Drying off the dairy cow

Most dairy cows generally have a non-lactating, “dry period” prior to parturition. As the milk production of dairy cows has increased dramatically during the last decades, cows managed conventionally with a 12 to 13 month-calving interval are dried off (DO) while still producing significant quantities of milk. The DO period is probably one of the most physiologically demanding periods for the high-yielding dairy cow, and may negatively affect animal welfare, but few studies have been performed in this area. Therefore, the general aim of the present work was to investigate how different DO procedures and milk yield at DO affect metabolism and udder health of the dairy cow. Furthermore, the effects of different calving intervals and breed were also evaluated. Three studies are included in this thesis. In the first study cows were randomly assigned to two different feeding treatments. One group was fed straw ad libitum, while the other group was fed silage [4 kg dry matter (DM)] daily and straw ad libitum to evaluate metabolic changes and health during DO. In the second study, the effects of daily milk yield at DO, different calving intervals (12 and 15 months) and breed on metabolism and udder health were studied when feeding additional silage at DO. The third study was conducted on over 10 000 lactating cows and the association between daily milk yield prior to DO and veterinary-treated clinical mastitis (VTCM) from DO until early lactation was evaluated. The overall results of this thesis show that extensively restrictive feeding DO protocols may have negative effects on metabolism. The plasma concentration of non-esterified fatty acids (NEFA) was markedly elevated during DO as an effect of restrictive feeding. Furthermore, plasma NEFA was related to the milk yield prior to DO. Feeding straw only during DO affected the rumen environment as shown by increased pH, a reduced concentration of volatile fatty acids, urea, and lower number of protozoa. Restrictive feeding also increased the plasma cortisol, which indicates an elevated metabolic load in this group. In addition, high milk yield at DO increased the risk for VTCM and the number of open teat canals during the dry period. Swedish Holsteins were at higher risk for VTCM from DO until early lactation compared to Swedish Red and White cows. In conclusion, this thesis shows that the common DO procedure to feed straw only may give rise to metabolic disturbances. However, this might be avoided without any apparent negative effects on udder health if a limited amount of silage is added during DO. As high daily milk yields at DO increase the risk for mastitis, alternative ways to reduce the milk yield at DO should be considered

Dry-off and dairy cow udder health and welfare : Effects of different milk cessation methods

The cessation of milking at the end of lactation is a routine management practice in dairy herds, and the importance of the dry period for milk production and udder health, has long been recognized. Among countries and herds, drying-off practices differ and include various milk cessation methods, such as changes in milking frequency and in feeding, the use of antibiotic dry cow therapy and teat sealants, and changes in housing. Published studies reporting methods of stopping milk production are scarce, and there are no uniform recommendations on optimal procedures to dry cows off for good udder health, cow welfare, and milk production. This review describes methods to stop mik production to prepare cows for the dry period and their effects on mammary involution, udder health, and dairy cow welfare. Milk yield at dry-off (the final milking at the end of lactation) is important for rapid involution, which stimulates the immune system and promotes good udder health and cow welfare. Based on the findings of this review, gradual cessation of milking over several days before the final milking can effectively reduce milk yield at dry-off and accelerate mammary gland involution while maximizing cow comfort and welfare. Data from this review indicate a target production level of 15 kg/day of milk or less at dry-off. (c) 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Current management practices and interventions prioritised as part of a nationwide mastitis control plan

The objectives of this study were to report performance and management data taken from a sample of UK dairy farms that have participated in the Agriculture and Horticulture Development Board Dairy Mastitis Control Plan (DMCP) and to identify important mastitis prevention practices that are not currently widely implemented. A total of 234 UK dairy herds were included in the study from which farm management and udder health data were collected. Herds were grouped according to their mastitis epidemiology and could be classed as (i) environmental dry period (EDP) (i.e. environmental pathogen with majority of infections being acquired during the dry period), (ii) environmental lactation (EL), (iii) contagious dry period (CDP) or (iv) contagious lactation (CL). The results of this study showed that many mastitis-related management practices that are generally considered to be important were not widely performed. A better understanding of those practices not widely adopted by UK dairy farmers at present may aid practitioners in identifying and overcoming potential barriers to improved mastitis control

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament: Part 1: tibial attachment.

Accepted versio

Metabolic profiles in five high-producing Swedish dairy herds with a history of abomasal displacement and ketosis

<p>Abstract</p> <p>Background</p> <p>Body condition score and blood profiles have been used to monitor management and herd health in dairy cows. The aim of this study was to examine BCS and extended metabolic profiles, reflecting both energy metabolism and liver status around calving in high-producing herds with a high incidence of abomasal displacement and ketosis and to evaluate if such profiles can be used at herd level to pinpoint specific herd problems.</p> <p>Methods</p> <p>Body condition score and metabolic profiles around calving in five high-producing herds with high incidences of abomasal displacement and ketosis were assessed using linear mixed models (94 cows, 326 examinations). Cows were examined and blood sampled every three weeks from four weeks ante partum (ap) to nine weeks postpartum (pp). Blood parameters studied were glucose, fructosamine, non-esterified fatty acids (NEFA), insulin, β-hydroxybutyrate, aspartate aminotransferase, glutamate dehydrogenase, haptoglobin and cholesterol.</p> <p>Results</p> <p>All herds had overconditioned dry cows that lost body condition substantially the first 4–6 weeks pp. Two herds had elevated levels of NEFA ap and three herds had elevated levels pp. One herd had low levels of insulin ap and low levels of cholesterol pp. Haptoglobin was detected pp in all herds and its usefulness is discussed.</p> <p>Conclusion</p> <p>NEFA was the parameter that most closely reflected the body condition losses while these losses were not seen in glucose and fructosamine levels. Insulin and cholesterol were potentially useful in herd profiles but need further investigation. Increased glutamate dehydrogenase suggested liver cell damage in all herds.</p

Description of the attachment geometry of the anteromedial and posterolateral bundles of the ACL from arthroscopic perspective for anatomical tunnel placement

The anterior cruciate ligament (ACL) consists of an anteromedial bundle (AMB) and a posterolateral bundle (PLB). A reconstruction restoring the functional two-bundled nature should be able to approximate normal ACL function better than the most commonly used single-bundle reconstructions. Accurate tunnel positioning is important, but difficult. The purpose of this study was to provide a geometric description of the centre of the attachments relative to arthroscopically visible landmarks. The AMB and PLB attachment sites in 35 dissected cadaver knees were measured with a 3D system, as were anatomical landmarks of femur and tibia. At the femur, the mean ACL centre is positioned 7.9 ± 1.4 mm (mean ± 1 SD) shallow, along the notch roof, from the most lateral over-the-top position at the posterior edge of the intercondylar notch and from that point 4.0 ± 1.3 mm from the notch roof, low on the surface of the lateral condyle wall. The mean AMB centre is at 7.2 ± 1.8 and 1.4 ± 1.7 mm, and the mean PLB centre at 8.8 ± 1.6 and 6.7 ± 2.0 mm. At the tibia, the mean ACL centre is positioned 5.1 ± 1.7 mm lateral of the medial tibial spine and from that point 9.8 ± 2.1 mm anterior. The mean AMB centre is at 3.0 ± 1.6 and 9.4 ± 2.2 mm, and the mean PLB centre at 7.2 ± 1.8 and 10.1 ± 2.1 mm. The ACL attachment geometry is well defined relative to arthroscopically visible landmarks with respect to the AMB and PLB. With simple guidelines for the surgeon, the attachments centres can be found during arthroscopic single-bundle or double-bundle reconstructions

EHS Rapid Guideline: Evidence-Informed European Recommendations on Parastomal Hernia Prevention—With ESCP and EAES Participation

