How has mastitis changed over the years? - Steve Williams – Sales ...

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How has mastitis changed over the years? - Steve Williams – Sales ...

ABCDHow has mastitis changed over the years?Steve Williams MBA


SummaryABCD• Mastitis; a changing disease• Where do we want to go?• How do we get there?


A changing diseaseABCDMean Incidence of mastitis (cases/100 cows/yr) 1 :Last Decade Recent survey (2007)17 – 43 47-65Somatic cell counts 2,3BMSCC700600500400300200100Equates to approximately20% of the national herd‘infected’01971 1976 1981 1986 1991 1996 2001 2003 2004 20052007 yearly Av 2008 yearly Av195,000 /ml 197,000 /ml


Proportion of Clinical MastitisClinical MastitisABCD increasing incidence of environmental mastitis decreasing incidence of contagious mastitisS.uberis (32%)E.coli (26.9%)CNSS. aureusothermixed1.00.90.80.70.60.50.40.30.20.10.0corynebacterium sppS. dysgalactiae1967 1982 2005ContagiousEnvironmental% bacterial spp cultured from clinical mastitis cases


Cases / 100 cowsOrigin of Clinical mastitisLactation DistributionABCD18161412Dry Period Origin IMILactation Origin IMI10864201 2 3 4 5 6 7 8 9Month of Lactation


Subclinical Mastitis% bacterial spp cultured from subclinical mastitis casesABCDS. uberisE. coliCNSS. aureusothermixedcorynebacterium sppS. dysgalactiae


Our changes.. Over the yearsABCDManagement;• 5 point plan• Mastitis awareness and education• Health planning and monitoring• Milk recordingDiagnosis;• Bacteriology and laboratory services• PCR• SCC monitoringIn Europe, the EEC directive 92/46 in April 1992 stated thatmilk with a somatic cell count (SCC) over 400 000 cells permL may not be used forfluid milk and starting in 1998 not even for humanconsumption 4


Cow changesABCD• Genetics• Milk yield• Metabolic challengePathogen changes• Behaviour – S. uberis environmental and contagious• Pathogenicity• Minor vs major pathogens


Where are we now?ABCD• Incidence ratesClinical:> 50 cases / 100 cows / yearAverage Mean Median47 – 65 % 71 41Subclinical:45% herd testdays above200,000 cells/mL


Where are we now? 2ABCD• % recordings (NMR , or Others) (50%)?• Udder health programssignificant increase in the last 10 years world wide 3Monitoring tools to identify areas of risk in the herd; Totalvet, Herd companion etc• New initiativesDairy Co Mastitis control Plan• Future work, projects and research


Where do we hope to be?ABCD• Always pushing the targets down even if theyare reached• Continue to improve management andmonitoring• Continue to highlight the importance of cowwelfare associated with mastitis• Earlier detection and treatment


Latest thoughts and research; a changingfutureABCD• Minor pathogens may have a protective role toplay.. Is there a safe zone?• Low cell count cows are at higher risk of E. colimastitis (Erskine ‘88, Miltenburg ‘96)If ICSCC is a risk factor the answer is not to encourage high cell countsFind ways to improve immune status or lower challenge for susceptiblecows• Addition of long acting NSAIDs improvetreatment outcomes when using antibiotics(McDougall et al 2009, JDS)


MastitisABCD• Infection• Inflammation• Whole cow disease.. Far reaching• Welfare.• Quarter and cow somatic cell counts directly representthe inflammatory status of the mammary gland. 4


Mastitis means….. INFLAMMATION!ABCDIncreased concentrations of cytokines, chemokines,prostaglandins and hence (SCC)Effects on udder healthPainPyrexiaReduced feed intakeReduced milk production


Role of long acting NSAIDs in mastitisABCD• NSAIDs Reduce PG concentrations & hencereduce:• Inflammatory response• SCC recruitment• Pain• Pyrexia• CL function


Why Metacam? NSAIDs vary in:ABCD• Specificity of inhibition of COX-1 and COX-2• Non-selective: asprin, indomethacin &phenylbutazone• Selective: meloxicam, carprofen, nimesulide& celecoxib• Highly selective: valdecoxib, rofecoxib,lumaricoxib & etoricoxib• Duration of action• Site of action (locally vs. centrally)• Action among species in T ½ and COX-1:COX-2Therefore this study is only relevant to Metacam


Previous data..ABCD• Impacts of mastitis on:PAINRUMENMOTILITYMILKPRODUCTIONCULL RATES


Previous data..2ABCD• So far no definitive field data providing NSAIDs benefits formastitis therapy in terms of:- SCC- Production- CullingOnly beneficial effects …In field casesClinical resolution Shipgel et al 1994,1996Experimental infectionsClincial resolution Vangroenwegehe et al 2005; Friton et al2002Milk yield Friton and Banting 2005Rumen motility Banting 2002


SCC Escalator…. HypothesisABCD• SCC are continuing to rise.• Of most high cell count cows these start and persist inthe 200 – 500,000 cells/ml group…..- These are the undected potential ‘problem’ cows.• Using Metacam in mild farmer diagnosed clinical casescan slow the escalator by reducing inflammation andSCC


The Escalator…….ABCD


The StudyABCD• Metacam; Most preferential COX 2 inhibitor in cattle.• Mamyzin; Routine mastitis tx in NZ• OBJECTIVE:To assess the effect of Metacam in conjunction withMamyzin onMilk ProductionSCCClinical outcomesCull ratesCompared to antimicrobial therapy alone


ProtocolABCD• 15 NZ spring calving herds (11,163 cows) 2007• Prospective, triple blind, negative controlled intervention study


SCC and Bacteriology: prior to tx, day 7,14,21Milk yield: daily across lactationCull: enrolment to 10 monthsABCDMild → Moderate cases /No systemic signsIntervention groupControl groupMetacam + Mamyzin 5g-5g-5gPlacebo + Mamyzin 5g-5g-5g361 cows 366 cows453 quarters 451 quarters


OutcomesABCD• Milk Yield not reduced by Metacam• SCC Significantly reduced• Cull rates reduced


Milk yield (L/cow/d)No reduction in milk yield Metacam vs Control. Drop ABCDinmilk yield around 30% in 7 days prior to mastitisdiagnosis27252321191715-7 -5 -3 -1 1 3 5 7 9 11 13 15 17 19 21(Dx > day 6 of lactation)Day relative to diagnosis of mastitis


Geometric mean SCC (x1000; SEM)SCC reduced significantly at each timepoint 7,14,21 daysABCD1,6001,4001,200MeloxicamControl1,00080060040020007 14 21Days after treatment550 (48) vs. 711 (62) geometric mean (SE) (x 1000) SCC/ml meloxicam vs. placebo,respectively; p


Cumulative % of cows removedABCDCull rates reduced 11.8% / 28.2% = 42%Fewer meloxicam than control cows removed for failing toconceive302520MeloxicamControl1510501 4 7 10 13 16 19 22 25 28 31 34 37 40 43Weeks after enrolment(39/237 (16.0%) vs. 67/237 (28.0%) for meloxicam vs. control cows,OR=0.42 (95% CI 0.26-0.68), p


Partial budget showed?ABCDEconomic Return: £58 per cow treated.


Conclusions by authorABCD• Treatment of farmer diagnosedclinical mastitis with Metacam inconjunction with Mamyzin resulted ina lower SCC and lower likelihood ofculling than for control cows.Metacam treatment did not alter therisk of clinical treatment failure orreduce milk losses caused bymastitis over 28 or 200 d aftertreatment


Why did we see these results?ABCD• SCC declined due to reduced prostaglandinconcentrations hence reduced chemotaxis• Reduced culling partly due to reduced risk ofbeing ‘non pregnant’Mastitis associated with:• Longer interval from calving to conception,more services per conception (Barker et al 1998)• Lower conception rates (Santos et al 2004)• Higher risk of embryo loss (Chebel et al 2004;McDougall et al 2005)• Increased PGF 2 concentrations (Hockett et al2005)


Specific points of interestABCD• Addition of Metacam to mild/moderate cases ofmastitis reduces SCCNovel finding (not altered by carprofen orflunixin in previous studies)• Reduced risk of cullingDirect / Indirect effect of long acting NSAIDEffect on DMI and cow health / udder helath


MetacamABCD• The long acting anti-inflammatory• Metacam use in everyday mastitisimproves longevity of the cow in the herd• No negative impacts on milk yield /retreatment rates• Benefits only demonstrated usingMetacam in conjunction with Mamyzin• Metacam use in mastitis improves welfare


References & AcknowledgementsABCD1. Bradley A.J et al (2007) Survey of the incidence and aetiology ofmastitis on dairy farms in England and Wales. Vet Rec. 160 253-2562. Dairy Co Datum website3. Bradley, A. J (2009) Mastitis Masterclass, Boehringer4. Schukken et al (2003) Monitoring udder health and milk qualityusing somatic cell counts. Vet. Res. 34 (2003) 579–596Dr Andrew Bradley MRCVSMark Bryan MRCVSLaura Randall MRCVS

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