Methods and processes of developing the strengthening the reporting of observational studies in epidemiology - veterinary (STROBE-Vet) statement

Herd-level risk factors associated with preweaning mortality on Ontario dairy farms

The objective of this cross-sectional, herd-level study was to identify associations between calf management practices and herd-level preweaning mortality on Ontario dairy farms. From April to August 2022, a convenience sample of 100 dairy farms from Ontario, Canada, were visited once. A questionnaire, covering farm biosecurity, calving, colostrum management, preweaning nutrition, and housing, was verbally administered at each farm visit. Furthermore, data regarding preweaning calf mortality were retrieved from each farm's herd management software or records, including the total count of calves that survived, were culled, or died during the preweaning period for the 365 d before the farm visit. Preweaning mortality was defined as the proportion of calves that died between ≥48 h and 60 d of age divided by the total number of calves alive after 48 h of age. The herd-level preweaning mortality risk on sampled farms ranged from 0 to 15.9%, with an average of 2.8% (SD = 3.8%). A multivariable Poisson regression model was used to evaluate associations between 22 explanatory variables and preweaning mortality. Factors associated with greater herd-level preweaning mortality were larger herd size; having treatment protocols for diarrhea, pneumonia or navel infection written in collaboration with a veterinarian (compared with farms with the same treatment protocols developed without a veterinarian), and the herd-veterinarian never inquiring about calf health (compared with farms where the herd veterinarian inquired sometimes). Factors associated with lower herd-level preweaning mortality were using the calving pen for sick cows, having more than 4 people working with calves, offering calves a minimum volume of ≥9 L of milk/day, and farmers with a level of formal education higher than secondary school. These results indicate that producers may be able to reduce preweaning calf mortality by providing adequate labor for calf care, offering calves sufficient volumes of milk, being proactive in communicating with their veterinary practitioners about calf health, and potentially by engaging in continuous education.

Exposure variables in veterinary epidemiology: are they telling us what we think they are?

This manuscript summarizes a presentation delivered by the first author at the 2024 symposium for the Calvin Schwabe Award for Lifetime Achievement in Veterinary Epidemiology and Preventive Medicine, which was awarded to Dr. Jan Sargeant. Epidemiologic research plays a crucial role in understanding the complex relationships between exposures and health outcomes. However, the accuracy of the conclusions drawn from these investigations relies upon the meticulous selection and measurement of exposure variables. Appropriate exposure variable selection is crucial for understanding disease etiologies, but it is often the case that we are not able to directly measure the exposure variable of interest and use proxy measures to assess exposures instead. Inappropriate use of proxy measures can lead to erroneous conclusions being made about the true exposure of interest. These errors may lead to biased estimates of associations between exposures and outcomes. The consequences of such biases extend beyond research concerns as health decisions can be made based on flawed evidence. Recognizing and mitigating these biases are essential for producing reliable evidence that informs health policies and interventions, ultimately contributing to improved population health outcomes. To address these challenges, researchers must adopt rigorous methodologies for exposure variable selection and validation studies to minimize measurement errors.

Patterns of periparturient rumination and activity time in multiparous Holstein cows with and without dyscalcemia in early lactation

Dyscalcemia, defined as reduced blood Ca at 4 DIM, is associated with reduced milk production and reproduction and an increased risk of negative health events. Cowside testing of blood Ca to diagnose dyscalcemia is difficult, and alternative methods to identify dyscalcemia are needed. Our objectives were to explore differences in periparturient rumination and activity time between cows with and without dyscalcemia and use activity and rumination variables to identify dyscalcemia. We performed a retrospective cohort analysis on data collected from multiparous Holstein cows (n = 182) from 2 herds in New York. Cows were affixed with ear or neck loggers to record daily activity (arbitrary units [AU]/d, defined by manufacturer) and rumination (min/d) times. Daily activity and rumination times were collected from 14 d before calving until 14 DIM. No cows received supplemental calcium or experienced clinical hypocalcemia during the study period. A blood sample was collected at 4 DIM and analyzed for total calcium concentration, and cows were subsequently classified as dyscalcemic if total calcium was ≤2.2 mmol/L (n = 57) or eucalcemic if total calcium was >2.2 mmol/L (n = 125). Linear mixed models were used to analyze differences in pre- and postpartum activity and rumination times between the calcemic groups. Logistic regression models were used to identify the probability of dyscalcemia from activity and rumination time variables from 0 to 4 DIM. Prepartum activity time was similar between eucalcemic and dyscalcemic cows (402.0 ± 10.4 AU/d and 395.1 ± 14.5 AU/d, respectively). Postpartum eucalcemic cows had greater activity time than dyscalcemic cows (436.1 ± 10.7 vs. 407.8 ± 14.7 AU/d, respectively). Prepartum rumination time was similar between eucalcemic and dyscalcemic cows (512.6 ± 9.8 min/d vs. 504.2 ± 14 min/d, respectively). Postpartum eucalcemic cows had greater rumination time than dyscalcemic cows (512.3 ± 10.5 min/d vs. 480.5 ± 15 min/d, respectively). Logistic regression models yielded AUC values ranging from 0.71 to 0.79, sensitivities of 17.5% to 40.3%, specificities of 91.2% to 94.4%, accuracy of 70.3% to 77.0%, positive predictive values of 59.0 to 76.0%, and negative predictive values of 72.0% to 78.0%. Our findings suggest that differences exist in postpartum activity and rumination times between cows that experience dyscalcemia and those that remain eucalcemic. Utilizing activity and rumination time data in the immediate postpartum period shows utility in identifying cows with dyscalcemia, which could aid in management decisions that ameliorate the associated negative outcomes; however, further work is needed to optimize their capabilities.

Application of Epidemiological Methods in a Large-Scale Cross-Sectional Study in 765 German Dairy Herds-Lessons Learned

From 2016 to 2020, the "PraeRi" study, conducted by three German veterinary universities, was aimed at enhancing animal health and welfare in dairy farms. With 765 dairy farms visited and 101,307 animals examined, this study provided a basis for improving animal health and welfare. The study population comprised three different regions representing a broad variety of characteristics. To ensure representative estimates, a sample size of 250 farms was determined for each region, employing a stratified sampling plan based on farm size. According to the information provided by the farmers, the most commonly occurring disease in their herds was mastitis without general disorder (14.2% to 16.3% of the herd-depending on the region). For most disorders, prevalence data were lowest for the region South compared with the two remaining regions. Multivariable regression analyses were performed to identify risk factors for various target variables, and the results were communicated through individual reports and benchmarking flyers to participating farmers. The authors encountered challenges in management and communication due to the project's size in terms of personnel, data, and farms examined. Harmonizing data management and hypothesis testing across all involved parties added complexity.

Association between echocardiographic indexes and urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) in dogs with myxomatous mitral valve disease

Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of tubular damage, and its elevation has been described in human and canine cardiorenal syndrome. The aim was to evaluate the association between echocardiographic indexes and urine NGAL (uNGAL) and uNGAL normalized to urine creatinine (uNGALC) in dogs with MMVD. This is a multicentric prospective cross-sectional study. A total of 77 dogs with MMVD at different ACVIM stages were included. All dogs underwent echocardiography, serum chemistry, and urinalysis. Echocardiographic data analyzed were shortening fraction (SF), left ventricular diastolic (LVIDDn) and systolic (LVIDSn) diameters normalized for body weight, left atrium to aortic root ratio (LA/Ao), maximal (LAVMax) and minimal (LAVMin) left atrial volumes, LA stroke volume (LASV), early diastolic mitral peak velocity (EVmax), EVmax to tissue Doppler E' wave (E/E'), aortic (VTIAo) and mitralic (VTIMit) velocity time integrals and their ratio (VTIMit/VTIAo), and tricuspid regurgitation velocity (TRVmax). In the univariate analysis LASV, TRVmax, LAVMax, LVIDDn, and VTIMit/VTIAo were independent predictors of increased uNGAL and uNGALC; however, only LASV [(OR: 1.96, 95% CI: 1.16 to 3.31) P = 0.01 for NGAL, and (OR: 2.79, 95% CI: 1.50 to 5.17) P < 0.001 for NGALC] and TRVmax [(OR: 1.73, 95% CI: 1.20-2.51) P = 0.002 for NGAL, and (OR: 1.50, 95% CI: 10.07-2.10) P = 0.015 for NGALC] remained statistically significant in the multivariable analysis. Based on our results, LASV and TRVmax are associated with increased uNGAL and uNGALC. These parameters might detect dogs with MMVD at higher risk of developing kidney damage.

