Multilocation trial of ceftiofur for treatment of postpartum cows with fever

Potential Benefits to Dairy Cow Welfare of Using a Ceftiofur-Ketoprofen Combination Drug for the Treatment of Inflammatory Disease Associated with Pyrexia: A Field Clinical Trial on Acute Puerperal Metritis

Simple Summary

Some diseases of dairy cows require the use of an antimicrobial and an anti-inflammatory drug in association to be fully cured and relieve pain. However, pharmacological treatments in cattle are subject to strict regulations and restrictions, and cow handling is not always easy and safe. For these reasons, only the antimicrobial is often administered, thus not fully applying the appropriate therapeutic protocol. This study investigated whether the use of a drug combining ceftiofur and ketoprofen in a single injection instead of ceftiofur alone can improve the healing and welfare of dairy cows affected by a pyretic inflammatory disease, such as acute puerperal metritis. The results show that the variation in the physiological parameters was similar between the two treatment groups, and daily activity and milk yield did not differ from healthy cows. However, affected cows that were treated with the combined drug seemed to be more likely to become pregnant within 120 days in milk than those that received the antimicrobial alone, having an estimated number of days open more similar to that of the healthy cows.

Abstract

This study aimed at investigating the benefits of using a drug combining ceftiofur and ketoprofen in a single injection on dairy cow welfare in the case of inflammatory disease with pyrexia, such as acute puerperal metritis (APM). Cows of an Italian dairy farm were examined between 5 and 14 days of calving: those with APM were randomly treated either with combined ceftiofur–ketoprofen (CD) or ceftiofur alone (C), starting from Day 0, and an equal number of healthy cows served as a control (CTR). Clinical examination and blood sampling were performed until Day 7 in each group according to specific schedules. Daily cow activity was recorded until Day 14 and daily milk production until Day 30. Additional data on fertility were collected until 120 days in milk (DIM). Data of 20 cows per group were analyzed. Body temperature and haptoglobin concentration dropped between Day 0 and 4 in both CD and C, approaching the level of CTR. The cure rate at Day 7 (body temperature < 39.0 °C) was 65 (CD) and 55% (C), without statistical difference. Neither cow activity nor milk production differed among the three groups. Reproductive performances in both CD and C were similar to CTR, but CD cows were 2.8 times more likely to be pregnant within 120 DIM than C, becoming pregnant about 14 days sooner. Both treatments (CD and C) have been effective in bringing the cows back to health conditions (CTR), and further studies would be needed to confirm the positive effect observed for CD on days open of the affected cows.

Heart rate variability in dairy cows with postpartum fever during night phase

Autonomic nervous function evaluated by heart rate variability (HRV) and blood characteristics were compared between Holstein Friesian cows that developed postpartum fever (PF; n = 5) and clinically healthy (CH; n = 6) puerperal cows in this case-control study. A cow was defined as having PF when its rectal temperature rose to ≥39.5°C between 1 and 3 days postpartum. We recorded electrocardiograms during this period using a Holter-type electrocardiograph and applied power spectral analysis of HRV. Comparisons between the groups were analyzed by t test or Mann-Whitney U test, and the relationship between rectal temperature and each parameter was analyzed using multiple regression analysis. Heart rate was higher in PF cows than in CH cows (Mean ± SE, 103.3 ± 2.7 vs. 91.5 ± 1.7 bpm). This result suggested that PF cows had a relatively dominant sympathetic nervous function. Total (44,472 ± 2,301 vs. 55,373 ± 1,997 ms) and low frequency power (24.5 ± 3.8 vs. 39.9 ± 5.3 ms) were lower in PF cows than in CH cows. These findings were possibly caused by a reduction in autonomic nervous function. The total white blood cell count (54.3 ± 5.1 vs. 84.5 ± 6.4 ×10²/μL) and the serum magnesium (2.1 ± 0.1 vs. 2.4 ± 0.1 mg/dL) and iron (81.5 ± 8.0 vs. 134.4 ± 9.1 μg/dL) concentrations were lower and the serum amyloid A concentration (277 ± 33 vs. 149 ± 21 μg/mL) was higher in PF cows than in CH cows. These results imply that more inflammation was present in PF cows than in CH cows. Multiple regression analysis showed that both of low frequency power and concentration of serum iron were associated with rectal temperature. We found differences in changes in hematologic results, biochemical findings, and HRV patterns between PF cows and CH cows.

