The first problem that needs to be addressed is which animals focus our attention.

All animals after parturition must be kept under control; however, this does not mean that all cows must be visited daily. In small and medium herds (<100 cows in milk), daily monitoring of each animal may be feasible, but one wonders what the benefit of a daily visit of each postpartum bovine might be.

There are many farms where all the cows of the group 0-10 DIM are subjected to an intravaginal visit every 48 h (to verify the presence and type of vaginal discharge) and to a daily rectal exploration to verify the uterine involution. Why cany out a manual exploration of the vagina, being able to produce a precise and punctual diagnosis without resorting to invasive methods? Let's not forget that, especially in the primiparous, there may be postpartum vaginal lacerations: also, for this reason, manual exploration of the vaginal vestibule, if possible, should be avoided. All postpartum animals should be monitored daily, but only sick or suffering animals should be visited. How to detect these animals early?

Through observation and daily monitoring of the group 0-10 DIM, it is possible to control the health status of the herd in the immediate postpartum.

We have already seen that there is the possibility of controlling the rectal temperature. In addition, it may be possible to control Body Condition Score (BCS), the ketosis test (Beta Hydroxy Butyrate [BHB]) level in blood or milk, rumen fill scoring, locomotion scoring, mobility scoring, edema scoring, fecal scoring, metritis scoring, etc. Most of these evaluations can be done mainly by observing the cows (Table 4.3).

TABLE 4.3 Bovine Monitoring Procedures.














Every 24 h









Every 48 h



Every 72 h



Every 120 h



AS, abdominal shape; ES, edema score; FS, Fecal score; LS, locomotion score; MS, mobility score; RF, respiratory frequency; RS, Rumen score; T, temperature; VD, vaginal discharge; VL, vaginal laceration.

Before doing one or all of the different tests that we have discussed, it is necessary to verify the production of each postpartum cow. A healthy cow progressively increases milk production, from the first days of lactation. A cow that does not produce milk and/or falls is a cow that must be observed in a special way: there is always a problem at the base of this situation. All herd management software can be configured so that cows that do not rise to milk and/or that decrease milk production by 6-8%, compared to the last milking, are brought to attention by the system. The clinician should check these animals immediately.

Attention: controlling them does not necessarily mean visiting them. First, verify that these animals are interested in the food and their score in the rumen.


A healthy cow, immediately after the delivery, begins to eat and then increases its milk production progressively. A cow that does not increase milk production, or that decreases milk production by 6-8% compared to the last milking must be subjected to an accurate clinical examination as soon as possible.

Every morning, before anything else, the person in charge of the postpartum, must verify the production of all the animals of this group, selecting those animals that have not increased or decreased production compared to the last milking. These animals must be visited as soon as possible.


The frontal observation of the cows must be carried out carefully and with great discretion. The cows must not be harassed but must be observed without causing stress. We must observe the cows of this group, trying to understand the hierarchies; but above all, it is fundamental to understand if each cow is well in the group, or if there are reasons for stress and/or tension.

It must be observed if the cow can easily access the food, if she can access the water easily, and if there are comfortable bunks where the cow can rest. It is also necessary to observe the location of the postpartum group with respect to the rest of the farm. INTERESTS IN FOOD

Observe the herd as it behaves in front of the food and observe the interest in the food of each individual cow. Do the animals eat regularly? Are there cows that are choosy? Are there cows that disturb the other cows that want to eat? How much food do they grow on average each morning in this group? Does the unloading of food occur regularly? Is the mixture well made? Do cows have an appetite? If cows refuse food, is it because they are not hungry (why?) or, because the mixture has problems (smell)?


A healthy cow is attentive to everything that surrounds it. The ears are an excellent indicator of the state of the cow’s sensory. A healthy cow has straight ears and moves whenever something catches the cow’s interest. Low ears are an indicator of a cow’s malaise. Cold ears are an indication that cows have fever: normally cold ears are an indication of a drop in skin temperature of at least 3°C, which roughly corresponds to an increase in the internal temperature of 1°C. HORNY SHINE, TEARING (KIND OF TEARING)

A healthy cow has bright corneas. The eyes follow with attention everything that happens near the cow. A sick cow has opaque corneas and a half-closed eye. The presence of excessive tearing can be an indication of an ocular pathology. It is always necessary to verify if the tears are single or bilateral. It is also necessary to verify what type of tearing is involved: serous, mucopurulent, or purulent. MUZZLE

The cow is an animal that cares very much for its personal hygiene!

A healthy cow constantly cleans the muzzle, which will be clean and moist. In a sick cow, the muzzle will be dirty and dry. Also, pay attention to the presence of nasal leaks: are they unilateral or bilateral? Are they serous, mucus-purulent, or purulent? Are they odorless or stinky?

