Animal Reproduction Science 96 (2006) 331353

A herd health approach to dairy cow nutrition and production diseases of the transition cow
F.J. Mulligan a, , L. OGrady a , D.A. Rice b , M.L. Doherty a
a b

School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Ireland Nutrition Services International, Randalstown Co., Antrim, Northern Ireland, United Kingdom Available online 8 August 2006

Abstract This paper presents a practical, on-farm approach for the monitoring and prevention of production disease in dairy cattle. This integrated approach, should be used in an interdisciplinary way by farmers, veterinarians, nutrition advisors and other relevant professionals for the improvement of animal health and welfare and producer protability. The key areas that form the basis for this approach are body condition score management, negative energy balance, hypocalcaemia, rumen health and trace element status. Monitoring criteria are described for each of these key areas, which when considered collectively, will facilitate the assessment of dairy cow health with regard to clinical and subclinical disease. The criteria, which are informed by published scientic literature, are based on farm management and environmental factors, clinical data, milk production records, dietary analysis, and assessment of blood and liver concentrations of various metabolites or trace elements. The aim is to review the efcacy of production disease control measures currently in place, and if necessary to modify them or formulate new ones. 2006 Elsevier B.V. All rights reserved.
Keywords: Dairy cow; Herd health; Production disease; Nutrition

1. Introduction The nutritional status of dairy cattle has a signicant inuence on many of the transition cow production diseases that result in nancial losses and reduced welfare. From a nancial perspective, producers are not only faced with the cost of treating dairy cows for specic production diseases, but they often incur additional consequential costs. For example, dairy cattle that develop
This paper is part of the special issue entitled Nutrition and Fertility in Dairy Cattle, Guest Edited by A. Evans and F.J. Mulligan. Corresponding author. E-mail address: Finbar.mulligan@ucd.ie (F.J. Mulligan). 0378-4320/$ see front matter 2006 Elsevier B.V. All rights reserved. doi:10.1016/j.anireprosci.2006.08.011

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clinical hypocalcaemia (milk fever) are eight times more likely to develop mastitis (Curtis et al., 1983). Similarly, cows with sub-clinical ketosis are eight times more likely to develop left displaced abomasum (Le Blanc et al., 2005). Apart from the losses arising from the clinical diseases, the losses arising from insidious subclinical disease in herd mates, together with the proven deleterious consequences for reproductive performance, claw health and udder health, make the prevention of these nutritionally related production diseases of paramount importance, for nancial and animal welfare reasons. Therefore the concept of a herd health or preventative approach to managing dairy cow nutrition and production diseases has great potential to assist farmers by providing increased protability and reassurance regarding the health status of the farm livestock. This will increase transparency, trust and acceptability on issues of animal health and welfare with the general public and consumers of dairy products. Integrated herd health and production management programmes that would bring information from various facets of dairy farming technology into one integrated dairy farming advisory service have been proposed (Brand et al., 1996; Kelly and Whitaker, 2001). This integrated multidisciplinary or team approach in preventative dairy herd health is employed with the emphasis on protability and sustainability as opposed to increased production per se. Based on this principal, the recent development of the dairy herd health initiative in Ireland is a multi-stranded project, including efforts by a range of bodies to coordinate programmes of preventive animal health (More and Barrett, 2005). It includes at its core, a programme of continuing education for veterinarians based on integrated modules such as bio-security, calf health, health economics, reproductive performance, lameness, nutrition and production disease, parasite control, and vaccination strategies. This article presents a practical, on-farm approach to preventing and monitoring production diseases of the dairy cow by the use of optimal nutrition and management throughout the whole lactation cycle but with specic focus on the transition period. The scientic basis for the methodology used in this approach is presented. This preventative and monitoring approach has been sub-divided into ve key areas: (1) (2) (3) (4) (5) Body condition score management (BCS). Negative energy balance (NEB). Milk fever and subclinical hypocalcaemia. Rumen health. Trace element and antioxidant status.

Table 1 Target incidence rates for clinical production diseases Clinical condition Milk fever Downer cow syndrome Hypomagnesaemic tetany Ketosis Left displaced abomasum Right displaced abomasum Low milk fat syndrome (milk fat < 2.5%) Retained placenta Lameness Target incidence rate 05% <10% of milk fevers 0% 05% 03% 1% <10% <10% <15% Relevant literature Houe et al. (2001)

Ingvartsen (2006), Heuer et al. (1999) Heuer et al. (1999) Nordlund et al. (2004) Mee (2004c), Heuer et al. (1999) Ingvartsen (2006), Heuer et al. (1999)

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2. A preventative approach The objectives of herd health are achieved by application of the concept of target performance. The comparison of herd performance to target incidence rates for production diseases forms the basis of preventive planning. The differences between the targets and performance in the context of animal health are the shortfalls (Table 1). This facilitates the focusing of herd investigations and serves to prioritise areas requiring immediate or extra attention. The reasons for the shortfalls must then be investigated in detail, with a view to identifying risk factors contributing to disease occurrence. The specic steps involved in the investigation are detailed below, along with the supporting literature. When the causes of the shortfall have been identied, both short-term and long-term control strategies can be formulated based on the risk factors involved. Subsequently, performance is monitored continuously to assess the efcacy of the actions taken. The cycle, including repeated monitoring and assessment of shortfalls is then repeated on a cyclical basis (Fig. 1). While the sensitivity, specicity and predictive value of many of the individual monitoring criteria used may be rather low when considered alone, it is our contention that consideration of the relevant criteria collectively provides a strong basis for herd health evaluation. 3. Key area 1: body condition score management The maintenance of an optimal body condition score relative to lactation stage, milk yield, nutrition and health status, throughout the lactation cycle is perhaps the most important aspect of dairy cow management that facilitates a healthy transition from pregnancy to lactation. The system of body condition scoring dairy cattle proposed by Edmondson et al. (1989), which is based on a ve-point scale (1 = emaciated; 5 = over-fat), is used in this preventative approach for production diseases. The BCS targets recommended in the present approach are shown in Table 2. 3.1. Body condition score target at drying-off and at calving Hayirli et al. (2002) demonstrated that dairy cattle that were over-conditioned (BCS > 4.0; using a scale of 15) in the last 3 weeks of gestation had a much greater depression in feed intake in the period immediately pre-calving when compared to cows with lower BCS. Those authors also reported a linear reduction in feed intake in the immediate pre-calving period as BCS increased. This phenomenon of feed intake reduction together with the mobilisation of adipose tissue and its accumulation in the liver has in some cases been associated with fatty liver syndrome, difcult calving, retained placenta and displaced abomasum (Cameron et al., 1998; Kaneene et al., 1997; Zamet et al., 1979a,b). Furthermore, It has been reported that dairy cattle with a BCS of 4 in the dry period (scale 15) have an increased likelihood of developing milk fever (Heuer et al., 1999). It is noteworthy that Cavestany et al. (2005) reported lower levels of BCS loss for cows calving
Table 2 Target BCS for dairy cattle (Holstein/Friesian) at different points of the lactation cycle BCS at drying off BCS at calving BCS at breeding BCS at 150 DIM BCS at 200 DIM BCS at 250 DIM 2.75 3.0 >2.5 2.75 2.75 2.75

