Research report
Koehorst
Research Report
FACULTY OF VETERINAIRY MEDICINE/ UTRECHT UNIVERSITY
Department of Farm Animal Health
Literature study Bovine Digital Dermatitis
Drs. M.J.H. Koehorst
Supervisors:
Dr. T van Werven
Drs. E.M. Kannekens
1
November 2008
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Index
Summary ............................................................................................................................................. 3
Introduction ........................................................................................................................................ 4
What is Bovine Digital dermatitis..................................................................................................... 5
The cause of Bovine Digital Dermatitis ............................................................................................ 5
Treatment of Bovine Digital Dermatitis........................................................................................... 7
Systemic Antibiotics ........................................................................................................................ 7
Individual topical treatment ............................................................................................................. 8
Antibiotics .................................................................................................................................... 8
Non-antibiotics ........................................................................................................................... 14
Group topical therapy..................................................................................................................... 19
Antibiotic footbaths .................................................................................................................... 19
Non-antibiotic footbaths ............................................................................................................ 20
Prevention ......................................................................................................................................... 28
Conclusion literature study ............................................................................................................. 28
Acknowledgements........................................................................................................................... 29
References ......................................................................................................................................... 30
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Summary
Bovine Digital Dermatitis is a multifactor disease which causes superficial epidermitis of the digit
at the coronary margin. It is likely to be caused by Spirochetes (Treponema spp). The presence of a
lesion is not always accompanied by lameness, but it can cause considerable pain and discomfort
that can reduce feeding, the milk production and the reproductive performance of the cow. Risk factors of getting BDD are breed, parity, stage of lactation ,calving season, housing system, heifer and
adult buying, and footbath use. There are a lot of treatment options for BDD the main treatment
groups are: (1) systemic antibiotics, (2) individual topical treatment, and (3) mass topical therapy
using a footbath. But it is unlikely that the use of systemic antibiotics will be economically viable as
a method of control of Bovine digital dermatitis, only in small numbers of animals. For topical
treatment a lot of options are available from Foam till antibiotic spray. Foot bathing is an important
key factor in controlling the disease, this is effective when its regularly repeated.
Environmental condition seems to be a important factor for the prevalence of the disease, liquid
manure and moist are factors for developing Bovine Digital Dermatitis.
The introduction of BDD into a dairy herd can lead to an ongoing struggle for control and treatment
of lesions in combination with a production loss.
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Introduction
Bovine digital dermatitis (BDD) is one of the most common conditions causing lameness in cattle
(Laven and Proven, 2000). In recent years there has been an increase of incidence of Dermatitis
Digitalis, as a result of fundamental changes in dairy cattle production (Laven and Logue, 2004,
Somers et al. 2005). The presence of BDD in the Netherlands is said to be around 30% in cows kept
in cubicle houses (Somers et al 2005). In the 1990’s, USA reports suggested that 11.9% of the dairy
cow population was affected with BDD and that the prevalence of BDD has increased (Epperson
and Midla, 2007). In Denmark in 1996 there was a herd prevalence of 4% and in 2008 85% of the
herds were affected and on average 21% of the cows in these herds were affected with BDD (Capion, 2008). In a infected herd, surveys in the Netherlands showed that around 20% of the herds are
affected with BDD (Holzhauer et al. 2006, Laven, 2008). The precise cause and factors which predispose to its occurrence in herds are still unclear. It is believed to be a multifactor disease (Shearer
et al. 2000). The disease has effect on the welfare of the cattle because BDD is very painful (Capion, 2008) and it has economic impact as well because the pain can cause lameness which affects
production and reproduction of the cattle (Capion, 2008). There are not may scientific articles
providing experimental data concerning its treatment, pathogenesis and control. This review is an
attempt to summarize the current state of knowledge about the pathogens causing digital dermatitis
and the treatment methods and their results on Bovine Digital Dermatitis. The main treatment
groups that are discussed are (1) systemic antibiotics, (2) individual topical treatment, and (3) mass
topical therapy using a footbath. This review discusses which treatments are suitable and effective
and which ones are not (Laven and Logue, 2004). Prevention and control plays a important role and
is also discussed.
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What is Bovine Digital dermatitis
Bovine Digital Dermatitis is a superficial epidermitis of the digit at the coronary margin. Other
names used for this disease are Mortellaro disease, hairy heel warts and Papillomatous digital dermatitis (Read and Walker, 1998, Cruz et al. 2001). It is a contagious inflammation of the epidermis
and it characteristically affects the skin at the plantar/palmer aspect of the bovine foot, near the heel
bulbs (Blowey and Sharp, 1988, Cruz et al. 2001,Vink, 2006). The heel bulbs are close together
which means that the typical site of Digital Dermatitis infection is more prone to continually being
moist, which favors the development of BDD (Read and Walker, 1998). The presence of a lesion is
not always accompanied by lameness, but it can cause considerable pain and discomfort that can
reduce feeding, the milk production and the reproductive performance of the cow (Laven and Proven, 2000, Kofler et al. 2004). The lesions occur 80-90% (Vink, 2006) in the hind feet and many of
the affected cows 66% have the lesions at both feet (Blowey, 2008) and that 41% of cows had lesions of varying severity. The presentation of the lesions differs in time: erosive, granulomatous
(strawberry-like: M2), proliferative (hyperkeratosis) and regressing (after treatment) (Vink, 2006).
By Döpfer et al. (1997) BDD was recorded using a standardized scoring system comprising five
stages (M0-M4). M0 is normal skin, M1 is an ulcerative little lesion, M2 is the active strawberrylike lesion (very painful), M3 is the lesion covered by a scab and M4 is the chronic proliferation
phase. M2 and M4 lesions are the most infectious stages of BDD and carry Treponema spp. on their
surfaces (Holzhauer et al. 2008). This is a very clear scoring system. In most of the used articles in
this research the different stadium of the disease that are found are not mentioned in the materials
and methods of the articles. Only in the article from Holzhauer et al. (2008), the stadium are clearly
mentioned and what is important to score: active infection is defined as a transition from
M0,M1,M3 or M4 to M2 and resolving M2 lesions were defined as transition from M2 to another
stage. In the study of Laven and Hunt 2001 for example they score lesion size, depth and color and
treated lesions of moderate severity. So it is very unclear in which phase of the disease is present in
this research and if the treatments can resolve M2 lesions, because that is the thing I want to see at a
treatment. Research in the future should all use one sort of scoring system so it is immediately clear
for other researchers what has been done and how in a research.
