I recently taught a herd-health course to local dairy producers and employees. We spent a considerable amount of time reviewing treatment protocols for common disease, with participants sharing their opinions and actions.  

For many diseases, the treatments were all very similar from farm to farm. But there was considerable variation among other ailments. 

Calf diarrhea treatment fell into this category. Do we withhold milk? Should we use antibiotics? What type of oral electrolyte? What about absorbents or protectants? 

There were many treatment protocols that lacked medical support. Let’s review the available research and make logical decisions in treating calf scours.

Withhold milk?

Despite the thought that we need to rest the gut, research has shown that continuing to feed milk during treatment does not prolong or worsen the diarrhea. A sick calf actually has an increased energy need over a healthy calf. 

Electrolyte solutions alone cannot meet the energy needs of the sick calf and she will go into negative energy balance (become ketotic). It may be reasonable to substitute a single feeding of milk with electrolytes, but regular milk feeding should resume at the next feeding.

The common recommendation is to offer 1 or 2 electrolyte feedings per day between the milk feedings.

Evaluate electrolytes

Note that not all electrolyte products are created equally. Oral electrolyte products should replace fluid and electrolytes lost during illness. They also need to provide some nutritional support in the form of energy and an alkalinizing agent such as acetate or bicarbonate to aid in the correction of acidosis. 

Some commercial products do not meet these criteria and may actually make the diarrhea worst by drawing fluid into the gut. 

Bicarbonate can also increase the pH of the abomasum, which may allow the growth of bad bacteria such as clostridium. Stay away from these products if abomasal bloat has been an issue in your herd.  

Antibiotics or no antibiotics?

Obviously, not all cases of diarrhea are caused by bacteria. Cryptosporidium, rotavirus and coronavirus are common non-bacterial causes.

Despite this, research has shown that calves with diarrhea and significant signs of illness (fever, lethargy, dehydration or bloody feces) are at risk for E. coli overgrowth in the intestines and throughout the body (septicemia), regardless of the initial cause of the diarrhea. 

Don’t use antibiotics indiscriminately, but there is ample evidence that an injectable antibiotic with gram-negative activity is beneficial in the treatment of calf diarrhea.

What about anti-inflammatory drugs?

Non-steroidal anti-inflammatory drugs (NSAIDs) such as flunixin reduce fever and generally improve behavior, so calves return to normal feeding behavior sooner.

Currently, there are no NSAIDs approved for the treatment of calf diarrhea, so discuss this extra-label use with your veterinarian.

Other treatments?

Bismuth, kaolin, charcoal and probiotics are widely used for the treatment of calf diarrhea. Currently, there is no available data to support the use of these products. 

It is unlikely that these treatments will do harm, but one study found an increased death rate when these products were used alone without antibiotics.

Define treatment criteria

Make sure that you discuss each of these areas with your veterinarian, as well as product selection and dosing — especially for extra-label drugs.

Also, have a detailed discussion with him about the criteria of when to treat a sick calf and which specific products to use. It is also important to recognize when oral fluids alone are not sufficient and intravenous fluids will be needed to correct dehydration.

Also remember, don’t look for a cure in a bottle. Prevention is the key, but when treatment is necessary, use a protocol that makes medical sense.

Mark J. Thomas is a veterinarian and partner in Countryside Veterinary Clinic, LLP in Lowville, N.Y.