Monitoring health and looking for sick cows

The postpartum period is a pivotal time in the production cycle of the cow, determining both production and reproduction performance. Early diagnosis and treatment of sick cows may be even more important than the type of treatment administered. Different health monitoring strategies, which parameters to use and how to interpret the results are discussed. Summarized by from Proceedings 3rd Florida & Georgia Dairy Road Show (2006)


Early diagnosis and treatment of sick cows may be even more important than the type of treatment administered. In lactating dairy cows, this concept cannot be overemphasized. A delay in treating a sick cow not only reduces chances for a full recovery but results in milk production loss and may impair reproductive performance, especially if the disease occurs early post partum. There are different opinions on health monitoring strategies, which parameters to use and how to interpret them. This paper reviews parameters that can be used to monitor postpartum health and discusses clinical signs to look for in sick cows.

Monitoring Postpartum Health

The postpartum period is a pivotal time in the production cycle of the cow, determining both production and reproduction performance. During the postpartum period, dairy cows are at risk of developing calving-related diseases, such as; hypocalcaemia, metritis, ketosis and displacement of the abomasum (Curtis et al, 1983). These are costly disorders with estimated economic losses ranging from 200 to 400 dollars per case per lactation (Bartlett et al, 1986).

Monitoring postpartum health allows the opportunity to identify sick cows early and provide supportive therapy. Furthermore, it can help prevent diseases. For example, a cow treated early for a uterine infection is less likely to develop secondary disorders such as displaced abomasum and ketosis. Another example would be a cow diagnosed with sub-clinical ketosis: if treated a loss in milk production can be prevented.

Monitoring postpartum health requires examination of all cows early postpartum (7 to 10 days in milk) by trained farm personnel. Parameters that can be used to evaluate health status of cows include rectal temperature, attitude, milk production, uterine discharge and urine ketones. In the authors’ opinion, a common problem for many farms monitoring postpartum health is that too much emphasis is given to one or two of these parameters. It is important to understand that the combination of these parameters must be considered when making a decision whether or not a cow is sick and requires treatment.

Rectal Temperature

The premise for evaluating rectal temperature post partum is that an elevated temperature indicates an abnormal health status. More specifically, in postpartum dairy cows, it most likely indicates a uterine infection or metritis. Monitoring rectal temperatures will result in a wide range of values from individual cows. The normal rectal temperature range for cattle can be from 101.5 to 103° F, where a fever is diagnosed when the temperature is > 103.0 F. The variation in rectal temperature is influenced by factors such as health status, age, season of year, and time of day.

Although an individual cow’s body temperature will vary, a healthy cow maintains a narrow range. A Pennsylvania study (Kristula et al, 2001) reported that cows experiencing no clinical problems at calving or during early post partum, had an average rectal temperature below 102° F for each day during the first 10 days postpartum.

However, cows with metritis may have rectal temperatures within the normal range and may not necessarily develop fever. A recent Florida study (Benzaquen et al, 2004) found that over half of the cows diagnosed with metritis during the first week post partum did not have a fever.

Cows with an abnormal parturition had rectal temperatures greater than 103.1 F related to metritis for significantly more days than cows that calved normally (Kristula and Smith, 2001). Furthermore, cows with an abnormal calving had a higher incidence of metritis when compared to cows with a normal calving (Benzaquen et al 2004). From these studies, it can be concluded that cows with an abnormal calving (dystocia, retained placenta or twins) should be monitored carefully early post partum.

Dairy cows diagnosed with fevers due to metritis during the postpartum period respond positively to antimicrobial treatment. The challenge when using monitoring programs is to decide when to treat cows.Research findings suggest that the majority of cows develop fever within one week after calving (Benzaquen et al 2004; Kristula and Smith, 2001). Therefore, monitoring programs using rectal temperature should be put in place for at least 7 days after calving.


Some people are better than others at identifying sick cows based on their general attitude or appearance. Farm employees with this ability must be identified and trained properly. They should be taught to look at the eyes, ears, presence of uterine discharge and overall demeanor. Positioning and appearance of the eyes within the socket to access level of dehydration or pain can be observed and scored. A scoring system such as 1 (minimal), 2 (mild), 3 (moderate), or 4 (severe) can be used (Smith and Risco, 2005). A cow with a score of 1 usually will have bright eyes that are positioned normally within the eye socket. A score of 2 will have dull eyes that are slightly sunken (1-2mm) within the eye socket. A score of 3 will have glazed eyes that are moderately sunken (2-4 mm) where as a score of 4 will have dry eyes that are severely sunken (>5mm) within the eye socket.

