Diagnosis and treatment programs for fresh cows

At the time of this writing (early 2004), there is a large amount of excitement and uncertainty about the management and nutrition of the transition cow. A good rule of thumb is that the more ways that are proposed to do something, the less certain it is which is correct. The wide range of opinions currently held on this subject probably means that our current knowledge about why fresh cows fail and how they should be treated and managed is inadequate. There is only one treatment for milk fever, and there are only two proper positions for a calf at calving. Yet fresh cow programs are proposed that range from intensive screening and treatment, including daily temperatures and drenching every fresh cow with a large amount of fluids, to nothing. The purpose of this article is to provide guidance for the veterinarian or consultant who wishes to help a client design a program. It cannot provide the ideal program for every herd. It can suggest a thought process, a series of questions that must be asked on the farm, and a training program for workers on the farm. This is an area that cries out for close collaboration between the veterinarian, the nutritionist, the management, and the workers. Specific procedures should be developed for each farm based on the past history of fresh cow problems in the herd, the priorities of the management, the facilities, the skills and interests of the workers, and the patterns of cow flow on the farm. The advice that follows is based on my own experience and the help of many others, who are acknowledged at the end of the article. It is not intended to be a literature review on the management of the transition cows. It will reflect my experience on larger dairy farms, but the principles apply to any size farm. In what follows I use the word failure to describe the cascade of events that befall a cow that is compromised by the common periparturient diseases: dystocia, hypocalcemia, ketosis, metritis. These cows have increased risk of a displaced abomasum (DA), and often go on to perform poorly during lactation.