Qualitative investigation of the underlying influences for the use of non-steroidal anti-inflammatory drugs in sick calves

• Focus groups explored factors influencing NSAID use in sick calves. • Barriers included disease sign normalisation, routine habits and unclear NSAID roles. • Desire to “do right” conflicted with habits and farm-level constraints. • Knowledge gaps and variable skills reduced consistent NSAID treatment. • Sector called for clear, evidence-based guidance on NSAID protocols. Neonatal disease and mortality in calves significantly impacts animal welfare, farm productivity, and industry sustainability, with conditions like diarrhoea and bovine respiratory disease (BRD) leading to long-term economic consequences. Non-steroidal anti-inflammatories (NSAIDs) have been shown to improve clinical outcomes in calves with BRD and diarrhoea, including improved growth rates, reduced pain, and decreased tissue damage. However, NSAID use for calf diseases by veterinarians and farmers has been highlighted to be low in on farm treatment protocols for sick calves. This study aimed to identify the factors which influence the use of NSAIDs on UK farms by veterinarians and farmers. Seven semi-structured focus groups with 15 farmers and 7 veterinarians were conducted to discuss the participants’ views on calf health and NSAID use, after viewing three short videos of pre-weaned calves. Transcripts were thematically analysed using NVivo and Braun and Clarke’s six-step framework. The results highlighted that intrinsic factors such as animal welfare priorities, perception of effectiveness and education influenced NSAID use, as well as extrinsic factors such as economic factors, legislation and ease of access. While participants expressed a strong desire to “do the right thing” for the calf, barriers included limited knowledge on use of NSAIDs, variable farm priorities, on farm practices and habits, as well as staff competency, skill set and access to veterinary advice. The concept of normalisation of suboptimal calf health emerged as an influencing factor, as well as historic calfhood diseases. The study highlighted the presence of an ambiguity over societal expectations regarding drug use and ambiguity around the roles and purpose of injectable medicine within treatment protocols. Veterinarians and farmers suggested a need for evidence-based, industry-led initiatives to support NSAID use, though there were differing views on who should lead such efforts.