Mastitis diagnosis and treatment in cattle Flashcards

1
Q

Definition

A
  • mostly caused by microorganisms
  • rarely due to other cause
  • inflammatory response
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2
Q

The infection

A
  • mostly through the teat canal (ascending)
  • mechanically through the skin of the udder
  • Through blood and lymphatic spreading (viruses)
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3
Q

Economical impact of mastitis

A

a-Direct costs
• Discarded milk
• Medicine and Veterinary costs

b-Indirect costs
• Decreased milk price
• Milk production decrease in the remaining lactation due to elevated SCC
• Separation of the animals requires labour
• Cost of replacement heifers
• Culling

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4
Q

Classification of mammary gland infections based on pathological changes

A
  1. Galactophoritis:
    gland cistern and teat cistern affection
  2. Parenchyme mastitis:
    minor cistern and ductus infection

3.Interstitial mastitis:
Inflammation in the alveoli and the interstitial tissue between the lobules

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5
Q

Clinical forms of mastitis

A

Clinical mastitis: 20%

Subclinical mastitis: 80%

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6
Q

Clinical forms of mastitis

Clinical mastitis

A

• Peracute
o Abnormal milk
o Abnormal mammary gland
o Sick cow (elevation in clinical baseline values, shock, exitus)
• Acute
o Abnormal milk
o Abnormal mammary gland manifest by inflammatory changes in the tissue such as redness, heat, pain, and swelling
• Subacute
o Abnormal milk only
Manifest by clots, flakes, and/or changes in the color and consistency of the milk secretion
• Chronic
o Chronic form with fibrosis, nodules and/or abscessation in the mammary gland

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7
Q

Clinical forms of mastitis

Subclinical mastitis:

A

• presence of inflammation with a normal appearing mammary gland and visibly normal
milk

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8
Q

Diagnosis of clinical and subclinical mastitis

clinical mastitis

A

Alterations in the milk + clinical signs of the animal

  • After milking the first strips we perform test milking
  • During this we observe the mammary gland
  • In case of positivity separated milking + treatment
  • E.Coli = Major cause of bovine clinical Mastitis
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9
Q

Diagnosis of clinical and subclinical mastitis

subclinical mastitis

A

• Somatic Cell Count (SCC)
o Uninfected→Neutrophils 1-11%, Macrophages 66-68 % (Surveillance) , Lymphocytes 1-2%, epithelial cells 2-5%
o Infected→Neutrophil 90% of total cells
o Leukocytes mean 80% of the somatic cells in uninfected quarters and 99% in uninfected quarters
→Str. agalactiae = Major cause of high SCC
• Milk lactose concentration decrease
o In damaged tissue, the secretory cells are unable to lactose biosynthesis
• Milk lactatate dehydrogenase concentration increase
o Due to cell damage LDH is released into the milk (secretory cells + leucocytes)
• Milk N-acetyl-b-D-glucosaminidase (NAGase) increase
o Due to epithelial cell damage exerts from cell lysosomes
• Acute phase proteins (haptoglobin, milk amyloid A)
o Due to increased permeability they cross the blood-milk barrier and occur in
milk
• Electrical conductivity (EC) of the milk increase
o Sodium Na and chloride Cl increases,
o Potassium K decreases

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10
Q

Diagnosis of clinical and subclinical mastitis

subclinical mastitis
somatic cell count determination

A

Milk with high SCC : Harmful to Hu + contains less casein + lower cheese yield

Direct
• Microscopic determination
• Automated electronic cell counters (flow citometry)
• Portable counters (DeLaval, Porta SCC)
o DeLaval Cell counter
▪ Propidium iodide→Stain nuclear DNA of somatic cells present in milk
▪ Measure with optical fluorescence readers→Proportional to SCC in milk
▪ Expensive

Indirect
• California Mastitest (CMT)
o Most reliable
o Detect viscosity change in milk
o Use of detergent + Bromocresol purple
o Importance in contagious pathogens mediated mastitis

