Marginal structural Cox model to estimate the causal effect of clinical mastitis on Québec dairy cow culling risk.

Health disorders, such as milk fever, displaced abomasum, or retained placenta, as well as poor reproductive performance, are known risk factors for culling in dairy cows. Clinical mastitis (CM) is one of the most influential culling risk factors. However the culling decision could be based either on the disease status or on the current milk yield, milk production being a significant confounder when modelling dairy cow culling risk. But milk yield (and somatic cell count) are time-varying confounders, which are also affected by prior CM and therefore lie on the causal pathway between the exposure of interest, CM, and the outcome, culling. Including these time-varying confounders could result in biased estimates. A marginal structural model (MSM) is a statistical technique allowing estimation of the causal effect of a time-varying exposure in the presence of time-varying covariates without conditioning on these covariates. The objective of this paper is to estimate the causal effect on culling of CM occurring between calving and 120 days in milk, using MSM to control for such time-varying confounders affected by previous exposure. A retrospective longitudinal study was conducted on data from dairy herds in the Province of Québec, Canada, by extracting health information events from the dairy herd health management software used by most Québec dairy producers and their veterinarians. The data were extracted for all lactations starting between January 1st and December 31st, 2010. A total of 3952 heifers and 8724 cows from 261 herds met the inclusion criteria and were used in the analysis. The estimated CM causal hazard ratios were 1.96 [1.57-2.44] and 1.47 [1.28-1.69] for heifers and cows, respectively, and as long as causal assumptions hold. Our findings confirm that CM was a risk factor for culling, but with a reduced effect compared to previous studies, which did not properly control for the presence of time-dependent confounders such as milk yield and somatic cell count. Cows experienced a lower risk for CM, with milk production having more influence on culling risk in cows than heifers.

Culling from the herd's perspective-Exploring herd-level management factors and culling rates in Québec dairy herds.

The relationship between cows' health, reproductive performance or disorders and their longevity is well demonstrated in the literature. However these associations at the cow level might not hold true at the herd level, and herd-level variables can modify cow-level outcomes independently of the cows' characteristics. The interaction between cow-level and herd-level variables is a relevant issue for understanding the culling of dairy cows. However it requires the appropriate group-level variables to assess any contextual effect. Based on 10 years of health and production data, the objectives of this paper are:(a) to quantify the culling rates of dairy herds in Québec; (b) to determine the profiles of the herds based on herd-level factors, such as demographics, reproduction, production and health indicators, and whether these profiles can be related to herd culling rates for use as potential contextual variables in multilevel modelling of culling risk. A retrospective longitudinal study was conducted on data from dairy herds in Québec, Canada, by extracting health information events from the dairy herd health management software used by most Québec producers and their veterinarians. Data were extracted for all lactations taking place between January 1st, 2001 and December 31st, 2010. A total of 432,733 lactations from 156,409 cows out of 763 herds were available for analysis. Thirty cow-level variables were aggregated for each herd and years of follow-up, and their relationship was investigated by Multiple Factor Analysis (MFA). The overall annual culling rate was 32%, with a 95% confidence interval (CI) of [31.6%,32.5%]. The dairy sale rate by 60 days in milk (DIM) was 3.2% [2.8%,3.6%]. The annual culling rate within 60 DIM was 8.2% [7.9%,8.4%]. The explained variance for each axis from the MFA was very low: 14.8% for the first axis and 13.1% for the second. From the MFA results, we conclude there is no relationship between the groups of herd-level indicators, demonstrating the heterogeneity among herds for their demographics, reproduction and production performance, and health status. However, based on Principal Component Analysis (PCA), the profiles of herds could be determined according to specific, single, herd-level indicators independently. The relationships between culling rates and specific herd-level variables within factors were limited to livestock sales, proportion of first lactation cows, herd size, proportion of calvings occurring in the fall, longer calving intervals and reduced 21-day pregnancy rates, increased days to first service, average age at first calving, and reduced milk fever incidence. The indicators found could be considered as contextual variables in multilevel model-building strategies to investigate cow culling risk.

Predictors of fatal outcomes resulting from acute Escherichia coli mastitis in dairy cows.

To evaluate the prognostic criteria for identifying cows at an increased risk of a fatal outcome from acute Escherichia coli mastitis, the potential cut-off values for five diagnostic parameters associated with a high mortality were determined by receiver operator characteristic curve analysis. These criteria were hematocrit value >32%, blood non-esterified fatty acid concentration >0.4 mEq/l, antithrombin activity <120%, platelet count <15 × 10(4)/ml and presence of dysstasia. Exceeding the cut-off values for at least three parameters on day 2 after onset predicted fatality (predictive value 87.5). When these prognostic criteria were applied to 34 clinical cases, cows that met three criteria were seven times more likely to die than cows that met fewer than three criteria.

