The Health Management Program in Dairy Cattle

The goal of health management programs is to ensure the optimal care and well-being of dairy
cattle and to reduce losses in productivity caused by disease and management errors. The health
management program is generally developed cooperatively by the herd veterinarian and the dairy
producer based on comparisons of herd performance with predetermined performance goals. The
structure of health management programs is unique to each farm but is typically keyed to the
scheduled veterinary herd visits that combine routine reproductive examinations, review of selected
herd performance records, and decisions and actions related to specific herd management issues.
Scheduled Farm Visits
The frequency of scheduled veterinarian visits is somewhat dependent on herd size. In herds of
<100 cows, one or two cows calve every week and a single, scheduled monthly visit is probably
appropriate. These herds may have more unscheduled visits for examination of sick cows than herds
visited more regularly. Larger herds in which cows are calving daily warrant more frequent visits, and
weekly scheduled visits are not uncommon for herds of >200 cows. A trend on extremely large dairy
farms (>2,000 cows) is employment of a full-time staff veterinarian to oversee and direct day-to-day
issues regarding health and performance. The frequency of scheduled herd visits for grass-based
seasonal dairy operations varies depending on the herd’s stage of lactation. More frequent visits are
necessary in early lactation and during the breeding period.

Activities at herd visits fall into four general categories: provision of individual animal health
care and emergency services, scheduled technical activities, scheduled analytic and training activities,
and provision of quality control programs. The frequency of individual activities varies.

Individual Health Care and Emergency Services:

The examination and treatment of individual animals is an important activity during scheduled
dairy visits. Frequent herd visits allow practitioners to examine cows early in the course of disease
when the likelihood of successful treatment is higher. Routine visits also allow veterinarians to monitor
the outcome of treatments and modify treatment protocols as needed. Ideally, monitoring programs
include a system to detect cows not performing as expected. Special attention should be paid to the
highest-risk cows, including frequent observation of animals during the periparturient period. Some
farms have adopted a system that includes routine daily monitoring of body temperature and rumen
activity of cows during the first 7 days after calving. Animals that fall outside normal limits are treated
according to predefined criteria or detained for examination by the herd veterinarian. All treatments
administered to dairy cows should be recorded in treatment logs (either computerized or handwritten)
to ensure adherence to proper meat and milk withholding periods. The frequency of unscheduled visits
for emergency medical services usually diminishes in herds that have adopted a health and production
management program.

Scheduled, Traditional, and Technical Activities:

Routine reproductive examinations account for much of the veterinarian’s time during
scheduled herd visits. Attaining reproductive success is an essential determinant of herd productivity.
The end point of reproductive examinations should be to identify nonpregnant cows that can be
returned to the breeding program and to generate data that can be used to determine the success or
failure of breeding programs. The implementation, success, and cost-effectiveness of scheduled
breeding programs should be reviewed frequently.

On smaller farms, it is often customary for the veterinarian to perform routine individual animal
treatments (such as IV injections), prophylactic activities (such as vaccinations), and some technical
tasks (such as dehorning calves) during scheduled herd visits. It is appropriate for the veterinarian, or
a technician under the veterinarian's supervision, to perform these tasks, because the farm staff may
not perform them often enough to become technically proficient. On larger farms, these tasks must
often be performed on a daily basis; in this case, farm employees should be trained to accomplish these
tasks.

Scheduled Analytic and Training Activities:

Conducting scheduled or unscheduled technical activities will not be effective unless a system
exists to capture the results of the activities and allow for analysis and ongoing revision. The structure
of the health and production management program must include time for the farmer and the herd
veterinarian to analyze and discuss herd management issues. In herds that depend on hired personnel
to implement designated tasks, time must be scheduled to observe and effectively train personnel
ultimately responsible for performing the activities. Development of standard operating procedures is
one method to ensure that agreed-on practices are implemented.

