Pain management
Pain management: recognition of pain in dairy cattle
Do veterinarians and producers agree on pain management?
Published on August 26, 2025
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Painful conditions or procedures are often experienced by dairy cattle, whether because of management practices or disease. While prevention of painful procedures and diseases should always be a goal, there are still painful occurrences that are unavoidable. In these cases where pain cannot be avoided, analgesics and local anesthetics should be used to appropriately manage pain. Proper management of pain is important for animal health and welfare and is an important consideration for the sustainability of dairy production.
In this article, we highlight some of the key points and opportunities reviewed in the article "Pain in Dairy Cattle: A Narrative Review of the Need for Pain Control, Industry Practices and Stakeholder Expectations, and Opportunities"[1] by Steven Roche, Julia Saraceni, Laura Zehr and David Renaud. This article reviews and discusses several of the common pain-related practices in dairy production, as well as the recommended pain management practices, effects of pain management, industry program requirements, and current levels of pain management adoption by producers and veterinarians in Europe and North America.
What is pain?
Pain is an adverse experience causing distress and decreased production in dairy cattle. Pain or inflammation can occur, as a result of diseases present on farm, or as a result of procedures imposed on animals as part of day-to-day farm management[2].
Pain, and its associated distress, is also undesirable from an animal welfare standpoint. Consumers consider animal welfare an important issue; therefore, ensuring proper pain management, and by extension good welfare, is important to maintain the social acceptability of dairy production.
Dairy cattle frequently experience painful conditions, which include both management procedures (e.g., dehorning, castration, abdominal surgery) and disease related pain (e.g., lameness, mastitis)[3]. While preventing pain is critical, many of these husbandry practices are needed, and diseases are unavoidable, leading to the necessity of pain management.
TABLE 1 | Causes of pain[2]
|
Painful disease processes |
Management procedures that cause pain |
| Lameness | Disbudding/dehorning |
| Mastitis | Tail docking |
| Joint/navel ill | Castration |
| Eye problems: pink eye and New Forest eye | Caesareans/abdominal surgery |
| Downer cows | Assisted births/dystocia |
| Pneumonia | |
| Metritis |
Regarding animal welfare
Globally, the dairy industry has developed quality assurance (QA) programs to meet public expectations regarding animal welfare and farming practices. These programs vary in their scope and regulatory enforcement, with some being industry-led and voluntary, while others have mandatory compliance requirements. proAction in Canada is industry-led and informed by multiple stakeholders and compliance is mandatory for all dairy producers in Canada[4]. These programs have contributed to a substantial increase in the adoption of pain management in the dairy industry. However, despite the progress, compliance and implementation remain inconsistent, with some regions and producers not fully adopting recommended pain management strategies.
Where do we go from here?
It is apparent that despite overwhelming evidence that certain conditions are painful, such as disbudding and dehorning, there remains a need to improve the uptake of pain management. To better understand why pain management is not always implemented, there is a need to understand the perspectives of producers and veterinarians.
Do veterinarians and producers agree on pain management?
Pain is a significant welfare concern within the dairy industry. Recognizing and managing pain are important factors for safeguarding animal welfare. In a survey of producers and veterinarians in Ireland, a questionnaire was sent via mail to Irish dairy farmers and large animal veterinarians to assess attitudes to pain and the use of non-steroidal anti-inflammatory drugs (NSAIDs) in pasture-based dairy cows[5]. A total of 1,002 surveys were received from dairy farmers and 116 from livestock veterinarians.
The aim of this study was to assess attitudes to pain and use of analgesics in both dairy farmers and livestock veterinarians, and the final aim was to establish the relationship between the pain score given to certain procedures and conditions and both NSAID use and empathy scores of farmers and veterinarians.
Survey results
In this study, farmers and veterinarians commonly perceived the same conditions and procedures as most painful. However, farmers scored surgical procedures significantly higher than veterinarians, and veterinarians scored lameness-related conditions, mastitis (clots in milk only) and hock hair loss significantly higher than farmers.
