Editor’s note: First in a two-part series

Are your dairy clients’ hospital pens like the Roach Motel -- cattle check in, but they don’t check out? Are your clients’ hospital pens some of the most poorly designed and/or managed pens on the dairy?

There are several factors that influence the usefulness of hospital pens. These include pen placement, pen design and size, bedding, segregation of sick and lame cows, animal handling, nutrition management, and employee training. This article will discuss design basics and location of hospital pens; the second article in this series will talk about management of the hospital pen. So if your clients are building, expanding or retrofitting, there are some things they ought to consider about one of the most important spaces on the dairy.

Hospital pen location

Where the hospital pen is placed should be the first consideration. “The hospital should not be immediately adjacent to transition cows -- i.e. there should not be nose-to-nose contact,” says Nigel Cook, BVSc, MRCVS, University of Wisconsin-Madison. “That sounds great, but this is rarely achieved in practice.”

Cook says the hospital pen should be in a location where herd workers pass frequently and that is convenient for locking up cows for exams and near to a milking facility -- the main parlor or a hospital cow parlor. “The best facilities have an office area elevated above the pen with a large window for viewing the whole area,” Cook adds. “That way the herdsman can enter records and do paperwork while still watching the sick cows and post-fresh cows.”

 Jim Brett

Jim Brett, DVM, Macon County Veterinary Hospital, Montezuma, Ga., adds that the hospital pen should be close to the parlor for easy access for lame or weaker cows, but not so close that they can have direct contact with the hospital cows. “This is more easily done on our smaller farms since they deal with low numbers and can use temporary panels if needed,” says Brett.

Greg Goodell, DVM, the Dairy Authority, Greeley, Colo., says, “We currently recommend the ‘square’ for designing special needs facilities on large dairies and will follow this approach on small dairies as best we can. The square consists of a pen arrangement close to the milking center where the fresh pen and close-up pens are on one side of the alley, and across the alley located at the end of an alley flush or scrape is the hospital pen.” Sometimes a pen for recovering lame cows would be located adjacent and uphill from the hospital pen.

If possible, a lame cow recovery pen should be separate from the sick-cow hospital pen, and lame cows should be kept on a bedded pack area close to the main parlor. “That puts them into a separate category from routine sick cows that can be managed in free-stalls,” adds Cook.

One of the worst places you can put a hospital pen is adjacent to the fresh cows. Cook notes that in many herds the immediate post-fresh cows under antibiotic residue withdrawal from dry cow therapy are actually commingled in the hospital pen with sick cows. “This is the worst case scenario, and it is very common in the Midwest.” Cook says that is due to hospital barns being designed as “special needs” facilities, and all animals with antibiotic residue risk are grouped together for management purposes -- including treated cows and fresh cows.

Situating the hospital pen near far-off dry cows, close-up dry cows and fresh cows so that water, manure and cow traffic is commingled between these groups is definitely a placement flaw, agrees Goodell. “While it does make sense to keep high-needs cows in the same vicinity, it is very important to keep sick cows separate from healthy cows, especially fresh cows who are suffering varying degrees of immunosuppression due to recent calving.”

Brett notes, however, that good management can make just about any hospital pen placement work. “You would think next to the maternity pen would be the worst, but I have one large farm with the hospital area next to maternity/close-ups, and there has been no increase in their hospital numbers or outbreaks,” Brett explains. “Maybe having the close-ups inside, out of the environment and heat stress, keeps their immunity levels from dropping due to the stress of calving. They are also on a very good and consistent vaccination program.”

Having hospital pens in a very isolated area where cows can be forgotten can also be a problem. “At one farm in particular, the cows were rarely seen, and treatments were done quickly without reassessments,” says Brett.

 This large dairy hospital pen on a Georgia dairy is bedded with sand for comfort and to reduce the spread of disease.

Size of the hospital

Goodell says hospital pen size seems to have been determined by the experts to be 2-3% of herd size, but he believes this is too low. “Most likely we should be designing for the maximum number of cows that would ever be in the hospital pen, not the average number of cows,” he suggests. Cost becomes the issue in this case and also what type of housing system the dairy is using. For example, if the housing system is a dry lot dairy, it would not be uncommon to see a monthly mastitis incidence ranging from 10-20% during a wet month, overwhelming any hospital pen built to accommodate 2% of the herd. “I would recommend building a hospital pen to hold 4-5% of the herd size,” says Goodell.

Goodell adds that the size of the sick pen should also be determined by the efficiency of administering proper care, treatments and monitoring of sick cattle. All cattle should be able to lock in headlocks after a milking for their treatments. To treat cows, half as many headlocks could be used or cows could be run through a chute individually, however that process is simply not efficient.