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Fig. 1. Monitoring and preventing production disease Adapted from Noordhuizen (2001).

with a BCS of <3 in comparison to those calving with a BCS > 3.0. In addition, Garnsworthy (1988) concluded that any BCS between 2 and 3 was adequate for dairy cattle at calving. The negative consequences of over-conditioning at calving are not conned to the period immediately around parturition. Garnsworthy and Webb (1999) summarised several experiments to demonstrate that body condition score loss in early lactation is almost linearly related to body condition score at calving. Similarly, Dechow et al. (2002) reported that management and environmental factors that increased BCS at calving resulted in more BCS loss in early lactation,

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while Kokkonen et al. (2005) demonstrated that fatter cows initiated more extensive mobilisation of body fat before calving and this continued during the rst weeks of lactation. Furthermore, cows with a BCS of 4.3 at drying off lost more condition in the dry period and up to 1 month into the following lactation, had a higher incidence of abomasal displacement, milk fever, ketosis, endometritis and an increased number of days to rst ovulation than cows with a BCS of 3.8 (Kim and Suh, 2003). In addition, Mayne et al. (2002) reported that dairy cows with a BCS of 3.0 in the dry period had a higher reproductive efciency in the following lactation in comparison to dairy cows with a BCS of 3.3. Much of the available data point to health and reproductive benets for cows with lower BCS at drying off and at calving with few adverse effects reported on milk production (Contreras et al., 2004), reproduction or health. 3.2. Body condition score target in early lactation The association between BCS loss in early lactation and subsequent reproductive performance is now well accepted (Mayne et al., 2002; Buckley et al., 2003; Shrestha et al., 2005). However, it is unclear whether or not body condition score at breeding per se has any inuence on reproductive efciency. Horan et al. (2005a) reported no signicant difference in the BCS at rst AI for cows that had normal and abnormal ovarian activity. While Heuer et al. (1999) has reported that the conception rate to rst service of thin cows (BCS 2) was similar to that of cows with normal body condition (BCS > 2 or <4), even though cows with a low BCS, experienced more endometritis. Pryce et al. (2001) reported that reproductive performance was strongly related to an absolute BCS value recorded once in early lactation. Therefore, apart from the importance of considering BCS loss in early lactation, Pryce et al. (2001) and the reports of Buckley et al. (2003) and Shrestha et al. (2005) emphasise the importance of achieving some minimal threshold value of BCS in early lactation. Since Buckley et al. (2003) have indicated that a BCS of more than 2.5 is required to avoid reduced odds of reproductive success, the BCS of >2.5 at breeding will be used as the target in this preventative approach. The targets in Table 2 imply that BCS loss in early lactation of 0.250.50 units is achievable where BCS at calving is 3.0. This is lower than the average BCS loss reported by Buckley et al. (2003) of 0.51 units for cows with an average 305-day milk yield of 6557 kg. However, Buckley et al. (2003) have reported that only 30% of cows with a pre-calving BCS of 3.25 lost 0.5 units of BCS or more. This level of BCS loss is also in keeping with the average condition score loss reported by Pryce et al. (2001) for cows yielding on average 28 kg/day in the rst 26 weeks of lactation. However, higher rates of BCS loss have been reported by Horan et al. (2005b) for grazing cows with a pre-calving BCS in the region of 3.253.5 and with a 305-day milk yield of between 6000 and 7900 kg. In particular, cows fed lower levels of concentrate supplementation at pasture, and higher milk production line cows, lost more BCS in early lactation. 3.3. On farm approach On farm records of BCS for all cows at key stages in the lactation cycle should be compared to the targets in Table 2. It is recommended that cows at drying-off, calving, breeding, 150 days in milk (DIM), 200 and 250 DIM, should be scored according to Edmondson et al. (1989). Scoring is best performed with the appropriate scale describing individual scores at hand, with each individual being palpated and not relying on visual assessment. Apart from calculating the average condition score for relevant groups of cows at key stages in the lactation cycle, the proportion of each group that deviate markedly from the target should be noted.

