Chaque forme pharmaceutique présente ses propres avantages et inconvénients acheter du diflucan
mais n'ont pas d'effets néfastes pour l'organisme dans son ensemble.
7th Boehringer Ingelheim Expert Forum on
well-beingJune 13th 2014, Madrid (Spain)
The enclosed abstracts are the property of the individualauthors. The comments and opinions expressed therein arethose of the authors and not necessarily reflect the positionor beliefs of Boehringer Ingelheim or its employees.
No abstract should be reproduced, transmitted or used for3rd party purposes without the express written consent ofthe author.
7th Boehringer Ingelheim Expert Forum on
Pain and stress around parturition: impact on mothers and their offspring.
Workshop: Knowledge and perceptions of cattle welfare among animal health professionalsProf. Marina (Nina) A. G. von Keyserlingk and Prof. Daniel M. Weary, Animal Welfare Program, University of British Columbia, Canada
How stress during pregnancy affects the offspringDr. Kenneth Rutherford , Animal Behaviour & Welfare SRUC, Edinburgh, UK
Long term effects of painful childbirth in womenProf. Patricia Lavand'homme, Department of Anaesthesiology, St Luc University Hospital Catholic University of Louvain, Brussels, Belgium
Use of non-steroidal anti-inflammatory drugs around calving can maximize comfort, productivity and fertility for the damDr. Richard Laven, Institute of Vet, Animal & Biomedical Sciences Massey University, New Zealand
The impact of dystocia on dairy calf health, welfare, performance and survivalDr. Marie Haskell, Animal Behaviour & Welfare SRUC, Edinburgh, UK
Prof. Marina (Nina) A. G. von Keyserlingk and Prof. Daniel M. Weary
Daniel M. Weary (B.Sc., M.Sc., D. Phil., Professor) and Marina A.G. von Keyserlingk (B.Sc., M.Sc. Ph.D., Professor) are NSERC Industrial Research Chair holders at The University of British Columbia and are recognized internationally for their research and outreach in animal welfare science.
Dan is originally from the Province of Quebec, and did his B.Sc. and M.Sc. degrees in Biology at McGill University before moving to the UK to do his doctoral studies in animal behavior at Oxford University. Dan worked as a research scientist for the Canadian government before moving to UBC in 1997 to co-found the University's Animal Welfare Program.
Marina's love of animals began while growing up on a beef cattle ranch in British Columbia. She completed her undergraduate in Agricultural Sciences at UBC, her M.Sc. at the University of Alberta and Ph.D. in Animal Sciences at the University of British Columbia. Marina worked as a research scientist in the animal feed industry for 6 years before joining UBC's Animal Welfare Program in 2002.
Dan and Marina direct an active group of researchers working on a variety of problems in animal welfare and they are frequent speakers for profes-sional audiences on this topic. Dan and Marina are the proud recipients of the 2013 Metacam 20 Bovine Welfare Award.
Knowledge and perceptions of
cattle welfare among animal
Identifying shared and divergent stakeholder concerns regarding farm animal welfare
Marina A.G. von Keyserlingk and Daniel M. WearyAnimal Welfare Program, Faculty of Land and Food SystemsUniversity of British Columbia, Canada
Concern about the welfare of food animals is
on the basis that that this interferes with the
not new; producers and veterinarians have long
natural cow-calf bond and results in separation
been concerned about the condition of animals
in their care and have tried to ensure that they are healthy and well nourished. In the tradition
A survey of over 25,000 Europeans citizens
of good animal husbandry, good welfare is often
found that they largely regard farmers as the
seen as maintaining production and the absence
individuals responsible for ensuring farm animal
of illness or injury. However, concerns about the
welfare. However, for farmers to safeguard soci-
proper treatment of farm animals also include
etal values around animal welfare would require
affected states like pain and distress that the
that they are aware of and share the values of
animals might experience as a result of proce-
other citizens on this issue. Research of farmer
dures like castration and weaning, and concerns
attitudes shows that the reverse may be true;
about the lack of naturalness, such as the
farmers often discount the views of non-farmer
inability to perform natural, motivated behaviors
citizens on the basis that these individuals are
like grazing when kept in confinement housing
sometimes ignorant of farm practices (Benard
(Fraser et al., 1997; von Keyserlingk et al., 2009).
and de Cock Buning, 2013). The results of a number of studies indicate that there is a
At least some disagreements about animal
disconnect between farm animal stakeholder
welfare are due to differences in how individuals
groups (who have strong ties to the food animal
value these different types of concern. For
production) compared to those who are more
example, an individual who highly values health
distant from the production cycle. For instance,
and functioning outcomes may argue in favor
citizens and farmers differ in the relative
of early separation of dairy cows and calves, on
importance they ascribe to the animals' ability
the grounds that this reduces vertical transfer of
to engage in natural behavior, pain and stress
pathogens and thus improves calf health. How-
(Te Velde et al., 2002; Vanhonacker et al., 2008).
ever, others may disagree with early separation
Contrary to citizens' views (Vanhonacker et al.,
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 5
2009; Fredriksen et al., 2011), farmers (Te Velde
veterinarians believed that farmers prioritize
et al., 2002; Tuyttens et al., 2010; Spooner et al.,
production and profit, while farmers believed
2014) and industry specialists (Cantrell et al.,
that they placed their highest priority on team-
2013) tend to associate animal welfare mainly
work and animal welfare.
from the perspective of the animal's health and biological functioning. For instance, intentionally Building consensus on animal welfare issues, causing pain to another creature is considered
between key players including farmers, citizens,
highly anti-social in mainstream society, but
government, and industry representatives, must
many pig farmers consider surgical castration
become a priority (Poletto and Hötzel, 2012). Fail-
of piglets without anesthesia an acceptable
ure to do so may result in lost opportunities that
practice (Spooner et al., 2012; Tuyttens et al.,
may have serious repercussions for all stakehold-
2012). In some cases it appears that these dif-
ers, including those whose livelihood depends on
ferences in values undermine citizen confidence
the success of the food animal industries.
in livestock producers. For example, Ventura et al. (2013), reported that some citizens who
Broad stakeholder input is also required to set
opposed cow calf separation at birth believed
meaningful goals for research, policy, and pro-
that producers were simply exploiting animals
ducer innovation that may move us toward more
and seeking productivity over welfare.
socially sustainable food animal production systems (Swanson et al., 2011; von Keyserlingk
Even among individuals associated with
et al., 2013). These stakeholder consultations
livestock production, different groups may hold
must include discussions between diverse stake-
contrary opinions. For example, Kristensen
holders but also within stakeholder groups. The
and Enevoldsen (2008) reported that Danish
facilitated discussion that will take place as part
of the 2014 Boehringer Ingelheim's Farm Animal Wellbeing Forum in Madrid provides one such opportunity.
