Metritis diagnosis and treatment practices in 45 dairy farms in California

Abstract

Minimizing the risk of antimicrobial-resistant organisms and antimicrobial residues in dairy and dairy beef products is a topic of nationwide interest. To design an effective outreach program on judicious use of antimicrobials, it is imperative to describe actual practices on dairies. Thus, our objective was to report current practices for metritis treatment in 45 dairies in California. Data were collected using a survey tool that included questions on systemic antimicrobial treatments, intrauterine treatments, supportive treatments, and treatment records. Researchers collected information based on cow-side observations and responses from fresh cow evaluators. Most dairies (n = 33; 70%) performed rectal exams for vaginal discharge (VD) evaluation and based systemic antimicrobial administration on the presence of (a) abnormal VD (fetid and nonfetid), regardless of fever (n = 11; 25%); (b) fever regardless of the odor of abnormal VD (n = 11; 25%); (c) fetid VD and fever (n = 1; 2%); (d) fetid VD (n = 3; 9%); or (e) fetid VD or fever (n = 3; 9%). Some dairies (n = 11; 24%) only detected abnormal VD if visible on tail, vulva, or floor; treatment decisions were based on the presence of abnormal VD (n = 9; 20%) or abnormal VD and fever (n = 2; 4%). On 3 (6%) dairies, VD characteristics were evaluated after rectal palpation, but no systemic treatments were administered. Cows exhibiting 1 nonspecific sign of health disorder (depressed general appearance, lack of appetite, or drop in milk yield) plus fever (n = 13; 29%), or even regardless of fever (n = 6; 13%), were treated with systemic antimicrobials. Overall, 8 (18%) dairies justified systemic antimicrobial treatment based on fever alone. Systemic antimicrobials used were ceftiofur products [ceftiofur hydrochloride (n = 26; 55%), ceftiofur sodium (n = 3; 7%), and ceftiofur crystalline-free acid (n = 8; 18%)], penicillin procaine (n = 8; 18%), and ampicillin (n = 3; 7%). Intrauterine infusions were done with penicillin procaine (n = 1; 2%) or oxytetracycline (n = 12; 27%). The dose and treatment length varied across dairies for i.m. ceftiofur hydrochloride (15 to 45 mL/d for 3 to 5 d), s.c. ceftiofur crystalline-free acid (20 to 25 mL once or twice), i.m. ceftiofur sodium (15 to 30 mL/d for 3 to 5 d), i.m. penicillin procaine (20 to 60 mL/d for 3 to 6 d), and i.m. ampicillin (25 to 35 mL/d for 3 to 6 d). The antimicrobial drug of choice, the dose, and the treatment length for metritis varied across the study dairies. Based on accepted industry best-management practices for metritis, a need exists to educate fresh cow evaluators on signs of health disorder indicative of metritis and on appropriate antimicrobial treatment regimens.

Analysis of puerperal metritis treatment records in a grazing dairy farm in Argentina

“…Systemic ATB alone or in combina tion with non-steroidal anti-inflammatory drugs (NSAID) are the treatments of choice for PM [7]. The most used ATB for systemic therapy of PM are thirdgeneration cephalosporins, penicillin pro caine, ampicillin, oxytetracycline, or a combination of ampicillin with oxytetracycline or cloxacillin [11] [12]. Also, intrauterine infu sions with penicillin procaine or oxytetracycline are used in some dairy practices [12].…”

“…The most used ATB for systemic therapy of PM are thirdgeneration cephalosporins, penicillin pro caine, ampicillin, oxytetracycline, or a combination of ampicillin with oxytetracycline or cloxacillin [11] [12]. Also, intrauterine infu sions with penicillin procaine or oxytetracycline are used in some dairy practices [12]. However, the majority of clinical trials during the last 2 decades have reported the use of 2 primary ATB for treat ment of PM in dairy cows which are ceftiofur (ceftiofur hydrochlo ride, 2.2 mg/kg; ceftiofur sodium, 2.2 mg/kg; ceftiofur crystalline free acid, 6.6 mg/kg) [ [14] and ampicillin (11 mg/ kg) [12] [15].…”

“…Also, intrauterine infu sions with penicillin procaine or oxytetracycline are used in some dairy practices [12]. However, the majority of clinical trials during the last 2 decades have reported the use of 2 primary ATB for treat ment of PM in dairy cows which are ceftiofur (ceftiofur hydrochlo ride, 2.2 mg/kg; ceftiofur sodium, 2.2 mg/kg; ceftiofur crystalline free acid, 6.6 mg/kg) [ [14] and ampicillin (11 mg/ kg) [12] [15]. Most authors agree that only cows with reduced milk production, dullness, watery brownish fetid VD, and a rectal tem perature higher than 39.5 °C should be treated with an ATB (PM) [1] [3] [8].…”

“…Most authors agree that only cows with reduced milk production, dullness, watery brownish fetid VD, and a rectal tem perature higher than 39.5 °C should be treated with an ATB (PM) [1] [3] [8]. However, a recent large study in 45 California dairies showed that 70 % of dairies performed rectal exams for VD evaluation; and that only 25 % based systemic ATB administration on the presence of fever regardless of odor or abnormal VD, 2 % on the presence of fetid VD and pyrexia (2 %), and 9 % on the presence of fetid VD or pyrexia [12].…”

“…Prudent use of ATB in dairy production medicine in general and in the treatment of PM, in particular, is becoming an important issue to minimize the risk of antimicrobialresistant organisms and to minimize the risk of antimicrobial residues in dairy products [12] [16]. Dairy practitioners must use the proper combination of diag nostic methods and ATB selection to maximize the cure rate and minimize antimicrobial resistance (AMR) and antimicrobial resi dues in milk.…”