I am an avid reader of Bovine Magazine, okay I have a confession, I am not a hard copy magazine guy as I like to get my news and information in the digital world using my phone or tablet. We pay very close attention to what is happening in the bovine veterinary world as a large portion of our target demographic comes from the bovine veterinary market. In fact, we currently have a campaign to help the veterinarian with their practice in the bovine market in both the beef and dairy segments. Our campaign is about, "Helping your practice makes perfect sense." We feel a responsibility to help the veterinarian with their everyday practice to insure they are getting the most from our Ibex® Portable Ultrasound System.
In a recent article produced by Dave Sparks, DVM of the Oklahoma State University Extension, he brings up why food animal veterinarians should be pregnancy checking their herds now instead of waiting later. His points I want to highlight include the following:
Far too many small to midsized cattle producers are saving pennies by not pregnancy testing while wasting dollars by not knowing which cows are open.
The old standby for pregnancy checking is rectal palpation. In this procedure the veterinarian enters through the rectum and palpates the reproductive tract through the rectal wall.
Ultrasound will detect earlier pregnancies than most operators can detect confidently by rectal palpation and also may show pathological conditions that rectal palpation may miss. (emphasis added)
A disadvantage is that it will take several days to be notified of the results so you probably will need to re-gather the cows to sort off the open ones. Another disadvantage is that it only tells you if the cow is pregnant or open and gives no indication of how far along the pregnancy is. Rectal palpation and ultrasound will indicate fairly closely what stage of pregnancy the cow is in. (emphasis added)
For obvious reasons we would love all producers to be pregnancy checking their herds using the ultrasound method instead of using either the palpation method or using the blood test method.
Addressing each point above I can say that the first of his points is a common sense approach to handling your herd. Anytime you are not pregnancy checking your herd, you are rolling the dice as to whether your cows are open. Spending money on cows that are open and will not be producing a return on investment is a gamble. I should point out however that it is a cost and one that has to be weighed with all the other factors of managing the herd for the best return.
In point two, I thought it important that we address the idea that rectal palpation has a very similar procedure to ultrasound. An ultrasound has the same rectal entry point that requires a veterinarian to check using their arm, but by using the Ibex® Customizable Extension (I.C.E.) handle, an "arm free" accessory, the procedure could be less invasive. The veterinarian saves wear and tear on the cow and more importantly perhaps, their arm.
In the third idea I have added some emphasis on the point that ultrasound shows some fairly significant differences to rectal palpation that are very important. An example of a difference would be whether the fetus is a viable fetus. There are many chances to misdiagnose a pregnant cow using palpation when palpation or feeling a viable fetus is not usually possible by just feel. It is tough to feel a heartbeat. Other abnormalities of a fetus, that may not be seen from palpation and only on ultrasound, may be missed and the pregnancy may turn out to be incorrect. In this instance seeing is believing.
In the final point, I have added emphasis to the idea that blood testing cows appears to be a cumbersome and time consuming process. Time is not always the friend of the producer and something that needs to be weighed into the herd management plan. The last emphasis in the final point is on the idea that blood testing cannot show at what stage the pregnancy is in or the gestation of the cow. This may be an important factor in the management of the herd. And it should also be noted that blood testing cows does not take into account false positives of cows that may have a fetus that is not viable or has an abnormality. This is something that needs to be addressed in the decision making process.
It appears that Dr. Sparks would have us believe that using ultrasound for pregnancy checking cows is cost prohibitive to the producers and that this method might be too expensive hurting the bottom line for the management of the herd. It was pointed out that regions and pricing varies, and we have not collected enough data to make a pronouncement of the costs involved in any of the processes mentioned. This is something that veterinarians and their clients should discuss. It may be that palpation and ultrasound are about the same price, making more sense to go with ultrasound. The cost of blood testing appears to be less but by the time you add all the added process and the cost of shipping and waiting, I think it is a costly and not an exact process with a good return on investment. Until blood testing is more of a contemporary test providing real time results it does not seem like the best choice.