These discussions will have three objectives: 1) to provide participants the opportunity to voice their concerns and discuss the most pressing animal welfare issues with their colleagues, 2) to allow researchers to describe and summarize the concerns discussed, and use this data to extend the scholarly literature on this issue, and 3) to provide the veterinary profession and the livestock industry with specific recom-mendations for how best to target solutions to animal welfare concerns. We predict that these discussions among the animal health profes-sionals attending the Forum will help identify a shared sense of priorities and key constraints to addressing the issues.
Benard, M., and T. de Cock Buning. 2013. Exploring the potential
Te Velde, H., N. Aarts, and C. Van Woerkum. 2002. Dealing
of dutch pig farmers and urban-citizens to learn through frame
with ambivalence: Farmers' and consumers' perceptions of
reflection. J. Agric. Environ. Ethics 26: 1015-1036.
animal welfare in livestock breeding. J. Agric. Environ. Ethics 15: 203-219.
Cantrell, R., B. Lubben, and D. Reese. 2013. Perceptions of food animal welfare in extension: Results of a two-State survey. J.
Tuyttens, F. A. M., F. Vanhonacker, E. Van Poucke, and W. Verbeke.
Extens. 51: 2FEA7.
2010. Quantitative verification of the correspondence between the Welfare Quality (R) operational definition of farm animal
Eurobarometer. 2007. Attitudes of EU citizens towards animal
welfare and the opinion of Flemish farmers, citizens and vegetari-
welfare. Special Eurobarometer 270 / Wave 66.1 - TNS Opinion
ans. Livest. Sci. 131: 108-114.
Vanhonacker, F., W. Verbeke, and F. A. M. Tuyttens. 2009. Belgian
Fraser, D., D. M. Weary, E. A. Pajor, and B. N. Milligan. 1997.
consumers' attitude towards surgical castration and immunocas-
A scientific conception of animal welfare that reflects ethical
tration of piglets. Anim. Welfare 18: 371-380.
concerns. Anim. Welfare 6: 187-205.
Vanhonacker, F., W. Verbeke, E. Van Poucke, and F. A. M. Tuyttens.
Fredriksen, B., A. M. S. Johnsen, and E. Skuterud. 2011. Con-
2008. Do citizens and farmers interpret the concept of farm
sumer attitudes towards castration of piglets and alternatives to
animal welfare differently? Livest. Sci. 116: 126-136.
surgical castration. Res. Vet. Sci. 90: 352-357.
Ventura, B. A., M. A. G. Von Keyserlingk, C. A. Schuppli, and D. M.
Kristensen, E., and C. Enevoldsen. 2008. A mixed methods
Weary. 2013. Views on contentious practices in dairy farming: The
inquiry: How dairy farmers perceive the value(s) of their involve-
case of early cow-calf separation. J. Dairy. Sci. 96: 6105-6116.
ment in an intensive dairy herd health management program. Acta Vet. Scand. 50.
von Keyserlingk, M.A.G., N. P. Martin, E. Kebreab, K. F. Knowlton, R. J. Grant, M. Stephenson, C. J. Sniffen, J. P. Harner, III, A. D.
Spooner, J. M., C. A. Schuppli, and D. Fraser. 2012. Attitudes of
Wright, and S. I. Smith. 2013. Invited review: Sustainability of the
Canadian beef producers toward animal welfare. Anim. Welfare
U.S. Dairy Industry. J. Dairy Sci. 96:5405–5425.
von Keyserlingk, M.A.G., J. Rushen, A.M.B. de Passillé, and D.M.
Spooner, J. M., C. A. Schuppli, and D. Fraser. 2014. Attitudes of
Weary. 2009. Invited review: The welfare of dairy cattle – Key
Canadian pig producers toward animal welfare. J. Agric. Environ.
concepts and the role of science. J. Dairy Sci. 92: 4101-4111.
Ethics DOI 10.1007/s10806-013-9477-4.
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 7
Dr. Kenny Rutherford
Kenny is an animal welfare researcher in the Animal Behaviour and Welfare team at SRUC (Scotland's Rural College) in Edinburgh. He completed his PhD in 2003 and since then has worked on various farm animal welfare research projects. These projects have involved on-farm welfare assess-ments of dairy cattle, investigations of the effects of prenatal stress in various livestock species, and work relating to animal pain assessment.
How stress during pregnancy affects the offspringKenny Rutherford Animal Behaviour & WelfareSRUC, Edinburgh, UK
The prenatal period is important in defining
cows to repeated transport during gestation
how individuals respond to their environment
increased the stress reactivity of their offspring
throughout life. Research in farm animal species
(Lay et al., 1997). Poor quality animal handling
has demonstrated the important role that
facilities, or poor stockperson behaviours, may
variation in maternal state can have on progeny
also increase the stress experienced by cows
health, welfare, and production (Rutherford et
either during their daily life, or for particular
al., 2012). In particular, prenatal stress or poor
handling events (such as hoof trimming).
maternal nutrition can affect how well offspring cope with their social, physical and infectious environment during later life. Although, prenatal
stress work in cattle has been limited, studies
Studies have examined the effects of environ-
show that maternal health status and other expe-
mental conditions on offspring birth weight and
riences of stress in pregnant cattle can affect their other parameters. Calves from dams exposed to progeny (Arnott et al., 2012). Such effects may be
winter weather were lighter than those born to
an important and overlooked source of variation
cows maintained in a thermo-neutral environ-
in calf outcomes under commercial conditions.