Management of Reproductive Disease in Dairy Cows

Postpartum diseases are common in dairy cows, and their incidence contributes to reduced fertility and increased risk of culling, making their prevention and management extremely important. Reproductive efficiency has a major impact on economic success of any dairy production unit. Optimizing reproductive efficiency contributes to overall efficiency of production units, minimizing environmental impacts and contributing to sustainability of food production. Additionally, control of reproductive diseases is important for maintenance of health and welfare of dairy cows; for minimizing use of antibiotics; and ensuring a wholesome, safe, and nutritious product.

Evidence for the use of ceftiofur for treatment of metritis in dairy cattle

Metritis is a cause of postparturient uterine disease in dairy cattle and is most commonly associated with watery fetid red-brown uterine discharge occurring in the first 21 days postpartum. The most severe form of metritis (puerperal metritis) often warrants antibiotic therapy. This article analyzes the current literature to determine the efficacy of ceftiofur in the treatment of metritis. Evidence-based review of the current literature suggests that there is evidence for the use of ceftiofur in the treatment of metritis. However, review of the literature also reveals the need for more studies with negative control groups.

Strategies for the treatment of dairy cows at high risk for postpartum metritis and for the treatment of clinical endometritis in Argentina

The objectives of this study were to evaluate the efficacy of (1) administering ceftiofur hydrochloride in dairy cows with calving-related disorders to prevent metritis and (2) a combination of GnRH and PGF2α for the treatment of clinical endometritis, under Argentinean dairy farming conditions. Cows at high risk (HRC) for metritis (dystocia, RFM >12 h postpartum, hypocalcaemia, twins, or stillbirth) were randomly assigned to receive either 1.1 mg/Kg of ceftiofur hydrochloride on three consecutive days (HRC treated group HRCT, n = 110) or remained untreated (HRC control group HRCC, n = 126). Cows with low risk (LRC, no calving-related disorders, n = 868) did not receive any treatment (LRC group, n = 868). All cows were examined for metritis between days 4 and 10 and for clinical endometritis between 24 and 30 days postpartum. The body condition score (BCS) was recorded at both examinations. Cows with endometritis at days 24 to 30 postpartum received either 1.5 mg of D-cloprostenol (PGF; n = 129) or 100 μg of GnRH followed by D-cloprostenol after 7 days (GnRH+PGF, n = 119). There was no overall effect of treatment on the incidence of metritis or on time to pregnancy. Treatment, however, reduced the incidence of metritis in cows with high BCS (HRCT = 24.0 %, HRCC = 38.5 %) but had no effect in cows with low BCS (HRCT = 38.7 %, HRCC = 37.5 %). The proportion of pregnant cows by days in milk was greater (P < 0.01) in LRC group compared with that of the HRCT and HRCC groups. No significant differences were found between groups PG and PG+GNRH. GnRH+PGF treatment, however, tended (P = 0.06) to increase pregnancy rate in cows with a moderate loss of BCS (76.5 vs 65.2 %) but tended to reduce pregnancy rate (54.5 vs 76.0 %) in cows with a more pronounced loss in BCS (>0.75 points).

