It is very important to examine the animal to try to determine why it is down. If there is a limb fracture, joint dislocation, ligament rupture or paralysing spinal cord injury, the decision to euthanise may be clear cut. If the animal looks bright, occasionally struggles to rise, and continues to eat and drink, recovery is a possibility and it is worthwhile persevering. However, if the animal deteriorates, loses interest in feed, or develops complications such as decubital lesions, consideration should be given to euthanising the animal.
Vigorous intervention is required to get recumbent animals standing before compressive musculoskeletal damage becomes irreversible. Specific treatment downers will be determined by the diagnosis, but in general they should receive antibiotics (procaine penicillin, oxytetracycline, ceftiofur, or tylosin), non steroidal anti-inflammatory drugs (flunixin meglumine, ketoprofen, meloxicam, or tolfenamic acid), calcium borogluconate, and magnesium sulphate solutions, together with supportive or nursing care. Try to provide the animal with a pen of its own by either relocating the affected animal or moving pen mates. Roll the animal from side to side every few hours and manipulate limbs where possible to reduce compression damage to limb muscles and nerves. Bandages may be applied to worn hooves to provide support and reduce the risk of infection.
Try to stand the animal up at least once daily. This can be done by encouraging the animal to stand with one or two people providing assistance at the tail head to lift at the same time as the animal tries to stand. Once the animal stands, one person can accompany the animal to provide lift and stability at the tail head until it appears more stable.
It is best to prepare for maximal effort on the first attempt to stand since animals may only try for one or two attempts. Move other animals out of the immediate pen area and, if appropriate, offer water to the animal, administer medications and allow a short period of rest in a sitting position before attempting to stand them up. Spreading sawdust in front of and around the animal, wrapping an absorbent paper towel around the tail to provide a better grip, removing pen rails in front of the animal (even if it means cutting them away), and ensuring two strong people are available to lift the tail or provide support, are measures that may be the difference between success and failure for the animal. Judicious use of an electric goad may be considered in cattle.
Once standing, weakened cattle may require the application of hobbles to prevent them doing the splits and dislocating a hip joint. Nylon straps around the cannon bones (metatarsi) allowing 0.5m distance between the legs should be used in preference to ropes.
Suspending the animal with ropes, slings or clamps is usually unrewarding unless managed carefully in an optimal environment and with purpose-designed equipment.
The prognosis is better for animals crawling or attempting to rise than animals remaining inactive. Strong consideration should be given to euthanising cattle that are unable to rise and show no improvement within a 24 hour treatment interval.