How long the M2 phase is present is not clear. When the disease is untreated the condition can persist for months, which can cause welfare problems (Laven and Proven, 2000). So when you are
treating already a healing lesion you can get positive results of the treatment. So every research
should have a control group!
The cause of Bovine Digital Dermatitis
The etiology of BDD is complex and the primary cause is still uncertain. Due to the rapid spread of
the disease it is likely to be caused by a contagious matter. Examination of the lesions and response
following topical treatment with antibiotics indicated the involvement of bacteria in the development of the disease (Read et al. 1992, Read and Walker, 1998). Superficial epidermal debris contains many Gram-negative bacterial species and the bacterial infection in the deeper layers of the
dermis is caused by a spirochete (Choi et al. 1997 , Vink, 2006, Walker, 1995). For example these
pathogens are mentioned to be found in lesions: Fusobacterium spp, Bacteroides spp, Campylobacter spp, poptococcus spp, Spirochetes phylotypes (Laven and Logue, 2004). It looks like Spirochetes are the predominant bacterial morphotype because they cause necrotic changes in the lesions,
so they might implicate the infection. (Read et al. 1992, Demirkan et al. 1998, Choi et al. 1997).
The found Treponema species indicated a close relatedness with the human spirochetes: T. denticola en T. medium/T. vincentii, T. phagedenis (Stamm et al. 2002 ,Choi et al. 1997).
The two spirochetes most likely to be implicated are the treponemes designated 2-1498 and 19185MED. Spirochetes have a predilection for keratinized cells and produce a toxin which is ker5
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atolytic (Blowey et al. 1994). It can produce two types of lesion: erosive (strawberry-like) or proliferative (wart-like).
The conclusion of a recent study after fluorescence in situ hybridization with a Treponema group
specific probe showed that Treponema accounted for more than 90% of the total bacterial population in the biopsies. These data strongly suggest that a group of apparently symbiotic Treponema
species are involved as primary bacterial pathogens in BDD (Klitgaard et al. 2008).
Beside the infectious cause of BDD which is discussed above, there are other risk factors like environmental, farm-management and individual animal factors that indirectly cause BDD. Probably
because of certain changes that happened in dairy farming like an increased herd size, increased
milk production, restricted grazing and increased housing (Somers et al. 2005, Holzhauer et al.
2006). These risk factors can be split in to two groups. Cow-Level factors and Herd -Level factors.
First a description about the Cow-Level factors which are breed, parity, stage of lactation and calving season (Rodriguez-Lainz et al. 1999, Somers et al. 2005 , Holzhauer et al. 2006). Breed is a risk
factor, herds with predominately Holsteins have a risk factor for developing BDD (Shearer, 2000,
Frankena et al. 1991) and other claw problems (Rodriguez-Lainz et al. 1999). The prevalence for
BDD at first-parity cows was higher than for other parities (Rodriguez-Lainz et al 1999, Read and
Walker, 1998, Somers et al. 2005). This can be explained by the metabolic and environmental
changes first lactation cows experience around calving. Nutrition can also be a risk factor associated
with BDD so a healthy diet around critical points in a cows life are important. Aging cows have
more development of immunity and a reduced risk for developing BDD with increasing parity
(Holzhauer et al. 2006, Read and Walker, 1998, Rodriguez-Lainz et al. 1999, Frankena et al. 1991,
Blowey et al. 1994, Somers et al. 2005). The stage of lactation might be a risk factor also, but different studies have contradicted results. The odds of BDD increased during the increasing days of
milking (Rodriguez-Lainz et al. 1999, Holzhauer et al. 2006). The seasonal changes in calvingrelated management and environment is also a risk factor for BDD, in winter there are cool, wet and
muddy conditions which are a predisposing for BDD (Rodriguez-Lainz et al. 1999). Experimental
transmission of BDD has only been achieved by soaking the skin of a calf with water daily for eight
days and then applying fresh BDD exudates onto scarified skin using gauze. Lesions of BDD developed within 14 days, whereas no BDD developed on dry skin. Wet environmental conditions are
extremely important in the development of the disease (Blowey, 2008).
Second a description about herd-level factors which are the housing system, heifer and adult buying, and footbath use (Rodriguez-Lainz et al. 1999). The housing system appears to be an important
risk factor for BDD. Outbreaks of the disease are only reported in housed cattle (Blowey and Sharp,
1988, Read and Walker, 1998, Cruz, 2001) so those systems with their environmental or biological
factors may be important risk factors (Rodriguez Lainz et al. 1996,1999, Cruz, 2001). There is mentioned in the report of Frankena et al. (1991) that BDD prevalence appeared to have increased in the
intervening period so there might be an association with prolonged housing periods and the increased prevalence of BDD in a herd (Frankena et al. 1991, Vink, 2006). The housing system which
is the most important factor vary among the studies, probably depending on other factors such as
geographical location, climate, dairy management and time (Rodriguez-Lainz et al. 1999). The hygiene of the housing, flooring type, access to pasture (Epperson and Lowell, 2007), foot care routines (claw trimming, lameness detection, and treatment (Capion, 2008)) as the presence of microorganism plays a part in occurrence of the disease. Drier flooring conditions (automatic scraped
slatted floor, during the dry period and separated before calving) give a lower risk for developing
BDD lesions (Somers et al. 2005). Predisposing factors for BDD are dampness with maceration of
the skin (Epperson and Lowell, 2007). The type of flooring seems to be important in the prevalence
of BDD. There is an increase of prevalence of BDD when herds are housed on concrete floors
(Somers et al. 2003). Purchasing replacement animals is also a risk factor because infection of other
animals can be by indirect contact, from the gastrointestinal flora, epidermal flora or buccal origin
(Vink, 2006). Purchased cattle, heifers and young stock that were raised off the farm and returned at
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a later date are a risk for a higher prevalence for BDD (Shearer, 2000). Buying new animals like
heifers could be a way of introducing the infection or in already affected farms increasing the infection pressure (Rodriguez-Lainz et al. 1999). Footbaths are particularly difficult as well as costly to
manage properly in large herds and can spread the disease when its not used in a proper way
(Shearer, 2000). Hoof trimmers who also work on other farms and do not routinely wash their
equipment are a risk for spreading BDD (Rodriguez-Lainz et al. 1999). Factors which predispose
BDD to its occurrence in herds are largely unclear. But the factors that are mentioned above may be
useful for prevention and/or control of BDD. Further research is required for better establishment of
the etiology and pathogenesis of BDD.
Treatment of Bovine Digital Dermatitis
The treatment of BDD has been aimed primarily at reducing the bacterial infection. There are different sorts of treatments for BDD varying from systemic antibiotics till topical foam products. But
there are only a few peer-reviewed studies published about the effectiveness of these treatments.