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4. Key area 2: negative energy balance It is well known that negative energy balance is a problem of early lactation cows arising from high milk energy output and relatively low feed intake. However, negative energy balance is also a problem for late gestation cows (Grummer et al., 2004) and may predispose them to many transition cow disorders such as displaced abomasum (Le Blanc et al., 2005), retained placenta (Cameron et al., 1998; Kaneene et al., 1997), dystocia (Zamet et al., 1979a,b), fatty liver and ketosis (Doherty, 2002; Bertics et al., 1992), reduced feed intake after calving (Doepel et al., 2002) and immuno-suppression (Goff, 2003). In particular, a large reduction in energy balance around calving may cause periparturient health disorders of dairy cattle (Grummer et al., 2004). 4.1. Preventing negative energy balance Since negative energy balance is a product of low energy input and high energy output, all attempts to try and prevent this problem in the pregnant or lactating cow should consider the strategies available to ensure that feed intake is least compromised during the last 3 weeks of gestation and the early period of lactation (Grummer et al., 2004). One of the most important aspects of ensuring adequate feed intake in the 3 weeks immediately prior to calving is to avoid the over-conditioning of dry cows (Hayirli et al., 2002). Grummer et al. (2004) implicated several management or environmental factors that are likely to be important for feed intake pre-partum, they are: overcrowding, group changes, diet changes, trough space, water quality and hampered cow comfort. The failure to feed lactating cows truly ad libitum (feed refusals of 515% are accepted) has been shown by Robinson (1989) to restrict feed intake. However, after considering practicality at farm level, Grant and Albright (1995) have recommended a feed refusal rate of 23%. It is the experience of the present authors that removing the refused feed and offering it to less critical animals (e.g. late lactation cows, but not heifers) can pay dividends. Furthermore, the latter authors suggested that reduced feed availability and or reduced trough space may lead to increased feed consumption and competition during the rst 26 h after feeding, with the possible consequences of increased digestive disorders and aggressive behaviour. Apart from restriction in feed availability and trough space, limited water availability and quality, poor grouping strategy, slippery oors, excess time standing in holding areas and excess time spent at milking will all limit feed intake (Grant and Albright, 1995). For farmers using grass silage as their conserved forage, large differences in voluntary feed intake potential (Steen et al., 1998) should be recognised and only those silages with a high intake potential should be used where avoiding feed restriction is critical. For grazing dairy cattle, it has been reported that once post-grazing sward height is less than 7 cm feed intake will be compromised (Gibb et al., 1997). Kolver and Muller (1998) indicated that feed DM intake is higher, and the degree of negative energy balance experienced in early lactation is lower, for TMR fed cows in comparison to grazing cows. The use of total mixed ration also facilitates the use of palatable feedstuffs such as molasses, which have been shown to improve energy balance in transition cows (Shah et al., 2004). Horan et al. (2005b) reported higher levels of BCS loss in early lactation for cows fed pasture with low levels of concentrate supplement (up to 0.85 units of BCS), versus cows fed pasture with higher levels of concentrate supplementation. This is supported by Mulligan et al. (2004) and Kennedy et al. (2002) who observed an increase in feed intake as concentrate supplementation rate increased at pasture. Cows with periparturient health disorders, such as retained placenta, fat cow syndrome and milk fever have been reported to have a lower feed intake in the early postpartum period (Zamet

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et al., 1979a,b). Several cytokines, including tumor-necrosis factor, interleukin 1 and interleukin 8, released as a component of the immune response to inammatory conditions such as mastitis and endometritis, may reduce feed intake (Ingvartsen and Andersen, 2000). Furthermore, Goff (2003) has extrapolated that the energy cost of an inammatory response for a dairy cow of 600 kg body weight may amount to 4 Mcal per day, and that this has deleterious consequences for cows already in negative energy balance. So conditions of ill health in the transition period are likely to be associated with reduced feed intake and possibly with increased energy requirement. 4.2. Monitoring energy balance: milk data Several authors have investigated the relationship between energy balance in the early lactation period and milk protein percentage (Von Tavel et al., 2005; Duchateau et al., 2005). Buckley et al. (2003) demonstrated that higher milk protein and milk lactose percentage were positively correlated with pregnancy rates early in the breeding season. These ndings are supported by Duchateau et al. (2005) in Belgian dairy cattle and by Von Tavel et al. (2005) in Swiss herds. Therefore milk protein percentage is one of the key evaluation criteria for monitoring energy balance in this article. However, milk protein percentage should be considered collectively with other criteria, as it is predictive value for energy balance when considered alone is likely to be low. The ratio of milk fat:milk protein percentage is a useful predictor of dairy cattle with a high risk of negative energy balance, ketosis, displaced abomasum, ovarian cyst, lameness, mastitis and higher likelihood of condition score loss of greater than 0.5 units (Heuer et al., 1999; Hamann and Kr mker, 1997; Buckley et al., 2003). Although Heuer et al. (1999) used the milk fat:protein o ratio of 1.5 for early lactation cows to indicate problem cows, other studies suggest that a lower value closer to 1.3 should be used (Buckley et al., 2003; Hamann and Kr mker, 1997). Heuer o et al. (2000) described cut-off points for energy balance in early lactation using milk variables asmilk fat:protein ratio > 1.4, milk protein < 2.9%, milk fat > 4.8% and milk lactose < 4.5%. The key monitoring criteria for assessment of early lactation cow energy balance in this article are for a nadir milk protein percentage of >3.05 (Von Tavel et al., 2005) and for a milk fat:protein ratio of <1.5. Furthermore, with the use of data such as concentrate feeding strategy, weeks postpartum, parity, energy corrected milk yield, and milk component data, energy balance can be predicted quite accurately (Reist et al., 2002). Such equations and prediction methods should be evaluated for use by nutrition advisors, farmers and veterinarians. It is important to reiterate that these criteria may be useful indicators when used collectively, and that lower standards of statistical association are assumed relevant for herd investigations than for research trials. The aim is to assess energy balance at herd not individual cow level. 4.3. Negative energy balance monitoring: blood metabolites This strategy is based on the use of betahydroxybutyrate (BHB) for the monitoring of subclinical ketosis in lactating cows with suggested optimal sampling times between 5 and 50 days in milk and the use of non-esteried fatty acids (NEFA) testing for the detection of prepartum negative energy balance and fatty liver in cows that are from 2 to 14 days pre-calving. In the case of both metabolites, it is suggested that 12 cows should be sampled from the at-risk or eligible group with an alarm level threshold reached if 10% of lactating cows have a BHB concentration in excess of 1.4 mmol/l or if 10% of pre-fresh cows have a NEFA concentration in excess of 0.400 mmol/l (Oetzel, 2004). Nielan et al. (1994) have used the BHB cut-off of 1.2 mmol/l as an indication