Prevalence and risk factors of fasciolosis in a bovine population from farms in Taiping, Malaysia

Fasciolosis is a zoonotic disease, considered an emerging neglected tropical disease threatening ruminant productivity and causing economic losses. Controlling fasciolosis is challenging due to the complex life cycle of Fasciola, which involves snail intermediate hosts. The high rainfall status in Taiping makes it an optimal region for snail abundance, which increases the opportunity to complete Fasciola's life cycle. Previous studies showed that liver condemnation caused by fasciolosis was highly prevalent in the Taiping abattoir compared to other investigated main abattoirs of Peninsular Malaysia. Therefore, the present study determined the prevalence of bovine fasciolosis and risk factors in farms from Larut and Matang (Taiping), Malaysia. Sampling was carried out from February until August 2020. In this cross-sectional study, a total of 371 fecal samples from bovines (dairy cattle, beef cattle, buffalo) were examined from 23 farms selected based on location, farmer consent, and history of anthelmintic usage. Animal's intrinsic and farm management details were recorded, and interview sessions were conducted with farmers to collect information on the potential risk factors. Individual fecal samples were examined for the presence of Fasciola egg using Flukefinder® sedimentation. There was moderate prevalence of bovine fasciolosis in Taiping (36.9%, n = 137/371). Significant risk factors (p < 0.05) were observed, which include buffalo group (OR = 9.5, 95% CI: 9.44-9.55), age of >3 years (OR = 5.5, 95% CI: 5.43-5.57), thinner animals with body condition score of 1 to 4 (OR = 1.2-14.9, 95% CI: 1.09-15.08), and larger grazing area (OR = 1.3, 95% CI: 1.30-1.31). Additional risk factors include the presence of more than one ruminant species in the same farm (OR = 2.0-2.1, 95% CI: 2.00-2.22), extensive housing system (OR = 4.0, 95% CI: 3.77-4.23), farm age (OR = 1.2, 95% CI: 1.20-1.21), and also co-infection with Paramphistomes (OR = 1.4, 95% CI: 1.10-1.71). The present study underscores the importance of local bovine fasciolosis epidemiology, which could be used to conduct future veterinary and public health programmes to inform effective parasitic management aimed at reducing the prevalence of fasciolosis.

An observational study demonstrates human-adapted Staphylococcus aureus strains have a higher frequency of antibiotic resistance compared to cattle-adapted strains isolated from dairy farms making farmstead cheese

BACKGROUND

Staphylococcus aureus is a multi-host zoonotic pathogen causing human and livestock diseases. Dairy farms that make artisan cheese have distinctive concerns for S. aureus control. Antimicrobial-resistant (AMR) S. aureus is a public and animal health concern. There is a need to study the population structure of AMR S. aureus at the human-animal interface and understand the path of zoonotic transmission. This cross-sectional observational study aimed to assess the genetic diversity and AMR patterns of S. aureus isolated from cattle and humans on conventional and organic Vermont dairy farms that produce and sell farmstead cheese.

RESULTS

A convenience sample of 19 dairy farms in Vermont was enrolled, and 160 S. aureus isolates were collected from cow quarter milk (CQM), bulk tank milk (BTM), human-hand and -nasal swabs. After deduplication, 89 isolates were used for the analysis. Sequence types (STs) were determined by multilocus sequence typing and cataloged to the PubMLST database. Nine defined and five novel STs were identified. For BTM and CQM samples, six STs were identified within cow-adapted CC97 and CC151. Two human-adapted STs were isolated from BTM and CQM. Seven human-adapted clonal complexes with eight STs were identified from human samples. One cow-adapted ST was isolated from a human. Antimicrobial susceptibility of the isolates was tested using disc diffusion and broth microdilution methods. Approximately 27% of the isolates were beta-lactam resistant and blaZ gene-positive. S. aureus isolates from human swabs were more likely to carry blaZ compared to isolates from CQM or BTM. S. aureus isolated from cows and humans on the same farm belonged to different STs.

CONCLUSION

Humans were more likely to carry beta-lactam-resistant S. aureus compared to cows, and on organic farms only human-adapted blaZ positive STs were isolated from BTM. Moreover, we identified potential spillover events of S. aureus sequence types between host species. The presence of penicillin-resistant-human-adapted S. aureus on both organic and conventional dairy farms highlights a "One Health" concern at the junction of public and animal health requiring further surveillance.

Circulating parathyroid hormone and serotonin in multiparous cows with differing postparturient serum calcium concentrations

Many multiparous dairy cows experience subclinical hypocalcemia (SCH) in the immediate postpartum period as they adapt to the demands of lactation. Furthermore, differing dynamics of SCH in the days following parturition are associated with varied health and production outcomes, with cows experiencing transient SCH producing more milk and facing fewer negative health events than cows with delayed or persistent SCH. Our objectives were to describe differences in mediators of calcium (Ca) homeostasis between cows experiencing differing Ca dynamics postpartum. A prospective cohort of 89 multiparous Holstein cows from 2 herds in New York were classified into 1 of 4 SCH groups based on mean serum total Ca (tCa) at 1 and 4 d in milk (DIM): normocalcemic (NC; [tCa] >1.89 mmol/L at 1 DIM and >2.25 mmol/L at 4 DIM, n = 30); transient SCH (tSCH; [tCa] ≤1.89 mmol/L at 1 DIM and >2.25 mmol/L at 4 DIM, n = 12); delayed SCH (dSCH; [tCa] >1.89 mmol/L at 1 DIM and ≤2.25 mmol/L at 4 DIM, n = 23); and persistent SCH (pSCH; [tCa] ≤1.89 mmol at 1 DIM and ≤2.25 mmol/L at 4 DIM, n = 24). Blood samples were collected at -5, -1, 1 through 5, 7, and 10 DIM and analyzed for tCa, parathyroid hormone (PTH), and serotonin. Repeated measures ANOVA models were used to analyze differences between SCH groups and changes over time for tCa, PTH, and serotonin. During the prepartum period, tCa was greater in the NC, tSCH, and dSCH cows as compared with the pSCH cows and there was marginal evidence for a difference in PTH between SCH groups. Postpartum tCa varied over time between SCH groups. Mean postpartum (95% confidence interval) tCa for respective SCH groups were NC = 2.32 (2.28, 2.35) mmol/L; tSCH = 2.20 (2.14, 2.25) mmol/L; dSCH = 2.17 (2.13, 2.21) mmol/L; and pSCH = 2.03 (1.99, 2.07) mmol/L. Mean concentrations of PTH in the postpartum period were NC = 70.1 (66.2, 74.4) pmol/L; tSCH = 72.1 (66.1, 79.2); dSCH = 75.8 (70.8, 81.5) pmol/L; and pSCH = 77.7 (72.4, 83.9) pmol/L. Serotonin was similar between SCH groups pre- and postpartum and followed a cyclical pattern from 1 to 10 DIM. Our results agreed with our hypothesis that differences in postpartum PTH might exist between cows experiencing different dynamics of SCH in the early lactation period; however, further studies are needed to confirm this difference. If true, this would suggest that Ca homeostasis may be disrupted in cows with dSCH and pSCH. Gaining a better understanding of these modulatory differences may aid in the prevention, management, and treatment of SCH.

Risk factors for Salmonella Dublin on dairy farms in Ontario, Canada

Salmonella Dublin is an emerging pathogen on dairy farms in Canada. In Ontario, Salmonella Dublin has been increasingly isolated from diagnostic laboratory samples. The objective of this observational cross-sectional study was to identify management practices associated with herd positivity for Salmonella Dublin. A convenience sample of 100 dairy farms was visited in Ontario, Canada, from April to August 2022. Farms were visited once to collect blood samples from 20 heifers between 4 and 24 mo old, sample bulk tank milk, and administer an in-person questionnaire on management practices. An additional bulk tank milk sample was collected before the visit by milk transporters. All bulk tank and serum samples underwent ELISA testing to determine Salmonella Dublin positivity (≥35% positivity on ELISA). Of the 1,990 heifers sampled, 44 (2.2%) animals were seropositive for Salmonella Dublin. At least one seropositive heifer was identified on 24% of participating farms. Based on the bulk tank milk samples collected during both sampling periods, 4% of farms were positive for Salmonella Dublin. Overall, of the 100 farms visited, 25% were classified as Salmonella Dublin positive, meaning at least one serum or bulk tank sample was interpreted as positive. A multivariable logistic regression model identified 5 factors associated with herd-level positivity for Salmonella Dublin. Specifically, introducing purchased animals within the last 2 years increased the likelihood that farms were positive for Salmonella Dublin (odds ratio [OR] = 4.6). Farms that had at least one animal leave the premises for a cattle show, embryo collection center, or loan to another farm and return within the last 2 years were also at a higher risk for Salmonella Dublin (OR = 4.9). Farms that removed manure from the surface of bedding in calving pens twice per month or after every calving were at greater risk for Salmonella Dublin than farms that removed manure less frequently (OR = 8.5). Farms that added bedding material to calving areas once or twice weekly were at lower risk for Salmonella Dublin compared with farms that added bedding less than once weekly (OR = 0.1). In addition, farms that kept 3 cows or less per pen in the calving area were at lower risk for Salmonella Dublin. Test positivity for Salmonella Dublin among Ontario dairy farms sampled is high, and dairy producers should consider avoiding management practices that are associated with an increased risk of Salmonella Dublin infection.

Calcium dynamics and associated temporal patterns of milk constituents in early-lactation multiparous Holsteins

At the onset of lactation, calcium (Ca) homeostasis is challenged. For the transitioning dairy cow, inadequate responses to this challenge may result in subclinical hypocalcemia at some point in the postpartum period. It has been proposed that dynamics of blood Ca and the timing of subclinical hypocalcemia allow cows to be classified into 4 Ca dynamic groups by assessing serum total Ca concentrations (tCa) at 1 and 4 days in milk (DIM). These differing dynamics are associated with different risks of adverse health events and suboptimal production. Our prospective cohort study aimed to characterize the temporal patterns of milk constituents in cows with differing Ca dynamics to investigate the potential of Fourier-transform infrared spectroscopic (FTIR) analysis of milk as a diagnostic tool for identifying cows with unfavorable Ca dynamics. We sampled the blood of 343 multiparous Holsteins on a single dairy in Cayuga County, New York, at 1 and 4 DIM and classified these cows into Ca dynamic groups using threshold concentrations of tCa (1 DIM: tCa <1.98 mmol/L; 4 DIM: tCa <2.22 mmol/L) derived from receiver operating characteristic curve analysis based on epidemiologically relevant health and production outcomes. We also collected proportional milk samples from each of these cows from 3 to 10 DIM for FTIR analysis of milk constituents. Through this analysis we estimated the milk constituent levels of anhydrous lactose (g/100 g of milk and g/milking), true protein (g/100 g of milk and g/milking), fat (g/100 g of milk and g/milking), milk urea nitrogen (mg/100 g of milk), fatty acid (FA) groups including de novo, mixed origin, and preformed FA measured in grams/100 g of milk, by relative percentage, and grams/milking, as well as energy-related metabolites including ketone bodies and milk-predicted blood nonesterified FA. Individual milk constituents were compared among groups at each time point and over the entire sample period using linear regression models. Overall, we found differences among the constituent profiles of Ca dynamic groups at approximately every time point and over the entire sample period. The 2 at-risk groups of cows did not differ from each other at more than one time point for any constituent, however prominent differences existed between the milk of normocalcemic cows and the milk of the other Ca dynamic groups with respect to FA. Over the entire sample period, lactose and protein yield (g/milking) were lower in the milk of at-risk cows than in the milk of the other Ca dynamic groups. In addition, milk yield per milking followed patterns consistent with previous Ca dynamic group research. Though our use of a single farm does limit the general applicability of these findings, our conclusions provide evidence that FTIR may be a useful method for discriminating between cows with different Ca dynamics at time points that may be relevant in the optimization of management or development of clinical intervention strategies.

