Dohmen, W.

Hogeveen, H.

Huijps, K.

Lam, T.J.G.M.

English

Wageningen Yield 

Nantes, 14-15 January 2010: Farm Animal Health Economics 
 
 
COSTS AND EFFICACY OF MANAGEMENT MEASURES TO IMPROVE UDDER 
HEALTH AT DUTCH DAIRY FARMS. THE USE OF EXPERTISE 
 
W. Dohmen,† K. Huijps,‡ T.J.G.M. Lam#, and H. Hogeveen†,§ 
†Dept. of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Utrecht, 
the Netherlands 
‡Coöperatie Rundvee Verbetering, Arnhem, the Netherlands 
#Dutch Udder Health Centre, Deventer, the Netherlands 
§Chair group Business Economics, Wageningen University, Wageningen, the Netherlands 
 
Introduction 
Mastitis is an endemic disease in the dairy sector worldwide and causes, amongst others, 
serious economic consequences (Halasa et al., 2007). Mastitis expresses itself in two ways: 
subclinical mastitis and clinical mastitis. To measure the mastitis situation at a farm, bulk tank 
somatic cell count (BTSCC) is often used as parameter for subclinical mastitis and clinical 
mastitis (CM) is often expressed as the incidence rate of CM (Barnouin et al., 2005). It is 
difficult to control mastitis, because it is a multi-factorial disease, has numerous causative 
bacteria and can be transmitted from cow to cow (contagious mastitis) and from environment 
to cow (environmental mastitis). The multifactorial nature of mastitis means that there are 
many risk factors for mastitis, requiring a number of different management measures to 
control.  
Literature on the efficacy of management measures mostly gives general information which is 
not applicable in a farm specific situation, especially when the effects need to be quantified 
for economic calculations. Quantitative data on continuous variables are usually a prerequisite 
for sound decision making. Preferably, such data are derived from field studies and 
experiments. However, these data often are not (yet) available or, if available, 
incomprehensive, unreliable, only indirectly applicable or a combination of these factors. This 
results in decisions being made without correct and complete information. In such situations, 
expert judgement is the only way to gain the required knowledge (Seabrook, 1984). 
 
Previous research 
One of the objectives of previous research by Huijps et al. (2009a, 2009b) was to analyze the 
efficacies of management measures regarding mastitis. The determined efficacies were used 
to calculate costs and benefits of different management measures. 
As a first step, the management measures were selected for which information is needed about 
efficacies for a mastitis problem, varying from 100% environmental to 100% contagious. 
Efficacies were needed specified on BTSCC and on the incidence of CM. These management 
measures came from the 10 point plan of the NMC (www.nmconline.org), which was the base 
of the more specified management measures as advised by the Dutch Udder Health Centre 
(Table 1). 
 
Table 1. Management measures included in the study based on the NMC 10 point plan and 
the Dutch Udder Health Centre (Huijps et al., 2009b). 
 Management measure description Short description 
1 All cows with clinical signs are milked last Milking clinical 
cases last 
2 All cows with an elevated SCC (>250,000 cells/ml) are milked 
last 
Milking subclinical 
cases last 
56
Nantes, 14-15 January 2010: Farm Animal Health Economics 
 
3 For all cows a separate cloth is used to clean the udder before 
attaching the cluster 
Separate cloth 
4 Clean udders are washed with water and are dried before 
attaching the cluster 
Wash dirty udder 
5 All cows are prestripped Prestripping 
6 During every milking milkers’ gloves are worn Milkers’ gloves 
7 All cows are treated with a good teat disinfectant after milking Post milking teat 
disinfection 
8 After milking a cow with clinical signs of mastitis the cluster is 
rinsed with hot water before another cows is milked 
Rinse clusters 
clinical  
9 After milking a cow with subclinical mastitis the cluster is rinsed 
with hot water before another cows is milked 
Rinse clusters 
subclinical  
10 Teat liners are replaced according to the manufacturer’s norm Replace teat cup 
liners 
11 A treatment protocol is set up together with a veterinarian and 
every month the therapies are evaluated together 
Treatment protocol 
12 All cows are dried of with an appropriate antibiotic Drying off 
13 After milking, cows are kept standing for at least 30 minutes Keep cows standing  
14 Add appropriate minerals to the feed of dry cows Dry cow minerals 
15 Decrease the number of cows to prevent overcrowding Prevent 
overcrowding 
16 Clean the stalls twice every day and make sure enough and clean 
bedding material is present 
Clean stalls 
17 Manually clean the yards twice every day Clean yards 
18 Optimize the feed according to farm specific needs Optimize feed 
 
