“Good Health Records”The Foundation of Consistent,

Effective Dairy Health Management

www.goodhealthrecords.com

John R. Wenz DVM, MS

Despite all our Knowledge% Cows with Disease is Rising

USDA, 2008 #N481.0308

Dairy Health Management

You know what to do…You don’t always know how well it’s getting done

“Good” Health Records are the Foundation of Consistent, Effective Dairy Health Management

www.dairymoos.com

Good Health Records Programin WA and ID

• Survey Dairy Producers (243)• Develop Software to Evaluate Outcomes• Demonstration Herd Project (43 herds)

Dr. Sarah Giebel– Impact of Standardized Health Records

• Time for recordkeeping• Importance of Feedback• Value

Dairy Health Record Quality is Poor

• Lack Accuracy and Consistency needed for efficient summary and analysis

Kelton et al., 1998; LeBlanc et al., 2006; Appuhamy et al., 2007; Wenz and Giebel, 2012

• “…many health record entries are focused on treatment, rather than diagnosis...”

Nordlund and Cook, 2004

WA and ID Survey of Health RecordsWenz et al., 2012 J.Dairy Sci. 95 Suppl.2:260

• Only 17% dissatisfied with quality and utility of their computer health records.

Perception of Health Record Quality is Based on Intended Use

• producers generally utilize individual animal data, whereas practitioners … are more concerned with herd summary information” (Etherington et al., 1995)

• Health Records are USER – DEFINED Why?• Variable Disease Definitions

User-defined Records InconsistencyBetween and Within Dairies

MetritisMETR

METRITSHOSP

ILLTEMPDIRTY

TREATEDFLUSHEDINFUSED

PEN

User-defined events used torecord metritis on 50 dairiesusing Dairy Comp 305®

Wenz and Giebel, 2012

How was health data recording decided?• 52% “Made it up as we went along”

Wenz et al., 2012 J.Dairy Sci. 95 Suppl.2:260

The PMO Provides a Standard for Complete Treatment Records

• Identity of animal(s) treated• Date(s) of treatment• Drug(s) administered• Dosage administered• Milk discard time; and• Withdrawal time prior to slaughter• Disease being treated (Not in PMO)*• Who administered treatments (Not in PMO)

*But, Ailment treated is determined when a residue violation is investigated

Meeting FDA Treatment RecordsRequirements

• Can be a combination of Electronic and Written (Confirm in your area)

• Example:– Computer:

• ID, Date, Disease, Drug, Withhold times and dates

– Paper/Written:• Treatment protocol book: Disease, Drug, Route, Dose• Daily Hospital List: ID, Date, Disease, Drug, WHO treated

10

3+4

FDA Warning Letter June 2010

• “Our Investigation also found that you hold animals under conditions that are so inadequate that medicated animals…are likely to enter the food supply. For example, you failed to maintain complete treatment records.”

11

FDA Turning up the Heat on Residues in MilkResults due any day now

USDA Turning up the Heat on Residues in MeatAugust 2012

New Multi-Residue Method (MRM) Testing is More Sensitive, More Drugs

DRUG (Partial List) Bovine Kidneyug/g

Old Test ug/g

Ampicillin (Polyflex) 0.02 0.05

Beta-dexamethasone 0.05 -

DCCD (Excenel/Excede) 0.2 -

Enrofloxacin (Baytril) 0.025 -

Florfenicol (Nuflor/Resflor) 0.1 -

Flunixin (Banamine) 0.0125 -

Lincomycin (LS-50) 0.05 1.5

Oxytetracycline 0.5 0.4

Penicillin G 0.1 0.05

Sulfadimethoxine (DI-METHOX) 0.05 -

One of 17 drugs other than intramammary, used to treat mastitis on 102 dairies

No Tolerance for any residue in lactating dairy cattle

ILLEGAL use (not labeled for mastitis, extra-label use not allowed)

“Creative” drug use is fostered by misconceptions of the uninformed

Need to Change the Focus of Dairy Health Management

Perception at the Cow LevelWhat Drug?

When can milk or the cow be shipped?