The association of subclinical hypocalcemia at 4 days in milk with reproductive outcomes in multiparous Holstein cows

Delayed or persistent episodes of subclinical hypocalcemia (SCH) have been associated with reduced milk production and feed intake and they put cows at risk for additional disease development. However, little is known about the effect of delayed or persistent SCH on reproductive outcomes. The objectives of our study were to describe the association between SCH status at 4 d in milk (DIM) with the odds of pregnancy to first service and time to pregnancy through 150 DIM. Data were collected from multiparous Holstein cows (n = 697) from 4 farms in New York State that did not receive supplemental Ca during the first 5 DIM. Cows were classified into 1 of 2 SCH groups based on blood total Ca (tCa) at 4 DIM: normocalcemic (NC; n = 515) if tCa >2.2 mmol/L at 4 DIM or SCH (n = 182) if tCa ≤2.2 mmol/L at 4 DIM. We created a multivariable logistic regression model to assess the association between SCH group and pregnancy to first service and a time-to-event analysis to evaluate the effect of SCH group on the hazard of pregnancy by 150 DIM. Cows that were SCH at 4 DIM had lower odds of pregnancy to first service [odds ratio = 0.75, 95% confidence interval (CI) = 0.61 to 0.93, incidence = 18.1%] compared with their NC counterparts (incidence = 27.4%). Similarly, SCH cows tended to have a lower hazard of pregnancy by 150 DIM (hazard ratio = 0.82, 95% CI = 0.67 to 1.01, incidence = 65.4%) than NC cows (incidence = 70.7%). Our results indicate that delayed or prolonged reductions in blood Ca in the early postpartum period, resulting in SCH at 4 DIM, were associated with reduced reproductive outcomes in multiparous cows. Our findings, in conjunction with previous reports of the negative associations of delayed or persistent SCH on health and production, suggest that reductions in blood Ca beyond the first day of lactation might be indicative of maladaptation to lactation, and the ramifications can persist beyond the immediate postpartum period.

The Impact of Vegan Diets on Indicators of Health in Dogs and Cats: A Systematic Review

There has been an increase in vegetarianism and veganism in human populations. This trend also appears to be occurring in companion animals, with guardians preferring to feed their animals in accordance with their own dietary values and choices. However, there has been controversy amongst vets and online commentators about the safety of feeding vegan diets to carnivorous species, such as cats and dogs. In spite of this controversy, to date there has been no systematic evaluation of the evidence on this topic. A systematic search of Medline, Scopus, and Web of Science was performed, identifying 16 studies on the impact of vegan diets on cat and dog health. Studies were appraised for quality using established critical appraisal tools or reporting guidelines. There was considerable heterogeneity in the outcomes measured, and study designs employed, with few studies evaluating key outcomes of interest. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was utilized for assessment of certainty in the evidence, with the evidence for most outcomes being assessed as low or very low. Whilst the quality and amount of evidence needs to be considered in formulating recommendations, there was no overwhelming evidence of adverse effects arising from use of these diets and there was some evidence of benefits. It is, however, recommended that future high-quality studies, with standardized outcome measures and large sample sizes, be conducted. At the current time, if guardians wish to feed their companion animals vegan diets, a cautious approach should be taken using commercially produced diets which have been formulated considering the nutritional needs of the target species.

Association between differential somatic cell count and California Mastitis Test results in Holstein cattle

The California Mastitis Test (CMT) has been used to estimate total somatic cell count (SCC) levels in milk; however, milk with similar SCC levels occasionally shows inconsistent CMT results, which limits the use of the CMT. This observational study aimed to investigate how differential cell counts in milk influence the CMT in Holstein cattle through the novel parameters differential somatic cell count (DSCC) and macrophage proportion (MAC). We performed the CMT on d 0, 3, 5, 7, 14, and 21 after identifying mastitis, and simultaneously measured SCC, DSCC, and MAC at the quarter level. We followed 58 mastitis events occurring in 41 cows and obtained 307 quarter-level records after data cleaning. We transformed SCC to somatic cell score (SCS) and MAC to its logarithm to fit the normal distribution and analyzed the data using the cumulative logit mixed model. Results showed that both an increase in SCS (odds ratio: 3.66, 95% confidence interval: 2.89-4.64) and the logarithm of MAC (odds ratio: 4.35, 95% confidence interval: 1.91-9.91) can contribute to a higher CMT score. During the healing process of mastitis, MAC tends to increase as SCC decreases; thus, even samples with low SCC can cause positive CMT reactions. We recommend that practitioners avoid making treatment decisions based on the CMT alone. We also noted that the CMT is sensitive to subclinical mastitis with high MAC, hence it could be considered an alternative to detecting high MAC (chronic) mastitis.

Watch your language: An exploration of the use of causal wording in veterinary observational research

Observational research may be conducted to predict an outcome or to identify associations between an intervention or risk factor (an “exposure”) and an outcome. However, the end goal of observational research often is to identify exposures that can be manipulated to improve an outcome, meaning that the aim is identify causal relationships. Causal inference from observational studies may be appropriate when an exposure-outcome of interest is identified, causal reasoning is used to identify confounders, confounders are adequately controlled, and theoretical issues, such as temporality, are considered. If these conditions are not met, causal inference cannot be made in an observational study. The objective of our study was to explore the use of causal language in veterinary observational studies, and to compare the use of causal language between studies that appear to be predictive or associational in purpose vs. those that appear to be exploring causal relationships. The dataset comprised 200 observational studies in veterinary species published between 2020 and 2022. The majority (117 out of 200) were cross-sectional studies. There were 48 studies that described an exposure-outcome of interest, and we considered these studies to be exploring potential causal relationships; of note, this liberal categorization would be anticipated to overestimate the proportion of studies suitably designed for causal inference. Overall, 172 studies (86%) used causal wording in at least one section of the article. Causal language was used in 128/152 (84%) of studies exploring predictions or associations; this language implies causation when it is not appropriate to do so. In studies designed such that causal inference might be possible, 44/48 (92%) used causal language in one or more sections. There were no substantive differences in the use of causal wording between observational study designs, exposure types, or whether the first author's affiliation was a country in which English is an official language. There is a need for authors of veterinary observational studies to explicitly state the purpose of the study (associational, predictive, or causal), and to use causal wording appropriately based on the aim of the study.

Association between prepartum nonesterified fatty acid serum concentrations and postpartum diseases in dairy cows

The objective of the present study was to quantify the relationships between prepartum nonesterified fatty acid (NEFA) concentrations and the development of subsequent diseases or culling and to identify the optimal thresholds allowing identification of animals at high risk of developing postpartum diseases or being culled. A total of 1,299 Holstein cows from 50 commercial herds located around Saint-Hyacinthe (QC, Canada) were enrolled in this observational study. Blood samples were collected from enrolled cows between 1 and 14 d before calving for serum NEFA quantification. Data concerning postpartum diseases and culling were collected from computerized record systems. The association between prepartum NEFA concentrations and postpartum diseases and culling was quantified using generalized linear mixed models, accounting for parity, season, week of sampling, and herd. Optimal NEFA thresholds were evaluated with receiver operator characteristic curves analysis for all diseases and then confirmed with generalized linear mixed models, considering NEFA as a categorical variable (high or low). Prepartum serum NEFA concentrations were associated with diseases diagnosed during the first 30 d in milk (DIM) and culling within the first 50 DIM. The optimal NEFA threshold associated with diseases was ≥290 µmol/L for retained placenta, ≥300 µmol/L for metritis and abomasal displacement, and ≥280 µmol/L for clinical mastitis and hyperketonemia. The level associated with the occurrence of at least one of these diseases in the first 30 DIM was ≥280 µmol/L, but it was ≥260 µmol/L for culling in the first 50 DIM. No relationship was found between NEFA concentrations and reproductive tract diseases (purulent vaginal discharge or cytological endometritis) or subclinical intramammary infection. Despite the strong relationship between prepartum NEFA concentrations and many diseases, the NEFA optimal threshold accuracy found in our study was low. In conclusion, our results demonstrate a relationship between NEFA concentrations in the 14-d period before calving and the subsequent development of diseases and culling. Prepartum NEFA concentrations thresholds between ≥260 and 300 µmol/L appear to be a strategic choice. However, considering the low accuracy, their use at the cow level should be performed with caution.

