The effect of an acidified, ionized copper sulphate solution on digital dermatitis in dairy cows

Digital dermatitis (DD) is the most important infectious claw disorder in dairy cattle and herd-based foot bathing with antibacterials, such as 4% formalin, is often used to prevent it. However, there is a lack of long-term studies of the effectiveness of such regimes and in this study the preventive and curative effect of 4% formalin was compared with that of an acidified, ionized copper sulphate solution over a 4-month period on a commercial 120-cow dairy farm. The cows were walked through a split-leg footbath where left claws were treated with an acidified copper solution twice daily for 5days/week, while right claws were treated with 4% formalin twice daily for 1day/every second week. Hind claws were scored for the presence and severity of DD in a trimming chute at the start of the study and every 4weeks throughout the study period. At the start of the study 21/110 cows had ulcerative DD lesions with 10 on the left hind foot, 8 on the right and 3 on both. These lesions, as well as any new lesions which arose during the study, were treated with chlortetracycline spray. During the study 440 observations were made and seven new DD lesions were recorded on left feet (copper treated) and 20 on right feet (formalin treated). Based on survival analysis, the risk of developing a new ulcerative DD lesion on copper-treated (left hind) feet was almost three times less (RR=0.37, 95% CI 0.16-0.91) than formalin-treated (right hind) feet. Cure rates of DD lesions were not different between copper and formalin.     

A study of duration of digital dermatitis lesions after treatment in a Danish dairy herd

Digital dermatitis (DD) is a contagious disease of cattle affecting the skin adjacent to the claws. Disease dynamics of DD have been described to some extend, but we still need to quantify the duration of lesions and look into non-treatment factors affecting this. The aim of this study was to estimate the duration of lesions due to DD and to evaluate parity and lactation stage as potential risk factors for longer duration of such lesions. An estimate of the duration of lesions will be a valuable parameter in the evaluation of the economic impact of the disease and will additionally allow estimates of incidence based on prevalence figures. From May 2007 until November 2008, lesions associated with DD in the hind legs of 151 Danish Holstein cows at the Danish Cattle Research Centre were clinically scored on fifteen occasions. The mean interval between recordings was 39 days. Onset and end of each new case were estimated as midway between recordings prior to a change in the presence or absence of a lesion. Kaplan-Meier survival functions and Cox proportional hazard regression were performed to estimate the duration and analyse differences in the duration of lesions between primi- and multiparous cows and between different stages in lactation at onset of the lesion. The median duration of lesions were estimated to be 42 days, less than most previous published estimates. The relatively aggressive regime of topical treatment in the study herd might have shortened the duration of the lesions. Furthermore the comparatively long interval between recordings introduced an element of uncertainty in this estimate. No significant effects of parity or days in milk at lesion onset on the duration of DD were found using these data though lesions developed earlier in the lactation may have a longer duration. Further data would be needed to confirm the latter.     

Lameness and claw lesions of the Norwegian red dairy cattle housed in free stalls in relation to environment, parity and stage of lactation

Approximately 88% of Norwegian dairy cattle are housed in tie stalls. Free stall housing for all dairy cattle will be implemented within 20 years. This means that the majority of existing stalls will be rebuilt in the near future. Fifty-seven free stall herds of the Norwegian Red breed were randomly selected and 1547 cows and 403 heifers were trimmed by 13 claw trimmers during the late winter and spring of 2002. The claw trimmers had been taught diagnosing and recording of claw lesions. Environment, management- and feeding routines were also recorded. Fifty-three herds had concrete slatted alleys while 4 had solid concrete. Thirty-five herds had concrete as a stall base, while 17 had rubber mats, 2 had wood and 3 had deep litter straw beds. The prevalence of lameness was 1.6% in hind claws. Models for lameness and claw lesions were designed to estimate the influence of different risk factors and to account for the cluster effects within herd and claw trimmer. Detected risk factors for lameness were: parity three and above and narrow cubicles; for heel horn erosions: lactation stage around 5-7 months after calving and solid concrete alleys; for haemorrhages of the white line: lactation stage around 3-5 months after calving and solid concrete alleys; for haemorrhages of the sole: parity one, lactation stage around 5-7 months after calving and short cubicles, for white line fissures: slatted concrete alleys; for asymmetrical claws: parities two and above and for corkscrewed claws: solid concrete alleys. The prevalence of lameness in heifers was low, however 29% had one or more claw lesions. Heifers that were housed in pens or free stalls had more heel-horn erosions, haemorrhages of the sole and white-line fissures than heifers in tie stalls. As new free stalls are being built, it is important to optimise the conditions for claw health.     