The effect of repeated episodes of bacteria-specific clinical mastitis on mortality and culling in Holstein dairy cows.

The objective of this study was to estimate the effect of a first and repeated cases of bacteria-specific clinical mastitis (CM) on the risk of mortality and culling in Holstein dairy cows. The pathogens studied were Streptococcus spp., Staphylococcus aureus, Staphylococcus spp., Escherichia coli, Klebsiella spp., Trueperella pyogenes, others, and no growth on aerobic culture. A total of 50,166 lactations were analyzed from 5 large, high-milk-producing dairy herds in New York State from 2003/2004 to 2011. Generalized linear mixed models with a Poisson error distribution were used to study the effects of parity, month of lactation, CM, calving diseases, pregnancy status, current season, and economic values on the risk of mortality and culling. Among first-lactation cows, the presence of a first CM case generally exposed cows to a greater risk of mortality in the current month (compared with the absence of a first case). This was especially acute with a first case of Klebsiella spp., where cows were 4.5 times more at risk [95% confidence interval (CI): 2.7-7.6] of mortality, and with a first case of E. coli were 3.3 times more at risk (95% CI: 2.5-4.5). In first-parity cows, the risk of culling generally increased with a case of bacteria-specific CM. This was observed among cows with a first case of T. pyogenes [relative risk=10.4 (95% CI: 8.4-12.8)], a first case of Klebsiella spp. [relative risk=6.7 (95% CI: 5.5-8.1)], a first case of Staph. aureus [relative risk=4.8 (95% CI: 2.7-8.4)], a first case of E. coli [relative risk=3.1 (95% CI: 2.7-3.6)], and a third case of Klebsiella spp. [relative risk=5.0 (95% CI: 3.1-8.0)]. In general, the presence of a first or second/third case resulted in cows in parity ≥2 with a greater risk of mortality. This was greatest for cows with a first case of Klebsiella spp. [relative risk=3.7 (95% CI: 3.3-4.3)], followed by a second/third case of Klebsiella spp. [relative risk=3.2 (95% CI: 2.5-4.0)], a first case of E. coli [relative risk=3.0 (95% CI: 2.7-3.3)], and a first case of other CM [relative risk=1.8 (95% CI: 1.6-2.0)]. Among cows of parity ≥2, the risk of culling was greater for cows as they progressed through lactations [i.e., cows in parity 4+ were 2.1 (95% CI: 2.0-2.2) times more likely to be culled compared with cows in lactation 2 (the baseline)]. The risk of culling dependent on the cow's characteristics can be easily calculated from the parameter estimates in the provided tables.

The effect of recurrent episodes of clinical mastitis caused by gram-positive and gram-negative bacteria and other organisms on mortality and culling in Holstein dairy cows.

The objective of this study was to estimate the effects of recurrent episodes of different types of clinical mastitis (CM) caused by gram-positive (Streptococcus spp., Staphylococcus aureus, Staphylococcus spp.) and gram-negative (Escherichia coli, Klebsiella, Citrobacter, Enterobacter, Pseudomonas) bacteria, and other organisms (Arcanobacterium pyogenes, Mycoplasma, Corynebacterium bovis, yeast, miscellaneous) on the probability of mortality and culling in Holstein dairy cows. Data from 30,233 lactations in cows of 7 dairy farms in New York State were analyzed. Cows were followed for the first 10 mo in lactation, or until death or culling occurred, or until the end of our study period. Generalized linear mixed models with a Poisson error distribution were used to study the effects of recurrent cases of the different types of CM and several other factors (herd, parity, month of lactation, current year and season, profitability, net replacement cost, other diseases) on cows' probability of death (model 1) or being culled (model 2). Primiparous and multiparous cows were modeled separately because they had different risks of mortality and culling and potentially different CM effects on mortality and culling. Approximately 30% of multiparous cows had at least one case of CM in lactation compared with 16.6% of primiparous cows. Multipara also had higher lactational incidence risks of second (10.7%) and third (4.4%) cases than primipara (3.7% and 1.1%, respectively). For primipara, CM increased the probability of death, with each successive case occurring in a month being increasingly lethal. In multipara, gram-negative CM increased the probability of death, especially when the gram-negative case was the first or second CM case in lactation. Primiparous cows with CM were more likely to be culled after CM than if they did not have CM, particularly after a second or third case. In multipara, any type of CM increased the probability of being culled. Gram-negative CM cases were associated with the numerically highest risk of culling.