Metritis in dairy cows: risk factors and reproductive performance

The objectives of this study were to assess the risk factors for metritis, its effects on milk yield and on reproductive performance, and the efficacy of ceftiofur therapy in Holstein dairy cows. Cows (n=303) from a commercial dairy herd in Argentina were studied. Cows were scored for body condition, and blood samples were collected on d -14, 7, 21, 31, 41, and 50 relative to parturition. Cows having a watery, purulent, or brown, and fetid vaginal discharge (VD) and rectal temperature ≤ 39.2°C were diagnosed as having clinical metritis, and those having a similar VD and rectal temperature >39.2°C were diagnosed as having puerperal metritis. Both clinical and puerperal metritis cows were randomly assigned to control (no treatment) or ceftiofur group (2.2mg/kg×3 consecutive days). Cure was declared if clear VD was observed at 21 d in milk (DIM). Blood samples were analyzed for nonesterified fatty acids, β-hydroxybutyrate, and blood urea nitrogen using commercial kits, and for insulin-like growth factor-1, insulin, and leptin by RIA. Data were analyzed with PROC MIXED, GENMOD, PHREG, and LIFETEST from SAS (SAS Institute Inc., Cary, NC). The risk for metritis increased with dystocia, retained fetal membranes, and dead calf [AOR (adjusted odds ratio)=2.58, 95% CI: 1.189-5.559], and as prepartum nonesterified fatty acids levels increased (AOR=1.001, 95% CI: 0.999-1.002). Conversely, risk decreased as prepartum insulin-like growth factor-1 increased (AOR=0.65, 95% CI: 0.349-1.219). Cows having either clinical or puerperal metritis produced less milk by 90 DIM than did healthy cows (2,236 ± 172 vs. 2,367 ± 77 vs. 2,647 ± 82 kg, respectively). Cows with puerperal metritis had lower risk for pregnancy by 100 DIM (AOR=0.189, 95% CI: 0.070-0.479) and a lower hazard rate for pregnancy by 150 DIM (hazard rate: 0.753, 95% CI: 0.621-0.911), and took longer to get pregnant (129 vs. 111 vs. 109 d, for puerperal metritis, clinical metritis, and healthy cows, respectively). Ceftiofur treatment was not associated with cure rate or milk yield but was related to increased risk for pregnancy at timed artificial insemination (AOR=2.688, 95% CI: 0.687-10.832), and for lower risk of reproductive cull (AOR=0.121, 95% CI: 0.014-1.066). In conclusion, abnormal calving and negative energy balance are associated with increased risk for metritis. Metritis, especially puerperal metritis, correlates with reduced milk production and poor reproductive performance. Finally, the likelihood for having a normal VD (indicative of cure) increased 2.6% for every day of increase in postpartum time and was 2 times higher for cows with clinical metritis than for those with puerperal metritis.

Evaluation of two doses of ceftiofur crystalline free acid sterile suspension for treatment of metritis in lactating dairy cows

The objectives of this study were to evaluate efficacy of a 2-dose regimen of ceftiofur crystalline free acid sterile suspension (CCFA-SS) for treatment of acute metritis in lactating dairy cows under field conditions and to provide additional safety and injection site tolerance data for injections at the base of the ear. Cows at 15 dairies with rectal temperature ≥ 39.5°C and fetid uterine discharge ≤ 10 d postcalving were randomly assigned by blocks of 2, based on order of entry and without regard to parity, to treatment with saline (1.5 mL/45.5 kg of body weight, n=509) or CCFA-SS (6.6 mg of ceftiofur equivalents/kg of body weight, n=514). Treatments were administered by subcutaneous injection in the posterior aspect of the ear where it attaches to the head; the first dose was administered on study d 0 and the second dose was administered in the contra lateral ear on study d 3. Rectal temperatures were recorded on study d 1 to 4 and 5 or 6 and cows were clinically evaluated daily from study d 1 to 13. Cows that exhibited increased adverse clinical signs of poor health or complications associated with metritis were categorized as a treatment failure and administered escape therapy. Each cow received a veterinary physical examination on study d 5 or 6 to determine if she should be removed from the study and on study d 14 to determine clinical cure or failure to cure. Clinical cure was defined as rectal temperature <39.5°C and non-fetid and purulent or mucopurulent discharge on study d 14 and no escape therapy administered. The injection procedure was scored after each injection (study d 0 and 3) and injection sites and ear carriage were scored on study d 5 or 6, 14, and 57±3. Of the 1,023 cows enrolled, 7 were completely censored due to protocol deviations and 34 were removed for protocol deviations or medical conditions not related to metritis. Clinical cure rate was higher for CCFA-SS than for saline (74.3 vs. 55.3%) and rectal temperatures for each of study d 1 to 5 or 6 were lower for CCFA-SS than saline. Injection procedure indices showed that CCFA-SS could be practically and safely administered using commercial dairy facilities. Although injection site scores were higher for CCFA-SS than saline at study d 5 or 6 and 14, ≥98.6% of ears were normal on d 57±3. Thus, a 2-dose treatment with CCFA-SS given 72h apart increased metritis clinical cure rate and was well tolerated in dairy cows.

