Applied Animal Science 35:596–605
https://doi.org/10.15232/aas.2019-01926
© 2019 American Registry of Professional Animal Scientists. All rights reserved.
PRODUCTION AND MANAGEMENT: Invited Review
Invited Review: Why cows die in US dairy herds
C. S. McConnel1* and F. B. Garry2
1
Department of Veterinary Clinical Sciences, Washington State University, Pullman 99164; and 2Department of
Clinical Sciences, Colorado State University, Fort Collins 80523
ABSTRACT
Purpose: Over the past several decades there has been
an appreciable, persistent, and concerning rise in dairy
cow mortality. The purpose of this review was to inte-
grate epidemiological, pathophysiological, and historical
perspectives to improve our understanding of why dairy
cows die and what can be done about it.
Sources: Refereed scientific journal articles, USDA re-
ports, and conference proceedings available in online data-
bases were consulted in this review.
Synthesis: Explorations of causes of dairy cow death
frequently have focused on associations between mortal-
ity and population characteristics, management, and
environmental factors. These studies often suggest that
intensification of the dairy industry may influence high
on-farm dairy cattle mortality. Other studies have focused
on pathophysiologic descriptions of specific deaths, along-
side the utility of incorporating postmortem evaluations
into on-farm management. Although it is most certainly
useful to establish broad associations between population
characteristics or specific disease entities and higher death
rates, mitigation strategies must be based on an under-
standing of why those associations or diseases are present
in the first place.
Conclusion and Applications: A multitude of factors
and complexities act in concert to influence why cows die
in US dairy herds. Understanding differences related to
why cows die requires insight into the impacts of environ-
ment, operational practices, economic concerns, and ani-
mal interactions on overall performance. Although there
are practical suggestions for addressing dairy cow mortal-
ity such as incorporating postmortem examinations and
standardized nomenclature, questioning why dairy cows
die is part of a larger discussion regarding the welfare of
animals in modern agricultural systems.
Key words: dairy, mortality, intensification, welfare
The authors declare no conflict of interest.
*Corresponding author: cmcconnel@​wsu​.edu
MORTALITY BY THE NUMBERS
The reason for writing this review has to do with num-
bers, and it is the culmination of over 15 yr of research
into dairy cow mortality by the authors. Our initial inves-
tigations were instigated by Colorado dairy farmers who
questioned why they were seeing incremental increases
in the number of dead cows on their farms. Those farm-
ers were not the first to ask why cows die in their dairy
herds, but they were at the forefront of a wave of national
and international inquiries into increasing dairy cow mor-
tality. Numerous investigations have been published on
this important topic over recent years, including a recent
literature review that thoroughly evaluated numbers and
trends from countries with modern dairy production sys-
tems (Compton et al., 2017). The purpose of the current
review is to expand the conversation by looking beyond
the numbers and into what the numbers tell us, through
a blend of historical perspective, relevant literature, and
personal insight into our present understanding of why
cows die in US dairy herds.
Summary studies of dairy cow removal have been in the
literature for decades (Seath, 1940; Asdell, 1951; O’Bleness
and Van Vleck, 1962). Seath used Kansas Cow Testing As-
sociation data from 1930 to 1935, for 37 herds representing
1,883 cows, to demonstrate that death losses represented
2.0% of the total dairy cow inventory (Seath, 1940). More
expansive DHIA data from 1932 to 1949, for 17 states rep-
resenting 2,792,188 cows, demonstrated that 1.1% of the
total cows on test died (Asdell, 1951). Death losses over
those years were remarkably uniform with yearly levels
ranging from 0.9 to 1.2%. With such low percentages of re-
moval rates, these reports did not seek to analyze reasons
for death. It seems safe to say that when removals and
death losses are very low, there is little stimulus to pursue
causation, and occasional losses are expected as part of
normal herd management.
Our studies of dairy cow mortality began in 2004 be-
cause some producers in Colorado were recording annual
death losses of 8 to 10% of their lactating cow inventory,
representing approximately a third of all cows perma-
nently removed from the herd in a year. Further inquiry
and evaluation of DHIA records from the western United
States suggested that this level of adult cow mortality was
common. Danish researchers published a literature review
of dairy cow mortality covering the years from 1965 to
 McConnel and Garry: Mortality in US dairies
2006, which showed upward trends in modern dairy mor-
tality levels both in the United States and internationally
(Thomsen and Houe, 2006). Their review demonstrated a
paucity of studies of underlying causes of dairy cow death
over a 40-yr time of gradually increasing losses. Of the 19
studies in their review, 2 included data after 2000, 6 were
from the United States, only 10 incorporated informa-
tion related to causes of death, and measures of mortality
ranged from 1 to 5%.
