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Rafael Bisinotto joins the OG3 to discuss transition health and the impact on reproductive performance. Metritis is the focus of Rafael's work so we spend much of our time there, including new research on what antimicrobial product to use. We talk in terms of dairy for this episode but much of this directly applies to beef as well.
Hosted by members of the University of Minnesota Extension Beef and Dairy Teams, The Moos Room discusses relevant topics to help beef and dairy producers be more successful. The information is evidence-based and presented as an informal conversation between the hosts and guests.
[music]
[cow mooing]
Joe: Welcome to The Moos Room, everybody. OG3 back, and we have two guests again. Luciano Caixeta is with us again. He's from the University of Minnesota College of Veterinary Medicine. He's acting as our co-host today. Thanks for being here, Luciano.
Luciano Caixeta: Thanks for having us.
Joe: He's brought another friend, happens to be another friend from Brazil. Rafael Bisinotto is here, and he is at the University of Florida. Got his DVM in Brazil. Worked at Florida to get his PhD. Did a postdoc at Cornell. Finally came, made the right choice, came to Minnesota for a while. Only lasted a couple winters, and then retreated back to Florida. Thank you for being here, Rafael.
Rafael Bisinotto: Thank you very much, Joe. Thank you very much Luciano for the invitation. Brad, Emily,
Joe: It's great to have another expert in the field. I don't think I'm an expert in pretty much anything. Jack of all trades. Emily has a clear expertise and knows everything. Then Dr. Bradley J. Heins, tenured professor is clearly an expert in many different things. Maybe.
Bradley Heins: I wouldn't call myself an expert, but thanks.
Emily: Bradley's more of a jack of all, master of none type thing.
Bradley: That's right. Exactly. I'll do anything.
Joe: He's especially good at being tenured.
Emily: Very good at it.
Bradley: I do work, you know that.
Joe: I know.
Emily: When?
Joe: We make fun of you, but you do work a lot, and that that's true. All right. Before we get into today's topic, Emily's going to read us through the super-secret questions, which we are only going to ask Rafael, because we got Luciano's answers last week, and we don't need them in game.
Emily: Rafael, your first question is, what is your favorite breed of beef cattle?
Rafael: Favorite beef cattle breed? Angus.
Emily: All right. Joe is happy. [laughs]
Rafael: Presuming, you should answer Nelore, but I got charged by those too many times to like them, number one, they're probably number two.
Joe: That's good to know. Luciano did get nostalgic and go Nelore, but I'm really excited that you went with Angus. That's very important because that puts Angus ahead of Herefords for the first time in a long time.
Angus at seven, Hereford's at six, Black Baldy at two, Belted Galloway at two, Brahman at one, Stabilizer one, Gelbvieh one, Scottish Highlander one, Chianina one, Charolais one, Simmental one, and Nelore one.
Emily: Whew. Is that all? Yes. All right. Super-secret question number two. Rafael, what is your favorite breed of dairy cattle?
Rafael: Oh, definitely, Holstein.
Emily: [laughs] Oh, Brad.
Bradley: I quit. I'm going to go feed calves.
Emily: Oh no, he's sad.
Joe: That was brutal. Brad and I are Jersey guys, so that's why we're disappointed. Holstein's at 11 now with a really, really strong showing in the last few episodes. Jersey's at seven, Brown Swiss at four, Dutch belted at two, Montbeliarde two, and Normandy at one. Again, a little disappointing, but I'll take it because Angus moved ahead of Hereford, which is really good. Bradley disagrees, but that's okay.
Let's move on. Let's get into the topic today. The topic today is really looking at, continuing piggybacking off our conversation with Phil Cardozo in last episode, and looking at the transition period. Really today what we're looking at is transition health, and its effect on fertility for those cows. That's where Rafael's done a ton of work, and that's why he's on today, but the place to start for me is thinking about, and this is a number that always surprises me, is how many cows actually develop metabolic, or infectious diseases in the first few months of lactation. Let's talk about that. How many cows is it really?
Rafael: It really depends on how aggressive you are at diagnosing, and what you call a disease. First, it was a metabolic going up or down, but we normally talk about over half of the cows having some sort of disorder in the transition period. I agree with you, it's a large proportion.
