Metritis complex in Michigan Holstein-Friesian cattle: incidence, descriptive epidemiology and estimated economic impact

Endometrial cytology and ultrasonography for the detection of subclinical endometritis in postpartum dairy cows

The objectives of the study were to validate the use of endometrial cytology (EC) and ultrasonography (US) to diagnose subclinical endometritis in clinically normal postpartum dairy cows, and to measure the impact of subclinical endometritis on reproductive performance. Holstein cows from two dairy farms were examined at Visit 1 (V1) at 20-33 days in milk (DIM), and clinically normal cows (n = 228), based on the absence of abnormal discharge on external inspection and vaginoscopy, were selected. The reproductive tract of selected cows was evaluated by transrectal palpation, US and EC. All cows in the study were re-examined at Visit 2 (V2) at 34-47 DIM (2 weeks after V1) and were subsequently followed for a minimum of 8 months (until pregnant or culled). Survival analysis was used to derive a case definition of subclinical endometritis, based on factors associated with decreased relative pregnancy rate. Positive EC at V1 (>18% polymorphonuclear leukocytes; PMN) or fluid in uterus at V1 (FIU1) were associated with a significant reduction in the relative pregnancy rate and identified cows with subclinical endometritis. Similarly, a positive EC (>10% PMN) at V2 or fluid in the uterus at V2 (FIU2), identified cows with subclinical endometritis. Cows with subclinical endometritis at V1 and at V2 had a relative pregnancy rate of 41 and 51% (hazard ratio for pregnancy of 0.59 and 0.49), respectively, compared to cows without subclinical endometritis. Given EC or US findings, no diagnostic criteria based on transrectal palpation of the uterus had predictive value for risk of pregnancy. In conclusion, subclinical endometritis, diagnosed by EC or US, was associated with reduced relative pregnancy rate.

Efficacy of ceftiofur hydrochloride sterile suspension administered parenterally for the treatment of acute postpartum metritis in dairy cows

OBJECTIVE

To evaluate the efficacy of ceftiofur hydrochloride sterile suspension administered parenterally for treatment of acute postpartum metritis (APM) in dairy cows.

DESIGN

Multilocation, randomized block, field trial.

ANIMALS

406 cows in the first 14 days postpartum.

PROCEDURE

Cows with rectal temperatures > or = 39.5 degrees C (103.1 degrees F) without clinical signs of respiratory or gastrointestinal tract disease and with a fetid vaginal discharge were allocated randomly in blocks of 3 to 3 treatment groups: sterile saline (0.9% NaCl) solution administered at a dosage of 2 mL/45.4 kg (2 mL/100 lb), SC or IM, once daily for 5 days (control); or ceftiofur hydrochloride administered at a dosage of 1.1 or 2.2 mg of ceftiofur equivalents (CE)/kg (0.5 or 1 mg/lb, respectively), SC or IM, once daily for 5 days. Cows were evaluated on days 6, 10, and 14, and clinical cure or failure to cure was determined. Clinical cure was defined as no additional antimicrobial treatment administered, rectal temperature < 39.5 degrees C, and absence of a fetid vaginal discharge.

RESULTS

On day 14, clinical cure rates were 77%, 65%, and 62% for the 2.2 mg of CE/kg, 1.1 mg of CE/kg, and control groups, respectively. No significant differences were detected in clinical cure rates between control and treatment groups on day 10 or 6.

CONCLUSIONS AND CLINICAL RELEVANCE

Ceftiofur hydrochloride administered at a dosage of 2.2 mg of CE/kg, SC or IM, once daily for 5 days was efficacious for treatment of APM in dairy cows.