Over the course of the following decade, several addi-
tional studies have explored the issue of dairy cow mortal-
ity, including USDA National Animal Health Monitoring
System (NAHMS) surveys that indicated a steady rise
in adult cow mortality to an average of 5.6% in the most
recent Dairy 2014 study (USDA, 2018). More recently,
Compton et al. performed a systematic literature review
and meta-analysis of articles related to mortality and cull-
ing that were published between 1989 and 2014 (Compton
et al., 2017). They estimated that both the annual inci-
dence risk and incidence density of mortality of cows has
increased significantly from 0.02 per cow and 2.32 per 100
cow-years to 0.04 per cow and 3.75 per 100 cow-years,
an increase per decade of 0.02 per cow and 1.42 per 100
cow-years, respectively. Although those numbers may be
difficult to appreciate in the context of dairy management,
they speak to an appreciable and persistent rise in adult
dairy cow mortality that concerns many in the industry.
Much of the recent conversation regarding dairy mortal-
ity levels has focused on adult cow death, but calf and
heifer mortality rates can also be monitored using rou-
tinely collected data (Santman-Berends et al., 2019). It is
estimated that over 8% of nulliparous heifers die (USDA,
2018), although operation-level mortality rates can vary
greatly (Walker et al., 2012; Kertz et al., 2017). Estimates
of the incidence risk of perinatal mortality (full-term birth
to 2 d of age) vary from 0.03 to 0.09 and appear to have
increased between 1990 and 2000 by an absolute 0.02
(Compton et al., 2017). Furthermore, the incidence risk
range of neonatal mortality (1 d of age to weaning) report-
ed by Compton et al. varied between 0.05 and 0.11 in the
2 decades from 1990, representing an important financial
loss to dairy farmers and reflecting challenges affecting the
welfare status of this age group.
This status quo is not desirable, and control programs
that effect change and reduce mortality can be valuable
to farmers. The rise in dairy cow mortality levels over
the past several decades suggests that there are aspects
of modern dairy systems that increase the risk of death
(Pinedo et al., 2010; Shahid et al., 2015; Compton et al.,
2017). This is both an obvious financial concern and an
important animal welfare issue posing a reputational risk
to the industry (Thomsen and Houe, 2006; Compton et
al., 2017; Liang et al., 2017). Although the use of routinely
collected data on cow and calf mortality may be a relevant
indicator of animal welfare in dairy herds (Ortiz-Pelaez et
al., 2008; Thomsen and Houe, 2018), there is no standard
by which to define what might be considered the natural
597
or normal level of mortality in dairy cow production. No
evidence suggests that there is any one factor that has led
to the rise in mortality and that could be reversed to lower
death rates. Rather, numerous factors apparently act in
concert to result in variable and rising rates of death on
given farms. If we are to understand why cows die in US
dairy herds, we need to put a name to the numbers.
MORTALITY BY THE NAMES
We feel that quantitative and qualitative assessments
of mortality can improve our understanding of why cows
die and what can be done about it. Whereas the numbers
indicate that dairy cow mortality is cause for concern, the
answer to the question of why dairy cows die is buried
within names. For the purposes of this review, we think
that the most effective way to capture the importance and
utility of names is through the use of an acronym: NAMES
(Nomenclature Arranged, Modified, and Evaluated for So-
lutions). We think that NAMES provides the bookends
for this discussion and can help simplify a complex set of
issues. Historical perspective is a good place to start.
For years our understanding of the cause of death has
been based on the philosophically enigmatic concept of an
underlying cause of death. This holds true for human as
well as veterinary medicine. In fact, the difficulty in nam-
ing an underlying cause of death has proven controver-
sial within the public health realm for well over a century
(Hamlin, 1995). Cause of death data began to be collected
in Great Britain in 1837 during the Industrial Revolution
when the law required that death be registered by cause
(Davis, 1997). A government official named Edwin Chad-
wick was interested in permanent sanitary reform and in-
sisted that the most important factor underlying death
was the disease. On the other hand, a medical statistician
named William Farr took an interest in the causes of the
disease, which during that period was taken to include
determinants such as diet, working conditions, and emo-
tional states. This philosophical debate eventually came
to a head as an argument over whether starvation per se
caused mortality in England and Wales. This was a politi-
cally sensitive issue at the time following the enactment in
1834 of the Poor Law Amendment Act meant to benefit
disenfranchised poor through the development of support-
ive “workhouses” (Hamlin, 1995). Farr argued that the
effects of hunger manifest indirectly leading to a variety
of diseases (Farr, 1839). For his part and largely due to
his role in the social welfare policy of the day, Chadwick
viewed the “starvation” terminology as an embarrassment
and argued that it was inconsistent and misleading specu-
lation (Hamlin, 1995).
