Grass tetany is a metabolic disease caused by low concentrations of magnesium (Mg) in the blood and cerebrospinal fluid. Mg is not stored in the body; therefore, a constant source in the diet is required. It occurs due to insufficient dietary Mg or excessive dietary potassium and/or nitrogen. Risk factors for this include:

• Animals in late gestation/early lactation because they have higher Mg demand
• Stock grazing lush pasture with low dry matter content (reducing cud chewing and digestion time).
• Pasture fertilized with nitrogen and/or potassium is a risk as it will inhibit Mg uptake

Typically, we see grass tetany in cattle grazing on fresh, rapidly growing pasture after periods of reduced feed intake, for example after poor weather, yarding/transport, or over the calving period. This lush pasture moves through the gut much quicker than hay, which reduces the opportunity for magnesium to be absorbed. Sudden death with signs of struggling (disturbed ground surrounding the animal) can be the first sign of grass tetany in the herd and often stress can trigger clinical signs.

What does it look like?

Mg is required for normal nerve conduction, muscle function and bone mineralization, hence most visible clinical signs are attributed to nerve and muscle function.

Grass tetany can present in different ways;

1. Peracute – staggering, collapse, convulsions, paddling and death
2. Acute – twitching ears, grinding teeth, salivation or frothing at the mouth, muscle tremors, aggression (including charging), hyper-responsiveness, bellowing. The animal can become progressively uncoordinated and develop muscle spasms and can die within hours.
3. Sub-acute – slight inappetence and agitation over 3-4 day period, reduced milk yield, diarrhoea, tucked abdomen, stiff gait, hyper-responsiveness to noise/handling
4. Chronic – usually seen around 6 weeks after calving and is associated with long term Mg deficiency. Often animals will have thin/rough coats, pale gums due to anaemia and possibly udder oedema/swelling and wasting. Often chronic hypomagnesaemia is also associated with hypocalcaemia (milk fever) and decreased milk yield.

Note the salivation and frothing at the mouth, dilation of nostrils and retracted eyeballs

_{Credit: Disease of Cattle in Australasia}

Note the flattened and disturbed dirt around the legs of this cow.

_{Credit: Disease of Cattle in Australasia}

Grass tetany can be confused with the early signs of hypocalcemia (milk fever), nervous ketosis, clostridial infections or lead poisoning. Diagnosis is often made on clinical signs and confirmed with blood testing.

If a dead animal is found on farm and grass tetany is suspected, we can test the fluid in the eye for magnesium levels. Please call and speak to us should this situation arise.

How is it treated/prevented?

To increase chances of successful treatment, intervention is necessary as soon as clinical signs are noticed. Ideally, this involves slow administration of intravenous magnesium and calcium (4in1 flowpacks). In cases where this isn’t possible, a flowpack under the skin is advisable. Note that on some occasions, additional sedations are needed to stop the cow convulsing.

Other treatment options include:  

• Magnesium sulphate fluids given under the skin
• Oral magnesium supplements

After treatment, it is common for a cow to take approximately 30mins to stand. There is no need to rush her.

There are a multitude of methods that can be used to prevent grass tetany including:

• Feeding hay
• Mg lick blocks (some better than others!).
• Pasture dusting with Mg
• Adding Mg to water troughs, although this is unpalatable
• Using rumen Mg bullets

A good starting point for prevention is ensuring stock have access to 4kg/head/day of hay as feed during times of lush pasture growth, plus Mg lick blocks.

Depending on your situation, one supplement may be more practical than others, for this reason, feel free to call the clinic and discuss the best option.

MILK FEEDING

Colostrum is usually acquired from the mother’s milk in the first 24-48 hours of life. However, a lot of orphans do not receive this due to mismothering or rejection. Colostrum is very important as it is rich in substances that help make up the baby’s immune system. If your orphan is less than 48 hours old then please source colostrum to bottle feed. Occasionally, we have frozen colostrum for sale, please contact us if you require colostrum.

Most commercially available milk replacement powders designed specifically for lambs and goats come in 20kg bags. Feeding of Divetelact is not recommended as it is low in lactose and energy.

Full cream milk powder can be used as an alternative to commercial milk replacers which may be favourable if you are only hand-raising one or two animals. To prepare, mix 1 cup of full cream powder into 3 cups of warm water. At CVLS we sell 500g tubs of milk replacer which you can purchase directly from us for a lamb specific replacement. Keep it in a container in the refrigerator until use and heat up when ready to feed. It is best practice to place the filled feeding bottle in a container of hot water and let it sit until the milk reaches a suitable temperature (approx. 30 degrees Celsius). The milk should never be microwaved as it creates uneven hotspots that can risk burning.

Ensure you test the milk on the skin on your inner wrist before feeding, if it burns or is uncomfortable on your skin then it will be too hot for the lamb/kids mouth and it poses risk of oesophageal or abomasal ulceration.

Often, orphaned goat kids (not applicable to lambs) will initially reject milk replacers. We recommend starting kids on pasteurised goat milk (this can be found in the milk section of the grocery store).

Blending the milk replacer with goat milk until the kid accepts the replacer helps with the transition.