The selective treatment of clinical mastitis based on on-farm culture results: II. Effects on lactation performance, including clinical mastitis recurrence, somatic cell count, milk production, and cow survival.

The objective of this multi-state, multi-herd clinical trial was to report on the efficacy of using an on-farm culture system to guide strategic treatment decisions in cows with clinical mastitis. The study was conducted in 8 commercial dairy farms ranging in size from 144 to 1,795 cows from Minnesota, Wisconsin, and Ontario, Canada. A total of 422 cows affected with mild or moderate clinical mastitis in 449 quarters were randomly assigned to either (1) a positive-control treatment program or (2) an on-farm culture-based treatment program. Quarter cases assigned to the positive-control group received immediate on-label intramammary treatment with cephapirin sodium. Quarters assigned to the culture-based treatment program were not treated until the results of on-farm culture were determined after 18 to 24h of incubation. Quarters in the culture-based treatment program that had gram-positive growth or a mixed infection were treated according to label instruction using intramammary cephapirin sodium. Quarters assigned to the culture-based treatment program that had gram-negative or no-growth did not receive intramammary therapy. It was already reported in a companion paper that the selective treatment of clinical mastitis based on on-farm culture results decreases antibiotic use by half and tends to decrease milk withholding time without affecting short-term clinical and bacteriological outcomes. The present article reports on long-term outcomes of the aforementioned study. No statistically significant differences existed between cases assigned to the positive-control program and cases assigned to the culture-based treatment program in risk and days for recurrence of clinical mastitis in the same quarter (35% and 78 d vs. 43% and 82 d), linear somatic cell count (4.2 vs. 4.4), daily milk production (30.0 vs. 30.7 kg), and risk and days for culling or death events (28% and 160 d vs. 32% and 137 d) for the rest of the lactation after enrollment of the clinical mastitis case. In summary, the selective treatment of clinical mastitis based on on-farm culture resulted in no differences in long-term outcomes, such as recurrence of clinical mastitis in the same quarter, somatic cell count, milk production, and cow survival for the rest of the lactation after clinical mastitis.

Bovine mycoplasmosis: silent and deadly.

The first international conference on bovine mycoplasmosis, held in Saskatoon, Canada, in 2009, marked an official recognition of the importance of mycoplasmas in bovine respiratory disease, mastitis, arthritis and other disorders. Furthermore, bovine mycoplasmosis has been identified as a major emerging infectious disease by the European Community 7th Framework Programme under the EMIDA ERA-NET, which is funding a three-year study into the development of improved diagnosis and control of bovine mycoplasmosis involving the UK, Germany, Italy and Israel. These developments coincide with the publication of the complete sequence of the Mycoplasma bovis genome, which offers fresh insight into the properties of this tiny wall-less bacterium. With this in mind, it is an appropriate time to review our knowledge of cattle diseases caused by mycoplasmas.

Correlated time to event data: Modeling repeated clinical mastitis data from dairy cattle in New York State.

Mastitis is the most prevalent production disease in dairy herds worldwide and is considered to be the most economically important disease of dairy cattle. Modeling the risk of cows contracting mastitis is therefore of great interest for both targeting prevention programs and evaluating treatment protocols. Clinical mastitis (CM) is a disease of recurrent nature, thus correlation between the subsequent events within one cow may be present. This would violate the assumption behind most statistical time-to-event models. In the case of time to event models, the semi-parametric Cox regression models have become the default tool in modeling the time to an event. Limited methods are currently available to evaluate marginal and random (frailty) effects to account for multiple correlation sources. The objective of this study was to explore the implications of using several Cox or related semi-parametric or parametric models to estimate the hazard for CM in the presence of correlation between events. We evaluated the Andersen-Gill model which uses robust standard errors to account for the correlation, the Conditional Anderson-Gill model that uses stratification to account for event dependence, the Frailty model that introduces a random term to account for unobserved (cow level) heterogeneity, and a related generalized linear mixed model that uses Poisson regression to allow multi-level modeling of time-to-event data. We analyzed data on the occurrence of CM from five dairy farms in New York State. Data were from 8206 cows with 721, 275, 119, and 57 first, second, third, and fourth occurrences of CM, respectively, in the same lactation. The analysis of our sample dataset demonstrated that both cow- and farm-level correlation are present in the case of CM. The Conditional Frailty model was able to model one source of correlation in a random effect and one in a fixed effect. Poisson modeling allowed for simultaneous estimation of within cow correlation and within herd correlation.

