News & Advice

Down cow first aid

Jul 2, 2023 | Dairy, Dairy Animal Health & Welfare, Minerals

We all know that sinking feeling when one of the cows in the paddock does not get up or we see one laid flat out instead of sitting up! Usually, it is either raining or on a day when we already have too much to do! What to do next?

There are really two things that need attention – someone needs to treat the down cow straight away (these cows can go downhill rapidly), but you must also consider the bigger picture – when should you talk to your vet to make sure an underlying herd-level issue isn’t going to continue to cause more problems?

For an easy to remember ‘trigger point for action’ when it comes to down cows…. think 2s!

If you are getting more than 2% down cows at any time e.g., 2/100 of the cows calved so far, or 2% of the cows calved this week or even 2 down cows on the same day or you have 2 days in a row with down cows, then please phone us for a chat. It is so easy, when you are so busy, to think nothing has changed and therefore you cannot understand why there are suddenly more down cows but having a second pair of eyes to review the prevention programme you have in place is often all that’s needed to find the thing that has changed and adjust the plan accordingly.

As for those individual down cows, if your down cow hasn’t responded to your treatment within 2 hours, call us for a second opinion. You should also seek vet advice for any cow that goes down before calving or if you don’t know why a cow is down (and therefore don’t know the best treatment).


Treating the individual down cow


A down cow is an emergency for the cow



The first thing we need to do is decide why she is down

  • Milk fever/grass staggers, nitrate poisoning, mastitis, calving, prolapse, broken leg, dislocated hip, another disease? 
  • If she is flat out, she needs to sit up, or she will blow up and die
  • Is she alert and able to hold her head up, or unconscious/non-responsive? 
  • If you’re not sure what’s going on, please call us and we will get one of our vets out to see her.

Helpful video: 


Does she need moving immediately?

  • Is she near a ditch/river and could fall in, or is she already in and may drown?
  • Is she stuck? 
  • Is she on concrete where she cannot get up easily? 

Helpful video: 



  • If nitrate poisoning, call your vet immediately, and check if other cows are affected 
  • If milk fever/grass staggers, a bag of calcium/magnesium metabolic solution is a good place to start (check out our handy guide to  Common metabolic down cow conditions and treatments if you need a refresher)
  • If calving, assess whether you can assist the cow or do you need a vet visit
  • If calving paralysis, immediate treatment with non-steroidal anti-inflammatory (e.g. Metacam) will increase chance of recovery 
  • If it is a prolapse, call the vet straight away, then putting clean warm towels around the prolapse and covering the cow whilst you wait will stop her losing more body heat 
  • In some situations, immediate euthanasia may be the best treatment, please contact your Vet. 



The most important thing that you can do for a down cow, following the initial treatment, is nursing care.

If the cow does not respond to the initial treatment quickly and is sitting down for more than a few hours she is likely to suffer from secondary damage caused by her body weight pressing against cold her surfaces (cows are big animals after all!) If she cannot get up, she should ideally be moved as quickly as possible to a barn with straw or shavings as bedding; if this is not possible, cover her where is she and this will help to some extent.

She needs food and water (in a wide-based container, that she won’t knock over). If she is with other cows this means moving them or running an electric fence around her to stop the other cows pinching her supplies.

Nursing takes time, a constant supply of food and water, turning the cow from side to side at least four times daily to help prevent muscle damage, lifting the cow at least once daily to help restore normal circulation. If you do not have time to do this, it may be kinder to the cow to euthanasie her straight away. Your vet will be happy chat with you to help you make these decisions.

Helpful Video:

Other resources you may find helpful:

Info Flyer: How to treat a cow with milk fever or grass staggers

Info flyer: Common metabolic down cow conditions and treatments

Info flyer: Downer Cow Vet Tips

Do you manage your Downer cows well?


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