Development and validation of a clinical respiratory disease scoring system for guiding treatment decisions in veal calves using a Bayesian framework.

Active infectious bovine respiratory disease (BRD) is an infection of the airways that needs to be diagnosed correctly so that appropriate treatment can be initiated. The simplest and most practical test to detect active BRD in dairy calves raised for veal is the detection and interpretation of clinical signs by producers or technicians. However, the clinical scoring system currently available for veal calves lacks sensitivity and specificity, contributing to economic losses and high use of antimicrobials. An accurate and reliable batch-level test to detect active BRD is essential to tailor antimicrobial use and reduce economic losses in veal calves. The objective of this study was therefore to develop and validate a new veal calf respiratory clinical scoring system (VcCRS), including reliable clinical signs (cough, ear droop or head tilt) and increased rectal temperature to detect active BRD in batches of veal calves housed individually, and to describe the accuracy of the scoring system for identifying batches of veal calves to treat. During 2017 to 2018, clinical examination, thoracic ultrasonography (TUS) and a haptoglobin concentration (Hap) were prospectively performed on 800 veal calves housed individually in Québec, Canada. Deep nasopharyngeal swabs were performed on 250 veal calves. A Bayesian latent class model accounting for imperfect accuracy of TUS and Hap was used to obtain weights for the clinical signs and develop the VcCRS. The VcCRS was then validated externally in 3 separate data sets. Finally, the applicability of the VcCRS at batch level was determined. We found that calves with 2 of the following findings-cough, unilateral or bilateral ear droop or head tilt, or increased rectal temperature ≥39.7°C-were considered positive and had a 31% chance of having active BRD. Without at least 2 of these 2 findings, a calf had a 100% chance of not having active BRD. At the batch level, we found that a batch with ≥3 positive calves among 10 calves sampled 2 wk after arrival at the fattening unit had a 94% chance of having an active BRD prevalence ≥10%. A batch with <3 positive calves had a 95% chance of not having an active BRD prevalence ≥10%. In this study, we developed a simple individual and batch-level score that is reliable across examiners and performs effectively in the detection of active BRD in veal calves. The implementation of this VcCRS in the veal calf industry would promote the elaboration of a protocol tailoring antimicrobial use.

Association between transfer of passive immunity and health disorders in multisource commingled dairy calves raised for veal or other purposes: Systematic review and meta-analysis.

Inadequate transfer of passive immunity (ITPI) in newborn dairy calves remains an important risk factor for mortality and morbidity. Most available studies are focused on calves delivered and raised on the same farms. This setting is far different from calves transported and commingled from different farms to be raised as veal or for other purposes. The aim of this systematic review and meta-analysis was to describe the association between ITPI and important health outcomes (mortality, bovine respiratory disease, and diarrhea) in multisource commingled dairy calves raised for veal or other purposes. We searched studies through CAB abstracts (via CAB direct), PubMed, and Web of Science (via ISI) databases until September 2, 2021. Observational studies and randomized trials written in English or French assessing ITPI association with any of the selected outcomes were included. Young dairy calves transported to commercial facilities and explicitly stated as being raised for veal production or not (then considered as "other") were our populations of interest. If raw or adjusted data were available for ≥5 studies for a given outcome of interest, then random effect meta-analysis models were used to investigate ITPI effects on this outcome. Nineteen studies were selected from 6,221 abstracts retrieved in the initial search. We observed significantly higher odds of mortality in calves with ITPI compared with those with successful transfer of passive immunity [odds ratio (OR) = 2.46; 95% confidence interval (CI): 1.43-4.22, n = 8 studies]. Calves with ITPI had higher odds of diarrhea (OR = 3.03; 95% CI: 1.2-7.62, n = 7 studies). A significant publication bias toward publishing studies with positive results was found in studies reporting on bovine respiratory disease (n = 5 studies), which revealed nonsignificant associations after correction of publication bias (OR = 1.40; 95% CI: 0.77-2.6). Heterogeneity could not be thoroughly investigated for mortality and diarrhea due to the limited number of studies. Therefore, the pooled estimates of the random models should be interpreted with caution despite their robustness to sensitivity analyses. In this study, we also observed that multiple definitions for transfer of passive immunity and outcomes were used in the literature. Moreover, the raising system definition was often limited. There seems, therefore, to be a need for standardized definitions of these parameters, as well as a better description of systems used for multisource commingled dairy calves raised for veal production or other production purposes.

Development of a multivariable prediction model to identify dairy calves too young to be transported to auction markets in Canada using simple physical examination and body weight.