Systematic review of causes and factors associated with morbidity and mortality on smallholder dairy farms in eastern and southern Africa.

This article presents the first systematic review of the causes and factors associated with morbidity and mortality, on smallholder dairy farms in Eastern and Southern Africa. It was conducted in August 2007. Primary studies on causes of morbidity and mortality on smallholder dairy farms in the region were identified, examined and descriptive information extracted. Electronic (CAB Abstracts, PubMed, ScienceDirect and Web of Science) and non-electronic databases were used to identify and retrieve the primary studies. The retrieval process included all types of study designs with no restriction on the year of publication and language. Mastitis, tick-borne diseases (TBDs), tick infestation and diarrhoea were among the most commonly documented causes of morbidity. TBDs, diarrhoea and trypanosomiasis were among the most commonly documented causes of mortality; however, a substantial number of mortalities with undiagnosed causes were also reported. Factors ranked as most negatively associated with mastitis were residual calf suckling and increased water availability on the farm while use of common udder towel was the factor most positively associated with mastitis. Zero-grazing was ranked as the factor most negatively associated with TBDs while age was most positively associated. More intervention studies are recommended in the region to better identify animal health constraints and their associated risk factors.

Heifer rearing conditions affect length of productive life in Swedish dairy cows.

Associations between rearing conditions and the risk of culling in dairy cows were studied by survival analysis. Data were collected from 1039 Swedish Red cows, 1029 Swedish Holsteins, and 56 cows of other milk or cross-breeds, representing all female animals born in 109 Swedish herds during 1998. Length of productive life was defined as the number of days from 1st calving to culling. The applied Weibull proportional hazards model included time-independent effects of breed, housing from 3 to 7 months of age, number of housing changes before calving, grazing before 1st calving, herd median age at 1st calving, age at 1st calving, cow housing, herd lactational incidence risk of veterinary-reported clinical mastitis, and the random effect of herd. Time-dependent effects were year, month, the interaction year by month, parity, number of breedings, pregnancy status, the interaction parity by pregnancy status, herd mean milk-production level, relative milk yield within breed-parity, and veterinary-reported clinical mastitis. The lactation was divided into six stages in which pregnancy status was assumed to be known by the farmer and culling could occur. Median productive life time in culled cows was 780 d and 14% of the records were censored due to terminated data collection. An individual calving age of 28.2-30.9 months was associated with the highest culling risk, 1.2-fold higher than calving at < or = 25.3 months, whereas the risk decreased almost linearly with a higher herd median age at 1st calving. Housing in slatted pens with >7 calves from 3 to 7 months was associated with a 1.7-fold increase in risk, relative to litter pens. If a cow had changed housing system 4 times before 1st calving it increased the risk of culling 1.4 times, relative to two housing changes. These results show that rearing factors affect the productive life time of dairy cows in Swedish family operations.

Livestock disease threats associated with intensification of pastoral dairy farming.

This paper provides an overview of the changes in the pasture-based dairy systems of New Zealand and Australia that may influence the health of cattle. There are relatively few available data that can be used to quantify the effects of increased intensification of milk production on the health of cattle. There is evidence that increased production increases the risk of mastitis and culling for udder health. Increased risks of mastitis with treatment with somatotropin support these findings; however, the risk of mastitis may decrease with increased milking frequency. Larger herds with greater stocking density should increase the risk for infectious disease, but evidence to support this contention is sparse. Very intensive grazing patterns associated with higher grass yields achieved using better cultivars and greater use of fertilisers favour nematode parasites. There is some evidence of anthelmintic resistance in both nematodes and liver fluke. Veterinarians will need to be aware of the potential for these to reduce the productivity of cattle. There have been benefits of improved nutrition on the efficiency of energy use for dairy production. Diseases such as bloat and ketosis appear to be of lower prevalence. It also appears that mineral nutrition of pasture-fed cattle is being better addressed, with gains in the control of milk fever, hypomagnesaemia and trace-element deficiencies. However, acidosis is a condition with a high point prevalence in pasture-based dairy systems where cows are fed supplements; one study in Australia found a point prevalence of approximately 11% of cows with acidosis. There is evidence from this study that the neutral detergent fibre (NDF) in pasture-based diets may need to be higher than 30% of the diet to maintain rumen stability. Laminitis and acidosis are different conditions with a similar pathogenesis, specifically highly fermentable diets. The prevalence of lameness was 28% in herds in Australia, suggesting that this condition must be a focus for preventive medical approaches, including the design of laneways, feed pads and dairies.