A critical evaluation of diagnostic methods used to identify dairy cows with acute post-partum metritis in the current literature

The overall objective of this study was to investigate how relevant research publications address the validity of diagnostic methods for acute puerperal metritis (APM) in dairy cows, a disease commonly treated with antibiotic drugs. Therefore, a literature search was conducted in Journal of Dairy Science, Theriogenology, Animal Reproduction Science and The Veterinary Journal utilizing the ScienceDirect database. The search revealed 259 articles addressing APM. After applying exclusion criteria, a total of 48 trials remained. It was determined whether the author gave a clear definition of APM, the time of diagnosis relative to calving, and the person who performed the diagnosis. Studies were checked for the presence of definitions of possible findings, thresholds, and test characteristics of the methods used. Overall 9 different diagnostic methods were employed. On average 2·5 ± 1·75 diagnostic methods were used in a study. References to support the use of the diagnostic methods were provided in 10 of 48 articles (20·8%). Vaginal discharge, transrectal palpation and rectal temperature were examined in 39, 22, and 21 of the studies, respectively. Thresholds for diagnostic tests and test characteristics were mentioned in 6 and 3 of the 48 articles, respectively. Based on this systematic review of 48 research papers the evidence supporting the use of the diagnostic methods to identify cows with APM has either been not reported or is weak. In conclusion, the reporting of the diagnostic methods to identify cows with APM needs to be improved and further high-quality research is necessary to improve diagnostic performance of the methods employed.

Factors associated with body temperature of healthy Holstein dairy cows during the first 10 days in milk

In this prospective observational study rectal and vaginal temperature of 82 (26 primiparous, 56 multiparous) early post-partum healthy dairy cows that calved without intervention within 3 months and did not show clinical signs of infectious and metabolic diseases were continuously measured and evaluated for associations with plausible factors during the first 10 days in milk (DIM). During May, June and July mean (±sd) temperature humidity index (THI) was 60·1±5; 66·8±5·6 and 74·2±4·3, respectively. Environmental conditions had a negligible effect on body temperature (BT) during May (P<0·05). During June and July, however, the ambient temperature and THI influenced BT (P<0·05). Furthermore, plausible factors like parity, DIM, months and time of day had an effect on BT (P<0·05). Overall, primiparous cows demonstrated 0·2°C greater BT during the first 10 DIM than multiparous cows. The effect of parity, however, on BT varied between DIM according to month (P<0·001). During this 3-month study period all cows demonstrated BT rhythms; however, the amplitude of BT increased from May to July (0·3 to 0·7°C). A greater proportion of the vaginal temperature measurements exceeded a threshold tested (⩾39·5°C) during July (46·8%) than in June (33·9%) and May (19·3%). Overall the percentage of BT values above a threshold of ⩾39·5°C was lower during the period 6.00–10.00 compared with the remaining 20 h (P<0·05). Therefore this study concluded that the BT of healthy post-partum dairy cows during the period 1–10 DIM post partum is greater compared with the reference range of 38·6 to 39·5°C reported by others and is influenced by parity, DIM, time of day and THI. When the association between BT and THI increased the reliability of threshold levels of BT (⩾39·5°C) decreased.

