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Ketoprofen at parturition in cattle and subsequent fertility

Clinical Scenario

You are on a routine fertility visit to a farmer who has a herd of approximately 150 Holstein-Friesians. He tells you he always gives a painkiller to cows which have had a difficult calving but he is thinking about giving everything that calves a painkiller because “they always seem a bit sore”. You wonder if this is likely to help him get them back in calf any quicker...

3-Part Question (PICO)

In [cattle at parturition] does the [routine administration of ketoprofen versus nothing] [affect subsequent fertility]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR exp Cattle/)

AND

(parturition.mp. OR calving.mp. OR calvings.mp. OR calve.mp. OR birth.mp. OR births.mp. OR birthing.mp. OR birthings.mp. OR periparturient.mp. OR puerperium.mp. OR postpartum.mp. OR labour.mp. OR labor.mp. OR obstetric.mp. OR obstetrics.mp. OR exp Parturition/ OR exp Postpartum Period/ OR exp Labor, Obstetric/ OR exp Obstetrics/)

AND

(NSAID.mp. OR NSAIDs.mp. OR non steroidal anti inflammatory.mp. OR non steroidal anti inflammatories.mp. OR non steroidal antiinflammatory.mp. OR non steroidal antiinflammatories.mp. OR nonsteroidal anti inflammatory.mp. OR nonsteroidal anti inflammatories.mp. OR nonsteroidal antiinflammatory.mp. OR nonsteroidal antiinflammatories.mp. OR analgesia.mp. OR analgesias.mp. OR analgesic.mp. OR analgesics.mp. OR ketoprofen.mp. OR exp Anti-Inflammatory Agents, Non-steroidal/ OR exp Analgesics, Non-narcotic/ OR exp Analgesia/ OR exp Analgesics/ OR exp Ketoprofen/)

CAB Abstracts 1910 to Present using the OVID interface

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR exp cows/ OR exp cattle/ OR exp Bos/)

AND

(parturition.mp. OR calving.mp. OR calvings.mp. OR calve.mp. OR birth.mp. OR births.mp. OR birthing.mp. OR birthings.mp. OR periparturient.mp. OR puerperium.mp. OR postpartum.mp. OR labour.mp. OR labor.mp. OR obstetric.mp. OR obstetrics.mp. OR exp parturition/ OR exp calving/ OR exp puerperium/ OR exp obstetrics/ OR exp birth/)

AND

(NSAID.mp. OR NSAIDs.mp. OR non steroidal anti inflammatory.mp. OR non steroidal anti inflammatories.mp. OR non steroidal antiinflammatory.mp. OR non steroidal antiinflammatories.mp. OR nonsteroidal anti inflammatory.mp. OR nonsteroidal anti inflammatories.mp. OR nonsteroidal antiinflammatory.mp. OR nonsteroidal antiinflammatories.mp. OR analgesia.mp. OR analgesias.mp. OR analgesic.mp. OR analgesics.mp. OR ketoprofen.mp. OR exp non-steroidal antiinflammatory agents/ OR exp analgesics/ OR exp ketoprofen/)

Search Outcome

MEDLINE

  • 191 papers found in MEDLINE search
  • 188 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 2 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 225 papers found in CAB search
  • 219 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 5 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Richards et al. (2009) Assumed UK

Title:

Effects of the administration of ketoprofen at parturition on the milk yield and fertility of Holstein-Friesian cattle.

Patient group:

Holstein-Friesian heifers and cows on four farms

Study Type:

Randomised controlled trial

Outcomes:
  • Incidence of retained foetal membranes (RFM) and endometritis
  • Early lactation milk yield
  • Subsequent fertility
  • If assistance was given during calving
  • Vaginal tears
  • Milk fever
  • Odour
  • Presence or absence of corpus luteum
Key Results:
  • Incidence of RFM in treatment group ‘tended to be lower’ but no other differences between the treatment and control groups were seen
  • Other findings were found, such as cows with milk fever were more likely to have RFM, which could be associated with subsequent fertility indirectly (but not a primary aim of the study)
Study Weaknesses:
  • Possibility of digit bias in treatment allocation process by using ear tag numbers
  • No direct comparison between groups prior to intervention
  • Unlikely that administration of intervention was blind
  • Not stated whether outcomes were assessed blind
  • No justification of sample size
  • Data on corpus luteum presence missing for three animals, milk yield data missing for one animal.  Five animals did not have a pre-breeding exam, but this was stated in the results
  • Stated p-value not always adhered to
  • Intervention donated unconditionally by Merial Animal Health (manufacturer of ketoprofen)
Attachment:
No attachments.

Comments

There are other papers looking at other NSAIDs and different outcomes.  There is a narrative review that looks at using non-steroidal anti-inflammatory drugs around calving, and one that looks at the effect of NSAIDs on fertility.

In addition, fertility could be affected by retained foetal membranes and endometritis indirectly; studies looking at these factors specifically could be addressed also.

Bottom line

Subsequent fertility does not appear to be affected by the use of ketoprofen at parturition.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Richards BD, Black DH, Christley RM, Royal MD, Smith RF, Dobson H (2009) Effects of the administration of ketoprofen at parturition on the milk yield and fertility of Holstein-Friesian cattle. Veterinary Record 165: 102-106.

About this BET

First author:
Marnie Brennan
Second author:
Kathryn Wareham
Institution:

CEVM, University of Nottingham

Search last performed:
2018-09-19 16:49:48
Original publication date:
2013-09-13 16:49:48
Last updated:
2018-09-19 16:49:48
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