Survival and prognostic indicators in downer dairy cows presented to a referring hospital: A retrospective study (1318 cases)

Prognostic indicators of outcome in nonambulatory beef cattle presented to 2 referral hospitals: A retrospective study of 63 cases

BACKGROUND

Down cow syndrome is commonly described in dairy cattle. The diagnosis and treatment of nonambulatory cattle is challenging and prognostic indicators of this condition in beef cattle have not been determined.

OBJECTIVES

Evaluate records of beef cattle (≥2 years of age) presented to 2 referral hospitals for inability to stand and identify prognostic indicators for survival to discharge.

ANIMALS

Sixty-three adult beef cattle treated for inability to stand at 2 referral hospitals.

METHODS

Medical records of 63 beef cattle presented for inability to stand between January 2010 and December 2022 were retrospectively analyzed. Continuous and categorical variables were included in univariate and multivariate regression models to evaluate their association with outcome.

RESULTS

Of 63 animals included in the study, 19% (12/63) were discharged, and the remaining 81% (n = 51) either died (11.1%) or were euthanized (69.8%). The odds of being discharged increased with each additional day of hospitalization (odds ratio [OR], 2.66; 95% confidence interval [CI], 1.39-6.89) and with each additional flotation therapy session (OR, 2.108; 95% CI, 1.209-4.219). Down beef cattle with a diagnosis of calving peripheral nerve paralysis and capable of walking out the tank after the first flotation session were 6.66 (95% CI, 1.58-35.51) and 30 (95% CI, 4.4-614.98) times more likely to be discharged compared with cattle that had other diagnoses and those that were unable to walk out the tank, respectively.

CONCLUSIONS AND CLINICAL IMPORTANCE

Treatment of nonambulatory beef cattle carries a poor prognosis. Practitioners can use information from our study as a guide for treatment or euthanasia decisions of nonambulatory beef cattle.

Evaluation of a novel dipotassium phosphate bolus for treatment of metabolic disorders in dairy cattle

A dipotassium phosphate bolus (K Phos-Boost) has been developed to treat both hypophosphatemia and hypokalemia, as the clinical signs of both conditions are similar and occur in the early post-partum period. The objective of this research was to evaluate the efficacy and application of the bolus for prevention and treatment of metabolic diseases that are common in dairy production systems. Study 1 (Pharmacokinetic study): Healthy post-partum cows were either untreated or received two K Phos-Boost boluses at times 0, 24, and 48 h. Blood was taken at t = 0, 2-, 4-, 6-, 8-, 10-, 24-, and 52-h post-treatment for analysis of total serum minerals. There was an increase in serum phosphorous to normal levels within 2 h of treatment with the bolus, but control cows remained hypophosphatemic. Serum potassium was significantly elevated 2 h after bolus administration relative to control, while calcium, magnesium, sodium, and chloride levels were not affected by the K Phos-Boost bolus. Study 2 (Downer Cow Treatment): K Phos-Boost boluses were provided to cows that were unresponsive to intravenous calcium therapy and had been unable to stand for over 24 h ("downer cows"). Most cows (16 of 19) treated with two boluses were standing without assistance between 1 and 24 h after treatment and the serum phosphorous was increased to normal levels in five of five tested animals. Study 3 (Ketosis Treatment): cows with clinical ketosis were provided with propylene glycol and K Phos-Boost boluses (n = 29) or only propylene glycol (n = 23). Cows treated with the K Phos-Boost bolus showed a more rapid recovery by increased milk production (3.9 kg/day) and rumination rate (97 min/day). Study 4 (Health Promotion): cows in herds with >40% post-partum hypophosphatemia received K Phos-Boost boluses (n = 130) or no treatment (n = 146) following calving. There was a trend for treated 2nd-lactation animals to have higher milk production after 30 DIM (49.1 vs. 46.2 kg/day; P = 0.09). There were no significant differences between control and bolus treated animals in the incidence of subclinical ketosis, post-calving total health events, or culling rates. The K Phos-Boost bolus is a novel product and has the potential to treat and prevent several important metabolic diseases in dairy cattle. The studies described in this paper are early investigations and further research should be conducted to demonstrate the applications of a dipotassium phosphate bolus in dairy cows.

Comparison of prepartum blood parameters in dairy cows with postpartum ketosis and new risk prediction candidates

Introduction

Ketosis is a predominant metabolic problem and a risk factor for several postpartum diseases. This retrospective study aimed to evaluate the complete blood count (CBC), plasma biochemistry, and osteocalcin and identify significant prepartum and early postpartum values expressed in ketotic cows.

Methods

In 135 Holstein Friesian cows, 210 parturitions of 114 primiparous and 96 multiparous cows were examined. According to the plasma concentrations of β-hydroxybutyrate (BHB; ≥ 1.4 mmol/L) or non-esterified fatty acids (NEFA; ≥ 0.7 mmol/L) in the postpartum period, cows were divided into healthy cows (CON) and ketotic cows (KET). Analyses of CBC and biochemistry profiles were performed from -6 to 4 weeks of parturition every 2 weeks (prepartum; BW-5, BW-3, and BW-1, postpartum; BW1 and BW3), and osteocalcin ELISA tests were performed using blood samples from -2 to 2 weeks of parturition (BW-1 and BW1).

