Sarah Flacks Notes from Dr Hubert Karreman’s Workshop for Cold Hollow Vet Service

April 24 2009
Abbey Sheldon VT

See also Dr Karreman’s handout for the workshop

Dr Karreman started out the workshop discussing the importance of each farm moving towards having well mineralized fertile soils, producing high quality and nutrient dense forages, not polluting the environment, and providing low stress housing and handling of the cows.  Organic systems work best when they mimic mother nature, when maximizing production is NOT the main goal, and where there is an understanding that absolute control over the farm isn’t necessary (or possible!).  This is all part of the prevention of health care problems.

Dr Karreman’s formula for healthy livestock.
•    Dry bedding
•    Sunshine and good barnyard management
•    Well managed pastures
•    Appropriate shelter
•    High forage rations
•    Clean water

High quality forages are essential for winter feeding and will make it possible to feed a lower amount of grain. Free choice minerals should also be provided, particularly for  herds on relatively low grain rations.  Dr Karreman likes to include kelp as part of the mineral feeding program.

Pastures are essential in summer feeding, should be rotationally or MIG (management intensive grazing) grazed and should be allowed to regrow to 7 to 10 inches before cows are returned to the area.  Summer supplemental feed should be low protein, high energy grain or corn silage (or BMR Sorghum Sudan baleage) with  some dry hay.  Dry hay is the easiest way to reduce the risk of bloat. PA farms are often grazing sorghum Sudan in mid summer during the drought.  This can be either grazed or baled.

Other prevention comments
•    Apple cider vinegar does seem to have a preventative effect for milk fever.
•    Feeding kelp either in the grain or free choice seems to help prevent several types of health care issues.
•    Watch for good rumen fill which indicates cows are getting enough DMI
•    Flax oil can be fed to improve coat
•    BCS (body condition score) should be closely monitored, particularly if you are feeding low or no grain.  Dr Karreman’s observation is that the crossbreds do better on no grain, particularly if they have been selected for low or no grain rations.  No grain feeding also requires very very high pasture quality and forage quality.

However, some problems will still occur and require treatment.

A multi prong approach to problem solving is the best way to succeed
•    Therefore alternative treatments don’t need to be 100% effective
•    A variety of approaches for any problem will give a better chance of success
•    If one pillar of the multi prong approach isn’t working, the other factors are still in place

Organic standard require that you treat a sick animal and you are not allowed to withhold treatment to maintain an animals organic status.

Organic treatments and methods require early treatment, may be labor intensive and may take longer

•    Tunnel ventilation in barns
•    Keep manure dry (under 40%) moisture
•    Keep animals dry – powdered limestone
•    Predator wasps – can be purchased and released
•    Many farmers put chickens out on the pastures after the cows to eat the hatching flies in the cow pies.
•    Some farmers will clip the pastures as a way to spread around the manure to dry out the pies to kill larvae. Other farmers will drag the pastures after grazing to have the same effect. This only works in relatively dry/hot weather.
•    Fly traps
•    Sticky tape
•    Botanical fly sprays

•    Most parasites are spread in the pasture, some are spread in pens and barnyards.  Good sanitation can help prevent reinfection.  Keeping animals continuously in the same pasture leads to more problems, as does animals who are not fed a well balanced diet or are mineral deficient.
•    The only approved chemical dewormer is ivermectin (dairy only).
•    Feeding or grazing high tannin forages can decrease problems.  Some of these forages include birdsfoot trefoil or chicory.
•    The animals that generally are most impacted by parasites are the calves from weaning age to about a year old, so that is the group to focus both prevention and treatment if needed.
•    Some plant based treatments which trails have been done on include Pyrethrum, Tonospora rumphii, Fumaria parviflori and allicin based product (garlic).  Other products which trials have been done on for coccidia included cayenne/garlic mixtures, Ferro (an iron based mineral which contains tannins) and black walnut hulls.  A 5 cc dose of 10% CuSo4 given just prior to dosing will close the esophageal grove so that the dose will go directly into the abomasums

Pink Eye
•    Watch for early signs of watery/weepy eyes.  Pink eye can occur in the winter but it is very uncommon.
•    Prevention includes fly population management
•    Treatment is to take them out of direct sun, use an eye patch if needed, maxigard pink eye vaccination. Hyper immune plasma injection may be a useful part of the treatment.  Dr Karreman does a subconjunctival injection of hyper immune plasma on calves but finds it doesn’t work as well on adult animals.  Some vets will also to a nictitans surgery on the eye flap.
•    Iodine supplementation may have a preventative effect, however once they have it iodine supplementation won’t be enough as a treatment.  Feeding kelp may have some preventative effect.
•    Bright eyes or one of the other eye spray or eye wash products or recipe’s can also work well as a treatment but requires regular treatment

Surgical procedures and drugs
•    There are local anesthetics and anesthesia drugs which are approved for use so they can be used to do surgeries or dehorning.
Other important medications
•    Epinephrine is allowed for allergic reactions
•    Banamine is allowed, as is Butorphanol and Furosemide
•    Electrolytes including IV calcium for milk fever is allowed.
•    Poloxalene is allowed (therabloat and bloatguard)

Complementary and Alternative Veterinary Medicine (CAVM)
•    Biologics
•    Botanicals
•    Acupuncture
•    Homeopathy

Common dosages for herbivores
Prep            goat        cow        horse
Decoction         120 cc         360 cc         240 cc
Powder         1 tsp         1 tbs
Tincture         5 cc        30 cc         30 to 45 cc
Note that one tbs = 15 cc

Thymol, which has GRAS status is stronger than oregano oil.  It is effective in vitro against B subtilis, Clostriduium E coli….

