This study investigates whether dry matter (DM) or water intake is affected by the presence of disease or estrus in dairy cows and whether water intake can serve as an accurate substitute for monitoring changes in DM intake (DMI). A combined cumulative sum (CUSUM) and Shewhart monitoring scheme is proposed to detect DMI changes and emerging disease or estrus. Daily readings from 35 inline water meters for 35 water cups in a tie-stall barn at the University of Minnesota were collected from September 2005 until June 2006. Two cows were assigned to each water cup. Individual DMI were recorded for each of the 70 cows on the study. All drug or hoof treatments administered to the cows along with breeding and calving events were also recorded and classified as 1 of the following 6 event categories: estrus, calving, mastitis, fever, hoof treatment, and other. Analysis of covariance was used to identify factors significantly changing intake. Only the first 150 d in milk (DIM) were considered in the analysis. Six event categories plus DIM, ambient temperature, relative humidity, and parity were entered as independents into the model. Calving, primiparity, and health events categorized as "other" were associated with decreased DM and water intake. Mastitis decreased DMI and fever negatively affected water intake. Both intakes increased with DIM, and water intake decreased with increase in humidity. Covariance analysis was used to investigate the relationship between DMI and water intake. In model 1, analysis was done for a pair of cows, whereas model 2 modeled DMI of the whole group of 70 cows. Water intake, ambient temperature, humidity, and DIM were entered as independents in both models and parity was entered in model 1. Polynomial models and 2-way interactions were also considered. Water intake, ambient temperature, DIM, and DIM(2) were kept in final models 1 and 2, and parity was kept in model 1. Final models for cow pairs and a group of 70 cows resulted in R(2) of 0.50 and 0.82, respectively. The proposed CUSUM-Shewhart DMI monitoring scheme successfully detected emerging disease even in the first week of lactation. Monitoring water intake can serve as an alternative to measurements of DMI for groups of cows and has the potential of predicting change in individual cow health and estrus status.