The controversy between Farr and Chadwick is as rel-
evant today as it was in the 1830s and serves to dem-
onstrate a fundamental issue related to naming causes
of death. The impossibility of reducing complicated and
varying sets of circumstances to a single named category is
clear, yet the necessity of distilling data into usable targets
598 Production and Management

is evident. We identify the causes we care about, and care Our answer to this conundrum has been to apply NAMES
about the causes we identify (Schulz, 2014). Consequently, to the face of the modern dairy industry.
a question of utility exists regarding attempts to name a
cause that implies other important components and sur- Nomenclature
rounding circumstances. The nomenclature used to de-
Explorations of causes of dairy cow death have often
scribe causes of death is a function of the type of informa-
focused on associations between mortality and population
tion being sought. For his part, Farr pointed out that for
characteristics, management and environmental factors,
a given cause, several classifications may be appropriate,
and genetics. Common sense would suggest that higher
and specialists such as physicians and pathologists might
rates of common production diseases are related to in-
choose to name causes of death differently based on their
creased mortality (Norgaard et al., 1999; Thomsen et al.,
perspective and particular inquiry (Registrar General of
2007). This has been shown in that both the highest fre-
England and Wales, 1856). Questions related to responsi-
quency of health disorders and a large proportion of dairy
bility focus attention on some factors, whereas questions
cow deaths are associated with early lactation (Thomsen
of periodicity, preventability, or remediation focus atten-
et al., 2004; Miller et al., 2008, Pinedo et al., 2010). More
tion on others (Hamlin, 1995).
specifically, a high proportion of deaths has been shown to
The same challenges related to early efforts at naming
occur consistently during the first 15 to 30 d after calving
human causes of death also apply to explaining why dairy
with the highest proportion occurring during the first few
cows die. The societal changes that were ongoing during
days after calving (Milian-Suazo et al., 1988; Stevenson
the early period of Great Britain’s human cause of death
and Lean, 1998; Thomsen et al., 2004). Increases in herd
data collection are remarkably similar to changes within
size, average SCC, or the proportion of purchased cows
the dairy industry over the past few decades. The Indus-
have been shown to result in an increasing mortality risk
trial Revolution of 18th and 19th century Britain shifted
at the herd level (Norgaard et al., 1999; Smith et al., 2000;
populations from a primarily agrarian lifestyle to an in-
Thomsen et al., 2006; Pinedo et al., 2010; Alvåsen et al.,
creasingly diverse, mechanized, and urbanized setting.
2014; Shahid et al., 2015). Increasing herd size, treatment
Along with the Industrial Revolution’s shift in popula-
for disease, and genetic and seasonal differences also have
tion dynamics and work conditions came policy change
been associated with increasing calf mortality rates across
and Farr’s representation of hunger and deprivation as
age groups (Gulliksen et al., 2009; Bleul, 2011; Rabois-
an economic phenomenon. His struggle to describe causes
son et al., 2013; Windeyer et al., 2014; Gonzalez-Peña et
of death in meaningful terms was, in effect, a product of
al., 2019). Data suggest that Jersey and crossbred dairy
unintended consequences brought on by the industrializa-
cows have reduced mortality levels relative to purebred
tion of Britain’s society. Yet for Chadwick, it was simply
Holsteins (Miller et al., 2008; G. W. Rogers, Geno Global
not acceptable that the laws of political economy might
Ltd., New Market, TN, personal communication, 2009).
be found incompatible with the laws of health (Hamlin,
However, heritability estimates for calf and heifer mortal-
1995).
ity have been low (Pritchard et al., 2013; Gonzalez-Peña
In recent decades we see a very similar progression of
et al., 2019), and estimates suggest that only about 1% of
events playing out within the dairy industry. Mechaniza-
the variation in the likelihood that a cow will die during
tion and intensification have developed worldwide in re-
a lactation is genetic, implying that the decline in dairy
sponse to economic pressure (Norgaard et al., 1999). Ac-
cow survival is primarily the result of changes in herd
cording to NAHMS data, 25.9% of US dairy operations
management as opposed to genetic selection (Dechow and
had more than 100 cows in 2013 compared with 11.5% in
Goodling, 2008). Overall, studies such as these provide
1991 (USDA, 2018). Increased mechanization and techno-
a means for understanding populations at risk but only
logical development has led to a decline in the number of
illustrate broad principles related to manageable risk fac-
employee working hours per dairy cow (Agger and Alban,
tors, potential mitigation procedures, or specific patho-
1996; Larsen et al., 1996). As the average dairy herd size
logic outcomes. Perhaps most importantly, these studies
continues to increase, it is predicted that integrated sen-
often suggest that characteristics related to intensification
sors, robotics, and automation will replace much of the
of the dairy industry such as less human contact time
manual labor on farms (Britt et al., 2018). Unintended
and priority for the animals may be associated with high
consequences have accompanied this intensification, and
on-farm dairy cattle mortality (Alvåsen et al., 2014; Sant-
as death rates have climbed, the industry has struggled to
man-Berends et al., 2014).
come to terms with a clear approach for describing why
Other research has attempted to define individual occur-
cows are dying. Addressing unintended failings of the mod-
rences of death based on the final outcome. Rather than
ern dairy “workhouse” with all of its social and physical
looking at population levels of diseases and associated lev-
considerations can quickly muddy the waters separating
els of death, such studies have focused on the pathophysi-
professional concern from political unease. Dealing with
ologic or anatomic descriptions of specific deaths. Some of
detrimental, unintended consequences requires openly ac-
the earliest research into removals attempted to classify
cepting that the laws of the current dairy economy might
specific reasons for cow deaths based on available records
at times be found incompatible with the laws of health.
