Having identified that a dairy animal has become sick the first action usually involves moving her to a hospital pen. This allows focus on the problem and, although the motivation is to keep the disease from affecting or infecting the rest of the herd, it actually can contribute to doing exactly that.

Avoid hospital pen moves.  Work first and foremost with Veterinarian

Dairy producers need to establish a valid veterinarian-client-patient relationship (VCPR). Working together they can find solutions and inaugurate protocols that manage health and avoid risky hospital pen moves.

1. The number one priority is to avoid hospital pen moves.
2. The first resource for avoiding pen moves is your veterinarian.
3. The veterinarian can have one of the single largest impacts on the dairy.
4.  train the staff on proper techniques
5. develop the treatment protocols
6. evaluate and review

Is Your Hospital Pen Helping or Hurting?

These are checkpoints to avoid in a hospital pen:

• Don’t mix sick and fresh cow groups together.
• Maternity pen and Hospital pen are distinctly separate (not combined) pen uses.
• Dirty needles spread contamination as do contaminated stomach tubes.
• Employ the best hygiene practices between cows during milking in hospital pen.
• Manure contamination must be avoided (i.e. leaked milk from mastitis cows).
• Target cow comfort.
• Don’t overstock the Hospital Pen.
• Be aware of social stress (it takes 3-5 days to become socially stable after a move).
• Hospital pen animals are susceptible to developing another problem (i.e. the mastitis cow becomes lame).
• Cows are 11 times more likely to contract Salmonella bacteria while in a hospital pen.
• It is possible for hospital pen cows to become carriers of diseases (pneumonia, foot warts, enteric disease etc.)
• Make sure that dairy staff has adequate training.
• All hospital pen treatments must be monitored and reviewed.
• Take full advantage of veterinarian expertise training ,supervising and monitoring

Hospital Pen Design Contributes to Cattle Care

• Separate lame cows from sick cows.
• Avoid water, manure and cow traffic between sick cows and healthy groups.
• Design features that facilitate better and more convenient cow care
  • provide 30 inches of bunk space per cow
  • allow water space at one foot per cow
  • easy access through man passes in headlocked or non-headlocked pens
  • treatment chutes or tilt tables, hot/cold water ,storage and refrigerators for drugs and other equipment useful for treatments and/or recordkeeping
• non-slip areas wherever sick or lame cattle walk (cushioned; rubber; sand)
• hospital pen not adjacent to transition cows
• convenient for treatment monitoring and milking
• Protected from the environment (roof, shade cloth, fans etc.) to reduce stress
• Misters and water should only be used over feed bunk

Trained People + Effective Protocols = Reduced Hospital Pen Time

• Train employees regularly and monitor for compliance with treatment protocols
• Limit employee access if the herd is large and more than one individual is required
• Have staff member who specializes in dealing with sick cows
• If possible, limit their activities to the hospital area
• Wear protective clothes and gloves and change when leaving
• Make washing machines/dryers available to employees, provide coveralls or employ a uniform service to help compliance in the area of preventing disease transmission.
• Always be aware of and avoid cross-contamination
• Care for and treat calves before breeding and treating sick cows
• If possible, only the calf staff should look after sick calves
• The example needs to be set by the owner or manager for best results
• Treatment protocols should be reviewed at least annually if not more often.

Monitoring the Hospital Pen:  Record. Review. Repeat.

With the goal of drastically reducing the need for and use of the hospital pen, dairy managers need to look to and use all the tools available.

Record keeping is paramount.  

1. Most dairy management software provides a means of tracking DIH (days in hospital).
2. Record every health event (mastitis; pneumonia; lameness etc.)
3. Record when cow moved into the hospital pen and when she moved out.
4. Record each treatment intervention (medication; antibiotics; etc.)
5. Review records regularly.
6. Review trends.
7. Repeat all steps.

HOSPITAL PEN Sanitary Protocols

To prevent disease being spread to other cows

• Daily pen cleaning
• Complete removal of retained fetal membranes and other residues of health events
• Routine cleaning of the pen (including waterers) with a strong disinfectant
• Decontamination of tools used in hospital pen (stomach pumps, pilling guns, halters, etc.)
• Frequent monitoring and adjusting of cleaning frequency as needed
• Handwashing is the most important thing to do to prevent transmission of infections.
• Employees  wear latex or nitrile gloves, wash their boots and wear clean coveralls daily
• Use footbaths in extreme situations utilizing

Hospital pen NO NO’s

On top of the fact that the move to the hospital pen is itself a stressor to an animal that is already vulnerable, the pens themselves can be risky environments because of potential of contracting a new infection. Recovering from one disease incident is much different than the survival rate after a cow gets a second disease, especially Salmonellosis or Mycoplasma mastitis. Salmonella infections can lead to reduced milk yield, weight loss, poor reproductive performance and death in dairy cows. Mycoplasma bovis (M. bovis) is another bacterium that easily can be contracted in the hospital pen. In one study, 70% of cows entering the hospital pen contracted M. bovis clinical mastitis within 12 days of entering the hospital pen. All dairy staff observing the hospitable pen need to be alert to any early signs of new illness.

Controlling Spread of Hospital Pen Diseases to the Dairy Herd

During their stay in the hospital pen, fresh cows can become carriers of disease. If they don’t show signs of a clinical infection and are returned to their regular pen, the bacteria they now are carrying can follow them back to the milking herd. For example, cows with subclinical Salmonella infections can shed the bacteria to their herdmates without showing any symptoms. This puts your entire herd at risk.

Mistakes in the Hospital Pen Can Lead to Drug Residue Violations

When cows with different illnesses enter the hospital pen, they also have different treatment protocols and needs. Mistakes can happen, which can lead to violative drug residues.

There are potential for slip ups:

• leg band missed
• timing or dosage confused
• proper records not kept

Unfortunate results

• Violative drug residues
• Diminishing consumer confidence in the food produced
• You could even lose your ability to do business if these mistakes continue.”

Hospital Pen Problems are Expensive

Contagious mastitis can be passed via equipment or milkers’ hands from sick cows to herdmates.

• Each outbreak of mastitis costs $200 per case
• Mycoplasma outbreaks often begin when sick cows are grouped with fresh cows.  Mycoplasma cost can add up to $20 per day
• Each case of Metritis costs between $304 and $354 in losses of production and performance.

The Bullvine Bottom Line

In a perfect dairy world, the hospital pen would be eliminated entirely, or at the very least, underused.  In the real world hospital pens are frequently needed in order to deal with health issues.  It is the job of dairy managers to make sure that the hospital pen doesn’t itself become a disease source. Information and awareness cost nothing but, combined with appropriate and timely action, could make a significant herd health difference. How does your hospital pen score? Better? Or worse..?

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