Evidence at the Herd LevelOutcomes of Health Management

Good Health Records

You need Health Records more like Repro Records

Repro Records• System defined

– Standard data entry– Consistent remarks

• Outcomes evaluation– Conception rate– Pregnancy rate

• Accurate and Consistent

Health Records• User-defined

– Whatever you want– However you want

• Count keeper– # of Events

• Variable accuracy and consistency

StandardizedFast and Easy Evaluation of Outcomes

To be “Good”, Health Records Should Support:

• Individual cow management decisions

• Residue avoidance/Regulatory compliance

• Outcomes-based health management decisions

3 Simple Rules for Good Health Records*

1. Record ALL Disease Episodes– Regardless of severity or therapy– Each Quarter or Foot as separate episode

2. Use a SINGLE, SPECIFIC Event for Each Disease– Record Diseases not Treatments– Differentiate Clinical from Subclinical/Screening

3. Record CONSISTENT Event Remarks – Same INFO (Treatment, Quarter, Severity)in the – Same ORDER using the – Same ABBREVIATIONS

*http://extension.wsu.edu/gdhr/information/how/pages/default.aspx

Good Records are achieved through Standard Protocol Implementation*Protocols must Balance 3 Key Functions of Health Records

*Until dairy management software companies make disease entry the same as entry of breedings (standardized)

NT – No treatment intend to keepBF – No treatment will be sold

Keeping Good Health Records Doesn’t Take Longer

Time Budget AnalysisTime to Capture and Enter Data

Before and After Standard Protocol Implementation…

Giebel et al., 2012 JDS 95 Suppl. 2:9

Capture Entry

Increase 4.5% (1/22) 22.2% (4/18)

Decrease or No Change 95.5% (21/22) 77.8% (14/18)

Veterinarians Need to be More Involved in Health (Records) Management

• WA and ID Health Records Survey Respondents– 80% - Vet Valuable Resource for Health Records– 30% - Vet helps decide how to record health data– 35% - Vet evaluates health record summaries

http://extension.wsu.edu/gdhr/tools/Pages/VetGuide.aspx

www.goodhealthrecords.com

HEALTHSUM Dairy Health DatabaseA tool available through veterinarians to

Evaluate the Outcomes ofYOUR Management, YOUR Cows on YOUR Dairy

• Is Your Prevention Program Effective?– Disease incidence Monitoring and Alerts

• By risk group (Pen, Lactation…)

• Is Your Treatment Program Effective?– Retreatment– Recurrence– Removal

Prevention Efficacy Example: Clinical Mastitis Incidence

• New vs. Recurrent*, ALL Clinical Mastitis (% Milking Herd)

*Cow had mastitis episode 15-60 days prior

*

Pen Level Incidence Example: A Story of Two Identical Open Lot Pens

Pen 56 (Avg.) – 120 cows, Lact – 2.9, DIM – 191, CM* – 10%Pen 58 (Avg.) – 123 cows, Lact – 2.8, DIM – 200, CM* – 5.2%

* CM – Clinical Mastitis

Treatment Efficacy Example: OUTCOMES of Clinical Mastitis Episodes that Occur in a Month

• Evaluated by Risk Groups– Lactation group– Initial treatment– Culture Result

• Retreatments

24 WA+ID herds Median (5.8%)

Treatment Efficacy ExampleOUTCOMES of Clinical Mastitis (CM) Episodes that Occur in a Month

RECURRENCE – CM Same Quarter 15-60 days later

24 herd Median (7.4%)

REMOVAL – Sold or Died within 14 days of CM

24 herd Median (12%)

LOST QUARTER – Dried or Killed quarter

17 herd Median (1.8%)

Clinical Mastitis Treatment Efficacy

• Recurrence by Culture Result Example

No GrowthColiforms Coag. Neg. Staph. Env. Strep.

Take Homes

• Need Dairy Health Management more like Repro Management– Change from Perception at the cow-level to

Evidence (Outcomes) at the herd-level• “Good” Health Records Support:

– Individual cow management decisions– Residue avoidance/Regulatory compliance– Outcomes-based health management decisions

Take Homes

• Don’t need standard disease definitions to Standardize Health Records

• Each dairy needs Standard Data Recording Protocols – Guided by the 3 Simple Rules of Good Records

• Resources at www.goodhealthrecords.com

Questions?

• Acknowledgements– USDA NIFA for Funding– WA and ID Dairies and Veterinarians– Dr. Sarah Giebel and Sandy Poisson– Drs. Dale Moore, Chris Schneider, David Galligan,

Ray Jussuame

www.goodhealthrecords.com