 McConnel and Garry: Mortality in US dairies
or producer recollection. As such, the relative importance
of dystocia, accidents, traumatic reticuloperitonitis, bloat,
and hypocalcemia as underlying problems was speci-
fied (O’Bleness and Van Vleck, 1962; White and Nich-
ols, 1965). However, capturing information regarding why
cows die can present a substantial challenge. Thomsen and
Houe’s review of dairy cow mortality found that only 10 of
19 studies gave some information on causes of death, and
none of the diagnoses were founded on necropsy examina-
tion (Thomsen and Houe, 2006). Consequently, percep-
tions based solely on antemortem histories have played a
significant role in determining recorded causes of death
within much of the relevant historical literature.
More recent publications including several by the au-
thors of this review have explored the utility of and mo-
tivations for incorporating postmortem evaluations into
on-farm management (McConnel et al., 2009; McConnel
et al., 2010; Thomsen et al., 2012; Salopek et al., 2017;
McConnel et al., 2019). It is notable that necropsy exami-
nation is an infrequent occurrence on dairies in the United
States. The most recent NAHMS survey reported that
only 22% of dairies performed necropsies on cows, 11% of
dairies necropsied heifers, and <5% of dead cows or heif-
ers were examined by necropsy (USDA, 2018). Thorough
necropsy-based postmortem evaluations are an important
component for defining the pathologic reasons underlying
dairy cow deaths. A dead animal is a total economic loss
to a producer and incurs costs associated with euthanasia,
disposal, and replacement; however, a thorough necropsy
examination may help offset those losses by providing
valuable management information that may benefit the
herd. Nonetheless, the value of a postmortem evaluation is
directly related to the accuracy, consistency, and mainte-
nance of data collected and its application to operational
management.
Regardless of the nature of the nomenclature applied
to causes of death, there is an argument to be made for
establishing a reduced set of standardized categories for
generic systems-level analyses of dairy calf and cow death
(Compton et al., 2017; Santman-Berends et al., 2019).
Historically, the least available dairy herd data comprised
records of disease and management events, and these were
subject to tremendous variability in the rigor and consis-
tency of their recording (Kelton, 2006). It is easy to query
dairy farm records and accurately assess individual cow
production performance or reproductive interventions, but
the integrity of information about specific disease occur-
rence, treatment success, health at time of removal from
the herd, or cause of death is highly questionable. More re-
cent efforts have challenged precedent with an eye toward
enhancing data procurement and standardization (Giebel
et al., 2012a,b). Although most farmers and practitioners
with whom we have worked on assessments of mortality
tend to want individualized nomenclature to some degree,
a framework can be developed from standards employed
by the USDA NAHMS surveys, Thomsen and Houe, or the
authors of this review (Table 1; Thomsen and Houe, 2006;
599
McConnel and Garry, 2017; USDA, 2018; Lombard et al.,
2019). These broad categories may fail to provide the nec-
essary detail to elicit specific changes to management, but
they do create useful groupings for ongoing assessments of
deviations from the norm.
Although it is most certainly useful to establish broad
associations between population characteristics and mor-
tality, or between specific disease entities and higher death
rates, mitigation strategies must be based on an under-
standing of why those associations or diseases are pres-
ent in the first place. For example, if a particular dairy
has high rates of euthanasia associated with down cows
during the postpartum period, mitigation strategies would
require an understanding of the occurrence of metabolic
diseases, birthing trauma, improper delivery techniques,
or facility design failure. Therefore, once basic terminol-
ogy is implemented consistently, additional layers of more
detailed nomenclature can be applied to help explore un-
derlying dairy system complexity. Understanding the com-
plexity within such a system demands the recognition of
those factors influencing particular outcomes as part of a
dairy’s evolving ecology. In other words, the devil is in the
details, and understanding why cows die requires more
descriptors than broad categories can provide. The level
of detail can take different forms as we and others have
explored over the years (McConnel et al., 2009; McConnel
et al., 2010; Thomsen et al., 2012; McConnel and Garry,
2017; Lombard et al., 2019; McConnel et al., 2019), but
the gist of the matter is that few causes of death can be
neatly packaged into broader categories on their own and
without additional detail. As a result, layers of informa-
tion related to immediate, intermediate, and underlying
significant issues or conditions such as disease processes,
facilities, employee interventions, and even weather should
become part of standard cause-of-death assessments. Re-
cording such detail alongside other pertinent dynamic and
concrete data including whether an animal died due to
euthanasia or natural causes provides a breadth of nomen-
clature that can be effectively arranged to provide context
for the content (Thomsen and Sørensen, 2008).