Volume of feed is essential as kids and lambs are renowned for being ravenous over-drinkers! Lambs and kids should be fed 15-20% of their body weight in milk or milk replacer each day. Overfeeding can lead to bloating, constipation or diarrhoea. Consider that their stomachs are only very small and cannot hold much at one time. Weighing lambs/kids once a week and calculating the target feed volume is optimal. Where possible, feed the orphan four times per day (three times a day minimum) for the first week and then transition to twice a day. If they weigh 2 kilograms, they will need 400mL of milk per day divided over two or three feedings.

Using human baby bottles are ideal for feeding small lambs and kids. Enlarging the hole in the standard nipple to allow for better flow will facilitate feeding.

HUSBANDRY

Keep your orphan warm and free from drafts and moisture. Heat lamps can be used to provide warmth but ensure they are kept out of reach to avoid burning. Dog crates are ideal for housing kids and lambs during the first weeks of life. Kids are very curious, so we recommend providing safe areas and pens for exploring, grazing, and exercising.

STARTING SOLIDS AND WEANING

Solid foods in the form of oaten or lucerne chaff and fresh water should be offered in the first week of life. Start with a small handful and increase when consumption is observed. Offer fresh chaff each day and discard refused feed.

At 2-3 weeks of age, orphans should be starting on a multipurpose weaner pellet (18-22% crude protein – check the back of the bag to see protein content) as well as chaff/hay. Begin with a tablespoon of pellets to start and replace daily (as with the chaff/hay). Once 3-4% of the orphans weight is being consumed in solid feed, usually 4-6 weeks of age, then weaning from milk should begin. Weaning can be very distressing for both you and your orphan – they can be very demanding/vocal when it comes to milk feeding. We usually advise weaning orphans when they are consuming over 1L of milk replacer per day. This can be started initially by reducing the number of feeds to twice a day, but their solid feed intake needs to be monitored closely.

Replace milk feeds gradually by substituting milk for 250-300ml of warm water, starting with one feed a day. It’s important that milk replacers are never diluted. This can help reduce the amount of vocalising for milk that the orphan may do during their weaning process. They will eventually lose interest in the bottle of water and vocalise less.

HUSBANDARY PROCEDURES

Vaccinations/worming

We recommend that lambs and kids be vaccinated at 4-6 weeks of age with Ultravac 5-in-1 vaccine and receive a booster 4 weeks after the initial dose. Then they get their usual annual booster thereafter. The vaccinations are sold in bulk at ag stores but at CLVS we sell them by the dose which is more convenient when you only have a few animals to vaccinate. If you would prefer us to vaccinate them for you or to show you how it is done, you book an appointment with us.

By the time kids and lambs are 6-8 weeks of age and starting to graze/eat solids worming/drenching should be considered. We recommend bringing us a sample of faeces (approx. 2g) so we can perform a faecal egg count to determine if worming is required. We will then advise on parasite control and drenching programs where appropriate.

Dehorning

If your goat kid or ram lamb is going to be kept as a pet, we recommend dehorning to reduce the risk of injury to children and other animals. Although, if they are going to be roaming large paddocks you should consider leaving horns intact so they can protect themselves from predators. If you choose to dehorn your goat kid or ram lamb, this needs to be done in the first 7 days of life, before the horn bud starts to erupt through the skin. We can do this for you at CVLS. If dehorning is delayed it requires major surgery and carries high risks of complications.

Tail docking

Lambs of heavy wool breeds should have their tails docked by 4-6 weeks of age (or sooner) to prevent excess faeces built up under their tails and subsequent fly strike. Fly strike is a painful and sometimes fatal condition where blowflies lay eggs in a sheep’s wet, soiled wool. When they hatch, the maggots will feed on the surrounding skin and tissues. If this is done at the 7-day mark then a rubber ring can be placed to remove the tail. If the tails are left for longer, then a surgical procedure may be required.

Castration

Male goat kids and ram lambs should be castrated at the same time as dehorning and/or tail docking. This can be done using the rubber ring method if done in the first 7 days of life. If left until they are older and testicles are well developed this may need to be done surgically.

COMMON ILLNESSES, VETERINARY CARE & EMERGENCIES

Scours

It is not uncommon for kids/lambs to suffer from scours/diarrhoea. If your kid/lamb is bright and continues to eat and drink, then provide oral electrolytes. The electrolyte feed should be given 2 hours prior to or after a milk feed. If you are feeding your lamb/kid four times a day, then consider replacing every second milk feed with the electrolyte feed to reduce risk of overloading. If feeding only twice daily, then in addition to the milk feeds is fine. If your kid/lamb becomes lethargic, refuses to suckle or stand at any time, contact us immediately.

Collapse/lethargy

If your kid/lamb becomes lethargic, refuses to feed, collapses or cannot stand, seek vet attention immediately. Neonates can become dehydrated or become low in blood glucose very rapidly, so these are emergencies in order to save the neonates life.

Teeth grinding

If your kid/lamb begins to grind their teeth and/or stops feeding, this can be a pain response. There is a possibility they have developed a stomach ulcer. It is very important to seek vet advice immediately.

Bloating

Stomach bloating can be life threatening in neonatal kids and lambs. There are many reasons why these animals can become bloated, all of which may require different treatments. Call a vet immediately if your lamb/kid becomes bloated, has difficulty breathing or is unable to stand.