“Spending an extra hour for two employees throughout the course of a year would pay for the additional headlocks and pen space,” says Goodell. “It is also a function of management style. Are the fresh cows milked in the hospital pen? Is there a separate pen for lame cows? Does the dairy utilize a mastitis pen? Answers to these questions will aid in the determination of the pen size best suited for the dairy. There is not a ‘one size fits all’ approach.”

 Nigel Cook

Cook adds that sizing pens is very difficult to provide for pre- and post-fresh cows as well as sick cows. He says the best approach is to build a series of pens typically of around 30 stalls in a two-row layout with frequent crossovers and centrally located water troughs. Gates can be used to open these pens up or close them off as needed, in order to protect bunk space and hold it at or close to 30 in. per cow.

In the open lots/pens in Brett’s area of Georgia, pens are kept to a minimum of one cow per 60-80 sq. ft. “In free-stall farms, we keep the pen to no more than 85% capacity. Increase your water space in your medic areas to one foot per cow; be sure they have easy access to water.”

Cook believes talking about stocking density is confusing. For sick cows and periparturient cows, the primary focus is on inches of bunk space per cow.

“We are not talking in terms of cows per headlock,” Cook notes. “With 24-inch-wide headlocks, cows will only fill about 80% of them at maximum fill unless forced.” So, one cow per headlock is not enough unless the headlocks are 30 inches wide, which is closer to what the cows are requiring for a feed-space dimension. “We need 30 inches of bunk space per cow, which means that all transition-cow and sick-cow free-stall pens need to be two-row designs --- otherwise we end up building a stall in a three-row pen that no cow will ever  use.”

Equipping the hospital pen

Hospital design features are also important. One design flaw Goodell sees is creating a hospital pen without easy access for personnel and/or cows. “Many dairies will design a hospital pen that is close to the milking center, but then make things difficult for employees to treat the cows,” he explains. An example is a hospital pen where the only access to entering the pen is on the ends of the pen, or it requires the employee to crawl over the headlocks or through the bunks.

Goodell believes placing man-passes every 20 or 30 headlocks or every 40-60 ft. in non-headlocked pens results in better cow care. “Building a man-pass every 20 headlocks may seem overdone,” says Goodell, “however, ask yourself how likely you or your employee may be to check on a cow before you go home if you must walk to the ends of the pen or jump the headlocks versus slipping quickly through a man-pass to provide that extra check?”

Cook says the hospital pen should have bedded pack and freestall areas -- preferably sand bedding. Bunk space should provide at least 30 in. per cow with 30-in.-wide headlocks so that every cow in the pen can be locked up, and sufficient room is available for the herdsman to work around the cow. In addition, there should be an area of the pen with just a post-and-rail for those individuals that are reluctant to lock up.

“All pens should be two rows of stalls, with the tail-to-tail layout offering advantages over head-to-head for cow movement and alley scraping,” says Cook. “There should be easy access to an enclosed chute area for surgeries and foot work.”

The use of separate feed bunks and waterers is a must for the hospital pens, as this area is one of the highest areas of disease transmission on the dairy. While designing special-needs pens, the builder or contractor should be cognizant of things like flush water and manure removal. “For example,” says Goodell, “a design where flush water begins in the hospital pen then continues flushing through the fresh cow pen, exposing all fresh cows to the diseases currently in the hospital pen, should obviously be avoided.”

A cow suffering any health event will be more negatively impacted by even slight weather stressors and should be protected from the environment. Cows will recover quicker when environmental stress is reduced. “Any structure that provides protection from cold, heat and wind should be employed in the design of the facility,” suggests Goodell. Brett adds that in his area of the South, hospital pens should be covered with a roof, not shade cloth, with fans in use. Misters and water should only be used over the feed bunk.

If possible, especially on larger dairies, having a hospital parlor to milk fresh cows and cows on medications requiring withdrawal can make sense. “This frees up your parlor because medicated cows may require additional time and have a slow milking time, and it helps eliminate residue violations,” explains Brett. “Withdrawal milk can be pasteurized and fed to calves to lower feed costs.”

Equipping the hospital pen for ease of use by employees is essential. On large dairies, most have multiple chute areas and tilt/foot tables, says Brett. “This helps the medic staff and me be more efficient in doing treatments.” Tilt tables are also great for teat surgery.

Hot and cold running water are also great to have in the treatment area. “Hot water helps during our short three-week winter in south Georgia,” Brett continues. “Having the area covered and the work area situated away from rain drifts makes work for me and the staff better in foul weather.”