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of hyperketonemia. Whitaker (1997) has described cut-off points for plasma NEFA at the end of pregnancy as 0.4 mmol/l and for lactating cows in early lactation as 0.7 mmol/l. For BHB, Whitaker (1997) has described cut-off values for milking cows as 1.0 mmol/l and for cows at the end of gestation as 0.6 mmol/l, while glucose concentrations should remain above 3.0 mmol/l for transition cows. It is the present authors experience that using a cut-off for lactating cow BHB concentration of 1.0 mmol/l identies to many false positives, and that assessing blood glucose concentrations is not very useful. Oetzel (2004) has suggested that the time of sampling within a day has a critical inuence on the outcome of blood metabolite analysis. For BHB, the ideal time for sampling is suggested as 45 h after feeding, while for NEFA just before feeding was recommended. Oetzel (2004) also indicates that for cows suffering from type II ketosis (resulting from pre-existing fatty liver) testing the 515 DIM group should prove useful, while for cows with type I ketosis (primary lactational ketosis) they typically do not become ketotic until 2142 DIM. So the optimal time for sampling cows for BHB may depend on whether negative energy balance and over-conditioning existed in the dry period that may have given rise to fatty liver. It is also worth noting that there are several cow-side tests available that rely on detecting high levels of ketones in urine or milk. 4.4. Negative energy balance monitoring: dietary evaluation The calculation of dietary energy balance for the lactating cow is facilitated by rstly predicting feed intake. Several equations are available in the literature that account for concentrate feeding level, live weight, week of lactation and milk yield (Vadiveloo and Holmes, 1979; NRC, 2001). The key monitoring criteria for dietary energy balance is that 95% of energy requirements should be supplied by the diet at 8 weeks post-partum (McNamara et al., 2002; Sutter and Beever, 2000). In practice, the key monitoring criteria for energy balance may be built from the most preliminary and easily available criteria (such as BCS and milk data) to the more difcult to attain or costly (such as blood metabolites or dietary energy balance estimation). Using this system, the cost of herd investigations only arises where initial suspicions are raised. 4.5. On farm approach (Table 3) Shortfalls for the incidence of ketosis, retained placenta and displaced abomasum; high milk fat to protein ratios, low milk protein and milk yields, and poor reproductive performance, necessitate the investigation of energy balance. It is important to appreciate that farm records are often incomplete and sometimes unavailable: Compare on farm records of BCS to suggested targets. Inspect individual cow milk recording data to assess energy balance by days in milk within early lactation or age. Ideally, this may be done before any farm visit. Evaluate feed trough space. Evaluate potential of feed management to restrict intake. Evaluate amount of feed offered and refused amount. Are cows really fed ad libitum? Evaluate the intake potential of the diet particularly home grown forages. Assess post-grazing sward height. In practice, the ability of farm advisors and veterinarians to recognise the over-grazed pasture is of critical importance. Furthermore, local soil and climatic conditions that may lead to reduced pasture intake should always be considered.

F.J. Mulligan et al. / Animal Reproduction Science 96 (2006) 331353 Table 3 Key monitoring criteria for negative energy balance in dairy herds Reference Percentage of energy requirements supplied 8 weeks after calving BCS at drying off BCS at calving % of cows with >0.5 units BCS loss in early lactation BCS at breeding % of early lactation cows with milk/milk protein > 1.5 % of early lactation cows with nadir milk protein < 3.05% % of early lactation cows with nadir milk lactose < 4.5% Weekly decline in milk yield (%) post-peak Trough space for transition cows Percentage refusals accepted in transition cow trough Post-grazing sward height for early lactation cows % cows 214 days pre-calving with blood BHB > 0.6 mmol/ % cows 214 days pre-calving with blood NEFA > 0.4 mmol/l % early lactating cows with blood BHB > 1.4 mmol/l % early lactating cows with blood NEFA > 0.7 mmol/l 95% 2.75 3.0 <25% >2.5 <10% <15% <15% 2.5% 0.6 m 3% 7 cm 10% 10% 10% 10%

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McNamara et al. (2002), Sutter and Beever (2000) Domecq et al. (1997) Mayne et al. (2002), Hayirli et al. (2002), Buckley et al. (2003) Buckley et al. (2003), Pryce et al. (2001) Pryce et al. (2001), Buckley et al. (2003) Heuer et al. (1999, 2000) Heuer et al. (2000), Mayne et al. (2002) Heuer et al. (2000), Buckley et al. (2003) Chamberlain and Wilkinson (2002) Grant and Albright (1995), Shaver (1993) Grant and Albright (1995), Robinson (1989) Gibb et al. (1997) Oetzel (2004), Whitaker (1997) Oetzel (2004), Whitaker (1997) Oetzel (2004) Oetzel (2004), Whitaker (1997)

Take blood samples from 12 cows due to calve within 14 days to measure BHB and NEFA. Take blood samples from 12 cows 1015 DIM or 1550 DIM (depending on if over-conditioned) for BHB and NEFA. Evaluate dry cow and early lactation cow diets for adequacy of energy supply by rstly predicting feed intake. 5. Key area 3: milk fever and subclinical hypocalcaemia Milk fever and subclinical hypocalcaemia (total blood Ca 2.0 mmol/l) are the most important macromineral disorders that affect transition dairy cows. On average 510% of dairy cows succumb to clinical milk fever, with the incidence rate in individual herds reaching as high as 34% (Houe et al., 2001). The incidence rate of subclinical hypocalcaemia has been recorded at 3040% on the day of calving for grazing New Zealand dairy cattle (Roche et al., 2002), while Houe et al. (2001) reviewed several studies that recorded an incidence rate for subclinical hypocalcaemia of between 23 and 39%. The occurrence of milk fever or subclinical hypocalcaemia is related to increased incidences of mastitis (Goff, 2003) dystocia (Correa et al., 1993), uterine prolapse (Risco et al., 1984), retained placenta (Curtis et al., 1983), endometritis (Erb et al., 1985) slower uterine involution and delayed rst ovulation after calving (Borsberry and Dobson, 1989; Jonsson et al., 1999), ketosis and displaced abomasum (Ostergaard and Grohn, 1999; Massey et al., 1993). Subclinical hypocalcaemia has also been associated with impaired gastrointestinal motility (Goff,