All these signs point the clinician toward a diagnosis of high or low airway pathologies. PRESENCE OF COUGH AND TYPE OF COUGH

The presence of cough, the frequency of cough, and the type of cough (dry and oily) help the clinician to suspect a pathology of the respiratory system, but also allow hypotheses to be made about the site of the pathology (upper or lower respiratory tract).


The subsequent observation of the cows in the group 0-10 DIM allows completing the clinical evaluation initiated with the frontal examination. At the end of this observation, it will be decided if it is necessary to submit the cow to a complete clinical visit. RUMEN FILL SCORING

One element that determines the health of the cow in transition and not only in transition is its ability to ingest dry matter. In principle, we can say that a cow that eats is not suffering and that the greater the ingestion of diy matter, the less the risk of becoming sick.

An excellent indicator of the health of the cow is the Rumen Fill Score or Rumen Score. A healthy rumen is an indication of a healthy cow; therefore, the rumen score is indirectly an indicator of the cow’s health status. Obviously, when evaluating the efficiency of rationing also in the postpartum, the analysis must not be limited to the rumen score, but other parameters must also be evaluated (palatability of the ration, homogeneity of the ration, possibility of the animals to choose, amount of food advanced, type of advanced food, etc.). However, for the technician who must evaluate the postpartum group on a daily basis, the evaluation of the rumen score is a precise and rapid indicator. It provides very useful indications related to the quantity of food ingested and on the speed of food transit in the last hours, which in turn are mainly related to the characteristics of the forage, its structure, and the relationship between the different nutrients (Hulsen, 2003).

The filling of the rumen depends on the amount of dry matter ingested, the composition of the ration, the digestive capacity of the rumen, and the speed of rumen transit. Rumen Fill Scoring is used to monitor ingestion disorders and is based on a 5-point score: score 1, the cow has not eaten anything in the last 24 h and score 5, the cow is eating regularly. For simplicity, a score of 3 is proposed, where score 1 is a cow that does not eat at least 24 h (skin fold from hook bone falls vertically, so hollow shape looks rectangular), score 3 that of a cow that eats regularly and so enough. UDDER OBSERVATION PERCENTAGE OF EDEMA SCORE

Pay attention to the size, shape, symmetry, presence of swellings (position, number, size, and consistency), color, smell (inguinal sores, intra-mammary sores), and presence of edema. Observe the teats (shape, size, direction, and presence of lesion); check if the cow loses milk spontaneously.

The Edema Score is an important indirect indicator of the nutritional and environmental management of the cow in the first part of the transition period. The edema of the udder can be associated with a genetic predisposition, but much more to an excess of sodium and/or potassium in the close-up ration, to very long dry period (> 70 days), to rations with low content of magnesium or protein, to poor drainage lymphatic caused by little space available for movement (overcrowding). LOCOMOTION SCORE AND MOBILITY SCORE

The locomotion scoring makes it possible to make precise assessments of foot health, establishing whether and which feet and hooves does a disease possibly affect. The scoring used is 1-5, where 1 corresponds to a healthy cow, 3 to a slight lameness, and 5 to a severely lame cow. Sometimes, the locomotion scoring is > 3, although there is no lameness; this can occur in case of gastro-enteric diseases (foreign body syndrome, abomasal volvulus, enteritis, etc.), abdominal diseases (peritonitis), or diseases of the reproductive system (puerperal metritis and vaginal lacerations). For this reason, in all cases of doubt, or when we want to ascertain a diagnostic suspicion, mobility scoring should also be carried out. This is a score ranging 0-4, where 0 corresponds to a cow with good or excellent mobility, being able to walk with a uniform load rhythm on all four feet, with a flat back; whereas score 3 corresponds to a cow unable to keep up with the healthy herd and an uneven load on a limb that is immediately identifiable or which cams with shortened strides and an arched back ( SHAPE OF ABDOMEN

In healthy cows, observation of the abdominal form from the right side allows a pear profile to be detected. The presence of an apple profile is an indication of an abdominal pathology (peritonitis) or gastrointestinal (bloating rumen, abomasum dilatation, abomasal volvulus, intestinal volvulus, etc.). TYPE AND FREQUENCY OF BREATHING

The observation from the left side of the type and frequency of breathing allows to establish if there are signs of a respiratoiy pathology that involves the upper or lower respiratoiy tract, or if there is only an increase in respiratoiy frequency associated with heat stress. OBSERVATION OF FECES

Faces are the expression of the cow’s digestive efficiency. It is necessary to evaluate the consistency, color, smell, quantity, and quality of the undigested material contained therein. Also, the “noise” that the fecal material makes falling on the ground, once expelled by the rectum, gives us precise indications.

The characteristics of the feces can also be determined by observing the ventral part of the tail and the tuft of the tail: the cows with diarrhea and/or who have had recent episodes of diarrhea have their tail smeared.

It is possible to cany out a fecal scoring: the score goes from 1 to 5. A score 1 corresponds to a cow with glossy, creamy, homogeneous stools, within which undigested parts are not visible or palpable. The score 5 corresponds to a cow with opaque stools, not homogeneous, inside which there is a lot of undigested food (Hulsen, 2003). VAGINAL DISCHARGE

Almost all cows immediately after delivery suffer from bacterial uterine contamination (Sheldon et al., 2011). However, only a part of them develops puerperal metritis, or gets sick. Most cows with postpartum uterine inflammation undergo spontaneous recovery. However, it is essential to identify the animals that fall ill with puerperal metritis early. Observation of vaginal discharge, their quantity, consistency, color, and odor are useful to identify these animals. All cows with vaginal discharge, very liquid, red-brown putrid, must be observed with great attention (Sheldon et al., 2006).


In the case of vaginal and/or cervix-vaginal lacerations, the cow may present a locomotion scoring > 3, without lameness. A vaginal or cervix-vaginal laceration is usually painful and can compromise the health of the cow, which reduces up to suspending the feed intake, predisposing the cow to other puerperal pathologies (ketosis, Left Displacement Abomasum (LDA), etc.). In the presence of a locomotion score > 3, in the absence of lameness, always check for vaginal lacerations by opening the vulva.


Rectal temperature is an excellent indicator of the health of the cow. Usually, a cow with an acute puerperal metritis has a rectal temperature > 39.5°C. However, the presence of fever is not indicative of a uterine pathology or in another place: 48% of the cows manifest a thermal rise > 39.5°C at least once in the first 10 days postpartum, without having any pathology of the reproductive system, or elsewhere (Wagner et al., 2007). Rectal temperature detection can be an excellent strategy to impose a work strategy based on animal observation: in the 10-15 s necessary to detect rectal temperature with a digital thermometer, a good observer can verify:

  • 1. Locomotion Scoring
  • 2. Mobility Scoring
  • 3. Rumen Fill Scoring
  • 4. Presence of vaginal discharge and their analysis (color, odor, and consistency)
  • 5. Status of the udder (edema, swelling, symmetry, color, odor, loss of milk, shape and size of the teats, etc.)
  • 6. Shape of the abdomen
  • 7. Frequency and type of breathing

Rectal temperature detection is therefore not the end, but the means by which to train the dairy workers in charge of postpartum cows to observe. In stables where the staff is attentive and well trained, it is possible to avoid taking rectal temperatures to all the animals in the first 10 DIM, limiting this detection only to the cows that actually need it. Normally, a cow of the postpartum group, which increases its production, which eats regularly, does not require rectal temperature measurement.


At the end of the frontal and posterior observation, the clinician obtained a series of information. This infonnation, together with the data related to the production of the cow, will allow the professional to establish whether to present the bovine to a clinical examination (Gnemmi et al., 2019).

In big, veiy big farms, it is possible to code each cow: a color is associated to each cow and, depending on the given color, the cow must be visited immediately, monitored in the next 12 h or monitored in the next 24 h. This is a system that allows the coding of cows due to the severity of each case (Gnemmi et ah, 2019).

The clinical examination of the bovine will include other tests, such as BHB. the diagnosis of the abomasal displacement, the rumen function evaluation, and others diagnostic tests. Some time may also be required for complementary tests such as ultrasound (Table 4.4).

TABLE 4.4 Definition of Codes According to the Clinical Characteristics Identified

Red code

Orange code

Yellow code


> 40°C
















Liquid, red-brawn, fetid

Dense, red-pink

Dense, white-yellow or pink, any smell


< 8-10%


= or a little increased

LC, locomotion score; P, production; MS, mobility score; MT, type, color, and smell of the vaginal discharge; RS, Rumen score; T, temperature.


The clinical visit must be carried out as a personal qualifier and according to the classical scheme (Rosenberger, 1979), or through an accurate anamnestic collection, a general objective examination, and a special physical examination of the apparatus that have been affected by the disease. Not all postpartum cows must be visited daily; only sick cows or those suspected of having a quiescent disease must undergo a clinical examination.

The tools that the professional must equip themselves with are few, but essential:

  • 1. Stethoscope
  • 2. Digital thermometer
  • 3. BHB and blood glucose equipment
  • 4. Gloves for rectal exploration
  • 5. Short latex or nitrile gloves
  • 6. Chalk to write on the cows
  • 7. Palm-computer or smart phone or notebook to record cow data
  • 8. 2.5 cc syringes with 18G° needles

The clinical examination serves to confirm the diagnostic suspicion. The cows in red code will have to be visited immediately; cows in orange code will be monitored for 12 h before the eventual clinical visit; the cows in yellow code will be monitored for 24 h before the eventual clinical visit.


  • dairy cow
  • post partum pathologies
  • uterine pathologies
  • diagnosis
  • monitoring procedure
  • transition management
  • herd prevention


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