Evaluation of an infrared thermography camera for measuring body temperature in dairy calves

The objective of this diagnostic accuracy study was to validate an infrared thermography (IRT) camera and its software (FLIR One, FLIR, Global) for accuracy and precision for ocular temperature readings to serve as a proxy for rectal temperature in commercially housed calves. A total of 318 male Holstein calves were enrolled into this study from the day of arrival to a calf rearing facility until 14 d later. Researchers took an ocular temperature reading using an IRT camera, and a rectal temperature on each calf each day in the morning. The reference standard method for body temperature in the calves was rectal temperature. We assessed the data for agreement between the IRT and the reference standard using Pearson correlations by calf (accuracy), coefficients of determination (precision), and Bland-Altman plots for bias. In addition, a logistic regression model was built using the reference method as the outcome, with IRT as an explanatory variable to assess the diagnostic accuracy of IRT as an indicator of fever (rectal temperature ≥39.5°C). There was a negligible correlation between the IRT readings and rectal temperature (r = 0.22) and the coefficient of determination for IRT to predict rectal temperature was negligible (R² = 0.05), suggesting poor precision. The average mean difference between the IRT data and rectal temperature was 0.55°C, and the differences between IRT and rectal formed a linear line around the mean difference, suggesting the Bland-Altman analyses showed proportional error and bias. The optimal probability cut-off for IRT readings for fever was at 39.5°C, and had a receiver operating characteristic area under the curve of 0.67, a sensitivity of 61%, a specificity of 71%, and 78% (3,134/4,427) of the samples were correctly labeled as either having a fever or not using IRT readings. In summary, the IRT camera and software were not validated for serving as a proxy for rectal temperature in commercially housed calves due to poor precision, and proportional error partially explained by ambient environmental conditions. We suggest that this infrared thermography system should not replace rectal temperature readings for use in commercially housed calves.

Navel healing in male and female Holstein calves over the first 14 days of life: A longitudinal cohort study

The objectives of this study were (1) to describe navel healing in male and female neonatal Holstein calves over a 14-d observation period, and (2) to determine the associations of dam parity, calving factors, and calf factors with navel measurements and time to healing. A total of 68 Holstein calves (43 female and 25 male) were enrolled. Navel healing outcomes (cessation of navel discharge, navel cord remnant drying, navel cord remnant drop-off) and navel stump measurement outcomes (proximal diameter, distal diameter, length) were recorded every 24 ± 1 h for a 14-d observation period. Data were also collected for dam parity, calving factors (time of birth, calving ease), and calf factors (calf sex, calf vitality at birth, birth weight, average daily gain, serum total protein, and medical treatment or treatments). The mean time to navel cord remnant drying was 2 d, and all calves had dry navels by d 5. A total of 56% of calves retained their navel cord remnant beyond the end of the observation period, and calves began to shed their navel cord remnants as early as d 2. In addition, at least once during the observation period, 85% of calves had a proximal navel diameter measurement over a 13-mm threshold recently proposed to identify navel infections. For distal navel diameter measurements, 72% of calves had a diameter over the 13-mm threshold at least once during the observation period. No associations were identified between navel healing outcomes and dam, calving, and calf factors. Navel measurement outcomes were associated with calving and calf factors. Specifically, proximal navel stump diameter was associated with the day of observation (decreased from d 5 to 14), calf sex (smaller in female calves), time of birth (larger in calves born overnight or unobserved, compared with the morning), and birth weight (larger in birth weights >44.1 kg compared with <38.5 kg). Distal navel stump diameter was associated with calf sex, medical treatment, and day of observation; however, we observed an interaction between sex and day of observation (larger in male calves on d 3 to 7, d 9, and d 12, compared with female calves), and sex and medical treatment (larger in untreated male calves, no difference between treated male and female calves). Navel stump length was associated with time of birth (longer in calves born overnight or unobserved compared with any other time) and the interaction of birth weight and day of observation (longer in birth weights >44.1 kg compared with 38.6-41.5 kg on d 3, 8-10, and 13, and 41.6-44.0 kg on d 3, 5, 7-8, and 13). The wide range in time to navel cord remnant drying and drop-off suggest that these measures may not be adequate indicators of calf age on their own. More research on navel healing is required to improve our understanding of factors that influence navel measurements and time to healing, as well as how this information could be used in an objective assessment of navel health.

Feeding behavior and activity levels are associated with recovery status in dairy calves treated with antimicrobials for Bovine Respiratory Disease

Calves with Bovine Respiratory Disease (BRD) have different feeding behavior and activity levels prior to BRD diagnosis when compared to healthy calves, but it is unknown if calves who relapse from their initial BRD diagnosis are behaviorally different from calves who recover. Using precision technologies, we aimed to identify associations of feeding behavior and activity with recovery status in dairy calves (recovered or relapsed) over the 10 days after first antimicrobial treatment for BRD. Dairy calves were health scored daily for a BRD bout (using a standard respiratory scoring system and lung ultrasonography) and received antimicrobial therapy (enrofloxacin) on day 0 of initial BRD diagnosis; 10–14 days later, recovery status was scored as either recovered or relapsed (n = 19 each). Feeding behaviors and activity were monitored using automated feeders and pedometers. Over the 10 days post-treatment, recovered calves showed improvements in starter intake and were generally more active, while relapsed calves showed sickness behaviors, including depressed feed intake, and longer lying times. These results suggest there is a new potential for precision technology devices on farms in evaluating recovery status of dairy calves that are recently treated for BRD; there is opportunity to automatically identify relapsing calves before re-emergence of clinical disease.

Disbudding and dehorning practices for preweaned dairy calves by farmers in Wisconsin, USA

Many dairy farmers in North America disbud or dehorn their cattle to improve human and animal safety. The Farmers Assuring Responsible Management (FARM v. 4.0) program requires that disbudding be performed before 8 wk of age with pain-control medication. The objective of this observational cross-sectional study was to quantify disbudding and dehorning practices of Wisconsin dairy producers to target future extension programming. Responses from 217 Wisconsin dairy producers and calf raisers were collected via digital surveys distributed at extension events and through industry contacts. Of the 217 respondents, 188 performed on-farm disbudding themselves. Most respondents (61%) used caustic paste as their primary method, which was most commonly applied on the day the calf was born (53%). Hot iron was used by 32% of respondents, and surgical methods (gouge, scoop, or wire saw) were used by 6% of respondents. Hot-iron disbudding was most commonly performed at 4 to 8 wk of age (41%) and 1 to 4 wk of age (33%), whereas surgical methods were most commonly performed at 8 wk or older (73%). Pain-control medication was used by 43% of respondents. Specifically, 35% used an anti-inflammatory, and 21% used a local nerve block. Veterinary involvement in creating the disbudding protocol was associated with increased odds of using pain control. Respondents with a target weaning age of ≥10 wk had greater odds of complying with FARM disbudding requirements and were also more likely to use polled genetics. Respondents aged 18 to 34 and respondents with >60 calves were more likely to have made changes to their disbudding or dehorning protocol in the last decade. Although use of pain control was higher than in previous US studies, full adoption of pain management requires further extension efforts. Veterinarians appeared influential on adoption of pain control, and their involvement may encourage adoption of pain management. Further research should investigate how the implementation of new FARM v. 4.0 standards will change the disbudding and dehorning practices of American dairy producers.

A modified functional hoof trimming technique reduces the risk of lameness and hoof lesion prevalence in housed dairy cattle

The objective of this study was to compare the impact of the functional hoof trimming (HT) method to an adaptation that results in increased modelling of the weight bearing claw on time to lameness and lesion prevalence in housed dairy cows. A total of 418 non-lame cows at early and late lactation were enrolled in the study and randomly allocated into 3 groups: functional HT (TRIM1), adaptation method (TRIM2), and an untrimmed group (CON). Locomotion scores (LS; 5-point scale) and animal-based welfare measures were assessed monthly from enrolment until the following 270 days in milk. Cows were considered lame when 2 consecutive LS = 3, or any assessment with a score of 4 or 5. Kaplan-Meier analysis was used to evaluate the difference in time to lameness between the groups. Multivariable CC Cox regression models were fitted to assess associations between covariates and time to lameness event, while associated factors for lesion prevalence were estimated using logistic regression models. The incidence rate of lameness was 29.3 cases/100/month, with corresponding rates of 28.7, 15.8 and 42.8 cases/100/months, in TRIM1, TRIM2 and CON, respectively. Time to first lameness event was higher in TRIM2 (mean ± S.E; 8.26 ± 0.16, P = 0.03) than CON (7.32 ± 0.2) and tended to be higher than TRIM1 (7.83 ± 0.19; P = 0.07). The risk of new lameness event was higher in cows with low BCS (≤2.5) (Hazard ratio; HR = 1.5; 95 % CI 1.1-2.1), while trimming all feet was a protective factor (HR = 0.58; 95 % CI 0.38-0.90). The prevalence of hoof lesions in the study population was 36.3 %, with the highest prevalence in CON (45.6 %), followed by TRIM1 (34.6 %) and TRIM2 (28.1 %). Seventy-eight per cent of hoof lesions were non-infectious and the majority of cows with hoof lesion in TRIM1 (72.3 %), CON (74.6 %) and TRIM2 (55.6 %) were lame. The odds of having a non-infectious hoof lesion were higher in CON (OR = 2.1; 95 % CI 1.2-3.7) compared to TRIM2, and in cows with hock injury (OR = 3.1; 95 % 1.1-9.7) relative to healthy hock, and tended to be higher in cows with low BCS (P = 0.09) relative to those with moderate BCS. Our results suggest that the adaptation to the functional method reduced the risk of lameness during lactation, however, proper management of under-conditioned cows is equally important.