Joe: Yes, that number always surprises me, and it scares me, to be honest, knowing that-- Especially, with some of the work that you've put out and other people have put out, how much of an effect it has, but the number's still high. Why haven't we been able to get a handle on that? We know a lot of things, and we've learned a ton in the last 50 years about dairy farming, and improved a lot of things. Why can't we get a handle on that number?
Rafael: If I had the answer, I probably could retire now. [chuckles] It is interesting. Some of the disease that I work with the most, that's called metritis, for example, is being studied, we know the microbiome and metabolome, and to a detailed level that is remarkable, but if you look back, we're still talking about 20 plus percentage of cows developing metritis, and that hasn't changed much.
I don't know exactly what the reasons for that are. The optimistic in me think that, as times go by, we are doing a better job at preventing disease, at the same time, that we are doing a better job diagnosing it. Maybe we're missing more cows before, that now we're not missing. That makes up for the difference in decline in incidents. That might play a small role in that.
It's very difficult to look at averages, but if you track what the best farms are doing, you probably see a much greater decline in incidence of these diseases, because you have a large variation between very well-managed farms, and the average farm, and the poor-managed farm. When you draw the line, and just get average from everybody, a lot of that improvement on the upper end, end up being missed. I think that there's been improvements over the years. We might not have been able to see as clearly, but I think the improvement's there.
Joe: Bradley, I mean, what are you doing to check on the dairy up at Morris? What are you doing to check on transition health? Are you doing fresh checks? What are you doing up there?
Bradley: Well, you can maybe guess what we're doing. We use sensors. We're looking at sensors, basically, to look at transition cows, and that if they're showing up on the alert list, we're checking them out. That's what we've gone to when you have a 300 cows, and a bunch of fresh animals. In my mind, that's a little bit easier. Granted, it doesn't take away from going out and viewing the cows, but at least it starts the process of trying to figure out what's happening in the cows, and which ones to check on.
Joe: That probably becomes even more important as you're seasonally calving, right? All of a sudden, you've got calves everywhere, where you didn't have any before.
Bradley: Right, yes.
Joe: Perfect. Where I'd like to start this conversation of transition cow diseases, is really a discussion about inflammation, because I think that's something that's pretty common. It doesn't really matter what we're talking about. Metritis, lameness, pneumonia, mastitis, they all have a component of inflammation, which really has been implicated as the problem when we're talking about reproduction down the road.
I think the question that always gets me, and I think the one that's probably the hardest to answer, and so, I'm going to ask it, is how does inflammation in the first three weeks affect me down the road for reproduction, potentially, two months later?
Rafael: It does it in two ways. I think the first and more obvious way is, some of those disease persist. Some cows that have inflammatory disease due to metritis in the first three weeks postpartum are the same cows that still have the metritis 30, 40 days after parturition, and beyond sometimes. For some cows, it's not a very distant inflammation way back when, and then a decline in reproduction much later.
For some cows, that's actually happening at the same time. It's not surprising that, out of all systems that you can imagine, reproduction will be the most sensitive to inflammation among other things. I'll get to that later, but what you said, some cows they do have a break, at least, to the best of our capacity, you spend a few weeks, or a month that you don't detect inflammation anymore, but you still see long-term impact on fertility later.
I think that's again for multiple reasons, one of them is, if you think about the follicle, like the follicle is as a unit, it takes months to develop from a primordial follicle, all the way to preantral, antral follicle that would ovulate, and donate another site to be fertilized and impacting, so when there's increase in inflammatory mediators or LPS, there are changes in granulosa cell expression that you can attack weeks to months later.
Some of the units that are important for reproduction, get long-term impacts from being exposed to infectious inflammatory disease. That's one component. Another component is that, especially, for uterine diseases, there is tissue damage. That's a part of the disease that we normally don't evaluate. We check, for example, for vaginal discharge for a cow's metritis, but we know from necropsy that a lot of those cows have a very extensive damage of the endometrium.
For example, damage to the oviduct. If the animal has small adhesions around the fimbria, or in the oviduct, it's something that after all we can see, as far as inflammation and disease is gone, is basically blocking the entry of the oocyte in the uterus. The type of research that we do, we normally don't pick up that level of detail. That's a cow that's probably not being infertile, in that case for a lack of inflammation, but there's an anatomical changes associated with the disease that probably also play a role.