Arrange
Maintaining accurate postmortem records can be dif-
ficult and can limit the capacity to easily retrieve records
that might provide valuable insight into historical death
patterns and guide future health planning and programs
(White, 2005). However, we are confident that pathophys-
iologic, anatomic, and farm details can be documented
consistently in on-farm databases and have proposed
methods for procuring and organizing relevant data and
associated nomenclature (McConnel et al., 2010; McCon-
nel and Garry, 2017; Lombard et al., 2019). Arrangements
of data can take many forms much like nomenclature may
be personalized to suit the needs of a given farm or prac-
tice. The intent is to create a format for data acquisition
and organization that allows broad categories to be parsed
600 Production and Management

into subcategories and contextual narratives. Meaningful
data are useful data.
In practice, this means that flowcharts, cause of death
statements, and mechanisms such as death certificates
with mortality codes may be warranted to document the
chain of events leading to death. For example, death due
to respiratory disease may define the end point of a pro-
gressive bacterial infection that resulted from delayed dis-
ease recognition or failure of a particular antimicrobial
treatment. Likewise, death resulting from septic metritis
might describe the termination of a pathological sequence
initiated by dystocia. Most current dairy record systems
define only the proximate or immediate biological cause of
death, and in most cases, this is done without the benefit
of necropsy analysis. Such record systems fail to acknowl-
edge the underlying causes that may be amenable to miti-
gation strategies and managed for improved outcomes.
A more meaningful cause of death statement accounts
for nonbiologic inputs such as management and environ-
mental factors that ultimately set a pathologic sequence in
motion within an at-risk population. Under such circum-
stances a death resulting from respiratory disease might
be linked to diagnostic failure and the need for additional
education of hospital personnel. Similarly, a death due to
septic metritis might be attributed to multifactorial tran-
sition period problems that speak to issues with close-up
facilities, peripartum nutrition, or maternity pen manage-
ment. Essentially, death is often less about the destination
(proximate pathology) than the journey (underlying risk
factors). Although there are no clear-cut rules for where
that journey begins, truly understanding the reason a par-
ticular cow died from a particular disease requires addi-
tional information based on historical inquiry. Was the
disease identified properly? Was it treated properly? Did
the cow respond as predicted? Were other disease prob-
lems also identified? Was the problem associated with a
particular risk on the farm? Exposing this contextual nar-
rative requires a mindset that death losses are important
and need to be pursued, and it often depends on input
from assorted employees involved in health management
on a farm.
Ultimately, the various details related to pertinent nec-
ropsy findings, the chain of events that directly caused
the death, and other significant issues or conditions that
contributed to the death should be recorded using a tool
such as a death certificate (McConnel and Garry, 2017).
Otherwise, the insights and potential benefits gained from
the postmortem inquiry are effectively lost. Information

Table 1. Broad cause of death categories for immature and mature cattle

NAHMS Dairy Thomsen and

Lombard et al.1   20142   NAHMS Death Loss3   Houe4   McConnel and Garry5
Accident   Calving problems   Calving-related problems   Accident   Calving trauma
Calving problem   Joint or navel   Digestive problems   Calving   Human error
problems
Congenital defect   Lameness or injury   Lameness or injury   Digestive   Injury
Diarrhea   Other known   Mastitis   Locomotor   Miscellaneous
problems
Joint or navel   Respiratory   Metabolic problems   Metabolic   Multifactorial transition
problems failure
Lameness or injury   Scours or diarrhea   Other diseases   Other known   Specific disease
Other digestive   Trauma   Other nonpredator   Udder or teat   Undetermined
causes
Other known reason   Unknown causes   Poisoning   Unknown    
Perinatal death       Predator causes        
Respiratory       Respiratory problems        
Respiratory and       Theft        
diarrhea
Septicemia       Unknown nonpredator        
causes
Stillbirth (dystocia)       Weather related        
Stillbirth (eutocia)                
Unknown reason                
1
Lombard et al. (2019).
2
USDA (2018). NAHMS = USDA National Animal Health Monitoring System.
3
USDA (2017).
4
Thomsen and Houe (2006).
5
McConnel and Garry (2017).
 McConnel and Garry: Mortality in US dairies
beyond necropsy findings may be readily available for only
a short time after a death. Observations made by dairy
personnel, recollections of events or circumstances that
may have influenced the outcome, and even information
gleaned from computer records are relatively quick and
easy to gather at the time of death but can be virtu-
ally impossible to find later. This type of information can
be used to define “poor disease identification” or “delayed
treatment” or “poor facility management” as underlying
reasons for death.