Blood calcium as a prognostic indicator of success after surgical correction of left displaced abomasum

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Subclinical hypocalcemia is common and linked with an increased risk of LDA.

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Prediction of cow prognosis after surgical LDA correction based on precorrection blood tCa concentration is of interest.

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No clear evidence supports the association of tCa at time of LDA diagnosis with milk yield after surgical correction.

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No clear evidence supports the association of tCa at time of LDA diagnosis with herd removal after surgical correction.

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Low to extremely low tCa concentrations were found in cows with LDA.

Subclinical hypocalcemia, a reduction in blood calcium concentrations without apparent clinical signs of milk fever, occurs in 25 to 50% of early-postpartum dairy cows. Research has shown that these cows are at an increased risk of additional early-lactation diseases, including left displaced abomasum (LDA), compared with their normocalcemic counterparts. However, no work has assessed the association of total calcium (tCa) concentration at the time of LDA correction with subsequent milk yield and survival within the herd. Pending future development of an economical and accurate on-farm test for hypocalcemia, the ability to assess LDA prognosis after surgical correction based on precorrection blood tCa concentration is of interest to practitioners. Therefore, our objective was to determine the association of blood tCa concentration at the time of LDA surgical correction with milk yield and herd removal in the 60 d after correction. Nine bovine practitioners, located in New York State, were involved in sample collection from 17 herds for this prospective cohort study. Immediately following LDA diagnosis and before surgical correction, blood samples were collected from 152 dairy cows within the first 30 d in milk for serum tCa determination. The association of tCa with milk yield (n = 110) and herd removal (n = 127) in the first 60 d after LDA surgical correction was analyzed using repeated-measures ANOVA and a generalized linear mixed model, respectively, controlling for parity and days in milk at LDA surgical correction and the random effect of herd or practitioner. We found no evidence to support an association of tCa at time of LDA diagnosis with subsequent milk yield, and when cows were grouped by median tCa into low and high groups (tCa ≤2.1 and >2.1 mmol/L, respectively), subsequent milk production was similar (39.4 ± 1.6 and 40.1 ± 1.4 kg/d for low and high, respectively). Furthermore, we found no evidence to support an association of tCa at time of LDA diagnosis with the odds of herd removal (odds ratio = 0.6; 95% confidence interval = 0.4–1.7). Therefore, our study provided no clear evidence to support the association of tCa at time of LDA diagnosis and correction with either milk yield or herd removal during the 8 wk after correction. However, it did demonstrate low to extremely low tCa concentration in cows with LDA. Whether calcium supplementation would improve health and production outcomes in these cows is unclear and worth investigating further.

Modifiable management practices to improve udder health in dairy cattle during the dry period and early lactation: A scoping review

The objective of this scoping review was to characterize all available literature on modifiable management practices used during the dry period that have been evaluated for their effects on udder health in dairy cattle during the dry period and the subsequent lactation. Five databases and two conference proceedings were searched for relevant literature. Articles published in or after 1990 were eligible for inclusion. Eligible interventions or exposures were restricted to modifiable management practices; however, antimicrobial and teat sealant products were enumerated but not further characterized, as systematic reviews have been published on this topic. Other modifiable management practices were reported in 229 articles. Nutrition (n = 79), which included ration formulation and delivery (n = 44) and vitamin and mineral additives (n = 35), was the most commonly reported practice, followed by vaccines (n = 40) and modification of dry period length (n = 27). Risk of clinical mastitis (CM) was the most commonly reported outcome (n = 151); however, reporting of outcome risk periods varied widely between articles. Cure of existing intramammary infections (IMI) over the dry period (n = 40) and prevention of new IMI over the dry period (n = 54) were most commonly reported with a risk period between calving and 30 d in milk. Future systematic reviews with meta-analyses could target management practices such as nutrition, vaccines, and dry period length to quantify their effects on improving udder health during the dry period and early lactation. However, the variation in reporting of time at risk for CM and other outcomes challenges the ability of future synthesis work to inform management decisions on the basis of efficacy to cure or prevent IMI and CM. Consensus on which core outcomes should be evaluated in mastitis research and the selection of consistent risk periods for specific outcomes in animal trials is imperative.

Antibiotic Prescription in Veterinary Consultations in Bhutan: A Retrospective Cross-Sectional Study

The veterinary prescription of antibiotics in low- and middle-income countries (LMIC) remains largely undocumented. In Bhutan, however, the national veterinary service keeps records of their activities and prescriptions, which offer an opportunity to establish a benchmark to assess the use of these agents in this and other LMIC. A cross-sectional retrospective study was designed and 2,266 handwritten veterinary records from 2017 were sampled from 23 animal health premises (AHPs) to estimate individual and an overall proportion of consultations that resulted in an antibiotic prescription. The frequency of antibiotic prescription per species, type of AHP, and according to WHO's AWaRe index and OIE list of priority antimicrobials were also explored. It was estimated that 31% (95% confidence interval: 29–33%; intracluster correlation: 0.03) of the veterinary consultations resulted in an antibiotic prescription. The incidence of antibiotic prescription was highest in consultations of poultry across AHP. Across species, diarrhea and wounds were frequently treated with broad-spectrum antibiotics including sulfonamides, tetracyclines, trimethoprim + sulfa, and penicillin. Between 45% and 70% antibiotics prescribed correspond to AWaRe's access group and up to 25% to AWaRe's watch group. Over 70% of antibiotics dispensed in veterinary consultations for any species correspond to the OIE's veterinary critically important antimicrobial agents. Overall, the study demonstrated positive features of veterinary antimicrobial stewardship in Bhutan, given the conservative proportion of consultation that results in this type of prescription and the type of antibiotic prescribed. Although the veterinary service closely follows the Bhutanese Standard Treatment Guidelines, the prescription of antibiotics to key species should be closely monitored. Our study suggests that further improvements of antibiotic stewardship can be achieved through standardisation of antibiotic prescription to some species, a revision of the guidelines toward reducing the prescription of antibiotics of high relevance for human medicine, and by including details of clinical investigation, use of tests, and treatment outcomes in veterinary consultation records.

Antibiotic Stewardship for Canine and Feline Acute Urinary Tract Infection: An Observational Study in a Small Animal Hospital in Northwest Italy

Antimicrobial stewardship programs (ASPs) have been suggested to reduce antimicrobial resistance phenomena in veterinary medicine, as antibiotics are commonly used without microbiological confirmation. The aim of the present study is to design a specific working flow for a tailored antimicrobial treatment in the case of canine and feline urinary tract infections (UTIs). Urine samples were collected by cystocentesis from 16 dogs and 12 cats presenting acute signs of UTI. The therapy was decided according to the minimal inhibitory concentration, and it was possible to monitor 14 dogs and 11 cats. Rescue therapy (amoxicillin and clavulanic acid) was included in emergency cases. Escherichia coli, Proteus mirabilis, and Streptococcus canis were isolated in dogs, and Escherichia coli, Staphylococcus pseudintermedius, and Staphylococcus aureus were isolated in cats. No multidrug-resistant strains were detected, but all Staphylococci were methicillin resistant. Only one cat received rescue therapy, and only one dog was recruited. Dogs were treated with tetracycline (1/14), fluoroquinolones (6/14), beta-lactams (6/14), and gentamicin (1/14), while cats received fluoroquinolones (3/11), nitrofurans (1/11), clindamycin (1/11), and beta-lactams (6/11). The success rate was very high. Our findings are interesting because this is the first ASP in Italy, and it may be used as a model to develop ASPs for other pathologies.

Measuring antimicrobial use on dairy farms: A method comparison cohort study

Antimicrobial use on UK dairy farms is measured for surveillance purposes, with veterinary sales data as a proxy for use. Two other methods of recording use have been used commonly on-farm: medicine waste bins and farm medicine records. However, none of these methods has been validated to measure antimicrobial use. The objective of this research was to assess agreement between the 3 most common methods for measuring on-farm antimicrobial use with a predetermined reference method on UK dairy farms. Antimicrobial use was measured prospectively on 26 UK dairy farms using medicine waste bins into which participants placed all discarded medicine packaging for a 12-mo period. At the end of 12 mo, farm medicine records and veterinary sales data were obtained retrospectively for participating farms. The reference method used was based on pre- and poststudy inventories combined with veterinary sales data. We investigated the systematic difference between the mean on-farm antimicrobial use measured by each of the 3 methods and a reference method, using one-way repeated-measures ANOVA models. Reliability and clinical relevance of the agreement between each pair of methods was quantified using the concordance correlation coefficient (CCC) and the Bland-Altman method, respectively. When compared with the reference method, veterinary sales data had excellent reliability for injectable antimicrobials and intramammary antimicrobials [95% confidence interval (CI) of CCC > 0.90] and moderate to excellent reliability for other antimicrobials (95% CI of CCC: 0.68-0.97). Medicine waste bins had good to excellent reliability for injectable (95% CI of CCC: 0.84-0.99), and intramammary products (95% CI of CCC: 0.78-0.94) and no agreement for other forms of antimicrobial. Farm medicine records did not agree for any form of antimicrobial when compared with the reference method. The use of veterinary sales data as a proxy for on-farm antimicrobial use in the UK represented excellent statistical reliability and offered clinically good agreement with the reference method when used to measure injectable antimicrobials. This study applies to the UK context and included a relatively small number of farms. However, these results have research and policy implications, both nationally and internationally, and are essential in accurately quantifying agricultural antimicrobial use to inform both animal and human health.

