Quantifying and mapping digital dermatitis-associated bacteria in lesion and nonlesion body sites and dairy farm environment.

The source of infection of digital dermatitis (DD), an infectious lameness condition, is still uncertain. In this cross-sectional study, we aimed to identify potential reservoirs of DD bacteria in dairy cattle body sites with different stages of the disease and farm environments. We collected skin swabs from 85 dairy cows from 5 herds, 3 with and 2 without DD, from foot, hock, and udder cleft skin (with lesions or not), saliva, urine, and feces. We also obtained environmental samples. Real-time quantitative PCR targeted Treponema phagedenis, Treponema medium, Treponema pedis, Porphyromonas levii, Bacteroides pyogenes, Fusobacterium necrophorum, and Fusobacterium mortiferum. Digital dermatitis-associated Treponema spp. were exclusively detected in DD-affected herds in DD-foot and other skin lesions, healthy skin, saliva, and environmental samples. In contrast, the non-Treponema spp. were found in samples from both DD-negative and affected herds. As expected, DD lesions had higher bacterial loads than healthy skin. Interestingly, similar counts were observed in udder cleft lesions, indicating a potential opportunistic behavior on compromised skin. None of the targeted species were detected in fecal samples, but P. levii, B. pyogenes, and F. necrophorum were detected in urine. All 7 species were detected in saliva, although in low quantities. No associations were observed between the presence of each bacterial species in DD lesions and urine; however, there was an association between the presence of DD-Treponema spp. in lesions and saliva, hock, and udder skin. Feces and urine do not seem to be a DD bacteria primary source, but saliva and other skin lesions may play a role. Longitudinal studies would improve our understanding of DD-associated bacteria's transient or persistent presence in these sites. Investigating the sources of DD-associated bacteria will guide future interventions to minimize bacterial shedding and transmission, ultimately more effectively reducing bacterial load, transmission, and sources of infection in dairy herds.

An observational study on the management of digital dermatitis through a repeated risk assessment on 19 Dutch dairy herds.

The etiopathogenesis of bovine digital dermatitis (DD) is not well understood, but its risk factors on dairy farms have been studied extensively. The objective of this study was to identify associations between a DD risk score [determined by a DD risk assessment questionnaire (RAQ)] and DD prevalence (determined by an in-parlor M-score). We also investigated whether feedback for farmers on their DD management using the DD RAQ resulted in changes that decreased DD prevalence in their herds. The DD RAQ consisted of multiple-choice questions related to foot health, housing, and general management that were used to create a total risk score (TRS). In 2016 and 2018, the DD RAQ-together with a DD prevalence determination in the lactating herd-was used on 19 Dutch dairy farms from 1 veterinary practice. After each visit, farmers and their consulting veterinarians received a 1-page summary that identified herd-specific strengths and weaknesses in DD management. In 2018, the summary included suggestions for improvement. In 2019, farmers and veterinarians were contacted to ask whether the use of the DD RAQ and the 1-page summary had led them to implement changes in their DD management in 2016 and 2018. We tested the association between TRS and DD prevalence using linear mixed model analysis. The TRS ranged from 13 to 65% and 20 to 68% in 2016 and 2018, respectively. Herd DD prevalence ranged from 15 to 59% and 27 to 69% in 2016 and 2018, respectively. For both years, the DD RAQ identified that DIM, herd size, and breed were often present in a manner associated with increased risk for DD. The linear mixed model analysis identified that each 10-point increase in TRS was associated with an increase in herd DD prevalence of less than 1%. The association between TRS and herd DD prevalence was caused mainly by risk factors related to housing. We found no important relationship between change in TRS and change in DD prevalence between the 2 visits. Only a few farmers indicated some form of change in their DD management following a visit. Veterinarians in general said that they discussed the 1-page summaries and DD control with farmers during a routine visit, but the majority admitted a lack of follow-up. We propose that the DD RAQ could be used as a tool to start a discussion on DD control on farm, but simply undertaking a DD RAQ and providing a 1-page summary of the results was insufficient to initiate behavioral change that led to a decrease in DD prevalence.

Effect of footbath protocols for prevention and treatment of digital dermatitis in dairy cattle: A systematic review and network meta-analysis.