Results

In primiparous KET (n = 114) before parturition, lower lymphocyte (Lym) in BW-5 and BW-3, lower red blood cell (RBC) in BW-5, higher mean corpuscular volume (MCV) in BW-1, and higher NEFA in BW-3 were significant compared with CON. Primiparous KET showed lower carboxylated osteocalcin (cOC) levels and a significant decrease after parturition. In multiparous KET (n = 96) before parturition, lower neutrophil (Neu) in BW-5, higher hemoglobin (HGB) in BW-5, higher MCV in BW-5 and BW-1, higher MCH in BW-5, lower total cholesterol (TC) in BW-5, higher triglyceride (TG) in BW-3, higher NEFA in BW-1, higher glucose (Glu) in BW-3, lower γ-glutamyl transferase (GGT) in BW-5, lower inorganic phosphate (iP) in BW-3, and higher body condition score (BCS) in BW-5 and BW-3 were significant compared with CON. Multiparous KET showed decreased cOC and uncarboxylated osteocalcin (ucOC) after parturition, which was lower than that in the CON group.

Discussion

The blood parameters expressing different values between CON and KET in prepartum or early postpartum periods are presumed to show individual nutrition and health states, liver function, and overweight status. These parameters could be valuable indicators that can be used to prevent the occurrence of ketosis and improve management practices by recognizing these differences in ketotic cows before calving.

Development of a Nomogram to Estimate the 60-Day Probability of Death or Culling Due to Severe Clinical Mastitis in Dairy Cows at First Veterinary Clinical Evaluation

Severe clinical mastitis is a frequent disease of dairy cattle. An effective mean of predicting survival despite treatment would be helpful for making euthanasia decisions in poor prognosis cases. The objective was to develop a nomogram for prediction of death or culling in the 60 days following a severe mastitis episode in dairy cows at first veterinary visit in farm settings. A total of 224 dairy cows presenting severe clinical mastitis and examined for the first time by a veterinarian were included in a prospective study. Clinical and laboratory (complete blood cell count, L-lactate, cardiac troponin I, milk culture) variables were recorded. Animals were followed for 60 days. A nomogram was built with an adaptive elastic-net Cox proportional hazards model. Performances and relevance were evaluated by area under the receiver operating characteristic curve (AUC), Harrell’s concordance index (C-index), calibration curve, decision curve analysis (DCA) and misclassification cost term (MCT). The nomogram included: lactation number, recumbency, depression intensity, capillary refilling time, ruminal motility rate, dehydration level, lactates concentration, hematocrit, band neutrophils count, monocyte count, and milk bacteriology. The AUC and C-index showed a good calibration and ability to discriminate. The DCA suggested that the nomogram was clinically relevant. Euthanizing animals having less than 25% probability of survival is economically optimal. It could be used for early euthanasia decisions in animals that would not survive despite treatment. To facilitate the use of this nomogram by veterinarians, a web-based app was developed.

Downer cows: a reanalysis of an old data set

AIMS

To compare the performance of two predictive models for the survival of downer cows.

METHODS

The first model had been developed in 1987 using a dataset containing missing values, while the second, new model was developed on the same dataset but using modern data imputation and analytical methods. Missing data were imputed using multiple imputation by chained equations and a logistic regression model fitted to the imputed data, with survival or not as the outcome variable. The predictive ability of the model built on the imputed data was contrasted with the original prognostic model by testing them both on a second smaller but complete data set, collected contemporaneously with the development of the original model but from a different region of New Zealand. Sensitivity, specificity, accuracy, and cut point for the two models were calculated.

RESULTS

The original 1987 model had a slightly higher accuracy than that of the new one with a sensitivity of 0.85 (95% CI = 0.72-0.94) and a specificity of 0.82 (95% CI = 0.7-0.91), using a cut point for the probability of survival = 0.313.

CONCLUSIONS

The original prognostic formula published by Clark et al. in 1987 performed as well as a modern model built on an imputed data set.

CLINICAL RELEVANCE

The use of a prognostic test based on the Clark model should remain an important part of the clinical examination of downer cows by New Zealand veterinarians.Abbreviations: AUC: Area under the curve; AST: Aspartate transaminase activity; CK: Creatine phosphokinase activity; GAM: Generalised additive model; NSAID: Non-steroidal-anti-inflammatory drugs; PCV: Packed cell volume.

Prognostic indicators for survival of downer cattle treated using a flotation tank in a referral hospital: 190 cases (2000-2020)

BACKGROUND

Nonambulatory cattle present therapeutic challenges in addition to animal welfare concerns. Flotation therapy is a treatment option, but more information regarding prognostic indicators for survival is needed to guide use of this modality.

HYPOTHESIS/OBJECTIVES

Evaluate historical and clinical variables assessed during hospitalization as prognostic indicators for survival in recumbent cattle undergoing flotation treatment in a referral hospital.

ANIMALS

A total of 190 nonambulatory dairy cattle.

METHODS

Retrospective case series. Medical records were analyzed from cattle undergoing flotation between 2000 and 2020. Univariable and multivariable logistic regression analyses were performed to assess the association of clinical variables with survival to discharge.

RESULTS

Eighty-nine of 190 (47%) recumbent cattle survived to discharge. For each additional day of hospitalization, cattle were 1.10 (95% confidence interval [CI], 1.02, 1.21) times more likely to survive. Cattle unable to walk out of the tank after their first float session were 0.11 (95% CI, 0.04, 0.28) times less likely to survive compared to cattle that could and inappetent cattle were 0.22 (95% CI, 0.07, 0.63) times less likely to survive compared to cattle with normal appetites. Cattle diagnosed with coxofemoral luxation or toxemia were 0.11 (95% CI, 0.02, 0.65) and 0.16 (95% CI, 0.02, 0.90) times less likely to survive, respectively, compared to cattle with causes of recumbency that were undetermined.

CONCLUSIONS AND CLINICAL IMPORTANCE

Walking out of the tank after the first float session, appetite, diagnosis, and days of hospitalization are associated with outcome in nonambulatory dairy cattle treated by flotation. These findings can be used to determine likely outcome and guide treatment, referral, or euthanasia decisions.