Calves born on Eastern Canadian dairy farms that are not kept in the herds are traditionally sold through auction markets and are raised for meat purposes such as veal calves. Since February 2020, a new Canadian federal regulation has forbidden calves <9 d old to be sold through auction markets. However, in the absence of a real-time birth registry consultation system, it would be of interest to look for predictors that could be associated with age to allow identification of calves too young to be transported. In the current retrospective cross-sectional study, 1,178 calves with a declared birth date (411 calves aged <9 d old; 34.9%) were assessed in 2 large Québec auction sites. Easy-to-record covariates [body weight (BW), breed phenotype, and presence of an umbilical cord remnant] as well as other clinical signs (umbilical swelling, enlargement, umbilical pain, wet umbilicus, skin tent, sunken eyes, ocular and nasal secretion, and hide cleanliness) were assessed. Two logistic regression models using age as a dichotomous dependent variable (<9 d old vs ≥9 d old) were built. The first model (model 1) considered all covariates, which were selected after univariable analyses and a backward stepwise selection process, whereas a more pragmatic model (model 2) only included the 3 easy-to-record variables (i.e., BW, breed, umbilical cord). Both models had similar accuracy to detect calves <9 d old (sensitivity of 38.4 and 37.5%, and specificity of 85.7 and 84.6% for model 1 and 2, respectively). Model 2 was subsequently more specifically studied as it employs a faster and easier assessment. Decision thresholds were tested for their robustness based on misclassification cost term (MCT) analysis with various prevalence of calves <9 d old and various costs of false-negative:false-positive ratio. Despite statistical significance, model accuracy, even if refined with MCT analysis, was limited at the individual level, showing the limits of using physical signs and BW or their combination as a reliable proxy of age. The sensitivity of these models to find calves <9 d old was not to be used for monitoring compliance with the Canadian federal regulation. The relatively high model specificity may help to use this model as a rule-in test (i.e., targeting positive calves for further investigation) rather than a rule-out test (due to its low sensitivity).

Evaluation of inter-rater agreement of the clinical signs used to diagnose bovine respiratory disease in individually housed veal calves.

In dairy calves raised for veal, typical clinical signs of bovine respiratory disease (BRD) are ocular discharge, nasal discharge, ear droop or head tilt, abnormal respiration, cough, and increased rectal temperature. Despite the existence of several clinical scoring systems, there are few studies on the variability of human recognition of individual BRD clinical signs. The objective of this study was therefore to assess the inter-rater agreement of BRD clinical signs in veal calves. We hypothesized that BRD clinical signs were not detected equally between veterinarians, technicians, and producers of the veal industry and that some clinical signs have higher inter-rater agreement than others. During 2017-2018, we prospectively recorded 524 videos of physical examinations of random veal calves from 48 different batches in Québec, Canada. A researcher, not involved in the inter-rater assessment, classified each video as presence/absence of each BRD clinical sign except rectal temperature. For each of the 5 clinical signs, 15 videos with and 15 videos without the clinical signs were randomly selected to avoid kappa paradoxes. Those 30 videos were then presented in a random order to experienced raters of BRD in veal calves: 6 veterinarians, 6 technicians, and 6 producers. The raters assessed the clinical signs using scores based on the Wisconsin and California scoring system with modifications (0 = absent, 1 = mild, 2 = moderate, 3 = severe for nasal discharge, ocular discharge, and ear droop or head tilt; and 0 = absent, 1 = moderate, 2 = severe for abnormal respiration and induced cough). We used median percentage agreement (Pa), median Cohen's kappa (κ), and Gwet's agreement coefficient 1 (AC1) to assess inter-rater agreement. The effect of scale combination was also tested to determine the optimal combination (4-scale 0/1/2/3 vs. 3-scale 0/1/2 vs. 2-scale 0/1,2,3; 0,1/2,3; or 0/1,2). The differences of inter-rater agreement between veterinarians, technicians, and producers were estimated by a Wilcoxon rank-sum test. The 2-scale combination (0,1/2,3 or 0/1,2) had the highest inter-rater agreement for all clinical signs. With this combination, induced cough was the clinical sign with the highest inter-rater agreement (Pa = 0.93; κ = 0.79; AC1 = 0.87) and abnormal respiration was the sign with the lowest inter-rater agreement (Pa = 0.77; κ = 0.20; AC1 = 0.74). According to Pa and AC1 values, the 2-scale inter-rater agreement of the 5 clinical signs was good (value > 0.6). According to κ, only ear droop or head tilt and induced cough had a substantial 2-scale inter-rater agreement (κ > 0.6). In general, the 2-scale inter-rater agreement was better among veterinarians than among technicians and producers, except for the ear droop/head tilt, where agreement was better among producers. We concluded that with severity scores assessed on a scale of 2 (0,1/2,3 or 0/1,2), the inter-rater agreement of BRD clinical signs was variable according to the sign in veal calves. BRD clinical signs were not detected equally between veterinarians, technicians, and producers of the veal industry. Future research could determine if this discrepancy could be improved by standardization training.

An observational cohort study on antimicrobial usage on dairy farms in Quebec, Canada.

