Table 1 Interview guide and summaries of the answers of a series of semi-structured interviews.

1. What percentage of your work is spend working with cattle?

Range from 30–100%

2. How many days post partum do you examine the fresh cow?

Fifteen veterinarians performed the clinical examination between 5–12 days post partum. Two veterinarians used 4–12 days and three veterinarians used 5–19 days post partum.

3. How do you examine the uterus of the fresh cow?

Sixteen veterinarians used vaginal exploration by hand. Two veterinarians only used rectal exploration. Two veterinarians used both vaginal and rectal exploration.

4. Which criteria do you include to diagnose metritis?

Nineteen veterinarians used a standardized metritis scoring system. The last veterinarian used his own scoring system. The nineteen veterinarians used metritis score 5 as a threshold for medical treatment. Three veterinarians consequently used temperature as a diagnostic indicator. Ten veterinarians included temperature on indication (depression, anorexia). Seven veterinarians never used the thermometer. One of these veterinarians explained that he could feel the temperature of the cow during the examination procedure. Another veterinarian told that elevated temperature was indicative to medical treatment.

5. Do you treat all cows according to the same criteria or could there be some considerations that would call for initiation of treatment nonetheless?

Nineteen veterinarians claimed to initiate treatment on identical and repeatable criteria with metritis score 5 as the threshold for medical treatment. However, during the interviews ten veterinarians in retrospect realized that various cow and herd factors (e.g. ketosis, mastitis, reduced milk production, change in behaviour as reported by the farmer, knowledge on metritis problems in the herd or knowledge on a difficult calving) changed their treatment threshold with a range of metritis scores from 4 (three veterinarians); 6 (six veterinarians) and 7 (one veterinarian) for treatment to be initiated.

6. Do you use the score system differently with increasing days in milk?

Four veterinarians said they would treat more aggressively by lowering the threshold for treatment as a consequence of increasing DIM.

7. Do you evaluate the results of the treatments, i.e. control the effect of the treatments?

Nine veterinarians reported that a systematic control effort was unnecessary because of the high success rate in metritis treatment. Nine veterinarians consequently controlled all cows treated at the last visit. Two veterinarians performed controls if the farmer requested it.

8. If you are called to a cow having a badly smelling placenta retained for 4–5 days, how do you then register the case in the Danish Cattle Database?

Twelve veterinarians would register a retained placenta into the database. Two veterinarians motivated this by the price difference between metritis and retained placenta (+ 25%) and that the registrations are combined with the billing system. One veterinarian explained that it was time-consuming to register two diagnoses, so he would only register the retained placenta. Six veterinarians would register a metritis.