HFV News MAY 2023

In this issue…

Left Displaced Abomasum (LDA) - are you aiming for <1%?

Gastroparesis - an emerging condition in dairy daughters by WWS bull "Phenom"

Can using anti-inflammatories in heifers at calving protect against lameness in her future?


Left Displaced Abomasum (LDA) - are you aiming for <1%?

An LDA occurs when the fourth stomach, the abomasum moves from its normal position on the bottom of the abdomen, and drifts to the left-hand side ending up on the wrong side of the rumen. It can then fill with gas and rise like a balloon, trapping it in position.

Picture to show the LDA in pink on the left hand side where the rumen should be


During late pregnancy the calf and uterus take up an enormous amount of room in the abdomen of the cow and cause the cows intakes to drop off as the calf grows and squashes the rumen. Once the cow calves there is suddenly a lot more space available in the abdomen, plus there's a lag in getting intakes back up, a delay in getting the rumen back up to capacity plus a diet change from dries to highs which can lead to gas accumulation in the abomasum. It is a combination of all these risk factors, especially in Holsteins, that mean the abomasum is at risk of moving into an abnormal position on the left side.

On top of these "normal" risk factors, there are abnormal risk factors which increase the risk of LDAs further:

FAT COWS: Have really poor intakes before and after calving, high risk of milk fever and ketosis

TWINS: Increased risk of retained cleansing and poor intakes before calving

FRESH COW DISEASE: Lameness, mastitis, retained cleansing, milk fever - all reduce intakes

GROUP CHANGES: Intakes drop for days after a group change

DIET CHANGE: From dries to highs


  • Older cow (3rd plus lactation) but heifers struggling for feed space can also get LDA
  • Freshly calved (7-21 days)
  • Decreased milk yield
  • Off feed - sometimes will eat forage but not concentrates
  • Some may scour, others may have stiff muck
  • Appear ‘empty’ on the left hand side
  • Some may appear dehydrated, with sunken eyes
  • Arched back due to abdominal pain
  • ‘Pear-drop’ smell to their breath
For those of you with stethoscopes on farm; you'll know the characteristic high pitched ping when you listen to the left hand side of a cow with an LDA. Remember to listen along a line between elbow and hip (red line below), put the stethoscope on the rib and using the other hand to flick in a circle around the stethoscope as you move it along that imaginary line.


The first job is to find and treat any underlying disease (ketosis, metritis, mastitis) - stabilising her medically before surgery helps with recovery post-op. The vast majority of LDA will need surgery to replace the abomasum back to its normal position.

A left sided surgery to correct an LDA

There are a few different surgical methods that you'll see us do - Tom opens up on the right, Paula opens up on the left but both methods end up with the abomasum permanently stitched into position and a rapid recovery for the cow - often they're back to normal intakes in a few hours after the op.


Some farms aspire to be LDA free; achieving less than 1% LDA rates means achieving a hugely successful transition period - three weeks before and three weeks after calving. Transition management of every individual is key on these farms to protect rumen fill for every cow.

Most farms would run at around 1-2 LDA for every 100 cows; any more than 1% LDA and we would want to have a chat about common risk factors and prevention strategies for your herd. Sometimes risk factors can affect multiple dry / fresh cows and you can get runs of LDAs - tricky grazing conditions for fresh cows in late Spring or calving cows outside can be a common seasonal risk factors.

Right sided surgery to correct an LDA


  • 80cm feed space for every cow
  • 10% spare cubicles for fresh cows
  • Clean feed face
  • Ad lib feed: aim for 5-10% refusals
  • Push up as often as possible, ideally every two hours
  • Regroup as little as possible and regroup in pairs
  • Fresh cows get 40 litres of fresh cow drink at calving
  • Fresh cows get ad lib access to fresh highs ration as soon as calved
  • Control milk fever - use Bovikalc Calcium boluses for at-risk cows - one at calving and one 12 hours later
  • SOFT cows get Kexxtone bolus 3 weeks before calving (SOFT = Sick, Old, Fat, Twins)

"Gastroparesis" an emerging condition in dairy daughters by WWS bull "Phenom"

Since Spring 2022 the UK Surveillance Network has reported multiple cases of "gastroparesis" in 9 to 24 month-old, Holstein bulling and in-calf dairy heifers. To date the majority, or all, of the affected heifers have had the same sire - a bull called "Phenom".

The affected heifers typically present with gut paralysis, progressive abdominal distension and weight loss, become inappetant, are non-responsive to treatment, and have had to be euthanised.

No obvious dietary or management risk factors have been identified. APHA has received either submissions or reports related to at least fifteen affected farms in the UK so far and there are likely to be more.