Quantification of antimicrobial usage (AMU) is crucial to measure the effect of intervention programs, to determine associations between usage and resistance, to compare populations, and for benchmarking purposes. The primary objective of the study was to describe quantitatively the AMU on Quebec dairy farms over 1 yr: (1) the total AMU, (2) the AMU per administration route (intramammary, injectable, oral, intrauterine), and (3) the AMU per antimicrobial class and according to the categorizations of Health Canada and the World Health Organization. The secondary objective was to assess the effect of several characteristics (herd size, level of milk production, and incidence rate of common infectious diseases) on AMU rate. The AMU data were obtained for 101 dairy farms randomly selected in 3 important Quebec dairy regions by collecting and recording all empty drug packaging and invoices for medicated feed (spring 2017 to spring 2018). The AMU rate was reported in number of Canadian defined course doses for cattle per 100 cow-years. The average herd size was 67 cows per farm, and 2/101 farms were certified organic. Overall, an estimated mean of 537 Canadian defined course doses for cattle/100 cow-years was observed. The intramammary route during lactation was the most frequently observed, followed, in decreasing order of usage, by oral route in the feed, intramammary route at drying-off, and injectable route. Oral (other than in animal feed) and intrauterine formulations were infrequently collected from the garbage cans. The 5 most frequently observed antimicrobial classes were, by decreasing order of usage, ionophores, penicillins, aminocoumarins, aminoglycosides, and polymyxins. Highest priority critically important antimicrobials as defined by the World Health Organization were mainly collected from intramammary formulations during lactation followed by injectable and drying-off intramammary formulations. The herd size was positively associated with the total AMU rate but not with the usage rate of highest priority critically important antimicrobials. Incidence of diseases along with preventive use of antimicrobials (drying-off and medicated feed with antimicrobials) explained 48% of the variance in total AMU rate.

Comparison between thoracic ultrasonography and thoracic radiography for the detection of thoracic lesions in dairy calves using a two-stage Bayesian method.

Infectious bronchopneumonia is a lower respiratory tract disease with major economic consequences in dairy calves. Thoracic radiography (TR) and thoracic ultrasonography (TUS) are two imaging diagnostic procedures available in bovine medicine for identifying thoracic lesions. However, no study has investigated whether one of these tests is superior to the other or if they provide comparable results for the detection of thoracic lesions in calves. The objective of this study was therefore to estimate and to compare the performances of TUS and TR for the detection of thoracic lesions in dairy calves. A prospective cross-sectional study was performed in a hospital setting. A total of 50 calves (≥7 days old; ≤100 kg; standing; pCO2 ≥ 53 mmHg; any reason of presentation) were enrolled. Every calf underwent TUS and TR. Only calves with thoracic lesions on TUS and/or TR were controlled by thoracic computed tomography (CT) (the gold standard). Calves without lesions were not controlled by CT. A two-stage Bayesian framework was used. The sensitivities (Se) and specificities (Sp) of both tests individually and used in series or parallel were estimated. The Se and Sp of TUS were 0.81 (95 % BCI (Bayesian Credible Interval): 0.65; 0.92) and 0.90 (95 % BCI: 0.81; 0.96), respectively. The Se and Sp of TR were 0.86 (95 % BCI: 0.62; 0.99) and 0.89 (95 % BCI: 0.67; 0.99), respectively. This study did not reveal any differences between both tests. Using TUS and TR in series was more specific than using both tests in parallel. The performances of TUS alone were not different from the performances of both tests in series or in parallel. In conclusion, TUS and TR were equivalent in detecting thoracic lesions in this study. Using TUS alone allowed an accurate detection of thoracic lesions in dairy calves. Further studies enrolling a larger sample (> 400 calves) and allowing adequate power to be achieved would be necessary to confirm these results.

Bayesian estimation of sensitivity and specificity of systematic thoracic ultrasound exam for diagnosis of bovine respiratory disease in pre-weaned calves.

Among the different clinical presentations of bovine respiratory disease, active pneumonia, defined as an infection of the lower airway with signs of inflammation, is the most important to diagnose correctly so appropriate treatment can be initiated. Diagnostic tests that accurately identify cases of active pneumonia are lacking; however, thoracic ultrasonography (TUS) seems promising. The primary objective of this study was to estimate the accuracy of TUS compared to reference tests for the diagnosis of active pneumonia in pre-weaned calves, using a latent-class model method (LCM). The tests used for comparison were the Wisconsin Clinical Respiratory Scoring Chart (CRSC, positive if ≥5) and serum haptoglobin concentration (Hap, positive if ≥15 mg/dL). Secondary objectives were to assess the incremental value on TUS accuracy of combining TUS of the right cranial part and caudal parts, and to determine the accuracy of various thresholds for depth of consolidation (≥0 cm, ≥1 cm, or ≥3 cm) for diagnosis of active pneumonia. One population of veal calves (n = 209) and one of dairy calves (n = 301) were enrolled. TUS, CRSC and Hap were all performed on each calf on the same day. TUS was performed by screening the mid to ventral portion of the lung caudal of the heart (the caudal sites), as well as the right parenchyma cranial to the heart (the cranial site). The maximal depth of consolidation (DEPTH) on TUS was recorded and noted separately for caudal and cranial sites. Different TUS cases were defined according to site and DEPTH. The accuracy of TUS was estimated by LCM for three tests conducted in two populations. Prevalence of active pneumonia was low (0.05) in both populations. In general, higher minimal consolidation depth thresholds led to increased TUS specificity (Sp) estimates, with minimal effects on TUS sensitivity (Se). With a TUS DEPTH threshold of ≥3 cm, adding TUS of the cranial site had little effect on accuracy. Using the ≥3 cm threshold with caudal sites only, posterior Se and Sp median estimates of 0.89 (95%BCI: 0.55, 1.0) and 0.95 (95%BCI: 0.92, 0.98), respectively, were obtained. In conclusion, in populations with low active pneumonia prevalence, adding TUS of the cranial site did not enhance the performance of the test. We suggest using a DEPTH threshold of ≥3 cm solely on caudal sites to detect active pneumonia.