There's differences in uterine, the endometrial gene expression that survive after infection is gone, and there's some nice studies that is based on association. We can't really claim cause and consequence, but cows that either had, or didn't have disease, later they were subjected to either AI or embryo transfer. The idea is that, a cow that is being inseminated, if there's a damage in the oocyte or the follicle, that will affect fertility.
If there's a damage in the uterus capacity to house pregnancy, that's also going to affect fertility, but in the embryo transfer recipient, the oocyte, basically, doesn't matter as much. There's probably some potential residual effects on the CL, but as far as the oocyte or the follicle, we're basically putting an embryo that was visually inspected, and is alive or healthy embryo.
You still see a very similar decline in fertility, and increase in pregnancy loss. There's definitely a long-term effect on the uterus capacity to do that crosstalk between the conceptus and the endometrium that is so important to promote elongation of the embryo, and establishment of pregnancy.
Joe: Do you see similar results or similar paths for both primiparous and multiparous cows? Are they different? Are the results fairly similar when we're talking about the pathways for these inflammation? Is one worse than the other? Do I need to worry about that heifer that gets sick, basically, more than I worry about that cow?
Rafael: I don't think we have the definitive answer, but if you take metritis as an example, primiparous cows are more likely to develop metritis. A first lactation cow, normally you have a greater incidence of metritis, which then if that's determining fertility, those should be your least fertile cows, but you see the opposite. That fertility is normally better for a first lactation cow, than it is for older cows.
I'm sure that they deal with inflammation in different ways. The lactational challenge for multiparous cows is larger than it is for a primiparous cow. I think primiparous cows, overall, at least based on epidemiological data, they deal with the aftermath of inflammation slightly better than multiparous cows, at least, when it comes for uterine diseases.
Joe: One of the things that we're dancing around a little bit in my mind is, we talked about, there's definitely differences in diagnosing these different diseases, or specifically uterine diseases. How does the producer know when that's cleared up? You talked about, there could be anatomic changes, there could be, basically, an impaired uterine environment, but how is that producer going to know that? How do they know that that's cleared up?
Rafael: I think normally the producer, or the veterinarian would know based on clinical signs. If the cow still has a purulent discharge, that cow is normally not inseminated. If there is clear clinical signs that lingers after the voluntary wait period, I think that's one way, but for the most part, I think it boils down to just infertility. A lot of times, it's not a conscious decision that we know this cow is infertile.
The cow gets three, four, five chances, and it gets to a critical time that, now it's no longer, for whatever reason, it's no longer profitable to impregnate that cow, and she becomes a reproductive cull. Indirectly, that's you're diagnosing that infertility, and removing that cow from the herd, but a lot of time comes as a consequence of infertility.
Joe: Maybe Luciano, you can comment on this as well. Do you think we have enough information about early metabolic or infectious disease, and inflammation to say, if a cow has a clinical event, should she get less chances to get pregnant? Because I know she's impaired already. Should she get more, because I know she's impaired already?
Should I wait longer? How do I handle that knowing up front that that's going to affect her? If it's bad enough, do I just cull her right away, and she never gets a chance? How are we handling that cow, knowing that it's affecting reproduction later?
Luciano: I'll say that some cows should be-- Do not breed cows from the get-go. I say that without having a list, list all the tops that they need to have to be on the cull, but some cows, like you see that she's not transitioning well, definitely never picking up production, had two or three disease events. You can tell, it's one of the worst transitioning cows. Those are usually cows, who might not have as great success reproductively as the average cow in a herd.
There is, in many farms, people know which cows are more likely to have trouble, but it's very hard to see someone should cull cow, do not breed from the get-go. Rather than that, I don't have like I mentioned before, a list of events that would make a cow less likely to be pregnant. Then, we can go both ways, do we need all those cows to be pregnant, because we need all those replacements? That's usually not the case anymore.
We can keep those cows with the other, all the average cow in a herd, and if she doesn't get pregnant, because many other reasons, including the fact that she had a poor transition, whenever she hits the farm regular times [unintelligible 00:16:38] she's had all her chances. Unfortunately, I don't have an answer or a formula that we can use, but I'm interested to see what Rafael thinks about it.