The clinical trails that have been done lacked control groups (Laven and Logue, 2006) and many of
the references to treatment have been anecdotal or limited to “response rates” with few details of
materials and methods (Laven, 2008, Thomsen et al. 2008)). The three main treatment groups are:
(1) systemic antibiotics, (2) individual topical treatment, and (3) mass topical therapy using a footbath (Laven and Logue, 2004, Vink, 2006). When treatment is started a correct claw conformation
and a correct heel height is necessary, so functional claw trimming should be carried out (Kofler et
al. 2004).
Because there is not a standard protocol what to do when Bovine digital dermatitis is present in a
herd, this review tried to make a summery of treatments. Treatment method of Bovine Digital Dermatitis as discussed below, has been primarily aimed at reducing bacterial infection.
Systemic Antibiotics
There are only a few investigators who have found that systemic treatments are effective (Read and
Walker, 1998, Rutter et al. 2001). Other investigators disagree with that and found that the treatment was ineffective (Blowey and Sharp, 1988 ,Borgmann et al. 1996 ,Britt et al. 1996, Laven and
Hunt, 2000, Silva et al. 2005). The antibiotic for parenteral use which is licensed in the Netherlands
is : third choice: -cefquinome (formularium 2007). Systemic antibiotics are a less attractive method
for treatment because of the lack of effectiveness, high costs and the milk withdrawal times (Vink,
2006). So the conclusion at the end is that it is unlikely that the use of systemic antibiotics will be
economically viable as a method of control of Bovine digital dermatitis, only in small numbers of
animals (Laven, 2008).
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Table 1: Reported individual systemic antibiotic treatments
Product
Regime
Systemic treatment with procaine penicillin
and ceftiofur
35 cows:
7 cows IM procaine penicillin 2
x daily for 3 days
(18,000 units/kg)
and 15 cows IM
ceftiofur (2
mg/kg daily) daily for 3 days
(Read and
Walker, 1998)
Systemic treatment with
cefquinome.
50 cows
Systemic:
cefquinome 3
days
Efficacy
pp: 7 responded
c: 13 responded
from strawberry
till crust
Comment
recurrence and new
lesion development: 48%
no control treatment (for whole
experiment only
two untreated cows
of the 35)
The response was
82% after 30 days
and 0% at 22 untreated cows.
(Rutter et al.
2001)
Parenteral
treatment with
oxytetracycline
(Silva et al.
2005)
30 cows
ineffective
4 treatments parenteral oxytetrarecovery rate of
cycline (10 mg/kg 56.67%
bodyweight, IM,
q48h)
surgical treatment
of BDD lesions.
control group was
not used so the
cows which spontaneous recovered
are undetacted.
Individual topical treatment
Topical treatment with an authorized product is far more commonly used for Bovine Digital Dermatitis than systemic treatment. Topical treatments of BDD are with antibiotics or disinfectants
which are locally applied. Most of the time it is sprayed on lesions directly but a bandage also can
be used (Epperson and Midla, 2007). Articles reported a success with relieving clinical signs (Hernandez and Shearer, 2000, Britt et al. 1996), but after a successful single topical treatment of BDD a
relapse can be expected within 5-7 weeks (Manske, 2001). In 48% to 60% of successfully treated
BDD cases within 7-12 weeks new lesions occurred (Capion, 2008). This might be due to persisting
microorganisms so more treatments and preventive measures for the herd are necessary (Manske,
2001). The following is a description about the available topical treatment methods.
Antibiotics
Individual topical treatment with antibiotics are applied per aerosol. The local therapy aerosols that
are licensed in the Netherlands are second choice antibiotics ; oxytetracycline-spray / chlortetracycline spray (formularium 2007). These aerosols are widely used and seem to be effective. Topical
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treatment with an oxytetracycline spray after cleaning the lesion was suggested as the best treatment
by Blowey and Sharp (1988) and its still the most commonly reported treatment option for individual cases (Laven, 2008, Laven and Logue, 2004). The effectiveness seems clearly established by
reports (Blowey and Sharp, 1988, Cruz et al. 2001). Treatment after hoof trimming with oxytetracycline solution were effective and had a cured rate of 87% in a research of Manske et al. (2002).
The feet that were not treated were used as within-cow controls for the treatments, which is a positive point in this study. After treatment a light bandage was applied to cover the medical treatment.
This bandage has probably positively influenced the results of this study, because the feet kept
clean and had a prolonged exposure of medical treatment on the lesion (Manske et al. 2002). But
when a farmer use oxytetracycline spray most of the times they don’t put a bandage on because its
to much labor. In this study there was made clear that lesion score of 1-3 was not good and lesion
score 0, 4-5 was healing and if no new lesions occurred this was scored as a preventive effect. Single treatment can be efficient, but most times repeated treatment is preferred. In different reports
different treatment regimes have been suggested ranging from a single treatment with oxytetracycline/gentian violet aerosol (Brizzi, 1993) to twice daily for 21 days (Britt et al. 1996). There is a
significant impact on the response to oxytetracycline when the disease is in the interdigital cleft or
above the heels or around the dew claws. Digital dermatitis in the interdigital cleft was less responsive to the treatment (Hernandez and Shearer, 2000). One of the most recent studies about topical
application of oxytetracycline showed that the healing rate of lesions after single topical treatment
is low and that the lesions in primiparous cows and large lesions had a pore recovery rate. The larger the lesion the more pcr-positive results for spirochetes. So this probably attributed to the inadequacy of a single topical application of oxytetracycline for eliminating the pathogen. Further was
explained in this study that the herd that was used had a long-tem exposure to topical treatments
with oxytetracycline so this may have contributed to the reduced efficacy of the topical treatment,
this was also found in a study of Shearer and Hernandez (2000b). The conclusion was that one-time
topical oxytetracycline treatment of individual cows is inadequate in a herd where BDD has been
endemic and were there has been a long-term use of oxytetracycline (Nishikawa and Taguchi,
2008). Overall the treatment that is recommended here at the Veterinary faculty in Utrecht is a three
day treatment of the lesion with oxytetracycline-spray / chlortetracycline spray.
There are many antibiotics for treatment of Bovine Digital dermatitis, but they have no additional
benefit over oxytetracycline and there are relatively few controlled peer-reviewed efficacy studies
about these (Laven, 2008, Laven and Loque, 2004). Laven and Hunt (2001) applied two different
antibiotic sprays on two treatment groups of 12 cows (Topical spray with Valnemulin and Lincomycin). This study found that there was improvement in BDD within 14 days of the first treatment.
But the starting lesions are to be said of moderate severity, but there isn’t mentioned which phase of
the disease the cows were in like M2 or M3. There is an lesion score reduction after 14 days, but
would a lesion with conventional treatment also reduce in size after 14 days? If the lesion had already a crust than without treatment it is possible that after 14 days the crust is coming loose and so
the lesion will be smaller. In the Netherlands these products are not authorized for topical use (formularium 2007).
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Table 2: Reported individual topical antibiotic treatments
Product
Regime
Topical treatment with oxytetracycline solution
12 cows
Topical oxytetracycline solution
(100 mg/ml) 3
times daily for
three weeks
(Britt et al.
1996)
Topical treatment with gentian violet and
tetracycline
aerosol spray
(Blowey and
Sharp, 1988)
Topical treatment with oxytetracycline
(Nishikawa and
Taguchi, 2008)
Topical treatment with oxytetracycline
(van Amstel et
al. 1995)
Efficacy
effective: mean
lameness score
decreased
Comment
control group: placebo (tap water)
mean lameness
score increased for
the control group
Topical treateffective
ment, consisting
of excoriation and
application of a
gentian violet and
tetracycline aerosol spray
89 cows (lesions
on hind feet)
5 ml of a solution
containing 100
mg/ml oxytetracycline on a cotton pad + elastic
bandage
Removed after 4
weeks
13.8% healed
completely (8 of
58 cases) in primiparous cows
and 38.7% (12 of
31 cases) in multiparous cows
control group was
not used so the
cows which spontaneous recovered
are undetected.
Topical treatment
with oxytetracycline mixture after cleaning with
water using a
high pressure
hose.
Prevalence reduced to 28%
7 months later new
outbreak; 37% of
lactating herd affected and 48% of
the affected cows
were new cases
and the rest were
reinfections.
one month treatment
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Product
Regime
Efficacy
Comment
Topical application of oxytetracycline powder in combination with formaldehyde aerosol
524 cows 30%
with DD.
Topical application and bandaging for three to
five days
effective in most
of the affected animals.
not enough information about materials and methods
and results (the
scoring, treatment)
no use of a control
(Cruz et al.
2001)
Topical treatment with oxytetracycline
(Manske et al.
2002)
50 cows: 200 feet
Treatment after
hoof trimming
with two applications of 5 ml of a
water-based oxytetracycline solution at a concentration of 100
mg/ml.
effective and had a The feet that were
cured rate of 87% not treated were
used as within-cow
controls for the
treatments
After treatment a
light bandage was
applied to cover
the medical
treatment, control
feet were left
without bandage
and after 5 days a
second treatment
was done and after 2 days the
bandage was removed
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Product
Topical application of oxytetracycline solution or benzathine penicillin powder
Koehorst
Regime
Efficacy
Comment
Topical applicaeffective on the
tion of oxytetraulcerative lesions
cycline solution
(30 cows).
or benzathine
penicillin powder.
50 cows with DD.
(el-Ghoul and
Shaheed, 2001)
Topical application of oxytetracycine and
four non antibiotic solutions
for treatment
(Hernandez et
al. 1999)
Individual topical
treatment with
oxytetracycline
25 mg/ml, for
eight days.
On basis of pain
and lesion scores:
effective.
used tap water as
control
more than the other products and the
(66 cows random- same as the comly treated with 4
mercial formulaproducts).
tion.
examined 14 and
30 days after initial treatment
Topical treatment with oxytetracycline solution compared
with treatment
with (3 x modified) Victory
solution.
(Shearer and
Hernandez,
2000b)
possible antibiotic
19 cows
low efficacy
resistance
Treatment with
oxytetracycline
17 of the 19 cows
no control group
solution (Terrahad lesions larger
mycin-343 Solu- than 2,5 cm diameble Powder, 25
ter
mg/ml).
lesion size score
Treatment once
were not signifidaily for 5 consecutive days, not cantly different
among groups
treated for 2 d,
and than treated
once daily for
three additional
treatments.
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Product
Topical treatment with oxytetracycline solution.
(Hernandez and
Shearer, 2000)
Koehorst
Regime
Efficacy
Comment
70 dairy cows
oxytetracycline
appeared signifi1 of 3 groups (in- cantly less effecterdigital cleft [n tive among cows
= 14], heels [30], with lesions on the
or dewclaw [26]) interdigital cleft
than for cows with
Individual treated lesions on the
topically with ox- heels or the dewytetracycline so- claw.
lution.
Cows with lesions
Cows were exam- on the interdigital
ined 14 and 30
cleft were less
days after initial
likely to respond to
treatment.
treatment, comPain and lesion
pared with cows
scores were exwith lesions on the
amined.
heels or the dewclaw.
Single topical
3 cows: oxytetraapplication with cycline single
oxytetracycline topical application of 5 g of sol(Read and
uble powder
Walker, 1998)
bandaged onto a
clean lesion for 7
days (3 cows)
no control study
3 responded (all
lesions responded (for whole experiment only two un;crust)
treated cows of the
35)
no recurrence or
new lesions were
seen.
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Product
Koehorst
Regime
Topical spray:
Two groups of 12
Valnemulin and cows.
Lincomycin
One group was
treated with 25
(Laven and
ml of a solution
Hunt, 2001)
containing 0.6 mg
lincomycin/ml
and the second
group was treated
with 25 ml of a
solution containing 100 mg/ ml
valnemulin. Each
animal was given
two treatments 48
hours apart.
Efficacy
There is an lesion
score reduction
after 14 days.
Comment
positive control
with lincomycine
1: six of 15 lesions
cured
2: five of 18 lesions cured.
Non-antibiotics
Because there are no clear studies about what the best efficient treatment is for Bovine Digital Dermatitis and because about the concerns regarding antibiotic resistance, costs, milk
withdrawal and environmental contamination. A lot of effort is put in investigation for other
treatment options than antibiotics, but the published data of the efficiency of these treatment
are limited.
Treatment options: hydrogen peroxide/ peroxyacetic acid, glutaraldehyde, PVP-iodine, acidified sodium chlorite solution, acidified ionized copper solution or copper sulphate. These
can be used for BDD. Also there has not been verified in controlled studies that the products
are efficient. (Vink, 2006, formularium 2007)
Other commercial products that may be effective in direct topical application are Victory
and Hoof Pro Plus. These have also variants for use in footbaths (Epperson and Midla,
2007).
Acidified ionized copper in a solution as a spray has been reported to have a curative effect
on BDD when it was used three times a day for three weeks and it seems to be less corrosive
and less hazardous to the environment than copper sulphate (Britt et al. 1996, Manske et al.
2002). But the same spray did not have an acceptable effect sprayed only once daily, eight
times during a two-week period (Hernandez et al. 1999).
In a research of Manske et al. (2002) the conclusion was that hoof trimming alone had the
same effect as a treatment with glutaraldehyde. The study of Kofler et al. (2004) used the
treatment on one side of the hoofs Protexin Hoof-Care paste and on the other side oxytetracycline spray. They had the results that there was improvement within 4-10 days of the first
treatment. So only short-term effects were seen and no conclusions can be drawn about the
long term effects.
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Table 3: Efficacy of antibiotic alternatives as topical sprays in the treatment of digital dermatitis.
Product
Regime
PVP–iodine (7.5%)
2 x daily for 5 days
(at milking).
(Assessed on Day 6
and 10)
(Laven and Logue,
2006)
Copper sulphate
(5%)
(Laven and Logue,
2006, Hernandez et
al. 1999)
Acidified ionized
copper solution
(Laven and Logue,
2006, Hernandez et
al. 1999)
Acidified ionized
copper solution
(Laven and Logue,
2006, Britt et al.
1996)
Hydrogen
peroxide /
Peroxyacetic acid
(Laven and Logue,
2006, Hernandez et
al. 1999)
Efficacy
Comment
No effect on prevalence cf. tap water
Daily for 8 days
Less effective than
(Assessed on Day 14 25 mg/ml
and 30)
oxytetracycline at
reducing pain and
(66 cows randomly
lesion
treated with 4 prod- score and not signifucts).
icantly better than
tap water
Daily for 8 days
Less effective than
(Assessed on Day 14 25 mg/ml.
and 30)
oxytetracycline at
reducing pain and
(66 cows randomly
lesion score and not
treated with 4 prod- significantly better
ucts).
than tap water
12 cows
3 x daily for 21 days
(at milking)
(Assessed on Day
21)
Significantly reduced lameness
score cf. tap water.
As effective at reducing lameness
score as 100 mg/ml
oxytetracycline 2
control group: placebo (tap water)
mean lameness
score increased for
the control group
Daily for 8 days
Less effective than
(Assessed on Day 14 25 mg/ml
and 30)
oxytetracycline at
reducing pain and
(66 cows randomly
lesion score and not
treated with 4 prod- significantly better
ucts).
than tap water
15
Research report
Product
Hydrogen
peroxide /
Peroxyacetic acid
Koehorst
Regime
No significant effect
on lesion size cf. tap
water. Mean lesion
size increased in all
groups
12 cows: 3 x daily
for 21 days
(Assessed on Day
21)
Significantly reduced lameness
score cf. tap water.
As effective at reducing lameness
score as 100 mg/ml
oxytetracycline 2
Two applications 5
days apart,
bandaged 7 days
(Assessed on Day
32)
Cure rate significantly less than lesions treated with
100 mg/ml oxytetracycline and not significantly better than
hoof trimming alone
22 cows
lesion size score
no control group
were not significantly different among
groups
(Laven and Logue,
2006, Britt et al.
1996)
Glutaraldehyde
(Laven and Logue,
2006)
Topical treatment
with Victory (soluble copper, peroxide
compound, and a
cationic agent) compared with topical
treatment with oxytetracycline solution
(Shearer and Hernandez, 2000b)
Comment
Daily for 21 days
(Assessed on Day
21)
(Laven and Logue,
2006)
Acidified sodium
chlorite solution
Efficacy
Treatment once daily for 5 consecutive
days, not treated for
2 d, and than treated
once daily for three
additional treatments.
control group: placebo (tap water)
mean lameness
score increased for
the control group
20 of the 22 had a
lesion score larger
than 2,5 cm in diameter.
16
Research report
Product
Topical treatment
with a modified
formulation of Victory (reduced soluble copper and peroxide compound,
but increased concentrations of cationic agent) compared with topical
treatment with oxytetracycline solution
Koehorst
Regime
17 cows
Treatment once daily for 5 consecutive
days, not treated for
2 d, and than treated
once daily for three
additional treatments.
Efficacy
Comment
lesion size score
no control group
were not significantly different among
groups
14 of the 17 had a
lesion score larger
than 2,5 cm in diameter.
(Shearer and Hernandez, 2000b)
Topical treatment
with a modified
formulation of Victory (soluble copper
and cationic agent
equivalent to the
original formulation
but with reduced
levels of peroxide
compound) compared with topical
treatment with oxytetracycline solution
20 cows
Treatment once daily for 5 consecutive
days, not treated for
2 d, and than treated
once daily for three
additional treatments.
lesion size score
no control group
were not significantly different among
groups
18 of the 20 had a
lesion score larger
than 2,5 cm in diameter.
(Shearer and Hernandez, 2000b)
17
Research report
Product
Protexin ® HoofCare paste
Koehorst
Regime
26 acute DD lesions: with Protexin
Hoofcare paste
(Kofler et al. 2004)
Efficacy
Comment
Improvement within control side:
4-10 days of the first oxytetracytreatment (both
cline spray
treatments)
Variation of treatment varying from
1-3 treatments depending their severity at examination.
control: 26 cases
with oxytetracycline spray
Topical treatment
with glutaraldehyde
(Manske et al. 2002
)
Topical treatment
with Formaldehyde
(39%)
(Read and Walker,
1998)
50 cows: 200 feet
1 foot was treated
with 5 ml of a 1:50
dilution of a gluaraldehyde formula and
the other feet was
not treated. After 5
days the treatment
was repeated and the
bandage was removed after 2 days
after the second
treatment.
single topical application (5 cows)
hoof trimming alone
had the same effect
as a treatment with
glutaraldehyde.
within-cow
control study
al 5 cows responded
and all the lesions
responded
no control
study
no recurrent and
new lesions were
seen
18
Research report
Koehorst
Product
Topical treatment
with hydrochloric
acid (36%)
Regime
Single topical application (4 cows)
(Read and Walker,
1998)
Efficacy
Only two cows responded
Comment
no control
study
No recurrence of
the lesions were
seen, at two cows
new lesions occurred.
Group topical therapy
Footbath solutions can be used to aid in the reduction and control of Bovine Digital Dermatitis. The
efficiency of the footbaths depends on a range of factors: foot bathing frequency, housing conditions, weather, nutrition and management.
