Case history: A 400-cow dairy unit in the Waikato suffered a severe outbreak of facial eczema (FE) despite consistent zinc supplementation and significantly elevated serum zinc concentrations.
Clinical findings: FE prevention had begun in mid-January 2006, via zinc sulphate supplementation in the water. Photosensitisation was reported on 06 April, contemporaneous with a marked increase in the number of Pithomyces chartarum spores in pasture samples. Within 10 days of this first clinical case, 100 affected cows had been dried off, eight of which subsequently died or were culled. Blood samples were collected from ten affected cows; all had serum zinc concentrations >17 micromol/L, and eight had gamma-glutamyl transferase (GGT) activities >200 U/ml, indicating that the photosensitisation was secondary to liver damage, i.e. probably FE. Further investigation identified that this herd had been receiving excess copper supplementation; 4/6 culled cows had liver copper concentrations within or above the marginal range for copper toxicity.
Diagnosis: Severe FE despite zinc supplementation that increased serum zinc concentrations above recommended levels.
Clinical relevance: As zinc supplementation significantly reduces apparent copper status, copper supplementation is often used to counteract this. Previous excess copper intake may reduce the efficacy of zinc in preventing FE, thus copper intake should be assessed prior to the start of zinc supplementation.