Rafael: I don't think there's a formula for that. If you're going to cull every cow that has a smaller chance of getting pregnant because of disease, going back to the beginning of the podcast, you're going to get rid of half of your cows from the get-go. That won't work. I think, what Luciano mentioned is very important. You have cows that go through metritis, and they recover and they get pregnant at first service.
You have a good chunk of them actually, 30%, 35%. It's lower than the cows without metritis, but some of them will get pregnant. Some of them don't have such a abrupt decline in milk production. They still continue to be profitable cows. By the time you know that answer, right? You already know she's pregnant, and her milk production didn't drop, it's already past the point that you would have made the decision.
The hindsight is always much better, but if you are at the event of metritis, you're looking at a cow that you're going to treat for metritis on week two postpartum, to look forward and say, "No, this is the cow that I'm going to cull, and that other cow with metritis, I'm going to retain." We still don't know who those cows are. We need more data on cows that cure versus cows that don't cure for multiple diseases. We need better markers at the time of diagnosis to do this prospective decision-making. We're still not there.
Joe: Do you think body condition plays a role in that as well? If you did have a calving body condition, and then you have a metritis that's a little bit lingering at 15 days fresh, and I know my body condition has also changed, that would be an additive effect, don't you think? Is that then enough information? I'm looking for, with the amount of heifers out there, and the amount of people just completely not worried about replacements, I'm looking for any reason to say, "All right, it's really not worth it for this cow."
I'm not advocating for everyone to just say, "All right. I'm going to decide in the first three weeks who is getting bred and who's not," but I mean, there's clear cases in my mind, at least subjectively, I've seen them in practice. When we add body condition, does that change the game?
Rafael: Again, looking backward, the cows that have the poor fertility, if you compare cows with metritis, the ones that had disease, and poor body condition score had lower fertility than cows that had just metritis, but not poor body condition score. If the two are definitely related, if she has poor body condition score because of metritis, or it now becomes a consequence of a metabolic disorder that she may have developed because of metritis, it's hard to know, but those cows are less likely to become pregnant.
Another one that we normally use as an outcome, but for the farm is very important, is cyclicity. Cows with disease are less likely to be cyclic. If you have a cow that has disease, but resumed cyclicity before its first breeding, versus a cow that has disease and were not able to recover cyclicity, the second cow is less likely to become pregnant. That's another criteria you could use. Now, I don't feel comfortable recommending this, because we don't have a really good metric that, if you follow these set of criteria, then you're going to have extremely high sensitivity and specificity to know which ones are going to be your successful cows, and which ones will not.
I think that will come with more data, like Brad mentioned activities. If you put data related to activity and rumination, and then data related to biomarkers, inflammatory markers, oxidative markers, we might have enough predicted value to determine that, that cow shouldn't stay. For now, I think that at least the way I see it, evaluating how cows are fairing off transition, you have an increasing milk production.
Comparing, maybe not peak production, but week two, week four milk production, see how they're transitioning. I think another point to that is, how many cows does that farm need? That determines how aggressive you're going to be at culling. If I need to retain more cows, then I'm going to keep more cows. If I need to sell cows, or I have too many coming in, then you start looking for problem cows, because you have to sell them, then by all means, get the cow with multiple diseases occurrence, cows with poor body conditions score, and other cows. You're probably selecting out the least profitable, the least fertile cows.
Joe: We've talked about the diseases, we've talked about how their effect on repro, and we're hoping that Brad will get us to enough information with all the sensors to come up with a formula, or metric at some point. You got a question, Brad?
Bradley: Oh, well, I always got something to say. You know that. I also think that genetics plays a role in disease transmission. There are some herds are genomic testing, and there are genetic evaluations for health. Metritis is one of them that you can get a genetic evaluation for. There may be some selection there for metritis in the past. We've done some of those studies here at Minnesota, former grad student, Mike Donnelly, we'll give him a shout-out.
He looked at health treatments on cows, and we found that every metritis event cost $117. It is not cheap to have a cow with metritis. That's just the treatments, not accounting for, we can't breed them, everything else that goes along with it. I guess my point is that, diseases in cows cost a lot of money to the farmer in many different ways.