Validation of a clinical scoring system for bovine respiratory disease complex diagnosis in preweaned dairy calves using a Bayesian framework.

Bovine respiratory disease complex is a major cause of illness in dairy calves. The diagnosis of active infection of the lower respiratory tract is challenging on daily basis in the absence of accurate clinical signs. Clinical scoring systems such as the Californian scoring system, are appealing but were developed without considering the imperfection of reference standard tests used for case definition. This study used a Bayesian latent class model to update Californian prediction rules. The results of clinical examination and ultrasound findings of 608 preweaned dairy calves were used. A model accounting for imperfect accuracy of thoracic ultrasound examination was used to obtain updated weights for the clinical signs included in the Californian scoring system. There were 20 points (95% Bayesian credible intervals: 11-29) for abnormal breathing pattern, 16 points (95% BCI: 4-29) for ear drop/head tilt, 16 points (95% BCI: 9-25) for cough, 10 points (95% BCI: 3-18) for the presence of nasal discharge, 7 points (95% BCI: -1 to 8) for rectal temperature ≥39.2 °C, and -1 points (95% BCI: -9 to 8) for the presence of ocular discharge. The optimal cut-offs were determined using the misclassification cost-term term (MCT) approach with different possible scenarios of expected prevalence and different plausible ratio of false negative costs/false positive costs. The predicted probabilities of active infection of the lower respiratory tract were also obtained using posterior densities of the main logistic regression model. Depending on the context, cut-off varying from 9 to 16 can minimized the MCT. The optimal cut-off decreased when expected prevalence of disease and false negative/false positive ratio increased.

Invited review: A systematic review and qualitative analysis of treatments other than conventional antimicrobials for clinical mastitis in dairy cows.

Clinical mastitis is an important disease in dairies. Its treatment is mainly based on the use of antimicrobial drugs. Numerous non-antimicrobial drugs and treatment strategies have already been reported for clinical mastitis treatment, but data on their efficacy have never been collated in a systematic way. The objective of this systematic review was to identify treatments other than conventional antimicrobials for the treatment of clinical mastitis in lactating dairy cows. A systematic review was performed with studies written in English or French selected from CAB Abstracts, PubMed, and Web of Science from January 1970 to June 2014. Controlled clinical trials, observational studies, and experimental challenges were retained. Lactating dairy cows with clinical mastitis were the participant of interest. All treatments other than conventional antimicrobials for clinical mastitis during lactation were retained. Only studies comparing the treatment under investigation to a negative or positive control, or both, were included. Outcomes evaluated were clinical and bacteriological cure rates and milk production. Selection of the study, data extraction, and assessment of risk of bias was performed by 3 reviewers. Assessment of risk of bias was evaluated using the Cochrane Collaboration tool for systematic review of interventions. A total of 2,451 manuscripts were first identified and 39 manuscripts corresponding to 41 studies were included. Among these, 22 were clinical trials, 18 were experimental studies, and 1 was an observational study. The treatments evaluated were conventional anti-inflammatory drugs (n = 14), oxytocin with or without frequent milk out (n = 5), biologics (n = 9), homeopathy (n = 5), botanicals (n = 4), probiotics (n = 2), and other alternative products (n = 2). All trials had at least one unclear or high risk of bias. Most trials (n = 13) did not observe significant differences in clinical or bacteriological cure rates in comparison with negative or positive controls. Few studies evaluated the effect of treatment on milk yield. In general, the power of the different studies was very low, thus precluding conclusions on noninferiority or nonsuperiority of the treatments investigated. No evidence-based recommendations could be given for the use of an alternative or non-antimicrobial conventional treatment for clinical mastitis. However, probiotics and oxytocin with or without frequent milk out should not be recommended. We concluded that homeopathic treatments are not efficient for management of clinical mastitis.

