The 32 nd OEFFA A. J. LUFT, DVM

Transcription

1 The 32 nd OEFFA 2011 A. J. LUFT, DVM

2 MASTITIS 1. Introduction 2. Immunity/Defense a. Physical Barriers b. Innate (Internal) c. Acquired (Adaptive) 3. Milk Quality a. Cow Comfort b. Milking Routine c. Milking Machine 4. Surveillance/Detection a. BTSCC b. CMT c. Culture 5. Mastitis a. Contagious b. Environmental 6. Dry Cow Protocols 7. Treatments 8. References

3 INTRODUCTION Mastitis is a continuous challenge to the industry Mastitis causing organism aren t what they used to be because of antibiotic selection Cows aren t the same as before Mastitis is the single most common cause for antibiotic/antimicrobial use Mastitis is the top reason why cows are culled

4 DEFENSE MECHANISMS A. Physical Barriers IMMUNITY 1. First line of defense: skin, streak canal 2. The teat end is the most important piece of real estate on any dairy 3. Important factors in teat end health a. Vacuum levels b. Unit on-time c. Pulsation rest phase length d. Weather/Environment

5 DEFENSE MECHANISMS B. Innate or internal IMMUNITY 1. Represents the next line of defense once penetrate physical barriers 2. Always poised to respond immediately to any infection even if no previous encounter 3. Primary determinant of the outcome of IMI 4. Recognizes highly specific parts of pathogens like cell membranes, cell wall, lipopolysaccharides, etc.

6 DEFENSE MECHANISMS IMMUNITY B. Innate or internal 5. WBC s (macrophages & neutrophiles) + microbes => Reactive Oxygen Species ROS [Superoxide anions + H2O2] a. ROS is an effective biological method to remove invaders and is akin to biological bleach b. If left uncheck ROS will damage host cells, resulting in collateral injury to the gland c. ROS is neutralized by antioxidant enzymes called glutathione peroxidase & superoxide dismutase d. These enzymes require adequate levels of Se, Zn, Cu & Mn as well as vitamins E & C

7 DEFENSE MECHANISMS IMMUNITY C. Acquired or adaptive 1. Requires several days to generate effector cells called lymphocytes 2. Generated by life experiences and by biological vaccines

8 MILK QUALITY USA average SCC during 2009 was ~233,000 cells/ml, but from producers who test Organic Valley national average SCC for 2009 was Dependent on 3 key areas: cow environment, milking routine & milking equipment

9 MILK QUALITY A. Cow Comfort & Environment 1. Most important factor that relates to the performance of a dairy cow, regardless of facility type 2. Will not likely reach full potential if not comfortable or clean 3. A cow that is standing in her stall will circulate 50% less blood through her udder than a cow lying down 4. Direct relationship between the degree of bacterial contamination of the udder and teat surface and milk quality and udder health 5. Dirty udders are 1.5X more likely to be infected with a major pathogen 6. The most successful & cheapest means to achieve udder health remains the strict & consistent hygiene of housing and the mammary gland

10 MILK QUALITY B. Milking Procedure 1. Provide a clean, low stress environment Remove udder hair when necessary Always wear gloves & keep them clean throughout shift Consistency with reduced excitability 2. Check foremilk & udder for mastitis Strip on to black plate or cup or dark surface Forestripping creates higher flow rates & faster milk out

11 MILK QUALITY B. Milking Procedure 3. Udder washing or predipping Minimize all water usage & do not wet milk If must use wash water use clean, warm, disinfected wash water: Basic H vs. Bleach Predipping works best if cows are relatively clean; must cover 75-90% of teat or up to base of udder 2 oz. 35% H2O2 + 2 oz. glycerin in one gallon of distilled water or commercial ½ % iodine

12 MILK QUALITY B. Milking Procedure 4. Dry teats completely with an individual paper towel; increases friction to reduce liner slips 5. Attach units within 1-2 minutes after the start of stimulation; territorial vs. sequential 6. Adjust units as necessary for proper alignment a. Poor attachment = poor milk out & liner slips b. 70% of liner slips are inaudible c. Most liner slips happen near the end of milking

