In the present study a positive VV score was associated with reduced reproductive performance and was more common in primiparous and low BCS cows. Of the at-risk cows, those with RFM, VD, dystocia, dead calf or twins were more likely to have a positive VV score.

There was a substantial measure of agreement between each method when scores were analysed by status. Cows that were positive with either method had inferior reproductive performance compared with cows with a score of zero. Treatment of cows diagnosed with a purulent or mucopurulent discharge with intrauterine cephapirin improved reproductive performance in both the vaginoscopy and Metricheck groups.

Intrauterine cephapirin infusion of MAR cows improved reproductive performance, depending on CTI. The greater treatment effect in VV-positive cows suggests that VV scoring is a useful tool for the diagnosis of endometritis.

This is the first report of anthelmintic-resistant O. ostertagi on Australian dairy farms. Resistance to all three available anthelmintic classes is of concern, given the high pathogenicity of this species. The study highlights the need for veterinarians and dairy farmers to be aware of the risks posed by anthelmintic resistance.