A randomised clinical trial of a metaphylactic treatment with tildipirosin for bovine respiratory disease in veal calves.

BACKGROUND: Bovine respiratory disease (BRD) is a major problem in veal calf rearing units. The objective of this randomised clinical trial was to assess the effectiveness of tildipirosin as a metaphylactic treatment in veal calves on the number of BRD treatments, lung consolidation on thoracic ultrasonography (TUS) and average daily gain (ADG). A total of 209 veal calves from a pre-weaning fattening unit were randomly allocated to receive one of two treatments (tildipirosin 4 mg/kg, subcutaneously, n = 109; placebo 0.9% saline, subcutaneously, n = 100) at day 12 after entry in the pre-weaned unit. The calves were followed for a 70-day period. Occurrence of mortality and BRD treatments were recorded during the pre-weaning period. At days 1, 12 and 30, TUS and clinical scores were performed and ADG was measured during the first and second months of feeding. RESULTS: The use of a metaphylactic treatment of tildipirosin 12 days after arrival of the veal calves was not associated with the number of BRD treatments performed by the producer, ultrasonographic lung consolidation or weight gain (P < 0,05). In this cohort of calves, the proportion of calves treated for BRD by the producer was low at 14% (29/209). However, 13% (26/209) of calves included in the study already had ultrasonographic lung consolidation lesions 12 days after their arrival, which was before treatment time, and 27% (56/209) had lung consolidation at day 30. CONCLUSION: In this study population with a low BRD prevalence, we were not able to detect any benefit of tildipirosin as a metaphylactic treatment of BRD at day 12 after arrival based on BRD treatments, TUS, and ADG.

Cerebrospinal Fluid Analysis in Recumbent Adult Dairy Cows With or Without Spinal Cord Lesions.

BACKGROUND: Diagnosis of central nervous system (CNS) lesions in recumbent dairy cattle (RDC) is challenging because neurologic examination is limited and medical imaging often is challenging or unrewarding. Cerebrospinal fluid (CSF) analysis is useful in the diagnosis of CNS disorders in cattle. However, its utility in identifying spinal cord lesions in RDC remains to be evaluated. HYPOTHESIS/OBJECTIVES: We hypothesized that CSF analysis would discriminate between RDC with and without spinal cord lesions. ANIMALS: Twenty-one RDC with spinal cord lesions (RDC+) and 19 without (RDC-) were evaluated. METHODS: Spinal cord lesions were confirmed at necropsy. Signalment, clinical findings, and CSF results were compared retrospectively. Total nucleated cell count and differential, protein concentration, and red blood cell count in RDC+ and RDC- were compared. RESULTS: Neoplasia, trauma, and infectious processes were the most frequent spinal cord lesions identified. Cerebrospinal fluid protein concentrations and TNCC were significantly higher in RDC+ compared to RDC- (P = .0092 and P = .0103, respectively). Additionally, CSF protein concentrations and TNCC in RDC- were lower than previously published reference ranges. Using an interpretation rule based on CSF protein concentration and TNCC, it was possible to accurately identify 13 RDC with spinal cord lesions and 6 RDC without lesions. It was not possible to determine spinal cord status in the remaining 18 RDC. CONCLUSIONS AND CLINICAL IMPORTANCE: Cerebrospinal fluid analysis is valuable in the evaluation of spinal cord status in RDC. The prognosis associated with these findings remains to be determined.

Cholangiohepatitis in Dairy Cattle: 13 Cases.

BACKGROUND: The signalment, clinicopathologic, bacteriological, histopathological, ultrasonographic characteristics, and the treatment and outcomes of adult cattle with cholangiohepatitis are poorly defined. ANIMALS: Thirteen Holstein cows with cholangiohepatitis. METHODS: Retrospective study of medical records of cattle admitted to the CHUV and the AVC between 1992 and 2012 and 2000 and 2012, respectively, for cattle older than 3 months of age with a histopathological diagnosis of cholangiohepatitis. Cholangiohepatitis was defined as the presence of portal inflammation surrounding or infiltrating bile ducts, with or without epithelial damage, and extending into the adjacent lobules. RESULTS: At the time of diagnosis of cholangiohepatitis, cows had decreased appetite (n = 7) or were anorectic (n = 6), had fever (n = 5), and had tachycardia (n = 8). Icterus was detected in 5 cows. Yellow discoloration was identified on the skin of the udder (n = 3), conjunctiva (n = 2), and vulva (n = 1). There was leukocytosis (n = 6), neutrophilia (n = 9), and hyperfibrinogenemia (n = 8). Alteration in the serum biochemistry profile included hyperglobulinemia (n = 8), hypoalbuminemia (n = 10), increased activity of GGT (n = 12), AST (n = 8), and ALP (n = 10), and hyperbilirubinemia (n = 10). Histopathological diagnosis included mild, subacute, nonsuppurative cholangiohepatitis (n = 4), mild suppurative cholangiohepatitis (n = 4), mild mixed (neutrophilic and lymphocytic) cholangiohepatitis (n = 3), and moderate, chronic, nonsuppurative cholangiohepatitis (n = 1). Six cows were discharged from the hospital, and 7 were euthanized. CONCLUSIONS AND CLINICAL IMPORTANCE: Cholangiohepatitis is a rare condition in adult cattle. Antemortem diagnosis can be challenging because clinical signs are unspecific.