Relationships of Efficiency to Reproductive Disorders in Danish Milk Production: A Stochastic Frontier Analysis

Relationships of various reproductive disorders and milk production performance of Danish dairy farms were investigated. A stochastic frontier production function was estimated using data collected in 1998 from 514 Danish dairy farms. Measures of farm-level milk production efficiency relative to this production frontier were obtained, and relationships between milk production efficiency and the incidence risk of reproductive disorders were examined. There were moderate positive relationships between milk production efficiency and retained placenta, induction of estrus, uterine infections, ovarian cysts, and induction of birth. Inclusion of reproductive management variables showed that these moderate relationships disappeared, but directions of coefficients for almost all those variables remained the same. Dystocia showed a weak negative correlation with milk production efficiency. Farms that were mainly managed by young farmers had the highest average efficiency scores. The estimated milk losses due to inefficiency averaged 1142, 488, and 256 kg of energy-corrected milk per cow, respectively, for low-, medium-, and high-efficiency herds. It is concluded that the availability of younger cows, which enabled farmers to replace cows with reproductive disorders, contributed to high cow productivity in efficient farms. Thus, a high replacement rate more than compensates for the possible negative effect of reproductive disorders. The use of frontier production and efficiency/inefficiency functions to analyze herd data may enable dairy advisors to identify inefficient herds and to simulate the effect of alternative management procedures on the individual herd's efficiency.

Comparison of ceftiofur hydrochloride and estradiol cypionate for metritis prevention and reproductive performance in dairy cows affected with retained fetal membranes

The objective of this study was to compare the effect of ceftiofur hydrochloride and estradiol cypionate (ECP) administration for metritis prevention and reproductive performance in dairy cows affected with retained fetal membranes (RFMs). After parturition, 97 dairy cows affected with RFM from a single dairy herd were randomly allocated to 1 of 3 treatment groups. Cows in-group 1 (n=31) were treated daily for 5 days with ceftiofur hydrochloride (2.2mg/kg, i.m.); cows in group 2 (n=33) were treated once with ECP (4 mg, i.m.); and cows in group 3 (n=33) were not treated. The proportion of cows with metritis, uterine involution patterns and the calving-to-conception interval were compared between groups. The proportion of cows that developed metritis was significantly different (P<0.05) in cows treated with ceftiofur hydrochloride (13%), compared with cows treated with ECP (42%) or cows that received no treatment (42%). Uterine involution patterns (i.e. median time to complete retraction of the uterus and mean diameter measure of cervix and uterine horns) were not significantly different between groups. Cows treated with ECP were 0.40 times as likely to conceive as control cows (P=0.05); median time to conception in cows treated with ECP (192 days) was longer, compared to control cows (124 days). We conclude that systemic administration of ceftioufur hydrochloride is beneficial for prevention of metritis, but its effect on reproductive performance was not significantly different to that of ECP or no treatment. In addition, administration of ECP did not have beneficial effects on metritis prevention and reproductive performance.

Defining and diagnosing postpartum clinical endometritis and its impact on reproductive performance in dairy cows

The objectives of this study were to validate diagnostic criteria for clinical endometritis in postpartum dairy cows and to measure the impact of endometritis on reproductive performance. Data were collected from 1865 cows in 27 herds, including history of dystocia, twins, retained placenta, or metritis. All cows were examined once between 20 and 33 d in milk (DIM) including external inspection, vaginoscopy, and transrectal palpation of the cervix, uterus, and ovaries. All cows were followed for a minimum of 7 mo or until pregnancy or culling. Survival analysis was used to derive a case definition of endometritis based on factors associated with increased time to pregnancy. The significance of clinical findings depended on the interval postpartum when examination took place. The presence of purulent uterine discharge or cervical diameter > 7.5 cm after 20 DIM, or mucopurulent discharge after 26 DIM identified cows with clinical endometritis. Given vaginoscopy, no diagnostic criteria based on palpation of the uterus had predictive value for time to pregnancy. The prevalence of clinical endometritis was 16.9%. Vaginoscopy was required to identify 44% of these cases. Accounting for parity, herd, and ovarian status, cows with clinical endometritis between 20 and 33 DIM had a hazard ratio of 0.73 for pregnancy (took 27% longer to become pregnant), and were 1.7 times more likely to be culled for reproductive failure than cows without endometritis.