Effects of repeated episodes of generic clinical mastitis on mortality and culling in dairy cows.

Bovine clinical mastitis (CM) can be detrimental to a dairy farm's profitability, not only in terms of lost production and treatment costs, but also because of the loss of the cows themselves. Our objective was to estimate the effects of multiple occurrences of generic bovine CM on mortality and culling. We studied 16,145 lactations from 5 large, high-producing dairy herds, with 3,036 first, 758 second, and 288 third CM cases observed in the first 10 mo after calving. Generalized mixed models, with a random herd effect, were used to quantify the effect of CM on mortality and culling. Other control variables included in the models were parity, stage of lactation, and other diseases. Clinical mastitis in the current month significantly increased mortality in all parities. Among primipara, odds ratios and 95% confidence intervals were 5.6 (1.7, 18.0), 23.3 (7.1, 76.2), and 27.8 (3.7, 209.9) for the first, second, and third CM episode, respectively. Among multipara, respective estimates were 9.9 (7.4, 13.2), 12.0 (8.0, 18.0), and 11.5 (6.1, 21.4). Clinical mastitis significantly increased the risk of a cow being culled for a period of at least 2 mo after any CM case. Our findings provide dairy producers with information on mortality and culling associated with CM cases without considering the causative agent, and can also be used for economic analysis of CM management options.

The cost of generic clinical mastitis in dairy cows as estimated by using dynamic programming.

The objective of this study was to estimate the cost of generic clinical mastitis (CM) in high-yielding dairy cows given optimal decisions concerning handling of CM cases. A specially structured optimization and simulation model that included a detailed representation of repeated episodes of CM was used to study the effects of various factors on the cost of CM. The basic scenario was based on data from 5 large herds in New York State. In the basic scenario, 92% of the CM cases were recommended to be treated. The average cost of CM per cow and year in these herds was $71. The average cost of a CM case was $179. It was composed of $115 because of milk yield losses, $14 because of increased mortality, and $50 because of treatment-associated costs. The estimated cost of CM was highly dependent on cow traits: it was highest ($403) in cows with high expected future net returns (e.g., young, high-milk-yielding cows), and was lowest ($3) in cows that were recommended to be culled for reasons other than mastitis. The cost per case of CM was 18% higher with a 20% increase in milk price and 17% lower with a 20% decrease in milk price. The cost per case of CM was affected little by a 20% change in replacement cost or pregnancy rate. Changes in CM incidence, however, resulted from changes in these factors, thus affecting whole-farm profitability. The detailed results obtained from this insemination and replacement optimization model can assist farmers in making CM treatment decisions.

[Mycoplasma mastitis in dairy cattle]. / Mycoplasma mastitis bij het rund.

The most important characteristics of Mycoplasma mastitis on dairy farms are described, based on two case studies. Clinical symptoms, diagnostics, epidemiology, and a plan of action are presented. In the herds investigated, Mycoplasma mastitis was characterized by multiple affected quarters unresponsive to treatment with antibiotic and/or anti-inflammatory agents. Most striking were a sandy sediment, brown colouring, and rice-like structure of the milk of affected animals. Clinical symptoms differed in the two affected herds. Diagnosis was based on bacteriological investigation of samples of milk and synovial fluid taken from infected cows. Affected animals were culled immediately, and the herds were monitored by repeated testing of bulk milk samples. It was concluded that a consequence of the increasing size of cattle herds in the Netherlands is that subclinical/clinical Mycoplasma mastitis may be diagnosed more frequently than in the past. In the case of Mycoplasma mastitis, farmers and veterinary practitioners are advised to draw up a plan of action together, incorporating aspects such as diagnostics at cow level, direct culling of affected animals, hygiene during milking, including post-milking teat disinfection, and routine monitoring of bulk milk. Unpasteurized milk should not be given to calves.

Pathogenomic analysis of the common bovine Staphylococcus aureus clone (ET3): emergence of a virulent subtype with potential risk to public health.