Positioning of the cow’s ears is also a good indicator of a cow’s attitude. Sick cows usually have ears that droop down due to depression, pain, or fever. Healthy cows on the other hand appear bright, alert and are curious about their environment. Upon being approached by someone, a healthy cow will often try to make contact with her nose and tongue.

In those farms that have locking stanchions, the attitude of the cow can be observed after feeding to evaluate appetite. A cow that is sick will not eat conversely; a healthy cow aggressively goes after her feed. In our clinical service we evaluate a cow’s appetite according to these scoring system; 1) cows that lock and eat, 2) cows that lock but appear dull and do not eat, and 3) cows that do not lock to eat and appear dull or sick. Cows that fall in categories 2 or 3 should be monitored or examined carefully.

Milk Production

Daily milk production is monitored on many farms. As mentioned earlier, a sick does not eat and consequently her milk production drops. Dairy cows with a normal postpartum period have a steady progressive day-to-day increase in milk production. Determining the deviation value to identify these sick cows varies between farms. Some managers create a list of all cows that deviate from a value equal to or more than a preset value. In most dairies, a 10 pound drop in production is frequently used. Trained employees will use this deviation list to identify these cows and perform a thorough physical examination. One goal for cows is a 10% daily milk increase during the first 14 days post partum (Overton, 2001). Heifers should have an 8% daily increase In addition, a cow should be producing close to 100 pounds of milk per day by 20 days post partum and heifers 70 pounds per day. Cows and heifers that do not meet these criteria should be identified and examined by trained farm personnel.

Uterine Discharge

A common disorder during post partum and commonly identified with a health monitoring program is metritis. Although, there is much debate on the diagnosis of metritis, in our clinical service, cows that appear sick and have a malodorous discharge from the uterus, regardless of rectal temperature, are considered to have metritis and require treatment. Therefore, we feel that evaluation of uterine discharge is important for the correct diagnosis of metritis. Particularly, as mentioned earlier, some cows affected with metritis do not develop fever. Discharges that are red-brown, contain mucus or pus, and are not malodorous should be considered normal. A watery, foul smelling discharge more often indicates a severe form of metritis that needs therapy as opposed to a mucoid discharge that more often indicates a recovery situation.

A common method used to evaluate uterine discharge is palpation of the uterus and visual inspection of the vulva for a malodorous brownish color discharge. However, this method of diagnosis has the drawback that it does not always produce discharge outside of the cow. Consequently, the use of vaginoscopy or the insertion of a gloved clean hand into the vagina and extending it to the cervix can be used to evaluate discharge.

Ketones in Milk or Urine

Ketone bodies in urine or milk can be used to diagnose ketosis in lactating dairy cattle. In our opinion, evaluation of ketosis in postpartum dairy cows is under used is valuable in diagnosing sick cows. The cost of subclinical ketosis per cow is estimated to be $78 (Geishauser et al, 2001). Ketosis has been associated with an increased risk to develop metritis, (Markusfeld, 1984; Markusfeld, 1987; and Reist et al, 2003) displaced abomasums (Geishauser et al, 1997) and mastitis (Syvajarvi et al, 1986). A negative impact on milk production may also occur and it has been reported that cows that produce a positive milk ketone test produce 1.0 to 1.4 kg less milk per day for the lactation (Geishauser et al, 1997). Identification and treatment of cattle suffering from subclinical ketosis in the immediate postpartum period could reduce the negative side effects of ketosis. Identification of post partum cows suffering from ketosis is accomplished either by analyzing urine or milk ketone levels using cowside tests. These cowside tests are available as powders (commonly used in milk) and as urinalysis strips. Measuring urine ketone levels is most common because obtaining a urine sample is uncomplicated, repeatable, and cost effective.

A recent study (Carrier et al, 2004) evaluated the performance of 3 cowside tests for detection of subclinical ketosis. The tests were: 1) a commonly used powder for detecting milk acetoacetate (KetoCheck, Great States Animal Health, St. Joseph MO), 2) a urine strip detecting ketones (acetoacetate) in urine (Ketostix, Bayer Corporation, Elkhart, IN), and 3) a milk test strip for ketone bodies (BHBA). The study concluded that either the Ketostix or milk ketome test strips would provide acceptable results for screening individual cows on commercial dairies to detect ketosis, but the KetoCheck would have limited application.

Putting It All Together

Disorders such as metritis, displaced abomasum and ketosis can be evaluated by monitoring temperature, attitude, milk production and urine ketone levels early post partum. A postpartum health monitoring program assures early identification of cows that are sick. Employing a post partum health monitoring program, Benzaquen et al (2004) reported that early treatment of cows with metritis resulted in pregnancy rates comparable to cows without metritis. This suggests that identification of cows with metritis early and prompt treatment may ameliorate the effects of metritis on reproduction. The following are key points to consider in the application of a post partum health monitoring program.