Treatment protocols are used to define standard treatments for common diseases on dairy
farms and should be used when multiple people have responsibility for administering antibiotic
treatments to dairy cattle or when extra-label drug use is prescribed. They also provide a mechanism
for increased communication about treatment plans between the veterinarian and producer.

The avoidance of residues in food products is a major responsibility of dairy practitioners.

Increased scrutiny regarding antimicrobial use in food-producing animals has arisen because of
concern about the development of antimicrobial resistance in foodborne pathogens. Although the
level of detected antibiotic residues in meat and milk products is extremely low, antibiotic residues in
bulk milk and carcasses are seen occasionally. In the USA, contamination of bulk milk is rare because
of an effective surveillance system based on rapid testing for selected antimicrobial agents of every
load of raw milk. Milk contaminated with antibiotics is discarded, and the producer is fined.

The requirements for extra-label drug use in the USA have been defined by regulatory officials under
the Animal Medicinal Drug Use Clarification Act and should be closely followed. The American
Association of Bovine Practitioners has responded to societal and regulatory concerns about the use
of antimicrobial agents by adopting recommendations for the prudent and judicious use of
antimicrobial agents in dairy cattle. In response to concerns about the development of antimicrobial
resistance in human medicine, the FDA is requesting that drug manufacturers begin the process of
eliminating the labeling and use of certain antimicrobials for production purposes (to increase feed
efficiency or weight gain). Specifically, antimicrobials of importance to human medicine will no longer
be permitted to be provided in feed or water solely for production purposes, and no new antimicrobials
will be approved for production purposes, although they can be approved for use in feed or water for
treatment or prevention of disease. For producers to use an antimicrobial in feed or water, they must
receive a feed directive from their veterinarian (essentially a prescription); over-the-counter sales of
antimicrobials for use in feed or water will no longer be allowed.
Some dairy practitioners function as the nutritional specialists for the dairy farms they serve. They may
collect feed samples for nutrient analysis, formulate rations, and advise the farmer regarding crop and
harvesting conditions. These veterinarians often devote a considerable amount of their professional
time to nutritional management. Other farms employ a professional nutritionist or use a nutritionist
employed by a feed company or local cooperative to formulate the rations and submit feed samples
for nutrient analysis. Regardless of the source of the dairy’s nutrition program, the veterinarian can
perform an essential oversight function simply by observing body condition and general health in cows
in certain high-risk areas (periparturient and high milk production), monitoring the incidence of
nutrition-related diseases such as parturient hypocalcemia and displaced abomasum, and ensuring
that the diet described on paper is adequately formulated and delivered to the cows. Assessing pasture
conditions by periodic inspection of pasture is an important component of managing the nutritional
program of herds that use management-intensive grazing. These quality control activities should be
conducted routinely as part of the health and production management program.

Quality Control Programs

Quality control refers to activities that ensure consistency in performing key management
processes. Vital management areas for most herds include nutritional management, milking
management, and young-stock programs. Some farms may also develop quality control processes for
environment and housing and farm-specific management of breeding bulls.

Milking management should be a standard element of quality control programs. Tasks such as
observing the milking routine and scoring the condition of teats should be performed at least quarterly.
A scheduled system of routine screening for mastitis pathogens can be implemented as part of the
milking management program. The veterinarian can teach farm personnel how to perform the
California Mastitis Test as part of a surveillance program. Animals routinely screened may include cows
at dry off, fresh cows and heifers, and newly purchased cows. Milk samples can be collected and
submitted for culture from quarters that show positive reactions.

Newborn calves and replacement heifers are often housed separately from lactating cows and
may not be observed routinely by the herd veterinarian. However, routine surveillance of critical
management issues such as adequate delivery of colostrum to calves and growth rates of replacement
heifers can be done as part of scheduled herd visits. The environment of dairy cattle can have
considerable influence on health and productivity. Some veterinarians routinely schedule
“walkabouts” through the housing areas to assess factors related to animal comfort and hygiene.
Udder cleanliness, hoof and hock lesions, and respiratory disease are often determined by housing
conditions. Herd walkabouts should include areas often ignored, such as dry-cow and heifer housing.