Treatment of acute puerperal metritis with flunixin meglumine in addition to antibiotic treatment

The objective of this field trial was to evaluate effects of a single administration of 2.2 mg/kg of body weight (BW) of flunixin meglumine (FM) in addition to a systemic antibiotic treatment in cows with acute puerperal metritis (APM). Outcome variables tested were proportion of cows with a fever, prevalence of chronic endometritis 18 to 22 and 32 to 35 d in milk (DIM), and reproductive performance measures in the current lactation. In addition, serum concentrations of haptoglobin and fibrinogen were analyzed. Daily milk yield within 6 d after the first treatment was recorded. Cows were examined 4 to 5 DIM by rectal palpation and vaginoscopy, and rectal temperature was measured. Fetid vulvar discharge and a body temperature > or = 39.5 degrees C were signs of APM. Cows with APM were treated in the reference group with 1.0 mg/kg of BW of ceftiofur on 3 to 5 consecutive days (CEF, n = 119). In the study group, cows received the same antibiotic treatment as in CEF and 2.2 mg/kg of BW of FM on treatment d 1 (CEF + FM, n = 119). Blood samples were collected 4, 6, and 10 DIM and analyzed for concentrations of haptoglobin and fibrinogen. A group of cows without APM remained untreated and served as controls (n = 9). There were no significant differences between CEF and CEF + FM in the proportion of cows with fever 1 d after the first treatment (33.6 vs. 46.2%), milk yield per milking 10 DIM (7.5 +/- 0.3 vs. 7.6 +/- 0.3 kg in primiparous, 9.6 +/- 0.4 vs. 10.6 +/- 0.4 kg in multiparous cows), prevalence of chronic endometritis 32 to 35 DIM (64.3 vs. 52.2%), and in reproductive performance (31.5 vs. 34.3% conception to first AI, 58.0 vs. 54.6% pregnancy rate, 107.8 +/- 36.9 vs. 101.6 +/- 41.4 d open). Compared with the control, CEF and CEF + FM had significantly greater concentrations of haptoglobin (1.1 +/- 0.28 vs. 1.9 +/- 0.06 and 1.8 +/- 0.07 mg/mL at 4 DIM; 0.3 +/- 0.15 vs. 1.1 +/- 0.06 and 1.2 +/- 0.07 mg/mL at 10 DIM) and fibrinogen (2.2 +/- 0.17 vs. 3.9 +/- 0.14 and 3.7 +/- 0.13 g/L at 4 DIM; 1.9 +/- 0.1 vs. 2.6 +/- 0.1 and 3.0 +/- 0.13 g/L, respectively, at 10 DIM) on all test days. The additional treatment with FM had no effect on these acute phase proteins. In conclusion, the single administration of 2.2 mg/kg of BW of FM in addition to a systemic antibiotic treatment of cows having APM did not result in beneficial effects on clinical cure, milk yield within 6 d after the first treatment, or reproductive performance.

Comparison of Two Management Strategies for Retained Fetal Membranes on Small Dairy Farms in Germany

The objective of this study was to compare 2 strategies for the management of dairy cows having retained fetal membranes (RFM) with regard to clinical traits, milk yield, and reproductive performance. In contrast to recent studies evaluating optimal strategies for the management of cows with RFM, this trial was conducted on small dairy farms with 26 to 166 cows per herd. In the systemic (SYS) group (n = 116), cows having RFM and a rectal temperature > or = 39.5 degrees C were treated with 1 mg/kg of body weight of ceftiofur on 3 to 5 consecutive days. The RFM cows without fever remained untreated. In the intrauterine (IUT) group (n = 115), all RFM cows received an intrauterine treatment with 6 g of tetracycline on 3 consecutive days combined with an attempt to remove the fetal membranes manually. The IUT cows with a fever received an additional systemic treatment with 10 mg/kg of body weight of amoxicillin on 3 to 5 consecutive days. Body temperature, daily milk yield, prevalence of vaginal discharge 28 to 35 d in milk (DIM), and reproductive performance traits within 200 DIM were monitored. The proportion of cows experiencing fever within 5 d after enrollment was greater in SYS compared with IUT. The proportion of cows with mucopurulent or purulent vaginal discharge 28 to 34 DIM did not differ between the groups. Furthermore, no significant differences between groups were found in daily milk yield in the first 10 d after enrollment, or in reproductive performance or proportion of cows culled. Significant differences in the proportion of cows with a fever in SYS and IUT have not been reported in studies with similar study designs conducted on large dairy farms. Further results on milk yield and reproductive performance, however, support findings that a management strategy for RFM based on a selective systemic treatment of feverish cows is at least as efficacious as a strategy based on intrauterine treatments of all cows and a systemic antibiotic treatment of feverish cows.