ment (Andreoli et al., 1988). Alternatively, heat stress can also adversely affect offspring. Tao and Dahl (2013) reviewed studies that have applied
Sources of prenatal stress in cattle
heat stress to cattle during gestation; they found that seven out of eight studies identified a signif-
Various aspects of cattle production could
icant reduction of calf weight as a consequence.
challenge pregnant animals, with possible conse-
Effects on birth weight have implications for
quences for their progeny.
welfare: low birth weight is associated with high neonatal morbidity and mortality rates, and can impair postnatal growth, performance and
carcass traits. Prenatal effects of the maternal
Common livestock production practices such
environment are not restricted to birth weight
as handling, restraint and transportation can be
however. Calves born to dry cows exposed to
stressful for cows, and may have implications for
heat stress had a reduced efficiency of transfer of
the offspring. For example, exposing pregnant
IgG from colostrum to their circulation, and an
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 9
impaired T-lymphocyte immune response (Tao et
et al. (2008) reported that dry cow treatment
al., 2012) compared to progeny whose mothers
of beef cows with intramammary antibiotics
had access to cooling (sprinklers and fans).
improved calf growth during the subsequent lactation, while Loyacano et al. (2002) found that
In some cases there may be interacting effects
failure to treat dams for nematodes or liver fluke
of environmental conditions and nutritional
during gestation resulted in decreased offspring
challenges to animals. For instance, in regions at
birth and weaning weights.
risk of drought, pregnant cattle may experience feed restriction due to restricted pasture growth.
Experiences of poor health can impact upon
In Australia, drought during particular periods
developing offspring in a number of ways. For
of gestation has been associated with a severe
instance, animals may be debilitated, and lose
health problem of neonatal beef calves termed
body condition, and it is also possible that
congenital chondrodystrophy (White et al., 2010). experiences of pain or sickness could act as a
source of prenatal stress. In many countries large numbers of dairy cows are seen to be lame, often
whilst pregnant, and this could have detrimental
Laboratory studies have shown that stimulation
effects on calf development. A study in sheep
of the maternal immune system can cause
(Wassink et al 2010) for instance, found that
variation in offspring biology. A particularly
treating for footrot during gestation caused an
pertinent question for the cattle industry is the
improvement in flock financial performance
degree to which disease experienced by the dam
through better lamb survival and growth.
during pregnancy can have consequences for developing offspring. An observational study of Swedish dairy farms found decreased calf size at
birth if the dam had clinical mastitis during the
Although not studied in cattle, social stressors
49 day period prior to calving (Lundborg et al.,
have been found to be a potent source of mater-
2003). Calves born to cows that had a disease
nal stress in other farmed species (Rutherford
from conception to 50 days before calving had
et al., 2012). Cows may experience social stress
a higher risk of developing respiratory disease.
by being kept in groups of inappropriate size or
Moreover, calves whose mothers experienced
composition, or being subjected to regular or
disease had a lower growth rate. Similarly, Lents
intermittent mixing with unfamiliar individuals.
Feeding set-ups that increase competition and
aggression may also cause social stress.
Andreoli, K. M., Minton, J. E., Spire, M. F. and Schalles, R. R. 1988. Influence of prepartum exposure of beef heifers to winter weather on concentrations of plasma energy-yielding substrates, serum hormones and birth weight of calves. Theriogenology 29,
Studies in other species have also shown how,
Arnott, G., Roberts, D., Rooke, J. A., Turner, S.P., Lawrence, A.B.
even in the absence of social problems, aspects
and Rutherford, K. M. D. 2012. BOARD INVITED REVIEW: The
of the housing environment during pregnancy
importance of the gestation period for welfare of calves: maternal stressors and difficult births. Journal of Animal Science 90,
can affect offspring. For cattle, uncomfortable
lying conditions, barren environments or housing Lay, D.C., Randel, R.D., Friend, T.H., Jenkins, O.C., Neuendorff, systems involving behavioural restriction (such
D.A., Bushong, D.M., Lanier, E.K. and Bjorge, M.K. 1997. Effects of prenatal stress on suckling calves. Journal of Animal Science 75,
as tie-stalls) could all affect fetal development.
Lents, C.A., Wettemann, R.P., Paape, M.J., Looper, M.L. and Buchanan, D.S. 2008. Effects of dry cow treatment of beef
cows on pathogenic organisms, milk somatic cell counts, and calf growth during the subsequent lactation. Journal of Animal Science 86, 748 – 755
Prenatal stress in cattle has implications for
Loyacano, A. F., Williams, J. C., Gurie, J. and DeRosa, A. A. 2002. Effect of gastrointestinal nematode and liver fluke infections
offspring welfare and performance. Cows spend
on weight gain and reproductive performance of beef heifers.
a large proportion of their post-pubertal life
Veterinary Parasitology 107, 227 – 234
pregnant and many of the factors that are known
Lundborg, G.K., Oltenacu, P.A., Maizon, D.O., Svensson, E.C. and
to affect cow welfare (e.g. health states such
Liberg, P.G.A. 2003. Dam-related effects on heart girth at birth, morbidity and growth rate from birth to 90 days of age in Swedish
as lameness or mastitis, housing conditions,
dairy calves. Preventive Veterinary Medicine 60, 175 – 190
quality of stockhandling) have potential to alter
Rutherford, K.M.D., Donald, R.D., Arnott, G., Rooke, J.A., Dixon,
developing fetal offspring with consequences for
L., Mettam, J., Turnbull, J. and Lawrence, A.B. 2012. Farm animal welfare: assessing risks attributable to the prenatal environment.
their postnatal life. Prenatal conditions may be a
Animal Welfare 21, 419 – 429
hidden risk factor for negative health and welfare
Tao, S. and Dahl, G. E. 2013. Invited review: heat stress effects
outcomes in cattle. In addition to effects on
during late gestation on dry cows and their calves. Journal of Dairy Science 96, 4079 – 4093
welfare, prenatal conditions may also affect the economics of cattle performance. Further work
Tao, S., Monteiro, A. P. A., Thompson, I. M., Hayen, M. J. and Dahl, G. E. 2012. Effect of late-gestation maternal heat stress on growth
is required to identify which possible causes
and immune function of dairy calves. Journal of Dairy Science 95, 7128 – 7136
of prenatal stress matter under commercial conditions, and how farmers could adapt their
Wassink, G.J., King, E.M., Grogono-Thomas, R., Brown, J.C., Moore, L.J. and Green, L.E. 2010. A within farm clinical trial to
management to improve performance. However,
compare two treatment (parenteral antibacterials and hoof
paying closer attention to the management of
trimming) for sheep lame with footrot. Preventive Veterinary Medicine 96, 93 – 103
pregnant animals may allow farmers to achieve
White, P.J., Ward, M.P., Toribio, J.A. and Windsor, P.A. 2010. The
higher standards of health, welfare and produc-
association between congenital chondrodystrophy of unknown
tion efficiency in the next generation of stock.
origin (CCUO) in beef cattle and drought in south-eastern Austra-lia. Preventive Veterinary Medicine 94, 178 – 184
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 11
Prof. Patricia Lavand'homme
After graduating as a Medical Doctor, Mrs Lavand'homme completed her PhD on "Alternative Drugs to Spinally administered Opiates in Animal Models of Neuropathic Pain" in 1999.
In 1997 and 2002 she participated in a Visiting Scholarship Program at the Wake Forest University School of Medicine, North Carolina, USA where she worked in the Pain Mechanisms Laboratory.
Patricia Lavand'homme is currently working at the Saint Luc University Hospital in Brussels, where she is director of the Acute Postoperative Pain Unit. She is also past-chairperson of the Scientic Subcommittee "Acute and Chronic Pain" of the European Society of Anesthesiologists (ESA) and associate editor of 2 scientific journals.
Long term effects of painful childbirth in womenProf. Patricia Lavand'hommeDepartment of Anaesthesiology St Luc University HospitalUniversity Catholic of Louvain, Brussels, Belgium
Advances in Analgesia and Anaes-
permitted considerable progresses in the field
thesia for Childbirth
during these last 150 years (Crowhurst and Plaat 2000). More importantly, the progresses have
Obstetric anaesthesia is currently one of the
been associated to a dramatic reduction in mater-
most valuated aspects of the anaesthesiology
nal and foetal mortality in developed countries.
specialty as patient's safety and wellbeing are now considered as indices of health care quality. It is worth noting that obstetric anaesthesia
The benefits of labour analgesia
and analgesia involves the management of two patients: the mother and the foetus/newborn.
The immediate benefits of labour analgesia not
However, for many years, the existences of false
only concern maternal comfort but also foetal
beliefs regarding labour and childbirth have ham-
wellbeing as the stress and the pain from labour
pered the development of obstetric anaesthesia:
contractions increase maternal levels of systemic
· Myth of painless vaginal childbirth both in
catecholamines with deleterious effects on la-
women and in animals. Later supported by the
bour progress and foetal heart rate. Further, pain
fact that pregnancy itself may induce some
causes maternal hyperventilation which favours
uterine vasoconstriction and foetal acidosis. Be-
· Religious beliefs presenting labour and child-
sides, obstetric guidelines currently recommend
birth pain as an inflicted punishment.
early placement of epidural analgesia in compli-
· Beliefs that labour pain has important biologi-
cated parturients, i.e. at high risk of emergency
cal functions and should not be relieved.
caesarean delivery, to increase both mother and
· Fear of deleterious effects of pharmacologic
methods of pain relief on both the labour course and the foetus.
Recently, as it is the case for other surgical pro-cedures, new concerns have emerged regarding
The development of safe and efficacious anal-
long term effects of the anaesthesiology practice.
gesic techniques (Lavand'homme and Roelants
Patients' outcomes like rehabilitation, fast
2009, Cohen et al. 2000) as well as the social
recovery, cancer recurrence and persistent pain
acceptance that it is unnecessary for the partu-
after surgical procedures have received major
rient to deliver children in pain and sorrow have
interest. In obstetric anaesthesia, the quality
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 13
Table 1. Evolution of Obstetric Analgesia and Anaesthesia
1853 Safe administration of chloroform to
Opening the way to Obstetric Analgesia:
Queen Victoria for labour and delivery of
several volatile anaesthetic agents were
her 8th child.
used e.g. nitrous oxide (Entonox) is still currently used for labour analgesia as an alternative to epidural analgesia.
1900 Administration of morphine with scopo-
Opioid analgesics have been used for
lamine to induce a state of semi consci-
many years with several risks (e.g. respi-
ousness called « twilight sleep ».
ratory depression, loss of consciousness,
1939 Synthesis of meperidine (pethidine),
inhalation) and without proof of anal-
opioid used until late 1980s for labour
gesic efficacy until the development of
2000 Use of patient-controlled intravenous
analgesia with ultra-short acting opioid remifentanil (pharmacokinetic adapted to labour physiology).
1901 to 1921 Development of spinal, caudal and
lumbar epidural blocks mostly for operative obstetrics e.g. caesarean deliveries.
1970s Establishing epidural analgesia services.
Local anaesthetics with lower cardiac
1980s Understanding and avoiding local anaes-
toxicity (like levobupivacaine and ropi-
thetics systemic toxicity.
vacaine) were developed.
1990s Development of « selective analgesia » for
The combination of low doses of local
labor and delivery.
anaesthetic with low doses of opioid has led to the reduction of motor and sym-pathetic blocks during epidural analgesia with less impact on labour course and mode of delivery (less assisted vaginal delivery), allowing "walking epidural analgesia".
2000s Evaluation of both short- and long-term
Impact of the type of anaesthesia/anal-
effects of peripartum anaesthesia and
· The mode of delivery· Maternal safety· Quality of life, mood and persistent pain
of life and the duration of pain after childbirth
wide (reaching 25 to 30 % in EU) for both medical
have attracted the attention of both the anaes-
indications and maternal choice, an important
thesiologists and the obstetricians. Among the
debate has raised over the relationship of the
20 % of the U.S. and European population who
method of delivery to maternal postpartum
report chronic non-cancer pain, the majority are
physical health. Inadequately controlled acute
females. Women are at increased risk compared
postoperative pain may result in harmful
to men to develop chronic pain and to exhibit
physiological and psychological consequences.
higher chronic pain intensity. Any tissue trauma
Pain treatment after childbirth may be even less
has the potential to cause persistent pain.
adequate than after surgery because the majority
While most patients will recover and return to
of mothers hesitate to use regular analgesics
normal life, others will suffer chronic pain and
like non-steroidal anti-inflammatory drugs and
long lasting disabilities. Although childbirth
opioids during breastfeeding. The PAD study
may be considered as a natural process, some
("Pain After Delivery"), the first large prospective
deliveries necessitate instrumentation and/or
multicentred study including patients both in
surgical intervention and thereby, a possibility of
US and Europe) tried to examine the impact of
persistent pain secondary to the physical trauma
those factors on the quality of life of women
of delivery should not be ignored.
after delivery (Eisenach et al.2013, Eisenach et al. 2008).
Impact of acute pain around birth
In the PAD study, severe acute pain (i.e. a pain score > 6 on a scale from 0 = no pain,
Among the risk factors to develop persistent
to 10 = worst possible pain) within 36 hours
pain after surgery, the degree of tissue injury
postpartum was present in 10.9 % of the
(by example, a nerve lesion) and the intensity of
women after vaginal delivery and in 17 % of
acute postoperative pain are commonly reported
the women after caesarean delivery, Eisenach
(Kehlet et al. 2000, Lavand'homme 2011). As the
et al. 2008). Caesarean delivery was associated
rate of caesarean delivery is increasing world-
with a 32.5 % increase in acute pain scores
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 15
and interfered more than vaginal delivery with
daily activities of the mother. The prevalence of pain 8 weeks after delivery was 10 % (95 % CI:
1. Lavand'homme P, Roelants F (2009) Patient-controlled intra-venous analgesia as an alternative to epidural analgesia during
7.7 – 12.3) after vaginal delivery and 9.2 % (95 %
labor: questioning the use of the short-acting opioid remifentanil. Survey in the French part of Belgium (Wallonia and Brussels).
CI: 5.5 – 12.6) after caesarean delivery. Almost
Acta Anaesthesiol Belg 60: 75 – 82.
half of the women reported pain affecting
2. Cohen SE, Yeh JY, Riley ET, Vogel TM (2000) Walking with labor
daily life activities. Interestingly, independent
epidural analgesia: the impact of bupivacaine concentration and
to the mode of delivery, the severity of acute
a lidocaine-epinephrine test dose. Anesthesiology 92: 387-392.
pain after childbirth was associated to the risk
3. Crowhurst JA, Plaat FS (2000) Labor analgesia for the 21st Century. Seminars in Anesthesia, Perioperative Medicine and
of experiencing persistent postpartum pain as
Pain 19: 164 – 170.
women with severe peripartum pain had a 2.5-
4. Kehlet H, Jensen TS, Woolf CJ (2006) Persistent postsurgical
fold increased risk of persistent pain. One point
pain: risk factors and prevention. Lancet 367: 1618 – 1625.
increase in acute pain score was associated
5. Lavand'homme P (2011) The progression from acute to chronic
with a 13 % increase in the odds of experiencing pain. Curr Opin Anaesthesiol 24: 545 – 550.
pain 8 weeks later. In another prospective study,
6. Eisenach JC, Pan P, Smiley RM, Lavand'homme P, Landau R, et
the degree of perineal trauma (lacerations,
al. (2013) Resolution of Pain after Childbirth. Anesthesiology 118: 143 – 151.
episiotomy) was responsible for the immediate
7. Eisenach JC, Pan PH, Smiley R, Lavand'homme P, Landau R,
intensity of pain (from 24 h until day 7 postpar-
et al. (2008) Severity of acute pain after childbirth, but not type
tum), but did not account for the incidence of
of delivery, predicts persistent pain and postpartum depression. Pain 140: 87 – 94.
persistent perineal pain (around 9 %) at 6 weeks (Macarthur and Macarthur, 2004).
8. Macarthur AJ, Macarthur C (2004) Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study. Am J Obstet Gynecol 191: 1199 – 1204.
The overall prevalence of postpartum depression
9. Liu TT, Raju A, Boesel T, Cyna AM, Tan SG (2013) Chronic pain
was 11.2 % at 8 weeks (11.4 % after vaginal
after caesarean delivery: an Australian cohort. Anaesth Intensive Care 41: 496 – 500.
delivery and 10.5 % for caesarean delivery) (Eisenach et al. 2008). Chronic pain and depres-
10. Johansen A, Romundstad L, Nielsen CS, Schirmer H, Stubhaug A (2012) Persistent postsurgical pain in a general population:
sion often co-exist. Postpartum depression is a
prevalence and predictors in the Tromso study. Pain 153: 1390 – 1396.
complication affecting 8 – 15 % of postpartum women within the first 6 weeks after delivery.
11. Gutierrez S, Hayashida K, Eisenach JC (2013) The puerperium alters spinal cord plasticity following peripheral nerve injury.
This condition may affect both maternal and
Neuroscience 228: 301 – 308.
neonatal health. Postpartum depression increases the risk of insecure infant attachment and behavioural problems in the child. Further, postpartum depression favours mother's suicide which accounts for 17 % of late pregnancy-re-lated death. As for the pain, independent to the mode of delivery, women reporting severe post-delivery pain were also at higher risk for the development of postpartum depression i.e. 3.0-fold risk of postpartum depression at 8 weeks by comparison with women having mild pain after delivery.
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 17
Dr. Richard Laven
After having qualified from the University of London in 1989, Richard Laven went into veterinary practice in the Cotswolds fulfilling the first of his veterinary ambitions. After almost four years he ended up back at the University of London doing a PhD on the bovine placentome. This was followed by working on a 650-cow dairy research farm in the South Downs – the main focus of which was lameness research. He acquired an interest in diagnosis and treatment of lameness, with a particular interest in the modification of the pain associated with lameness, especially the use of NSAIDs. This led to a more general interest in the use of NSAIDs in cattle and how the veterinary profession can best use them to enhance cattle welfare.
Use of non-steroidal anti-inflam-matory drugs around calving can maximize comfort, productivity and fertility for the damDr. Richard LavenInstitute of Vet, Animal & Biomedical SciencesMassey University, New Zealand
Calving is a critical time for the health and
veterinarians give NSAIDs, at least occasionally,
welfare of the cow. A normal calving is essential
to cows with dystocia (Huxley and Whay 2006).
if subsequent fertility and production are to be
However, on most farms, dystocia cases are dealt
optimized. Dystocia significantly decreases milk
with by farm staff and Huxley and Whay (2007)
production and fertility, and increases culling
reported that < 50 % of farmers thought analgesia
(Tenhagen et al., 2007). Much of this is mediated
was necessary for moderate dystocia. So many
by inflammatory disease such as metritis.
dystocia cases do not receive NSAIDs.
Dystocia is also painful. Veterinarians asked to estimate the pain associated with moderate dys-
Furthermore, there has been a paucity of studies
tocia and a caesarean section scored the former
focusing on the short-term benefits on feed
as 7 – 8 (median on a 0 – 10 scale) and the latter as
intake and behaviour of treating dystocia with
10 (Huxley and Whay, 2006, Laven et al., 2009).
NSAIDs. Newby et al. (2013) found no significant effect of treating cows with dystocia with meloxi-cam 24 h after calving on dry matter intake, milk
The use of analgesia at calving
production, blood metabolites, or health events. However, meloxicam increased feeding time as
Providing cows that have had dystocia with
well as bunk visit frequency for 24 h. This may be
effective analgesics and anti-inflammatories
because the meloxicam was administered too
is thus likely to improve cow well-being, and,
late after calving. This again highlights the issue
perhaps, productivity. On first principles,
that getting farmers to use NSAIDs is likely to
non-steroidal anti-inflammatory drugs (NSAIDs)
have the most benefit.
are likely to be the most effective drug group for such treatment as they are anti-inflammatory, anti-pyretic, and anti-endotoxic as well as pro-
"Blanket treatment" with NSAID's
ducing peripheral and central analgesia.
NSAIDs are relatively frequently used by vet-
Studies which have analyzed the benefits of
erinarians. Surveys have shown that > 65 % of
treating all calving cows with NSAIDs are more
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 19
common. Blanket treatment with flunixin seems
Restoration of ovarian and uterine
to be contra-indicated: Shwartz et al. (2009)
reported that it significantly increased rectal tem-perature and decreased dry matter intake, while
One key focus of NSAID studies post-calving is
Duffield et al. (2009) found that it increased
the effect of NSAIDs on the restoration of ovar-
placental retention and metritis risk.
ian and uterine function after calving. Flunixin treatment can reduce PG production, but time
Data on blanket treatment with other NSAIDs
after calving has a bigger impact (Königsson et
is not so negative. Meier et al (2014) reported
al., 2002). Treatment with NSAIDs may therefore
no effect of carprofen treatment immediately
not return PG production to normal in cattle with
after calving on milk production, cow health or
an abnormal puerperium; i.e., their impact on
reproductive performance, while Richards et al.
inflammation may be insufficient to prevent the
(2009) concluded that treatment with ketoprofen
negative effects of elevated PG.
after calving had no effect on productivity, health or production except for a tendency to reduce
In cattle with a normal puerperium, higher
placental retention. This finding is at odds with
concentrations of PGFM are associated with a
the prominent role that PGF2α plays in placental
shorter involution period (Lindell et al., 1982);
release (Laven and Peters, 1996). In contrast
thus the use of NSAIDs post-partum could
there are several reports that blanket treatment
potentially compromise involution. However,
with salicylates can result in improvements such
both Odensvik and Fredriksson (1993) and
as improved milk production (Trevisi and Bertoni
Guilbault et al. (1987) showed that treatment
2008; Farnley et al., 2013). These differences may
with NSAIDs suppressed PG production but not
be due to differences in the action of different
Both Guilbault et al. (1987) and Stahringer et al.
This focus on blanket treatment with NSAIDs
(1999) suggested that treatment with NSAIDs
is interesting from a scientific perspective, but
had a negative impact on ovarian activity. Both
none of the successful studies have identified
of these studies were small studies and used
an economically viable treatment model, despite
multiple frequent doses of NSAIDs. In contrast,
blanket treatment of normal cows implying a
both Richards et al. (2009) and Meier et al (2014)
focus on economics rather than welfare. If we
found no negative fertility effect of two or three
want to improve welfare then it is surely better to
doses of NSAIDs, so it may be frequency and
look at the economic benefits of treating cows
length of treatment that is driving the effect;
which need NSAIDs, such as those with dystocia.
such a treatment is likely to be uneconomic, particularly in cattle with a normal puerperium.
The recumbent cow
Another area where NSAID treatment can be useful is in the treatment of the recumbent cow. For cows with disease, such as toxic mastitis/
metritis, the benefits of NSAIDs are relatively
postpartum cows with partially suppressed endogenous pro-duction of prostaglandins. 1. Uterine and ovarian morphological
clear. For calving injury, the published evidence
responses. Theriogenology 27, 931 – 946.
is little more than anecdotal. Longo et al. (1993)
Huxley, J.N., Whay, H.R., 2006. Current attitudes of cattle prac-
compared ketoprofen with flunixin in cattle that
titioners to pain and the use of analgesics in cattle. Veterinary Record 159, 662 – 668.
were recumbent after dystocia, and concluded
Huxley, J.N., Whay, H.R., 2007. Attitudes of UK veterinary
that both treatments resulted in significant, rapid
surgeons and cattle farmers to pain and the use of analgesics in cattle. Cattle Practice 15, 189 – 193.
improvement. This was a small study with no negative control, so further research is needed
Huxley, J.N., Archer, S.C., Biggs, A.M., Bradley, A.J., Breen, J.E., Green, M.J., Higgins, H.M., Hudson, C.D., Husband, J.A., May, W.,
to establish the value of using NSAIDs in cows
Reader, J.D., Statham, J.M.E., Thorne, M.H., Wapenaar, W., 2010. An expert review of the diagnosis, prognosis and treatment of
which are recumbent due to calving injury.
recumbency in adult cattle. Cattle Practice 18, 53 – 60.