Background: Growing evidence on the use of mesh as a prophylactic measure to prevent parastomal hernia and advances in guideline development methods prompted an update of a previous guideline on parastomal hernia prevention.Objective: To develop evidence-based, trustworthy recommendations, informed by an interdisciplinary panel of stakeholders.Methods: We updated a previous systematic review on the use of a prophylactic mesh for end colostomy, and we synthesized evidence using pairwise meta-analysis. A European panel of surgeons, stoma care nurses, and patients developed an evidence-to-decision framework in line with GRADE and Guidelines International Network standards, moderated by a certified guideline methodologist. The framework considered benefits and harms, the certainty of the evidence, patients’ preferences and values, cost and resources considerations, acceptability, equity and feasibility.Results: The certainty of the evidence was moderate for parastomal hernia and low for major morbidity, surgery for parastomal hernia, and quality of life. There was unanimous consensus among panel members for a conditional recommendation for the use of a prophylactic mesh in patients with an end colostomy and fair life expectancy, and a strong recommendation for the use of a prophylactic mesh in patients at high risk to develop a parastomal hernia.Conclusion: This rapid guideline provides evidence-informed, interdisciplinary recommendations on the use of prophylactic mesh in patients with an end colostomy. Further, it identifies research gaps, and discusses implications for stakeholders, including overcoming barriers to implementation and specific considerations regarding validity

The lateral meniscus as a guide to anatomical tibial tunnel placement during anterior cruciate ligament reconstruction

Purpose: The aim of the study is to show, on an MRI scan, that the posterior border of the anterior horn of the lateral meniscus (AHLM) could guide tibial tunnel position in the sagittal plane and provide anatomical graft position. Method: One hundred MRI scans were analysed with normal cruciate ligaments and no evidence of meniscal injury. We measured the distance between the posterior border of the AHLM and the midpoint of the ACL by superimposing sagittal images. Results: The mean distance between the posterior border of the AHLM and the ACL midpoint was -0.1mm (i.e. 0.1mm posterior to the ACL midpoint). The range was 5mm to -4.6mm. The median value was 0.0mm. 95% confidence interval was from -0.5 to 0.3mm. A normal, parametric distribution was observed and Intra- and inter-observer variability showed significant correlation (p<0.05) using Pearsons Correlation test (intra-observer) and Interclass correlation (inter-observer). Conclusion: Using the posterior border of the AHLM is a reproducible and anatomical marker for the midpoint of the ACL footprint in the majority of cases. It can be used intra-operatively as a guide for tibial tunnel insertion and graft placement allowing anatomical reconstruction. There will inevitably be some anatomical variation. Pre-operative MRI assessment of the relationship between AHLM and ACL footprint is advised to improve surgical planning.The article is available via Open Access.Published (Open Access

Aspects of parastomal hernia

Parastomal hernia (PSH) is a common complication to all ostomies, and all too well known to colorectal surgeons. Up to half of all stomates get a PSH. PSH may present itself as a protrusion or a bulge of the stoma that contains bowel or other content of the abdominal cavity. The symptom load varies from none to debilitating. An unknown fraction of patients with PSH receives correctional surgery. The overall aim of this thesis was to investigate prevalence and treatment of PSH in Sweden, explore whether prophylactic mesh when constructing a colostomy is a viable option for prevention, investigate the health economic impact of PSH and probe into the patient’s own experiences of living with a PSH. The thesis is based on both qualitative and quantitative research. Paper I and III are a randomised controlled multicentre trial, paper II is retrospective audit of the treatment of PSH in Sweden, paper IV is a health economic analysis of colostomy costs and paper V is an interview of survivors of colorectal cancer, with a colostomy and PSH. The conclusions are as follows: The frequency of PSH surgery was much lower than expected, no specific risk factor could be identified, and perhaps centralisation of surgery should be considered. Most common cause for surgery was cosmetic. Prophylactic mesh in a sublay position don’t prevent PSH but doesn’t seem to add significant complications. PSH cost no more than a colostomy with no PSH, regarding appliances and stoma nurse visits. The common theme of long-time rectal cancer survivors with PSH is coping and a deep sense of gratitude being a survivor