Ceftiofur Derivatives in Serum, Uterine Tissues, Cotyledons, and Lochia after Fetal Membrane Retention

The objective of the study was to determine concentrations of ceftiofur derivatives after subcutaneous application of ceftiofur hydrochloride in cows with retained fetal membranes. Concentrations of ceftiofur derivatives detected as desfuroylceftiofuracetamide were determined in blood serum, endometrium, caruncles, cotyledons, and lochia during 72 h. After induction of parturition, 2 primiparous and 4 multiparous cows having retained fetal membranes for at least 12 h were studied. All cows received 3 consecutive injections (C1 to C3; 24 h apart) of 1-mg ceftiofur equivalents per kilogram of body weight as ceftiofur hydrochloride sterile suspension. Samples of blood, endometrium, caruncles, cotyledons, and lochia were collected immediately before each injection (0 h) and again at 4, 12, and 24 h after C1, C2, and C3. Blood samples were collected from coccygeal vessels. Caruncles were removed from the uterine lumen by manual extirpation and separated from cotyledons. Endometrial tissue (0.5 g) was collected by using Kenny's biopsy apparatus. For all samples, concentrations of potentially active ceftiofur derivatives were quantified using an HPLC assay. Within 2 h (serum), 4 h (endometrium), and 12 h (caruncles, cotyledons, lochia) after C1 and during the entire study period, mean concentration of ceftiofur derivatives exceeded the reported minimum drug concentrations required to inhibit the growth of 90% of isolates for relevant bacteria such as Escherichia coli, Fusobacterium necrophorum, and Arcanobacterium pyogenes. Only in single samples did concentrations decrease temporarily below the reported minimum drug concentrations required to inhibit the growth of 90% of isolates.

Comparison of Two Strategies for Systemic Antibiotic Treatment of Dairy Cows with Retained Fetal Membranes: Preventive vs. Selective Treatment

The objective of this study was to evaluate the efficacy of a blanket systemic preventive treatment (PT) of cows having retained fetal membranes (RFM) with 1 mg/kg of ceftiofur administered the first day after calving regardless of their body temperature. This strategy was compared with a selective treatment (ST) strategy in which only cows having RFM and a rectal temperature > or = 39.5 degrees C within 10 d postpartum received ceftiofur. Cows that retained their fetal membranes for at least 24 h after calving were allocated to 2 groups. Rectal temperature was measured daily for 10 d postpartum. Sixty PT cows having RFM received a daily ceftiofur (1 mg/kg of body weight) treatment, administered subcutaneously during the first 3 d after diagnosis of RFM. If rectal temperature was > or = 39.5 degrees C after 3 daily treatments, cows received ceftiofur for 2 more days. Therapy in 53 ST cows was based on selective administration of ceftiofur to cows having fever during the first 10 d postpartum. Treatment was conducted for 3 to 5 consecutive days as described for PT cows, beginning on the first day of fever. In both groups, manual removal of the placenta was not attempted and antibiotic drugs were not administered into the uterus. For every cow having RFM enrolled in PT or ST, 1 cow without RFM that had calved on the same day was enrolled in a healthy control group (n = 113). All cows received two 25-mg doses of PGF(2alpha): 1 dose between 18 and 24 d and 1 dose between 32 and 38 d postpartum. The PT did not reduce the proportion of cows experiencing fever during 10 d postpartum compared with ST cows (71.7 vs. 69.8%). Results were compared using logistic regression models and survival analyses. The artificial insemination submission rate between 42 and 62 d postpartum was greater in PT (41.2 vs. 20.8 vs. 24.5%), but total conception rate was less in ST and control cows, respectively (25.0 vs. 38.9 vs. 36.2%). In this trial, a preventive systemic antibiotic treatment of all cows having RFM was not superior to a selective antibiotic treatment of cows only in case of fever.

