Challenges To Traditional Veterinary Programs

With the control of epidemic diseases, endemic diseases have emerged as the main health problem. These

Table 1 Percentage of veterinarians reporting on services they provide to cattle farms on a monthly to weekly basis

>75%

50 75%

25 50%

20 25%

<20%

Individual animal service

Injections (IV, IM, SC)

Treat metritis

Repair/open teat

Rumenocentesis

Rumenotomy

Treatment (PO, IMM)

Treat mastitis

Episiotomy

Toggle DA

Ultrasound

Physical exam

Examine hoof

Eye flap

Amputate digit

Adominocentesis

Breeding exam cow

Omentopexy/

Sample milk for

Artificial

Transfaunation

Treat pneumonia

abomasopexy

bacteriologic culture

insemination

Rectovaginal

Treat diarrhea

Breeding exam bull

Skin biopsy

tear repair

Treat bloat

Cesarean section

Fetotomy

Intestinal

Castration

Remove

Uterine detorsion

anastomosis

Dehorning

supernumerary teats

Fecal exam quantitative

Radiology

Obstetrics

Subconjunctival

Excise foot fibroma

Uterine prolapse

eye injections

CMT test

Vaginal prolapse

Urinalysis

Necropsy

CBC

Fecal flotation

Fracture splint

Tattooing

More invasive clinical

Wound management

chemistry tests of

Venipuncture

body fuids

Epidural anesthesia

Herd level service Vaccination program Anthelmintic program Cont resp pblm Cont diarrhea pblm Cont off feed pblm

Body condition scoring Sanitation/hygiene prgm Estrus synchronization Cont infertility pblm Cont abortion pblm Client education Dev insecticide prgm Residue avoidance prgm

Cont mastitis Cont nutrition pblm TB testing

Advice on milk replacer SMSCC analysis Advise on feed additives Assess heifer growth Use of computer records Use of spreadsheets Assess DHIA records

Economic analysis Ration formulation Financial advice Assess feed particles Assess milking tech.

Advice on waste disposal Milking machine evaluation

Assess housing/

ventilation Ration analysis Forage sample for testing Bulk tank milk analysis Advise on grazing Assess an intervention Advise on genetics

IV intravenous, IM intramuscular, SC subcutaneous, PO per os, IMM intramammary, Treat treatment, Prgm program, Pblm problem, Cont control, Dev develop, TB tuberculosis, DHIA Dairy Herd Improvement Association, CMT California Mastitis Test, CBC complete blood count, Tech technique, DA displaced abomasum. (From Refs. 3 and 4.)

disease conditions include mastitis, metritis, foot infections, pneumonia, enteritis, and noninfectious metabolic conditions. Infectious endemic diseases are caused by agents normally found in the environment and host population.1-5-1 Host environment pathogen interactions influence disease incidence.1-5-1 The presence of the agent alone is not sufficient to cause disease. Disease occurs when multiple factors upset the balance in animal resist ance and organism pathogenicity. Environmental factors contribute to upset this balance. Factors that influence endemic disease include seasonal conditions, nutrition, ventilation, hygiene, pathogen buildup, milking practices, and general husbandry.

Metabolic conditions constitute a significant proportion of endemic health problems in a dairy herd.[6-8] These conditions are associated with parturition.[6-8] Risk factors that contribute to metabolic conditions include body condition, nutrition in both the nonlactating and lactating periods, age of the cow, and stage of lactation.[6-8]

Endemic disease and metabolic conditions may affect 30% to 60% of animals calving on an annual basis. Animals may be affected by more than one problem, and an animal may experience repeated bouts of the same problem within a lactation.[6,7] Subclinical forms of endemic and metabolic conditions may not be apparent, but they may reduce production and reproduction. Total eradication of endemic disease conditions is unlikely because control is complicated by host management environment interactions. Typically, veterinarians and producers need to reach a consensus on acceptable incidence rates of these diseases within a herd.

Endemic disease problems on dairy farms have led to pressures to change the approach to disease control in dairy herds. First, identification of the pathogenic factor is insufficient to control the disease. Therefore, testing to identify the organism has less value than in epidemic disease situations. Second, management and environment play significant roles in influencing disease rates. Consequently, veterinarians must evaluate management and environment, not just the cow, to identify factors influencing disease rates. Third, communication skills are critical to inform and motivate the dairy producer to change management and environment practices in order to reduce the incidence of disease. The veterinarian must have a thorough knowledge of animal husbandry, epidemiology, and communication to effectively work with dairy producers to control these diseases.[5,10]

Dairy producers are looking for cheaper solutions to health care for endemic disease. Whereas in traditional programs calling a veterinarian to diagnose and treat an epidemic problem was valued, calling a veterinarian to treat an endemic problem has less perceived value. Producers recognize these conditions with fairly high accuracy because they see them often and usually know what treatments will be appropriate. Early identification of a case, appropriate treatment, and residue avoidance are critical aspects in the control of endemic disease conditions and often do not require the veterinarian to be the primary animal health care provider.

Veterinarians are under pressure either to provide cheaper diagnostic treatment services for endemic cases or to train herd personnel to diagnose and treat these cases. The veterinarian needs to evaluate interventions and success of outcomes, and to monitor the incidence of cases. Care must be taken that should a new disease emerge in the herd, the veterinarian is notified and appropriate steps are taken to ensure it is not a pandemic disease or a zoonotic disease risk.

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