  • Identify key farm employees that have the interest to work with and treat sick cows. Train and work with them on a periodic basis. Have your veterinarian work with them side by side routinely. The basic premise in looking for sick cows is that the cow should be evaluated as a whole considering attitude, rectal temperature, milk production and urine evaluation for ketone bodies.
  • Create Standard Operation Practices (SOP’s) for detecting sick cows, physical examination and treatment procedures for individual diseases. Review these practices frequently.
  • Based on farm facilities and employee abilities; you and your veterinarian should decide which program works best for your herd.
  • It is important that health monitoring takes place for at least the first week post partum. Days 3 to 7 appear to be the most critical.
  • Evaluate attitude, rectal temperature and urine sample for presence of ketone bodies daily for 10 days post partum.
  • Examine cows for metritis, displaced abomasum and mastitis if they have fever (Temp > 103. F) or appear sick, regardless of temperature.
  • Cows that test positive on a urine ketone sick should be treated for ketosis.
  • Consider an evaluation of uterine discharge on days 3, 5 and 7 to make sure that cows with metritis that do not have fever are not missed.
  • Evaluation of changes in daily milk production for the first 20 days post partum is a valuable tool that can be used effectively to evaluate health.
  • Look for sick cows beyond the postpartum period. It is important to recognize that sick cow monitoring must be performed for all cows. Farm personnel involved in moving, feeding, milking or breeding cows should be aware that they play a major role in the identification of sick cows. Consequently, they too should be trained in how to look for sick cows. Milkers should also be well trained in how to identify cows with mastitis.

Literature Cited

  1. Bartlett PC, Kirk JH, Wilke MA, et al. 1986. Metritis complex in Michigan Holstein- Friesian cattle: incidence, descriptive epidemiology and estimated economic impact. Prev Vet Med 4:235-248.
  2. Benzaquen, ME, Risco CA, Archibald LF, Thatcher MJ and Thatcher WW. 2004. Evaluation of rectal temperature and calving related factors on the incidence of metritis in postpartum dairy cows. Pages 197-198 in: Proceedings of the 37th Annual Convention of the American Association of Bovine Practitioners, Fort Worth, TX.
  3. Carrier J, Stewart S, Godden S, Fetrow J and Rapnicki P. 2004. Evaluation and use of three cowside tests for detection of subclinical ketosis in early postpartum cows. J. Dairy Sci. 87:3725-3735
  4. Curtis CR, Erb HN, Sniffen LJ, et al. 1983. Association of parturient hypocalcaemia with eight periparturient disorders in Holstein cows. J Am Vet Med Assoc 183:559- 561.
  5. Geishauser T, Leslie K, Kelton D, Duffield T. 2001. Monitoring subclinical ketosis in dairy herds. Comp Cont Ed 23(8):S65-71.
  6. Geishauser T, Leslie K, Duffield T, Edge V. 1997. Evaluation of aspartate aminotransferase activity and beta-hydroxybutyrate concentration in blood as tests for left displaced abomasums in dairy cows. Am J Vet Res 58:1216-20.
  7. Kristula M, Smith BI and Simeone A. 2001. The use of daily postpartum rectal temperature to select dairy cows for treatment with systemic antibiotics. The Bovine Practitioner 35 (2) June:117 – 125.
  8. Markusfeld O. 1984. Factors responsible for post parturient metritis in dairy cattle. Vet. Rec. 114:539.
  9. Markusfeld O. 1987. Periparturient traits in seven high dairy herds. Incidence rates, association with parity, and interrelationships among traits. J. Dairy Sci. 70:158.
  10. Overton T, 2001. Proceedings, Pro-Dairy Winter Meeting, Ithaca, NY.
  11. Reist M, Erdin DK, von Euw D, Tschumpelin KM, Leuenberger H, Mannon HM, Kunzi N, Blum JW. 2003. Use of threshold serum and milk ketone concentrations to identify risk for ketosis and endometritis in high – yielding dairy cows. AJVR 64(2): 186-194.
  12. Smith BI, Donovan GA, Risco CA, Littell R, Young C, Stanker LH, et. al. 1998. Comparison of various antibiotic treatments for cows diagnosed with toxic puerperal metritis. J Dairy Sci. 81:1555-1562.
  13. Smith BI and Risco CA. 2005. Management of periparturient disorders in dairy cattle. Veterinary Clinics (In Press).
  14. Syvajarvi J, Saloniemi H, Grohn Y. 1986. An epidemiological and genetic study on registered diseases in Finnish Ayrshire cattle. Acta Vet Scand 27:223-234.


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