Joe: Do you guys have any comments on the genetic side of this? I don't know if that's something you guys have looked at and looking at, if I am genetic testing, are there markers that are reliable enough to really count on?
Rafael: Yes, there are. I'm not a geneticist and I don't work with genetics directly, but there are markers, SNP markers for health traits. They have been validated. When people compare disease incidents, for example, the 25% more resistant to disease genetically speaking, versus the bottom fourth, there are differences in incidents. There are markers, there are data showing that the markers are measuring disease incidents in herds.
I think continue to select for those markers would eventually result in more sound, healthier cows. They're able to transition better. We shouldn't really rely on that as heavily as, for example, the improvements that we saw over the last decades on new production or composition. Disease is a much more multifactorial trait than new production is, and the weight that we're going to allow those traits to take into, for example, net merit.
If we select these composite traits for profitability, a lot of other traits are going to have much bigger weight. People are not going to select just for health. You're going to continue selecting for a more profitable, more productive cow, and with a smaller weight for health. I think on the long run, you're going to have benefits from genetics, and I think that's going to be important.
Joe: We can't rely specifically on genetics to fix this issue, we know that. On this show, we talk pretty much prevention and management for everything.
Emily: You just always have to steal my comments and questions, don't you, Joe?
Joe: That's my job. I've been trying--
Emily: I kept trying to unmute, and you kept talking over me, and this is what happened. Well, as Joe was saying, because I told him to say it, we talk a lot about the management piece on the show, and I don't know how you can't with any of these things. I'm curious, Rafael, and Luciano as well, what are maybe those two or three really key management things that you think can aid in prevention?
Rafael: I'm going to say one that I know Luciano's not going to say, and I'm biased towards it anyways. I think reproduction, it's a major area to be concerned with. The least efficient reproductively the farm is, the more cows getting pregnant too late, you're going to have some more over-conditioned cows that parturition more, metabolic disorders on the subsequent lactation.
In a sense, being reproductively efficiency, end ups leading you to continue to be reproductively efficient. I think that's an important one. Thinking about treating diseases, maternity management is critical. We starting from hygiene, so there's data out there that cows, they're dirty, they're more likely to have metritis, so not surprised there. Hygiene on the prepartum groups. Very important hygiene in the maternity, and very important.
There's some data from Ohio from Dr. Schunmann.
I thought that study was very interesting. He developed an app to track maternity events. Everybody was logging in when the cow was first saw, and moved to the maternity pen, and evaluated progress, and when the cow finally deliver, and then the outcomes, if it was a live calf, stillborn calf. They tracked the incidents of stillbirth across the hours of the day. If I'm not mistaken, in that study, that there was 12-hour shifts.
The incidence of stillbirth in the two hours around shift change, so an hour prior to an hour after, was two or three times greater than for cows that calve in any other one of the 10 hours of the shift. That's probably communication, like I'm leaving my shift, and I'm eager to go home, or I'm tired, or there's not a philosophy of communication between the shift that is leaving, and the shift that's coming in.
Maybe I don't monitor a cow as closely as I could or should, because I don't know exactly when she started delivering. Communication in the maternity pen is very critical. Again, training the team of people that will assist cows through delivery. They have to understand lubrication, cleanliness, force, and when to ask for help, when to call the vet. I think all those are very important. There's data relating all those back to incidents of metritis, and then back to fertility, and so on and so forth.
Joe: Luciano, what do you think?
Luciano: Well, I think that it's much more general, like episode we talked about nutrition very important, to keeping those cows as prepared as possible to fight back those diseases, but one other thing that we didn't talk last time, and we didn't talk about now is, I would say cow comfort, and having cows stress free. I believe its Dr. Gordy Jones here, who constantly keeps saying that production of milk is the absence of stress, or something like that. That's his book, but that's what it is.
Cows, if we are adding salt to the injury, like making them suffer even more than the stress that they're going through around calving, we are just making them more likely to have diseases, and have bad outcomes after that. Cow comfort, and making sure cows are with the least amount of stress as possible, that goes with stocking density, cleanliness like Rafael mentioned before, the routine of the farm, and the way things are moving, the cow movements, all those things play a role in it. Sometimes we don't think about it, and they're very important.