The Prevalence of Campylobacter in Live Cattle, Turkey, Chicken, and Swine in the United States and Canada: A Systematic Review and Meta-Analysis

Campylobacter cause gastroenteritis in humans and may be shed in the feces of livestock and poultry species, including cattle, chicken, turkey, and swine. However, a synthesis of the prevalence on farms in the United States and Canada is currently lacking. Thus, our objective was to conduct a systematic review and meta-analysis to estimate the prevalence of Campylobacter coli, Campylobacter jejuni, and Campylobacter spp. on livestock and poultry farms operated under commercial conditions in the United States and Canada. The relevant literature was identified and examined for eligibility based on a priori inclusion and exclusion criteria. Relevant data were extracted, and a meta-analysis was performed. The data were transformed using the Freeman-Tukey arcsine transformation to stabilize the variance. A separate meta-analysis was performed for each animal species, level of sampling (individual versus pooled), and species of Campylobacter, for a total of 29 meta-analyses. C. jejuni and Campylobacter spp. were present in all livestock and poultry species of interest, whereas C. coli was found in all species of interest with the exception of chickens. Furthermore, substantial heterogeneity was observed in most meta-analyses. In an attempt to account for this, subgroup analyses were performed on potential moderators. However, with the exception of beef cattle, where studies in feedlot cattle reported a consistently higher prevalence compared with adult cattle on pasture, significant heterogeneity remained in the majority of meta-analyses after accounting for potential moderators. The results of this review can be used to inform future risk assessment, consumer and producer awareness, and resource allocation, and identify gaps for future research.

Cow- and herd-level factors associated with lameness in dairy farms in Peninsular Malaysia

Lameness is a major welfare issue in dairy cows. This study was aimed at investigating the cow- and herd -level factors associated with lameness in dairy farms from four states in Peninsular Malaysia. The study population was 1001 lactating cows from 28 dairy farms located in Selangor (n = 9), Perak (n = 8), Negeri Sembilan (n = 6) and Johor (n = 5). Lameness was assessed by locomotion scoring. Individual cow characteristics such as breeds, parity, body condition score (BCS), hock condition, leg hygiene, presence of claw lesion and claw overgrowth were recorded. Data on herd characteristics, management practices and housing design were collected by on-farm inspection and farmers' interview. Mixed-eff ;ects logistic regressions were used to model the data and to assess the factors associated with lameness. Cow-level lameness prevalence was 34.2 % (95 % CI 22.2-50.0 %), with all the farms having at least one case of lameness. Claw lesions were recorded in 470 cows (46.9 %; CI 33.3-63.3 %) of which 296 (62.9 %) of them were lame. Of these, 78.9 % of the lesions were present on the rear feet and 25.5% of the cows had more than one foot affected. The proportion of cows having non-infectious and infectious claw lesions were 81.9 % and 18.1 %, and the predominant claw lesions were sole ulcers (24.9 %), white line disease (19.6 %), sole haemorrhage (10.2%), swelling of coronet (9.6 %), toe ulcers (8.4 %), and digital dermatitis (5.6%). Cows at third or more parities had higher odds of lameness (OR = 2.2; 95 % CI 1.2-4.1) compared to primiparous cows. Low BCS (< 2.5) increased the odds of lameness (OR = 4.8; 95 % CI 2.9-7.9) relative to cows with moderate BCS, and cows with hair loss around the hock (OR = 1.4; 95 % CI 1.1-1.9) relative to those with normal hock condition. Greater odds of being lame was observed in cows having claw lesion (OR = 15.2; 95 % CI 10.4-19.2) and those with overgrown claw (OR = 3.3; 95 % CI 2.4-4.5). There was increased odds of lameness in farms with high stocking density (OR = 1.8; 95 % CI 1.1-3.1), concrete floored walkways (OR = 1.9; 95 % CI 1.0-3.6), dirty floors (OR = 2.3; 95 % CI 1.9-3.7), and practicing preventive claw trimming (OR = 2.3; 95 % CI 1.9-4.6). Based on the high lameness prevalence, these findings could assist dairy farmers to make informed decisions on areas to implement on-farm changes to reduce lameness in the studied herds.

One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant gram-positive infections

Despite improvements in hospital infection prevention and control, healthcare associated infections (HAIs) remain a challenge with significant patient morbidity, mortality, and cost for the healthcare system. In this review, we use a One Health framework (human, animal, and environmental health) to explain the epidemiology, demonstrate key knowledge gaps in infection prevention policy, and explore improvements to control Gram-positive pathogens in the healthcare environment. We discuss patient and healthcare worker interactions with the hospital environment that can lead to transmission of the most common Gram-positive hospital pathogens – methicillin-resistant Staphylococcus aureus, Clostridioides (Clostridium) difficile, and vancomycin-resistant Enterococcus – and detail interventions that target these two One Health domains. We discuss the role of animals in the healthcare settings, knowledge gaps regarding their role in pathogen transmission, and the absence of infection risk mitigation strategies targeting animals. We advocate for novel infection prevention and control programs, founded on the pillars of One Health, to reduce Gram-positive hospital-associated pathogen transmission.

Histologically low-grade, yet biologically high-grade, canine cutaneous mast cell tumours: A systematic review and meta-analysis of individual participant data

Low-grade canine cutaneous mast cell tumour (cMCT) with metastasis at the time of treatment is uncommonly reported, with few studies focusing on this specific clinical entity. The specific objective of this study was to systematically review the veterinary literature and perform a meta-analysis summarizing the clinical presentation, treatments reported and clinical outcomes from dogs with histologically low-grade cMCT and metastasis present at initial treatment. A total of 980 studies were screened with eight publications providing data on 121 dogs ultimately included. The most common treatments were surgery with adjuvant chemotherapy in 83/121 (69%) dogs; combined surgery, radiation and chemotherapy in 17/121 (14%) dogs; chemotherapy alone in 12/121 (10%) dogs and surgery alone in 7/121 (6%) dogs. Dogs with distant metastasis (n = 22) experienced significantly shorter survival compared with those with regional lymph node (RLN) metastasis (n = 99; median 194 vs 637 days; P < .01). Two variables were significantly associated with increased risk of death: presence of distant (vs RLN) metastasis (hazard ratio = 2.60; P < .01) and not receiving surgery as a component of treatment (hazard ratio = 3.79; P < .01). Risk of bias was judged to be low in terms of selection and performance bias but high in terms of detection and exclusion bias. In conclusion, dogs with cMCT and RLN metastasis can be expected to live significantly longer than those with distant metastasis, and surgery appears to have a role in extending survival of metastatic low-grade cMCT.

The effect of tylosin on antimicrobial resistance in beef cattle enteric bacteria: A systematic review and meta-analysis

BACKGROUND

Tylosin is a commonly used in-feed antimicrobial and is approved in several countries to reduce the incidence of liver abscesses in beef cattle. Macrolides are critically important antimicrobials in human health and used to treat some foodborne bacterial diseases, such as Campylobacter jejuni and Salmonella. Feeding tylosin could select for resistant enteric bacteria in cattle, which could contaminate beef products at slaughter and potentially cause foodborne illness. We conducted a systematic review and meta-analysis to evaluate the impact of feeding tylosin to cattle on phenotypic and genotypic resistance in several potential zoonotic enteric bacteria: Enterococcus species, Escherichia coli, Salmonella enterica subspecies enterica, and Campylobacter species. This review was registered with PROSPERO (#CRD42018085949).

RESULTS

Eleven databases were searched for primary research studies that fed tylosin at approved doses to feedlot cattle and tested bacteria of interest for phenotypic or genotypic resistance. We screened 1,626 citations and identified 13 studies that met the inclusion criteria. Enterococcus species were tested in seven studies, Escherichia coli was isolated in five studies, three studies reported on Salmonella, and two studies reported on Campylobacter species. Most studies relied on phenotypic antimicrobial susceptibility testing and seven also reported resistance gene testing. A random-effects meta-analyses of erythromycin-resistant enterococci from four studies had significant residual heterogeneity. Only two studies were available for a meta-analysis of tylosin-resistant enterococci. A semi-quantitative analysis demonstrated an increase in macrolide-resistant enterococci after long durations of tylosin administration (>100 days). Semi-quantitative analyses of other bacteria-antimicrobial combinations revealed mixed results, but many comparisons found no effect of tylosin administration. However, about half of these no-effect comparisons did not record the cumulative days of tylosin administration or the time since the last dose.

CONCLUSIONS

When fed at approved dosages for typical durations, tylosin increases the proportion of macrolide-resistant enterococci in the cattle gastrointestinal tract, which could pose a zoonotic risk to human beef consumers. Feeding tylosin for short durations may mitigate the impact on macrolide-resistant enterococci and further studies are encouraged to determine the effect of minimizing or eliminating tylosin use in beef cattle. There may also be an impact on other bacteria and other antimicrobial resistances but additional details or data are needed to strengthen these comparisons. We encourage authors of antimicrobial-resistance studies to follow reporting guidelines and publish details of all comparisons to strengthen future meta-analyses.