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11
Q

Diagnosis of clinical and subclinical mastitis

subclinical mastitis
Evaluation of CMT

A
Negative
    Evaulation: Fluid
    SCC: < 250 000
±
    Evaulation: Minor flakes
    SCC: 300 000
\+
    Evaulation: MAjor flakes
    SCC: 900 000
\++
    Evaulation: Increased density
    SCC: 2 700 000
\+++
    Evaulation: Jelly
    SCC: 8 100 000
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12
Q

Additional tools in the diagnostic of intramammary infections

A
  1. Bacteriological culture sampling
  2. PCR sampling

The sampling
• At the level of a quarter
• At the level of the cow
• At the level of the herd

Selection Criteria
• Clinically affected animals before the therapy
• At the time of drying off
• After calving
• animals with high SCC
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13
Q

Additional tools in the diagnostic of intramammary infections

Bacteriological culture sampling

A

• Easy culturing ( ! Mycoplasma spp.! )
1
1.A Bulk tank microbiology:
o raw milk quality testing
o IMI link: S aureus, Streptococcus agalactiae, and Mycoplasma spp.
▪ other pathogens: not only from the cow
o Standard Plate Count – SPC (Bactoscan, flow citometria)
1.B On-farm culturing method 1.C Classical laboratory culturing

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14
Q

Additional tools in the diagnostic of intramammary infections

Bacteriological culture sampling

Target numbers of bulk tank microbiology

A

Parameter / Goal [cfu/mL]

SSC – Somatic Cell count: < 150 000
SPC – Standard Plate Count: < 5 000
Thermoduric number (after cleaning the milking machine): < 175
Coliform: < 20
Pseudomonas: < 500
Streptococcus uberis: < 200
total Staphy. count: < 200
Staphylococcus aureus: < 50
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15
Q

Additional tools in the diagnostic of intramammary infections

Bacteriological culture sampling

Sampling guide for microbiological culture sampling

A
  1. Clean hand or glove
  2. Cleaning and drying of the teat
  3. Predipping and towel cleaning
  4. Milking first 4-6 strings
  5. Cleaning the teat end with an alcohol impregnated towel
  6. keeping the tube in 45o one string is milked into the tube
  7. identification of the tube
  8. 4 C° max. 72 h, freezer (coliform !!)
  9. Cooling bag, lab transport

! Staph. aureus !: at the end of the milking !!!!

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16
Q

Additional tools in the diagnostic of intramammary infections

  1. PCR – Polimerase Chain Reaction
A

• Advantage: within 4 hours
• Multiplex PCR and ‘real-time’ PCR assays
o Not able to distinguish between dead and alive organisms

Culture result [Cases %] (Mild / Moder. / Severe)
Streptococcus uberis [18,2 %] (62,3 / 33,8 / 3,9)
Escherichia coli [15,5 %] (45,8 / 36,6 / 17,6)
Staphylococcus aureus [7,3 %] (64,5 / 30,6 / 4,8)
Streptococcus dysgalactiae [7,2 %] (63,9 / 34,4 / 1,6)
Non-aureus staphylococci [5 %] (64,3 / 26,2 / 9,5)
Corynebacterium bovis Y [3 %] (72 / 28. / 0)
Yeast [2 %] (58,8 / 23,5 / 17,6)
No growth [19,9 %] (65,5 / 29,2 / 5,4)

17
Q

Pharmacological therapy of mastitis

A

First step : Determination of severity of clinical mastitis ( mild / moderate / severe )
• Milk change only→Mild
• Abnormality in milk + udder parenchyma→Moderate
• Clinical mastitis + systemic involvement→Severe ( ++ coliform organisms assoc.)
o But also due to Streptococci, Arcanobacterium, pyogenes, yeasts…

18
Q

Pharmacological therapy of mastitis

Cases occuring in early lactation

A
  • The immunity of the cow is impaired
  • There are less circulating neutrophils, harder to get into the udder
  • Bacteria easier causing a septicaemia
19
Q

Pharmacological therapy of mastitis

Answer of the immune system /1

A
  • Release of immature neutrophils from bone marrow
  • Less effective phagocytosis
  • Extra-cellular release of ROS (Reactive Oxygen Species)
  • Much more tissue damage
  • Endotoxins are free in tissue to cause more inflammation
  • Maybe toxic shock
20
Q