Joint and navel ill

On day 1 of birth, neonatal kids and lambs should have their navels sprayed to prevent joint and navel infections. Navel dips should be made using 7% iodine solution, ensuring navels are evenly dipped and solutions are kept clean. If pens are dirty and damp, the infection risk will be greater even if navels are treated after birth. If your neonate becomes lame with swollen joints or they have a swollen navel give your vet a call to organize a visit and the appropriate treatment.

If you have any questions or concerns, please contact Compass Veterinary Livestock Services on 8556 2496

Amelia Cannadine BVB DVM

The University of Sydney, Australia

• Corresponding author email: amelia.cannadine13@gmail.com

Vol 9, Issue 4 (2024)
Submitted: 22 Jul 2023; published: 18 Oct 2024; next review: 31 Jan 2026

PICO question
In periparturient cows does the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) aid in reducing pain-related behaviours after parturition when compared to cows not administered NSAIDs?

Outcomes reported

The evidence suggests that NSAIDs can reduce some pain-related behaviours and increase resting behaviours in postpartum cows, with the effect being most consistently observed when administered between 6 and 48 hours before calving or within 3 hours after calving. This effect was most consistently observed in individuals that had experienced uncomplicated calving events and primiparous animals. Primiparous animals administered meloxicam prior to natural calving displayed significantly more lying bouts on the day of calving when compared to primiparous control animals and primiparous animals administered meloxicam postpartum. A separate study reported that cows administered ketoprofen spent less time in lateral recumbency than cows in the placebo group, irrespective of whether calving was assisted. Additionally, when treatment cows were in sternal recumbency, they spent more time with their head in a rested position than the placebo group. There was no significant difference in feeding behaviours postpartum between treatment and placebo animals. There were conflicting results between papers assessing activity levels.

Conclusion

In some cows, in particular cows with an uncomplicated parturition, NSAIDs can reduce some pain-related behaviours and increase some resting behaviours postpartum. The NSAID should be administered between 6 and 48 hours before calving or within 3 hours after calving.

How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Clinical scenario

In recent decades, awareness around the importance of nonsteroidal anti-inflammatory drugs (NSAIDs) in animals has increased dramatically (Edwards, 2021). NSAIDs have been reported to be efficacious at reducing pain inflicted on cattle during husbandry procedures, such as castration, dehorning, and disbudding (Steagall et al., 2021). However, it is not only these procedures that have proved to induce pain in cattle. The literature has demonstrated the presence of an inflammatory state in postpartum cows from the tissue trauma associated with calving, even in healthy individuals (Humblet et al., 2006; Trimboli et al., 2020).

To date, the effects of postpartum analgesia on production parameters has been the focus in existing literature (Carpenter et al., 2016). However, very few studies include measures more typically considered to be sensitive indicators of welfare status, such as behaviour. Lying, for example, is a biologically important behaviour associated with sleeping and ruminating which can be reduced if an animal is experiencing stress, and potentially pain can have a similar effect (Gladden et al., 2021; Ruckebusch, 1975; Tucker et al., 2021). Given that pain is a primary welfare concern, determining whether the provision of immediate postpartum analgesia provides welfare benefits is essential, particularly in primiparous cows or in cows experiencing, or expected to experience, varying severities of dystocia (Gladden et al., 2021). Thus, evaluation of the evidence that measures behavioural parameters in periparturient cows administered NSAIDs is required to inform veterinarians and producers whether such a protocol can optimise welfare in the breeding herd.

The evidence

The evidence consists only of randomised control trials, which are ranked as high-level evidence due to their unbiased design and minimal risk of systematic errors (Burns et al., 2011; Sargeant et al., 2022). The evidence is weakened by those studies that omitted evidence of sample size calculations or 95% confidence, which would have evaluated whether sample size was sufficient, thus we cannot confirm whether there were enough study subjects to reduce type two errors (Jones et al., 2003; Mainau et al., 2014; Swartz et al., 2018). Furthermore, the variation in methodology between the papers limits the ability to compare them. Three NSAID types were utilised amongst the studies, namely, meloxicam (Mainau et al., 2014; Swartz et al., 2018), ketoprofen (Gladden et al., 2021), and acetylsalicylic acid (Barragan et al., 2020). Only one study included administration of an NSAID prior to calving as part of their protocol (Swartz et al., 2018), whilst administration post-calving was conducted in four of the studies (Barragan et al., 2020; Gladden et al., 2021; Mainau et al., 2014; Swartz et al., 2018). The studies containing the greatest number of significant findings for the reduction in pain-related behaviours and the promotion of resting behaviours came from those cows that were administered an NSAID prior to or promptly after parturition.

Summary of the evidence

Barragan et al. (2020)

Population:

Postpartum dairy cows (breed not reported) that did not experience a fetotomy or caesarean or were not diagnosed as having a health disorder in the first week of lactation were included in the study. This study was performed between May and July 2016 in three organic dairy farms in Colorado, USA, that milked 3,000–5,300 cows.

Sample size:

464 cows

intervention details:

• Within 12 hours after parturition, cows were blocked by parity and calving ease and randomly assigned to one of two treatment groups:
  • The treatment group (ASP) (n = 223) received 4 consecutive treatments every 12 hr with acetylsalicylic acid (100 mg/kg; 2 boluses).
  • The placebo group (PLC) (n = 241) received 4 treatments every 12 hr with gelatin capsules (2 capsules) filled with water. 
• At 21 ± 3 days prior to parturition, cows and pregnant heifers were moved to prepartum pens in a common maternity facility. The prepartum pens consisted of loose pens with wood shavings as bedding material and free access to a contiguous dry lot. Within one day of parturition, postpartum cows were moved to their respective farms. Fresh cows were housed on sand-bedded 6-row free stall barns with access to a contiguous dry lot. Space allowance per cow was not discussed.

Study design:

Randomised control trial.

Outcome studied:

• Daily milk yield data was obtained from on-farm computer systems.
• Within each treatment, a subset of cows was randomly assigned to receive an activity logger accounting for parity (primiparous and multiparous) and calving ease (eutocia and dystocia).
• At enrolment, data loggers were placed on the right hind leg of a subset of cows for assessment of lying time (LT), number of steps (STP), number of lying bouts (LB), and lying bouts duration (LBD). The activity data loggers were removed 7 days in milk later (7 DIM).
• Blood samples were collected from coccygeal blood vessels at 7 ± 3 and 14 ± 3 DIM for assessment of beta-hydroxybutyrate (BHB) concentrations.

Main findings (relevant to PICO question):

• A total of 16 cows (ASP = 9; PLC = 7) were not included in the study due to loss of follow up during treatment administration. Furthermore, cows diagnosed with having a health disorder in the first week of lactation were removed from the study. As a result, 464 animals remained in the study (223 in the treatment group and 241 in the placebo group).
• A smaller sample size was utilised for the activity tracking data (ASP = 36; PLC = 41) and it is unclear whether a power calculation or was performed for this smaller subset and there was no evidence of 95% confidence intervals to evaluate whether the smaller sample size was sufficient.
• Overall, there was no difference in LT, LB, and LBD between cows in the ASP and PLC groups. However, cows treated with aspirin tended to spend less time lying down and tended to have shorter LBD during the first day after parturition compared with PLC cows. But these findings were deemed insignificantly different (P > 0.05).
• Cows in the ASP group had more STP compared with cows in the PLC group. 

limitations:

• No mention of animal ethics approval.
• There was no mention of blinding of any personnel involved in the study.
• Accurate prediction of the degree of calving difficulty was not possible until the cow was in labour, so to assess activity patterns accounting for parity and calving ease, a subset of cows in each treatment group were randomly assigned to receive activity data loggers at the time of first treatment.

Gladden et al. (2021)

Population:

Holstein dairy cows from a 700 dairy cow herd in Scotland were recruited (year not reported) provided that they were not lame, they had no signs of clinical illness at parturition, and they gave birth to a live female Holstein calf.

Sample size:

72 cows recruited.

Intervention details:

• Following recruitment, cows were randomly allocated to either a treatment group or a placebo group (number in each group not stated) and administered either a single dose of ketoprofen (Ketaprofen 10%) at 3 mg/kg or a single dose of saline within 3 hours of parturition.
• Parity was also considered when allocation with similar numbers of primiparous and multiparous animals in each treatment group.
• 37 cows experiencing assistance at parturition (17 treatment and 20 placebo) and 35 cows not experiencing assistance at parturition (18 treatment and 17 placebo).
• Both treatments were administered by deep intramuscular injection within 3 hours of parturition.
• Initially cows were housed in cubicles before being moved to a straw-bedded group pen three weeks prior to expected parturition. Parturition occurred in this pen after which cows were moved to an adjacent postpartum pen, or before, the next milking after parturition. Each pen allows for 9 m²lying space per cow.

Study design:

Randomised control trial.

Outcome studied:

• Behavioural observations began immediately post-parturition, and behavioural data was collected using instantaneous sampling. A 48-hour time budget was constructed for every cow.
• Postpartum behaviour was analysed every even hour of the first 24 hours, with a sampling interval of every 20 minutes.
• Behavioural observations were considered in four 12-hour time blocks: 0–12 hours, 12–24 hours, 24–36 hours, and 36–48 hours.
• ‘Primary’ behaviours (lying behaviours, standing and walking) were recorded during all time points that the cows were visible whereas ‘secondary’ behaviours (social behaviours, grooming behaviours, feeding and drinking directed behaviours) were exhibited concurrently with primary behaviours and were recorded when observed.

Main findings (relevant to PICO question):

• Due to technical failure, substantial video footage for some animals was lost, and these animals were not included in behavioural analysis. Thus, 72 cows (rather than 94 cows originally recruited) were included in the final behavioural analysis. It is unclear whether the final sample met the requirements of the power calculation performed.
• Cows in the NSAID treatment group spent less time in lateral recumbency with their head in a rested position and less time overall in lateral than cows in the placebo group.
• Additionally, when lying in sternal recumbency, cows in the NSAID group spent less time with the head held in an elevated position and more time with their head in a rested position than cows in the placebo group.
• The interaction between assistance and treatment status did not significantly affect any behaviours or postures.