Prevalence of claw lesions in Norwegian dairy cattle housed in tie stalls and free stalls

Approximately 88% of Norwegian dairy cattle are housed in tie stalls. Free-stall housing will be implemented for all cattle within 20 years. This means that most existing barns have to be rebuilt in the near future. We designed our study to estimate the prevalence of claw lesions in Norway and to reveal possible differences between tie stalls and free stalls. Fifty-five tie-stall herds and 57 free-stall herds were sampled by computerized systematic selection and 2665 cows were trimmed by 13 claw trimmers, during the late winter and spring of 2002. The claw trimmers had been taught diagnosing and recording of claw lesions. Environmental factors, management and feeding routines also were recorded. Forty-eight percent of cows housed in tie stalls had one or more claw lesions versus 71.8% in free stalls. Prevalences recorded in the hind claws were: 4.2% of the animals had dermatitis in tie stalls versus 5.7% in free stalls; 7.9% versus 38.0% had heel–horn erosions; 7.3% versus 13.6% had haemorrhages of the white line; 11.7% versus 20.4% had haemorrhages of the sole; 2.8% versus 3.2% had sole ulcers and 5.5% versus 9.7% had white-line fissures. Most lesions were mild. A model was designed to estimate cluster effects within herd and within claw trimmer. The cluster effect within herd was significant for all lesions. The cluster effect within claw trimmer was only significant for heel–horn erosions in front and hind claws and for white-line fissures in front claws. Agreements between some of the claw lesions were revealed. The study confirms that in Norwegian dairy cattle, most claw lesions are more prevalent in free stalls than in tie stalls.     

Udder cleft dermatitis and sarcoptic mange in a dairy herd

OBJECTIVE: To determine prevalence of udder cleft dermatitis in a dairy herd that was experiencing an outbreak of sarcoptic mange. DESIGN: Clinical survey. ANIMALS: 1,597 Holstein cows and late-gestation heifers. PROCEDURE: Animals were examined for udder cleft dermatitis and for skin lesions consistent with sarcoptic or chorioptic mange. Skin scrapings were collected from 56 cows and examined for ectoparasites. The herd was revisited 1 year later, and prevalences of udder cleft dermatitis and lesions consistent with mange were determined in 506 cows. RESULTS: Of the 1,597 cattle examined, 280 (18%) had udder cleft dermatitis, and 1,397 (87.5%) had lesions consistent with mange. In 43 of 56 (77%) cows, skin scrapings revealed Sarcoptes mites. Udder cleft dermatitis was significantly more common in older than in younger cows. In first-lactation cows, udder cleft dermatitis was less common during the first 4 months of lactation than in the later stages of lactation, but udder cleft dermatitis was identified in cows in all stages of lactation and in cows that were not lactating. The herd was treated with eprinomectin to control mites, and prevalence of lesions consistent with mange 1 year later was only 2.8%. However, prevalence of udder cleft dermatitis was still 12%. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cows in any stage of lactation and cows that are not lactating can have udder cleft dermatitis but that lesions are more common in older cows. Control of sarcoptic mange was accompanied by a moderate reduction in the prevalence of udder cleft dermatitis but did not eliminate the condition.     

Effect of lameness on milk yield in dairy cows

OBJECTIVE: To examine the relationship between lameness and milk yield in dairy cows. DESIGN: Cohort study. ANIMALS: 531 dairy cows. PROCEDURE: Cows affected with lameness were classified into 1 of 3 groups on the basis of type of diseases or lesions observed, including interdigital phlegmon (foot rot), papillomatous digital dermatitis (foot warts), or claw lesions. Cows not affected with lameness were classified as healthy. From Dairy Herd Improvement Association records, 305-day mature equivalent milk yield data were collected at the end of lactation or when the cow left the herd. Milk yield was compared between cows affected with lameness and healthy cows. RESULTS: 167 (31%) cows were affected with lameness during lactation. Lame cows had claw lesions (60%), papillomatous digital dermatitis (31%), or interdigital phlegmon (9%). Milk yield in lame cows with interdigital phlegmon (mean, 17,122 lb) was significantly less, compared with healthy cows (19,007 lb). CONCLUSIONS AND CLINICAL RELEVANCE: In this herd, interdigital phlegmon was associated with a 10% decrease in milk production. Lame cows with claw lesions or papillomatous digital dermatitis produced less milk than healthy cows, but the difference was not significant.     