13 MILK QUALITY B. Milking Procedure 7. Ideal time of 5 minutes for milk out; avoid excessive machine stripping & over milking 8. Shut off vacuum before removing unit 9. Dip teats immediately after unit removal a. Single most effective practice to reduce new contagious infections b. Dipping preferred over spraying c. Empty & clean dip containers daily d. If < 10 F dip but dry off after 30 seconds; avoid dry dipping 10. Check milk filters regularly to monitor situation

14 MILK QUALITY C. Milking Machine 1. Improperly functioning machine does present an increased mastitis risk 2. Outdated equipment often leads to more mastitis & lower milk production 3. Change inflations per manufacturer s recommendations: if you see a change after new inflations then you waited too long 4. Use properly sized milking equipment

15 MILK QUALITY C. Milking Machine Best guide to determine the adequacy of the milking machine is to watch the cows 1. Teat end condition 2. Liner slip frequency 3. Nervous stepping or unit kick off 4. Completeness of milk out 5. Unit on-time per cow

16 SURVEILLANCE/DETECTION CAN T IMPROVE ON WHAT YOU DON T MEASURE 3 WAYS TO ROUTINELY MONITOR & DETECT ABNORMAL MILK 1. BTSCC 2. CMT 3. Culturing

17 SURVEILLANCE/DETECTION A. Bulk Tank Somatic Cell Count (BTSCC) Cells = WBC s primarily macrophages & neutrophiles Determines milk quality & troubleshoot herds with mastitis issues Normal subclinical milk = SCC <200,000 Abnormal milk = SCC >200, Subclinical until reaches >500, Inflammatory response has been elicited and is infected 3. High levels reduces cow productivity, cheese quality & yield, palatability and shelf life

18 SURVEILLANCE/DETECTION A. BTSCC Benefits 1. Provides a logical approach for troubleshooting herds with multiple milk quality and mastitis issues 2. Less expensive than quarter milk sampling the whole herd 3. Can be done in ~96 hours 4. An important tool for total herd health management 5. Documentary evidence of milk quality

19 SURVEILLANCE/DETECTION A. BTSCC Limitations 1. No information about individual cows 2. Cannot be frozen and must be shipped on icepack 3. Must be processed within 36 hours of collection 4. Information on herd management practices are required to interpret analysis

20 SURVEILLANCE/DETECTION BTSCC goals: CRITERIA BTSCC Herd average (actual) Herd average (Linear Score) IDEAL UDDER HEALTH TARGETS <250,000 cells/ml <200,000 cells/ml <3.0 LS 100% of first calf heifers <100,000 cells/ml >85% of herd <200,000 cells/ml >95% of herd <500,000 cells/ml

21 SURVEILLANCE/DETECTION BTSCC: BTSCC/ml % Quarters Infected % Production Loss 200, , ,000, ,500,

22 SURVEILLANCE/DETECTION B. California Mastitis Test {CMT} Quick, easy, cow-side test but low sensitivity Necessary when need to identify individual problem quarters or cows Measure of the inflammation within a quarter Use the first stream or two of milk Do not mix or read test in >10 seconds Trace level or higher = infection False positive = colostrum, injury, fluctuating vacuum, estrus, mycotoxins, systemic disease, stress

23 SURVEILLANCE/DETECTION B. CMT: N = Negative 0 200K SCC Normal milk but possible infection T = Trace K SCC 1 = Weak Positive 400K -1.2M SCC 2 = Distinct Positive 1.2M -5.0M SCC Slight thickening, disappears w/ continuous rotation, subclinical Distinct thickening but no gel, subclinical Immediate thickening w/ slight gelling, clinical 3 = Strong Positive >5.0M SCC Gel formation, clinical

24 SURVEILLANCE/DETECTION C. Culturing Milk sample collection 1. Flip top containers only 2. Collect sample prior to milk out 3. Strip a few streams of milk 4. Dip with predip and wait 30 seconds and wipe off 5. Wipe with alcohol pad 6. Prep & clean far side teats first & sample near side first 7. Immediately plunge sample into ice bath to chill 8. Freeze sample to better recover pathogens from WBC s

25 MASTITIS Problem solving a mastitis problem A. 300, ,000 cells/ml BTSCC 1. Clean pulsators & vacuum controllers 2. Check milking procedures 3. Check teat dipping procedures 4. Review dry cow program B. > 750,000 cells/ml BTSCC 1. Follow same as above 2. Use the CMT to ID problem cows