Königsson, K., Gustafsson, H., Kindahl, H., 2002b. 15-Ketodihy-
For hypocalcaemia, the benefit of NSAIDs may
dro-PGF2a, progesterone and uterine involution in primiparous
not seem immediately obvious; however, irre-
cows with induced retained placenta and post-partal endome-tritis treated with oxytetracycline and flunixin. Reproduction in
spective of the cause of recumbency, recumbent
Domestic Animals 37, 43 – 51.
cattle suffer significant trauma resulting in
Laven, R.A., Peters, A.R., 1996. Bovine retained placenta: Aeti-
muscle and nerve damage. Nevertheless, even
ology, pathogenesis and economic loss. Veterinary Record 139, 465 – 471.
though an expert review (Huxley et al., 2010), concluded that, other than fluid therapy, the
Laven, R.A., Huxley, J.N., Whay, H.R., Stafford, K.J., 2009. Results of a survey of attitudes of dairy veterinarians in New Zealand
provision of NSAIDs was the only important
regarding painful procedures and conditions in cattle. New Zealand Veterinary Journal 57, 215 – 220.
aspect of veterinary treatment for downer cows, published research on this topic is conspicuous
Lindell, J.-O., Kindahl, H., Jansson, L., Edqvist, L.-E., 1982. Post-partum release of prostaglandin F2a and uterine involution
by its absence.
in the cow. Theriogenology 17, 237–245.
Longo F., Consalvi, P.J., Van Gool, F., 1993. Comparison of ketoprofen and flunixin efficacy in the treatment of post partum
musculo-skeletal disorders in cattle. In: Proceedings of 26th Conference of Buiatria Italia, pp. 1339–1342.
Newby, N.C., Pearl, D.L., LeBlanc, S.J., Leslie, K.E., von Keyser-
Inflammation and pain are commonly seen post
lingk, M.A.G., Duffield, T.F. 2013.Effects of meloxicam on milk production, behavior, and feed intake in dairy cows following
calving. In such cases, first principles suggest
assisted calving. Journal of Dairy Science, 96, 3682 – 3688.
that NSAIDs are likely to be of value in improving
Odensvik, K., Fredriksson, G., 1993. The effect of intensive
the health and welfare of cattle. However, the
flunixin treatment during the postpartum period in the bovine.
evidence base regarding their effectiveness is
Zentralblatt fur Veterinarmedizin 40, 561 – 568.
Richards, B.D., Black, D.H., Christley, R.M., Royal, M.D., Smith,
limited, so currently they are likely to be under-
R.F., Dobson, H., 2009.Effects of the administration of ketoprofen at parturition on the milk yield and fertility of Holstein-Friesian
used as cost will limit farmer acceptance without
cattle. Veterinary Record 165, 102 – 106.
Shwartz, G., Hill, K.L., Van Baale, M.J., Baumgard, L.H., 2009. Effects of flunixin meglumine on pyrexia and bioenergetic variables in post parturient dairy cows. Journal of Dairy Science 92, 1963 – 1970.
Stahringer, R.C., Neuendorff, D.A., Randel, R.D., 1999. The effect of aspirin administration and parity on plasma salicylate concen-
Duffield, T.F., Putnam-Dingwell, H., Weary, D., Skidmore, A.,
trations and postpartum reproductive parameters in Brahman
Neuder, L., Raphael, W., Millman, S., Newby, N., Leslie, K.E., 2009.
cows. Prostaglandins and Other Lipid Mediators 58, 125 – 138.
Effect of flunixin meglumine treatment following parturition on cow health and milk production. Journal of Dairy Science 92, 118.
Tenhagen, B.A., Helmbold, A., Heuwieser, W., 2007. Effect of various degrees of dystocia in dairy cattle on calf viability, milk
Guilbault, L.A., Thatcher, W.W., Drost, M., Haibel, G.K., 1987.
production, fertility and culling. Journal of Veterinary Medicine,
Influence of a physiological infusion of prostaglandin F2a into
Series A 54, 98 – 102.
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 21
Dr. Marie Haskell
Marie Haskell is a Senior Researcher and Reader at SRUC (Scotland's Rural College) in Edinburgh. Her main research area is the behaviour and welfare of dairy cows, with emphasis on how to assess cow welfare using behaviour. Other areas of interest include investigating animal personality and assessing motivation. Prior to this, her work focussed on under-standing and measuring motivation and cognitive abilities in hens and pigs in work at the Roslin Institute, Edinburgh, and during her PhD at the University of Melbourne. Marie has been part of a number of collaborative research projects that have aimed to use a number of tools to improve animal welfare.
The impact of dystocia on dairy calf health, welfare, performance and survivalDr. Marie HaskellAnimal Behaviour & WelfareSRUC, Edinburgh, UK
On a dairy farm, the birth of a calf marks the start cow, so it is commonly observed that heifers are of the productive lactation period for the cow
more likely to experience dystocia than mature
and the farming business. However, parturition
cows. Twin calves are also a risk factor due to
is a challenging process and a high-risk time for
the increased possibility of malpresentation.
both the mother and her offspring. A difficult
Over- and under-condition of the dam are also
or dystocial birth often means that assistance
risk factors (Mee, 2008).
must be provided during delivery. It is difficult to assess the internal state of the cow in terms of what she experiences, so operationally, dystocia
Impact of dystocia
is normally described in terms of the level of assistance that is required, from none through
Dystocia has negative impacts on the farm, the
mild to severe. Reported prevalence of severe
cow and the calf. Increased labour requirements
calving difficulty in dairy cows ranges from 2
and often professional assistance is required for
to 22 %. However, assistance at calving (which
difficult calvings. Dystocia is associated with a
includes lower degrees of difficulty) is more
reduction in milk yield in the subsequent lacta-
prevalent, with estimates varying from 10 % to
tion, and poorer cow fertility and health, which
over 50 % of calvings (Mee, 2008).
have negative consequences for farm economics as well as for cow welfare. With respect to the
Risk factors for dystocia
The most common cause of dystocia is the phys-ical incompatibility between the pelvic size of the dam and the size of the calf. Because of this, a high calf birthweight is known to be a risk factor for dystocia. It also follows that male calves are also more likely to experience dystocial birth because of their higher birthweight. Pelvic size is influenced by the stage of maturity of the
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 23
calf, it is well-documented that dystocia is asso-
calves having a threefold greater risk of dying
ciated with higher mortality in the immediate
compared to calves from a normal birth. Survival
post-natal period. In general, however, there
to the age of first breeding or service was also
has been less attention paid to the effects of a
affected, with calves born from a moderately
dystocial birth on the surviving calf. The growth,
difficult birth having a higher risk of dying. How-
survival, health and welfare of the calf may be
ever, those animals that survived beyond this
adversely affected (Murray and Leslie, 2013).
stage showed the same probability of survival as calves from a normal birth. Growth rates did not appear to be affected, as we found no evidence
Survival and growth
of an effect of a dystocial birth on growth to weaning (Barrier et al., 2012).