Risk factors for digital dermatitis in dairy cows kept in cubicle houses in The Netherlands

The presence of digital dermatitis (DD) in dairy cows has increased considerably over the last 10 years in The Netherlands, resulting in a current prevalence of approximately 30% in cows kept in cubicle houses. Our objective was to evaluate a diversified sample of cow- and herd-related risk factors for DD in dairy cows housed in cubicle houses with different flooring systems. Associations were analysed in random-effects logistic-regression models using 2,134 cows (37 herds) and 2,892 cows (47 herds) in the pasture and housing studies, respectively. At cow-level, the odds of having DD were increased in the case of lower parity and lactation. Important risk factors at herd-level were: restricted grazing time, fast rise in concentrate amount after calving, feeding by-products, herd trimming only at long intervals, and introduction of dry cows into the lactating herd before calving. The odds for DD were lower if cows were housed on a slatted floor with manure scraper and provided long and wide cubicles, and if calves were reared in the dairy cows' accommodation.     

Prevalence of digital dermatitis in first lactation cows assessed at breeding cattle auctions

The prevalence of digital dermatitis (DD) in first lactation cows (FLCs) presented at 10 breeding cattle auctions was determined in a single auction centre in Austria over a period of 14 months. At each auction, FLCs were selected randomly for claw examination from the monthly auction catalogue. After obtaining owner consent, the hindclaws were examined in a walk-in crush. The type of lesion (M1–M4) and the diameter of DD lesions together with claw horn lesions and the trimming status of the claws were evaluated.From a total of 1110 FLCs registered for the ten auctions, 399 (36%) were randomly chosen for examination and 199 FLCs (17.9%) could be defined. In 63 cows (15.7%), the owners refused consent. A total of 24 FLCs were found to have DD lesions on one or both hindlimbs, resulting in a DD prevalence of 12.1%. The size of lesions ranged from 0.5–3 cm in diameter. No influence of environmental factors (such as season or housing) on the prevalence of DD could be found. In 30/199 (15.1%) of FLCs examined, claw horn lesions such as double sole, white line disease and sole ulcer were observed, but both claw horn and DD lesions were seen in only three cows. Potential buyers at auctions should be aware of both conditions, as the 12.1% prevalence of DD and the 15.1% prevalence of claw horn lesions in FLCs are considerable. Critical evaluation of claw health and DD is essential when purchasing breeding cattle.     

Herd and cow-level prevalence of sole ulcers in The Netherlands and associated-risk factors

A cross-sectional study was performed, to (re)evaluate the prevalence of sole ulcers (SUs) and the risk factors involved in dairy herds that perform claw trimming on a routine base. Twenty hoof trimmers collected data on the presence or absence of claw disorders on the hind claws of dairy cows during whole herd trimming in 383 herds in The Netherlands. A questionnaire was used to acquire information on management and housing. Additional data on parity, breed and stage of lactation of the cows were provided by the Dutch Herd Book Organization.

Sole ulcer was present in 85% of the herds and in 5.6% (S.E. 0.2) of the study population (n = 22,454 cows). The within-herd prevalence varied from 0% (14.6% of herds) to 26% (0.3% of herds) and in herds with SU was most frequently diagnosed 1–5% of the trimmed cows (45% of all herds).

The risk for SU increased significantly with increasing parity. Cows that were at or after peak of lactation (>60 days in milk, DIM) had higher odds on SU in comparison to cows that were between 0 and 60 DIM (OR = 0.6).

The presence of other non-infectious claw disorders appeared to predispose to SU. Based on an estimation of the population attributable fraction, it was concluded that if sole hemorrhages, chronic laminitis (CL), white line disease and interdigital hyperplasia were the cause of SU and if those diseases could have been prevented in the study population, 35.4, 5.8, 11.6 and 4.6% of the SU cases respectively could have been prevented. Because of this relation, an effective intervention strategy of SU should focus on an integral approach of reducing the first stages of the bovine laminitis complex, whereas SU and CL are considered to be a later stage.