Although we feel that a death certificate is warranted
for capturing this level of detail for a given death, there
are several possibilities for recording such data within on-
farm computer systems. In our experience, the most com-
mon practice is to structure the record system so that
sequences of letters or numbers serve as proxies for par-
ticular characteristics of interest such as target areas for
intervention; euthanasia versus death by natural causes;
and immediate, intermediate, and underlying causes of
death. The point is that regardless of the methodology,
data should be recorded strategically and arranged such
that the continuum of events affecting certain outcomes
can be effectively modified and ultimately evaluated.
Modify
Modifications are dual purpose with regard to the ques-
tion of why cows die. On the one hand, as particular is-
sues influencing death are recognized on a given dairy, the
management system clearly should be modified to rectify
underlying problems. On the other hand, any interventions
will undoubtedly influence ongoing operations and may
themselves lead to additional unintended consequences af-
fecting mortality frequency and causality. Consequently,
as adjustments are made to the system or previously un-
recognized challenges come to light, nomenclature and ar-
rangements within records should be modified accordingly.
Terminology potentially may be added or subtracted from
categories to refine descriptions of specific pathologies and
environmental impacts, and to direct future evaluations.
Much like there is no normal level of mortality, we doubt
that there is a correct number of descriptors for record-
ing why cows die. Our experience has been that a finite
number of possibilities tends to capture the routine causes
of death, but discussions around additions (or subtrac-
tions) of terminology can generate worthwhile insight into
on-farm dynamics (McConnel and Garry, 2017). In fact,
our initial attempts at capturing underlying, intermedi-
ate, and immediate causes of death were limited to those
disease events previously listed within on-farm computer
record systems. As we integrated death certificates with
cause of death statements into routine farm management,
input from various employees, nutritionists, owners, and
veterinarians informed our choices of relevant terminology.
Instead of simply identifying causality through the lens
of diagnosed disease states, modifications were made to
include terminology encompassing facilities, nutrition, and
601
weather-related issues that provided useful insight into on-
going areas of concern.
Modifications may be years in the making as a dairy’s
ecology and industry standards evolve. As an example at
the national level, the national livestock health and man-
agement monitoring program we now know as NAHMS
came about after several decades of modifications to sys-
tems assessing the well-being of livestock in the United
States (Dargatz, 2009). Perhaps the most important take-
home message from the development of NAHMS studies
has to do with the acquisition of stakeholder input. Objec-
tives for each study are determined based on consultation
with a diverse group including livestock producers, veteri-
narians, members of allied industry groups, researchers,
educators, and others (Hueston, 1990). A similar approach
is warranted for on-farm mortality records with input and
oversight sought from various layers of management and
consultancy. Involving these varied stakeholders in discus-
sions regarding why cows die initiates buy-in to the pro-
cess of acquiring and modifying health records to better
inform health management decisions on a dairy. Imple-
menting such thorough data recording protocols should
not require much more time and effort but is expected to
result in the accuracy and consistency needed for efficient
summary and evaluation (Wenz and Giebel, 2012).
Evaluate
Names and numbers provide the necessary information
for on-farm evaluations. Mortality figures need to be pro-
duced frequently to detect deviations as soon as possible
(Perrin et al., 2012; Torres et al., 2015), but this may
necessitate different preferred definitions for monitoring
versus communicating outcomes (Santman-Berends et al.,
2019). Annual mortality figures relative to average invento-
ries tend to be preferred for communicating to the general
public and various stakeholders as they are intuitive and
unaffected by seasonal fluctuation. Quarterly assessments
of mortality are less suitable for summary statements but
provide seasonal insight and enable earlier detection of
deviations from the norm. Alternative measures include
incidence density, incidence risk, or lactational mortality
risk, which accounts for the increased risk of dying during
early lactation (Thomsen and Houe, 2006). Recently, we
explored the use of a time-based summary measure that
incorporates the temporal effect of death into population
assessments of dairy cow health and well-being (McCon-
nel et al., 2018). As with frequency measures, simple but
meaningful standardized nomenclature has been recom-
mended for capturing reasons attributed to mortality and
facilitating on-going communication regarding broad areas
of concern. However, more nuanced descriptors of ana-
tomic and pathophysiologic outcomes provide necessary
insight when the number of cases within generic categories
exceed expectations (Thomsen et al., 2012; McConnel et
al., 2019). As importantly, incorporating information re-
garding other significant ecological attributes influencing
602 Production and Management
the frequency and classification of deaths can help inform
management and drive meaningful change (McConnel and
Garry, 2017; Thomsen and Houe, 2018).
Regardless of the names and numbers chosen to docu-
ment and evaluate mortality, definitions of parameters
should be comprehensible to farmers and dairy personnel
to maximize understanding of underlying challenges and
to increase compliance when subsequent actions have to be
taken (Santman-Berends et al., 2019). Information about
the effect of production practices on mortality in the gen-
eral population of cows can help identify at-risk individu-
als for more individualized attention. Data extracted from
postmortem reports can help unravel the underlying caus-
al factors contributing to multifactorial disease problems
(Kuker et al., 2018). Evaluations of changes in produc-
tion practices and health outcomes can provide important
insight into the success of educational programs and the
achievement of milestones. Eventually, comparisons over
time may signal when there is a need to modify disease
control efforts or production practices locally, regionally,
or nationally (Dargatz, 2009).
Ultimately, many epidemiological and practical con-
siderations must be taken into account when evaluating
why cows die. Advantages and disadvantages of various
mortality parameters should be evaluated on their own
merit within a given dairy ecology (Santman-Berends et
al., 2019). Relevant performance figures are identified, and
frequency measures are calculated and compared across
time, in space, and among animal groupings to identify
patterns, clues, and plausible reasons for underlying bio-
logical outcomes. With this knowledge, subsequent diag-
nostic testing and other examinations, and investigations
into relevant on-farm activities can be focused and actions
prioritized based on those most likely to make the greatest
difference in addressing underlying problems. In the end,
the resolution of most herd issues influencing why cows die
resides with the action of the farmer, and potential solu-
tions are based on tackling causal factors through mutual
understanding and prioritized actions (More et al., 2017).
Solutions
Unfortunately, there is no single answer or solution to
the question of why cows die in US dairy herds. Over the
years, one of the most challenging aspects of our inquiries
into why cows die has been the revolving door of proposed
solutions and temporary fixes. Plausible solutions may
mitigate death due to one problem, but of course, cows
continue to die at higher than acceptable levels as new
challenges arise that require novel interventions. As we
have pointed out previously, names and numbers provide
the framework for addressing those challenges associated
with dairy cow mortality; however, solutions are rarely
straightforward and often enmeshed with attempts at un-
derstanding the problems. In fact, this last point describes
the problem–solution space characterized by a “wicked
problem,” for which it is unlikely that any proposed solu-
tion can simultaneously address all the issues of concern
(Croney et al., 2018).
We believe that putting NAMES to the face of the mod-
ern dairy industry starts with accepting that dairy cow
mortality poses a wicked problem. Without going into ex-
cessive detail, it is worth acknowledging that wicked prob-
lems were described by Horst Rittel in response to the
limitations of the corporate linear “systems approach” of
design and planning that focused primarily on efficiency
(Rittel and Webber, 1973). The dairy industry has adopt-
ed a similar approach with attendant limitations through
the integration of standardized protocols streamlining rou-
tine management. Wicked problems are distinguished by
6 primary characteristics (Rittel and Webber, 1973; Conk-
lin, 2006). For the purposes of this discussion, we have
framed those characteristics as follows (McConnel, 2010):
(1) Understanding why cows die and resolving associated
problems are concomitant to each other. (2) No definitive
“The Problem” exists, and no definitive “The Solution” ex-
ists either. Dairy cows will continue to die. The issue is un-
derstanding what is acceptable in terms of frequency and
causality. (3) Solutions to wicked problems are not right
or wrong. Assessments of proposed solutions vary and de-
pend on stakeholders’ independent values and goals. (4)
Every wicked problem is essentially unique. Dairy farms
are composed of so many novel factors and conditions, all
embedded within a dynamic ecosystem, that the problem
of addressing reasons for mortality will necessarily require
individualized solutions. (5) Dairy systems are complex
and every implemented solution has unintended, often ir-
reversible, consequences that evolve over an extended peri-
od of time. (6) Wicked problems have no given alternative
solutions. A host of potential solutions arises, but some
solutions may never even be considered. With regard to
reasons for dairy cow death, no criteria exist by which to
determine that all solutions to underlying issues have been
identified and explored.
Given these characteristics of a wicked problem as a func-
tion of why cows die, we suggest that engaging the prob-
lem requires exploring dairy system complexity. Although
it is most certainly useful to establish associations between
population characteristics and mortality, or between spe-
cific disease entities and higher death rates, mitigation
strategies must be based on understanding why those as-
sociations or diseases are present in the first place. The
numerous interacting factors within an individual dairy
farm community comprise a complex network of connec-
tions. These connections form a system that is inherently
altered through any process that attempts to break it into
its component parts or even subject it to analysis. The
whole is always different from the sum of its parts and is a
product of evolution. Cause is intertwined with effect, and
the sheer number of connections means that predictive
rules may not apply. A constant shift in the farm com-
munity’s dynamic occurs, influencing interactions among
factors (cows, people, nutrition, facilities, weather, and so
 McConnel and Garry: Mortality in US dairies
on) and even within factors (emotional or physical varia-
tions in workers, or biologic fluctuations within cattle).