The most common footbath is the walk-through variety. Footbaths can clean debris from feet and/
or apply a disinfectant or antibiotic to the feet. Also footbath are used in a preventive strategy. The
advantage of footbaths is that it require a minimal amount of expense to set up and maintain. With
topical applications areas of the foot can escape contact, but with footbaths the solution can totally
immerse the foot on the other hand the walk through bath has a short contact time of the feet with
the solution (Vink, 2006, Epperson and Midla, 2007).
The problem of using footbaths is that the protocols (timing, frequency) and the solutions are used
inconstant which influence their efficiency. Other problems that come forward by using footbaths is
that cows defecate and urinate in the bath, which inactivates and dilutes the active ingredients in the
solution. Also the feet are covered with feces and so the active ingredients can not reach the skin.
These are a couple of reasons why footbaths have disappointing results. The solution must contain
the correct concentration of chemicals and be maintained at the correct temperature. Changing the
solution is recommended to do every day or after passing of 200 cows. Cleaning the feet before entering a footbath is preferable so that the solution can reach the skin for optimal effect. Afterwards,
the skin should be allowed to dry to ensure optimal effect of the chemicals (Nuss, 2006). There is
surprisingly little controlled data about the multitude of substances that are used in footbaths for
control of BDD. Their mode of use is subjective and the effectiveness varies considerably (Nuss,
2006).
Antibiotic footbaths
In a study from Laven and Proven (2000) two groups with 55 and 56 cows were treated with a
erythromycin footbath. There wasn’t an control group used in this study. For examination of the
lesions clinical sign like exudation, reddening, creaminess and scabbing was used, but definition of
the stadium the disease was in lacked, so it is not clear which stadium of the disease was predominant in the beginning and the end. The study lasted only 11 days and the lesions take longer time to
change in size, also there is not known what the long term effect is of the treatment. So how long it
takes before there is a relapse and the disease starts all over again is not known. That the use of
erythromycin in footbaths reduced the lesions rapidly is the only short term conclusion that can be
done (Laven and Proven, 2000). Is this because of a microbiological effect on other bacteria than
19
Research report
Koehorst
the spirochetes? that is not clear. In the study is said that footbath regimen will only partly control
and not eliminate digital dermatitis and spray is more effective (Laven and Proven, 2000). Antibiotics in footbaths has a lot of uncertainties, because it is not known which optimal concentrations and
intervals between treatment must be used. Also the number of cows which can walk through the
solution before it must be refreshed is unknown. More problems are bacterial resistance and it is a
ballast for the environment. Also there are no specific guidelines on disposal of the leftover solution
of the footbath. The use of antibiotics in footbaths is not registered in the Netherlands (Vink, 2006,
formularium 2007).
Table 4: Reported antibiotic footbaths.
Product
Regime
Erythromycin footbath Test: 55 cows and 56
untreated for 11 days.
(Laven and Proven,
2000)
This was done on day
0 with group 1 and on
day 4 with group 2.
Footbaths erythromycin(350 mg erythromycin/liter): 4 days 2
times a day.
These 56 cows were
then treated in the
same way (after 4
days) and both groups
were re-examined
seven days later.
Oxytetracycline footbaths (6 g/liter)
(Cruz et al. 2001)
Oxytetracycline footbaths (6 g/liter) for 10
minutes daily (three
days) and improvement of general housing hygiene
Efficacy
Their lesions were
significantly less active and painful than
those of the 56 untreated cows.
Comment
only control group for
4 days
There were no significant differences between the clinical
signs observed in the
two groups, and the
benefits of the treatment had persisted for
the 11 days of the trial.
were beneficial as
control measures
not enough information about materials
and methods and results (the scoring,
treatment)
no use of a control
group
Non-antibiotic footbaths
Usable products for the footbaths are formalin, copper sulphate, peracetic acid, peroxide-based
products and others. Next will follow a discussion about the studies that are found which are about
the effects of products in footbaths.
20
Research report
Koehorst
Formalin is an solution of formaldehyde and methanol. Formalin can be used for the treatment of
BDD in the Netherlands. There are results published about the use of formalin footbaths, but adverse effects were observed depending on the concentration and frequency of use. Only in a research of Laven and Hunt (2002) formalin (2,5%) has been effective in BDD control. Formalin has
powerful disinfectant properties but is less appealing from a welfare perspective, because of painfulness, respiratory and contact irritant and it is carcinogenic (Vink, 2006, Epperson and Midla,
2007).
Copper sulfate has been commonly used as a footbath disinfectant due to availability and ease of
use. Copper sulfate solution is considered to be effective for 150-300 cow passes (Epperson and
Midla, 2007). The results on the use of copper sulfate are contradictory. Some articles find that it
appears to be effective in reducing BDD lesions (Bergsten et al. 2006, Laven and Hunt, 2002). A
negative aspect is that the use of 2% CuSO4 in footbaths leads to unwanted copper piling in the
paddocks and needs to be disposed as chemical residue by the law (Vink, 2006, formularium 2007).
The foam product Kovex® (peracetic acid, glycerin and a skin toner) is also claimed to be effective
to use for BDD. But there have not been any controlled trails, so maybe the effect was due to the
mechanical cleaning of the feet (Laven and Logue, 2004). In the study of Bergsten et al. (2006) had
no evidence of an effect of a foam bath with Kovex® were 101 cows walked through for two times
a day.
A study about Victory crystalline formulation came to the conclusion that there might be evidence
of an quickly and effective footbath product. But management plays a role in the overall effectiveness of footbaths (Gradle et al. 1997). Other commercial products for use as footbath disinfectants
that where shown to be effective are Double Action (Epperson and Midla, 2007). A footbath containing a solution of acidified ionized copper might also be an effective treatment of BDD (Manske
et al. 2002). Footbathing in this research the solution was more effective than foot bathing in water
(Manske et al. 2002). Virocid (glutaraldehyde), Kickstart 2 (organic acids), and Hoofcare DA (quaternary ammonium compounds) where tested in a controlled study from Thomsen et al. (2008).
They used footbaths twice a day for 8 weeks and they found no effect on percentage cured or percentage new infections for any of the tested hoof products. Because they treated one side of the cow
and the other side was the control this may have caused a greater infection pressure in the herd due
to a high number of pathogens in the environment. So a possible underestimation of the effect of the
hoof-care products (Thomsen et al. 2008). There need to be done more large scale trails such as that
by Thomsen et al. (2008) to find effective products.
