Keen eye, sharp nose: Use your senses to head off metritis losses

By Todd Birkle, D.V.M.

Metritis is a costly disease that can’t be completely prevented. However, through aggressive fresh cow monitoring, we can reduce its impact on farm profits.

Todd Birkle, D.V.M., a fresh cow and reproduction manager for Pfizer Animal Health, based in Huntington, Ind.

Metritis is a common reproductive disease facing post-fresh cows on all dairies. Typically seen during the first 10 days in milk, metritis is a uterine infection accompanied by inflammation involving multiple layers of the uterus. Symptoms may include the presence of a foul smelling, watery vaginal discharge. Fever also may or may not be noticed, with temperatures of 103˚F or higher. Other signs of disease may be less obvious. Herd incidence rates are between 10% and 30%.

Losses from metritis include a decline in fertility, loss of milk production, increased labor costs, and a greater risk of culling. A case of metritis is estimated to cost producers between $304 and $354 from losses in production and performance, according to research from Dr. Mike Overton, University of Georgia. Those costs are highly dependent on milk prices and replacement costs.

Risk factors

The disease is commonly associated with calving challenges. According to Dr. Carlos Risco, from the University of Florida, there are several risk factors:

• Retained placenta – Failure to expel the fetal membranes within 12 to 24 hours after calving creates a likelihood of developing metritis 6 times more than a normal birth.

• Dystocia – A difficult calving increases the likelihood of metritis by 2.1 times more than a normal calving.

• Stillbirth – A stillborn calf raises the likelihood that the dam will develop metritis by 1.5 times.

• Twin birth – Compared to a cow that gives birth to a single calf, a cow that produces twins is 3.4 times more likely to experience a retained placenta and 10.5 times more likely to have dystocia – creating an indirect link to metritis.

Avoid metritis

Even a case of metritis identified and treated early is going to be costly, so the true goal of any transition program is to minimize the chance an animal will develop metritis in the first place. This is accomplished by keeping focus on these key transition critical control points:

1) Avoid too much cow movement.

2) Reduce overcrowding.

3) Avoid mixing first lactation heifers with adult cows.

4) Never let them run out of quality feed.

Properly trained and monitored maternity personnel are a must for any farm to ensure they minimize the incidence of overly traumatic dystocias.

Detect and treat

Our approach with challenges such as metritis is to aggressively monitor fresh cows and look for warning signs of disease. The goal is to recognize and treat the disease early to minimize its performance impact. I recommend a protocol which relies on three separate screenings:

1) Check the udder in the parlor before being milked to see if it is full and tight or if the cow is showing signs of decreased milk production. Mark any suspect cows with a paint stick or chalk on the back of the lower leg for examination following milking.

2) Walk the front of the cows when they are in lock-ups after milking to visually examine their mood, appearance and appetite. Specifically, look for signs of dehydration, eye or nasal discharge, droopy ears, or “sad cows” that just don’t seem right. Throw feed on the suspect cows when noted for easy identification and examination once you enter the pen.

3) Palpate the cervix and vagina of all fresh cows for specific signs of metritis, including a uterine discharge with a strong odor on day 4 after calving and again on day 7. Pay close attention to cows showing symptoms of disease.

All cows marked in the parlor or identified as being “off” from the front should get a “mini-exam” once the technician enters the pen. A mini-exam would consist, at the minimum, of the following:

1) Temperature.

2) Check for displaced abomasum.

3) Rectally palpate to assess manure and uterine discharge.

Treatment recommendations

If a cow shows definitive signs of metritis, our recommendation is that she stays in the fresh pen and be treated 5 days with ceftiofur, plus supportive treatment if warranted. If she has a concurrent disease that requires the use of a pharmaceutical with milk withhold, such as mastitis, then she will need to be moved to the hospital pen. Milking females with uncomplicated metritis should not be exposed to hospital cows. For cows that show symptoms of dehydration, mastitis or other disease, supportive care and treatment decisions should be made with the input of the herd veterinarian.

It is important to follow the label recommendations for the treatment chosen. While cows are being treated, they should be checked daily for signs of improvement. Even if metritis clears up before five days of treatment is completed, it is recommended to finish the regiment. After treatment, all cows should be reexamined.

I tell producers to trust their nose on the odor and their general assessment of the animal. If there are still signs of disease, continue treatment for three more days.


Todd Birkle, D.V.M., a fresh cow and reproduction manager for Pfizer Animal Health, based in Huntington, Ind. E-mail: