Managing The Costs Of Metritis With Early Detection And Treatment

Early identification followed by appropriate intervention is key to successfully treating any disease.
Early identification followed by appropriate intervention is key to successfully treating any disease.
(File Photo)

This article was written by Eric Moore, DVM, Technical Services, Norbrook Laboratories.

Metritis, one of the most common fresh cow diseases, can be costly to the health and productivity of dairy cows and farms. But it doesn’t have to be that way; the disease’s economic consequences can be reduced. The key is careful monitoring of fresh cows combined with early diagnosis, timely intervention and effective treatment.

Getting a handle on metritis
Metritis is a uterine infection that affects about 20% of lactating dairy cows, although the incidence can range from 5% to more than 40% of cows in some herds. Typically seen within the first 10 days in milk (DIM), metritis is characterized by a foul-smelling, reddish-brown, watery vaginal discharge and systemic signs of illness such as decreased feed intake and milk production, with or without fever. It can range from a mild infection that a healthy cow’s uterus can clear without intervention to a severe, life-threatening disease.

The costs associated with metritis can be substantial. Metritis can lower a cow’s milk production, decrease her fertility and future pregnancy rates, put her at greater risk of culling, and increase labor and treatment costs. One key reproductive parameter contributing to increased costs is prolonged time from calving to pregnancy. This can be affected by postpartum conditions such as metritis during the first 30 DIM and subclinical or clinical endometritis, an inflammation of the endometrium (innermost uterine lining) that occurs during 31 to 60 DIM. Altogether, each metritis case is estimated to cost between $329 and $386 per cow.1

Although metritis cannot be completely prevented, its costly consequences can be minimized. Cows with metritis should be identified early and appropriately treated to reduce the disease’s effects and return cows to reproductive health as effectively and quickly as possible.

Monitoring strategies help detect issues early.
Early identification followed by appropriate intervention is key to successfully treating any disease. For dairies, that means closely monitoring fresh cows for clinical signs and symptoms of metritis. Since metritis often follows calving complications such as retained placenta, dystocia, twins or stillbirths, these cows in particular should be monitored closely for metritis signs.

Fresh cows should be observed at least twice daily for a minimum of 10 days, and preferably for 14 days, after calving. When checking fresh cows, check both the front and back of each fresh cow. The following steps can help identify cows with metritis or another fresh-cow health problem:
•    Evaluate uterine/vaginal discharge. Cows normally can have an odorless, red to brownish-red (mostly bloody) vaginal discharge for up to 14 days after calving. But a fetid-smelling, reddish-brown to gray discharge is a sign of an infection or retained placenta.
•    Check rectal temperature for fever. While a fever greater than 103 degrees Fahrenheit can be a telltale sign of a health problem, be aware that as many as 60% of cows with metritis don’t have an elevated temperature. (Normal rectal temperature for dairy cows ranges from 100.4 to 102.8 degrees Fahrenheit.)
•    Assess manure consistency. Manure should be firm enough to form a patty. However, foul-smelling manure with a fluid consistency or that contains blood may indicate disease or a poorly functioning rumen.
•    Look for cows with a decreased appetite. Check for the absence of feed “holes” in front of cows after they’ve been at the feed bunk to identify those that are standing at the bunk but not eating.
•    Check udder fill before milking and milk weights daily or at every milking. Milk yield and udder fill can provide clues about a cow’s overall health and how it has been eating. An udder that isn’t full can be a sign that the cow may be experiencing metritis, ketosis, hypocalcemia (milk fever), displaced abomasum or pneumonia.
•    Assess the cow’s appearance and demeanor. Watch for signs of general depression such as standing alone, lack of appetite and low hanging head. Sunken eyes can suggest dehydration, while crusty eyes and nasal discharge can indicate a potential respiratory problem. Cold, droopy ears also may indicate a sick cow, possibly one with low blood calcium (hypocalcemia). And don’t forget to check tail position since a raised tailhead can be a sign of uterine inflammation.

Cows with metritis typically can stay in the fresh pen and don’t need to be moved to a hospital pen unless the case is complicated.

Treat early to reduce disease impacts and return fresh cows to production.
Once a diagnosis of metritis is confirmed, prompt treatment with a systemic antibiotic is appropriate to return the cow to health and peak productivity. Cefenil RTU (ceftiofur hydrochloride) sterile suspension from Norbrook Laboratories is now approved by the Food and Drug Administration for use in lactating dairy cows to treat acute metritis associated with ceftiofur-susceptible bacteria. It’s also approved for treatment of foot rot and bovine respiratory disease.

The first ready-to-use, veterinary-prescription, generic ceftiofur hydrochloride injectable, Cefenil RTU is easy to incorporate into existing fresh cow monitoring and disease treatment protocols. To treat metritis, administer Cefenil RTU subcutaneously or intramuscularly at a dosage of 2 mL sterile suspension per 100 pounds of body weight once every 24 hours for five consecutive days.

With Cefenil RTU, there’s zero milk discard, so milking routines aren’t disrupted. There’s also no need to move cows to hospital pens which can add stress to an already-stressed cow. The injectable suspension’s three-day preslaughter withdrawal is one of the shortest withdrawal times for treatments on the market today.

To learn more about Cefenil RTU, contact Norbrook at (866) 591-5777 or go online at

Observe label directions and withdrawal times. Not for use in calves to be processed for veal. As with all drugs, the use of Cefenil RTU (ceftiofur hydrochloride sterile suspension) is contraindicated in animals previously found to be hypersensitive to the drug. See product labeling for full product information.

© 2020 Norbrook Laboratories Limited. All rights reserved. The Norbrook logos and Cefenil are registered trademarks of Norbrook Laboratories Limited. Excenel is a registered trademark of Zoetis Inc.

1.    Overton M, Fetrow J. Economics of postpartum uterine health. In: Proceedings of the 2008 Dairy Cattle Reproduction Council Convention. 2008:39-44.



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