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Objectives: Acute puerperal metritis (APM) is a potentially life threatening, painful disease and is often treated with third-generation cephalosporins. An increasing antibiotic resistance is well documented and associated with decreasing clinical efficacy, animal welfare and economic consequences. Hence, there is the need to evaluate alternative therapies to antibiotics. Nonsteroidal anti-inflammatory drugs are frequently used as supportive treatment in addition to antibiotics and high self cure rates of APM are described. Therefore, the objective of this study was to compare the efficacies of ketoprofen and ceftiofur for the treatment of APM.
Materials and Methods: Between June 2013 and February 2015 a total of 610 dairy cows from 6 farms in Germany were enrolled. Inclusion criteria was a rectal temperature (RT) ≥ 39.5 °C and a reddish-brown fetid vaginal discharge within the first 10 DIM. Cows meeting the inclusion criteria were randomly allocated to treatment with ketoprofen (3 mg/kg of body weight, n = 300) or treatment with ceftiofur (1 mg/kg of body weight, n = 310), both administered on 3 consecutive days. Rectal temperature was recorded daily for a period of 7 days after enrollment. Cows that showed RT ≥ 39.5 °C on day 4 to 7 after inclusion received an extended treatment (extT) with ceftiofur for 3 (ketoprofen group) or 2 (ceftiofur group) more days. Between 21 and 40 DIM cows were examined with the metricheck device and vaginal discharge was categorized on a 5-point scale according to the presence of pus.
Results: A total of 52 cows (35 from ketoprofen group, 17 from ceftiofur group) were excluded from analysis due to missing protocol compliance (n = 37) or concurrent disease (n = 15). Cows initially treated with ketoprofen were more likely to have an extT than cows treated with ceftiofur (61% vs 31%, odds ratio 3.47, P < 0.01, n = 558). Occurrence of purulent vaginal discharge (PVD) was similar for both treatment groups (ketoprofen: 56%, ceftiofur: 53%, P = 0.64). However, cows with an extT had 2.12 (P < 0.01, n = 438) times the odds of PVD than cows without extended treatment. Treatment group did not affect mean 100 DIM milk yield (P = 0.58), first artificial insemination (AI) pregnancy risk (P = 0.25), time to first AI (P = 0.65) and time to pregnancy (P = 0.56).
Conclusions: More than half of the cows initially treated with ketoprofen needed an extT with ceftiofur. However, the number of ceftiofur doses administered could almost be cut in half as well without negative effects on the prevalence of PVD, milk yield, and reproductive performance