M-score and wound healing assessment of 2 nonantibiotic topical gel treatments of active digital dermatitis lesions in dairy cattle.

This open-label, randomized clinical trial with positive control compared the treatment of active digital dermatitis (DD) lesions (stages M1, M2, and M4.1) on dairy cattle hind feet with an enzyme alginogel or a copper and zinc chelate gel (coppergel). Upon recruitment (d 0), active DD lesions were cleaned, photographed, treated, and bandaged. This procedure was repeated on d 3 and d 7, with treatment and bandaging discontinued for those lesions that had transitioned to the M0, M3, or M4 stage on d 7. Day 10 was considered the end of the treatment trial, and all recruited feet were cleaned and photographed. Treatment effect of the 2 products was assessed not only using the M-score but also using general wound healing progress criteria. Improvement of M-score was defined as transition to M0, M3, or M4 stages, or to lesions with a smaller ulcerative area (e.g., M2 stage to M1 stage). Lesions with improved wound healing had at least one of the following criteria when compared with the previous observation: decreased defect size, healthier granulation tissue color (pink-red instead of purple-grayish), more regular aspect of granulation tissue surface, wound contraction, or epithelization starting from the surrounding skin. Both primary outcomes were assessed using a multivariable logistic regression analysis. Lesions treated with the enzyme alginogel had a decreased adjusted odds ratio for M-score improvement (aOR: 0.04; 95% confidence interval: 0.01-0.11). Lesions treated with the coppergel mostly transitioned to chronic lesions, whereas lesions treated with the enzyme alginogel mostly remained active lesions. The wound healing progress of almost 70% of the lesions treated with coppergel could not be scored, for the greater part due to the presence of crust materials. With these unscorable lesions classified as "improved," there was no treatment effect on wound healing progress (aOR: 0.99; 95% confidence interval: 0.34-3.05), whereas with unscorable lesions classified as "not improved," the enzyme alginogel outperformed the coppergel with regard to wound healing progress (aOR: 2.48; 95% confidence interval: 1.07-5.79). None of the products used in our study achieved high cure rates (transition to the M0 stage) for active DD lesions. Low cure rates of topical treatment of DD, together with the important role of chronic lesions in the epidemiology of DD, indicate that future research should investigate how to achieve successful wound management of DD lesions, thereby mitigating pain associated with the lesions and reducing both transmission and prevalence of DD within 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.

Interobserver agreement of digital dermatitis M-scores for photographs of the hind feet of standing dairy cattle.

Digital dermatitis (DD) is the leading infectious cause of lameness in dairy cattle, and it affects their welfare and productivity worldwide. At the herd level, DD is often assessed while cows are standing in a milking parlor, and lesions are most commonly evaluated using the M-score. The objective of this study was to examine the interobserver agreement for M-scores of the feet of standing cattle, based on digital color photographs of dairy cattle hind feet. A total of 88 photographs and written descriptors of the M-score were sent to 11 scorers working at 10 different institutions in 5 countries. The scorers received no formal training immediately before scoring the photographs; however, all regularly used the M-score to score DD. The answers for 36 photographs were excluded from the analysis because the photograph either had more than 1 M-stage as mode or not all scorers assigned an M-score to it. The M-scores of the 11 scorers from 52 photographs were available for analysis. Interobserver agreement was tested using Gwet's agreement coefficient (AC1) and the mode was assumed correct. Overall, moderate agreement emerged for the M-score (AC1 = 0.48). For the individual M-stages, almost perfect agreement existed for M0 (AC1 = 0.99), M1 (AC1 = 0.92), and M3 (AC1 = 0.82), and substantial agreement for M2 (AC1 = 0.61), M4 (AC1 = 0.65), and M4.1 (AC1 = 0.71). This outcome indicates the degree of individual variation in M-scoring in this context by unstandardized, experienced European observers, particularly for the M2, M4, and M4.1 stages. Standardized training is likely to improve the consistency of M-scoring and thus the generalizability of future DD research results on this important endemic disease.

Effects of reduced intramammary antimicrobial use during the dry period on udder health in Dutch dairy herds.

Dry cow therapy (DCT) in the Netherlands changed from mainly blanket to selective antimicrobial DCT. This transition was supported by a national guideline, with the individual somatic cell count (SCC) at the last milk recording before dry-off as the main selection criterion for antimicrobial DCT. The aim of this retrospective observational study is to evaluate the SCC dynamics during the dry period at the herd and individual dry period level following the national transition from mainly blanket to selective antimicrobial DCT. At the herd level, we used 2 data sets to evaluate the SCC dynamics during the dry period: (1) a national data set containing 3,493 herds with data available from 2011 through 2015 and (2) a veterinary practice data set containing 280 herds with data available from 2013 through 2015. The herd level analysis was carried out using key performance indicators provided via milk recording (CRV, Arnhem, the Netherlands): the percentage of cows that developed a new intramammary infection (IMI) during the dry period and the percentage of cows cured of an IMI during the dry period. The effect of DCT at individual dry period level was analyzed with a mixed-effects logistic regression model based on 4,404 dry periods from 2,638 cows in 20 herds within the veterinary practice data set. For these 20 herds, individual SCC data from milk recordings and individual cow DCT were available from 2013 through 2015. No significant changes were observed to the SCC dynamics during the dry period at the herd level. The percentage of cows that developed a new IMI during the dry period ranged between 16 and 18%, and the percentage of cows cured from an IMI during the dry period ranged between 74 and 76%. At the individual dry period level, a low SCC at the first milk recording following a dry period was associated with the use of intramammary antimicrobial DCT with or without the concurrent use of an intramammary teat sealer [odds ratio (OR) = 2.16 and OR = 2.07, respectively], the use of DCT with an intramammary teat sealer only (OR = 1.35), and a low SCC at the last milk recording before dry-off (OR = 1.78). This study demonstrates that the selection of cows for DCT without antimicrobials based on SCC thresholds at the last milk recording is possible without significant changes to udder health and reduced the use of antimicrobials.