for the management, but the work is done primarily to detect management issues from her past that can be corrected for future cows if a pattern of these is recognized in this category of cow.

Anything that is suspected of creating issues or that needs to be monitored can initiate a record keeping initiative to either prove it or disprove it. The statement "if we can measure it we can manage it" is true.

Conclusion

There are traditional records about health care that validate the VCPR that we used to increase our offering to the dairies as veterinarians.

There are non-tradition recordings for the cows that don't fit dairy science categories that need to be managed that require us to establish something unique as a recording.

Watch cows that appear to have a medical problem but are undiagnosed and we want to "watch" their progress.

Will cows that are recognized as the animals the "will" likely leave the herd as fresh cows and we'd like an opinion about why before they leave.

Non-achiever cows that stumble to a start with no diagnosable condition responsible. These we'd also like as educated opinion as possible to make management changes to prevent.