Our recent campaign is to help veterinarians and their practice. To us this makes perfect sense. We would love to have you contact us to determine if buying an ultrasound makes sense for you and your practice. Right now in the month of September we have a program that allows you to buy an Ibex® Portable Ultrasound at never before seen prices. If you are a producer, ask your veterinarian to use ultrasound on your herd. We want to help the veterinarian but we also want to help you!
Let us know, are you performing ultrasound, blood testing or palpating your herd? Are you pregnancy checking your herd this fall? If not, you might want to explore the opportunity to succeed.
By: Ryan Giles
Accurate diagnosis and treatment of ovarian cysts are important aspects of proper reproductive management for any dairy herd. While the negative effects of ovarian cysts on normal estrous cyclicity, conception, and prolonged calving intervals are evident; determining which type of cyst is on an ovary (follicular, luteal, or even a cystic corpus luteum) can be difficult. Diagnosis of each type is important as the proper treatment for follicular and luteal cysts differs, and use of ultrasound is the best tool for achieving this.
Let’s characterize each type of ovarian cyst and describe the benefits of ultrasound to diagnose them.
Development of follicular cysts in cows occurs when a follicle reaches the ovulatory size (about 17 to 19 mm), but fails to ovulate leaving a large persistent follicular structure on the ovary. A single follicular cyst or multiple cysts can form on the ovary (s). Length of time for the anovular follicle to persist on the ovary before it’s considered a follicular cyst is usually at least 10 days. There are various classifications of a “true follicular cyst”, but a classic identifying feature is a follicular structure on the ovary that is at least 25 mm in size in the absence of any corpus luteum. The appearance of follicular cysts is clear using ultrasound with the large cystic structure having a very thin outer wall with black fluid extending to its outer edges as shown in the image below.
As you can see, diagnosis of this type of cyst is clear with use of an ultrasound, and the presence of a second follicular cyst is evident on the left side of the ovary as well. Rupture of these cysts is quite easy from rectal palpation, which can traumatize the ovary leading to hemorrhaging, and possible adhesion formation on the ovary. The less invasive approach of using an ultrasound can reduce the chances of rupturing follicular cysts, and also is extremely effective to determine whether the cyst is active or benign. Palpating any other structure on an ovary is extremely difficult when a cyst is present, so many times an active corpus luteum is not found on the ovary along with the cyst. An example of this is shown below where the cyst is very prominent on the left side of the ovary, but can be classified as benign due to the corpus luteum sitting to the right of it.
While the causes of follicular cysts are unclear, their development has been linked to genetics, nutritional factors of under- or over- feeding, high milk production (increased steroid metabolism), and stress. However, there is a major theory for how the above factors may cause the formation of follicular cysts. An ovulatory follicle begins to produce large amounts of estradiol, which targets the hypothalamus of the brain and triggers the initial cascade to cause ovulation. It’s believed that there is poor communication within this cascade that inhibits ovulation leading to follicle persistence and follicular cyst development.
Hormonal treatment of a follicular cyst with GnRH (human chorionic gonadotropin has also been used) will generally cause the cyst to luteinize and subsequent treatment with prostaglandin F2α will resolve the luteinizing cyst by triggering luteolysis.
Luteal cysts are believed to develop from follicular cysts that have continued to develop into their later stages. They often progress into luteal cysts by forming a thicker wall of luteal tissue around their outer edges as shown in the image below. You can also see a very slight bit of white “cobwebs” within the lumen of the luteal cyst where the cyst appears to be attempting to further luteinize.
With luteal cysts originating from follicular cysts, the same mechanisms for follicular cysts development described above exist for luteal cysts. The major distinguishing factor between the two is that luteal cysts partially luteinize. Luteal cysts can also have different appearances on the ultrasound depending on the rate of luteinization. This is apparent in the next two images below depicting more examples of luteal cysts. You can see in this first image that luteinization has occurred along the bottom rim of the cyst and again the cobwebs of fibrous tissue are attempting to luteinize the rest of the cyst, but the upper portion of the lumen is still fluid-filled.