Glycyrrhizin (from licorice) used intramammary id staph mastitis showed positive effects

Phyto Mast, is made with wintergreen, licorice, thymol, Radix and oleium brassica campestris.  This is infused into the udder for for coag neg staff and strep but not for all mastitis organisms.  He withholds milk for 24 hours.  There are trials being done on this product right now.

In Europe they have a European agency for the evaluation of medical products and have established maximum residue limits for food producing animals for all compounds evaluated and are including botanicals in this list.

Immune modulating plants
•    Panax ginseng
•    Cinnamonium cassiu
•    Bupleurum falcatum
•    Angelica sylvestris
•    Aloe secondiflora
o    All these plants were used in agueous or alcoloh extracts to effect livestock immune function

John Uri Lloyd and the Eclectics school of medicine used botanicals extensively.  Dr Karreman discusses some of their information and remedies in his book.  Their dosages were about 30 cc of tinture for a cow 2 to 3 times a day.  Same as dosages listed above in these notes.

Homeopathy.  This is still quite controversial with many vets.  Dr Karreman uses it as one treatment methods.  He suggests reading Dr Ed Schaeffers book on homeopathy.  Most of the farms that use it regularly are smaller herds where they know the individual cows fairly well.
•    Homeopathic remedies come in different potencies.  X is low potency, C is higher potency and M is very high potency.
•    All homeopathic remedies are made from highly diluted original materials and any potency which is higher than 24 X or 12C technically has no starting material remaining and are considered energy medicine from that dilution and higher.
•    Classical homeopaths use single remedy.
•    Lower potency is used for acute physical problems such as mastitis, pyometra, scours. Higher potency remedies need a very accurate match of remedy to symptoms.  Some homeopathic pharmacies sell multi potency remedies called homeochords.
•    Homeopathic remedies can be given orally, in the vulva or in a spray, which is applied to any mucous membrane.

Common Homeopathic Remedies used by dairy farmers
Aconite – homeopathic remedy for fever, sudden onset
Arnica – homeopathic remedy for sore muscles, strains, trauma, bruises to soft tissues, laminitis
Nux Vomica – homeopathic for mild bloat, indigestion, reduced apetite, rumen stasis
Calc carb
Calc phos
Hepar sulph
Merc corr

Note that maintaining a good relationship with your vet, and having your treatment/medications correctly labeled with a vets label is important for all meds stored for use in food animals.  You can have points taken off on your milk inspection for non vet labeled medications

•    Vaccines are allowed on organic animals.  There are vaccines for coliforms/salmonella (J Vac, Endovac bovi, SRP), Respiratory IBR/PI3 (TSV 2, Nasalgen, Onset), Calf scours (Scourgard 4KC, Endovac bovi/JVac).  There is also a vaccine for pink eye.  Dr Karreman recommends using the modified live if using the modified live.  There are a couple different vaccines that work for lepto (spirovac).  There is also a staph mastitis vaccine – though there were comments that it is not showing significant improvement in herds it been tried in
•    The amount and types of vaccines to use depends on farm history, what illnesses are issues and if it is an open or closed herd.
•    Homeopathic nosodes, which are homeopathic remedies made from byproducts of a disease.  Nosodes do not work as a preventative the same way vaccines do, but may be useful in treating an outbreak.

Serum products
•    Bovi sera, bob ax 2X, plyserum
Plamaphoresis products:
•    botulism antitoxin, hyper immune plasma
Colostrums whey products (ultra filtered whey)
•    biocel CBT, Impro
Bacterial cell wall fractionates:
•    immunoboost (OMRI approved)
IgY from eggs

Plant based materials to stimulate immune response
•    Panax Ginseng

Acupuncture:  There are a couple of vets in VT doing this now.  There is a chart of the acupuncture charts in Dr Karremans book.  Dr Karreman often uses an injection of vitamin B12 at the acupuncture point he is treating at.

DR Karremans suggested some items farm health care toolbox
Colustrum whey products
herbal tinctures
homeopathic remedies
laxative boluses (magnesium hydroxide/pink pills)
pill gun
alcohol and pads
butane powered de horner
calendula Echinacea ointment
teat dilators
IV calcium
IV dextrose
Hypertonic saline
Flunuxin (banamine)

. Calf scours
•    If there is a history of scours, he suggests vaccinating with scourgard a week prior to dry off and one month later.
•    If calves get scours in the first week of life he suggests 1 cc immunoboost and 3 cc/100 lbs bose selenium (both injected).  Tube feed electrolytes if it won’t drink
Prevention is good quality colostrums fed with in first  6 hours of birth, start them on hay right away, good sanitation, feed plenty of whole milk for 3 to 4 months and wean gradually to reduce stress. Dr Karreman likes nurse cow systems but this isn’t a good fit for all farms.

