Production medicine probably means something different to each of us, which has also been the case with written treatment
plans definitions, our standards for accountability of welfare, defining the KPI's to monitor, and our drug protocols.
Historically many practitioners considered arranging the pregnancy check of groups of cows on a prescheduled regular basis
as production medicine. Our herd check times has certainly allowed a lot of time to discuss the various management group issues
over the back of the cow while our hand was doing its job, but fertility work is only one portion of production medicine.
Our training has been in medicine; the diagnosis and treatment of individual cows. As our herds have gotten bigger we have
organized this diagnosis and treatment philosophy of the individual cows into the proactive written treatment protocols. We
are able to predict what to expect based on the health conditions common for a management group. Writing treatment plans is
still not production medicine. It is allowing some medical decisions to be made in our name because we know what we expect
to happen at various stages of the lactation cycle.
Dairy science has requirements and recommendations about the basic sciences that apply to all ages and management groups such
as nutrition, housing, milk harvest, immunization, and genetics. Establishing a standard package of key performance indexes
served the double purpose of monitoring the performances of individual management groups on a regular basis and supplying
the same data to all the team members to improve our ability to communicate. The question is to communicate about what?
The answer varies, but basically it is to understand the effects of specific management practices on the health aspects of
the cow. Dairy science has demonstrated that various management practice decisions or facility short comings has an odds ratio
for serving as a risk factor for some condition.
For example:
• Poor sanitation of the udder as measured by udder hygiene scoring is associated with an increased incidence of mastitis.
• Increased standing time is associated with increased claw horn lesions.
• Developing one fresh cow condition increases the risk of developing an LDA. The odds ratio is different for each
metabolic condition.
• A failure of absorbing adequate colostrum at birth is still measurable as decrease production for lactating cows.
The team concept has flourished because the interplay between these factors is just an endless list. Our role is to understand
the presence of these and then use our broad base of management group involvement to prevent a management decision being made
that benefits one management group at the expense of another except by conscious decision.
Production medicine represents a huge level of knowledge:
• Requirements for each of the basic sciences by management group
• Recommendations to maximize the productivity of each management group which may differ from the requirements
• Management decisions relative to the care package that create pre disposing risks for conditions
• The consistency of delivery of the management plan by dairy personnel
As our herds have gotten larger the effects of weaknesses in any management group on the productivity of whole have been only
too easy to identify. The impact of many of the production medicine concerns is measurable by comparing the epidemiology of
the conditions with the expected pattern with an awareness of the predisposing factors that result from previous management
decisions.
To prioritize which management deficiencies are most significant it seems getting the first step right is critical for almost
any process. Applied to the cow:
• For the life cycle of the first step is birth to wean.
• For the lactation cycle the first step is the dry period
• For the health care standard operating procedure the first step is detection.
• The care package required or recommended for the new calf is defined as the 5 C's
• Colostrum
• Calories
• Comfort
• Cleanliness
• Consistency