Limitations:

• Blinding to the treatment status was successful but blinding of the observer to assistance status of the subjects was not possible.
• Cows were recorded as not visible when they were milking, and it is likely that this has caused the proportion of the time budget engaged in standing behaviours to be slightly underestimated. This could have resulted in some behaviours being under-represented.
• Parturition assistance was provided by one experienced stockperson, and early intervention with parturition assistance was only performed if the calf’s birth was a malpresention. Thus, cows experiencing assisted parturition may not have experienced as much soft tissue trauma and associated pain as cows managed in a less optimal manner.
• Only parturition events that produced live female Holstein calves were included in this study which may also have minimised the degree of soft tissue trauma experienced by recruited cows.
• Although instantaneous sampling intervals of 20 min have been shown to represent standing and lying behaviours well, feeding behaviours are better represented by shorter sample intervals. Therefore, it is possible that the proportion of time spent feeding was underestimated.

Mainau et al. (2014)

Population:

The study took place in Spain between September and December 2008. Cows (from first to sixth parity) from a commercial dairy farm that had 1000 Friesian dairy cows were selected given they had an acceptable body condition score (≥ 2.5 and ≤ 3.5), did not have lameness, and had no other clinical sign of illness. Only calving that required no assistance or assisted calving by means of an easy manual pull applied only by 1 person were studied. Dystocic calvings, stillbirths, cases that required additional anti-inflammatory treatment, and twin calvings were excluded.

Sample size:

60 cows.

Intervention details:

• Cows were randomly allocated into 2 groups according to parity and treated with either 0.5 mg/kg meloxicam (Metacam 20 mg/mL solution injection) or 0.5 mg/kg placebo (excipient without pharmacologically active ingredient), injected subcutaneously in the neck. Treatments were administered when cows entered the post-calving pen within a maximum of 6 hours.
• Twenty-five heifers (12 in the meloxicam group and 13 in the control group) and 35 multiparous cows (17 in the meloxicam group and 18 in the control group) were included.
• Each cow was studied from 5 days prior to the expected calving date to one month after calving.
• To ensure blinding, the meloxicam and control groups were labelled A and B, respectively, to ensure blinding of producers and to the treatment and control groups.
• Approximately five days prior to calving, cows were moved to the pre-calving pen. The pre-calving pen was covered in fresh straw. Once the calf was moved, cows were moved to the post-calving pen. Space allowance per cow was not discussed.

Study design:

Blinded randomised control trial.

Outcome studied:

• During calving, the following events were recorded: calf position, sex of calves and level of calving assistance.
• Milk production (kg/cow/milking) was recorded for 1 month.
• Rectal temperature was measured using a single thermometer probe and a consistent penetration depth for all measurements. Rectal temperature was taken when cows were placed in the precalving pen (day -5), twice for 3 days after calving, and every time a blood sample was taken.
• Just before administration of either treatment or placebo, blood samples were collected from the coccygeal vein of 20 cows (balanced for parity and treatment) to determine serum amyloid A (μg/mL) and haptoglobin (mg/mL) on the day of calving (day 0) and on days +2, +4, and +15 after calving.
• Cow activity, calculated as the average number of steps per hour over 1 day, was obtained using pedometers from 1 day before to 7 days after calving. Pedometers were placed above the fetlock on the left hind leg of each animal.
• To monitor cow behaviour throughout the day, 2 video cameras and a digital recorder were installed in each pen.
• Cow behaviours were observed for 2 days before and after calving. Screening was performed by 2 different observers who were previously trained by individually observing the same 4 cows over 2 days. Every 10 minutes, the cows were classified into the following behaviours: cow posture, location of cows in pen, feeding, tail position, and body behaviours.

Main findings (relevant to PICO questions):

• Video recording and therefore behaviour data could only be retrieved from 54 cows: 26 from the treatment group (9 heifers and 17 multiparous cows) and 28 from the control group (10 heifers and 18 multiparous cows).
• Overall activity (average number of steps per hour over a day) was comparable between treatment groups before calving.
• Heifers from the meloxicam group showed a significantly higher activity during the first 2 days after calving than heifers from the control group. The activity of multiparous cows was comparable in both groups.
• There was no significant effect of treatment, parity, or calving assistance on postures, changing posture, location in pen, or feeding behaviours.

Limitations:

• It was unclear whether the sample size was calculated and there was no evidence of 95% confidence intervals to evaluate whether sample size was sufficient.
• Although treatments were administered within a maximum of 6 hours of entering the post calving pen, administration times would have varied between treatment cows.
• The scan methodology with a 10-minute interval utilised in this study may not have been sensitive enough to detect changes in eating behaviour.

Swartz et al. (2018)

Population:

Pregnant dry cows and heifers (Holstein Friesians and Jerseys) that received their respective treatment in the window specified by their treatment group and that did not calve with twins or calve via caesarean.

The study was conducted on a Dairy Research Complex in Virginia, USA, and enrollment occurred from August 2016 through August 2017.

Sample size:

194 (87 multiparous Holstein, 48 primiparous Holstein, 41 multiparous Jersey, and 18 primiparous Jersey).

