Your browser is out-of-date!

Update your browser to view this website correctly. Update my browser now



“Have you seen much pneumonia recently?”

Prevention, early detection and prompt treatment of bovine respiratory disease is essential to minimise its impact

“Have you seen much pneumonia recently?” – a conversation opener offered by most farm clients around this time of year which indefinitely leads to their detailed account of the weather over the last few days. Although it may be the fifth time you’ve had the con­versation that day, it is the perfect opportunity to review the client’s management of bovine respiratory disease (BRD) and spark discussion on the benefits of how early detection and treatment of BRD can reduce the impacts of disease.

BRD affects 46 percent of calves before they reach nine weeks of age (Johnson et al., 2017). A recent study by Dunn et al. (2018), using ultrasound images to assess the lung damage in young calves, revealed that lung lesions can develop as early as 12 days of age and can have long-term effects on the lifetime productivity of dairy heifers and beef calves (Table 1).

TABLE (1) BRD can have long-term effects on the lifetime productivity of dairy heifers and beef calves

Many farmers will only consider the immediate treatment costs of BRD which could be conservatively estimated at £5 per case for medication alone, but this can just be the tip of the iceberg when compared to the long-term economic impact of decreased longevity and production. In reality, it is estimated that the overall cost of BRD would be closer to £772 per case in young dairy heifers (Table 2; Bartram et al., 2017).

TABLE (2) The total economic lifetime cost of respiratory disease in dairy and beef calves can be as high as £772 per case in dairy heifers

The additional hidden costs are an accumulation of the impacts of delayed weaning (estimated at £3.53 per day; Boulton et al., 2015), delayed first calving, reduced longev­ity in the herd, reduced daily liveweight gain, reduced first and second lactation yields and replacement costs – the average price of freshly calved Holstein Friesian heifers at time of writing is £1,419 (AHDB, 2020). With these effects in mind, prevention, early detection and prompt treatment of BRD is essential to minimise its impact.


It is widely considered that the cause of BRD is multifactorial, and it therefore seems appropriate that the treatment of BRD should be too. Alongside the immediate treatment of cases with appropriate antibiotic and non-steroidal anti-inflammatory (NSAID) therapy, it is also important to verify that calves are receiving early immune protection from good colostrum management and nutrition.

BRD is heavily influenced by the environment and, al­though ventilation and humidity are critical, management changes play a monumental role in the success of treat­ment. Such changes can include providing jackets, increas­ing the volume or concentration of milk replacer in relation to seasonal declines in the average ambient temperatures and ensuring the hygiene of pens and feeding equipment. It is important that frequent group changes are avoided and that disbudding is done using a minimally invasive meth­od at an appropriate age, and using local anaesthetic and NSAIDs in order to minimise undue stress which leads to susceptibility of disease.

Vaccination against BRD reduces morbidity, reduces se­verity of disease and also reduces nasal shedding of virus from infected calves. Concurrently these effects will help to reduce infection pressure (Masset et al., 2020). Uptake of vaccines among dairy and beef producers is disappointingly low, estimated at 25 percent of dairy calves and 35 percent of beef calves (Boulton et al., 2015). One suggested reason for this is that farmers’ understanding of the lifetime impact of respiratory disease is limited. It is possible in some cir­cumstances to produce autogenous vaccines to help control emerging BRD challenges such as Mycoplasma spp.

Early detection

Delaying antibiotic and NSAID therapy can lead to an increase in lung damage (lung consolidation) by the disease-causing organism. Lung consolidation describes the presence of heterogeneous hypoechoic areas in the lung tissue on tho­racic ultrasound examination, usually as a result of infection, causing a decrease in the effective function of the lung tissue (Teixeira et al., 2017). The greater the lung consolidation, the lower the growth rate, the greater the risk of culling, the higher age at first calving and lower pregnancy to first ser­vice (Adams and Buczinski, 2016; Teixeira et al., 2017). It can be challenging for clients and practitioners to detect early signs of acute pneumonia. Several aids have been developed to assist farmers and practitioners in early detection of BRD.

  • Scoring charts

UC Davis has developed a BRD scoring system for pre-weaned dairy calves. The scoring card illustrates varying severities of BRD clinical signs that are associ­ated with a numeric score. The user adds up the scores of the clinical signs shown by their patient and if the score is greater than 5 the calf may be positive for BRD

  • Ultrasound

Thoracic ultrasound has been proposed as a calf-side tool to aid BRD diagnosis. Thoracic scanning can be used to confirm farm employee’s detection of respira­tory disease, assess animals with unknown respiratory disease history and help a farmer to make manage­ment decisions. Thoracic ultrasonography of the lungs is performed using a 6.2MHz linear transducer screen­ing the right 2nd through 10th and left 3rd through 9th intercostal spaces. Each calf is classified as not having lung consolidation (hyperechoic line with reverberation artifact with or without comet tail) or with lung consoli­dation (any detectable heterogeneous hypoechoic area) using a scoring system detailed by Cramer and Ollivett (2019). More useful information and descriptive videos on this technique are available online (University of Wisconsin-Madison, 2021)

