Vets and farmers consistently under-using pain relief in cows

Ceva Animal Health hosted its second Break the Pain vet conference and round table meeting earlier this year, which brought together 40 farm vets from around the country to learn more about the most-current thinking on NSAID use in the dairy cow and to challenge barriers to pain management.

Taking place at the Lancaster House Hotel in Lancaster, the conference featured presentations on the extensive role of NSAIDs in pain relief at calving¹, for the treatment of pain and lameness associated with digital dermatitis² and for managing mobility on farm³.

The speakers included Nicola Gladden, farm animal clinical assistant professor at the University of Nottingham; James Wilson, foot health consultant at Herd Health Consultancy; Bethany Griffiths, veterinary surgeon at Farm Gate Vets in Cumbria; Emily Craven, PhD student at the University of Nottingham; and veterinary epidemiologist Natalie Robinson.

Nick Bell, director of Herd Health Consultancy, facilitated the round table discussion.

A key finding from the conference was that vets and farmers frequently under-used pain relief for dairy cows⁴.

A discrepancy was also found between vets’ perceptions of farmers’ willingness to pay and farmers’ actual readiness to provide pain relief, with cost of NSAIDs not being a significant concern for farmers.

Concerns

Concerns pertaining to cost may be further ameliorated by the proven productivity gains of using NSAIDs strategically, with a substantial return on investment of £1.66 for every £1 invested³.

Vets should not make assumptions when it comes to pain relief and spend time with clients to investigate their thoughts on NSAIDs.

It was also suggested during the conference that perhaps the term “anti-inflammatories” would get more buy-in from farmers than pain relief, due to this terminology being commonly used in human health.

The disparity in the perception of pain among the on-farm mobility team – which includes vets, vet technicians, hoof trimmers and farmers – was also discussed, with research demonstrating that farmers consistently scored pain lower than vets, and usually lower than foot trimmers and vet technicians⁴. It is, therefore, advisable to spend time with the whole mobility team to help identify any disparity in mobility scoring and offer training, as appropriate, to try to ensure consistency.

Another key finding highlighted was that only 50% of farmers were found to be using NSAIDs for conditions such as active digital dermatitis⁴, a painful condition that is one of the most frequently recorded diseases associated with lameness in dairy cows².

Extensive role of NSAIDs

During the conference, the speakers revealed the extensive role of NSAIDs in three key areas: calving; for the treatment of pain and lameness associated with digital dermatitis; and for managing mobility on farm.

A snapshot of the research presented includes the following.

• The use of NSAIDs at calving improves the welfare of both cows and calves in the postpartum period¹. Productivity gains are demonstrated, with milking performance found to be 664kg higher in the ketoprofen-treated cows than those in the control group at 305-day yield after calving. In addition, the ketoprofen-treated group tended to conceive 22 days sooner than the control group (p=0.056), and a numerically greater proportion of ketoprofen-treated cows conceived by 100 days in milk (65.7% versus 48.6%).
• Administering ketoprofen when treating cows with digital dermatitis has beneficial effects on their mobility and their milk production². Cows in a control group were 2.57 times more likely to be lame with digital dermatitis at a second evaluation compared to those treated with an intramuscular injection of ketoprofen (3mg/kg). Cows that were lame in the control group prior to treatment and did not receive ketoprofen were more than 20 times more likely to remain lame a week post-treatment compared to cows that did receive ketoprofen. On average, all treated animals (including those that were not lame) gave nearly 3kg/day more, but the freshly calved cows, which were lame at diagnosis, gave more than 10kg/day more over the seven days of the study.
• NSAIDs should be used routinely in heifers at first and subsequent calvings, and in conjunction with conventional best practice of a therapeutic trim and a hoof block, every time a dairy heifer is identified as lame³. This protocol led to an absolute reduction in lameness of approximately 10% and severe lameness of 3%, compared with animals treated in accordance with conventional best practice of a therapeutic trim and a hoof block on the sound claw (if deemed necessary) every time they were treated for lameness.

We, as a profession, are missing opportunities when it comes to discussing pain relief in cows. It is important to question ourselves, our protocols and how we communicate with farmers. Adapting to each farmer’s unique communication style is essential for effective interaction.

It is also advisable to keep communication practical and non-judgemental, in a bid to improve both welfare and production.

• All NSAIDs are currently off-licence in neonatal calves and in heifers at calving.
• This article appeared in Vet Times (2025), Volume 55, Issue 47, Pages 14-15