Intervention details:

• Holstein and Jersey cows in the study were randomly assigned to one of three treatment groups:
  • Meloxicam administration no more than 48 hours before calving and no less than 6 hours before calving, and a placebo administered within 12 hours postcalving (MEL-PRE, n = 60).
  • Placebo administration no more than 48 hours before calving and no less than 6 hours before calving, and meloxicam administered within 12 hours postcalving (MEL-POST, n = 69).
  • Placebo administration no more than 48 hours before calving and no less than 6 hours before calving, and a placebo administered within 12 hours postcalving (CTL, n = 65).
• Meloxicam tablets were administered by mouth at 1 mg/kg body weight. Meloxicam tablets were placed into gel capsules and an empty gel capsule was used as a placebo.
• Farm managers and staff were masked to treatments during calving.
• Vaginal thermometer was utilised to detect the drop in temperature that occurs 48 hours before calving. Cows and heifers had their temperature taken approximately 14 days before their calving date to aid in detection of the drop in temperature 48 hours prior to calving. When the temperature declined approximately 0.6 °C or more the treatment regimen was initiated.
• Approximately three weeks before expected calving dates all pregnant dry cows and heifers were moved to group housing in compost-bedded pack barn with access to a close-up dry cow total mixed ration. Following calving, cows were moved into an adjacent compost-bedded pack pen. After the first week of lactation, cows were moved into a deep sand-bedded free stall barn, where they remained for the rest of the trial. A minimum area of 9.3 m² per cow was maintained in both housing areas.

Study design:

Blind randomised control trial.

Outcome studied:

• Cows and heifers were monitored continuously 24 hours/day using 3 video cameras. Dystocia was defined when stage 2 of labour was > 70 minutes and eutocia was defined as < 70 minutes.
• Animals were fitted with an accelerometer (AfiTag II, AfiMilk Ltd.) that measured activity, lying time, and lying bouts. Data recording began 14 days before the expected calving date and concluded at 7 days in milk (DIM).
• Rectal temperatures for the first 7 DIM were taken at ~09:00. using a digital rectal thermometer and clinical disease events were diagnosed by two veterinarians.

Main findings (relevant to PICO question):

For the accelerometer behaviour measurements, some cows did not have day -3 data, thus the final sample size for behavioural data included only 165 animals.

Lying time:

• No effect of treatment was identified for lying time.

Activity:

• No treatment effect was found in the eutocic animals.
• Dystocic MEL-PRE animals were less active than dystocic CTL. Moreover, dystocic MEL-POST animals were also less active than dystocic CTL animals.
• No difference was noted between the dystocic MEL-PRE and dystocic MEL-POST animals.
• No differences were found between treatment groups within the Holstein breed.
• A treatment effect was noted in the Jersey breed whereby Jerseys that where in the MEL-PRE group were significantly less active on d -1, d 1, and d 2 when compared with the Jersey CTL. Additionally, Jersey MEL-PRE were less active than Jersey MEL-POST on d 2. Jersey cattle in the MEL-POST group were less active than Jersey CTL on d 6.

Number of lying bouts:

• Primiparous MEL-PRE animals had more lying bouts on d 0 than primiparous CTL and primiparous MEL-POST.
• Primiparous CTL had fewer lying bouts on the day of calving than that of all treatment groups of multiparous animals.
• Similarly, primiparous MEL-POST animals had fewer lying bouts on the day of calving when compared with all treatment groups of multiparous animals.
• A parity effect was identified on the day before calving, as primiparous MEL-POST animals showed more lying bouts than multiparous MEL-POST.

Lying bout duration:

• No effect of treatment was identified.

Limitations:

• Sample size calculation was omitted and there was no evidence of 95% confidence intervals to evaluate whether sample size was sufficient.
• 194 cows were used for analysis after the enrolment of 237 cows due to cows not receiving the precalving treatment within the specified timeframes. 
• The definition of dystocia was defined by calving length, versus intervention status utilised in other studies which may contribute to the significantly different findings between papers.

Appraisal, application and reflection

Five randomised control trials were included in the analysis. Two of the studies did not state whether there was blinding of study personnel (Barragan et al., 2020; Gladden et al., 2021) as the element of observer bias may influence the outcome. Studies by Swartz et al. (2018) and Mainau et al. (2014) omitted calculations to determine the sample size required to deliver sufficient study power and there was no evidence of 95% confidence intervals to evaluate whether their chosen sample size was sufficient. Consequently, some of the non-significant results may be an artefact of low power, limiting the reliability of each study’s conclusions. This may stand for those studies that utilised a small subset of the study animals for the behavioural analysis component, without a sample size calculation to justify the number of individuals within these smaller subsets, the reliability of the results is questionable (Barragan et al., 2020; Gladden et al., 2021). It is important to address that these analyses are of a subjective nature and must be interpreted with caution. Nevertheless, all of the studies had at least one significant finding relating to pain-related behaviour in postpartum cows.

There were no reports of retained placenta or stillbirths associated with NSAID administration in any of these studies. The papers that utilised meloxicam all reported that there was no association between the incidence of adverse outcome post-calving and NSAID administration (Mainau et al., 2014; Swartz et al., 2018). However, the paper that utilised ketoprofen did measure the incidence of these undesirable side-effects, but the outcome was not reported (Gladden et al., 2021).

Studies using flunixin meglumine were excluded from this analysis as cows treated with Flunixin post-calving had an increased risk of retained placentas, still births and metritis (Duffield et al., 2009; Newby et al., 2017). This is due to its propensity to preferentially inhibit cyclooxygenase 1 (COX-1), in contrast to meloxicam which is predominately a cyclooxygenase 2 (COX-2) inhibitor (Trimboli et al., 2020). Thus, it has been recommended that flunixin should not be administered to cattle within 24 hours of parturition (Newby et al., 2017). Ketoprofen’s COX selectivity in cows has not been reported, but it has been reported to lower incidence of retained foetal membranes (Richards et al., 2009). Acetylsalicylic acid has been reported to be a weak inhibitor of both COX isoforms (Barragan et al., 2020). However, the paper that utilised acetylsalicylic acid did not report on the incidence of any of the aforementioned undesirable effects (Barragan et al., 2020).

Lying was reported in all of the papers included in the analysis. When primiparous animals were administered meloxicam prior to natural calving, they displayed significantly more lying bouts on the day of calving when compared to primiparous control animals and primiparous animals that were administered meloxicam postpartum (Swartz et al., 2018). Interestingly, the number of lying bouts in the pre-calving meloxicam group on the day of calving was more similar to the multiparous cows (Swartz et al., 2018). Furthermore, primiparous controls and primiparous animals that received meloxicam postpartum had significantly fewer bouts of lying on the day of calving than all treatment groups of multiparous cows (Swartz et al., 2018). Multiparous animals typically deliver more easily than primiparous animals, but this data suggests that the anti-inflammatory effects of pre-calving meloxicam in primiparous animals allows for an easier calving, or a calving comparable to that of multiparous cows (Swartz et al., 2018). Although these conclusions are not measuring the reduction in a pain-related behaviour and thus are not directly aligned with the research question, the presence of a behaviour associated with the reduction in pain is important to report. The study that administered meloxicam to their treatment animals’ postpartum concluded insignificant lying results (Mainau, 2014). However, significant lying results were also reported in a study by Barrier et al., 2014 which stated that when cows undergoing a caesarean were administered meloxicam prior to the first incision, they spent more time lying and had more bouts of lying within the first 16 hours and 24 hours respectively, when compared to the placebo group (Barrier et al., 2014).

The study by Swartz et al. (2018) relied on the drop in rectal temperature that occurs prior to parturition to aid in calving detection. This method of detection has moderate accuracy (at best) and resulted in 43 cows being removed from the study as they did not receive the pre-calving treatment within the specified timeframe. This demonstrates that the application of administering meloxicam before calving is challenging. Advances in identifying the onset of calving through technology that measures rumination, lying and activity provides promising potential in this space (Borchers et al., 2017; Fadul et al., 2017).

To support the theory that NSAID administration reduces pain postpartum, the Gladden et al. (2021) study   analysed specific lying postures found that all cows administered ketoprofen spent less time in lateral recumbency than cows treated with saline, irrespective of whether calving was assisted. Lateral recumbency in adult cattle is considered an abnormal lying posture exhibited when animals are in pain or are unwell (Hudson et al., 2008; Petherick et al., 2014). Therefore, this suggests that pain is experienced after parturition in all cows and ketoprofen administration improves comfort irrespective of parturition experience (Gladden et al., 2021). It is important to recognise that this conclusion is drawn based on the theory that lateral recumbency in cattle is an indicator of pain. Additionally, when treatment cows were in sternal recumbency, they spent more time with their head in a rested position than the placebo group (Gladden et al., 2021). Such posture is usually adopted when in a deep sleep (i.e., rapid eye movement sleep) (Ruckebusch, 1975). It is possible that pain reduced the duration of the placebo group’s sleep, explaining why the placebo group spent less time with their head rested (Gladden et al., 2021; Ruckebusch, 1975). The Gladden et al., 2021 study only included parturition events that produced live dairy female Holstein calves (Gladden et al., 2021). Considering that male dairy calves consistently weigh more than females the selection of only female associated calving events limits the usefulness  of this data and its ability to be extrapolated to all calving events (Dhakal et al., 2013; Olson et al., 2009).

Activity measures of the study animals were taken either via the use of accelerometers or pedometers (Barragan et al., 2020; Mainau et al., 2014; Swartz et al., 2018). One study found no significant effects in eutocic animals (Swartz et al., 2018). However, dystocic animals in this study that received meloxicam prior to or after calving were less active than the dystocic control animals postpartum (Swartz et al., 2018). The administration of meloxicam may have reduced activity by alleviating inflammation, allowing cows to rest more easily postpartum (Swartz et al., 2018). Conversely, studies also concluded that cows or heifers treated with NSAID postpartum had increased activity when compared to the control animals and that postpartum administration does lead to a reduction in inflammatory mediators, ameliorating behaviours associated with pain, and allowing these individuals to exhibit their normal behaviours (Barragan et al., 2020; and Mainau et al., 2014). Consequently, activity as a behavioural measure was difficult to analyse due to the conflicting findings presented.

Two of the studies assessed the differences in feeding behaviour postpartum (Gladden et al., 2021; Mainau et al., 2014) . These studies did not find a significant result regarding feeding behaviour. These insignificant results could have been explained by the adoption of scan methodology whereby feeding was measured in 10- or 20-minute intervals. Feeding behaviours are better represented by shorter sample intervals (Gladden et al., 2021; Mainau et al., 2014; Mitlöhner et al., 2001). Thus, it is possible that the proportion of time spent feeding was underestimated as the chosen interval was not sensitive enough to detect a change in feeding behaviour (Gladden et al., 2021; Mainau et al., 2014). Due to the discrepancy in the results reported and the potential that the scan methodology adopted could have had an influence, the need for further exploration into NSAID effect on feeding behaviour postpartum is validated.

Upon critical analysis, NSAID proved to reduce pain-related behaviours or increase resting behaviours in postpartum cows most consistently when they were administered 48 hours prior to but no less than 6 hours before calving, or within three hours of calving  (Gladden et al., 2021; Swartz et al., 2018). This conclusion proved to be most consistent in individuals that had experienced uncomplicated calving events, primiparous animals and potentially those that experienced dystocia; however, due to the conflicting analysis of activity between studies, this should be interpreted with caution (Gladden et al., 2021; Swartz et al., 2018). This analysis has revealed that the inflammatory state that has been identified and reported on in postpartum cows which experienced uneventful calving could be dampened down by NSAID administration (Gladden et al., 2021). Additionally, multiparous animals typically deliver calves more easily than primiparous cows, but the literature suggests NSAID administration to primiparous cows in the recommended time frame could allow for a calving experience similar to that of a multiparous cow (Swartz et al., 2018). As a result, if NSAID are introduced into primiparous calving protocols to improve calving ease, not only could the culling rates of animals who experienced calving difficulties be reduced, but animal welfare could be improved (MLA, 2019; Swartz et al., 2018). To explore this further, and due to the low numbers of studies which focuses on NSAID administration to cows that experienced uncomplicated calving events, are primiparous or that experienced dystocia more research is warranted.

Interestingly, two included studies measured milk yield postpartum and found that milk-yield was greater in the cows administered NSAID when compared to those that received a placebo (Barragan et al., 2020; Swartz et al., 2018). It cannot be denied that administration of NSAID to cows is laborious for producers but the increase in milk-yield may provide them with some incentive to consider administering NSAID to cows approaching parturition or promptly post-parturition.

Methodology

Search strategy

Databases searched and data dates covered:

CAB Abstracts Web of Science Core Collection from 1910 to 31 January 2024
Medline via OVID SP from 1946 to 31 January 2024

Search strategy:

CAB Abstracts:

TS=(Cows OR Cattle NOT calves) AND TS=(behaviour OR behavior) AND TS=(Parturition) AND TS=(Flunixin OR Ketoprofen OR meloxicam OR NSAID OR Tolfenamic acid OR acetylsalicylic acid OR aspirin)

Medline:

(cows.mp. or cattle/) and (behaviour.mp. or behavior/) and (parturition/) and (flunixin.mp. or ketoprofen/ or meloxicam/ or anti-inflammatory agents, non-steroidal/ or tolfenamic acid.mp. or acetylsalicylic acid.mp. or aspirin/)

Dates searches performed:

31 Jan 2024

Exclusion/inclusion criteria

Exclusion:

Systematic reviews or meta-analyses of randomised control studies, review articles, conference proceedings, case reports/studies that are irrelevant to the PICO.

Inclusion:

Studies must contain information that is relevant to the PICO question, and they must be randomised control trials.

Search outcome

ORCiD

Amelia Cannadine: https://orcid.org/0000-0003-0147-6601

Conflict of interest

the author declares no conflicts of interest.

References

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Pestivirus, also known as Bovine Viral Diarrhea Virus (BVDV) can reduce the immunity of a group or herd of cows, making them susceptible to other diseases processes such as pneumonia, scours, abortion storms and reduced fertility. Depending on when an animal is exposed to the virus will affect the impact it has on the animal, and possibly the unborn foetus. For example, in early stages of pregnancy it may cause resorption of a foetus, or it can lead to the production of Persistently Infected (PI) animals. Around the 5month gestation mark it can cause deformities as the virus interrupts the natural development of the foetus. After 6 months gestation it is a relatively common cause of abortion.

A biosecurity review of your property or properties should be carried out to ascertain the risk of bringing BVDV onto your farm, followed by antibody testing a select number of unvaccinated, homebred heifers that are over 9m of age, providing they have been in a stable group for a minimum of two months. Bulk milk sampling for dairy herds also provide us with information about the status of herds. Smaller beef herds may be more suited to doing ear notching off all animals on farm.

In recent months, as a result of BVDV we have seen abortion storms in a group of naïve heifers, poorly grown calves in a closed herd, and calves born with limb and eye deformities. There is a vaccination available, however it should only be used as part of the bigger picture towards eradication.

Swans Veterinary Labs are currently offering to cover the antibody testing of heifers to help producers ascertain their disease status for Pestivirus (until the end of November 2025). Get in touch if this is a service you would like to explore.