Welfare, pain relief and productivity

Pain management plays a critical role in animal welfare. Freedom from pain, injury and disease is one of the core animal welfare principles established by the Five Freedoms framework defined in 1965. In fact, chronic pain, and to a lesser extent acute pain, results in poor welfare of production animals¹.

Consequences of pain in cattle: poor welfare and decreased productivity levels

Pain affects cattle behaviour and alters their activity patterns², while also impacting their general health. Pain in cattle leads to production losses (milk yield, growth rates) and reduced reproductive performance^3,4, directly impacting farmers’ income and well-being. Growing societal concerns about animal welfare creates additional pressure on the agricultural industry to produce food in a more ethical and sustainable way, making pain management in cattle more important than ever.

Despite the increased recognition of pain in cattle, there are still many situations in which pain is not mitigated by the implementation of adequate pain management protocols.

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Welfare, pain and productivity.

As custodians of animal welfare, vets have a critical role to play to ensure cattle welfare and implement pain management protocols, in partnership with farmers.

How to mitigate cattle pain on farms? The constant dilemma between welfare, cost and productivity

Current protocols and commonly used molecules in cattle

Although husbandry procedures are known to be incredibly painful, and pain in cattle is widely recognised and acknowledged, pain relief is not systematically implemented^5,6.

For instance, research suggests that pain associated with clinical mastitis is often not treated⁷. Costs, ease of use and administration of drugs, as well as legal restrictions specifically for the use of pain relief products in food-producing animals⁸ are the main factors responsible for the absence of pain management protocols on farms.

The lack of pain management protocols for painful procedures poses a serious welfare issue. It is critically important to implement targeted analgesia in livestock medicine, considering the negative welfare outcomes associated with unmitigated pain⁹.

Pain in cattle can be managed through the implementation of pre-emptive or reactive analgesia. When conducting painful procedures where pain is predictable, pre-emptive analgesia is recommended. In theory, the most effective analgesia is achieved through a multimodal approach, combining agents that act on different physiological pathways.

In the absence of Maximum Residue Limits (MRLs), some potent molecules, such as opioids, can’t be used. Other analgesic options like general anaesthesia can’t always be used for obvious practical reasons either. Some molecules are licensed in livestock for systemic analgesia such as NSAIDs (non-steroidal anti-inflammatory drugs) including meloxicam, carprofen, ketoprofen and tolfenamic acid. For general anaesthesia alfa-agonists like xylazine and detomidine can be used but they do not provide adequate analgesia.

NSAIDs are the most commonly used products for treating lameness¹⁰. Epidural analgesia, intravenous regional anaesthesia and local nerve blocks are different techniques that can be used to provide local anaesthesia¹¹.

For livestock undergoing routine husbandry procedures, implementing a multimodal pain relief strategy incorporating both local anaesthesia, to address nociception, together with NSAIDs to manage pain, is recommended as best practice. Meloxicam is the most advocated molecule, because of its prolonged half-life, enabling a duration of action up to 72 hours¹².

Recently, the use of topical anaesthesia received some attention⁶. Farm animals suffering from painful oral lesions inflicted by insect-borne viral diseases such as bluetongue (BT) and epizootic hemorrhagic disease (EHD) could benefit from non-antimicrobial alternative treatments to reduce unnecessary suffering, support recovery and help getting back rapidly to good levels of productivity. Research suggests that the use of topical or local anaesthesia, ideally combined with NSAIDs for analgesia, reduces pain during and after husbandry procedures and is therefore a robust and affordable strategy^1,12,13,14.

Benefits of using NSAIDs in painful conditions

Painful conditions in cattle, such as mastitis, lameness, respiratory diseases and post-surgical pain, require the implementation of a pain protocol.

Recent research highlights the potential benefits of using NSAIDs to help restore the activity patterns of dairy cows suffering from painful conditions². The benefits of using NSAIDs to mitigate pain in cattle depends on various factors, including the molecule, dosage, route of administration, time of administration in relation to the painful condition². It is worth noting that NSAIDs are the only analgesics available for food-producing animals in Europe providing long-acting pain relief^11,15 (24h to 72h of pain relief per dose).

Although mastitis is recognised as a painful condition, the pain associated with clinical mastitis is often not managed. NSAIDs can be used to treat clinical mastitis in cows¹⁵, their beneficial effects have been demonstrated in studies on experimental lipopolysaccharide-induced mastitis models.

Meloxicam has a beneficial effect in cows with Escherichia coli lipopolysaccharide - induced mastitis by relieving pain and decreasing udder oedema and body temperature¹⁶.

