Recumbent Cow Three Days After Calving
At a six-cow crossbred unit in Nagaon, Assam, a four-year-old cow that calved three days ago is found recumbent at 7 p.m. She is sternal but cannot rise, has cold ears, rectal temperature 37.6°C, rumen contractions one per three minutes, dry dung, and no foul vaginal discharge. She produced 9 L this morning, was fed about 8 kg rice straw and 2 kg concentrate, and has not eaten since noon. The owner reports that she staggered after the evening milking and went down. The nearest veterinarian is 50 km away and cannot arrive before morning. A worker has a bottle of oral calcium gel, a stomach tube, and 20 L of warm water. The shed floor is slippery and two people are available. Mobile phone signal is weak but a call can be made.
1. Rank the most likely causes of the recumbency and state what the worker may and may not do before the veterinarian arrives. Explain your reasoning for each action.
Read the worked answer
Ranking with reasons
- Hypocalcaemia (milk fever) is the leading possibility: recent calving, acute recumbency, cold ears, subnormal temperature, rumen stasis and no fever or foul discharge fit the classic picture. It is not confirmed without a veterinarian.
- Ketosis is possible because she is off feed and producing 9 L, but ketotic cows are often alert and may show ketone odour; this cow is too depressed for ketosis alone.
- Metritis or retained fetal membranes must be considered, but the absence of foul discharge and fever makes it less likely.
- Traumatic injury or nerve damage is possible after slipping on the wet floor; the history of staggering before going down keeps metabolic disease higher on the list.
Safe actions
- Move her to deep, dry bedding and keep her sternal; use a rope and two people, not force.
- Offer warm water and palatable hay; do not force fluids into the mouth.
- Record temperature, rumen movements, appetite, manure, urine and ability to sit up every two hours.
- Call the veterinarian and follow instructions.
Do not
- Do not give intravenous calcium or any injection without the veterinarian.
- Do not pour oral calcium gel into a recumbent cow that is not swallowing reliably; aspiration is a serious risk. Oral calcium is only useful if she is standing and swallowing, and only on veterinary advice.
- Do not stomach-tube an unreceptive cow unless trained and instructed.
- Do not walk her repeatedly or leave her on the slippery floor.
2. Write the information the worker should give the veterinarian by phone and a practical night monitoring sheet. Include the triggers that would justify an emergency visit or a change in plan.
Read the worked answer
Phone report (SBAR format)
- Situation: Four-year-old crossbred cow, calved three days ago, recumbent since evening, unable to rise.
- Background: 9 L milk this morning; fed 8 kg rice straw and 2 kg concentrate; no foul vaginal discharge; has not eaten since noon.
- Assessment: Temperature 37.6°C, cold ears, rumen contractions one per three minutes, dry dung, sternal recumbency, staggering before going down.
- Request: Ask whether to give oral calcium, whether to start any treatment, and what signs should trigger an immediate visit.
Night monitoring sheet Record every two hours: time; rectal temperature; rumen contractions per two minutes; whether she is sternal or flat; ability to lift head; appetite and water intake; manure and urine; any shivering, grinding of teeth or laboured breathing.
Triggers for urgent action
- Breathing becomes laboured, noisy or rapid.
- She goes flat and cannot be kept sternal.
- Temperature falls below 37°C or rises above 39.5°C.
- She becomes bloated on the left side.
- She cannot swallow or fluid runs from the nose.
- No improvement by morning, or worsening at any check.
Judgement point: The worker is managing risk, not diagnosing. Keeping her dry, sternal and warm prevents aspiration and pressure damage while avoiding unnecessary drugs is the correct priority until veterinary help arrives.