This second image is a luteal cyst (on the right side of ovary) in its early stages where the thin outer walls of the cyst still resemble that of a follicular cyst, but the cobwebs are apparent throughout the lumen as the cyst attempts to luteinize. You can see a second cyst on the left side of the ovary as well.
A major advantage of ultrasound when dealing with these cysts is its ability to distinguish a luteal cyst from that of a very young corpus luteum (day 5 or 6 of the estrous cycle). An early corpus luteum will also have a fluid-filled lumen and cobwebs as it continues to luteinize. Using rectal palpation, it is extremely difficult to palpate an early corpus luteum let alone distinguish it from a luteal cyst as they both have similar palpable features, but can be more clearly differentiated with an ultrasound. An early corpus luteum is depicted below and you can see the difficulties in palpating the difference between this and a luteal cyst.
Since luteal cysts invariably have luteal tissue and produce progesterone, the best treatment for resolving them is administration of prostaglandin F2α to initiate luteolysis. Because some early luteal cysts are not yet responsive to prostaglandin F2α, another approach includes treatment with GnRH first and then prostaglandin F2α in order to further luteinize the cyst with GnRH and then administer prostaglandin F2α to resolve it.
For further bovine ultrasound training, contact http://bovinetraining.com/.
All ultrasound images above were taken with the Ibex Portable Ultrasound and MC8.0MHz transducer.
Dr Kesterson in Bridgeport, Nebraska knows that offering ultrasound to preg check cows gives his producers invaluable information for making management decisions.
By Hilary Parker
Today, we’re asking a question that bovine veterinarians are often too busy to ask themselves: Is your customer service good enough to ensure your clients won’t go somewhere else?
After all, just because you have worked with a dairy farm or cattle ranch for a while — even years — that doesn’t mean that the producer couldn’t up and try another vet in your area. He or she may be keeping an ear to the ground for tips on other bovine vets… unless, that is, your skills are complemented by strong customer service.
Susan Ward, a frequently-cited small business consultant, notes that while good salespeople can sell anything to anyone once, good customer service is all about bringing customers back. It’s also about sending them away happy, she says — happy enough that they recommend you, your team and your work to others.
“How do you go about forming such a relationship?” she asks. “By remembering the one true secret of good customer service and acting accordingly: ‘You will be judged by what you do, not what you say.’”
The IBEX bovine ultrasound is an excellent way to provide great customer service!
Ward offers the following tips for establishing good customer service:
1) Answer your phone.
Get call forwarding, an answering service — even hire staff if you need to. But make sure that someone is picking up the phone when a current or potential calls your business. And no, a recorded robot is not the same thing as a live person.
2) Don't make promises unless you will keep them.
Not plan to keep them — will keep them. Reliability is one of the keys to any good relationship, and good customer service is no exception. If you say, “I’ll be back to check on the herd on Tuesday,” make sure you’re there on Tuesday. Otherwise, don't say it. The same rule applies to client appointments, AI schedules, etc. Think before you give any promise, because nothing annoys customers more than a broken one.
3) Listen to your customers.
There’s nothing more exasperating from a customer’s perspective than telling their vet about a problem they’re experiencing and then discovering that that person hasn't been paying attention and needs to have it explained again. Listen long and hard to your customers. Let them talk and show them that you are listening by making the appropriate responses. Don’t cut them off mid-sentence or assume you understand the entire nature of the problem until they’ve finished, even if you suspect that you do. The animal is the patient, but the producer is the customer.
4) Deal with complaints.
No one likes hearing complaints, and many of us have developed a reflex shrug, saying, “You can't please all the people all the time.” Maybe not, but if you give the complaint your attention, you may be able to please this one person this one time — and position your business to reap the benefits of good customer service.
5) Be helpful — even if there's no immediate profit in it.