26 MASTITIS Etiology 1. Mechanical: wounds, injury, milking machine, chemical, weather, disease 2. Environmental: contaminants, (myco-)toxins 3. Physiological: depressed immunity, nutritional deficiency, water issues, other stressors Types 1. Contagious 2. Environmental

27 MASTITIS 1. Contagious Major pathogens: Staphylococcus aureus (SA), Streptococcus agalactiae, & Mycoplasma sp. Management factors important in transmission of contagious pathogens including the milking machine, milking procedures, milker s hands, teat washing materials & treatment protocols Chronic, high SCC s, usually subclinical milk SA is the most difficult to eradicate

28 MASTITIS Staphylococcus aureus (SA) 1. 43% of all dairy operations have cultured positive for SA 2. Ubiquitous organism found everywhere around the barnyard, humans & cattle; therefore can reappear at anytime and must be monitored routinely 3. Well adapted to survive on the host surface such as teat skin & streak canal, as well as within the host mammary gland 4. Produces more damage to tissue than other pathogens by developing deep, sequestered abscesses with heavy scar tissue = poor cure rate 5. Infected glands are the main source of spread

29 MASTITIS Staphylococcus aureus: 6. Cross infection by intraunit transmission may account for up to 40% of new infections Newer units avoid intraunit transmission 7. Implicated in intramammary infections in calves & yearlings by contaminated bedding, waste milk, cross suckling & flies 8. Occationally turns into gangrenous mastitis

30 MASTITIS SA: Treat or not to treat 1. Must palpate udder immediately after milking for knots or masses within the udder interior 2. Check for enlarged mammary LN s 3. Older animals in late lactation with chronicity and lumps/bumps have poor cure rates 4. Requires extended therapies

31 MASTITIS Staph. aureus Control 1. Dry, clean teats 2. Properly sized & functioning equipment 3. Backflushing = minimal effect 4. Postdipping = single most effective practice to reduce new infections 5. ID infected quarters & cows and milk last 6. Dry cow therapy 7. Cull chronically infected older cows 8. Vaccination/Nosodes 9. Establish active milk quality program with vet

32 MASTITIS 2. Environmental Streptococcus sp, Staphylococcus sp & Coliforms Primary reservoir is the environment not the gland resulting in vastly different dynamics of infection Acute, clinical & sometimes toxic mastitis

33 MASTITIS Environmental Streptococcus 1. S. uberis, S. dysgalactiae, & other Strep. Sp 2. Most susceptible 2 weeks prior to calving until 2 weeks after calving and for the first 2 weeks after dry off 3. 59% last < 30 days duration with 39% spontaneously recovering 4. Clotty, flaky milk with little or moderate swelling & seldom systemic or toxic 5. Antimicrobials have minimal effect 6. Dry cow therapy can be effective

34 MASTITIS Coliforms 1. E. coli, Klebsiella, and others 2. Dry > lactation; summer > winter 3. Very short duration of infection < 20 days; spontaneous cure rate of 50% % result in clinical mastitis with 8-10% turn into peracute, toxic mastitis 5. Peracute infections associated with a stressor & more likely a function of the cow & not a particular hot strain 6. Once clinical mastitis appears the cow s innate immune system has killed most of the pathogens and releases endotoxins, which causes all the inflammation of the gland; not reliably cultured because of host inflammatory response 7. Antimicrobials are of little value and may even exasperate reaction

35 MASTITIS Environmental Mastitis - Control 1. Predipping: reduces environmental mastitis by 50% 2. Dry cow therapy is effective for Streps but not coliforms 3. Environmental management: clean, dry, well ventilated; inorganic bedding vs. organic bedding 4. Proper milking procedures & milking machine function 5. Nutrition: vitamin E & Se 6. Encourage teat sphincter closure 7. Immunization/Nosodes

36 TREATMENT PROTOCOLS Holistic Medicine 1. The patient as a whole + the ecosystem in which it lives 2. Focus on removal or reduction of predisposing factors (stressors): management (proactive) rather than treatment (reactive) 3. Stimulate as many systems of the body with a multi-pronged approach 4. Always correct any high fever, dehydration or impaired circulation before any treatment success can begin 5. All medicines work best if started early before chronic or permanent changes can take hold 6. A producer must not withhold conventional medicine to preserve organic status if determined to be beneficial

37 TREATMENT PROTOCOLS STRESS 1. 3 catagories a. Environmental: faulty nutrition, bad water, lack of sanitation, poor designed or maintained equipment, unsuitable habitat, etc b. Physiological: production & reproduction c. Psychological: weaning, peeking order, treatments 2. All animals vary in their ability to accommodate stress: older animals < than younger & is cumulative 3. Vitality: many levels of health and just because there are no visible symptoms of disease does not mean profitable and healthy animals

38 TREATMENT PROTOCOLS All treatments may be lawful, but not all treatments are beneficial to the patient Just because you can, doesn t mean you should Clinical cure: Abnormal to normal appearance + other normal signs (decreased swelling, increased yield & increased appetite) Bacteriological cure: Negative milk culture days after treatment

39 TREATMENT PROTOCOLS VCPR = Veterinary Client - Patient Relationship The veterinarian has assumed responsibility for making clinical judgements regarding the health of the animal(s) and the client has agreed to follow the veterinarians instructions The veterinarian has sufficient knowledge of the animal(s) in question. Must have visited the premises within the last year and personally acquainted with the history and records of the farm The veterinarian has agreed to be readily available for all situations

40 TREATMENT PROTOCOLS A. Immune modulators/stimulators: aloe vera, Immunoboost, whey & serum antibodies B. Antioxidants: vitamin E & C, trace minerals (Cu, Zn, Mn & Se), tinctures & botanicals C. Probiotics: ¾ of the bodies immune system lies in the GI tract D. Antimicrobials: herbal tinctures, botanicals, E.O. & antibiotics E. Homeopathy F. Others: Aspirin, Flunix, etc

41 TREATMENT PROTOCOLS Mild swelling with abnormal milk 1. Aloe vera: 10 oz liquid or 8 oz pellets BID, 3 days 2. Whey: cc SQ SID, 3 days 3. Dietary antioxidant (Nutri-Vit) or Vitamin C: 30-60cc SQ or IM BID, 3 days 4. Liniment of E.O. BID+, 3 days 5. Strip when possible

42 TREATMENT PROTOCOLS Acute/Toxic: Fever, hot-hard-watery quarter, offfeed, depressed, +/- dehydration 1. Correct fever, dehydration & circulation first 2. IV: ½ dextrose + ½ to 1 CMPK W/ 250 Vitamin C + 1 bottle Whey(Impro or Biocel) + 5cc MultiMin + 30cc Tri-Support tincture 3. IV 2-3 bottles of hypertonic saline + 10 gallons of oral water 4. Homeopathy: Phytolacca, Bryonia, Apis mel, Aconite, Nosodes, etc 5. Liniment of E.O. & strip q2-4hours

43 TREATMENT PROTOCOLS High, chronic SCC 1. Culture milk and ID pathogen oz aloe pellets + 2oz kelp + 2oz Nutri-Vit + humates blend together with small amount of grain and topdress daily for up to 30 days 3. For Staph & Strep use Impro Environ 1 formula at 30cc SQ daily on day (+/ ) Repeat 3 day flush-out every 10 days if nessesary 4. If clinical increase aloe pellets to 8oz BID + 2oz kelp & Nutri-Vit, 3-5cc Tri-Support BID in vulva, 3cc antioxidant tincture BID in vulva (all for 3 days then start steps 2 &3) 5. Repeat milk culture 10 days after last flush-out

44 DRY COW MANAGEMENT If the system isn t broke, don t fix it Only treat high SCC or clinical quarters Use high SCC protocol for 3-5 days then quite milking and treating for 7 days: required for endocrine system to shut down lactation After 7 days rest, strip out quarter(s) and if clinical use acute cow protocol and premilk until clear or calving If unresolved after 2 attempts then pre-milk until freshening and treat accordingly or cull after calving

45 REFERENCES National Mastitis Council Alternative Treatments for Ruminant Animals by Paul Dettloff, DVM CROPP Technical Bulletin, Natural Mastitis Treatments, by Paul Dettloff, DVM Milking Routine, The Key to a Dairy s Profitability, by Andrew P. Johnson, DVM Building a Holistic Foundation for Animal Health, by Richard J. Holliday, DVM