Systematic Review of the Diagnostic Accuracy of Haptoglobin, Serum Amyloid A, and Fibrinogen versus Clinical Reference Standards for the Diagnosis of Bovine Respiratory Disease.

BACKGROUND: Bovine respiratory disease (BRD) is a worldwide animal health concern especially in feedlot, dairy, and veal calves. One of the greatest challenges is the absence of a gold standard for achieving an accurate antemortem diagnosis. Various blood markers, including the acute-phase proteins (AAP), have been proposed as potential valuable tools for BRD diagnosis. OBJECTIVES: To perform a systematic review of the literature to assess the accuracy of selected APP (haptoglobin [Hp], serum amyloid A [SAA], and fibrinogen [Fb]) as diagnostic tools for cattle with naturally occurring BRD when compared with clinical reference standards of diagnosis. METHODS: This review was performed with eligible studies selected from CAB Abstract and MEDLINE from 1946 to 2015, as well as the "gray literature." Methodological quality of included studies was assessed using the QUADAS-2 tool developed for diagnostic accuracy studies. The accuracy parameters sensitivity (Se) and specificity (Sp) were obtained from the articles or through contact with the authors when not directly reported. RESULTS: A total of 314 studies were identified, from them, 23 met inclusion criteria as diagnostic studies for naturally occurring BRD. Quality of studies showed high risk of bias for case selection (70% of articles) and unclear risk of bias for index test (65%), reference standard (74%), and flow and timing (61%). There were high concerns regarding applicability for case selection (61% of studies) and reference standards used for defining BRD (48%). The concerns regarding index test application were low (83% of the studies). Only 4-8 studies could be included in the meta-analysis for each APP. No pooled estimates or pooled accuracy measurements were performed due to the low number of studies and multiple differences between studies, including reference standard definitions. CONCLUSIONS AND CLINICAL IMPORTANCE: On the basis of these findings, it is not possible to make conclusions regarding the accuracy of APP for BRD diagnosis. The reporting of accuracy of APP for BRD detection is inconsistent among studies. Recommendations to improve capability for future meta-analyses in this area include reporting studies on diagnostic tests following the Standard for the Reporting of Diagnostic Accuracy Studies (STARD), as well as trying to standardize BRD definition across future studies.

Respiratory pathogens in Québec dairy calves and their relationship with clinical status, lung consolidation, and average daily gain.

BACKGROUND: Bovine respiratory disease (BRD) is 1 of the 2 most important causes of morbidity and mortality in dairy calves. Surprisingly, field data are scant concerning the prevalence of respiratory pathogens involved in BRD in preweaned dairy calves, especially in small herds. OBJECTIVES: To identify the main respiratory pathogens isolated from calves in Québec dairy herds with a high incidence of BRD, and to determine if there is an association between the presence of these pathogens and clinical signs of pneumonia, lung consolidation, or average daily gain. ANIMALS: Cross-sectional study using a convenience sample of 95 preweaned dairy calves from 11 dairy herds. METHODS: At enrollment, calves were weighed, clinically examined, swabbed (nasal and nasopharyngeal), and lung ultrasonography was performed. One month later, all calves were reweighed. RESULTS: Twenty-two calves had clinical BRD and 49 had ultrasonographic evidence of lung consolidation. Pasteurella multocida, Mannheimia haemolytica, and Histophilus somni were isolated in 54, 17, and 12 calves, respectively. Mycoplasma bovis was identified by PCR testing or culture in 19 calves, and 78 calves were found to be positive for Mycoplasma spp. Bovine coronavirus was detected in 38 calves and bovine respiratory syncytial virus in 1. Only the presence of M. bovis was associated with higher odds of clinical signs, lung consolidation, and lower average daily gain. CONCLUSIONS AND CLINICAL IMPORTANCE: Results suggested that nasopharyngeal carriage of M. bovis was detrimental to health and growth of dairy calves in small herds with a high incidence of BRD.

Preoperative and postoperative L-lactatemia assessment for the prognosis of right abomasal disorders in dairy cattle.