  • Smart ear tags and technology

Temperature-sensing ear tags are designed to detect increases in a calf’s body temperature before it dis­plays clinical signs of disease. Similarly, activity collars are able to detect changes in a calf’s activity and feeding behaviour if paired with a milk feeding system, which can help aid early detection of BRD. The limita­tion to these technologies is that they can encourage overuse of antibiotics, be costly in commercial settings and be difficult to set up/use (Mahendran, 2020)

  • Necropsy

Necropsy may seem an oxymoron for early detec­tion of BRD but can prove an invaluable examination that lends itself to aid prompt diagnosis in an acute outbreak of severe pneumonia where fatalities are seen. CPD training courses are worth enquiring about through local veterinary laboratories, veterinary schools or pharmaceutical company representatives

Prompt treatment

The most common BRD pathogens are viruses. Therefore, antibiotics are used to help prevent or treat secondary infections rather than the primary cause. In group out­breaks where a viral pathogen is suspected, it is important to consider the use of live intranasal vaccines as treatment. Alongside an antibiotic and/or vaccine it is imperative to consider the use of NSAIDs. The use of NSAIDs has welfare and economic benefits since it has been proven to reduce pyrexia and lung consolidation, therefore minimising reduction in daily liveweight gain (Friton et al., 2005). In turn, maintaining daily liveweight is critical to reducing the risk of long-term production and economic losses such as delayed calving and reduced milk yield. There are several NSAIDs available for use in cattle. Meloxicam has the ben­efit of having a longer duration of activity than some other products. Furthermore, combination products containing antibiotic and NSAID in one injection make treatment easier and protocols simpler for clients, ensuring that every calf receives the NSAID it requires.


Adams, E. and Buczinski, S.


Short communication: Ultrasonographic assessment of lung consolidation postweaning and survival to the first lactation in dairy heifers. Journal of Dairy Science, 99, 1465-1470

Bartram, D., Hogan, C. and Penny, C.


Estimating the lifetime total economic costs of respiratory disease in beef and dairy calves in the UK. Value in Health, 20, A643

Boulton, A., Rushton, J. and Wathers, D.


A study of dairy heifer rearing practices from birth to weaning and their associated costs on UK dairy farms. Open Journal of Animal Science, 5, 185-197



Cow and heifer prices | AHDB

Cramer, M. and Ollivett, T.


Growth of preweaned, group-housed dairy calves diagnosed with respiratory disease using clinical respiratory scoring and thoracic ultrasound – a cohort study. Journal of Dairy Science, 102, 4322-4331

Dunn, T., Ollivett, T., Renaud, D., Leslie, K., LeBlanc, S., Duffield, T. and Kelton, D.


The effect of lung consolidation, as determined by ultrasonography, on first-lactation milk production in Holstein dairy calves. Journal of Dairy Science, 101, 5404-5410

Friton, G., Cajal, C. and Ramirez-Romero, R.


Long-term effects of meloxicam in the treatment of respiratory disease in fattening cattle. Veterinary Record, 156, 809-811

Johnson, K., Chancellor, N., Burn, C. and Wathes, D.


Prospective cohort study to assess rates of contagious disease in pre-weaned UK dairy heifers: management practices, passive transfer of immunity and associated calf health. Veterinary Record Open, 4, e000226

Mahendran, S.


Use of fever detection in combination with thoracic ultrasonography to identify respiratory disease, and compare treatments of antimicrobials and NSAID: a randomised study in dairy calves. Veterinary Record Open, 7, e000415

Masset, N., Meurens, F., Marie, M., Lesage, P., Lehebel, A., Brisseau, N. and Assie, S.


Effectiveness of two intranasal vaccines for the control of bovine respiratory disease in newborn beef calves: A randomized non-inferiority multicentre field trial. The Veterinary Journal, 263

Teixeira, A., McArt, J. and Bicalho, R.


Thoracic ultrasound assessment of lung consolidation at weaning in Holstein dairy heifers: Reproductive performance and survival. Journal of Dairy Science, 100, 2985-2991

University of Wisconsin-Madison


Calf health module | Dairyland Initiative

Alison Brough

Alison Brough, BVSc, MRCVS, graduated from University of Liverpool in 2017 and works at Ark Vets in Lockerbie. Alison has a keen interest in dairy youngstock and is currently studying for her CertAVP.

More from this author

Looking for a range of resources, insights and CPD all in one place?

Join the ALL-NEW Veterinary Practice community; the online platform with nugget-sized, CPD-accredited veterinary training and resources!

Everything you need for your professional development, delivered by experts.

One place. One login. It’s online. All the time.

Annual subscription: £299 for Vets and £199 for Vet Nurses

Subscribe Now