At postmortem examination, the abdomen and the rumen are very distended, and the rumen contents have a distinctive frothy texture. Abomasal impaction and/or ulceration has also been a feature of some of the cases.

One of the affected farms uses collars which pick up rumenation and the outputs show reduced, and eventually absent, rumen contractions at the time when the clinical signs became apparent.

The breeding company has been working with partners across the UK disease surveillance network, private vets, and a specialist genetic research team in France since May 2022.

At the time of writing, the mechanism underlying this syndrome is uncertain. The gross pathological and histopathological findings of the cases have so far been inconclusive. The appropriate blood and tissue samples have been collected from affected and non-affected (control) animals. These are currently being analysed to try and uncover the precise genetic mechanism of the issue and, will hopefully aid better understanding of this syndrome.

The working hypothesis is that the bull carried a new mutation that is inherited and passed on to his daughters. There appears to be mosaicism of the bull’s germ cells, where there is more than one genetic line of the germ cells (as the result of genetic mutation), and the condition appears to develop in approximately 25% of his offspring.

It is thought that animals sired by this bull which are functioning normally beyond their first calving, are unlikely to have inherited the mutation, and therefore may remain healthy and possibly not transmit this fatal condition.

The bull has been removed from AI service and his semen has been removed from the market. He does not have any sons in AI service. The breeding company will contact customers directly who bought this bull’s semen. Farmers that suspect they have experienced cases, but that have not yet been approached by the breeding company, should contact the breeding company directly.

Can using anti-inflammatories in heifers at calving protect against lameness in her future?

Claw horn lesions (CHL) are the most common cause of lameness in UK dairy systems and yet we are only just starting to understand what causes them and how to prevent them.


Claw horn diseases include sole ulcers, sole bruises and white line disease - they are a pressure lesion; All the weight of the cow bears down on the wedge-shaped bone in her hoof – this squashes the protective fat pad underneath this bone and disrupts the layer of cells that create the sole.

The fat pad is the thin layer of tissue under the bone (red arrow)

As soon as the cells of the sole start getting slightly squashed we see blood being incorporated into the sole – a sole bruise.

A sole bruise on the left claw

If the cells of the sole continue to be squashed the cells making the sole are killed and that’s when we see a sole ulcer.

A sole ulcer on the left claw

A sole ulcer is actually just a hole in the sole, because the cells have been squashed so badly that they can no longer produce the sole. Understanding why the cells are at risk of being squashed is the key to preventing lameness.


Claw horn lesions are influenced by three main factors:

  1. The environment
  2. Calving
  3. Changes to the structure of the foot.


A cow’s environment can cause excess pressure on the sole of the foot and the factors will depend on the management system on farm. This can include standing time, concrete, cubical comfort, forced waiting times for AI and how often foot-trimming is carried out.


Cows produce a hormone called "relaxin" which softens and breaks down the connective tissue in the pelvis which gives the calf enough room to exit at calving.

Relaxin doesn't only break down tissue in the pelvis, it also breaks down the tissue that attaches the bone in the hoof meaning the bone moves around more just after calving – putting the thin layer of cells making the sole under more pressure.


Not only is the bone within the hoof moving around at calving, but the fat pad underneath that bone which is meant to protect the sole, breaks down and thins so more pressure reaches the sole.


Fresh heifers have a lot to contend with in early lactation - joining the milking herd with bigger dominant cows, change of diet, learning to lie in a cubicle, standing on concrete waiting to be milked or AI. There is a real danger that we ruin first-calving heifers within the first few months of lactation because of all the pressure that goes on their feet post calving.


The digital cushion is the pad of fat that sits under the bone in the foot that plays a key role in preventing lameness. Not only does inflammation after calving break down the structure of the fat pad but as heifers and cows lose weight after calving, the fat pad shrinks. Both of the risks increases the risk of sole bruising and causes lameness which if not trimmed will end up as a sole ulcer.

Did you know? The thickness of the fat pad in pregnant heifers increases by walking and standing on a hard surface and thins when grazing or housed on straw. Walking heifers daily on a hard surface in the last 2 months before she calves can really help develop her protective fat pads.


The inflammation happening under the bone in the foot with a sole bruise or a sole ulcer changes the bone itself and the bone reacts by growing sharp spikes as shown in the photo below: it's obvious to see the bony change in the sole ulcer foot on the right compared to a non-sole ulcer foot on the left:

This permanent bony change means this heifer will FOREVER be a sole ulcer risk and will need a routine trim to "model out" the sole directly under the pressure point every 3-4 months to prevent her becoming a chronic sole ulcer cow.