Flunixin meglumine reduces clinical signs of depression, lowers rectal temperature and heart rate, increases rumen motility or cud chewing and eating time in experimental lipopolysaccharide endotoxin models compared to control groups⁷. Similarly, ketoprofen reduces rectal temperature, respiratory rate and udder oedema, while increasing ruminal contractions in cows with induced lipopolysaccharide endotoxin mastitis⁷.

NSAIDs quicken the recovery of lame cows¹⁷ and improve productivity^15,18. Research supports the use of ketoprofen in treating and preventing lameness¹⁹.

NSAIDs and surgery

NSAIDs can also be used to relieve post-operative pain in cows and calves¹⁵. The administration of NSAIDs to calves undergoing surgical castration^15,20 or disbudding^15,21 significantly reduces the behavioural and physiological responses associated with pain.

The use of NSAIDs during disbudding has been shown to make the procedure less aversive²², suggesting that a multimodal pain mitigation strategy, including NSAIDs, can help reduce the negative experience associated with the procedure in the hours that follow^{6, 22, 23}.

For dehorning, flunixin meglumine provides up to 6 hours of analgesia when used in combination with a local anaesthetic nerve block⁶ (cornual nerve).

Expanding NSAIDs use for pain management: a missed opportunity on farms?

Research suggest that farmers would like to give NSAIDs to cattle to mitigate pain in many painful conditions. The most painful ones according to farmers are caesarean section, digit amputation and left displaced abomasum surgery (LDA)¹⁵. These conditions are also the most likely to get a prescribed NSAIDs treatment from the vet¹⁵.

Given the proven benefits of NSAIDs in mitigating pain in cattle, and the willingness of farmers to use them, there is a clear opportunity to increase NSAIDs use. This is supported by a recent study, suggesting the need to increase awareness on NSAIDs use and their benefits to cattle welfare¹⁵, for both cows and calves. As such, NSAIDs should ideally be systematically used for commonly performed husbandry procedures⁵.

References

^{1. Stilwell, G.; Windsor, P.A.; Broom, D.M. Pain Management for Ruminants During Common Farm Husbandry Procedures. In Advances in Animal Health, Medicine and Production; Duarte, A.F., da Costa, L.L., Eds.; Springer: Cham, Switzerland, 2020; pp. 27–51.}

^{2. Mainau E, Llonch P, Temple D, Goby L, Manteca X. Alteration in Activity Patterns of Cows as a Result of Pain Due to Health Conditions. Animals (Basel). 2022 Jan 12;12(2):176. doi: 10.3390/ani12020176. PMID: 35049798; PMCID: PMC8773241.}

^{3. Ginger L, Ledoux D, Bouchon M, Rautenbach I, Bagnard C, Lurier T, Foucras G, Germon P, Durand D, de Boyer des Roches A. Using behavioral observations in freestalls and at milking to improve pain detection in dairy cows after lipopolysaccharide-induced clinical mastitis. J Dairy Sci. 2023 Aug;106(8):5606-5625. doi: 10.3168/ ds.2022-22533. Epub 2023 Jun 1. PMID: 37268578.}

^{4. Leslie KE, Petersson-Wolfe CS. Assessment and management of pain in dairy cows with clinical mastitis. Vet Clin North Am Food Anim Pract. 2012 Jul;28(2):289-305. doi: 10.1016/j.cvfa.2012.04.002. PMID: 22664209.}

^{5. Huxley JN, Whay HR. Current attitudes of cattle practitioners to pain and the use of analgesics in cattle. Vet Rec. 2006 Nov 11;159(20):662-8. doi: 10.1136/ vr.159.20.662. PMID: 17099174.}

^{6. Kleinhenz M, Viscardi A, Coetzee JF, Invited Review: On-farm pain management of food production animals. Applied Animal Science. Volume 37, Issue 1. 2021. Pages 77-87. ISSN 2590-2865. https://doi.org/10.15232/aas.2020-02106 .}

^{7. Petersson-Wolfe CS, Leslie KE, Swartz TH. An Update on the Effect of Clinical Mastitis on the Welfare of Dairy Cows and Potential Therapies. Vet Clin North Am Food Anim Pract. 2018 Nov;34(3):525-535. doi: 10.1016/j.cvfa.2018.07.006. PMID: 30316508.}

^{8. Robles I, Arruda AG, Nixon E, Johnstone E, Wagner B, Edwards-Callaway L, et al. Producer and veterinarian perspectives towards pain management practices in the US cattle industry. Animals. 2021;11(1):209.}

