Specific Challenges in Conducting and Reporting Studies on the Diagnostic Accuracy of Ultrasonography in Bovine Medicine

Literature Review of the Principal Diagnostic Tests to Detect Bovine Respiratory Disease in Pre-Weaned Dairy and Veal Calves

Bovine respiratory disease (BRD) is an infection of the upper and lower respiratory tract, characterized by an inflammation of the lung. Different diagnostic tests can be used to detect BRD, including clinical respiratory scoring systems, thoracic auscultation, and imaging tests like thoracic ultrasonography and thoracic radiography. Although commonly used, none of these diagnostic tests are perfect for detecting BRD. This article reviews the advantages and drawbacks of these techniques and their performance in detecting BRD in pre-weaned dairy and veal calves.

Diagnostic and Prognostic Value of Clinical Scoring and Lung Ultrasonography to Assess Pulmonary Lesions in Veal Calves

This study on veal calf respiratory disease assessed the association between an on-farm clinical scoring system and lung ultrasonography with the postmortem inspection of the lungs. The comparisons allowed the calculation of predictive values of the diagnostic methods. In total, 600 calves on an Austrian veal calf farm were examined at the beginning and the end of the fattening period. Overall, the area under the curve (AUC) for ultrasonographic scores was 0.90 (rsp = 0.78) with a sensitivity (Se) of 0.86. The specificity (Sp) was 0.78, and the positive predictive value (PPV) was 0.74. The AUC for the physical examination was 0.76 (rsp = 0.55) with a Se of 0.64, an Sp of 0.81, and a PPV of 0.69. For the combination of ultrasonography and physical examination, an AUC curve of 0.85 (rsp = 0.69) was calculated. A Se of 0.65 and a Sp of 0.88 with a PPV of 0.73 was calculated. This study concluded that both physical and ultrasonographic examination scoring are reliable examination methods for the detection of lung diseases in veal calves.

Interpretation and Analysis of Individual Diagnostic Tests and Performance

Diagnostic tests are performed daily by bovine practitioners at the individual and population level. At the individual level, they help not only for making a diagnosis, but can also serve to rule in or rule out a specific condition, monitor treatment response, establish a prognosis, or to determine infection status. Performing an individual diagnostic test is technical; however, its interpretation and contextualization requires medical and epidemiologic skills that veterinary practitioners are able to master. This article shows the added value of the context of test prescription and correct interpretation highlighting the central role of the veterinary practitioner.

Comparison of thoracic ultrasonography and thoracic radiography to detect active infectious bronchopneumonia in hospitalized dairy calves

Background

The best test between thoracic ultrasonography (TUS) and thoracic radiography (TR) or the best combination of tests (series or parallel) to detect active infectious bronchopneumonia (BP) in hospitalized dairy calves remains unknown.

Hypothesis/Objectives

To estimate performances of TUS and TR to detect active BP in hospitalized dairy calves and to determine the best strategy for using these tests based on a panel diagnosis method (PDM). Performances of TUS and TR were hypothesized to be equivalent.

Animals

Fifty hospitalized dairy calves (≥7 days old; ≤100 kg; standing; pCO₂ ≥ 53 mm Hg; any reason of presentation).

Methods

Each calf prospectively and sequentially underwent physical examination, thoracic auscultation, blood analyses, and TUS and TR. Three blinded experts determined whether active BP was present/absent based on PDM. Krippendorff's alpha measured interexpert agreement. The sensitivities (Se) and specificities (Sp) of TUS and TR alone and in series or parallel were compared (McNemar's test; P < .05).

Results

Interexpert agreement was moderate at 0.58 (95%CI: 0.42; 0.73). The Se and Sp of TUS were 0.84 (95%CI: 0.60; 0.97) and 0.74 (95%CI: 0.57; 0.86), respectively. The Se and Sp of TR were 0.89 (95%CI: 0.67; 0.99) and 0.58 (95%CI: 0.39; 0.75), respectively. No significant difference was found in the Se and Sp of TUS and TR when analyzed alone, in series or in parallel.

Conclusion

Thoracic ultrasonography or TR alone equally detected active BP in hospitalized dairy calves. Series or parallel analysis provided no additional benefit. Its ease of use and widespread accessibility support using TUS as a first‐line test to detect active BP in hospitalized dairy calves.

Bovine Respiratory Disease Diagnosis: What Progress Has Been Made in Clinical Diagnosis?

Bovine respiratory disease (BRD) complex is a worldwide health problem in cattle and is a major reason for antimicrobial use in young cattle. Several challenges may explain why it is difficult to make progress in the management of this disease. This article defines the limitation of BRD complex nomenclature, which may not easily distinguish upper versus lower respiratory tract infection and infectious bronchopneumonia versus other types of respiratory diseases. It then discusses the obstacles to clinical diagnosis and reviews the current knowledge of readily available diagnostic test to reach a diagnosis of infectious bronchopneumonia.

Development of a clinical scoring system for bovine respiratory disease in weaned dairy calves

Clinical scoring systems for bovine respiratory disease (BRD) in weaned dairy calves have been developed in the past with calves experimentally infected with specific respiratory pathogens. In this prevalent case control study, a BRD clinical scoring system for weaned calves was developed using field data from 689 dairy calves housed in group pens on 5 dairies in California. Of the 689 calves in the study, 89 were selected because they appeared sick based on the display of lethargy, depression, or separation from the group, whereas the remaining 600 were randomly selected. Clinical signs were recorded for all calves, and BRD case status was determined by thoracic auscultation and ultrasound examinations, which were interpreted in parallel. Of the 689 calves, 238 were identified as BRD cases. Five survey-adjusted generalized linear mixed models with a logit link function, calf as the unit of analysis, and dairy as a random intercept were assessed using 3-fold cross-validation. The best model chosen based on performance and parsimony contained the variables cough (2 points), abnormal respiration (1 point), low body condition (5 points), sunken eyes (4 points), and a 24-h ambient temperature range >15°C (1 point) with a 2-point cutoff for a BRD suspect score. An alternative model did not contain a score for the covariate 24-h ambient temperature range and had a 1-point cutoff. The best model was tested on 174 observations not used for model training and resulted in 77.0% screening sensitivity, 100% diagnostic sensitivity, and 61.9% specificity. Adding rectal temperature ≥39.2°C (102.5°F) as a second-tier test increased specificity to 76.7% and lowered the screening sensitivity to 64.8% and diagnostic sensitivity to 76.9%. The alternative model had a screening sensitivity of 84.2%, diagnostic sensitivity of 100%, and specificity of 45.7%. Adding rectal temperature ≥39.2°C (102.5°F) as a second-tier test for score-positive animals improved specificity of the alternative model to 62.6% while lowering its screening sensitivity to 70.5% and diagnostic sensitivity to 76.9%. Use of a 2-tier California BRD postweaning scoring system may provide producers and veterinarians with a new tool to monitor BRD in group-housed dairy calves. Furthermore, the scoring system may aid in judicious medical intervention for BRD cases and reduce unnecessary treatments of animals with antimicrobials.