Pharmacological therapy of mastitis

Answer of the immune system /2

A
Normal cow:
• Phagocytosis
• Internal killing by ROS
• Endotoxins protected
Peri-parturient cow
• No successful phagocytosis
• External killing by ROS
• Endotoxins are free in tissue

Because all of these in the periparturient period toxic mastitis is more common

MASTITIS ACUTA GRAVIS (= Acute Mastitis) →Mastitis phlegmonosa
→Mastitis necroticans →Mastitis gangrenosa

21
Q

Pharmacological therapy of mastitis

Antibiotic treatment

A

• First steps when choosing antibiotics:
o Lactating cow vs. Dry cow
o How many administrations ?
o Further medical therapy
o Initiation of treatment as early as EC change
• Empirical therapy
• Culture and Susceptibility Test ( CST )
o Identifies the infecting pathogens + provides specific data regarding drug efficacity
• Faster and more complete recurrence than self cure
• Decrease the chance of remission
• Decrease milk yield drop

22
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

A
  1. Sensitivity
  2. Bactericidal or bacteriostatic
  3. Withdrawal period
  4. Price

• The conus is partially inserted into the teat canal
• Close the end of the teat and massage up to the direction of the udder
• Post dip all four teats
• Record treatment
• Local treatment ( IMM )
• Parenteral treatment (IM)
• combination ( IMM + IM)
• “Aggressive” treatment: longer duration + higher dose
For parenteral treatment only those antibiotics, which reach sufficient concentration in the alveoli

23
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

If at day 4 still no progression towards cure :

A
  • Change antibiotic
  • Preferably on the basis of bacteriology and sensitivity
  • Never treat longer than 7 days
  • High likelihood of a yeast: check for it
  • Cull or dry off quarter
24
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

Effectiveness of treatment:

A
  • Bacteriological elimination → < 400,000 SSC ↓
  • Up to 4-6 weeks
  • No cure: subclinical mastitis (SCC remains high)
25
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

Clinical cure rate

A

It is normal for cured cows to still have clots at day 4 or 5

26
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

General guidelines:

A
  1. Antibiotic usage should involve veterinary guidance and extra label use should be avoided
    when on-label use is a possibility.
  2. Antibiotics should only be used when there is a reasonable likelihood that a bacterial infection that is sensitive to the proposed antibiotic is present.
  3. Narrow spectrum antibiotics that are less critical for treating human illnesses should be used as a first choice.
  4. Antibiotics should be used for as short a duration as possible.
27
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

General guidelines / Contagious Mastitis

A
Staphylococcus aureus ( 40-70 %) Streptococcus agalactiae ( 8-10 % ) 
Mycoplasma ( 5-12% ) 
Corynebacterium bovis ( 1-1.7 % ) 
Streptococcus dysgalactiae ( 1.6 %) Streptococcus uberis ( 1.4 % )
28
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

General guidelines / Environmental Mastitis

A

E.Coli ( 40 % )
Klebsiella
Arcanobacter

29
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

General guidelines / Opportunist Mastitis

A

Staphylococcus epidermis ( 1.3 % ) Staphylococcus simulans ( 1.0 % ) Staphylococcus chromogenes ( 0.7% )

30
Q

Pharmacological therapy of mastitis

Antibiotic treatment / How to choose antibiotics?

Bacteriostatic/Bactericidal

A
Bacteriostatic
    Tetracyclines
    Spectinomycin
    Clindamycin, Lincomycin 
    Aminoglycosides (↓ conc) 
    Trimethoprim- Sulfonamides 
    Macrolides
Bactericidal
    Penicillins and cephalosporins 
    Fluoroquinolones
    Rifampicin
    Aminoglycosides (↑ conc) 
    Cefalexin - Kanamycin synergy

Early lactating cow: always bactericidal

Narrow spectrum antibiotics that are less critical for treating human illnesses should be used as a first choice

31
Q

Pharmacological therapy of mastitis

Antibiotic treatment

Additional treatments

A

• More milking events, oxytocin
• Fluid therapy
• Anti-inflammatory drugs (meloxicam, metamizole, hydrocortisone)
• Glucose IV
• non-antibiotic treatment
➔ relative low number of scientific evidence Disinfectants
Bacterial culture