Two kinds of inputs were used to determine the efficacy of different management measures. 
First, an extensive literature search was carried out. All peer-reviewed papers in scientific 
journals from 1996 to 2006, and papers describing field experiments from 1986 to 2006, were 
searched. Results as described in these papers had to be quantified as a percentage decrease in 
BTSCC or in incidence of CM related to one of the management measures. Selected papers 
were valued from 0 (not relevant) to 3 (very relevant), based on availability of data, country, 
materials and methods, and the potential to recalculate the data from the paper to a percentage 
decrease in BTSCC or incidence of CM. Because literature was incomplete, expert opinions 
were additionally included based on a questionnaire. To reach experts from different fields, 
three expert sessions were organized: one with dairy farmers, one with veterinarians, and one 
with experts from different milk and feed industries. The experts were asked to indicate a 
minimum, most likely and maximum effect for every management measure, specified for a 
100% environmental mastitis problem and a 100% contagious mastitis problem, and specified 
for three udder health situations. The different udder health situations were: 1) good (BTSCC 
< 150,000 cells/ml and CM incidence < 20 cases per 100 cows per year)), 2) average (BTSCC 
> 150,000 and < 300,000 cells/ml and CM incidence between 20-30 cases per 100 cows per 
year), and 3) bad (BTSCC > 300,000 cells/ml and CM > 30 cases per 100 cows per year). 
Efficacy is defined as the percentage decrease in BTSCC and the percentage decrease in 
incidence of CM. Efficacies were based on the situation in which the management measure is 
57
Nantes, 14-15 January 2010: Farm Animal Health Economics 
 
a new measure on the farm, it is not yet implemented. They were asked to indicate these 
effects for a default farm, defined as a farm under Dutch circumstances, with 65 milking cows 
and a milking parlor with 12 places. The results of the expert sessions and the literature search 
were combined to determine the efficacy of the management measures using Monte Carlo 
expert evaluation analysis. Analysis was carried out using @Risk (Palisade Corporation, 
Ithaca, NY). This resulted in a minimum, most likely, and maximum value of efficacy for all 
management measures in different farm situations. 
For all management measures in all situations, a large variance (min; max) was found, 
indicating the uncertainty and/or variation of the efficacies. The efficacies for the different 
situations are presented in Table 2. Further results on efficacies, costs and benefits of the 
different measures can be found in Huijps et al. (2009a, 2009b). 
The efficacies of the management measures were an important input of the calculations of the 
costs and benefits of those measures. It is therefore important to have accurate and reliable 
data. Efficacies were based on a combination of literature and expertise. On average, expert 
values were lower than literature values (when literature was available). This can be caused 
by the fact that the experts were cautious in their answers. (Huijps et al., 2009a, Huijps et al., 
2009b). 
Further research on efficacies of the different management measures is needed. 
 
Further research 
Objectives 
The first objective of the future research is to determine efficacies of the 18 management 
measures on BTSCC and CM with larger accuracy. The second objective is to analyze the use 
of expertise in estimating efficacies. 
 
Survey design 
Two groups of experts will be asked to estimate the efficacies of the 18 management 
measures as described in Huijps et al. (2009a) with the use of a new designed questionnaire. 
Efficacy is defined as the percentage decrease in BTSCC and the percentage decrease in 
incidence of CM. Efficacies are based on the situation in which the management measure is 
not yet implemented on the farm. In this new questionnaire the experts will be asked to 
indicate a minimum, most likely and maximum effect for every management measure, 
specified for a 100% environmental mastitis problem and a 100% contagious mastitis problem 
for a default farm. A default farm is defined as a farm with 65 milking cows, a milking parlor 
with 12 places, a BTSCC of 200,000 cells/mL and a clinical mastitis incidence of 25 cases per 
100 cows per year (thus, 20 cases for the default herd). No distinctions will be made in 
different udder health situations. The first group of experts (group A) will fill in the 
questionnaire with two management measures (drying off and post milking teat disinfection) 
given as reference measures. The efficacies of these two measures are well known from 
clinical trials from literature and the values will be given in the questionnaire. The experts can 
estimate the efficacies of the 16 remaining management measures by using the two given 
reference measures. Because two efficacies are given, not only the absolute values can be 
used, but also the ratio between the two reference measures. Finally, the experts will be asked 
how their own perspective of the reference measures matches the given values. The second 
group of experts (group B) will be asked to fill in the exact same questionnaire, but without 
the values of the two reference measures given. 
 