Risk factors for metritis in Danish dairy cows

A retrospective longitudinal study of metritis was conducted in Denmark on data collected during 1993-1994. Data on herd size, breed, parity, and treatment of disease were obtained from the Danish Cattle Database. Management and production-facility data were collected using a questionnaire, conducted as a telephone interview in 1994. The study included 2144 herds from three regions in Denmark (102,060 cows). Herd-level variables included were: herd size, housing, flooring, grazing, calving measures, and calving supervision. Cow-level variables were: parity, breed, calving season and whether the cow had been treated by a veterinarian for dystocia or the diseases: retained placenta, reproductive disease, ketosis, milk fever, or dry cow mastitis. Marginal multivariable logistic-regression analyses were performed. The cow with highest odds of metritis was a first or greater than or equal to third parity cow, of large breed, that calved during November-April, in a zero-grazing herd. The cow had been treated for dystocia, retained placenta, and at least one other reproductive disease, but not for ketosis.

Multilocation trial of ceftiofur for treatment of postpartum cows with fever

OBJECTIVE

To evaluate the effect of ceftiofur for treatment of postpartum cows with fever.

DESIGN

Multilocation randomized complete block design trial.

ANIMALS

330 cows.

PROCEDURE

Cows with rectal temperature > or = 39.5 C (103.1 F) during the first 10 postpartum days were randomly assigned to a treatment (ceftiofur; 1 mg/kg [0.45 mg/lb] of body weight daily for 3 days) or untreated control group. Cure (no additional or alternative antimicrobial treatment used, rectal temperature < 39.5 C, and no other concurrent clinical signs of disease when evaluated at 9 or 10 days after enrollment), milk production, and rectal temperature were evaluated.

RESULTS

Ceftiofur-treated cows were significantly more likely to be cured than control cows (56.0 vs 28.9%, respectively), with an odds ratio of 3.14 when vaginal discharge (a factor with moderate interaction with treatment) was present at enrollment. Among cows that had an abnormal calving (a significant interaction factor), treated cows had first milking yield 2.27 kg (5 lb) greater than control cows. Treated cows had a significantly greater reduction in rectal temperature (1.19 C [2.14 Fl), compared with control cows (1.04 C [1.87 F]).

CONCLUSIONS AND CLINICAL RELEVANCE

Parenteral administration of ceftiofur significantly improved cure rate, milk yield, and rectal temperature in postpartum cows with fever and vaginal discharge or dystocia. These findings provide information to determine appropriate treatment for postpartum cows, which for years has been debated in the dairy industry.

Evaluation of a systemic antibiotic treatment of toxic puerperal metritis in dairy cows

The objective of this study was to evaluate the efficacy and economic efficiency of a systemic treatment of toxic puerperal metritis in dairy cows with ceftiofur. Cows with abnormal vaginal discharge at a postpartum examination (d 4 to 6 after calving) and a rectal temperature > or = 39.5 degrees C were assigned to three treatment groups. Cows in group 1 (n = 70) received 600 mg of ceftiofur intramuscularly (i.m.) on 3 consecutive days. Cows in group 2 (n = 79) received an intrauterine treatment with antibiotic pills consisting of 2500 mg of ampicillin and 2500 mg of cloxacillin and an additional 6000 mg (i.m.) of ampicillin. This treatment was performed on 3 consecutive days. Cows in group 3 (n = 78) received the same intrauterine treatment as in group 2. In addition, 600 mg of ceftiofur was administered i.m. on 3 consecutive days. Body temperature was recorded daily for 6 d after first treatment. There were no significant differences among the groups regarding clinical efficacy at d 6 after first treatment. The cure rates based on rectal temperatures declining to below 39.5 degrees C on d 6 after treatment were 82.9, 84.8, and 84.6% for groups 1, 2, and 3, respectively. Reproductive performance did not differ significantly between group 1 and groups 2 and 3 for any of the measures tested. A financial analysis with 87 different cost scenarios demonstrated that a systemic treatment of toxic puerperal metritis in cattle with ceftiofur is an effective alternative to the combination of local and systemic treatments.