Joe: There's something to this cycle, repro efficiency cycle. If you can get cows pregnant at the correct time, and then body condition falls in line with that, then it comes back around. I think once you're in that cycle, things are good. I think the way to get into that cycle is through all these other things you guys talked about, which is the cleanliness, the communication, cow comfort, all those other things that we've mentioned a million times on the show with management.
If you can get into that cycle of getting that repro efficiency, it'll run itself really well. If you can keep track of all those other things, and make sure that you don't have heat stress, or cold stress, or diet changes that really screw with keeping everything flowing. I think we'll change gears a little bit, and talk about Rafael's-- Some of his latest work with metritis. Talking about-- Really, that it does have an effect on reproduction. There is a clear difference between cows which had metritis and not, but then also some of the treatment decisions that we make, and what medication to use to treat not clinical mastitis, but clinical metritis. Rafael, can you walk me through how that was set up when you're comparing these two medications?
Rafael: Most of this study was actually done by a colleague of mine, Fabio Lima, which is at UC Davis now. When we were in grad school, those are the first studies that I got involved with. The idea was to evaluate just alternatives. More alternatives, the merrier, that was the initial thought. We did some studies comparing Ceftiofur products with ampicillin products.
Bottom line from what we found, there were some minor differences on timing to cure, but the overall cure in the end was similar between the two drugs.
We never concluded one was better than the other. Which again, on itself, it's a good outcome because it gives you more alternatives. More recent work done by [unintelligible 00:31:12] which used to be in Minnesota, is here now in Florida. He's running away from the cold a little, but there's also changes in the dynamics of the farm if you-- Depending on what treatment you decide to use.
Some products require the cow to be milk separate, you end up movement of cows to the hospital and milk withdrawal times, where other alternatives, that's not necessary. He evaluated changes in behavior. He tracked behavior with activity collars and rumination collars, and the conclusion was pretty similar that, despite some initial reshuffling when cows removed, there was not a lot of disturbance, which again, farms will be able to choose what fits best for their routine and goals.
More recently, we moved away a little from evaluating which one of the two antimicrobials was better. Dr. Galvan here in Florida has done some study with alternative methods. He try cytosine particles, which is a shellfish molecule, not a traditionally classified antimicrobial. As part of this push to find known antibiotic measures to treat cows with metritis, unfortunately, the in vitro data didn't replicate itself in vivo.
His conclusion was that, there was not a good alternative to treat cows with metritis. That didn't add to the basket of alternatives that we have. The work that we are doing in my lab more recently, are focusing on two main things. Number one is, within the group of cows that developed metritis, we know that there's some of these cows that are able to recuperate and become pregnant on the first breeding, for example, maintain that pregnancy to term, whereas some other cows are not able to.
We sample uterine contents from these cows, and now we're looking at differences in uterine microbiome and metabolome, trying to understand what's related to metritis that truly dictates whether the cow becomes infertile or not. There's a lot of information comparing healthy cows with cows with metritis, but within metritis, what's different between the ones that get pregnant, versus the ones that don't? That hasn't been done yet. That's ongoing.
Hopefully, in the near future, we're going to have more insight on that. The main goal for us to do that is, maybe there's additional treatments that we can develop, focusing not only on clinical cure, but also in improving fertility in cows that are being treated for metritis. We're trying to understand some of that dynamic before we can evaluate strategies to improve fertility.
The other area that we are very interested now is the importance of cure. With one of my students just finished his work with evaluating performance of cows with metritis, treated with antimicrobials that were then a week later were considered to be cured. The way that was done was the same metric check that we used to evaluate the vaginal discharge to diagnose metritis.
The same technique was applied a week after the treatment was completed, and cows were either classified as cured, so that vaginal discharge of five, or the reddish brownish fatted watery discharge was no longer present, and cows that were not able to cure, so they still had the same clinical signs a week later. He was able to show that it is very important to cure.
That comes not as a surprise, that was expected, but it's good to put some numbers to it. The cows that, after being treated for metritis were not able to cure, they were more likely to develop clinical, and to be clinical in the metritis. Those are some of the cows that you have that persistent infection and inflammation that drags past close to the voluntary wait period.