Cows trimmed during late summer were at a higher risk for SU than cows trimmed in other periods of the year. Finally, cows in herds with purchased heifers were at a higher risk (OR = 1.4) for SU than cows in herds that did not purchase heifers. A comparable positive effect was visible in herds with mattress bedding.     

Correlations of measurements of subclinical claw horn lesions in dairy cattle

Measurements were made of the extent of sole and white line lesions on the claws of 115 Holstein-Friesian cows on at least three and at most 16 occasions, and some cows were followed up to their third lactation. All the measurements were made between 12 weeks before calving and 45 weeks after calving. In total, 1016 repeated observations were made. Correlations were calculated between pairs of claws, between types of lesion (sole and white line), and between pairs of the different measurements (number of lesions, proportion of the claw affected, maximum severity score and proportion of the claw affected weighted for severity). The outer hind claws had the greatest extent of lesions of both types. Spearman correlation coefficients and confidence intervals measured the strength of the association. All the associations between claws were positive, suggesting that the lesions did not occur in isolation. Sole and white line lesions were not associated at individual observation points. Lesions on the left and right claws were markedly similar, except for sole lesions on the two inner hind claws, and for white line lesions on the two outer hind claws.     

Incidence of lameness requiring veterinary treatment in dairy cattle in Queensland

A survey of the incidence of lesions causing lameness in dairy cattle was conducted by veterinarians in 9 practices in Queensland between November 1984 and July 1985. One hundred and eighty five cases were treated in 83 dairy herds. The average incidence of lameness which required treatment by veterinarians was 2.7 cases per 100 cows per 9 months, with a range of 1.4 to 5.5% in the 9 practices. Foot lesions constituted 83.2% of all lesions; the most common being interdigital necrobacillosis (15%), deep sepsis (8.9%), white line disease (8.4 per cent), axial groove fissure (8.4%), bruised sole (5.6%) and foreign body in the sole/heel (5.6%). Sixty-five per cent of foot lesions occurred in the hind feet and 63% of these lesions occurred in the lateral claw, while 37% of foot lesions occurred in abnormally shaped claws. Limb lesions accounted for the remaining 16.8% of lesions, and 50% of these lesions occurred in the hip and stifle, while trauma was the main cause of limb lesions.     

Lesions causing lameness requiring veterinary treatment in pasture-fed dairy cows in East Gippsland

In 653 mature dairy cows examined for lameness between February 1987 and July 1988 there were 783 lesions identified. Most of these were located below the pastern (90.5%) and most lesions involved hindlimbs (79%). Of digital and interdigital lesions, hind limbs had the most lesions (69.2%). Medial digits of forelimbs were least affected (7.8%) and lateral digits of hindlimbs were the most affected (44.4%). Lateral digits of forelimbs were slightly more affected than medial digits of hindlimbs (17.0% vs 14.8%). Ten different types of lesions contributed to 84.5% of foot lameness. Most common were axial wall cracks (21.7%), underrun sole (14.6%), footrot (13.0%), punctured sole (9.3%) and white line disease (7.2%). Age, rainfall and the early lactation period were factors determining the incidence of lameness.     

Observations of lameness, hoof conformation and development of lesions in dairy cattle over four lactations

Lameness and lesions in the claws of 31 autumn-calving Holstein Friesian dairy cows were recorded from before their first-calving until their fifth lactation. The animals were managed by the same herdsman and housed adjacently in the same building in one of two herds grazed either on clover-rich pastures (herd 1) or on conventional ryegrass (herd 2). All four hooves were examined routinely four times during each lactation, and claw lesions were scored for severity and drawn on hoof maps. Heel erosion and infectious skin conditions of the hoof were also recorded, and hoof conformation, hardness, and growth and wear were measured. The animals' locomotion was scored weekly throughout the winter housing period and any observed to be lame were examined to determine the cause. The development of lesions was modelled by using hierarchic smoothing splines. There was no significant effect of herd except on the prevalence of lameness in lactation 2 when the incidence of (inter)digital dermatitis was higher in herd 2. Lesion and locomotion scores were significantly higher by lactation 4 (P<0.05). There were significant effects (P<0.05) of weeks postcalving on lesion formation, claw conformation, and heel erosion.     