Effect of disease on reproduction in the dairy cow: a meta-analysis

Effects on reproduction of dystocia, stillbirth, abortion, milk fever, retained placenta, metritis, cystic ovaries, anestrus, ketosis, displaced abomasum, locomotor disorders, and mastitis were reviewed. Papers were considered if they provided quantitative estimates of diseases on days to first estrus, days to first service, conception rate at first service, days from first service to conception, days to conception or days open, calving interval, conception rates at various days post partum (dpp), and number of services per conception or per cow. Only papers in English in peer-reviewed journals were selected for analysis of post 1960 data from intensive dairy regions. Seventy papers fulfilled the selection criteria. Summary estimates of disease effects were calculated according to meta-analysis methods, and study designs were described in detail to identify possible heterogeneity of the results. Stillbirth, milk fever, displaced abomasum and mastitis had no effect on reproduction. Clinical ketosis, dystocia and retained placenta were associated with 2 to 3 more days to first service and with a 4 to 10% lower conception rate at first service, resulting in 6 to 12 more days to conception. Locomotor disorders were associated with an average increase of 12 d to conception, with wide variation depending on lesions and stage of occurrence. Metritis was associated with 7 more days to first service, 20% lower conception rate at first service, resulting in 19 more days to conception. Cystic ovaries were associated with 6 to 11 more days to first service and with 20 to 30 more days to conception. Anestrus was associated with 26 more days to first service and with an 18% lower conception rate at first service, resulting in 41 more days to conception. Abortion was associated with 70 to 80 more days to conception.

Risk factors for post partum ovarian dysfunction in high producing dairy cows in Belgium: a field study

An epidemiological study of risk factors for postpartal ovarian disturbances was carried out on 334 high-yielding dairy cows in 6 well-managed Belgian herds. Ovarian activity was closely monitored using progesterone profiles, based on twice weekly RIA-analysis for progesterone in milk fat, starting at 10 d after calving and continuing until the confirmation of a new pregnancy. Attention was focused on abnormal cyclicity during the preservice, postpartum period; cows were divided into 6 different categories. Three of these categories (normal profile, delayed cyclicity, and prolonged luteal phase) were of major importance and were analyzed using a multiple variable logistic regression model. Season of calving (stable vs pasture, odds ratio (OR)=5.7), an extended length of the previous dry period (> 77 vs < or = 63 d, OR=2.9), problem calvings (OR=3.6), abnormal vaginal discharge (OR=4.5), health problems during the first month of lactation (clinical disease, OR=5.4; ketosis, OR=11.3), and clinical parameters illustrating the appearance of a severe negative energy balance significantly increased the risk for delayed cyclicity before service. Parity (> or = 4 vs 1, OR=2.5), problem calvings (OR=2.9), occurrence of puerperal disturbances (OR ranged from 3.5 to 11.0), health problems during the first month of lactation (OR=3.1), and an early resumption of ovarian cyclicity after calving (< 19 d vs > 32 d, OR=2.8) increased the risk for prolonged luteal cycles before service.

A review of the feeding-health-production complex in a dairy herd

Diseases may be an important link in the relationship between feeding and production in a dairy herd. The low frequency of relevant disorders calls for studies on survey data on a large population. However, this approach suffers from lack of detailed herd feeding data and consequently only few have studied feeding as a risk factor for disease. Therefore, we reviewed information from various studies to integrate what is known of the feeding-health-production complex in a dairy herd. The need for putting together information from different sources, the herd effects, and the fact that the effect of one factor cannot be kept constant for investigation in a real-life dynamic herd call for a conceptual model as a framework for the review. The complexity is minimized to allow the representation of important elements. Within-cow relationships (such as feeding-disease relationships, disease interrelationships, and disease-production relationships) are reviewed specifically for: ketosis, milk fever, displaced abomasum, acidosis, sole ulcers and laminitis, and bloat. The major feeding management factors involved are concentrate feeding (level and how it is provided) and overconditioned cows. Disease interrelationships are important. Generalization of production loss from diseases is complicated due to the variety of estimates and measures used.