Performance Targets
Performance targets reflect herd standards of performance that are perceived as indicators of
successful herd management. They are useful as comparison values for herd performance and as a
starting point to initiate discussions about potential areas for improvement. To use a performance
target, it is necessary for a herd to have a record system that allows for generation of comparable herd
indices. In many instances, performance targets have been calculated as arithmetic averages, which
are useful indicators of herd performance when the contributing data (such as milk, fat, and protein
yields) are normally distributed and have a reasonable degree of variation. However, many
reproductive indices and values such as SCCs are not distributed normally, and erroneous conclusions
about herd performance may be made if averages alone are used to make management decisions.
Appropriate frequency distributions are more useful for these types of data.

Key indicators for performance targets should be defined. The monitoring system should specify the
indices used, the animals included, and the time interval to reassess progress made toward reaching
each target. Typical performance indicators include milk production, reproductive performance, milk
quality, replacement management, cow removal, animal health, and special reports (see
Table: Examples of Activities for Routine Monitoring a). Performance targets should be reviewed at
appropriate intervals with realistic expectations regarding the amount of time it takes to effect change
in an index. For example, management actions taken to reduce days to first calving would require ≥9–
10 months to become apparent. A more timely value such as age at conception would more rapidly
reflect current management changes.

Record Keeping
A system of unique individual cow identification is a prerequisite for a successful health management
program. The most common methods of animal identification are ear tags, collars, and branding.
Increasingly, farms are using electronic identification via transponders on ankle bands or neck straps.
At a minimum, data must be recorded on birth, breeding, and calving dates and periodic milk yield.
Under ideal circumstances, summarized data should be available for the nutritional program, disease
occurrence, and financial performance.

Record analysis is a necessary component of the health management cycle. Most or all dairy herd
improvement (DHI) systems allow for electronic access to performance data, and various computerized
systems for herd management are used throughout the industry. Most monitoring systems can be
characterized broadly as one of the following: 1) manual (handwritten) card systems, 2) on-farm
computer programs, 3) DHI, or 4) DHI and on-farm computer. Regardless of the type of system used, it
should be easy to use and relevant to the day-to-day operations of the dairy.
One important function of record systems is the generation of “action” lists (due to calve, due to dry,
etc). This function is critical in large herds in which cattle are not individually known by the animal
handlers and can be overlooked easily. Most systems also provide for a minimal level of herd analysis,
such as the generation of timely performance reports for production, reproduction, and disease. Some
programs can also generate statistics. The record-keeping system should allow the producer and
veterinarian to understand and modify the formulas used to generate herd performance indices. For
parameters and values used to monitor herd health and production

(See Table: Parameters Useful to Monitor Health and Production of Dairy Herds.)

The veterinarian should ensure that collected data are used in a timely manner. Accurate data
collection is most likely when the producer is using the data frequently and understands its value. The
validity of data generated from both manual and automated data collection systems should be
reviewed and critically assessed. Unusual results and deviations from normal performance targets
should be challenged. The producer and the veterinarian should agree on defined actions based on the
herd status and goals. Actions are generally diagnostic, preventive, or treatment oriented. Typical
activities might include listing animals for routine herd fertility or illness examinations, or selecting
cows to obtain milk samples for culture, to vaccinate, to consider culling, to breed, to receive body
condition scoring, or to receive treatments.

Investigations of Health and Production Problems

Even on the best managed farms, unexpected health and production problems arise.
Surveillance programs incorporated in health and production management programs should detect
problems early, before considerable financial damage has occurred. Systems to investigate herd
outbreaks have been described. Epidemiologic concepts of disease investigation are useful to identify
risk factors and to stimulate corrective action.