A common clone (ET3) of Staphylococcus aureus is responsible for a large proportion of cases of bovine mastitis and occasionally causes zoonotic infections of humans. In the present study, we report the identification of a virulent clonal subtype (ST151) of ET3, which resulted in increased tissue damage and mortality in a mouse model of mastitis. ST151 has undergone extensive diversification in virulence and regulatory-gene content, including the acquisition of genetic elements encoding toxins not made by other ET3 strains. Furthermore, ST151 had elevated levels of RNAIII and cytolytic toxin-gene expression, consistent with the enhanced virulence observed during experimental infection. Previously, the ST151 clone was shown to be hypersusceptible to the acquisition of vancomycin-resistance genes from Enterococcus spp. Taken together, these data indicate the emergence of a virulent subtype of the common ET3 clone, which could present an enhanced risk to public health.

Economic effects of bovine mastitis and mastitis management: a review.

Several studies have been published since 1990 on the economics of mastitis and mastitis management. However, hardly any of these studies has discussed the consistency of results with other studies. In the present paper, the economic factors associated with mastitis are explained, providing a framework for economic analysis. As a second step calculations of the costs of mastitis and the costs in relation to the benefits of mastitis management published since 1990 in peer-reviewed journals are extensively reviewed and analysed. The result shows a large variation in the calculated costs and benefits of mastitis and mastitis management between the different studies. Moreover, it is clear that important factors were ignored in some of the studies. The framework provided in this paper can provide a basis for analysis for future studies on the economics of mastitis and mastitis management.

The effect of veterinary-treated clinical mastitis and pregnancy status on culling in Swedish dairy cows.

The interaction of the effects of pregnancy status and veterinary-treated clinical mastitis on culling in Swedish dairy cattle was analyzed with survival analysis. The data were from 978,780 cows with first calvings between 1988 and 1996. Four breeds (Swedish Red and White (SRB), Swedish Friesian (SLB), Swedish Polled Breed and Jersey) were included in the analysis, together with the SRB x SLB crossbreds. Length of productive life was defined as the number of days between first calving and culling or censoring (end of data collection). The model (Weibull proportional hazard) included the interaction of parity by pregnancy status by veterinary-treated clinical mastitis, peak test-day milk-yield deviation within herd-year-parity, age at first calving, year by season, region, breed, herd production level, and the random effect of herd. The effects of pregnancy status and veterinary-treated clinical mastitis were modeled as time-dependent covariates. The lactation was divided into five stages during which a veterinary-treated clinical mastitis and culling might occur and in which the pregnancy status was assumed to be known and culling could occur. Open cows had a pronounced effect on culling: they had a very high risk of being culled in all lactations, and it was even higher if they were treated for mastitis in early lactation. For pregnant cows, the later they got pregnant during the lactation, the greater their risk to be culled. The risk associated with cases of veterinary-treated clinical mastitis remained important throughout the lactation.

Comparison of disease severity scoring systems for dairy cattle with acute coliform mastitis.

OBJECTIVE: To compare use of 4 disease severity scoring systems to predict bacteremia (yes vs no) and outcome (survived vs died or culled) in dairy cows with acute coliform mastitis (ACM). DESIGN: Retrospective cohort study. ANIMALS: 99 dairy cows with ACM. PROCEDURES: Cows were classified as having mild, moderate, or severe disease with a scoring system based on systemic disease signs alone (systemic severity score [SSS] system), a system based on local disease signs alone (local severity score [LSS] system), and 2 previously described systems based on a combination of local and systemic signs (local-systemic score 1 [LS1] and local-systemic score 2 [LS2] systems). Test performance was calculated to determine whether a severe disease classification could be used to predict bacteremia or outcome. RESULTS: 21%, 53%, 63%, and 38% of cows were classified as having severe disease with the SSS, LSS, LS1, and LS2 systems, respectively. For both bacteremia and outcome, sensitivity was highest for the LS1 system, but specificity and accuracy were highest for the SSS system. Examination of a scatterplot of true-positive rate versus false-positive rate for each of the scoring systems indicated that the SSS and LS2 systems were similar in their ability to correctly identify cows with bacteremia or an adverse outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the SSS scoring system was better for identifying cows with bacteremia or an adverse outcome than was the LSS system and that the LS1 and LS2 systems were intermediate in their discriminatory abilities.

Dairy cow mortality. A review.

We reviewed the literature to give an overview over the mortality among dairy cows in countries with a relatively intensive dairy production. A total of 19 studies focussing on dairy cow mortality were identified. Information about objectives, measures of mortality, sample sizes, study designs, causes of death and risk factors from these studies is presented and discussed. Additionally, recommendations for future recordings of mortality that will enable better possibilities for comparison of study results, generalization of results from a study population to a larger population and meta-analysis are given.