Comparison of various antibiotic treatments for cows diagnosed with toxic puerperal metritis

Holstein cows (n = 51) that had been diagnosed with toxic puerperal metritis were used to determine the treatment efficacy of various antibiotics. On the day of diagnosis, cows affected with toxic puerperal metritis were assigned randomly to three treatment groups. Cows in groups 1 and 2 received 22,000 IU/kg of procaine penicillin G i.m. for 5 d. In addition, cows in group 2 received an intrauterine infusion of 6 g of oxytetracycline on d 1, 3, and 5. Cows in group 3 received 2.2 mg/kg of ceftiofur sodium i.m. for 5 d. Dependent variables used to determine antibiotic efficacy included milk yield on d 1 through 12, rectal temperature on d 1 through 5, and serum haptoglobin concentration on d 1, 3, and 5. No difference was observed among groups for milk yield on d 1 and 12 or for temperature on d 1 and 5. Serum haptoglobin was elevated to > 10 mg/dl for cows in all groups; however, no difference was observed among groups on d 1 and 5. Because all groups showed a favorable response, this study suggests that there is no difference in treatment efficacy among antibiotics used to treat cows affected with toxic puerperal metritis.

Uterine health and disorders

Nonspecific uterine infections reduce the reproductive efficiency of cows and the profit potential of dairy farms. Fortunately, most cows do not develop severe uterine infections. The term uterine infection indicates that the uterus is contaminated with pathogenic organisms. Actinomyces pyogenes, either alone or with other bacteria, is often associated with uterine infections. When A. pyogenes was isolated from uterine fluids after d 21 postpartum, cows developed severe endometritis and were infertile at first service. However, the exact causes of uterine infections are unknown but are associated with several factors. Cows with dystocia, retained placenta, twins or still-births, and various metabolic disorders are more likely to develop metritis than are other cows. Aberrant immune function before and after calving seems to predispose cows to severe uterine infections. Few cows die from uterine infections, but cows with uterine infections are more likely to be culled for poor reproductive performance. Also, uterine infections can reduce milk production, and some treatments contaminate milk. Because they are nonspecific, uterine infections are difficult to prevent; attention to sanitation and periparturient hygiene, especially during assisted calving, may be the best defense. Evidence that aberrant immuno function predisposes cows to uterine infections indicates that methods for regulating immune function in periparturient cows have the potential for preventing or treating uterine infections.

Body measurements, metritis, and postpartum performance of first lactation cows

Effects of herd, sire, season, body height, BW, age at calving, and metritis on future performance of first lactation cows were evaluated in eight commercial Israeli Holstein herds. Short, heavy first lactation cows had an odds ratio of 3.1 of incidence of metritis at calving compared with all others; 648 first lactation cows were measured at wk 1 postpartum. Sire, herd, age, height, season, and BW contributed to peak milk yield. Metritis did not affect peak yield. Herd, sire, height, and age contributed to mature equivalent corrected 305-d milk yield. No effect was found for BW, season, or metritis. Herd was the only variable contributing to month of peak yield and rate of monthly drop in yield. Interactions between BW, height, and incidence of metritis were significant. Tall, heavy first lactation cows with metritis peaked higher and yielded more than those without metritis. Short, light first lactation cows with metritis yielded less and peaked lower than their healthy counterparts. Metritis did not affect future fertility, but season and the interaction between BW and height did. Tall, heavy first lactation cows had a lower pregnancy rate from first AI, independent of milk yield. The relative importance of height as a predictor of future milk yield is underestimated. The interaction between height and BW may have an antagonistic effect on yield and fertility.

Impaired post partum neutrophil function in cows which retain fetal membranes

The post partum neutrophil function in cows which had retained fetal membranes (RFM) for at least 24 hours post partum were compared with matched herdmates which had not retained their fetal membranes. Cows from a single dairy herd which had spontaneously occurring RFM (n = 8) were matched with herdmates (n = 8) which had calved within 48 hours before or after them and had not experienced RFM. Blood samples were collected from the cows three times post partum: two to five days, three weeks and six weeks. Neutrophils were isolated by differential centrifugation followed by hypotonic lysis of erythrocytes. In vitro neutrophil function was assessed by superoxide anion (O2-) generation and by stimulus-induced shape change. Neutrophils from cows with RFM produced significantly less superoxide anion during the first week post partum and six weeks post partum. Cows with RFM had impaired neutrophil shape change immediately post partum. Shape change responsiveness increased in both groups from the first post partum week to three weeks post partum.