You can see the "model" in this trimmed foot - removing sole takes pressure off the sole ulcer site


  • make sure heifers have had contact with concrete to develop their fat pads
  • make sure heifers have comfy cubicles and lie in quickly - if they're refusing a cubicle, get them onto a straw yard ASAP and use a course of anti-inflammatory to minimise the damage to the inside of the foot
  • make sure there are spare cubicles so heifers have options where to lie and don't have to squeeze in between two dominant cows
  • make sure there is 80cm feed space in the milkers so less dominant heifers can feed easily and minimise weight loss

A new study looks at routine treatment of heifers with anti-inflammatory at calving to stop the cycle of inflammation getting started in the foot.

438 dairy heifers were calved in over 2.5 years in a commercial dairy herd in Derbyshire and divided into 4 groups:

Group 1: trimmed and block applied if needed every time they became lame

Group 2: trimmed and block applied if needed PLUS 3 day course of Kelaprofen every time they became lame

Group 3: trimmed and block applied if needed PLUS 3 day course of Kelaprofen every time they became lame PLUS a 3 day course of Kelaprofen at every calving

Group 4: just a 3 day course of Kelaprofen every time they became lame - this group weren't trimmed unless they were severely lame


The heifers were randomly assigned to a group and then mobility scored every 2 weeks for the 2.5 years of the study. The number of cases of lameness were recorded as were any culls.


Animals in group 3 were 30% less likely to ever become lame or severely lame
Animals in group 2 and 3 were 15% less likely to be culled than group 1 or 4 heifers
Group 3 protocol for all heifers would reduce all future lameness cases on farm by 10%
Return on investment of £1.66 for every £1 spent on group 3 protocol

So, what does this mean for your farm?

The study shows that using anti-inflammatory in heifers at calving, and again if she goes lame, stops the inflammation cycle starting in the foot which is protective not only for that lactation, but for her lifetime.
Ketoprofen was the anti-inflammatory used in the study - Kelaprofen is our version of this drug - it has zero milk withhold

Group 3 Protocol:

  1. 3 days of Kelaprofen IM on day 1, 2 and 3 after her first calving
  2. Early detection & prompt effective treatment of lameness plus 3 days of Kelaprofen IM on day 1, 2 and 3 after trimming when she goes lame
  3. 3 days of Kelaprofen IM on day 1, 2 and 3 after calving when she calves in again


A 3 day course of Kelaprofen costs around £14 per heifer.

In comparison, the cost of a single case of a sole ulcer in the UK is £520 (treatment costs, loss of production, extended lactation, risk of culling)

Please feel free to get in touch with Paula or Tom if you want to discuss this further.


The vet-med supply chain over the last few years has been volatile as you will all know. Old brand names have come and gone, there are new pressures on limiting the use of certain types of meds, there have been sudden batch recalls on some favourite meds, not to mention the recent supply issues with some of our core vaccines.

At HFV we focus on clear communications between medicine suppliers, vets and farmers so we can help you plan ahead, find alternatives for the must-haves and put prevention strategies in place. Our annual medicine review is a good way to look at specific diseases and treatment protocols on your farm as well as review doses and withdrawal times. We recommend all our clients and your staff download the NOAH compendium app on your phones so you can quickly review data sheets in case brand names change and you need to quickly double check withholds.


We've got good supply of 250 dose and 125 dose bottles - the smaller dose bottles should be back in stock over the next few months to get smaller numbers of breeding ewe lambs on the Heptavac P program. We have good supply of Ovivac P Plus for all non-breeding lambs.


Bovivac-S is out of stock for the next couple of months - we have plenty in our vaccine store but if you are looking for booster doses for the summer please get in touch with Paula to pre-order these in.


Pen & Strep is currently on a manufacturing delay - we have some stock left but would recommend swapping to Betamox if needed as a first line treatment. Don't forget, despite being considered a first line treatment, Pen & Strep is actually a group C antibiotic and shouldn't be used routinely as first line when we have group D antibiotics available.


Iodine prices have soared in the last few months due to disruptions in the supply chain in South America - please don't risk using a more dilute iodine or blue spray on navels. We have secured a large amount of 10% Strong Iodine - a 2 litre tub is £47 ex VAT and will do a LOT of navels!


Paula: 07764 747855 paula@haywoodfarmvets.com

Tom: 07837 291097 tom@haywoodfarmvets.com

Amy: 07989 304202 amy@haywoodfarmvets.com

Enquiries: mail@haywoodfarmvets.com

Website: haywoodfarmvets.com

Open hours: M-F 08:30 - 16:00

Out of Hours: 01630 810016

Created By
Paula Scales