Claw trimming routines in relation to claw lesions, claw shape and lameness in Norwegian dairy herds housed in tie stalls and free stalls

We assessed the prevalence of claw lesions, abnormal claw shapes and lameness in relation to most-recent claw-trimming routines in Norwegian dairy herds housed in tie stalls and free stalls. Equal-sized groups were randomly sampled from both tie and free stalls in each of the three most animal-dense regions in Norway. The study population consisted of 2551 cows of the Norwegian Red breed housed in 54 tie stalls and 52 free stalls. Fourteen educated claw trimmers performed claw trimming and recording of claw lesions once during the spring of 2002. A multivariable model including cluster effects and individual-cow factors was fit for each claw lesion and abnormal claw shape.

In tie-stall herds with routine trimming 39.9% of the cows had one or more lesions or abnormal shapes in front or hind claws versus 52.8% in herds with no routine trimming. Hind-claw results in tie stalls with concrete stall base: herds trimmed occasionally had more haemorrhages of the white line (OR = 2.8) and corkscrewed hind claws (OR = 3.6) versus herds trimmed routinely; herds never trimmed had more heel-horn erosions (OR = 2.6) versus herds trimmed routinely and less haemorrhages of the white line (OR = 0.3) and the sole (OR = 0.2) versus herds trimmed occasionally.

In free-stall herds with routine trimming 76.8% of the cows had one or more lesions or abnormal shapes in front or hind claws versus 68.9% in herds with no routine trimming. Hind-claw results in free stalls with concrete stall base: herds never trimmed had less haemorrhages of the white line (OR = 0.3) and the sole (OR = 0.3) versus herds trimmed routinely; and also less haemorrhages of the white line (OR = 0.3) and white-line fissures (OR = 0.3) versus herds trimmed occasionally. Hind-claw results in free stalls with rubber-mat stall base: herds trimmed occasionally had less heel-horn erosions (OR = 0.5) and more dermatitis (OR = 5.4) versus herds trimmed routinely.

The routine claw trimming performed in Norwegian free stalls has not had the desired effects on claw lesions and abnormal claw shapes. Routine trimming in tie stalls, however, seems to have prevented claw disorders.     

A study of the dynamics of digital dermatitis in 742 lactating dairy cows

Digital dermatitis (DD) is a contagious disease of cattle affecting the skin of the claw. The disease presents with a range of severities and can be associated with lameness. Information about the disease dynamics of DD is scarce. Parity and lactation stage have been identified as risk factors for DD and studies have also indicated that not all cows are equal regarding their risk of recurrent disease and prospects for cure from DD. The aim of this study was to investigate host heterogeneity to DD and to identify disease patterns of DD and factors associated with the development and resolution of lesions. In three commercial dairy herds, 742 lactating cows were observed for DD lesions weekly for 11 or 12 weeks. The effects of parity, lactation stage and duration of preceding episode on the hazard of transitions between healthy and lesion states were analysed using a multilevel multistate discrete-time model. One or more DD lesions were observed in 460 cows and lesions were observed in 2426 out of 10,585 observations. In total, 1755 uncensored episodes with DD lesions were observed. Early lactation was associated with a reduced risk of developing lesions compared with mid and late lactation. Lesions that developed in late lactation had a greater likelihood of resolution compared with lesions that developed during early lactation. There was a reduced risk of lesions developing in parity 3 compared with parity 1 cows, but an increased risk of lesions developing in parity 2 compared with parity 1 cows. In the present study, the mean duration of uncensored DD episodes was 1.7 weeks indicating that the duration of the majority of DD lesions might be shorter than the 42 days reported previously. The transitions between disease states suggest that DD is a dynamic disease, and that the early stage lesions are more transient than expected from previous studies. We conclude that studies with shorter observation intervals than one week are needed to fully understand and describe the individual and group dynamics of DD.     

Prevalence and severity of foot lesions in Danish Holstein heifers through first lactation