The other day I popped into a local watch shop because I had lost the small piece that clips the pieces of my watchband together. When I explained the problem, the proprietor said that he thought he might have one lying around. He found it, attached it to my watchband — and charged me nothing! Where do you think I'll go when I need a new watchband or even a new watch? And how many people do you think I've told this story to?
6) Train your staff (if you have any) to be always helpful, courteous and knowledgeable.
Do it yourself or, if your schedule is too hairy, hire someone to train them. Talk to them about good customer service and what it is (and isn't) regularly. Better yet, show them with your own customer interactions. Most importantly, give every member of your staff enough information and power to make those small customer-pleasing decisions, so he or she never has to say, “I don't know, but so-and-so will be back at...”
7) Take the extra step.
For instance, if someone walks into your office and asks you to help them find something that you don’t happen to carry, don't just say, “Sorry, we don’t carry that.” Instead, give them ideas on where they could find it and then take that extra step to call the store and ask. Whatever the extra step may be, if you want to provide good customer service, take it. They may not say so to you, but people notice when you and your staff make an extra effort and they will tell other people.
8) Throw in something extra.
Whether it's a coupon for a future discount, additional information on how to use the product or a genuine smile, people love to get more than they thought they were getting. And don’t think that a gesture has to be large to be effective. The local art framer that we use attaches a package of picture hangers to every picture he frames. It may be a small thing, but it’s so appreciated.
Of course, the trick is to apply these tips consistently. Doing half of them some of the time isn’t what will resonate with your customers. But if you can turn these tips into habits, you’ll be the vet that your clients refer other producers to.
By Hilary Parker
Ever wished you could just suggest what human fertility doctors often do to get their patients to relax and conceive? “Here, Bessie, have a glass of wine.”
Well, until they make such a cocktail for cows, Dr. Dan Goehl, DMV, who runs the Canton Veterinary Clinic in Canton, Mo., swears by “breeding boxes” for reducing stress during reproductive-related procedures.
Many of his clients now use these stress-reducing, build-it-yourself breeding boxes (the commercial ones often are referred to as “breeding barns”) in order to give the heifer a sense of calm. If you’ve got money lying around, there are commercial units available, but it’s fairly easy to construct your own without all the bells and whistles, Goehl told Bovine Veterinarian magazine. Simply build a dark, enclosed box that can fit one or two cows and allows them to walk into the box. No head restraint is used; instead, a bar simply drops behind the cow as she faces the closed end of the box, then stands for AI. Once it’s complete, a rope releases the front door and the cow walks out.
“Heifers walk into these amazingly well and tend to stand much better,” Goehl said. “They do not fight the headgate because there is none and they do not go down on their knees.”
Often, the boxes are portable, allowing vets and other AI specialists to use them with multiple clients. And because the semen handling occurs in the shade, it can make for better conception.
Colorado State University uses the IBEX with the I.C.E. (Customizable Extension) to preg check heifers in Yuma, Colorado.
A breeding box and an IBEX portable ultrasound ought to have your herd synched in no time.
By; E.I. Medical Imaging
We (E.I. Medical Imaging) get asked all the time, "How early can I use ultrasound in a cow?" or "How early can I preg check my cows?"....and of course there is not one correct answer to this question.
There are numerous variables to consider when determining the best time or day to ultrasound cows for pregnancy (or lack of pregnancy= open cows!).
Things to consider are;
1. Skill and experience of ultrasound operator
2. synchronization protocol and management of ultrasound information
3. Dairy employee schedules (make sure the right staff is working on the right days. For example; breeders, herdsman, vaccinations, etc)
Plan a schedule and stick to it! Breeding is all about the timing! Work with your veterinarian and decide what is best for your herd.
Just as a refresh course, the purpose of early bovine ultrasound is to find open cows and return them back into the breeding pool as quickly as possible.
Ultrasound image above shows an Open uterus (non-pregnant)
Tips to early pregnancy diagnosis in cows:
Develop a consistent routine for checking the uteurus structure. For example; cervic down the right horn, right ovary, across the bifrication, left ovary, backing down the left horn and across the utuerus on the way out.