BACKGROUND: Preoperative L-lactatemia and heart rate have been suggested as prognostic indicators of outcome for cows with right dilatation of the abomasum or volvulus (RDA/AV). However, postoperative L-lactatemia has not been assessed as a potential prognostic tool. OBJECTIVES: To determine the prognostic value of postoperative L-lactatemia (LAC2 ), duration of treatment (Dt), relative L-lactatemia difference (compared with preoperative L-lactatemia [LAC1 ]) ([LAC2 - LAC1 ]/LAC2 ) and change in L-lactate over time ([LAC2 - LAC1 ]/Dt) as compared to preoperative findings (LAC1 and heart rate [HR]) as prognostic factors in dairy cows with RDA/AV. ANIMALS: A total of 41 dairy cows were included: 19 with AV and 22 with RDA; 11 cows had a negative outcome (NO) and 30 cows had a positive outcome (PO) based on telephone follow-up with owners 30 days after surgery. METHODS: Prospective cohort study. Analysis was performed using logistic regression and comparison of area under the receiver operating characteristics curve (AUC) using nonparametric tests. RESULTS: LAC1 > 1.4 mmol/L or LAC2 > 2.2 mmol/L had the same accuracy with sensitivity of 100% (95% CI, 75.1-100%) and specificity of 80% (95% CI, 61.4-92.3%) for predicting NO. The relative L-lactatemia difference ([LAC2 - LAC1 ]/LAC1 ) or lactate kinetics ([LAC2 - LAC1 ]/Dt) were not associated with prognosis. The AUC of the preoperative model (which included HR and lnLAC1 ) was 0.92 (95% CI, 0.83-1.0) and that of the postoperative model (including only lnLAC2 ) was 0.95 (95% CI, 0.88-1.0); these were not significantly different. CONCLUSIONS AND CLINICAL IMPORTANCE: Postoperative L-lactatemia is helpful to predict outcome in cows with RDA/AV. The short-term change in blood L-lactate is not a useful prognostic indicator, at least during the period of time spent on the farm for surgery and treatment.

Validation of an ultrasound imaging technique of the tympanic bullae for the diagnosis of otitis media in calves.

BACKGROUND: Otitis media is a common disease in calves that can be subclinical, making antemortem on-farm diagnosis challenging. OBJECTIVES: To evaluate the sensitivity and specificity of ultrasonography of tympanic bullae for the diagnosis of clinical and subclinical otitis media and to evaluate the reproducibility of the technique. ANIMALS: Forty calves 19-50 days of age were selected from a veal calf farm. METHODS: Prospective study. Ultrasonography was first performed on the farm by ultrasonographer A (US A). Ultrasonography was repeated by ultrasonographer A (US A') and another ultrasonographer (US B) at the Centre Hospitalier Universitaire Vétérinaire. Images were later reread by both examiners and a diagnosis was recorded. The calves were euthanized and submitted for necropsy, and histopathologic diagnosis was used as the gold standard. RESULTS: Forty-five bullae were affected by otitis media and 35 bullae were normal. Sensitivity and specificity of the ultrasound technique ranged from 32 to 63% and 84 to 100%, respectively, depending on the examiner and classification of suspicious ultrasonography results. Kappa analysis to evaluate interobserver agreement between A' and B yielded a к value of 0.53. Agreement within the same examiner (A versus A') yielded a к value of 0.48, and real-time ultrasound versus rereading of recorded images for A' and B yielded к values of 0.58 and 0.75, respectively. CONCLUSIONS: Sensitivity and specificity of the ultrasound imaging technique are, respectively, low and high for diagnosis of clinical and subclinical otitis media in calves, with moderate reproducibility.

Comparison of thoracic auscultation, clinical score, and ultrasonography as indicators of bovine respiratory disease in preweaned dairy calves.

BACKGROUND: The diagnostic tools for bovine respiratory disease diagnosis include clinical inspection, thoracic auscultation, and ultrasonography. HYPOTHESIS: Thoracic auscultation and clinical examination have limitations in the detection of lung consolidation in dairy calves. ANIMALS: Prospective cohort of 106 preweaned calves from 13 different dairy herds (10 with a history of active bovine respiratory disease (BRD) in calves and 3 without suspected BRD problems). METHODS: Each preweaned calf was clinically inspected using the Wisconsin calf respiratory scoring chart (CRSC) and treatment history was noted. Systematic thoracic auscultation and ultrasonography then were performed, the latter focusing on lung consolidation. Mortality was recorded over a 30-day period. RESULTS: A total of 56 of 106 calves had ultrasonographic evidence of lung consolidation. The sensitivity of thoracic auscultation to detect consolidation was 5.9% (range, 0-16.7%). Only 41.1% (23/33) of calves with consolidated lungs had been treated previously by the producers. When adding CRSC and previous BRD treatment by the producer, sensitivity of detection increased to 71.4% (40/56). The area under the receiver operating characteristics curve was 0.809 (95% CI, 0.721-0.879) for the number of areas within the lungs with consolidation and 0.743 (95% CI, 0.648-0.823) for the maximal depth of consolidation as predictors of death within 1 month after examination. These were not significantly different (P = .06). CONCLUSIONS AND CLINICAL IMPORTANCE: This study shows that thoracic auscultation is of limited value in diagnosing lung consolidation in calves. Ultrasonographic assessment of the thorax could be a useful tool to assess BRD detection efficiency on dairy farms.

