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Taking metritis treatment shortcuts? It will cost you

Doug Hammon Published on 23 May 2014

Metritis is a common fresh cow disease that can affect up to 30 percent of a dairy herd. It can have serious impacts, including reduced fertility, lower milk production, a greater risk of culling and increased labor and treatment costs.

These can add up to more than $350 per cow for each case of metritis. Multiply that by 10, and you’ll see how quickly metritis can stink up your fresh pen and your bottom line.



Working with your veterinarian to establish early diagnosis and treatment protocols is just the beginning to protecting the health and well-being of your cows.

It’s important to understand how metritis treatment affects the cow’s uterus so you can ensure she is healthy on the inside as well as on the outside. Metritis cannot be completely avoided, but with quick identification and full treatment, its effects can be reduced.

Identifying metritis
Metritis occurs most commonly following calving complications such as dystocia, retained placenta, twins or stillbirths. It can range from a mild disease with a high rate of spontaneous cures to a severe, acute disease that can be life-threatening. Key symptoms to watch for include:

  • A foul-smelling, watery vaginal or uterine discharge
  • Fever of 103ºF or higher (Although not all cows with metritis will develop a fever)
  • A uterus that is thin-walled or contains gas
  • Depression, dehydration or lack of appetite

Screening fresh cows within the first 10 days of calving and quickly treating cows with symptoms of metritis are the best ways to prevent more costly complications of metritis. Here are steps for a complete fresh cow screening:

  • Check the udder for fullness before milking. Fresh cow udders should be full and tight.
  • Watch for drops in production from one milking to the next.
  • Examine uterine discharge and beware of red-brown or watery discharge accompanied by a strong, foul odor.
  • Assess the cow’s attitude and demeanor. Look for “depressed cows” with sunken, dull eyes, nasal discharge or cold, lowered ears.
  • Watch for cows that might be hanging back from the feedbunk or look dehydrated, and check for fever. A temperature of 103ºF or higher could be an indication of metritis.

What’s happening on the inside?
After calving, most cows suffer some level of immune suppression, which happens naturally around the time of calving. Cows with low dry matter intake or elevated non-esterified fatty acid (NEFA) levels prior to calving suffer more profound immune suppression around the time of calving. This makes them more susceptible to many diseases, including metritis.


Under normal conditions, the defense cells of the immune system are active and guard the uterus against bacterial infection during the natural process of uterine repair.

Defense cells help eliminate bacteria and prevent infection of the uterus following calving. Immune-suppressed animals have impaired defense cells that are less active, limiting their ability to fight invading bacteria.

The invading bacteria, such as Escherichia coli, begin to grow faster than defense cells. These bacteria pave the way for subsequent infection with other bacteria, damaging the lining of the uterus, which can lead to metritis. The cow might develop a fever and look sick on the outside, but more serious, long-lasting effects are occurring on the inside.

How to treat metritis
Working with your veterinarian to establish treatment protocols is important. Most cows with metritis can stay in the fresh pen and should not be exposed to cows in a hospital area unless the case is complicated. Your veterinarian can examine your cow by checking her temperature, checking for a displaced abomasum and rectally palpating the cow to assess her manure and uterine discharge.

For a fast recovery, consult your veterinarian to establish an on-label treatment regimen of antibiotics as early as possible. Antibiotics neutralize bacteria to help the defense cells fight the infection. Together with the defense cells, they keep bacteria from growing back and re-infecting the uterus.

Make treatment work
Though it might be tempting to stop treatment when cows look better, it is important to complete the full duration of therapy. Treating cows for the full therapy duration is critical to fight infection while the uterus continues to heal.


Although halting treatment might appeal from a cost-savings vantage point, the defense cells often are still too weak to fight the infection on their own. Bacteria can begin to grow back and prolong the uterine infection. This can result in the cow relapsing and a prolonged recovery.

For a successful recovery, treat cows for the full therapy duration to help ensure that the appropriate amount of medicine is administered for fighting infection, preventing bacterial regrowth and allowing the uterus to heal.

Once the uterus heals completely, defense cells return to normal and are ready to fight infections on their own. A full treatment also reduces the chance of relapse, which can be even more costly and severe for the health and well-being of the animal and your bottom line.

It is important to remember the true cost of treatment involves more than the cost of the antibiotic. If an initial, incomplete treatment fails, you will need to invest in re-treatment. This delay can reduce milk production, lower conception rates and increase intervals between calving and pregnancy.

Closely monitoring cows for early diagnosis of metritis is key to any fresh cow program. Completing a full antibiotic treatment as recommended by your veterinarian, even if the cow looks healthier, is important to ensure full recovery and minimize relapse. PD

References omitted due to space but are available upon request. Click here to email an editor.

doug hammon

Doug Hammon
Managing Veterinarian
Zoetis Dairy Technical Services