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59
Nantes, 14-15 January 2010: Farm Animal Health Economics 
 
Participants 
In total, two groups of experts (group A and group B) will participate in this survey and data 
of the group of experts (group C) as described in the previous research by Huijps et al. 
(2009a) will also be used for analysis. Group A exists of the same 15 experts (veterinarians, 
dairy farmers and experts from different milk and feed industries) as described by Huijps et 
al. (2009a). Group A will fill in the questionnaire with the given values of the two reference 
measures. The veterinarians and dairy farmers will estimate the efficacies of all the 
management measures. The experts from different milk and feed industries will estimate only 
the management measures related to their own field of expertise. Group B exists of 8 newly 
acquired experts (only veterinarians). Group B will fill in the whole questionnaire without the 
given values of the reference measures. The existing data of group C will be used for further 
analysis. 
 
Analysis 
The results of the three groups will be compared with reality based on a chosen control 
reference measure. This is an a priori chosen third management measure of which the efficacy 
is also known from literature. The value of the effect of this control reference measure will 
not be shown to the participants in the questionnaire. The differences between the estimated 
efficacy of the control reference measure and the true value of the control reference measure 
will also be compared to each other. Probably the most reliable method is the one which has 
the smallest difference between the estimated efficacy of the control reference measure and 
the true value of the control reference measure. Furthermore, the absolute values of the 
different efficacies found in the different groups will be compared to each other by using pair 
wise comparisons. The results of group A and group C will also be compared by analyzing the 
variation within persons. Further analysis will be performed when the new results are more 
equal to the control reference measure or big differences are found compared to group C. New 
efficacies will be determined by using Monte Carlo expert evaluation analysis, as described in 
Huijps et al. (2009a). The ratio’s between the different efficacies for the different 
management measures in different farm situations known from the research by Huijps et al. 
(2009b) can be used for transformation of the efficacies found in the present research to the 
different farm situations. 
 
Acknowledgement 
This study is part of the five-year mastitis program of the Dutch Udder Health Centre and was 
financially supported by the Dutch Dairy Board. 
 
References 
Barnouin J., S. Bord, S. Bazin, and H. Chassagne. 2005. Dairy management practices associated with incidence 
rate of clinical mastitis in low somatic cell count herds in France. J. Dairy Sci. 88(10): 3700 – 3709. 
Halasa, T., K. Huijps, O. Østerås, and H. Hogeveen. 2007. Economic effects of bovine mastitis and mastitis 
management: A review. Vet. Q. 29(1): 18 – 31. 
Huijps, K., H. Hogeveen, T. J. G. M. Lam, and A. G. J. M. Oude Lansink. 2009a. Costs and efficacy of 
management measures to improve udder health at Dutch dairy farms. J. Dairy Sci. In press. 
Huijps, K., H. Hogeveen, T. J. G. M. Lam, and A. G. J. M. Oude Lansink. 2009b. Farm level variation in costs 
and benefits of mastitis management measures. J. Dairy Sci. In preparation. 
Seabrook, M.F. 1984. The psychological interaction between the stockman and his animals and its influence on 
performance of pigs and dairy cows. Vet. Rec. 155(4): 84 – 87.  
60


Dairy management practices associated with incidence rate of clinical mastitis in low somatic cell count herds in France.

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

Oude Lansink. 2009a. Costs and efficacy of management measures to improve udder health at Dutch dairy farms. J. Dairy Sci.

Oude Lansink. 2009b. Farm level variation in costs and benefits of mastitis management measures. J. Dairy Sci. In preparation.

The psychological interaction between the stockman and his animals and its influence on performance of pigs and dairy cows.

Costs and efficacy of management measures to improve udder health at Dutch dairy farms: the use of expertise

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Costs and efficacy of management measures to improve udder health at Dutch dairy farms: the use of expertise

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