Efficacy of ketoprofen for treatment of spontaneous, culture-negative, mild cases of clinical mastitis: A randomized, controlled superiority trial

The objective of this randomized, controlled superiority trial was to assess the efficacy of ketoprofen for the treatment of spontaneous, culture-negative clinical mastitis cases that were not treated with antimicrobials. Holstein cows from 3 herds were eligible for inclusion if they had mild or moderate culture-negative clinical mastitis cases in 1 quarter or more. Upon detection of clinical mastitis, farm personnel performed on-farm culture (OFC) using commercially available bi-plates. Samples used for OFC were also cultured in a research laboratory. Cows with culture-negative clinical mastitis that met the inclusion criteria were randomly allocated to 1 of 2 experimental groups: in the ketoprofen (KET) group, cows received an intramuscular injection of 3 mg/kg of ketoprofen upon confirmation of a negative OFC result; and in the control (CON) group, cows received no treatment or placebo. Milk samples were collected 14 and 21 d after detection of clinical mastitis for microbiological examination and somatic cell counting. Study outcomes were clinical cure (within 7 d after inclusion in the study), relapse (within 14 d after inclusion) and recurrence of clinical mastitis (15 to 90 d after inclusion), risk of new intramammary infection, and quarter milk somatic cell count at 14 and 21 d. We used Cox proportional hazards, logistic regression, and repeated-measures models to compare each outcome between groups. After exclusion of moderate cases (n = 6), a total of 123 clinical mastitis cases (CON = 58 and KET = 65) were used for analyses. Risks of clinical cure [83.08% (54/65) and 91.23% (52/57); hazard ratio = 1.20, 95% confidence interval (CI) = 0.82-1.76], relapse [19.23% (10/52) and 18.00% (9/50); hazard ratio = 1.09, 95% CI = 0.45-2.62], and recurrence of clinical mastitis [17.31% (9/52) and 18.00% (9/50); hazard ratio = 1.26, 95% CI = 0.49-3.38] were not different between the KET and CON groups, respectively. The odds of a new intramammary infection at 14 d [20.75% (11/53) and 29.79% (14/47); odds ratio = 1.76, 95% CI = 0.66-4.73] or 21 d [28.57% (12/42) and 15.22% (7/46); odds ratio = 0.45, 95% CI = 0.16-1.30] were not different between the KET and CON groups, respectively. Mean somatic cell count was not different between the groups at 14 or 21 d. The results of this study suggest that a single intramuscular injection of ketoprofen as sole treatment for OFC-negative, mild clinical mastitis did not reduce time to clinical cure, relapse or recurrence of clinical mastitis, risk of subsequent intramammary infection, or milk somatic cell count compared with untreated controls.

Association between teat-end hyperkeratosis and mastitis in dairy cows: A systematic review

A systematic review was conducted to elucidate the role of teat-end hyperkeratosis (THK) as a risk factor for clinical mastitis (CM) or subclinical mastitis (SCM). Scientific papers on the subject were identified by means of a database search. All types of peer-reviewed analytical studies, observational or experimental and published in English, could be included in the review, regardless of publication year. Of 152 identified records, 18 articles were selected, of which 8 were prospective cohort studies, 9 were cross-sectional, and 1 was a hybrid case-control study. Internal validity of studies was assessed using a score system ranging from 0 to 6, based on design, risk of bias, and statistical methods. The most frequent study limitation was improper use of statistical methods to avoid confounding of associations between THK and CM or SCM. The 3 studies that used CM as outcome (all with high validity scores) showed positive associations with THK (especially severe), although the magnitude and statistical significance of the estimates differed among them. Most studies that used SCM as the primary outcome (based on microbiological examination of milk) reported that only severe THK was associated with SCM. Two studies with high validity scores reported moderate to strong associations between severe THK and incidence or prevalence of Staphylococcus aureus intramammary infection. Two studies with high validity scores reported that only severe THK was associated with the risk of somatic cell count (SCC) ≥200,000 cells/mL and increased mean SCC, respectively. Although 4 cross-sectional studies reported positive associations between THK and SCC, these associations were possibly spurious because confounding factors, such as parity, were not considered in the analyses. Results of the reviewed studies suggest that severe THK is a risk factor for both CM and SCM, as defined by microbiological examination of milk, SCC thresholds, or mean SCC. The effect of severe THK on both contagious (especially Staphylococcus aureus) and environmental CM or SCM emphasizes the importance of teat health for mastitis control. Four studies demonstrated that quarters with mild THK had lower prevalence of intramammary infection or lower mean SCC than quarters with no THK, suggesting that development of mild THK, as a physiological response to milking, can have a protective effect. Dairy consultants should focus on monitoring and minimizing occurrence of severe THK to prevent CM and SCM.

Factors associated with lameness prevalence in lactating cows housed in freestall and compost-bedded pack dairy farms in southern Brazil

The aim of this cross-sectional study was to investigate factors associated with lameness in dairy cows on intensive farms in southern Brazil. Farms (freestall: n = 38; compost-bedded pack: n = 12) having on average 274 (range: 41-901) lactating cows were visited once in 2016 (March to October). Potential risk factors for lameness at the cow, pen and herd levels were investigated through inspection of facilities, examination of cows and the use of data collected on routine management practices. All milking cows on each farm were assessed for gait score and BCS (n = 13,716). Associations between lameness, days in milk (DIM), BCS, parity, and test-day milk yield were investigated in 16 farms with available data (n = 5,301 cows). Mixed-effects linear and logistic regressions were used to model the data. Within-herd lameness prevalence was 41.1% (range: 13.8-64.5, SD = 11.3). First- and second-lactation cows after 120 DIM and older cows after 335 DIM were more likely to be observed lame than early lactation cows. Greater parity and low BCS (≤ 2.75) were associated with increased odds of lameness. Severely lame cows had lower milk yield (on average 1.3 kg/d) than non-lame cows. Freestall dairies using mattresses as stall base had greater within-pen (95% CI: 52-69%) and herd-level (38-57%) lameness prevalence than compost-bedded farms. Higher lameness prevalence was observed on farms having slippery feed bunk alley floors (32-49%) and shortened dry periods (< 60 days: 32-42%). First-lactation pens had lower predicted within-pen lameness prevalence (0-4%) and special-needs pens higher (52-73%) compared with the prevalence observed in compost-bedded fresh-cow pens (19-41%). Freestall pens using sawdust deep-bedding had greater (46-68%) within-pen lameness prevalence, but the prevalence in barns using sand was not different from compost-bedded farms. Given the high lameness prevalence observed in this study, there is a great opportunity for implementation of lameness prevention programs. Providing walking surfaces with high traction that facilitates mobility and using soft and deep-bedded material, such as compost and sand (and avoiding the use of mattresses) may reduce lameness prevalence in the types of dairy farms visited in this study.

Antimicrobial-based dry cow therapy approaches for cure and prevention of intramammary infections: a protocol for a systematic review and meta-analysis

In dairy herds, application of antimicrobials at drying-off is a common mastitis control measure. This article describes a protocol for systematic review and meta-analysis to address three crucial points regarding antimicrobial usage at drying-off: (1) comparative efficacy of antimicrobials used for preventing new and eliminating existing intramammary infections (IMI); (2) comparison of selective and blanket dry cow therapy approaches in preventing new and eliminating existing IMI; and (3) assessment of the extra prevention against new IMI that can be gained from using antimicrobial-teat sealant combinations versus antimicrobials alone. Five PICO (Population, Intervention, Comparator, Outcome) questions were formulated to cover the three objectives of the review. Medline, CAB Abstracts, Web of Science, and conference proceedings will be searched along with iterative screening of references. Articles will be eligible if: (1) published after 1966; (2) written in English or French; and (3) reporting field clinical trials and observational studies, conducted on dairy cows at drying-off, with at least one antimicrobial-treated group and one IMI-related outcome. Authors will independently assess the relevance of titles and abstracts, extract data, and assess bias and the overall quality of evidence. Results will be synthesized and analyzed using pairwise and network meta-analysis. The proposed study will significantly update previously conducted reviews.

Infection control practices employed within small animal veterinary practices-A systematic review

Effective infection control (IC) provides a safe environment for staff, clients and animals of veterinary practices by reducing the risk of nosocomial and zoonotic infections, which are associated with increased hospital stays, costs, morbidity and mortality. An equally important issue arising from nosocomial infection is the loss of trust between the client and the veterinary practice that has potential negative impacts on the veterinary practice in terms of economic risk and the well-being of staff. Furthermore, an emerging and significant threat, in this context, is antimicrobial resistance. The aim of this systematic review was to critically review published reports that documented current IC practices and evaluated interventions to improve IC practices. A systematic literature search using ten databases to identify papers published over a 20-year period (February 1996 to February 2016) was conducted for studies that met the inclusion criteria. Included studies were assessed using the PRISMA and STROBE-Vet statements. A total of 14 of 1,615 identified studies met our inclusion criteria. Infection control practices included hand hygiene, sharps handling, environmental cleaning, personal protective equipment and personnel vaccination. Descriptive studies were the predominant research design for assessing IC compliance. Only three studies were interventions. Compliance with IC protocols was poor and only marginally increased with multimodal educational campaigns. There was significant variation in the implementation of IC by veterinary staff. Workplaces that had IC policies, management support and a staff member supporting their implementation were more likely to embrace good IC. Infection control data in veterinary practices were inconsistently reported and collected. Clearly defining IC and determining prevalence of these practices within the veterinary field is important given the limited research in this area. Further, developing and implementing educational campaigns for this sector is needed.

Observational Study Design in Veterinary Pathology, Part 2: Methodology

Observational studies are a basis for much of our knowledge of veterinary pathology, yet considerations for conducting pathology-based observational studies are not readily available. In part 1 of this series, we offered advice on planning and carrying out an observational study. Part 2 of the series focuses on methodology. Our general recommendations are to consider using already-validated methods, published guidelines, data from primary sources, and quantitative analyses. We discuss 3 common methods in pathology research—histopathologic scoring, immunohistochemistry, and polymerase chain reaction—to illustrate principles of method validation. Some aspects of quality control include use of clear objective grading criteria, validation of key reagents, assessing sample quality, determining specificity and sensitivity, use of technical and biologic negative and positive controls, blinding of investigators, approaches to minimizing operator-dependent variation, measuring technical variation, and consistency in analysis of the different study groups. We close by discussing approaches to increasing the rigor of observational studies by corroborating results with complementary methods, using sufficiently large numbers of study subjects, consideration of the data in light of similar published studies, replicating the results in a second study population, and critical analysis of the study findings.