This way you see all of the structures and can adequately diagnosis "open" if no fluid and fetus are found.
Early Bovine Pregnancy Images:
38 Day Bovine Pregnancy
30 Day Bovine Pregnancy
33 Day Bovine Pregnancy
43 Day Bovine Ultrasound
Ultrasound images all taken with the IBEX portable ultrasound
Did you find this article helpful? What would you like to learn more about?
Veterinary students from Charles Sturt University in Australia spend the day learning bovine ultrasound with Craig McConnell, DVM, Radincon X-Ray and the IBEX ultrasound.
The Bovine wet lab focused on;
- Bovine pregnancy (early and late stage)
- Fetal sexing
- Normal and abnormal reproductive structures
The class also learned about the features of the IBEX portable ultrasound manufactured by E.I. Medical Imaging.
Craig McConnel, DVM shows students on the IBEX Pro ultrasound
A student wears the InSite2 monitor glasses with the Ibex ultrasound and learns how the light-weight, portable design is convenient for reproductive ultrasound of bovine.
In this picture, the student ultrasounding (right) is using the IBEX Lite and InSite2 monitor glasses and the student on the left is able to see the ultrasound on a wireless monitor.
Thank you to RADINCON X-RAY for sharing these great pictures with us!
Attached are some bovine ultrasound scans from an umbilical abscess in a 3 month old beef heifer calf on grass submitted by Dr. Paul Chard, Brush Colorado (Follow Dr Chard on twitter @CattleVet)
Dr. Paul Chard said, "The owner called and asked me to come look at this calf and my biggest worry was that it might be an umbilical hernia. In a beef calf at that age I rarely see umbilical abscesses. Those commonly show up in younger calves secondary to omphalitis (postnatal umbilical infection). My most likely differential pre-exam was umbilical hernia."
"We head and heel roped this calf in the pasture. The mass was too firm to effectively palpate for the presence or absence of abdominal contents or a defect in the body wall. Within 10 seconds I was able to make a definitive diagnosis of umbilical abscess and lance and drain the abscess before the calf became stressed out. Try that with an Aloka", commented Dr. Chard.
"The images show thickened skin with a 7mm thick abscess wall. The fluid shown is flocculent indicating the presence of purulent fluid (pus). The umbilicus is clearly visible and is well out if harm's way for surgical drainage of the abscess".
"In contrast, an umbilical hernia would have had multiple loops of bowel or at the least omentum shown on the image."
"The Ibex portable ultrasound allowed me to more efficiently and humanely treat this animal in its own environment without leaving its mother for a trip to the clinic, ended Dr. Paul Chard".
Follow more by Dr. Chard on twitter @CattleVet
What do you use your IBEX Ultrasound to Diagnosis in the field? Send us your story! firstname.lastname@example.org
Article by: Jill Colloton
Bovine Services, LLC has been a provider of ultrasound training courses for veterinarians and ultrasound services for both dairy and beef clients since 2000. Bovine Services, LLC is owned and operated by Jill Colloton, DVM.
Three tips for fetal sexing:
1. Train your eye with video first. Fetal sexing an exercise in frustration for those who can’t quickly and confidently identify structures on a moving fetus. I suggest beginning with Brad Stroud’s “Bovine Reproductive Ultrasound” DVD. The first section is an excellent primer on fetal anatomy and fetal sexing. Follow this with his “Fetal Sexing Unedited” DVD quiz video to hone skills. (To purchase training videos click here.)
2. Position the probe as close to the fetus as possible. Image quality deteriorates as distance increases. In most cases it is possible to achieve this by manipulating the probe only, although retraction may be necessary in cows with large or deep reproductive tracts.
Twins; Heifer/Bull calves
3. Encourage your clients to present cows at 60-80 days in gestation for sexing. Earlier the fetus may not be adequately developed to accurately diagnose gender. Later the fetus may be out of reach, obscured by large placentomes, or too large to orient easily. Fetal sexing at 60-80 days by an experienced ultrasonographer is very nearly 100% accurate.