Pharmacologic considerations in the management of peripartum conditions in the cow

As is true with the use of drugs in veterinary medicine in general, there are many controversial issues in the management of peripartum conditions in the cow. For example, the use of PG versus antibacterial drugs in the management of postpartum uterine infections has advocates for the use of either approach. Intrauterine versus systemic administration of antibacterial drugs for the prophylaxis or treatment of postpartum metritis is another area of debate. Clearly, more research is needed in this area. Equally clearly, however, the research results that are available are being disregarded on a daily basis. In considering this discussion of the use of drugs in the peripartum period, one is struck by the frequency that optimum drug therapy of a condition relies on the extralabel use of nonapproved preparations. What guidelines are available to the practitioner in this regard? One example is lack of availability of appropriate dosage regimens or withdrawal times for food derived from treated animals. Unfortunately, pharmacokinetic and residue studies that would aid in establishing guidelines generally are not available and, in most instances, are not forthcoming. Extrapolation of data from other species to the ruminant or extrapolation of information from one drug to a related compound (such as prediction of residue and withdrawal data from an approved aminoglycoside, dihydrostreptomycin, to another unapproved drug, gentamicin) is fraught with difficulties. The need for research in this area is obvious, and lack of such information is one of the major dilemmas in trying to establish rational drug therapy in the food-producing animal. Recent developments in drug therapy have led to innovative approaches for the management of peripartum and other diseases in cattle. The use of PG in the treatment of reproductive disorders, so commonplace and widely accepted in contemporary veterinary practice, is a relatively recent approach that continues to be refined with the development of new, more potent, more specific PG analogs. What will be the role of ceftiofur, a potent, third-generation cephalosporin that currently is approved only for the treatment of respiratory infections in cattle, in the management of reproductive tract infections? The fluoroquinolones, which represent a novel approach to the control of infectious diseases, are being increasingly used in veterinary and human medicine, and one may predict that these powerful antimicrobial drugs will find application in bovine practice, including for the treatment of peripartum infections. Pharmacologic manipulation of immune and defense mechanisms also is an approach with some promise.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of disease on days open assessed by survival analysis

Survival analysis, a regression technique for analyzing data in which the time to an event is the measured outcome, was used to quantify the effects of five common herd diseases on days open in dairy cattle. Data were collected retrospectively from health and production records of 467 cows in five herds. In the 5-yr study period, 1059 lactations were followed to a conception or culling event. Retained placenta, nonsystemic metritis, systemic metritis, ovarian cysts, and lameness were associated with a decrease in conception rate and an increase in median days open. The hazard ratios for conception were .66, .83, .70, .70, and .69 and the increase in median days open 5, 15, 13, 22, and 28 d for the five diseases, respectively. Several attributes of survival analysis make it a valuable tool for quantifying days open in dairy cattle, including the ability to use reproductive information from observations which fail to conceive. Additionally, results obtained from survival analysis complement economic and decision analyses and will facilitate accurate cost assessment of suboptimal reproductive performance.

Impact of protein nutrition on reproduction in dairy cows

In most but not all published studies, feeding diets with high concentrations of crude protein decreased reproductive efficiency. We were able to resolve some of the inconsistencies among published reports by considering the fate of consumed protein in the rumen and then using logistic regression analysis to identify factors affecting pregnancy. Our models showed that type and amount of protein fed explained much of the variation in conception rate. Age and dietary concentration of energy were identified as modifiers of the impact of protein on reproduction. Protein nutrition can affect reproduction through toxic effects of ammonia and its metabolites on gametes and early embryos, through deficiencies of amino acids, and by exacerbations of negative balances of energy. Alterations in the hypothalamic-hypophyseal-ovarian axis may be responsible for many of the effects of protein on reproduction.