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Table 4 Key monitoring criteria for the prevention of milk fever in dairy herd Reference BCS at 250 DIM BCS at drying off BCS at calving Intake of Ca (g/day) Diet P% Diet Mg% Diet K% DCAB Blood Ca concentration, 1224 h post-calving Blood Mg concentration, 2448 h pre-calving Blood P (inorganic P) concentration, 1224 h post-calving Incidence of retained placenta in multiparous cows Incidence of LDA in multiparous cows Incidence of dystocia in multiparous cows Incidence of clinical milk fever Urine pH (if DCAB strategy used) 2.75 2.75 3.0 30 0.3% of DM 0.30.4% of DM <1.8% of DM 100 to 200 mequiv./kg DM >2.0 mmol/l 0.81.3 mmol/l 1.42.5 mmol/l <10% 3% <10% <5% 6.26.8 (Holstein cows) Domecq et al. (1997) Buckley et al. (2003), Mayne et al. (2002) Horst et al. (1997), Goff (2004) Lean et al. (2006), Goff (2004) Lean et al. (2006) Goff (2004) Goff and Horst (1997) Oetzel (2004) Whitaker (1997) Whitaker (1997) Mee (2004c), Heuer et al. (1999) Mee (2004c) Houe et al. (2001) Goff (2004)

2003), which will reduce feed DM intake. Several criteria that may be useful in the monitoring of hypocalcaemia on-farm are presented in Table 4. 5.1. Monitoring and preventing milk fever: body condition It has been reported that dairy cattle, which are over-conditioned at calving have an increased odds ratio for the development of milk fever (Ostergaard et al., 2003). Sorensen et al. (2002) reported that body condition score management in the dry cow is a regularly used control strategy for the prevention of milk fever. Similarly, cows experiencing subclinical hypocalcaemia have been found to have a higher mean body weight over the rst 60 days post-partum in comparison to cows with higher blood calcium concentration (Kamgarpour et al., 1999). Therefore, the recording and management of body condition score at drying off and at calving, forms part of the key monitoring criteria for assessing the risk of and preventing milk fever and subclinical hypocalcaemia in dairy herds. 5.2. Monitoring and preventing milk fever: dietary calcium concentration Low calcium diets fed prepartum are commonly used as a control strategy for the prevention of milk fever (Sorensen et al., 2002). The use of low Ca diets pre-partum causes the activation of Ca homeostatic mechanisms including the secretion of parathyroid hormone and the activation of 1,25-dihydroxyvitamin D3, which increase Ca absorption from the gut and Ca resorbtion from bone (Chamberlain and Wilkinson, 2002). However, for this strategy to work successfully, the

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calcium intake for pre-calving cows needs to be limited to between 10 and 30 g of total Ca /day (Horst et al., 1997; Goff, 2004). This level of calcium intake is quite difcult to achieve and has led to the development of calcium binders such as zeolite and vegetable oils (ThilsingHansen and Jorgensen, 2002; Wilson, 2003). The key monitoring criteria for dietary Ca content if this low Ca feeding strategy pre-partum is used is that Ca intake should be 30 g/day. In comparison, cool-season grasses, grass silage, grass hay, wheaten straw, maize silage, legume silage and legume hay contain approximately: 5.6, 5.5, 5.8, 3.1, 2.8, 13.4 and 15.2 g of Ca/kg of DM (NRC, 2001). Therefore, for many forage types it will be difcult to meet this target of Ca intake 30 g/day, and if this strategy is used to control hypocalcaemia, additional Ca supplementation prepartum from mineral mixes and compounds or Ca-rich by-products should not be fed. Roche (2003) has highlighted this problem for New Zealand pasture, which is too high in Ca prepartum, and too low in Ca postpartum, to effectively control hypocalcaemia. Furthermore, Roche (2003) has pointed out that great variation exists in the macromineral concentration of pasture from farm to farm and even from paddock to paddock, complicating milk fever control strategies. 5.3. Monitoring and preventing milk fever: dietary cation anion balance (DCAB) and K The concept of dietary cation anion balance has focused attention on the level of K that is contained in the feed of precalving dairy cattle (Horst et al., 1997). It is now widely accepted that the homeostatic mechanisms that result in milk fever prevention work more efciently when DCAB is negative (Block, 1996). The most common strategy employed to achieve this negative DCAB is the addition of anionic salts to the diet of pre-calving cattle (Goff, 2004). Horst et al. (1997) concluded that it is almost impossible to achieve this negative DCAB if the DCAB of forages or feeds (including by-products) used in this period is >250 mequiv./kg of DM while Goff (2004) has stated it is very difcult to control hypocalcaemia if total ration K is >1.8%. Furthermore, it has been concluded, by Goff and Horst (1997) that dietary K% is more important than dietary Ca in the prevention of milk fever. Therefore, as a key monitoring criteria for milk fever and hypocalcaemia a diet K% of 1.8% has been used in this preventative strategy. For those using the addition of anionic salts to try and prevent milk fever and hypocalcaemia, three key monitoring criteria have been suggested (1) that DCAB for dry cows is between 100 and 200 mequiv./kg DM (Goff and Horst, 1997), that urine pH for cows fed using the DCAB strategy is 6.06.8 and that dietary Ca concentration is 1.2% of the diet (Oetzel et al., 1988). The monitoring of urine pH for eight or more close-up cows fed using this DCAB strategy is extremely useful to determine if optimal dietary acidication has been achieved (Oetzel, 2004). 5.4. Monitoring and preventing milk fever: dietary Mg concentration The daily intake of dietary Mg is of critical importance in the control of milk fever and subclinical hypocalcaemia (Chamberlain and Wilkinson, 2002; Goff, 2004). The strategy of milk fever and subclinical hypocalcaemia prevention by ensuring that Mg supplementation levels are optimal in the periparturient period has been suggested by Roche (2003) and is used extensively in practice (Sorensen et al., 2002). In a recent review, increasing Mg supplementation was found to have the greatest inuence amongst dietary strategies for the prevention of milk fever (Lean et al., 2006). Therefore, one of the key monitoring criteria for the prevention of milk fever is that dietary Mg concentration for pregnant dairy cattle should be in the region of 0.4% of dietary DM (Lean et al., 2006; Goff, 2004). To identify herds where Mg feeding strategy is not optimal,

