Comparison of two treatment strategies for cows with metritis in high-risk lactating dairy cows

Acute puerperal metritis (APM) and clinical metritis (CM) are uterine diseases frequently diagnosed in dairy cows. These diseases are responsible for important economic loss because of their effect not only on reproductive performance but also on milk production. The objective of this study was to assess the impact of two different treatments for metritis on dairy cows by measuring their reproductive performance in the next gestation. The end points to measure the reproductive performance included the conception rate at the first artificial insemination, the number of days at conception, and the proportion of nonpregnant cows at over 150 days after beginning milk production. The study was carried out in a high production dairy cow farm located in Lleida (northeast Spain). Recordings of 1044 parturitions of 747 Holstein cows were controlled in this farm from 2009 to 2014. Cows were diagnosed as suffering from metritis (APM or CM) if the following parameters were observed: an abnormally enlarged uterus; a fetid, watery, reddish brown uterine discharge with (APM) or without (CM) fever (>39.5 °C); and presence (APM) or absence (CM) of signs of systemic illness (decreased milk production, dullness, or other signs of toxemia) within 21 days postpartum. Afterwards, cows suffering from metritis (APM or CM) were randomly assigned and balanced to two groups: (1) animals receiving parenteral amoxicillin intramuscularly plus intrauterine infusion with oxytetracycline (P + I group) and (2) animals receiving only parenteral amoxicillin intramuscularly (P group). Furthermore, reproductive performance of cows without metritis was used as reference (control group). Metritis was diagnosed in 27.5% of the total parturitions included in the study (288 of 1044). In particular, metritis was diagnosed in 30.5% (118 of 387) and 25.9% (170 of 657) of parturitions from heifers and multiparous cows, respectively. Reproductive performance was not significantly affected by the parity, the season at the first artificial insemination, the season at conception, the bull, or the inseminator. The P + I treatment was able to significantly reduce the number of days at the first insemination and at conception when compared with the P treatment in heifers. In multiparous cows, this significant effect was only observed for days at conception. Additionally, the P + I treatment was able to significantly increase the percentage of pregnant animals at the first insemination and decrease the percentage of nonpregnant cows at greater than 150 days in milk production for both heifers and multiparous cows when compared with the P treatment.