^{9. Zoltick, Abigale & Mann, Sabine & Coetzee, Johann. 2024. Pain pathophysiology and pharmacology of cattle: how improved understanding can enhance pain prevention, mitigation, and welfare. Frontiers in Pain Research. 5. 10.3389/ fpain.2024.1396992.}

^{10. Craven E, Stavisky J, Robinson N, Dean R. How do different members of the on farm mobility team perceive lameness, and what factors influence their NSAID use? Vet Rec. 2024 Mar 2;194(5):e3412. doi: 10.1002/vetr.3412. Epub 2023 Oct 29. PMID: 37899275.}

^{11. Hudson, C., Whay, H. and Huxley, J. (2008), Recognition and management of pain in cattle. In Practice, 30: 126-134. https://doi.org/10.1136/inpract.30.3.126.}

^{12. Windsor PA. Role of Topical Anaesthesia in Pain Management of Farm Animals, a Changing Paradigm. Animals (Basel). 2022 Sep 17;12(18):2459. doi: 10.3390/ ani12182459. PMID: 36139319; PMCID: PMC9495143.}

^{13. Windsor, P.A. Progress with Livestock Welfare in Extensive Production Systems: Lessons From Australia. Front. Vet. Sc. 2021, 8, 674482.0}

^{14. Windsor, P.A.; Lomax, S.; White, P. Progress in pain management to improve small ruminant farm welfare. Small Rum. Res. 2016, 142, 55–57.}

^{15. Browne, Natasha & Conneely, Muireann & Hudson, Chris. 2022. Use of Non-Steroidal Anti-Inflammatory Drugs and Attitudes to Pain in Pasture-Based Dairy Cows: A Comparative Study of Farmers and Veterinarians. Frontiers in Veterinary Science. 9. 10.3389/fvets.2022.912564.}

^{16. Fitzpatrick CE, Chapinal N, Petersson-Wolfe CS, DeVries TJ, Kelton DF, Duffield TF, Leslie KE. The effect of meloxicam on pain sensitivity, rumination time, and clinical signs in dairy cows with endotoxin-induced clinical mastitis. J Dairy Sci. 2013 May;96(5):2847-56. doi: 10.3168/jds.2012-5855. Epub 2013 Mar 21. PMID: 23522672.}

^{17. Thomas HJ, Miguel-Pacheco GG, Bollard NJ, Archer SC, Bell NJ, Mason C, et al. Evaluation of treatments for claw horn lesions in dairy cows in a randomized controlled trial. J Dairy Sci. (2015) 98:4477–86. doi: 10.3168/jds.2014-8982.}

^{18. Carpenter AJ, Ylioja CM, Vargas CF, Mamedova LK, Mendonça LG, Coetzee JF, et al. Hot topic: early postpartum treatment of commercial dairy cows with nonsteroidal antiinflammatory drugs increases whole-lactation milk yield. JDairy Sci. (2016) 99:672–9. doi: 10.3168/jds.2015-10048.}

^{19. Wilson JP, Bell NJ. 2022: “Use of NSAIDs in the management of lameness in dairy cattle”; Livestock; 27(6). doi: 10.12968/live.2022.27.6.254.}

^{20. Ting STL, Earley B, Hughes JML, Crowe MA. Effect of ketoprofen, lidocaine local anesthesia, and combined xylazine and lidocaine caudal epidural anesthesia during castration of beef cattle on stress responses, immunity, growth, and behavior. J Anim Sci. (2003) 81:1281–93. doi: 10.2527/2003.8151281x.}

^{21. Winder, C.B.; Miltenburg, C.L.; Sargeant, J.M.; LeBlanc, S.J.; Haley, D.B.; Lissemore, K.D.; Godkin, M.A.; Duffield, T.F. Effects of local anesthetic or systemic analgesia on pain associated with cautery disbudding in calves: A systematic review and meta-analysis. J. Dairy Sci. 2018, 101, 5411–5427.}

^{22. Ede, T.; von Keyserlingk, M.A.G.; Weary, D.M. Assessing the affective component of pain, and the efficacy of pain control, using conditioned place aversion in calves. Biol. Lett. 2019, 15, 4.}

^{23. Duval E, von Keyserlingk MAG, Lecorps B. Organic Dairy Cattle: Do European Union Regulations Promote Animal Welfare? Animals. 2020; 10(10):1786. https://doi. org/10.3390/ani10101786.}

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