Digital dermatitis (DD) is an infectious bacterial disease affecting cattle feet. Footbaths are a common herd-level control method for DD; however, variations in product, concentration, and frequency of use complicate comparisons between protocols. The objective of this systematic review was to evaluate all walk-through footbath protocols reported that determined efficacy for prevention and treatment of DD lesions in dairy cattle. An extensive literature search was conducted, including electronic databases and gray literature updated until March 2018. Studies identified included all liquid walk-through footbath protocols that were compared to other footbath protocols or no footbath. Only studies with treatment or prevention of DD lesions as an outcome were included. Literature search and subsequent screening identified 14 publications with 24 treatment comparisons and 24 prevention comparisons. Studies included mostly had low and/or unclear risks of bias. Descriptive analyses were performed according to prevention and treatment outcomes, with case and success definitions summarized as odds ratios (OR). A subsequent network meta-analysis was conducted of 11 studies, comparing 17 protocol comparisons for the prevention outcome and 10 studies comparing 19 protocol comparisons for the treatment outcome, using semi-informative priors in a Bayesian statistical framework. Results of a random effects Bayesian network meta-analysis indicated only 5% copper sulfate used at least 4 times/wk was superior to both no footbath (OR: 5.26; 95% CrI: 1.27-28.8) and a water placebo (OR: 9.47; 95% CrI: 1.03-85.8) in treatment of DD. No other protocol was associated with a reduction in DD, and there were no differences in pair-wise comparisons between any active treatments. Unfortunately, for both outcomes (treatment and prevention), small sample sizes (adjusted for clustering) limited the power to detect substantial differences between protocol effects. Thus, despite widespread use of footbaths, limited strength of evidence for use remains and standardized protocols with large sample sizes are needed to further investigate effectiveness of footbath protocols for control of DD. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Comparison of effects of routine topical treatments in the milking parlor on digital dermatitis lesions.

Digital dermatitis (DD), an infectious bacterial disease affecting the feet of dairy cattle, can cause lameness and decrease milk production, fertility, and animal welfare. Current DD treatment typically involves routine hoof trimming and topical antibiotics. Several nonantibiotic commercial topical products are used for controlling DD lesions; however, there is limited or no evidence regarding their effectiveness. The objectives of this study were to evaluate 2 commercially available topical applications on their ability to (1) clinically cure active DD lesions to nonactive lesions and (2) prevent recurrence of active DD lesions. Ten farms were visited weekly. In the milking parlor, the hind feet of lactating cattle were cleaned and scored (M-stage scoring system). Cattle with DD lesions at the first visit were randomly allocated to 1 of 4 treatment groups: positive control (tetracycline solution), HealMax (AgroChem Inc., Saratoga Springs, NY), HoofSol (Diamond Hoof Care Ltd., Intracare BV, Veghel, the Netherlands), and a negative control (saline). All products were applied to lesions using a spray bottle. Tetracycline, HealMax, and HoofSol had a higher probability of clinical cure for active lesions compared with saline 1 wk after the first treatment (wk 1), with 69, 52, and 79% clinical cure of active lesions, respectively, compared with 34% with saline. At wk 7, the probability of clinical cure for active lesions was 10, 33, 31, and 45% of lesions treated weekly with saline, tetracycline, HealMax, and HoofSol, respectively (no difference among treatments). The substantial clinical cure with saline highlighted the potential importance of cleaning feet. In wk 1, treatment with saline, tetracycline, HealMax, and HoofSol resulted in a probability of recurrence of active DD lesions of 9, 11, 11, and 8%, respectively, with no product being superior to saline. After 7 wk, the probability of recurrence of active lesions was 5, 7, 6, and 6% for saline, tetracycline, HealMax, and HoofSol respectively, with no difference among groups in wk 7. These results provide alternatives to antibiotics for treatment of DD lesions and highlight the potential importance of cleaning feet in the milking parlor.

Missing pieces of the puzzle to effectively control digital dermatitis.

Since the first report of bovine digital dermatitis (DD) in 1974, there is a large body of the literature published; however, effective prevention and control of the disease remain elusive. Although many aspects of the pathogenesis of DD have been investigated, even some of the most basic questions such as the aetiology of this disease remain under debate. Treponema spp. have been strongly associated with DD lesions and occur in abundance in advanced lesions; however, efforts to induce disease with pure cultures of these organisms have been largely underwhelming and inconsistent. Furthermore, although the disease has been presented for several decades, there is limited scientific evidence regarding effective treatment of DD. Apparent discrepancies between effectiveness in vitro and in vivo have challenged the scientific community to identify new potential treatment options. With no treatment resulting in a 100% cure rate, the current expectation is manageable control, but prospects for the eradication of the disease are unlikely using current approaches. In order to develop more effective approaches to control DD on-farm, there is a critical need for a deeper understanding regarding the causation, ecology, transmission and treatment of this disease. In this article, we attempt to provide insights into specific research needs related to DD in order to assist the industry, researchers, pharmaceutical companies and research sponsors with decision-making and identified research gaps.

Prevalence of digital dermatitis in young stock in Alberta, Canada, using pen walks.