TABLE 2 | The agreement of farmers and veterinarians with statements relating to analgesia and pain in cattle, in a survey investigating attitudes to pain and analgesic use in pasture-based dairy cows.[5]
| Statement | Veterinarian agreement (%) | Farmer agreement (%) | P-value |
|---|---|---|---|
| Analgesics may mask deterioration in the animal's condition | 25 | 38 | 0.006 |
| Cattle benefit from receiving analgesic drugs as part of their treatment | 98 | 90 | 0.012 |
| Some pain is necessary to stop the animal becoming too active | 15 | 18 | 0.371 |
| Cattle recover faster if given analgesic drugs | 97 | 75 | 0.00 |
| Drug side effects limit the usefulness of giving analgesics to cattle | 10 | 12 | 0.397 |
| Farmers are happy to pay the costs involved with giving analgesics to cattle | 63 | 75 | 0.006 |
| Farmers would like cattle to receive analgesia but cost is a major issue | 26 | 30 | 0.356 |
| Farmers do not know enough about controlling pain in cattle | 70 | 63 | 0.133 |
| Vets do not discuss controlling pain in cattle with farmers enough | 57 | 56 | 0.994 |
Statistical differences between the agreement of veterinarians and farmers are reported for each statement, based on logistic regression models (***P < 0.001, **P < 0.01, *P < 0.05).
Higher pain scores for conditions and procedures given by dairy farmers and veterinarians were associated with increased NSAID use. However, the use of NSAIDs was low, relative to the pain score, for Burdizzo castration (farmers and veterinarians), white line separation (farmers and veterinarians) and abscess (veterinarians), mastitis with clots in milk only (farmers) and calving with no assistance (farmers).
Veterinarians who graduated less recently had significantly lower odds of using NSAIDs. Veterinarians perceived cost as more of a barrier than farmers did; Pain scores in this study can be used as a baseline for farmers and veterinarians to determine whether pain is being underestimated by themselves and to further assess whether they are appropriately treating this pain.
For those working with dairy cows, there is a need to continue education on the benefits of analgesia, especially for conditions and procedures that have low NSAID use relative to pain score.
TABLE 3 | Proportion of farmers that would like a cow to receive NSAIDs for different conditions and procedures, and the proportion of veterinarians that give NSAIDs for ≥50% of cases for each condition and procedure, in a survey investigating attitudes to pain and analgesic use in pasture-based dairy cows.[5]
| Condition/procedure | Proportion farmers that would like a cow to receive NSAIDs for each condition/procedure (%) | Proportion veterinarians using NSAIDs for ≥50% of cases for each procedure/condition (%) |
| Disbudding (calf) | 64 | 62 |
| Burdizzo Castration (calf) | 44 | 32 |
| Surgical castration (calf) | 86 | 65 |
| Digit amputation | 97 | 88 |
| Sole ulcer treatment | 80 | 75 |
| Sole hemorrhage | 63 | 54 |
| White line abscess | 74 | 64 |
| White line (no abscess) | 35 | 34 |
| LDA surgery | 91 | 72 |
| Mastitis | 26 | 42 |
| Cesarean section | 98 | 76 |
| Dystocia | 73 | 68 |
| Calving (no assistance) | 6 | n/a |
How can we prevent the pain "habituation"
Farmers and veterinarians generally considered the same conditions and procedures as more severe. Differences in pain scores were, however, found between veterinarians and farmers for some conditions and procedures. Farmers scored LDA, LDA surgery and a caesarian section significantly higher than veterinarians. A possible explanation is that veterinarians see these procedures and conditions as routine, whereas for farmers these are rare and severe occurrences.
In contrast, veterinarians gave significantly higher pain scores to lameness related conditions [digital dermatitis, white line separation (no abscess), white line abscess, and treatment of a sole ulcer], mastitis (clots in milk only) and hock hair loss compared to farmers. This demonstrates that farmers and veterinarians can become habituated to the pain of certain conditions because of frequent exposure. It is important for cow welfare that efforts are made to prevent this “habituation” of pain. Once pain is recognized, it can then be treated.
Pain compromises animal welfare and can reduce dairy cow productivity. To enable pain to be alleviated, pain must firstly be recognized by both farmers and veterinarians.
Disagreements about pain management
Disagreements about pain mitigation occurred infrequently; however, this could be due to few discussions about pain management in general. There is opportunity for veterinarians to engage with their producers in more discussions about pain management[6].
The need for more education
The majority of farmers believe that they are not educated enough on controlling pain and that veterinarians do not discuss controlling pain enough with farmers. Similar findings were found in UK farmers, whereby 62% of farmers did not feel educated enough on pain relief and 53% felt that veterinarians did not discuss the use of pain relief enough with farmers[7]. This study also showed that knowledge on pain relief increased the willingness of farmers to use NSAIDs. Farmers should be educated on the benefits on NSAID use in terms of both welfare and profitability. A quarter of veterinarians also agreed with the statement “Analgesics may mask the deterioration in the animal’s condition.” This shows that veterinarians may also benefit from further education on pain relief within the dairy sector. This may also lead to improved knowledge transfer from veterinarians to farmers.
In interviews, with producers from Ontario, Canada about the use of pain control for disbudding and dehorning, it was identified that farmer attitudes surrounding the benefit of pain control, cost, and lack of education about procedures to provide pain control were primary barriers against providing pain control [8]. Lack of producer education was also found to be a barrier to the use of pain control for Brazilian farmers[9].
As veterinarians are highly regarded by producers to drive management changes[10] and alter the use of pain management[11], they should be engaged in the process to highlight the benefits of pain management and provide education to producers regarding proper methods for pain management.
Conclusions
Scientific literature highlights that there are many painful conditions and procedures that commonly occur in dairy cattle. These conditions and procedures require pain mitigation from an animal welfare standpoint, and in many cases, pain management carries additional advantages for the animal’s health and production. Pressure from consumers regarding animal welfare has provided further emphasis on the importance of reducing the incidence of pain in dairy cattle. Although, in some conditions and procedures, it is clear that there are advantages to providing pain management, the actual uptake lags behind, meaning there is still a need to communicate the benefits of pain management for these conditions to producers and veterinarians. Given the importance of a veterinary-client-patient relationship for developing pain mitigation protocols, understanding the communication between veterinarians and producers is key to the implementation of robust, industry-wide pain management protocols.
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Extract from : Pain in Dairy Cattle: A Narrative Review of the Need for Pain Control, Industry Practices and Stakeholder Expectations, and Opportunities by Steven Roche, Julia Saraceni, Laura Zehr and David Renaud.
This narrative review was funded by Solvet (AVL-2025-01).
References:
- Pain in Dairy Cattle: A Narrative Review of the Need for Pain Control, Industry Practices and Stakeholder Expectations, and Opportunities. Steven Roche , Julia Saraceni , Laura Zehr and David Renaud
- Pain management in cattle. Maura Langan MVB, Veterinary Ireland Journal I Volume 7 Number 4.
- Kleinhenz, M.D.; Viscardi, A.V.; Coetzee, J.F. Invited Review: On-farm pain management in food production animals. Appl. Anim. Sci. 2021, 37, 77–87.
- proAction Reference Manual 2023.
- Use of Non-Steroidal Anti-Inflammatory Drugs and Attitudes to Pain in Pasture-Based Dairy Cows: A Comparative Study of Farmers and Veterinarians. Natasha Browne, Muireann Conneely, and Chris Hudson. 2022.
- Frequency of disagreements between producers and veterinarians about pain management in cattle. Sage Mijares, Lily Edwards-Callaway, Elizabeth Johnstone Lorann Stallones, Noa Román-Muñiz, Catie Cramer, and Johann Coetzee. 2022
- Huxley JN,Whay HR. Attitudes of UK veterinary surgeons and cattle farmers to pain and the use of analgesics in cattle. Cattle Pract. (2007) 15:189–93.
- Mahendran, S.A.; Booth, R.; Burge, M.; Bell, N.J. Randomised positive control trial of NSAID and antimicrobial treatment for calf fever caused by pneumonia. Vet. Rec. 2017, 181, 45.
- Saraceni, J.; Renaud, D.L.; Nelson, E.; Van Os, J.M.C.; Miltenburg, C.; Winder, C.B. Ontario dairy producers’ perceived barriers and motivations to the use of pain control for disbudding and dehorning calves: A qualitative study. Animals 2022, 12, 973.
- Cardoso, C.S.; von Keyserlingk, M.A.G.; Hotzel, M.J. Trading off animal welfare and production goals: Brazilian dairy farmers’perspectives on calf dehorning. Livest. Sci. 2016, 187, 102–108.
- Wilson, J.P.; Green, M.J.; Randall, L.V.; Rutland, C.S.; Bell, N.J.; Hemingway-Arnold, H.; Thompson, J.S.; Bollard, N.J.; Huxley, J.N. Effects of routine treatment with nonsteroidal anti-inflammatory drugs at calving and when lame on the future probability of lameness and culling in dairy cows: A randomized controlled trial. J. Dairy Sci. 2022, 105, 6041–6054.