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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
health professionals
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.
21: 273-283.
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 foetus safety.
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 after delivery.
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. difference shown. 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 dairy farms.
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.

Source: http://www.farmanimalwellbeing.eu/files/article_33.pdf