Digital dermatitis (DD), an infectious bacterial foot lesion prevalent in dairy cattle worldwide, reduces both animal welfare and production. This disease was recently identified in replacement dairy heifers, with implications including increased risk of DD and decreased milk production in first lactation, poor reproductive performance, and altered hoof conformation. Therefore, a simple and effective method is needed to identify DD in young stock and to determine risk factors for DD in this group so that effective control strategies can be implemented. The objectives of this study were to (1) determine prevalence of DD in young stock (based on pen walks); and (2) identify potential risk factors for DD in young stock. A cross-sectional study was conducted on 28 dairy farms in Alberta, Canada; pen walks were used to identify DD (present/absent) on the hind feet of group-housed, young dairy stock. A subset of 583 young stock on 5 farms were selected for chute inspection of feet to determine the accuracy of pen walks for DD detection. Pen walks as a means of identifying DD lesions on the hind feet in young stock had sensitivity and specificity at the animal level of 65 and 98%, with positive and negative predictive values of 94 and 83%, respectively, at a prevalence of 37%. At the foot level, pen walks had sensitivity and specificity of 62 and 98%, respectively, with positive and negative predictive values of 92 and 88%, respectively, at a prevalence of 26%. Pen walks identified DD in 79 [2.9%; 95% confidence interval (95% CI): 2.3-3.6%] of 2,815 young stock on 11 (39%; 95% CI: 22-59%) of 28 farms, with all 79 DD-positive young stock ≥309 d of age. Apparent within-herd prevalence estimates ranged from 0 to 9.3%, with a mean of 1.4%. True within-herd prevalence of DD in young stock, calculated using the sensitivity and specificity of the pen walks, ranged from 0 to 12.6%, with a mean of 1.4%. On the 11 DD-positive farms, the proportion of young stock >12 mo of age with DD lesions was 9.9% (95% CI: 7.8-12.0%). Multilevel logistic regression was used to assess associations with potential risk factors for DD lesions, including age, leg cleanliness, and lactating herd DD prevalence. Presence of DD in young stock increased as their age increased and was associated with increased prevalence of DD in the lactating herd. Pen walks can be used to identify specific young stock with DD or groups where management practices can be implemented to prevent disease proliferation and transmission.

Comparison of the efficacy of a commercial footbath product with copper sulfate for the control of digital dermatitis.

Digital dermatitis (DD) is the most prevalent foot lesion affecting dairy herds worldwide. Its implications include production losses and decreased animal welfare. Footbathing is the most common herd-level prevention strategy for DD. Because many common footbath products have negative environmental and health consequences, replacement products expected to have improved safety but equal efficacy are being developed. Therefore, the aim of this study was to evaluate the efficacy of a new quaternary ammonium-based commercial footbath product (QAC) for reducing the prevalence of active DD lesions compared with an industry standard (copper sulfate; CuSO4) and typical on-farm footbath practices. A controlled intervention trial was conducted on 19 Alberta dairy farms over 12 wk, with 9 farms allocated to the QAC group (1% QAC daily, 5 d/wk), 5 to the CuSO4 group (5% CuSO4 daily, 5 d/wk), and 5 to a noninterference group (maintained typical footbath practices). A total of 22,285 observations on 3,465 lactating cows were assessed for DD lesions and leg cleanliness in the milking parlor. Five farms discontinued use of the QAC product for various reasons. Noninferiority analysis was used to assess QAC ability to decrease the proportion of cows with 1 or more active DD lesions compared with CuSO4 after 6 wk. Multilevel logistic regression models for repeated measures were used to evaluate efficacy of QAC compared with CuSO4 and noninterference farms in reducing the prevalence of active DD lesions at the foot level over 12 wk. The noninferiority analysis determined that the proportion of cows with 1 or more active DD lesion decreased 2.19 (95% CI: 1.39-3.46) times less after 6 wk of study on the QAC farms compared with CuSO4 farms, making QAC inferior to CuSO4. The multilevel logistic regression models determined that the proportion of active DD lesions increased in the QAC herds, whereas this proportion decreased in the CuSO4 and noninterference herds over 12 wk. Additionally, cows in mid- and late-lactation had a higher odds of having active DD compared with fresh cows. Older cows (parity 3 and ≥4) had a decreased odds of active DD compared with first-parity cows. At the farm level, a higher baseline active DD prevalence resulted in increased odds of active DD; however, this did not modify the effect of treatment or week of study. We concluded that QAC was inferior to CuSO4 and typical on-farm footbath practices, and further development of novel footbath products is required to develop an ideal alternative.

Effectiveness of a standardized footbath protocol for prevention of digital dermatitis.

A footbath is the most common herd-level approach to control digital dermatitis (DD) in intensive dairy farming. However, wide variation in footbath design and protocols suggests a gap between evidence-based management practices and on-farm implementation. The objective was to evaluate effectiveness of a standardized footbath protocol in decreasing prevalence of active DD lesions in lactating dairy cattle. The protocol was based on current scientific literature, including footbath design and management. The M-stage classification system was used to score DD lesions. Scores were also combined into a simplified scoring system: no lesions (M0), active lesions (M1, M2, and M4.1), and chronic lesions (M3 and M4). A controlled intervention trial was conducted on 9 farms over 22 wk. Each farm served as its own control with data collected for 10 wk before and 12 wk after intervention. A total of 1,978 lactating cattle were assessed biweekly for DD lesions and leg cleanliness in the milking parlor. Lactating cattle were also inspected in the trimming chute at 3 time points: start, intervention, and end of trial. Intervention consisted of implementing an automated footbath that measured 3 m long, 0.50 m wide, held a fluid depth of 0.15 m, along with a weekly footbath protocol using 5% CuSO4 for 4 consecutive milkings, with footbath content replaced at a maximum of 200 cow passes. Multilevel logistic regression models for repeated measures were used to evaluate effects of the standardized footbath protocol in preventing active DD lesions. For the purpose of analysis, farms' within-herd prevalence of active DD lesions (at baseline) was assessed and categorized as low (<15%) or high (≥15%). Farms with low or high within-herd prevalence of active DD lesions at trial outset had a mean cow-level prevalence of active DD lesions of 8% (range, 2 to 13) and 31% (range, 18 to 43), respectively. At milking parlor inspections, apparent prevalence of active DD lesions decreased from the time of footbath intervention, but this effect interacted with the farms' baseline prevalence of active DD lesions. In that regard, on farms with high prevalence of active DD at baseline, apparent prevalence of active DD lesions decreased after intervention, whereas on farms with low prevalence of active DD at baseline, apparent prevalence of active DD lesions did not change. At the cow level, poor leg cleanliness was associated with higher prevalence of active DD lesions. At trimming chute inspections, prevalence of active DD lesions decreased from start to the end of the trial (22 and 14%, respectively); concurrently, prevalence of feet with no DD lesions (M0) increased (39 and 48%). We concluded that on farms with high DD prevalence, implementation of proper footbath design and improvement of footbathing management will decrease prevalence of active DD lesions and increase prevalence of feet without DD lesions. In addition, improving cow cleanliness will further result in control of active DD lesions.

Validation of the M-stage scoring system for digital dermatitis on dairy cows in the milking parlor.

A high prevalence of digital dermatitis (DD) and the benefits of early topical treatment highlight the need for simple tools for routine DD detection. The objective of this study was to determine the accuracy of scoring DD lesions using the 5 M-stage scoring system in the milking parlor compared with the trimming chute as the gold standard. Three observers inspected 3,585 cows and 6,991 hind feet from 9 farms in the milking parlor using a mirror (glued to a plastic kitchen spatula) and a headlamp, followed by inspection in a trimming chute within 5 d. Interobserver agreement for scoring DD in various settings was ≥82% (kappa >0.74; weighted kappa >0.76). At trimming chute inspections, 68% of cows had at least 1 DD lesion, 19% had 1 hind leg affected, and 49% had both hind legs affected. Within-herd DD prevalence ranged from 16 to 81% of cows affected. True within-herd prevalence was 2, 6, 0, 36, and 14% for M1, M2, M3, M4, and M4.1 lesions, respectively. At the foot level, DD prevalence was the same (58%) in the milking parlor and trimming chute inspection, but distribution of M-stages differed. Milking parlor inspection as a means of identifying the presence of DD lesions had a sensitivity of 92% and specificity of 88%, with positive and negative predictive values of 91 and 89%, respectively. Agreement between milking parlor and trimming chute inspections was 73% (kappa = 0.59, weighted kappa = 0.65) for the 5 M-stage scoring system and 90% (kappa = 0.80) if only the presence of a lesion was noted. Test characteristics varied greatly among M-stages, with the highest sensitivity for detecting M4 (82%) and M2 (62%) lesions, and the lowest for detecting M4.1 (20%), M1 (7%), and M3 (0%) lesions. In the milking parlor, 20% of M2 lesions were misclassified as M4.1, 8% of M4 lesions were misclassified as M0, and 68% of M4.1 lesions were misclassified as M4. The majority (87%) of DD lesions were located between the heel bulbs; 10 and 2% of DD lesions affected the interdigital space and the front of the foot, respectively. The sensitivity to detect the presence of a lesion when it occurred between the heel bulbs was 93%, but <67% if it occurred elsewhere on the foot. We concluded that inspection of the rear feet in the milking parlor was an inexpensive and simple method of detecting and scoring DD lesions. If the objective is to determine herd-level DD prevalence and routine monitoring, this method was adequately reliable. However, if the objective is to follow up DD in cows with history of interdigital hyperplasia or to detect M1 or M4.1 lesions, this method was not sufficiently reliable. Although DD scoring in the milking parlor as a routine practice should facilitate early detection, prompt treatment interventions, and herd monitoring, it was not sufficiently reliable to replace definitive identification of M-stages in the trimming chute.