Calf respiratory problems
•    Pneumonia must be treated immediately at first sign of symptoms.  Sometimes coughing calves will improve if you move them to a better ventilated place when you first notice them coughing.
•    Watch for wet rings around eyes, dry hacking cough, increased rate of breathing.  These animals are good candidates for treating successfully without antibiotics.
•    Later symptoms is coughing, nasal discharge, claves laying down, some white pus from eyes, rapid breath with belly breathing.  These animals generally will need antibiotics to save them.
•    High fever isn’t always bad, so reducing fever with banamine may not be the first thing you should do.  Dr Karreman has a decision tree for treating coughing animals that he uses to decide which treatment to use and when.

Milk Fever
•    IV calcium is allowed, not all the oral calciums are allowed
•    Catching milk fever early is important, it can rapidly become an emergency.  Early symptoms are slow to eat, quivering muscles
•    Watch for low potassium also.  These cows will have a crooked neck.  CMPK will be the better IV electrolyte for this.

Pinched Nerve/calving paralysis
•    Provide good footing/traction
•    Use homeopathic arnica and hypericum every few hours
•    Acupuncture can be helpful
•    Flunixin
•    If she is down for an extended time watch her to make sure she is not going downhill.

Retained Placenta
•    Manuel, gentle removal after 5 days
•    Lavage/infuse uterus until normal discharge or until cervix closes
•    Therapeutic flush with saline until clear drainage
•    Antiseptics (iodine 1 gram infused or placed as pill daily x5 + days or Van Beek Scientific Uterine Capsules
Pyometra – infected uterus
•    Dr Karreman is having good results treating puss filled uteruses by Infusing with Utre Sept (botanical essential oil for antiseptic effect) with Aloe use 1 part utre sept with 6 parts aloe daily for 3 to 5 days in a row.

Reproduction treatments
•    Gently try to rupture
•    Acupuncture
•    Homeopathic
o    Apis
o    Lachysis
Not showing heats
•    Heat seek botanical powder – one capsule every day until heat or until finished (6 doses).  Note this will not help if the cows uterus is filled with puss
•    If all else fails get a bull
o    To prevent infertility, done overfed protein, maintain good mineral nutrition
•    Foot rot? Bruise or injury? Or strawberry? Or laminitis?
•    Overfeeding protein can lead to laminitis – usually several months later
•    Prevention of lameness is important!
•    For treating
o    Use foot baths – either hydrated lime or copper sulfate
o    Cleanse with hydrogen peroxide then iodine tincture
o    Treat with a wrap of sugar and betadine mixed to make a thick paste.

Non antibiotic treatments of infectious disease
•    Stimulate immune system with biologics such as hyper immune plasma, immunobooste
•    Use strong antibacterial phytotherapy such as herbal antibiotic tincture.
•    Use antioxidants such as vitamin C.  also some BoSe
•    Fluid therapy/electrolytes/dextrose/saline in some cases
•    Antiseptics such as herbal antibiotic powder
Natural treatment for hot coliform mastitis
200 cc IV hyper immune plasma or bovi sera
5 cc immunoboost
90 cc photo biotic tincture
vitamin C

High SSC staph aureus
Cull the animal or separate it
Immune modulation during dry period with panax ginseng or one of the impro product.  A nosode may also be useful at this point.

High SSC strep ag
Consider immune stimulants and local irrigation
Then use immunobooste for a few days or panax ginseng then after 5 days or so begin using phytomast 6 milkings in a row.  Homeopathic strep nosode may also be useful

For Fever and/or infection
IV electrolytes and dextrose
Antibiotic tincture
Hyperimmune plasma
Vitamin C
Magnet if hardware is possible
Phytomast for some types of mastitis
Homeopathic remedy or nosode

Udder Rot
Usually develops in moist areas and will grow out farther around the perimeter.
A surgical scrub and drying can clear this up.
Its best not to put a salve on it because it needs to dry up.

Pump stomach with alfalfa meal, electrolytes,
Also Ketonic or glycerin (propylene glycol is not allowed)
IV dextrose and calcium
B vitamins
Molasses may also be useful

Abscess – check first to make sure its not a blood filled hematoma
Drain, lavage and cleanse but don’t use the hydrogen peroxide for too many days in a row because it will prevent healing.

Lumpy Jaw (actinomycosis)
Sodium iodide IV repeated every 4 to 6 days – note this can cause cow to abort
Hyper immune plasma 200 cc IV
Vitamin C 500 cc IV

Edema and pleurisy –older cow
Diuretic herbs such as juniper or vet can provide furosemide

Immunoboost 1 cc/200 lbs sub cu and it seems to generally resolve in about 2 weeks.

3 situations where antibiotics are needed and should be used promptly
1.    Peritonitis – this is why Dr Karreman uses antibiotics when doing C sections
2.    Bone infections
3.    When two or more organic systems are involved and the animal is depressed.  For example metritis and bacterial pneumonia or hot coliform mastitis and metritis.