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blood Mg concentration may be determined in cows that are expected to calve in the next 2448 h (Whitaker, 1997). The ideal range has been reported as 0.81.3 mmol/l (Whitaker, 1997). 5.5. Monitoring and preventing milk fever: dietary P concentration Lean et al. (2006), has also reported that dairy cow dietary P concentration is closely related to the risk of developing milk fever. The latter authors have reported that increasing dietary P from 0.3 to 0.4% for pregnant dairy cattle would increase the risk of developing milk fever by 18%. Similarly Goff (2004) has suggested that a diet supplying more than 80 g/day of P to pregnant dairy cattle may block the production of 1,25-dihydroxyvitamin D3. Goff (2004) has indicated that the NRC requirement of 0.4% P may be excessive and Lean et al. (2006) has shown that increasing dietary P from 0.3 to 0.4% will increase the incidence rate of milk fever. Therefore, a key monitoring criteria for the development of milk fever and subclinical hypocalcaemia is that dietary P is 0.3%. 5.6. Monitoring and preventing milk fever: blood calcium concentration Monitoring of dairy herds for subclinical hypocalcaemia has been described by Oetzel (2004). This monitoring approach involves blood-sampling cows about 1224 h after calving. The total blood calcium concentration of 2.0 mmol/l has been suggested by Oetzel (2004) as a target for subclinical hypocalcaemia. 5.7. On farm approach Shortfalls in the target incidence of milk fever, retained placenta, displaced abomasums, dystocia, downer cows, poor feed intake or poor reproductive efciency in early lactation necessitate the consideration of milk fever and subclinical hypocalcaemia as contributing factors. BCS management is critical for the prevention of milk fever with the target BCS at calving of 3.0 being suggested in this article. The BCS of all cows should be assessed at calving and at drying-off. The specic strategy for milk fever control on the farm should be identied. All farms should have some pre-determined strategy for milk fever control. The calculation of Ca intake in the close up dry period, from added Ca and estimates or actual values for the forages and by-products used, needs to yield a value of 30 g/day if this strategy is to prevent milk fever. A key monitoring criteria for milk fever and hypocalcaemia is that calculated diet K concentration should be 1.8% in the close-up dry period. The DCAB of forages used in close-up dry period should be <250 mequiv./kg of DM, with the target DCAB after addition of anions being 100 to 200 mequiv./kg DM. Target urine pH for cows fed using the DCAB strategy is 6.0 to 6.8. It is essential to monitor the urine pH of eight close up dry cows if using the dietary DCAB strategy. A dietary Mg concentration of close to 0.4% should be achieved after consideration of the Mg in home grown forages and added Mg. The authors of this review have found it useful to assess blood Mg concentration in cows that are within 7 days of calving.

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It is important that dietary P is limited to 0.3% or less after considering forages and added dietary P. It is vital that all cows have access to the minerals fed and that only palatable anionic salts are fed if they are to be used. Adequate feed availability is of importance in the immediate pre-calving period (last 5 days) if for example a substantial amount of the Mg allowance for dairy cattle is supplied by the forages or mix fed. The authors of this article have encountered many herd problems of milk fever that were related to the grazing of cows on relatively high quality pasture in the close-up dry period. All milk fever control strategies may be assessed by taking blood samples from cows calved within the previous 24 h. Blood Ca levels should be >2.0 mmol/l. 6. Key area 4: rumen health Garrett et al. (1997) reported a 40% incidence rate of low rumen pH within one-third of herds studied. Subacute ruminal acidosis has been linked to laminitis (Enemark et al., 2002; Oetzel, 2000), decreased DMI (Garrett, 1996), erratic feed intake, reduced rumination behaviour (Chamberlain and Wilkinson, 2002), poor condition score in lactating animals (Oetzel, 2000), loose faecal consistency (Nordlund et al., 1995; Oetzel, 2000), low milk fat syndrome (Nordlund et al., 1995; Oetzel, 2000), caudal vena cava syndrome (Nordlund et al., 1995) and abomasal displacement/ulceration (Olson, 1991) and immuno-suppression (Kleen et al., 2003). Nordlund et al. (1995) stated that early transition cows and cows at peak dry matter intake are most at risk from SARA. Early transition cows are at higher risk due to reduced absorptive capacity of the rumen (Dirksen et al., 1985), poorly adapted rumen ora, and the rapid introduction to high-energy dense diets. However, Oetzel (2005) reported a higher prevalence of SARA in cows from 80 to 150 DIM than for cows of less than 80 DIM for TMR fed herds. Others have raised concerns over the occurrence of SARA in pasture fed dairy cattle (Bramley et al., 2005). 6.1. Preventing and monitoring of SARA Nordlund (2003) suggested monitoring cows for lameness, displaced abomasum, body condition score loss, caudal vena cava syndrome, low milk fat syndrome, ration formulation and rumen uid analysis as part of a herd investigation for SARA. 6.2. Monitoring of SARA Donovan et al. (2004) demonstrated an increase in the incidence rate of subclinical laminitis in cows subjected to a rapid change from a low energy diet precalving to a high energy diet postcalving. Nordlund et al. (2004) suggested that an incidence rate of lameness of greater than 15% warrants further investigation. On assessment of hoof lesions, Nordlund et al. (1995) suggested that an incidence rate of laminitis greater than 10% would arouse suspicion of SARA. Allen (1997) summarised data from several trials demonstrating a weak relationship between milk fat percentage and ruminal pH, while Garrett (1996) showed poor correlation between milk fat percentage and the presence of SARA on farm. However, Cook et al. (2005) suggested if 10% of cows in a herd have a milk fat percentage of 2.5%, then SARA may be suspected. Faecal consistency/bre and rumen ll have also been suggested as cow level assessments of bre within the diet and rumen function (Zaaijer and Noordhuizen, 2003; Garry, 2002). Several practical

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Table 5 Key monitoring criteria for rumen health Targets Lameness incidence Laminitis incidence Incidence of displaced abomasums Rumination % resting cows ruminating Chews per bolus in resting cows Erratic feed intake: yes/no Faecal consistency score Faecal sieve test Caudal vena cava syndrome Milk fat depression mid-lactation animals Groups Individual % concentrates in diet % cereals in concentrate % diet starch and sugars Dietary bre table Crude ber ADF NDF NDF from forage % forage length >13 mm >40 mm Long bre in the ration Component fed herds kg of concentrate fed at milking Rate of increase in concentrates after calving Feed space available per animal <15% with locomotion score 3+ 10% 3% >80% 70 No 3 All particles < 0.5 cm 0% <10% animals milk fat 2.5% Milk protein % fat % < 0.4% <65% 40% <2025% 1517% 1921% 2730% 2122% 30% 510% 12 kg 6 kg 0.75 kg/day 0.6 m Grant and Albright (1995) Oetzel (2005) Zaaijer and Noordhuizen (2003) Kleen et al. (2003) Reference Nordlund et al. (2004) Nordlund et al. (1995)

Chamberlain and Wilkinson (2002)

Oetzel (2000) and Cook et al. (2005)

Shaver (1993)

Shaver (1993)

criteria that may be useful for monitoring rumen health on dairy farms when used collectively are presented in Table 5. 6.3. Monitoring of SARA: diagnostic sampling Factors related to low rumen pH are total dry matter intake, sorting of TMR feeds, irregular feeding patterns, feeding forage and concentrate separately (Oetzel, 2005), meal size (component feeding versus TMR), feed particle size, dietary bre and starch concentrations (Nordlund, 2003). Nordlund and Garret (1994) described rumenocentesis as a technique for consistently sampling rumen pH on-farm. Dufeld et al. (2004) demonstrated that samples collected by rumenocentesis correlated well with actual rumen pH in comparison to samples collected via oral stomach tube as the buffering effect of saliva was avoided. Because of the daily uctuations in pH, Nordlund

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and Garret (1994) recommended sampling cows at 25 h after component feeding or 58 h after introduction to TMR to detect the daily nadir in ruminal pH. Oetzel (2003) suggested the sampling of 12 cows at risk with a positive herd diagnosis if 3 or more have a rumen pH of less than 5.5. 6.4. On farm approach The clinical picture may vary greatly between farms with no one sign conrming the presence of SARA, meaning a closer assessment of the problem is needed. SARA is suspected as a problem at herd level if: Higher incidence of lameness (laminitis mainly), displaced abomasum, body condition score loss, caudal vena cava syndrome, erratic feed intake or milk yield. More than 15% of dairy cows with a locomotion score of 3. Less than 80% of resting cows are ruminating. Faecal consistency for lactating cows is extremely loose (score < 3). Ten percent of the mid-lactation cows have milk fat concentrations of 2.5% or if 10% of the mid-lactation cows have a milk fat concentration less than the milk protein concentration by 0.4%. Dietary levels of effective bre are not adequate. High levels of total concentrate or cereals are being fed. Feed trough space and management are not ideal. 7. Key area 5: trace element and antioxidant status Although trace element status is thought to be of less importance than other nutritional risk factors for periparturient health problems and reproductive performance, trace element deciency may be linked to conditions such as retained foetal membranes (Gupta et al., 2005), abortion (Mee, 2004a) and weak calf syndrome (Logan et al., 1990; Van Wuijckhuise et al., 2003). Husband (2006) has recently reported combined selenium and iodine deciency in a dairy herd with a high incidence of retained foetal membranes, milk fever and vulval discharge. Furthermore, differences in reproductive performance have been demonstrated in cattle and sheep when comparing trace element supplementation strategies (Black and French, 2004; Hemmingway, 2003). Other authors have reported differences in the incidence of mastitis after supplementation with high levels of Vitamin E in the dry period and in early lactation (Weiss et al., 1997) but results of supplementation differ between trials (Moyo et al., 2005). Xin et al. (1991) emphasised that the amount of copper needed for optimal immune function may exceed that amount which will prevent more classical deciency signs. Consequently the assessment of trace element status should form part of all herd health nutritional monitoring strategies. 7.1. Key monitoring criteria for trace element and antioxidant status The prevalence of herd health problems including mastitis, weak calf syndrome, retained foetal membranes, ill thrift, poor reproductive performance and myoptahies, can often form the initial basis for assessing trace element status. In addition, for many of the nutrients under consideration, classical deciency signs may be observed, although in the authors experience these can cause a misdiagnosis. For example, a spectacled appearance around the eyes of cattle arising from lightening of the coat colour has been suggested as a classical sign of copper deciency (Chamberlain

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Table 6 Key monitoring criteria for dairy cow trace element status Reference Cu Se >1011 mol/l of plasma >20 mg/kg liver DM 2101200 ng/ml whole blood 1.252.5 g/g liver DM (adult) 2.38.0 g/g liver DM (newborn) >50 iu/g of Hb >50 g/l of plasma >20 mmol/L plasma >0.4 g/ml of plasma 0.81.4 g/ml of serum >100 mg/kg dry liver 70200 ng/ml of whole blood 670 ng/ml of serum 2.0 mol/l 33.5 g/ml periparturient cows Kincaid (1999), Mee (2004b), Whitaker (1997) NRC (2001) Kincaid (1999) Kincaid (1999) Kincaid (1999) Whitaker (1997), Mee (2004b) Mee (2004b), Kincaid (1999) Whitaker (1997) NRC (2001) Kincaid (1999) NRC (2001) Kincaid (1999) Paterson and MacPherson (1990), Rice et al. (1981) Weiss (1998)

GSPx Inorganic iodine T4 Zn

Mn MMA -Tocopherol

and Wilkinson, 2002; NRC, 2001). However, such an appearance may also be caused by ill-thrift. Furthermore, Underwood (1981) has described anaemia, fragile bones, cardiac failure in young animals and reproductive inefciency characterised by depressed expression of oestrus behaviour in cows as a result of copper deciency. In the experience of the present authors, lameness associated with physitis in weaned dairy calves has been a common manifestation of Cu deciency. Other trace elements such as selenium and Vitamin E exhibit classical deciency signs such as nutritional muscular dystrophy (NRC, 2001), while iodine deciency results in the classical deciency symptoms of enlarged thyroid glands in the calf together with weak or dead hairless calves (NRC, 2001; Van Wuijckhuise et al., 2003). It should be noted that while classical deciency signs may be used to implicate trace element or antioxidant deciency, herd health problems related to trace element deciency are often reported in their absence; the amount of trace elements needed for optimal immune responses may exceed the amounts required to prevent classical deciency signs (Xin et al., 1991) and the addition of organically complexed trace elements to diets with already adequate levels has shown benecial effects on reproductive performance (Campbell et al., 1999). 7.2. The use of animal tissue samples for assessment of Cu, I and Se status The diagnosis of trace element deciency is often reliant on blood or liver analysis (Table 6). Whitaker (1997) described optimal values for plasma Cu of 9.4 mol/l and for serum of 7.5 mol/l. However, Mee (2004b) and Husband (2006) have reported higher reference ranges for plasma Cu concentration and it is known that liver copper stores may be depleted whilst plasma or serum Cu concentrations are maintained. Therefore the measurement of liver Cu concentrations by liver biopsy may be required to detect subclinical deciency (Chamberlain and Wilkinson, 2002; Whitaker, 1997). NRC (2001) described liver Cu concentrations of below 20 mg/kg on a

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DM basis or 5 mg/kg wet weight as the cut-off value for Cu deciency. Apart from blood and liver Cu concentrations, the concentrations of ceruloplasmin and superoxide dismutase in blood have also been used to assess Cu status (Ward and Spears, 1997). For the assessment of Se status in dairy cattle, blood, milk and liver Se concentration are often used along with glutathione peroxidase (GSPx) (Knowles et al., 1999; Mee, 2004b; Whitaker, 1997). Grace et al. (2001) have shown close relationships between blood Se and milk Se and between milk Se and GSPx status of New Zealand dairy cows treated with Se injection. Since Knowles et al. (1999) reported that the response patterns of dairy cattle to Se intake in terms of whole blood GSPx and Se are very similar it is likely that both are equally accurate criteria for assessing dairy cow Se status. However, Chamberlain and Wilkinson (2002) suggested that the measurement of serum GSPx may be more accurate than red blood cell GSPx as serum GSPx is reective of a recent change in Se status whereas red blood cell GSPx is not, as it is dependent on the rate of erythropoesis and erythrocyte turnover. Whitaker (1997) described an optimal level of GSPx of more than 50 units/g of haemoglobin, whereas Mee (2004b) has reported a reference range for GSPx of 42161 iu/g of haemoglobin. The assessment of iodine status in dairy cattle is often based on the concentration of thyroxine (T4) or plasma inorganic iodine (PII) (Chamberlain and Wilkinson, 2002). Both the latter authors and Kincaid (1999) questioned the usefulness of T4 for assessing iodine status of dairy cattle. Kincaid (1999) pointed out that low iodine intake during pregnancy can result in goitre even when serum T4 in the dam was apparently normal (Azoulas and Caple, 1984). Furthermore, Rhandawa and Rhandawa (2001) reported no difference in the concentrations of plasma triiodothyronine (T3) and T4 between iodine decient and normal cows. However, signicantly lower PII concentrations were found in iodine decient cows in this study. It is also notable that Rhandawa and Rhandawa (2001) concluded that the response to iodine supplementation was the most reliable index of thyroid dysfunction associated with iodine deprivation. The authors of this paper agree with this statement, but also feel that the assessment of PII is extremely useful. 7.3. On farm approach Key monitoring criteria for trace element status have been suggested based on dietary concentrations or daily supplies as well as blood concentrations of trace elements and or metabolites. Although care has been taken to ensure only values derived in the same way are used to inform these criteria, it is important to use these suggested values carefully as reference ranges can vary widely between laboratories both nationally and internationally. Initial suspicions of trace element deciency are often reliant on the occurrence of classical deciency signs on the farm being investigated or in that locality. An assessment of dietary trace element supply should be made based on what trace elements have been added to the diet and compared to suggested targets. The investigators should consider local trace element deciencies or excesses (e.g. high molybdenum areas). Interactions with other mineral sources like concentrates should always be considered. Blood samples may be taken from marker animals, that are fed the home-grown forage or pasture only (e.g. maiden heifers), for assessment of farm-specic trace element status. Blood samples may be taken from eligible groups within the herd (e.g. early lactation cows or close-up dry cows) for assessment of trace element status.

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For trace element problems of the dairy cow and calf that occur close to parturition, trace element status in dry cows, not lactating cows should be assessed. The use of liver analysis from fallen animals or liver biopsy may prove useful for the detection of some trace element deciencies (e.g. subclinical Cu deciency). Assessing the response to supplementation for specic trace elements or mixes in the eligible group of cows is often invaluable. It is important that only a proportion of the eligible group are treated to truly diagnose deciencies. 8. Conclusions The development of a strategy for the prevention of production diseases in dairy cattle relies upon the use of optimal nutritional and management strategies, as well as the close monitoring of clinical and subclinical disease. Criteria have been presented that may be used in the monitoring and prevention of production diseases that are associated with body condition score, energy balance, hypocalcaemia, rumen function and health and trace element status. Ideally herds should be assessed using the suggested monitoring criteria in each key area, facilitating the assessment of the preventative measures currently being employed. This exercise will also facilitate the diagnosis of subclinical conditions and characterise the overall prevalence of production disease. Where shortfalls are identied, the monitoring criteria suggested will allow the identication of the primary risk factors involved. The aim is to review the efcacy of control measures currently in place, and if necessary to modify them or formulate new ones. The integrated approach described has been used effectively in many herd investigations in Ireland, and opportunities exist to assess its impact in terms of animal health and welfare and protability in detail. References
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