Several studies have shown that foot lesions and clinical lameness occur before first calving and develop further during the lactation period. Lameness may cause production losses, but the relationship between foot lesions, particularly in the claw horn, and lameness in heifers is unclear. The objectives of this study were to describe the development of and evaluate the relationship between lameness and foot lesions in Danish Holsteins before and after first calving. In a longitudinal study, 147 heifers were examined for lameness and foot lesions 2–5 times over an 18-month period. Lameness was assessed by means of a visual locomotion score and foot lesion severity was recorded.The prevalence of a locomotion score 3 was 25% before calving, and 90% at approximately 250 days in milk (DIM). Prevalence of moderate to severe sole haemorrhage (SH) was 27% before calving and 56% at 250 DIM, and that of moderate to severe white line lesion (WLL) 44% before calving with a peak of 70% at 200 DIM. There was one case of white line abscess but SH was seen throughout the entire study period. Digital dermatitis (DD) was prevalent prior to first calving (15%) and peaked at 39% at 0–100 DIM. Heel horn erosion (HHE) occurred in almost all cows (93–100%) and was strongly correlated with DD (r = 0.51). The correlation coefficient between SH and WLL was also high (0.42). The relatively high correlations between WLL and both DD and HHE were more surprising (0.38 and 0.35, respectively), those between SH and both DD and HHE were moderate (around 0.18). Interdigital dermatitis was significantly correlated with both HHE and DD, but completely unrelated to SH and WLL.The overall average locomotion score increased by about one-half of a score unit from 1 month prior to calving until 250 DIM, with a large difference between herds, although this was unsurprising as cows may alter their locomotion pattern with management factors (e.g. floor properties). DD and WLL were both associated with a locomotion score 3 but of the cows with severe WLL there was no clear association between a locomotion score 3 and DD. The highest locomotion scores occurred among cows with DD but without WLL.     

The effect of digital lesions and floor type on locomotion score in Dutch dairy cows

This study describes the effects of floor system, digital dermatitis (DD) and interdigital dermatitis and heel-horn erosion (IDHE) on locomotion performance in 225 dairy cows of 12 commercial dairy herds. Nine herds were kept in cubicle houses with concrete passageways (either solid, slatted, or grooved concrete) and three herds were kept in straw yards. Animals were at most five times examined at monthly intervals for lesion severity of DD and IDHE and for locomotion score. Locomotion score was rated on a scale ranging from 1 to 5 (from normal to severe) and disturbed locomotion (lameness) was defined as a score > or =3. A logistic regression model was used to analyze the 943 observations using lameness (yes/no) as outcome variable. The proportion of observations scored as lame (locomotion score > or =3) increased from 18% 1 month after trimming to 29% at 4 months after trimming. Severe lesions of DD and IDHE were associated with a significantly higher proportion of lame cows. The proportion of animals with disturbed locomotion increased from 16% to 40% as the severity of DD increased and from 17% to 30% with increasing severity of IDHE lesions. Locomotion performance highly differed between the cubicle house and straw yard group. Only 1% of all gaits in straw yard cows were scored as lame, while in cubicle housed cows these percentages varied from 24% to 46% with grooved floors showing the highest average locomotion score. Due to the extreme low incidence of lameness in straw yards, the statistical analysis had to be restricted to observations on concrete floors (n=744). The logistic regression model with lameness (yes/no) as dependent variable and random effects of cow and herd resulted in Odds Ratios for severe DD and IDHE of, respectively, 3.2 and 3.2, both significantly larger than unity. Cows housed at grooved concrete floors showed the highest OR of 6.5 compared to solid concrete floors. Recovery of lameness was poor as disturbance in gait lasted several months.     

The association of hoof lesions at claw trimming with test-day milk yield in Danish Holsteins

In a cross-sectional study, performed between October 2002 and April 2003 on 55 Danish dairy herds with 6161 predominantly Holstein Friesian cows the prevalence of 9 hoof lesions was determined.

All test-day yields (TDY) of kg energy corrected milk (ECM) in the lactation of diagnosis were recorded. For the purpose of including hoof lesions in a decision support model an attempt was made to aggregate the lesions into digital dermatitis (DD), other interdigital diseases (OID, infectious diseases other than DD) and hoof horn diseases (HHD, related to metabolic disorders and trauma). A division was made based on the stage of lactation in which the lesions were diagnosed; during the first 100 days in milk, between days 101 and 200 and between days 201 and 305. Associations between the presence of hoof lesions at trimming and milk production were analyzed by linear mixed modeling at the cow level, clustered within herd. The data of primiparous cows was analyzed separately from the multiparous cows.

Based on the associations between TDY and the individual lesions aggregated into HHD, this aggregation as initially planned could not be justified and was therefore not maintained. For OID the value of early diagnosis was apparent; an early diagnosis and early treatment (<101 DIM) was associated with either a positive value or a value less negative compared to a diagnosis and treatment in late lactation (201–305 DIM). This pattern was not as clearly present for the other lesions.