A number of studies have shown that the calf or calves are more likely to be stillborn or die shortly after a difficult birth (Lombard et
Calf vigour and neonatal stress
al., 2007; Barrier et al., 2012b). In our study, stillbirth rates were up to 7-8x higher in calves
We can assume that the increased mortality is
delivered after a very difficult calving. Post-mor-
due to damaging impacts of the difficult calving
tem examination of stillborn calves showed that
on the biological functioning of the animal.
mild and more extensive bruising of the body
Dystocia can cause hypoxia and acidosis in the
was only present in calves that experienced an
calf, which can be fatal. For those that survive,
assisted birth, and were absent in still-born
there may be other effects that adversely affect
calves from non-assisted births (Barrier et al.,
functioning and health. We assessed levels of
2013a). Survival to weaning was also shown to
stress hormone in neonatal calves and found
be affected by a dystocial birth, with affected
that calves born with assistance had 4x higher
cortisol levels in first 24 hours of life, compared
sulphide turbidimetry (ZST) test which assesses
to calves born without assistance. We also
immunoglobulin levels in blood. It was shown
assessed rectal temperature, as an indication of
that assisted calves had lower levels of immu-
the ability to thermoregulate, but there was no
noglobulins , although all calves had low levels.
By following the calves through the first months of life, it was also shown that calves born from
In the neonate, passive immunity is acquired
a more severe dystocial birth (malpresentation)
from immunoglobulins in the colostrum, but the
had more health treatments than those with
capacity of the gut to absorb immunoglobulins
normal births or less severe dystocia (Barrier et
decreases rapidly after birth. Prompt suckling
after birth maximises the acquisition of passive immunity. We used video-recordings to compare
In conclusion, a dystocial birth can have pro-
the behaviour of calves from non-assisted and
found effects on the survivability, health and
dystocial births in the first 3 hours after birth.
welfare of calves. This suggests that reducing
The results showed that assisted calves were less
overall levels of dystocia or severity of dystocia
vigorous and took longer to attempt to stand,
will have positive impacts on the health and
achieve standing, walk and reach the udder than
welfare of calves but also on the economics of
unassisted calves. Assisted calves were not less
likely to suck, nor was there a difference in the time taken to achieve a successful suck. How-ever, only a third of assisted animals achieved
successful suckling within 3 hours of birth. These differences were not due to the behaviour of the
Barrier, A.C., Dwyer, C.M., Macrae, A.I and Haskell, M.J. (2012a). Survival, growth to weaning and subsequent fertility of liveborn
dam, as there was no difference between assisted dairy heifers after a difficult birth. Journal of Dairy Science, 95,
6750 – 6754.
and unassisted dams in the level of maternal behaviour shown (Barrier et al., 2012b). Murray
Barrier, A.C., Ruelle, E., Haskell, M.J., and Dwyer, C.M. (2012b). Effect of a difficult calving on the vigour of the calf, the onset of
and Leslie (2013) suggested that a method of
maternal behaviour, and some behavioural indicators of pain in
assessing calf vigour would help to identify ani-
the dam. Preventive Veterinary Medicine, 103, 248 – 256.
mals that require therapeutic interventions, and
Barrier, A.C., Mason, C., Dwyer, C.M., Haskell, M.J., and Macrae, A.I., (2013a). Stillbirth in dairy calves is influenced independently
increase survival and welfare in calves.
by dystocia and body shape. The Veterinary Journal, 197: 220 – 223.
Barrier, A.C., M.J. Haskell, M.J., S. Birch, S., Bagnall, A., Bell, D.J.,
Immunity stress and health
Dickinson, J., Macrae, A.I. and Dwyer, C.M. (2013b). The impact of dystocia on dairy calf health, welfare, performance and survival. Veterinary Journal, 195, 86 – 90.
Although assisted calves were statistically
Lombard, J.E., F.B., Garry, S.M. Tomlinson and L.P.Garber, 2007.
not less likely to suck, the results suggest that
Impacts of dystocia on health and survival of dairy calves. J. Dairy Sci., 90:1751 – 1760.
assisted calves had lower vigour than non-as-
Mee. J.F., 2008. Prevlaence and risk factors for dystocia in dairy
sisted calves. It is recommended that calves
cattle: a review. Vet. J., 176: 1 – 17.
achieve a first suckling within 3-4 hours of
Murray, C.F. and Leslie, K.E., 2013. Newborn calf vitality: risk
birth, so this suggests that assisted calves may
factors, characteristics, assessment, resulting outcomes and
suffer. This finding was confirmed using a zinc
strategies for improvement. Vet. J., 198: 322 – 328.
7th Boehringer Ingelheim Expert Forum on Farm Animal Well-Being 25
Dehorning is acutely painful. That's why a local anaesthetic is often given – but a few hours later its effect wears off and pain erupts. Co-administration of Metacam – licensed for dehorning pain – provides time-appropriate pain relief. So now, at last, you can make dehorning a metacomfortable experience for everybody.
ESSAY ZUR ANALYSE VON VERDIS OTELLO - JANINE CHRISTGEN ESSAY ZUR ANALYSE VON VERDIS OTELLO - JANINE CHRISTGEN 1. Zur langjährigen Genese von Verdis „Schokoladenprojekt" Verdis Otello zeigt sich als ein Opernprojekt, welches in seiner Genes viele Jahre in Anspruch nehmen sollte. Zwischen den ersten Gesprächen mit Boito (1879), über eine mögliche
TABLE OF CONTENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .