P.L. Ruegg

The selective treatment of clinical mastitis based on on-farm culture results: I. Effects on antibiotic use, milk withholding time, and short-term clinical and bacteriological outcomes.

The objective of this multi-state, multi-herd clinical trial was to evaluate the efficacy of using an on-farm culture system to guide strategic treatment decisions in cows with clinical mastitis. The study was conducted in 8 commercial dairy farms ranging in size from 144 to 1,795 cows from Minnesota, Wisconsin, and Ontario, Canada. A total of 422 cows affected with mild or moderate clinical mastitis in 449 quarters were randomly assigned to either (1) a positive-control treatment program or (2) an on-farm, culture-based treatment program. Quarter cases assigned to the positive-control group received immediate on-label intramammary treatment with cephapirin sodium. Quarters assigned to the culture-based treatment program were cultured on-farm and treated with cephapirin sodium after 18 to 24h of incubation if they had gram-positive growth or a mixed infection. Quarters with gram-negative or no growth did not receive intramammary therapy. The proportion of quarter cases assigned to positive-control and culture-based treatments that received intramammary antibiotic therapy because of study assignment was 100 and 44%, respectively; the proportion of cases that received secondary antibiotic therapy was 36 and 19%, respectively; and the proportion of cases that received intramammary antibiotic therapy because of study assignment or secondary therapy was 100 and 51%, respectively. A tendency existed for a decrease in the number of days in which milk was discarded from cows assigned to the culture-based treatment program versus cows assigned to the positive-control group (5.9 vs. 5.2 d). No statistically significant differences existed between cases assigned to the positive-control and cases assigned to the culture-based treatment program in days to clinical cure (2.7 vs. 3.2 d), bacteriological cure risk within 21 d of enrollment (71 vs. 60%), new intramammary infection risk within 21 d of enrollment (50 vs. 50%), and treatment failure risk (presence of infection, secondary treatment, clinical mastitis recurrence, or removal from herd within 21 d after enrollment; 81 vs. 78%). In summary, the use of an on-farm culture system to guide the strategic treatment of clinical mastitis reduced intramammary antibiotic use by half and tended to decrease milk withholding time by 1 d, without significant differences in days to clinical cure, bacteriological cure risk, new intramammary infection risk, and treatment failure risk within 21 d after the clinical mastitis event.

Investigation of mastitis problems on farms

The production of high-quality milk is a high-priority issue for dairy farmers and milk processors. The investigation of mastitis problems on dairy farms is an area of increasing demand and is an ideal way for veterinary practitioners to increase involvement in production medicine programs. Goals for the amount of clinical and subclinical mastitis should be predefined on dairy farms, and a herd investigation initiated when needed. The use of a structured approach to mastitis problems can identify risk factors for infection, result in rapid resolution of mastitis problems, and hasten the application of appropriate preventive practices.

Risk factors associated with short-term post-treatment outcomes of clinical mastitis

The objectives of this study were to characterize 60-d outcomes after treatment of mild (abnormal milk) and moderate (abnormal milk and abnormal udder) cases of clinical mastitis (CM) occurring in a single quarter of cows on Wisconsin farms (n=4) and to determine risk factors associated with those outcomes. Duplicate milk samples were collected from the affected quarter of each cow for microbiological analysis at the onset of CM (PRE) and 21 d later (POST). Cows were treated only in the affected quarter using an intramammary product containing 125 mg of ceftiofur. Bacteriological cure was defined as absence of pathogens in the POST sample obtained from the enrolled quarter. Recurrence was defined for the cow when CM occurred after the milk-withholding period for the enrolled case of CM. Retention in the herd was defined when a cow was retained within the herd for the 60-d follow-up period. Somatic cell count reduction (SCCR) was defined at the cow level as somatic cell count (SCC) below 200,000 cells/mL at the Dairy Herd Improvement Association test day occurring between 21 to 55 d post-treatment. The effects of farm, days in milk, parity, severity, microbiological diagnosis at PRE, previous milk yield, previous SCC, previous occurrence of CM and treatment duration on selected post-treatment outcomes were assessed using Chi-squared analysis and logistic regression. Microbiological results at PRE were distributed as: Escherichia coli (n=14), Klebsiella spp. (n=11), Enterobacter spp. (n=8), Serratia spp. (n=7), other gram-negative species (n=3), Streptococcus spp. (n=25), coagulase-negative staphylococci (n=4); Staphylococcus aureus (n=1); Streptococcus agalactiae (n=1), other gram-positive species (n=9), and culture negative (n=60). Treated quarters were more likely to experience bacteriological cure when the cow experienced CM for the first time in the lactation and when no pathogen was recovered from PRE milk samples obtained from the enrolled quarter. Parity and bacteriological cure were associated with the probability of recurrence. Greater milk yield at previous Dairy Herd Improvement test was the most important predictor for retention within the herd. When SCC before CM was >200,000 cells/mL the probability of having SCCR after treatment was decreased. When the case experienced bacteriological cure, the cow was less likely to experience recurrent cases and was more likely to have SCCR below 200,000 cells/mL. Post-treatment outcomes, such as recurrence and SCCR, are strongly associated with bacteriological cure and, when monitored, can be used to help determine if a treatment has been successful. Information about the etiology of CM, history of clinical and subclinical mastitis, and parity are useful to review when making strategic treatment decisions.

Characterization of clinical mastitis occurring in cows on 50 large dairy herds in Wisconsin

In recent years, the US dairy industry has experienced significant demographic changes, with an increase in the number of large herds. The objectives of the present study were to characterize clinical mastitis occurring in cows on large dairy herds in Wisconsin. Participating herds (n=50) were required to have a minimum of 200 lactating animals, participate in monthly DHI testing (including monthly individual cow somatic cell count), use computerized herd records, use a milking routine that included fore-stripping quarters for detection of mastitis, and use antimicrobials to treat affected cows. After study personnel visited the farm, each herd was instructed to enroll the next 17 cows that experienced clinical mastitis, regardless of severity. At detection of clinical mastitis and 14 to 21 d after treatment ended, duplicate quarter milk samples were collected from all affected quarters and used for microbiological analysis. Treatments of affected cows were performed according to existing individual farm protocols. Cow level follow-up data was collected for 90 d after enrollment. Microbiological diagnoses at enrollment included gram-negative (35.6%), no growth (27.3%), gram-positive (27.5%), and other (9.6%). Of the 741 cases, the most prevalent pathogens were Escherichia coli (22.5%), followed by environmental streptococci (12.8%), Klebsiella spp. (6.9%), and coagulase-negative staphylococci (6.1%). Bacteriological cure was 75.0% for cases caused by gram-negative pathogens (n=136), 50.8% for cases caused by gram-positive pathogens (n=128), 47.5% for cases caused by other pathogens (n=40), and 73.2% for cases which did not result in microbial growth (n=123). Of the 583 cases with severity recorded, the distribution of mild, moderate, and severe symptoms was 47.8, 36.9, and 15.3%, respectively. The majority of cases presenting with severe symptoms were caused by gram-negative pathogens. Treatment cure was greater for gram-negative pathogens and cases for which no pathogens were recovered as compared with cases caused by other etiologies. Cows experiencing severe cases were more likely to receive multiple antimicrobial treatments.

Evaluation of herd sampling for Salmonella isolation on midwest and northeast US dairy farms

Epidemiologic investigations of Salmonella infections in dairy cattle often rely on testing fecal samples from individual animals or samples from other farm sources to determine herd infection status. The objectives of this project were to evaluate the effect of sampling frequency on Salmonella isolation and to compare Salmonella isolation and serogroup classification among sample sources on 12 US dairy farms sampled weekly for 7-8 weeks. Three herds per state were enrolled from Michigan, Minnesota, New York and Wisconsin based upon predefined herd-size criteria. Weekly samples were obtained from cattle, bulk tank milk, milk filters, water and feed sources and environmental sites. Samples were submitted to a central laboratory for isolation of Salmonella using standard laboratory procedures. The herd average number of cattle fecal samples collected ranged from 26 to 58 per week. Salmonella was isolated from 9.3% of 4049 fecal samples collected from cattle and 12.9% of 811 samples from other sources. Serogroup C1 was found in more than half of the samples and multiple serogroups were identified among isolates from the same samples and farms. The percentage of herd visits with at least one Salmonella isolate from cattle fecal samples increased with overall herd prevalence of fecal shedding. Only the three herds with an average fecal shedding prevalence of more than 15% had over 85% of weekly visits with at least one positive fecal sample. The prevalence of fecal shedding from different groups of cattle varied widely among herds showing that herds with infected cattle may be classified incorrectly if only one age group is tested. Testing environmental sample sources was more efficient for identifying infected premises than using individual cattle fecal samples.

Somatic cell count status across the dry period as a risk factor for the development of clinical mastitis in the subsequent lactation

The objective of this study was to determine the risk of clinical mastitis in the first 120 d in lactation based on previous somatic cell count (SCC) history in a herd with a very low prevalence of contagious pathogens. A total of 218 cows from a university herd were enrolled at dry-off. Duplicate quarter milk samples were collected from all quarters at dry-off, postcalving (2 to 9 d in milk), and before treatment of all first cases of clinical mastitis that occurred during the first 120 d of the subsequent lactation. Quarter SCC statuses across the dry period were defined based on comparison of quarter SCC between the date of dry-off and the postcalving sampling periods. The relationship between the probability of developing clinical mastitis in the first 120 d of lactation and SCC status across the dry period and other explanatory variables was assessed using logistic regression. In the first 120 d postcalving, 68 first cases of clinical mastitis occurred in 47 cows. Of quarters that experienced a microbiologically positive clinical case, the same microorganism was never isolated from milk samples obtained at dry-off or consistently isolated from milk samples collected at all sampling periods. Coagulase negative staphylococci were the most prevalent pathogens isolated from subclinical intramammary infection, whereas gram-negative pathogens were the most common pathogen associated with clinical cases. Quarters that had at least 1 case of mastitis during the previous lactation were 4.2 times more likely to have a first case of clinical mastitis in the current lactation than quarters that did not have clinical mastitis in the previous lactation [odds ratio (OR) = 4.2 (1.8, 10.0)]. Quarters of cows of greater than fourth parity were 4.2 times more likely to have a first case of clinical mastitis than quarters of cows of second parity [OR = 4.2 (1.4, 10.0)]. Quarters with SCC > or =200,000 cells/mL at dry-off and postcalving were 2.7 times more likely to experience a first case of mastitis than quarters with SCC <200,000 cells/mL at both periods [OR = 2.7 (0.97, 7.67)].

Dynamics of somatic cell counts and intramammary infections across the dry period

The objectives of this research were to study the relationship between somatic cell count (SCC) and intramammary infection (IMI) across the dry period and the risk of subclinical mastitis at the first dairy herd improvement (DHI) test of the subsequent lactation. A secondary objective was to determine SCC test characteristics for diagnosis of IMI at both the cow and quarter levels. A total of 218 cows from a university herd were enrolled at dry-off. Duplicate quarter milk samples were collected from all quarters at dry-off, calving and on the day of the first DHI test. Somatic cell count status across the dry period was defined based on the comparison of quarter SCC from dry-off and the post-calving sampling periods and comparison of composite SCC from DHI samples from the last test and first test of the following lactation. Of new IMI detected from post-calving milk samples (n=45), 46.7, 26.7 and 11% were caused by CNS, Streptococci and Gram-negative bacteria, respectively. Of cured IMI at post-calving (n=91), 61.5, 23.1 and 9.9% had CNS, Streptococci and Coryneforms isolated from dry-off milk samples. The most frequent microorganisms related to cured IMI were CNS (33%). Of chronically infected quarters across the dry period (n=10), only one had the same species of pathogen isolated from dry-off and post-calving samples. The sensitivity of a SCC threshold of 200,000 cells/mL for detection of subclinical IMI was 0.64, 0.69 and 0.65 for milk samples obtained at dry-off, post-calving and first DHI test, respectively. The specificity was 0.66, 0.84 and 0.93 for milk samples obtained at dry-off, post-calving and first DHI test, respectively. Quarters with SCC> or =200,000 cells/mL at both dry-off and post-calving sampling periods were 20.4 times more likely to be subclinically infected by a major pathogen (rather than being uninfected) and 5.6 times more likely to be subclinically infected by a minor pathogen (rather than being uninfected) at the first DHI test than quarters with SCC<200,000 cells/mL at both periods. Cows with SCC greater than 200,000 cells/mL at both the last and the first DHI test between lactations produced 9.1 kg less milk on the first DHI test day than the average milk production of cows with SCC less than 200,000 cells/mL at both periods.