For multiparous cows, those cows that didn't cure, produce less milk than the ones that cure. Overall fertility was worse for cows with metritis that didn't cure, versus cows that cure. Also, not surprising, cows that don't cure, they're more likely to die, they're more likely to be culled from the herd. Improving cure, it's very important. Part of that is therapy. If we can design therapy, therapeutic approaches that would increase cure, we can probably also get better performance of cows with metritis.
I think we discussed this so far, it's very important to create a condition to minimize the disease, and that should always be step number one. I think we can also work with-- We're probably not going to eliminate metritis completely. Having embedded therapies is also important. What's interesting about that is, some of the risk factors for lack of cure are also risk factors for metritis.
Cows that have retained fetal membranes, we know that they're more likely to develop metritis. Among the cows that develop metritis, those that had retained fetal membranes, they're also less likely to be cured after treatment. In that sense, preventing retained fetal membranes, probably, helps you in two ways, decreasing metritis incidents, and also improving percentage of cows that cure.
Joe: That's really interesting. Yes, I guess I didn't really think about that, that we hadn't really put numbers to that, that the risk factor of certain things for metritis was also a risk factor for lack of cure. That's good to know that someone's really putting numbers to that. Did you guys look at the true economics, and put numbers to things on get a pretty good idea of what this costs when you also factor in reproduction, or it's a big ask?
Rafael: No, it's in the plans to do that. Just based on all the inputs for that model. You have a cow that was treated just the same, that had lower production, less fertility, greater risk of being sold or die. There will be an economic benefit for curing. We haven't calculated how much that is now, but that's an interesting number, we probably should come up with.
Joe: My last question on this, and I think we'll check with everyone else, and see if they have any questions, but how important in this whole discussion of treatment of metritis is supportive care? We've talked a lot about antimicrobials, but we haven't really said anything about NSAIDs, and/or any other adjunct therapies that we've talked about when it comes to supportive care.
Rafael: Yes. I think the reason why we don't talk about supportive care as much is, not because it's not important, it's because it's not as extensively evaluated as much as antimicrobials are. Therefore, we have less numbers, and we only are left with the concept that, "Yes, we should probably provide supportive care for these cows, but don't ask me what the numbers are, in response to that, because those are going to be lacking."
I think it's very important. In this study, another thing that we measure is fever and diagnosis. Some cows have metritis with fever, versus without fever, and cows with fever were less likely to cure, and they have poor performance compared to cows without fever. That's showing that the systemic presentation of the disease is an aggravating factor on top of the local uterine effect of the disease.
For that, the supportive therapy, I think that's where a lot of the benefit will come. A lot of these cows are less active. A lot of these cows are drinking less, they're eating less, which then reflects in lower milk production, and providing supportive care, it's critical. We know metritis is a painful disease. There's some studies from Germany that they evaluated pain responses in cows with metritis, and to the best of our abilities, we understand that that's a painful inflammatory disease. Pain management also is probably important from the cow's perspective to increase comfort, and help the cow getting out of that disease scenario.
Joe: Well, good. I think we've covered what we need to cover. It's time to wrap it up. There's plenty to digest in this episode. Thank you for listening. Thank you Rafael and Luciano for being here. We really appreciate your time.
Rafael: Thank you very much, Joe. Thank you very much Luciano for the invitation, and congratulations on organizing this. I really like this dynamics you guys are creating with the podcast, and the conference, and the meeting rooms. I think the audience is going to really benefit from this.
Joe: We appreciate it. If there are scathing rebuttals, comments, questions, you guys know how to find us, please email themoosroom@umn.edu.
Emily: That's themoosroom@umn.edu.
Joe: If you want more information you can know, always go to extension.umn.edu. Follow us on Twitter @UMNmoosroom. On Facebook we're @UMNBeef, and @UMNDairy. Oh, I forgot, sorry. On Twitter, we're also @UMNFarmSafety. With that, we'll cut the plugs. No more plugs today. Thank you everybody for listening. We'll catch you next episode.
Emily: Hey [unintelligible 00:40:41]
Bradley: Yes, I usually look at a cow with metritis and go, "Yep, Holstein."
Speaker 2: [laughs] That's called bias.
Joe: Little bit, tiny bit of bias. [crosstalk]
Speaker 2: Just a little.
[laughter]
[music]
[cow mooing]
[00:40:56] [END OF AUDIO]
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