Preoperative cow-side lactatemia measurement predicts negative outcome in Holstein dairy cattle with right abomasal disorders.

The objectives of the current study were (1) to determine the gain in prognostic accuracy of preoperative l-lactate concentration (LAC) measured on farm on cows with right displaced abomasum (RDA) or abomasal volvulus (AV) for predicting negative outcome; and (2) to suggest clinically relevant thresholds for such use. A cohort of 102 cows with on-farm surgical diagnostic of RDA or AV was obtained from June 2009 through December 2011. Blood was drawn from coccygeal vessels before surgery and plasma LAC was immediately measured by using a portable clinical analyzer. Dairy producers were interviewed by phone 30 d following surgery and the outcome was determined: a positive outcome if the owner was satisfied of the overall evolution 30 d postoperatively, and a negative outcome if the cow was culled, died, or if the owner reported being unsatisfied 30 d postoperatively. The area under the curve of the receiver operating characteristic curve for LAC was 0.92 and was significantly greater than the area under the curve of the receiver operating characteristic curve of heart rate (HR; 0.77), indicating that LAC, in general, performed better than HR to predict a negative outcome. Furthermore, the ability to predict a negative outcome was significantly improved when LAC measurement was considered in addition to the already available HR data (area under the curve: 0.93 and 95% confidence interval: 0.87, 0.99). Important inflection points of the misclassification cost term function were noted at thresholds of 2 and 6 mmol/L, suggesting the potential utility of these cut-points. The 2 and 6 mmol/L thresholds had a sensitivity, specificity, positive predictive value, and negative predictive value for predicting a negative outcome of 76.2, 82.7, 53.3, and 93.1%, and of 28.6, 97.5, 75, and 84%, respectively. In terms of clinical interpretation, LAC ≤2 mmol/L appeared to be a good indicator of positive outcome and could be used to support a surgical treatment decision. The treatment decision for cows with LAC between 2 and 6 mmol/L, however, would depend on the economic context and the owner's attitude to risk in regard to potential return on its investment. Finally, performing a surgical correction on commercial cows with RDA or AV and a LAC ≥6 mmol/L appeared to be unjustified and these animals should be culled based on their high probability of negative outcome.

Mycoplasma bovis infections in cattle.

Mycoplasma bovis is a pathogen causing respiratory disease, otitis media, arthritis, mastitis, and a variety of other diseases in cattle worldwide. It is increasingly recognized by the veterinary and livestock communities as having an important impact on the health, welfare, and productivity of dairy and beef cattle. M. bovis diseases can be difficult to diagnose and control because of inconsistent disease expression and response to treatments and vaccines, and large gaps in our understanding of the epidemiology and pathophysiology of these diseases. There are limited data on which to base evidence-based decisions for treatment and control, and the literature contains differing clinical biases and opinions. This document is intended for veterinarians dealing with cattle and is focused on the cattle production systems of North America. The goal of the consensus statement panel was to encourage an evidence-based approach to M. bovis problems. The scientific literature was critically reviewed, including peer-reviewed journal articles and reviews obtained by database searches using the terms "Mycoplasma bovis" or "mycoplasma + cattle." Where other data were lacking, conference proceedings were reviewed as a source of expert opinion.

Comparison of computed tomography and routine radiography of the tympanic bullae in the diagnosis of otitis media in the calf.

BACKGROUND: Otitis media is difficult to diagnose antemortem. Case reports have described computed tomography (CT) in the diagnosis, but not all cases were confirmed. HYPOTHESIS: CT is a sensitive and specific imaging modality of the tympanic bullae and can be used as the gold standard for the diagnosis of otitis media. ANIMALS: Sixteen Holstein calves 5-7 weeks of age were included. METHODS: Prospective study. All calves were sedated with i.v. xylazine (0.05-0.15 mg/kg) for routine radiography (3 views) and CT of the tympanic bullae followed by necropsy. RESULTS: Based upon necropsy findings, 10 of 16 calves were affected with otitis media, 4 unilaterally and 6 bilaterally. Imaging changes associated with otitis media included increased soft tissue opacity within the bulla, thickening of the bulla wall, enlarged bulla, and osteolysis of the bulla wall and trabeculations. The most frequent radiographic changes were lysis of trabeculations and increased soft tissue opacity, which were present in 56.3% of affected bullae. On CT, increased soft tissue opacity within the bulla was present in 93.8% of affected bullae. Sensitivity of radiography and CT was 68.8 and 93.8% and specificity was 50 and 100%, respectively. The κ value between radiography and CT with necropsy diagnosis was 0.19 for radiography, indicating poor agreement, and 0.94 for CT, indicating excellent agreement. CONCLUSION: CT is more specific, more sensitive, and easier to interpret than radiography and can be used as the gold standard in the diagnosis of otitis media in the calf.