Observational Study Design in Veterinary Pathology, Part 1: Study Design

Observational studies are the basis for much of our knowledge of veterinary pathology and are highly relevant to the daily practice of pathology. However, recommendations for conducting pathology-based observational studies are not readily available. In part 1 of this series, we offer advice on planning and conducting an observational study with examples from the veterinary pathology literature. Investigators should recognize the importance of creativity, insight, and innovation in devising studies that solve problems and fill important gaps in knowledge. Studies should focus on specific and testable hypotheses, questions, or objectives. The methodology is developed to support these goals. We consider the merits and limitations of different types of analytic and descriptive studies, as well as of prospective vs retrospective enrollment. Investigators should define clear inclusion and exclusion criteria and select adequate numbers of study subjects, including careful selection of the most appropriate controls. Studies of causality must consider the temporal relationships between variables and the advantages of measuring incident cases rather than prevalent cases. Investigators must consider unique aspects of studies based on archived laboratory case material and take particular care to consider and mitigate the potential for selection bias and information bias. We close by discussing approaches to adding value and impact to observational studies. Part 2 of the series focuses on methodology and validation of methods.

Cow- and herd-level factors associated with lameness in small-scale grazing dairy herds in Brazil

This cross-sectional study aimed to assess lameness occurrence and to identify the associated risk factors in small-scale grazing dairy herds. Forty four farms (mean lactating herd size was 42 cows, SD = 11.2, range: 28-74) located in the south of Brazil were visited twice, approximately 4 months apart, in 2015. Locomotion was scored in 1633 and 1836 cows at the first and second visit, respectively. Potential risk factors for lameness were assessed through inspection of cows and facilities, and a questionnaire for farmers about herd management practices. Multilevel logistic regressions, using herd as random effect, were fitted to investigate the cow-level risk factors for accumulated incident (not lame at the first visit but lame on the second), chronic (lame on both visits) and recovered (lame at the first visit but sound on the second) cases of lameness. A multilevel linear regression, using municipality as a random effect, was fitted for herd-level analysis. Cumulative lameness incidence between two visits (1110 cows in 41 herds) was 29.6% (range: 0-80); lameness prevalence (n = 44 herds) was 31% (10-70) and 35% (5-76) at the first and second visits, respectively. The odds of incident cases were greater in Holstein cows [odds ratio (OR) = 4.0, 95% confidence interval 2.1-7.6] compared with Jerseys, in cows in parities 2-3 (OR 2.5, 1.4-4.4) or >3 (OR 6.6, 3.3-13.1) relative to parity 1, in cows having a low body condition score (BCS) of 2-2.75 or 3 on the first visit (OR 2, 1.1-3.7), and in cows with observed hoof abnormalities (OR 2.5, 1.3-4.7). Similar associations were found for chronic cases, with Holstein and crossbred cows having greater odds of lameness, compared to Jersey, and chronic cases being more likely in cows with increasing parity, with BCS at first visit of 2-2.75, and with presence of hoof abnormalities. Jersey or crossbred cows (OR 3.2, 1.3-8.1) and cows in parity 1-2 (OR 3.6, 1.6-8.4) had higher probability of recovery from lameness. Having a herd composed of Holstein cows was associated with 13.5% (CI 4.3-22.8) greater incidence of lameness (n = 35). For every 1 km/h increase in the average speed of movement of the herd to or from milking, lameness incidence increased by 5% (CI 0.1-10). Given that the occurrence of lameness was high there is great opportunity to reduce lameness in this population. This study highlights some management and prevention practices that may reduce lameness in these grazing herds.

Checklist for One Health Epidemiological Reporting of Evidence (COHERE)

One Health is defined as the intersection and integration of knowledge regarding humans, animals, and the environment, yet as the One Health scientific literature expands, there is considerable heterogeneity of approach and quality of reporting in One Health studies. In addition, many researchers who publish such studies do not include or integrate data from all three domains of human, animal, and environmental health. This points to a critical need to unify guidelines for One Health studies. This report details the Checklist for One Health Epidemiological Reporting of Evidence (COHERE) to guide the design and publication format of future One Health studies. COHERE was developed by a core writing team and international expert review group that represents multiple disciplines, including human medicine, veterinary medicine, public health, allied professionals, clinical laboratory science, epidemiology, the social sciences, ecohealth and environmental health. The twin aims of the COHERE standards are to 1) improve the quality of reporting of observational or interventional epidemiological studies that collect and integrate data from humans, animals and/or vectors, and their environments; and 2) promote the concept that One Health studies should integrate knowledge from these three domains. The 19 standards in the COHERE checklist address descriptions of human populations, animal populations, environmental assessment, spatial and temporal relationships of data from the three domains, integration of analyses and interpretation, and inclusion of expertise in the research team from disciplines related to human health, animal health, and environmental health.

Odds Ratio or Prevalence Ratio? An Overview of Reported Statistical Methods and Appropriateness of Interpretations in Cross-sectional Studies with Dichotomous Outcomes in Veterinary Medicine

One of the most commonly observational study designs employed in veterinary is the cross-sectional study with binary outcomes. To measure an association with exposure, the use of prevalence ratios (PR) or odds ratios (OR) are possible. In human epidemiology, much has been discussed about the use of the OR exclusively for case–control studies and some authors reported that there is no good justification for fitting logistic regression when the prevalence of the disease is high, in which OR overestimate the PR. Nonetheless, interpretation of OR is difficult since confusing between risk and odds can lead to incorrect quantitative interpretation of data such as “the risk is X times greater,” commonly reported in studies that use OR. The aims of this study were (1) to review articles with cross-sectional designs to assess the statistical method used and the appropriateness of the interpretation of the estimated measure of association and (2) to illustrate the use of alternative statistical methods that estimate PR directly. An overview of statistical methods and its interpretation using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted and included a diverse set of peer-reviewed journals among the veterinary science field using PubMed as the search engine. From each article, the statistical method used and the appropriateness of the interpretation of the estimated measure of association were registered. Additionally, four alternative models for logistic regression that estimate directly PR were tested using our own dataset from a cross-sectional study on bovine viral diarrhea virus. The initial search strategy found 62 articles, in which 6 articles were excluded and therefore 56 studies were used for the overall analysis. The review showed that independent of the level of prevalence reported, 96% of articles employed logistic regression, thus estimating the OR. Results of the multivariate models indicated that logistic regression was the method that most overestimated the PR. The findings of this study indicate that although there are methods that directly estimate PR, many studies in veterinary science do not use these methods and misinterpret the OR estimated by the logistic regression.

Revisiting an old disease? Risk factors for bovine enzootic haematuria in the Kingdom of Bhutan

Bovine enzootic haematuria (BEH) is a debilitating disease of cattle caused by chronic ingestion of bracken fern. Control of BEH is difficult when bracken fern is abundant and fodder resources are limited. To fill a significant knowledge gap on modifiable risk factors for BEH, we conducted a case-control study to identify cattle management practices associated with BEH in the Bhutanese cattle population. A case-control study involving 16 of the 20 districts of Bhutan was carried out between March 2012 and June 2014. In Bhutan sodium acid phosphate and hexamine (SAP&H) is used to treat BEH-affected cattle. All cattle greater than three years of age and treated with SAP&H in 2011 were identified from treatment records held by animal health offices. Households with at least one SAP&H-treated cattle were defined as probable cases. Probable case households were visited and re-classified as confirmed case households if the BEH status of cattle was confirmed following clinical examination and urinalysis. Two control households were selected from the same village as the case household. Households were eligible to be controls if: (1) householders reported that none of their cattle had shown red urine during the previous five years, and (2) haematuria was absent in a randomly selected animal from the herd following clinical examination. Details of cattle management practices were elicited from case and control householders using a questionnaire. A conditional logistic regression model was used to quantify the association between exposures of interest and household BEH status. A total of 183 cases and 345 controls were eligible for analysis. After adjusting for known confounders, the odds of free-grazing for two and three months in the spring were 3.81 (95% CI 1.27-11.7) and 2.28 (95% CI 1.15-4.53) times greater, respectively, in case households compared to controls. The odds of using fresh fern and dry fern as bedding in the warmer months were 2.05 (95% CI 1.03-4.10) and 2.08 (95% CI 0.88-4.90) times greater, respectively, in cases compared to controls. This study identified two husbandry practices that could be modified to reduce the risk of BEH in Bhutanese cattle. Avoiding the use of bracken fern as bedding is desirable, however, if fern is the only available material, it should be harvested during the colder months of the year. Improving access to alternative fodder crops will reduce the need for householders to rely on free-grazing as the main source of metabolisable energy for cattle during the spring.

Rapid systematic review and meta-analysis of the evidence for effectiveness of primary production interventions to control Salmonella in beef and pork

Non-typhoidal Salmonella spp. (hereafter referred to as Salmonella) on beef and pork is an important cause of foodborne illness and death globally. A systematic review of the effectiveness of interventions to reduce Salmonella prevalence or concentration in beef and pork was undertaken. A broad search was conducted in Scopus and CAB abstracts. Each citation was appraised using screening tools tested a priori. Level 1 relevance screening excluded irrelevant citations; level 2 confirmed relevance and categorized studies. Data were then extracted, and intervention categories were descriptively summarized. Meta-analysis was performed to provide a summary estimate of treatment effect where two or more studies investigated the same intervention in comparable populations. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to assess the confidence in the estimated measures of intervention effect for data subgroups.