All images were taken with the IBEX portable ultrasound, L6.2 Transducer (8-5MHz Multi-frequency Linear).
What other tips do you have for bovine fetal sexing?
by #1. What is your Diagnosis? Heifer or Bull calf?
#2. What is your Diagnosis? Heifer or Bull Calf?
#3. What is your diagnosis? Bull or Heifer calf?
Answer Key; Image #1 Heifer , Image #2 Heifer, Video #3 Bull calf
By: Jill Colloton, DVM Bovine Services, LLC
Pregnancy vs. Open Diagnosis
Accomplished ultrasonographers can determine pregnant versus open status with excellent accuracy as early as 27 days in cows and 26 days in heifers (Romano, 2006)
27 Day Bovine Pregnancy
Palpation is less than 80% accurate for accurate diagnosis of normal ovarian structures. For diagnosis of cystic ovarian conditions palpation is only from 10% (Stevenson) to 50% (Lievaart) accurate. Ultrasound can approach 100% for identification of a corpus luteum. Correct diagnosis of ovarian structures is particularly important to maximize the effectiveness of synchronization programs.
Mature Follicle with CL
Fluid filled CL. The thin wall would make it easy to misdiagnose this structure as a follicular cyst on palpatiation
Note the very thin outer walls and irregular shapes of these follicular cysts
Ultrasound can assess the quality of intra-uterine fluid - purulence vs. mucous. It can also detect very small amounts of fluid that would not be palpable in subclinical metritis cases. In clinical cases it can determine if the discharge is due to metriris or vaginitis.
Note the clear mucous in the lumen of the uterus on the left side of the screen and the 18mm follicle on the right side.
Note the flocculence representing purulent material in the lumen of the uterus. Although in heat this cow would clearly not be fertile. On palpation this uterus would feel identical to the previous image of a normal uterus.
Fetal remnants and placental membranes can remain in utero weeks to months after fetal death (Ginther), creating a false positive diagnosis of pregnancy by palpation. Lack of fetal viability is readily apparent with ultrasonography.
In this 54 day twin pregnancy the amount of fluid and the size of the amnions is perfectly normal. However, the flocculence in the amniotic fluid, the lack of heartbeats, and the lack of form in the fetuses confirm fetal death.
Note the extreme flocculence in the pregnancy fluids and the degradation of the dead fetus. On palpation there would still be cardinal signs of pregnancy, including a membrane slip.
Skilled ultrasonographers can diagnose more than 90% of twin cases if cows are examined before 100 days in gestation. Diagnosis of twin pregnancies in the same uterine horn is particularly important due to the high rate of embryonic and fetal loss for unilateral twins (Lopez-Gatius)
Normal bilateral twins at 39 days.
Male fetus at 70 days. Note the umbilicus at 9:00 and the bright white male genital tubercle just below it at the junction of the umbilicus and body wall.
Knowing fetal gender is important to producers for cull decisions, marketing decisions, peripartum monitoring, and calf management decisions.
Femal fetus at 65 days. The perineal area with a cross section of the tail and the bi-lobed female gential tubercle is on the left of the screen. The tarsi and cloven hooves are well-delineated on the right of the screen.
Though rare, fetal anomalies such as schistosomus reflexus, multiple heads, fetal ascites, and extreme arthrogryposis are devastating if allowed to go to term. Ultrasound, particularly at the stage for fetal sexing, can often identify these anomalies much earlier.
Two-headed fetus. Fetal anomalies are most often noticed during fetal sexing examinations.
For more bovine ultrasound imagesand cine loop videos by Dr. Colloton and other respected bovine ultrasound practitioner please visit www.eimedical.com. For more information on durable, water- resistant, portable cattle ultrasound equipment the Ibex Pro and Ibex Lite or call toll free 1.866.365.6596 * 970.669.1793