1. Monitoring for Transition Cow Issues Todd Duffield, DVM, DVSc tduffiel@uoguelph.ca

2. Monitoring for Transition Cow Issues What are the Issues ? How do we find them ? Do they matter ? What can we do about them ? FOCUS ON ENERGY METABOLISM

3. What are the Major Transition Cow Issues?

4. Goals Calve without problems Avoid disease Make lots of milk Get pregnant by 120 DIM Impediments  RP  Dystocia  Metritis  Ketosis  DA  Mastitis  Rumen acidosis  Lameness  Endometritis  Anestrus  Insemination Severity, timing, and duration of negative energy balance Hypocalcemia Immune function Cow environment Feed intake Ways to gain insight into the success of the process  Clinical disease  Production  Measure DMI  BCS  Understanding cow experience  Feed access  Lying time  Housing design  NEFA, BHBA, etc

5. Time for transitions Development of lactation in mammary gland ~ 3 weeks Rumen microflora adaptation ~ 10 – 14 days Altering metabolic set-point ~ 6 weeks (?) Social adjustment to new group 2 d to 1 week

6. Monitoring Transition Cow Issues What are the Issues ? How do we find them ?

7. Disease Incidence 2006 NA Study (Carson, 2008) Northeast n=650 Midwest n=570 Southeast n=465 West n=668Total Milk Fever2%3.3%2.0%2.5% Ketosis6.0%10.5%6.4%15.3%9.6% RP5.2%7.9% 9.4%7.6% Metritis5.7%6.3%19.5%34.5%16.5% DA4.5%5.1%4.6%0.5%3.7%

8. Problems with Clinical Disease? Frequently Poorly Recorded Disease Definitions not Standardized “After the Fact” in an Ideal Monitoring Program Probably LESS Sensitive than Metabolic “Subclinical” Tests

9. Clinical ketosis treatment rate is a poor estimate of ketosis (Duffield et al 1998)

10. What about Milk Components? Subclinical Ketosis Associated with: – ↓ Milk protein % – ↑ Milk fat % At First DHI test postcalving But… Best test is PFR ≤ 0.75 – Sensitivity: 58% – Specificity: 69% BOTTOMLINE: The test is CRAP.

11. Summary of Herd Level Tests for Identifying High Risk Herds for SCK 1.Subclinical Ketosis in  20% of Herd at 1 st of 2 nd week postcalving 2.DA Incidence  5.0 % 3.  40% of Herd with Low PFR (< 0.75) [or approximately 0.70 in true protein system] 4.> 10 % of Herd Fat Precalving (BCS  4.0) REQUIRES EXTERNAL VALIDATION: Only based on 25 Herds in SW Ontario

12. What about DMI? Precalving DMI a good predictor of SCK postcalving. U of G research: – < 12 kg DMI in last 3 weeks = 6X Increased Risk of SCK. Problems – Getting it Measured – Demographics in Group Heifers Lot’s close to calving

13. Frequency Distribution of DMI for 160 Holstein Cow and Heifers during Last 3 Weeks Precalving Individual GOAL 2 S.D’s 1 S.D 16.5% lower Mean 50% lower Group Target

14. Typical patterns of DMI and NEFA Overton/Burhans, 2001

15. Serum/Blood Metabolic Tests What Does Work? Energy Monitors in Transition Cows: – Precalving – NEFA – Postcalving – BHBA Calcium status within a few days of calving – hypocalcemia Haptoglobin – inflammation DO NOT USE AVERAGES – looking for EXCEPTIONS –Therefore % above or below a cutpoint for group interpretation Focus of Talk ↓ Ca, ↑ Culling risk but need more research Non-specific but associated with metritis, need more data

16. J.M. Gay The “Iceberg” Concept

17. Monitoring Transition Cow Issues What are the Issues ? How do we find them ? Do they matter ? FOCUS ON ENERGY METABOLISM

18. Investigating or Monitoring Energy Metabolism in Transition Cows PreCalving - NEFA PostCalving - Ketones

19. Relationship between Precalving DMI and serum NEFA R 2 = 0.29

20. Prepartum NEFA cutpoints for predicting postpartum SCK  0.6 NEFA (mmol/L ) nP- value OR  0.7 170.044.8 270.103.0  0.5 460.561.4  0.4 680.511.4 Osborne, 2003

21. Increased Pre-Partum NEFA Associated with: ↑ risk of LDA (Cameron et al, 1998; LeBlanc et al, 2005, Carson, 2008; Ospina et al, 2010) ↑ risk of RP and/or Metritis (Dyk, 1995; Carson, 2008; Quiroz-Rocha et al, 2009; Ospina et al, 2010) ↑ risk of ketosis (Osborne, 2003; Gooijer et al, 2004; Ospina et al, 2010) ↑ risk of early culling (Duffield et al, 2006) ↓ milk yield (Carson, 2008; Ospina et al, 2010) ↓ Pregnancy Risk (Ospina et al, 2010)

22. Cow-Level Associations of Pre-calving NEFA (mmol/L) with Disease/Production Outcomes Weeks relative to Calving Author, Year Cut-pointOutcomeImpactP-Value Carson, 2008 0.3Retained PlacentaOR = 1.8<0.001 Quiroz-Rocha, 2007 0.4Retained PlacentaOR = 1.2<0.01 Carson, 2008 0.3MetritisOR = 1.8<0.001 Carson, 2008 0.5 Displaced Abomasum OR = 2.4<0.001 Leblanc, 2005 0.5 Displaced Abomasum OR = 3.6<0.001 -2 Ospina, 2010 0.3DA, CK, MetritisOR > 1.8<0.01 Carson, 2008 0.5Milk Yield ↓ 1.6 kg/d 0.02 -2 Ospina, 2010 0.3Milk Yield ↓ 2.2 kg/d <0.01 Carson, 2008 0.31 st Test LS ↑ 0.24 0.03 -2 Ospina, 2010 0.3Pregnancy Risk ↓ 18%<0.01

23. LeBlanc et al, 2005

24. Precalving NEFA and Subsequent DHI Milk Yield Carson, 2008

25. Investigating or Monitoring Energy Metabolism in Transition Cows PreCalving - NEFA PostCalving - Ketones

26. Summary of Objective Serum BHBA Thresholds for Hyperketonaemia ThresholdMeasureRiskAuthor umol/Lmg/dL 120012LDA8XLeBlanc 140014LDA3XGeishauser 120012LDA/Ketosis3XDuffield 100010LDA/Ketosis/Metritis2XOspina 140012Repro (CR)40%  Walsh 140014Repro (CR)55%  Whitaker 100010Repro (Pregnancy risk)13%  Ospina 140014Culling2XDuffield 140014Milk Loss1.9 kgDuffield 100010Milk Loss1.3 kgOspina NOTES: 1. Minimum Threshold = 1000 umol/L BHBA 2. Effect Increases with increasing BHBA concentration. 3. Optimum Cutpoint 1000 to 1400 umol/L BHBA

27. When Do I Test? Weeks: 1, 2, +/- 3 Postcalving Frequency: every 1 to 2 weeks Who: ALL cows and 1 st lactation heifers

28. Cow-side tests for ketosis (relative to serum BHB ≥1400 µmol/L) Milk Keto-Test 100 µmol/L – Sensitivity = 83% – Specificity = 82% 200 µmol/L – Sensitivity = 54% – Specificity = 94% Oetzel, 2004 Cost = $2/test Powder lacks sensitivity The ONLY reliable milk ketone test

29. Cow-side tests for ketosis (relative to serum BHB ≥1400 µmol/L) Milk Keto-Test 100 µmol/L – Sensitivity = 83% – Specificity = 82% 200 µmol/L – Sensitivity = 54% – Specificity = 94% Oetzel, 2004 Cost = $2/test Powder lacks sensitivity Urine Ketostix (read at 5 seconds) “small” (15µmol/L) – Sensitivity = 79% – Specificity = 96% Carrier et al, 2004 Cost = $0.25/test Acetest tablet lacks specificity The ONLY reliable urine ketone test

30. Cow-side tests for ketosis (relative to serum BHB ≥1400 µmol/L) Milk Keto-Test 100 µmol/L – Sensitivity = 83% – Specificity = 82% 200 µmol/L – Sensitivity = 54% – Specificity = 94% Oetzel, 2004 Cost = $2/test Powder lacks sensitivity Urine Ketostix (read at 5 seconds) “small” (15µmol/L) – Sensitivity = 79% – Specificity = 96% Carrier et al, 2004 Cost = $0.25/test Acetest tablet lacks specificity Blood Precision XTRA BHBA Sensitivity = 87-93% Specificity = 93-100% Heuweiser,2007 Oetzel, 2008 Burke,2008 Cost = $2/test Precision XTRA: - Highly Accurate test - Like having the Lab in your Hand!

31. How do you know where you are unless you look?

33. Herd Monitoring Example – 100 Cow Freestall 1 SD Goal 2 SD 3 SD

34. Herd Monitoring Example – 100 Cow Freestall 1 SD Goal 2 SD 3 SD 2 DA’s, 4 RP’s

35. What Do I Do With the Data? A.Monitoring B.Problem Investigation 1.Group Interpretation - HERD LEVEL – Identify/Dx problems and make changes prior to major losses – Proactive rather than Reactive (if monitoring) 2.Individual Interpretation - INDIVIDUAL LEVEL – Early treatment may ward off Clinical Disease Purpose of Data Gathering Level of Interpretation Prevention Treatment

36. Case Example 1A - Individual 80 Milking Cows in a Tiestall – Owner starts a weekly Keto-Test monitoring program 1 st week of September Tests all cows 3 weeks fresh Tuesday mornings – Week 1: 0/6 – Week 2: 0/5 – Week 3: 1 / 4 Owner calls because +ve Cow has a PING – I go – It’s an LDA – Farmer didn’t know she had a problem until he tested!

37. Case Example 1B - Herd 80 Milking Cows in a Tiestall – Owner starts a weekly Keto-Test monitoring program 1 st week of September Tests all cows 3 weeks fresh Tuesday mornings – Week 1: 0/6 – Week 2: 0/5 – Week 3: 1 / 4 – Week 4: 0/5 – Week 5: 1/6 – Week 6: 1/8 – Week 7: 7/10 Now What?

38. Herd Example 1B Change was Real – Testing was being done correctly Of the 7 +ve: – 1 was 500 umol/L – 3 were 200 umol/L – 3 were 100 umol/L – CUD cows eating well – Changed to higher fiber, lower energy Baleage – All cases were > 11 DIM

39. What’s Normal?

40. Cutpoints Used for Herd-Level Analysis – based on 2006 study Param eter Time Relative to Calving CutpointMedian Herd Prevalence SUGGESTED HERD GOAL NEFA- 1 Week Pre0.5 mmol/L25%< 3/12 +1 Week Post1.0 mmol/L20%< 2/12 BHBA+1 Week Post1400 umol/L15%< 2/12 High Risk Herds set at or above Median Herd Prevalence High Risk Herds Low Risk Herds

41. Validated* Herd-Alarm Levels (Ospina et al, 2010) Time Relative to Calving ParameterCutpointAlarm Level Prevalence Mean Proportion of Herds Above Alarm Level PrepartumNEFA (mEq/L) ≥ 0.315%75% PostpartumNEFA (mEq/L) ≥ 0.715%65% PostpartumBHBA (mg/dL) ≥ 1215%40% *Alarm levels associated with: ↑ risk of DA & CK, ↓ Pregnancy Rate, and ↓ Milk Yield at the Herd-Level

42. Weekly prevalence of Subclinical Ketosis in Four Large New York Dairies Using Precision Xtra BHBA ≥ 1.3 mmol/L (13 mg/dL)

43. Weekly prevalence of Subclinical Ketosis in Four Large New York Dairies

44. Monitoring Transition Cow Issues What are the Issues ? How do we find them ? Do they matter ? What can we do about them ? FOCUS ON ENERGY METABOLISM

45. 1.MONITOR – Need to Know Where You Are – Need to Detect Change Transition Cow Issues Key Prevention Strategies

46. Cutpoints Used for Herd-Level Analysis Param eter Time Relative to Calving CutpointMedian Herd Prevalence HERD GOAL NEFA- 1 Week Pre0.5 mmol/L25%< 3/12 +1 Week Post1.0 mmol/L20%< 2/12 BHBA+1 Week Post1400 umol/L15%< 2/12 High Risk Herds set at or above Median Herd Prevalence High Risk Herds Low Risk Herds

47. Variables Associated with High Risk Herds VariableOdds Ratio’s (p-value) for High Risk Herds Classified by: > 25% Wk -1 NEFA ≥ 0.5 > 20% Wk +1 NEFA ≥1.0 > 15% Wk +1 BHBA ≥ 1.4 Wreck (All 3 categories) Fresh Group6.0 (P=0.03)4.3 (P=0.04)9.0 (P=0.01) 3 Transition Rations 0.17 (P=0.04) Heifers and Cows mixed in Close-up Group 5.0 (0.07)9.0 (0.05)--- data too sparse--- Anionic diet fed to Close- ups 0.21 (0.02)0.22 (P=0.02)0.16 (P=0.03) Cows calve in Maternity pens 3.7 (0.04) = “Social Stress”

48. Relationship Between Mean Herd Precalving NEFA and Close-up Diet NDF R 2 = 0.30 High NDF Limits Intake

49. Relationship Between Mean Herd Precalving NEFA and Close-up Diet NDF R 2 = 0.30 High NDF Limits Intake

50. 1.MONITOR 2.MANAGEMENT Transition Cow Issues Key Prevention Strategies

51. 1.MONITOR 2.MANAGEMENT 3.MANAGEMENT

52. 1.MONITOR 2.MANAGEMENT 3.MANAGEMENT 4.MANAGEMENT Dry Matter Intake Transition Cow Issues Key Prevention Strategies

53. Failure to ALLOW cows to eat is an International problem Australia Canada Mexico

54. 1.MONITOR 2.MANAGEMENT 3.MANAGEMENT 4.MANAGEMENT 5.Feed Additives 1.Rumensin 2.Propylene Glycol 3.Rumen protected choline 4.Yeast 5.Others? Transition Cow Issues Key Prevention Strategies Definitely Maybe – Temporary Fix Selected Use – Fat Cows Transition Cows Benefit ? Efficacy / Economics? ↑ Dry Matter Intake

55. A Poor Transition Matters: 1.Reduced Health 2.Lost production 3.Impaired Reproduction 4.Risk of Culling LOOK! To see where you are  MONITOR CONCLUSIONS TRANSITION COW ISSUES

56. 1.MONITOR ENERGY METABOLISM : -Precalving: Need to use NEFA -  Need a Cowside NEFA test to improve practicality -Postcalving: Choose a KETONE test that suits you. CONCLUSIONS TRANSITION COW ISSUES Key Prevention Strategies

57. 1.MONITOR 2.MANAGEMENT 3.MANAGEMENT 4.MANAGEMENT CONCLUSIONS TRANSITION COW ISSUES Key Prevention Strategies DMI ↑ = Social Stress ↓ Feed Quality ↑ BCS ↓ Feed Access ↑

58. 1.MONITOR 2.MANAGEMENT 3.MANAGEMENT 4.MANAGEMENT 5.Feed Additives ? -use the ones with proven Science. CONCLUSIONS TRANSITION COW ISSUES Key Prevention Strategies DMI ↑ = Social Stress ↓ Feed Quality ↑ BCS ↓ Feed Access ↑

59. Questions? or Discussion