Quick access to medications and supplies is a must. Remember to plan the storage area to separate lactating and non-lactating drugs. Other useful things are more storage for medical supplies, refrigerators for drugs and other items needed for treating cows, office or computer stations, etc.

 Bedding such as sawdust, which promotes organic growth, is not recommended for hospital pens.

Bedding and flooring

Two of the keys to a successful hospital pen is cow comfort and the prevention and/or reduction of pathogen build-up. Bedding and flooring factor into both of those situations.

These three veterinarians agree that sand is best for hospital pens. “Sand bedding is inert, relatively cheap in this part of the country and has a good cushion,” says Brett. He adds that in some small herds they have used temporary pens on grass. “It’s the only thing better than sand. The temporary pens can utilize grass areas around the holding pen.”

“We also operate sand-bedded packs, but management is difficult and requires frequent removal of wet and contaminated areas,” adds Cook. “Many farms use straw on top of sand, especially during the cold winter weather.”

Goodell agrees that sand is always an excellent choice regardless of housing design since it promotes excellent cow comfort and has very little organic matter to it, so pathogens have a difficult time using it as a growth media. He cautions, however, that providing a sand pack with no shade can be detrimental on a hot day. “Try walking barefoot across a beach on a 90-degree day and you’ll understand why,” he says.

Hospital pens with only harrowed lots work very well if the pen size is adequate and the pen properly managed. “I’ve seen straw, chopped straw, sand and compost all used successfully in the hospital pen,” says Goodell. “The key is management.”

Good bedding alone is not the answer. Bedding maintenance can make the different in cow comfort and pathogen buildup. Cook suggests that hospital bedded areas be cleaned more frequently than normal bedded packs -- at least every two weeks at a minimum.

Sick cows spend more time lying down and are more susceptible to mastitis. Even sand grows bacteria when contaminated with milk, urine and feces, so regular removal and addition of fresh sand is required. “For stalls, we recommend a coarse-grade sand that drains well. This material usually leaves the stall rather than becoming compacted in the bottom,” explains Cook. Weekly additions of fresh sand are sufficient for most pens, but twice weekly is probably necessary for hospital pens where contamination is greater since mastitis cows make up 90% of the sick cow population in these pens and their milk will leak to contaminate the beds. Other bedding material needs to removed/replaced daily.

One of the worst things for hospital cows is rough concrete. Concrete walks should be cross-grooved. Brett recommends spreading a light coat of sand over the concrete after the area is flushed to add some grit to the floor. Goodell agrees that sprinkling sand on the alleys to and from the pens and milking center, the hospital pen feed alley and the fresh pen alleys is standard practice for some dairies.

“This simple practice has saved more weak or newly fresh cows than any single management practice I can think of,” says Goodell. Rock salt can be used if sand will not work. In addition, keeping pens and alleys free of small rocks that are common in new pens or expansion projects can also help in reducing lameness and injury.

Very sick and weak cows should not be placed in a situation where they are likely to slip. “Rubberized transfer lanes are a must,” say Cook. Feed alleys can be grooved concrete provided the job is done properly with ½- in. deep and ¾-in. wide grooves set 3-3¼ in. on center. “Rubber in front of the feedbunk can be used, provided that stall design is perfect.”

Next: Dairy hospital pen management

Dairy Hospital-Pen Design Basics

Nigel Cook, BVSc, MRCVS, Jim Brett, DVM and Greg Goodell, DVM, offer these basic design parameters for dairy hospital pens:

  • Hospital pen location should not be immediately adjacent to transition cows, but should be convenient for treatment, monitoring and milking.
  • Lame cows should be separated from sick cows.
  • Water, manure and cow traffic between sick cows and far-off dry cows, close-up dry cows and fresh cows should be avoided.
  • Hospital pens should be designed for the maximum number of cows that would be in the hospital at one time, or around 4-5% of the herd.
  • Hospital pens should provide 30 inches of bunk space per cow and allow water space at one foot per cow.
  • Man-passes in headlocked or non-headlocked pens can facilitate better and more convenient cow care.
  • Near the hospital pen should be any treatment chutes or tilt tables, hot/cold water, storage and refrigerators for drugs and other equipment useful for treatments and/or recordkeeping.
  • Hospital pens should be protected from the elements and shaded when possible.
  • Sand bedding is preferred in hospital pens, but other materials can be used if they are very well managed.
  • Areas where sick or lame cattle will be walking should be non-slip and provide either a cushioned walkway or be sprinkled with sand to prevent slipping.