In the studies that were found the frequency of using the footbath was different. Some studies used
the footbaths varying from 7 days treatment (Laven and Hunt, 2002), 30 days treatment twice a day
(Silva et al. 2005) and 47 days treatment (Manske et al. 2002). So there is a difference in the insensitivity of treatment which can have a better effect on percentage cured or percentage new infections (Thomsen et al. 2008). Most commercial footbath products seem to be effective, but there is
little peer reviewed scientific evidence available (Laven and Logue, 2004). One major problem that
was discovered by Holzhauer et al. (2004) that the use of formalin 4% in footbaths was not every
were the same, they discovered a variation from 9,6% to 0,9%. one major problem was the delivery
system ; footbath size ( 110-930 L) and the number of liters of footbath/cow (0.78-12) walking
through it had a big variation. This will affect the response to treatment and that there is no data on
the best design of footbath to treat BDD (Laven, 2008).
21
Research report
Koehorst
Table 5: Reported effectiveness of non-antibiotic footbaths in the treatment of digital dermatitis
(see Laven and Logue 2006 for details).
Product +
Regime
Efficacy
Comment
concentration
Formalin 12.5%
(Laven and Logue,
2006)
Formalin 5%
Stand in formalin for
one hour, repeat one
week
91% cure rate
Non-controlled
observation
Not reported
Ineffective, may
exacerbate digital
dermatitis
Anecdotal report
Twice weekly
Good control
Anecdotal report
Daily for 14 days
Good control
Anecdotal report
Daily for 7 days
As effective as 2 days
erythromycin in
reducing lesion score
Peer-reviewed
controlled clinical
trial
(Laven and Logue,
2006)
Formalin 5%
(Laven and Logue,
2006)
Formalin 5 to 10%
(Laven and Logue,
2006)
Formalin 2.5%
(Laven and Logue,
2006)
Formalin /
NaOH
5% / 5%
(Laven and Logue,
2006)
CuSO4 2.5%
Twice weekly for 12
Eliminated digital
weeks (combined with dermatitis
3 days systemic
antibiotics for lame
cows)
Peer- reviewed
clinical report
Not reported
Ineffective
Anecdotal report
in peer-reviewed
paper
Not reported
Ineffective
Anecdotal report
in peer-reviewed
paper
(Laven and Logue,
2006)
CuSO4 0.5%
(Laven and Logue,
2006)
22
Research report
Product +
Koehorst
Regime
Efficacy
Comment
concentration
CuSO4 2.0%
Daily for 7 days
As effective as 2 days
erythromycin in
reducing lesion score
Peer-reviewed
controlled clinical
trial
Daily for three days
repeated fortnightly
Effective control
Anecdotal report
Daily for 7 days
As effective as 2 days
erythromycin in
reducing lesion score
Peer-reviewed
controlled clinical
trial
(Laven and Logue
2006)
ZnSO4 20%
(Laven and Logue,
2006)
Peracetic
acid 1%
(Laven and Logue,
2006)
Footbath containing
1% sodium hypochlorite
(Silva et al. 2005)
30 cows
recovery of 73.3%
twice daily for 30 days
After surgical treatment of BDD lesions.
control group was not
used so the cows
which spontaneous
recovered are undetected.
23
Research report
Product +
Koehorst
Regime
Efficacy
Comment
concentration
Solution of acidified
ionized copper
(Manske et al. 2002)
The footbath was used more effective than
for 47 days divided in water
five periods from 3 to
16 days of treatment.
The cows walked
through the footbath
twice daily. Scoring of
the lesions happened
in the 0-5 scale and
there was looked at a
preventive effect. Of
the 44 cows remaining, only 12 cows
were affected by DD
score 1-3 in both hind
legs, and therefore no
satisfactory withincow comparison of
treatments was possible.
Virocid (glutaraldeThey used footbaths
hyde), Kickstart 2 (or- twice a day for 8
ganic acids), and Hoof weeks
care DA (quaternary
ammonium compounds)
(Thomsen et al. 2008)
Victory crystalline
formulation
negative control in the
form of the left side of
the footbath filled
with water.
no effect on percentage cured or percentage new infections for
any of the tested hoof
products
controlled study
quickly and effective
footbath product.
non-controlled
observation
scored a reduction in
lesion size.
scoring; not clear what
was the active stadium
(M2), not enough data.
(split footbath)
(scoring Manske
2002)
260 cows
19 cows with lesions
(Gradle et al. 1997)
two times a day for six
days
only three cows did
not responded after 12
days.
24
Research report
Product +
Koehorst
Regime
Efficacy
Comment
concentration
Kovex-Foam-System
(Fiedler, 2004)
55 cows:
22 test group +
33 control group
8 weeks:
- foam used twice a
day in the
first week and then
suspended in the following week.
- foam twice daily on
3 consecutive days,
then were not treated
for 11 days. This
change of treatment
was to be maintained
permanently. After 12
weeks the final assessment
of the hind extremities.
7% copper sulfate solution
(Bergsten et al. 2006)
lower number of animals affected in the
test group than in the
control group.
recurrence; yes
non-peer reviewed
control group use
intensive treatment:
reduced incidence of
BDD
less intensive: not effective in controlling
BDD
112 cows (DD was
seen in every fifth
cow)
twice daily in footbath
(left feet)
effective
four months observation
and increasing the
odds of improvement
of DD by approx. 2,5
times
right feet: control in
15 liters of water
decreased the odds of
having DD by 10
times
25
Research report
Product +
Koehorst
Regime
Efficacy
Comment
concentration
Copper sulphate and
peracetic acid in water
solution (DeLaval)
240 cows (DD was
seen in every fifth
cow)
no effect on DD
footbath twice daily
(Bergsten et al. 2006)
four months observation
Peracetic acid and hydrogen peroxide (Kovex ® , Ecolab)
101 cows (DD was
seen in every fifth
cow)
footbath twice daily
no effect on DD
66 cows untreated
controls
(Bergsten et al. 2006)
during 56-113 days of
exposure on DD
Copper sulphate, formalin and peracetic
acid in footbaths
(Laven and Hunt,
2002).
169 cows with
reductions in lesions
scores
252 lesions
copper sulphate, formalin and peracetic
acid in footbaths for 7
days
(no significant effect
of treatment and no
significant interaction
between treatment and
time).
treated with erythromycin were foot
bathed for two days
Comparison of five
different footbath
treatments.
4% formaline
(Holzhauer et al.
2006b)
64 cows, 9 months
Weekly, for 1 day,
twice a day, a 4%
formalin walkthrough
footbath
resulted in significantly less M2-lesions
compared to the preinvestigation period
throughout the whole
observation period
a pre investigation
was done were M2
stadium were treated
with chlortetracycline
spray (4 weeks, three
times a week) and after that the cows were
divided into five
groups
26
Research report
Product +
Koehorst
Regime
Efficacy
Comment
concentration
Comparison of five
different footbath
treatments.
4% formaline
15 cows, 9 months
Every other week, for
1 day, twice a day, a
4% formalin
walkthrough footbath
effective to prevent a
DD outbreak within
those intervention
groups
a pre investigation
was done were M2
stadium were treated
with chlortetracycline
spray (4 weeks, three
times a week) and after that the cows were
divided into five
groups
15 cows, 9 months
Increased hygiene
measurements combined with a 2% multicompound solution
walk-in footbath (30
min.) at D0, D7, D30
and D90 and then every 6 months
effective to prevent a
DD outbreak within
those intervention
groups
a pre investigation
was done were M2
stadium were treated
with chlortetracycline
spray (4 weeks, three
times a week) and after that the cows were
divided into five
groups
15 cows, 9 months
not effective in preventing an outbreak
a pre investigation
was done were M2
stadium were treated
with chlortetracycline
spray (4 weeks, three
times a week) and after that the cows were
divided into five
groups
(Holzhauer et al.
2006b)
Comparison of five
different footbath
treatments.
2% multicompound
solution
(Holzhauer et al.
2006b)
Comparison of five
different footbath
treatments.
2% multicompound
solution
Weekly, for 1 day,
twice a day, a 2%
multicompound
walkthrough footbath
(single outbreak)
(Holzhauer et al.
2006b)
Comparison of five
different footbath
treatments.
3% soda lime
(Holzhauer et al.
2006b)
14 cows, 9 months
Weekly, for 1 day,
twice a day, a 3% soda
lime walkthrough
footbath
not effective in preventing an outbreak
(high rate of new infections)
a pre investigation
was done were M2
stadium were treated
with chlortetracycline
spray (4 weeks, three
times a week) and after that the cows were
divided into five
groups
27
Research report
Koehorst
As conclusion about topical therapy with oxytetracycline and non-antibiotic mass treatment were
unable to reduce the prevalence of BDD and failed to eliminate the disease. Treatment is there for
treating affected cattle and trying to control high levels of the disease, but it does not take away the
problems because of bad environmental management (Laven, 2008b).
Prevention
Because Digital dermatitis is probably a multifactor disease, not only the treatment options for the
bacterial agent are necessary, but other factors must also be taken into account. This means optimal
housing, feeding and management are important.
Vaccination is also a form of prevention that is been tested in diverse studies. In one study there
was showed a reduction in the incidence of BDD between 63%-90% (Keil et al. 2002). But a later
study did not have satisfying results (Berry et al. 2004). So further research has to be done about the
effectiveness of vaccines.
There are articles about a better environment for cows, because of the lameness problems. Next follows advice that is given in these articles to minimalize foot problems.
An inappropriate flooring has been implicated as a cause for foot problems. So the advice is that
there must be softer flooring (no use of concrete) and adequate draining is necessary to protect the
cows hooves from wetness which makes them more susceptible to wear and damage (Rushen et al.
2004). Moisture and reduced access to air can establish and spread Digital Dermatitis. Research
showed that damage to the skin and horn by liquid manure is a important factor of developing Bovine Digital Dermatitis. Another important factor of spreading Digital Dermatitis is the introduction
of affected animals in to the herd. So management is important to take into account (Nuss, 2005).
Environmental condition seems to be a important factor for the prevalence of the disease. The prevalence was high when the hygiene was poor and a lot of slurry was present in the stable. But also
under high standards of hygiene and in (muddy) paddocks the disease was observed (Blowey et al.
1988, Döpfer, 1994, Cruz et al. 2001).
There is a new opinion that to much effort is put in treatment options for BDD and there has to be
more attention to prevention of BDD (Blowey, 2008). BDD has to be compared with mastitis because it has a lot of similarities. There has to be taken into account that animals with lesions are infectious and act as reservoirs for infection of others, there are sub clinical carriers which has to be
dealt with and the environment plays a important role. Also regular disinfection of the affected
body part (twice daily for mastitis) is required for control. Foot bathing is an important key factor in
controlling the disease, this is effective when its regularly repeated. Blowey (2008) suggests in his
article that teat treatment happens twice a day to control mastitis, so it will be illogical that a one
time treatment in one month will control BDD (Blowey, 2008).
Conclusion literature study
Many articles have been written about Bovine digital dermatitis and its treatment options, but do
not have the answer for the best treatment option. There still is not a product on the market that
cures the affected animals in a short period and prevent reoccurrence of the disease. Also no farmer
could afford a treatment associated with long withdrawal times for milk (Manske et al. 2002). Mentioned products in this article have to applicated repeatedly and needs time to have effect. Then
there are the products that can have bad effect on the environment and user. What the Dairy industry wants is a new treatment option that fulfill al above mentioned options. In the article from Laven
and Loque 2004 key points are mentioned which a product should possess. These are in short: prov28
Research report
Koehorst
en effectiveness, even in presence with fecal and slurry contamination, ability to act in footbath
conditions, cause no detrimental changes to skin and horn of the foot, longer persistence on the skin
for prevention, no production of more pathogens in it, no deleterious environmental effects, no long
term harm to man and cattle and finally meet to legislative requirements and have no withdrawal
period for milk and meat. After making this article the final conclusion can be made that BDD is
still a frequent problem on dairy farms. It is a multifactor and severe condition and can’t be solved
with 1 treatment option. We do not possess the data to give a conclusion about which product will
suit which farm, the optimal concentration of that product and which product is the most beneficial
economically (Laven and Logue, 2004). Hopefully when more attention is paid to the etiology of
BDD the results of that will lead to more effective preventive measures (Capion, 2008). Blowey
2008 regarded to the fact that there has to be disinfected regularly like with mastitis to control the
infectious disease. This is something that must be made clear to people who come across BDD. Further new conclusions can be done about the use of oxytetracycline. One-time topical oxytetracycline treatment of individual cows is inadequate in a herd where BDD has been endemic and there
has been long-term use of oxytetracycline. Reduced healing of lesions is seen and how larger the
lesion how slower the lesion heals. Probably due to antibiotic resistance (Nishikawa and Taguchi,
2008) which also is seen in the study of Shearer et al. (2000). The introduction of BDD into a dairy
herd can lead to an ongoing struggle for control and treatment of lesions in combination with a production loss (Capion, 2008).
Acknowledgements
Drs Elzo Kannekens is acknowledged for his critical comments on the manuscript.
29
Research report
Koehorst
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