The selective treatment of clinical mastitis based on on-farm culture results: II. Effects on lactation performance, including clinical mastitis recurrence, somatic cell count, milk production, and cow survival

The objective of this multi-state, multi-herd clinical trial was to report on the efficacy of using an on-farm culture system to guide strategic treatment decisions in cows with clinical mastitis. The study was conducted in 8 commercial dairy farms ranging in size from 144 to 1,795 cows from Minnesota, Wisconsin, and Ontario, Canada. A total of 422 cows affected with mild or moderate clinical mastitis in 449 quarters were randomly assigned to either (1) a positive-control treatment program or (2) an on-farm culture-based treatment program. Quarter cases assigned to the positive-control group received immediate on-label intramammary treatment with cephapirin sodium. Quarters assigned to the culture-based treatment program were not treated until the results of on-farm culture were determined after 18 to 24h of incubation. Quarters in the culture-based treatment program that had gram-positive growth or a mixed infection were treated according to label instruction using intramammary cephapirin sodium. Quarters assigned to the culture-based treatment program that had gram-negative or no-growth did not receive intramammary therapy. It was already reported in a companion paper that the selective treatment of clinical mastitis based on on-farm culture results decreases antibiotic use by half and tends to decrease milk withholding time without affecting short-term clinical and bacteriological outcomes. The present article reports on long-term outcomes of the aforementioned study. No statistically significant differences existed between cases assigned to the positive-control program and cases assigned to the culture-based treatment program in risk and days for recurrence of clinical mastitis in the same quarter (35% and 78 d vs. 43% and 82 d), linear somatic cell count (4.2 vs. 4.4), daily milk production (30.0 vs. 30.7 kg), and risk and days for culling or death events (28% and 160 d vs. 32% and 137 d) for the rest of the lactation after enrollment of the clinical mastitis case. In summary, the selective treatment of clinical mastitis based on on-farm culture resulted in no differences in long-term outcomes, such as recurrence of clinical mastitis in the same quarter, somatic cell count, milk production, and cow survival for the rest of the lactation after clinical mastitis.

Decision tree analysis of treatment strategies for mild and moderate cases of clinical mastitis occurring in early lactation

The objective of this study was to develop a decision tree to evaluate the economic impact of different durations of intramammary treatment for the first case of mild or moderate clinical mastitis (CM) occurring in early lactation with various scenarios of pathogen distributions and use of on-farm culture. The tree included 2 decision and 3 probability events. The first decision evaluated use of on-farm culture (OFC; 2 programs using OFC and 1 not using OFC) and the second decision evaluated treatment strategies (no intramammary antimicrobials or antimicrobials administered for 2, 5, or 8 d). The tree included probabilities for the distribution of etiologies (gram-positive, gram-negative, or no growth), bacteriological cure, and recurrence. The economic consequences of mastitis included costs of diagnosis and initial treatment, additional treatments, labor, discarded milk, milk production losses due to clinical and subclinical mastitis, culling, and transmission of infection to other cows (only for CM caused by Staphylococcus aureus). Pathogen-specific estimates for bacteriological cure and milk losses were used. The economically optimal path for several scenarios was determined by comparison of expected monetary values. For most scenarios, the optimal economic strategy was to treat CM caused by gram-positive pathogens for 2 d and to avoid antimicrobials for CM cases caused by gram-negative pathogens or when no pathogen was recovered. Use of extended intramammary antimicrobial therapy (5 or 8 d) resulted in the least expected monetary values.

Assessment of herd management on organic and conventional dairy farms in the United States.

The objective of this study was to evaluate management characteristics on organic and similarly sized conventional dairy farms located in New York, Wisconsin, and Oregon. Data from 192 organic farms (ORG), 64 conventional nongrazing farms (CON-NG), and 36 conventional grazing farms (CON-GR) were collected during farm visits and were size-matched and analyzed. The average lactation number of animals on ORG and CON-GR farms was 2.6 lactations, which was greater than that on CON-NG farms (2.3 lactations). A greater percentage of first-lactation heifers were found on conventional farms than on ORG farms. Facilities used by adult animals, including housing and milking facilities, did not differ among the grazing systems. Cattle on conventional farms were fed approximately twice as much grain as cattle on ORG farms and had greater milk production. Little difference was found for the average reported somatic cell count and standard plate count, suggesting that milk quality is not dependent on grazing system. Milking procedures were similar across all 3 grazing systems, indicating that an industry standard now exists for milking and that milk quality problems will need to be addressed with other management problems in mind. Although some disease prevention measures were commonly utilized on ORG farms, such as keeping a closed herd and having a written record of treatments administered to the animals, the use of outside support and vaccinations were found to be less prevalent on organic farms than on conventional farms.