Admittedly, the previous paragraphs are a bit dense and
heavy on philosophy. But the reality is that a weakness
in establishing why cows die and proffering meaningful
solutions to underlying problems has to do with the real-
ity that death is factual, but causes of death often rely on
opinion and are as much a matter of philosophy as fact
(Heasman et al., 1962). Addressing issues influencing why
cows die requires accepting this reality as a component
of the complexity and evolving ecology of dairies. The
crux of the matter is that managing such systems
requires flexible interventions based on simple ac-
tions that can themselves evolve into complex and
desirable behaviors (Snowden, 2001). We believe those
simple actions begin by incorporating NAMES into dairy
mortality management to build a shared understanding of
the problem and facilitate dialog and learning within the
co-evolutionary dairy community.
APPLICATIONS
So, why do cows die in US dairy herds? Of course, the
answer is that it depends on a multitude of factors and
complexities. The more relevant questions are what are
you going to do about mortality in your herd, and how
do we as an industry manage associated troublesome wel-
fare implications? On the one hand, there are practical
suggestions for addressing dairy cow mortality on a day-
by-day basis. These include the following: (1) Implement
euthanasia guidelines to facilitate humane and timely on-
farm euthanasia decisions. (2) Incorporate postmortem
examinations into mortality oversight, targeting those
deaths that lie outside of obvious instances such as trau-
matic accidents. (3) Use digital photos of necropsies to
document and disseminate information through on-farm
group messenger applications for smartphones or tablets.
(4) Incorporate farm employees into the diagnostic and
record-keeping process to stimulate interest in the prob-
lem. (5) Take the time to record aspects influencing a
death beyond anatomical and pathophysiological descrip-
tors. (6) Standardize health event nomenclature in simple
and consistent terms using a coding system tailored to an
individual farm’s challenges. (7) Summarize and evaluate
data to detect deviations from the norm. In other words,
components of a program for decreasing dairy mortality
include educating and engaging workers within the sys-
tem, monitoring processes governing animal husbandry,
analyzing outcomes to identify trends, and establishing
accountability. Taking such measures can provide over-
sight and direction with the flexibility to tackle problems
as they arise.
On the other hand, dairy cow mortality is part of a larger
discussion regarding the welfare of animals in agricultural
systems. This discussion simultaneously addresses scien-
tific controversies over how to define “animal welfare,” eco-
603
nomic concerns of producers, and ethical debates over the
use of animals for food production (Croney et al., 2018).
There is increasing concern that “industrialized” farming
insufficiently focuses on quality of life issues, and there is
an argument to be made for a clearly articulated vision
of enhanced care and compassion to alleviate public con-
cerns (Croney and Anthony, 2011). To that end, Britt et
al. argue that in the future dairy cows will have improved
health and longevity driven by ongoing improvements in
genomic selection and dairy farm facilities (Britt et al.,
2018). Continued integration of the dairy farming sector is
predicted to lead to more specialization in managing cattle
of different ages and stages of production, and on-farm
and remote sensors, robotics, and automation are expect-
ed to improve the prediction of complex events such as
death (Borchers et al., 2017). In other words, options for
addressing animal welfare concerns such as dairy cow mor-
tality include (1) engineering the animals themselves to
better fit their environments, or (2) engineering their en-
vironments to better fit the animals (Croney et al., 2018).
That brings us back full circle to the controversy between
Farr and Chadwick and the reality that the laws of the
current dairy economy might at times be found incom-
patible with the laws of health. Not only are innovations
unlikely to provide engineering solutions that fully address
all of the issues underlying why cows die, but some of the
innovations that promise to improve welfare will face re-
sistance from producers due to start-up costs and previous
investments in widely used, current designs. Even so, Britt
et al. conclude that understanding differences in herd-level
outcomes related to productivity, animal well-being, and
economic viability will require additional insight into the
impacts of environment, operational practices, and animal
interactions on overall performance. They point out that
this will require novel ways of capturing data that are not
collected routinely, and implementing consistent standard
operating protocols for monitoring and recording health
and disease events (Britt et al., 2018). We agree and be-
lieve that understanding and addressing why cows die in
US dairy herds begins and ends with NAMES (Nomen-
clature Arranged, Modified, and Evaluated for Solutions).
ACKNOWLEDGMENTS
Our investigations into dairy cow mortality and reasons
for why cows die have been a work in progress for over 15
yr. There are numerous dairy personnel and veterinary
colleagues to whom we owe a debt of gratitude for helping
frame the discussion and move things forward. This review
in particular is dedicated to our late mentor, friend, and
colleague, Dave Van Metre, who was unparalleled in his
ability to distill the complexities of veterinary medicine
and herd health into meaningful and memorable practical
applications. This work was partially funded by the USDA
National Institute of Food and Agriculture, Hatch project
1016366.
604 Production and Management
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