Step-by-step guide to identify and treat lame cows

Lameness levels have increased from 38 to 40 cases per 100 cows, probably as a result of heat stress over the summer and more time spent standing to cool down.

But this has not been helped by a slow uptake of recommended treatment protocols, research shows.

In 2015, the results of an extensive four-year AHDB research trial showed that a combined approach to treating lameness was most effective, with an NSAID (non-steroidal anti-inflammatory drug), trimming and use of a block resulting in the highest number of cured cows after five weeks.

But data just released by dairy consultant Kingshay has demonstrated a gap in the understanding and application of this recommended treatment protocol. Its results show:
  • Just 27% of farmers, vets and foot trimmers surveyed administered an NSAID to every lame cow as part of a standard treatment protocol for lameness.
  • Alarmingly, a further 17% did not consider using pain relief at all (see box: Common mistakes in lameness treatment).
  • The cost of the NSAID was not a barrier when it came to farmers administering pain relief. Instead, farmers weren’t aware of the beneficial role of NSAIDs in lameness treatment or didn’t know that NSAID product options had zero milk withdrawal.
lameness in cow
lameness in cow


There is a strong business case for using a complete treatment programme for reducing lameness levels in a herd.

Stage one: Detect lameness early


This approach is key to break the cycle on farm and further reduce overall herd levels of lameness.
  1. Some herds score mobility once every quarter, which is fine for spotting trends, but scoring more frequently will help with early detection.
  2. The very best herds score mobility every 1-2 weeks and encourage everyone handling the cows to be continuously observant, as this is the most effective way of spotting a lame cow early.
  3. If using the AHDB mobility scoring system, any cow scoring 2 or above – uneven weight bearing or shortened strides, with affected limb(s) immediately identifiable – should have its foot lifted.

Top tips for detection

  • Sole ulcers start with a bruise beneath the pedal bone, which can develop into an ulcer over 8-12 weeks. Therefore, it’s imperative to treat within the first 2-3 weeks before the bruise progresses into a more serious ulcer which increases the chance of the cow going lame again in the future.
  • Most feet affected by an early bruise look normal to the untrained eye. Lifting the hoof and carefully checking for heat, pain, and whether the foot is overgrown, can help detect early deep bruising before it becomes visible on the sole a number of weeks later.
  • Participating in ongoing refresher training to top up skills is worthwhile for the whole farm team.

Stage two: Use an NSAID

Using an NSAID, such as Dinalgen, can help reduce swelling and inflammation and relieve built-up pressure within the foot.

Daily doses of an NSAID should be given for three consecutive days, with the first dose before any major therapeutic trimming is carried out.

This will help relieve pain before the trimmer works on the foot.

Common mistakes in lameness treatment

  • Not treating quickly enough
  • Glue pressing on the heel bulb (too much glue around the heel)
  • Not fitting the block far enough back on the claw
  • No pain relief provided.

Stage three: Therapeutic trimming

When trimming, follow the “five-step method”. This is used internationally with proven results.
  • The first three steps restore the functional shape of the foot by improving the angle, while shortening the toe length helps reduce pressure on the heel.
  • Cut the inside claw (for hind feet) or the outside claw (for front feet) to the correct length and trim any excess sole at the toe until the white line rejoins at the toe. This will steepen the foot angle, provided you spare the heel.
lameness in cow
Therapeutic trimming

  • Trim the partner claw to match in length, level across the toes and balance in the heel. The aim is for 50:50 weight bearing between the inside and outside claws.
  • Model out the centre sole where sole ulcers occur, sparing the toe triangle. This will redistribute weight on to the walls of the toe and heel.

Stage four: Apply a block

The fourth element of the five-step method is to apply a block on the sound claw, which lifts the affected opposite claw off the ground, reducing weight bearing and providing the best chance of recovery.

This can be very effective when combined with trimming down the heel slightly on the painful claw.

Once a block is applied, any loose horn and ridges can be removed by the trimmer, which completes the fifth and final part of the process.

Top tips for blocking

  • Blocks are best attached with specialist glue and should stay on for a maximum of six weeks. It is important not to leave blocks on for too long as this can damage the tendons.
  • Blocks can be made of wood or synthetic materials. Often wooden blocks are best as they gradually wear down as the foot heals and can easily be pulled off if necessary. On some surfaces, such as in sand units, plastic blocks may be a better option as they last longer but are more likely to need removing once the cow has recovered.
  • When fitting a block, match the hoof size to an appropriately sized block.
  • Use a paper towel or hair dryer to dry the hoof prior to fitting the block. This is a low-cost practice that helps the block stay on, increases the treatment effectiveness and boosts recovery rates.
  • Knowing how and where to place the block is key to successful treatment. If new to fitting blocks, ask a foot trimmer or vet for a bit of training.
  • Monitor mobility during the recovery period to check that the block is comfortable. If a cow is not walking correctly this can indicate that it needs attention.
  • For very lame cows it can be a good idea to give them a shorter walk to the parlour.

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