Strategies to Improve the Therapy of Retained Fetal Membranes in Dairy Cows

In this field trial, a protocol for the treatment of retained fetal membranes (RFM) without any intrauterine therapy was compared with 3 protocols based on the intrauterine use of antibiotic pills (AP), the manual removal (MR) of the fetal membranes, or the combination of both (PR). The study was conducted on 5 commercial dairy farms in Germany. Cows with RFM for at least 24 h after calving were assigned to 1 of 4 treatment groups. Cows of all groups with a rectal temperature >or= 39.5 degrees C received a systemic antibiotic treatment with ceftiofur (1 mg/kg per d) for 3 to 5 consecutive days. In case of continued fever after 5 treatments, cows received a different antibiotic as an escape therapy. In the reference group (REF; n = 131), cows did not receive any additional treatment. All cows in group AP (n = 119) received intrauterine treatment with antibiotic pills consisting of 1,000 mg of ampicillin and 1,000 mg of cloxacillin for 3 consecutive days. In group MR (n = 121), an attempt was made to remove the fetal membranes manually, but uterine pills were not administered. In group PR (n = 130), an attempt was made to remove the fetal membranes manually and all cows received a local antibiotic treatment as in group AP. All cows received 2 doses of 25 mg of PGF(2alpha): one dose between 18 and 24 d and another between 32 and 38 d postpartum. Statistical analyses were performed using binary logistic regression models and survival analyses with group REF as reference. Of all animals, 79.8% had a body temperature of >or= 39.5 degrees C at least once within 10 d postpartum and were treated with ceftiofur. Occurrence of fever within 10 d postpartum was significantly lower in groups AP and PR compared with reference group REF, but was not different between groups MR and REF. Risk of receiving an escape therapy in case of fever after 5 treatments with ceftiofur did not differ among groups. Reproductive performance measures did not differ significantly between group REF and any of the comparison groups. Compared with a treatment protocol based only on systemic treatment with antibiotics for cows with a fever, neither intrauterine antibiotics nor manual removal of fetal membranes alone or in combination reduced proportions of cows needing an escape therapy nor did those treatments improve reproductive measures in the current lactation. Systemic treatment alone based on elevated rectal temperature was effective and reduced use of antibiotics compared with therapies that included intrauterine antibiotics.

The postpartum uterus

The cow is notable among the domestic species for the almost ubiquitous bacterial contamination of the uterine lumen after parturition and the high incidence of clinical uterine disease. Such uterine disease not only disrupts uterine tissues, but also ovarian follicle growth and function by perturbation of the hypothalamus, pituitary, and ovary. Other events such as the postpartum negative energy balance also have similar multilevel effects on postpartum endocrinology. Return of ovarian cyclical activity is dependent on the innate immune system resolving uterine bacterial contamination,prompt uterine involution, and a short interval to the negative energy balance nadir. Although the risk factors for uterine disease have been described, preventive strategies are not widely adopted. Thus, veterinarians must identify and treat uterine disease efficiently to limit their negative effect on fertility.

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

OBJECTIVE

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

DESIGN

Multilocation, randomized block, field trial.

ANIMALS

406 cows in the first 14 days postpartum.

PROCEDURE

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

RESULTS

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

CONCLUSIONS AND CLINICAL RELEVANCE

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

Association between postpartum pyrexia and uterine bacterial infection in dairy cattle

The temperature of 90 dairy cattle was recorded for the first 10 days after parturition and the animals were categorised as either normal (< 39.7 degreesC) or pyrexic. Swabs were collected from the uterine lumen seven, 14, 21 and 28 days after parturition for aerobic and anaerobic culture; bacteria were identified and their growth was scored semiquantitatively. Blood samples were collected three times a week for the estimation of the concentrations of acute phase proteins. The cows' temperatures were often above the accepted normal range, but it was not a good indicator of the number of bacteria in the uterus. However, pyrexia was correlated with the presence of specific uterine pathogens (P < 0.05) and in particular with Prevotella species (P < 0.01). The pyrexic animals had a higher plasma concentration of the acute phase protein (alpha1-acid glycoprotein (P < 0.05). Although pyrexia is an indicator of postpartum inflammation, additional clinical signs are necessary to identify uterine bacterial infection.