Delivering the highest quality dairy products since 1946

Dr. Niles has been a featured speaker, both nationally and internationally on topics relating to proper cow care, in particular, maternity care on modern dairy farms. With a diverse professional background, Dr. Niles is currently the Operations Manager for the Pagel Family Businesses, overseeing two Kewaunee county dairies, Dairy Dreams, LLC and Pagel’s Ponderosa Dairy, LLC. Dr. Niles serves as president of Peninsula Pride Farms, a farmer lead environmental stewardship organization in Kewaunee and southern Door Counties. He participates in the following organizations: AVMA; AABP; DCWC; DBA and NMC.

Introduction
The standards, practices, and norms of modern dairy
treatment practices bear almost no similarity to the practices
that I encountered upon leaving veterinary school and
starting dairy practice in 1982. Basically, everything has
changed, most for the better. In 1982, the largest herd I serviced
had 80 cows. Today, that could be the hospital pen in a
5,000-cow dairy. Early on, most antibiotic treatments were
actually administered by the veterinarian. On many dairies
today, that is a rare exception. Treatment protocols existed
mainly in the practitioner’s head and could vary day to day
for a variety of reasons. Written record systems, when used
at all, were often no more sophisticated than an index card
stuck in the cow trainer above the patient. There were several
major disrupters that changed these norms over time.
Dairies modernized and expanded. As a consequence, it was
not practical for individual treatments to be administered
by a veterinarian. At the same time, the training, focus, and
skill sets of herd and hospital managers allowed these treatments
to be done with proper discipline without immediate
veterinarian supervision. Regulatory changes, such as the
Animal Medicinal Drug Use Clarification Act (AMDUCA),
focused a much brighter light on the legal limitations and
responsibilities of veterinarians, as well as better defining the
veterinarian-client-patient relationship (VCPR). No longer
could veterinarians design treatments “on the fly.” Equally
important, society changed around us. The 1% of the US
population that still farms lost touch with the 99% who do
not. The 99% want to know how animals are treated, why
they are treated, and how their families can be protected
from impurities in their food supply. None of this was on my
veterinary radar in 1982.

Basic Principles of Designing a Treatment System

The bedrock principle of designing a treatment system
for implementation on a large modern dairy starts with clearly
designating the exact individuals who will be implementing
any treatments. This obviously includes the veterinarian with
the VCPR for the herd. As mandated by AMDUCA, this is the
only person who can design treatment protocols for prescription
medications for use on the farm. This also includes not
only the fresh cow and hospital managers, but all the other
people who might be involved in administering antibiotics,
identifying animals to be treated, recording treatments and
observing restrictions, such as meat and milk withholding.
All of these individuals will need some amount of training.
If the dairy can’t identify who all these individuals are, that
is where the herd veterinarian needs to start.
The next step in the process is to collect all individuals
who have any responsibility for making treatment decisions,
in order to agree on a finite list of diseases and treatments
that will be confronted by the treatment team. It didn’t seem
like it on the day I received my Doctor of Veterinary Medicine
degree, but there is actually a very small number of disease
conditions of interest to a dairy treatment crew. The group
needs to start out by making this list. Leadership by the veterinarian
is important here.
Once the disease entities of concern are identified,
a list of approved treatment protocols for each disease is

the next step. The veterinarian obviously has a crucial role
here. Treatments need to be legal, appropriate, and within
the skill sets of the treatment crews. Once again, there may
be several different treatment protocols approved, such as a
primary and secondary intramammary treatment tube. For
each, the dose, duration of treatment, and appropriate withhold
times need to be established. This meeting should be
in the form of a discussion, so that any legitimate ideas can
be discussed. However, at the end of the day, no treatments
can be conducted on the dairy that is not established on
this list. Once a treatment protocol has been assigned, it is
automatically established as to what follow-up treatments are
scheduled, what day the cow is to be reexamined, and what
day it will be tested for drug residues. This even carries out
to meat residues. The day the protocol is assigned to a cow,
we already know what its meat withhold clear date will be.
The disease and treatment lists should be reviewed
occasionally and updated as treatment options are added or
removed. The bedrock principle has to be that no treatments
can be administered that differ from the established treatment
protocols in drug type, dose, duration or withhold. No
“cowside” modifications are permitted. One final point on
the treatment protocol table; it is a very good idea for the
veterinarian of record to conduct an occasional audit done
by another veterinarian. The second veterinarian could be a
partner, pharmaceutical tech service or even a neighboring
practitioner. This can often identify a minor protocol breach
that has unintentionally crept into the system.

Implementing the Program

Once all the written protocols are established and
agreed to, the details of practical implementation need to be
established. How does the treater know that he or she is treating
the right cow? If the hospital pen is loaded on a carousel
to be treated in between shifts, there could be significant time
pressure to get treatments done. The treater needs to know
with 100% accuracy which teat is to be treated with which
medication, which udder needs to be checked for treatment
response, which needs to be sampled for residues. An error
here can be catastrophic. In our herds, we use a DC305
treatment list that shows all treatments and checks planned
for that day in the hospital pen. As the technician identifies
a cow, the list will immediately tell him what action is necessary.
I also strongly recommend an automated system of
physical ID. On our parallel parlor, we scan the cows in for
treatment as they load into the parlor and immediately resort
the hospital list to show cows in the order in which they are
standing. In the rotary parlor, we put leg bands with an RFID
tag attached on the back legs of cows entering the hospital.
These tags are scanned from behind the cow, so the treater
knows what action to take. We find this far safer than a visual
identification by a human.
As cows prepare to be moved out of the hospital pen,
they must be tested for antibiotic residues. The purpose
here is not to double check the established withhold times
determined when a drug is approved by the Food and Drug
Administration. Instead, this is our final protection against
releasing a cow that has been accidentally treated outside its
intended protocol. Finally, a cow’s meat hold date is also
established the moment the treatment protocol is entered
into the computer. That date stays with the cow record. As
we make a list of beef cows to be sent to slaughter on a given
day, our list automatically includes her meat withhold date.
That gives us one final check to make sure a cow is not being
sent too soon.
Conclusion
The transformation in the dairy industry from small
farms with hands-on treatments delivered by the veterinarian,
to large herds with dedicated treatment teams would
seem like a recipe for residue disaster. Instead, when training
protocols and procedures are in place, we can end up with
a system that is actually safer and more disciplined than the
traditional model. There is both a serious responsibility on
the veterinarian’s shoulders in such a program, as well as a
tremendous opportunity to provide value and leadership to
a key client.

-Dr. Niles