Bovine Mastitis: Diagnosis and Management Volume 2 - Issue 5

Neelam Kushwaha¹* and Anand Mohan²

• ¹ Hospital Registrar, Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Udgir, Maharashtra, India
• ² Assistant Professor, Veterinary Epidemiology and Preventive Medicine, College of Veterinary and Animal Sciences, Udgir, Maharashtra, India

Received: May 21, 2019;   Published: June 17, 2019

Corresponding author: Neelam Kushwaha, Hospital Registrar, Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Udgir, Maharashtra, India

DOI: 10.32474/CDVS.2019.02.000148

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Abstract

Mastitis is inflammation of the parenchyma of mammary gland characterized by a range of changes in the milk and glandular tissue. It is a most important disease of dairy cattle causing huge economic losses. Due to the involvement of multiple etiological agents in mastitis it always remained a challenge to treat and control it worldwide. For the management of mastitis, the random use of antimicrobial agents with inappropriate dose is a major concern as it leads to the emergence of bacterial resistance to antibiotics. In addition to this, the poor hygiene and animal husbandry practices make the dairy animal susceptible to the infection. Therefore, this review highlights on the diagnosis of mastitis in its early stage, continuous monitoring, treatment, management and new control measures for mastitis.

Keywords: Bovine; Control; Diagnosis; Management; Mastitis

Introduction

Mastitis is inflammation of the parenchyma of mammary gland regardless of the cause, characterized by a range of physical and chemical changes in the milk and pathological changes in the glandular tissue [1]. The most important changes in the milk are discoloration, presence of clots and large numbers of leukocytes [2]. Swelling, heat, pain and edema of mammary glands are very common in clinical mastitis, but subclinical mastitis is not readily detectable by manual palpation or by visual examination of the milk. In India high prevalence of both subclinical and clinical mastitis in dairy herds has been reported [3].

Economic Losses due to Mastitis in Dairy Animals

Mastitis is single, largest problem in dairy animal in terms of economic losses in India. Mastitis reduces milk by 21% and butter fat by 25%. The overall loss from dairy animals was estimated at Rs 1390 per lactation, in which major losses were owing to the reduction in return from milk yield to the extent of 48.53% followed by veterinary expenses which accounts for 36.57% of the total loss [4]. It has been reported that a complete fibrosis of one quarter leads to an average decrease in market value by Rs 4000 and Rs 2500 for crossbred cows and buffaloes, respectively [5]. In addition to the economic loss, the consumption of mastitic milk poses a major public health hazard to the whole humanity. Tuberculosis, streptococcal sore throat, brucellosis, and food poisoning may spread by consumption of raw (unpasteurized) milk.

Etiology

Based on epidemiology and pathophysiology, primary pathogens have been classified in to two broad class i.e. contagious and environmental mastitis pathogens [1].

I. Contagious mastitis pathogens- The most common pathogens causing contagious mastitis are Staphylococcus aureus and Streptococcus agalactiae. Mycoplasma bovis and coagulase- negative staphylococci are a less common cause of contagious mastitis. The usual source of contagious pathogens is the infected glands of other cows.

II. Environmental mastitis pathogens- Environmental mastitis is associated with three main groups of pathogens, the coliforms (E. coli, Enterobacter sp., Serratia sp. and Klebsiella spp.), environmental Streptococcus spp (Streptococcus uberis and Streptococcus dysgalactiae and Arcanobacterium pyogenes. The source of these pathogens is the environment of the cow.

Regardless of the etiological agent the infection of the mammary gland always occurs via the teat canal. The development of mastitis is more complex and can be most satisfactorily explained in terms of three stages: invasion, infection and inflammation [2]. Invasion is the stage at which pathogens move from the teat end to the milk inside the teat canal. Infection is the stage in which the pathogens multiply rapidly and invade the mammary tissue. After invasion the pathogen population may be established in the teat canal and, with this as a base, a series of multiplications and extensions into mammary tissue may occur, with infection of mammary tissue. Multiplication of certain organisms may result in the release of endotoxins, as in coliform mastitis, which causes profound systemic effects with minimal inflammatory effects.

Factors predisposes spread of mastitis in farm animals are

i. Major factor is poor sanitation and hygiene.

ii. Non availability of veterinary services followed by poor literacy and awareness.

iii. Socio-cultural practices and agro-climatic condition. Diagnosis of mastitis Mastitis can be detected by the following tests at an early stage of the disease [1,2].

A. Visualization and Palpation of the Udder: In clinical mastitis, visually the udder may turn red, hard and hot to touch. Udder may be painful at the time of palpation.

B. Visualization of Milk: In clinical mastitis, at the time of milking, gross changes in the milk such as the presence of flakes, clots or serous, blood and watery secretions may be observed.

C. Strip Cup Test: This test is generally used in determining the presence of clinical mastitis. In this test an enamel plate divided in four strip cups is used and the bottom of the plate is black in colour so that the milk flakes are easily observed by tilting the cups at an angle.

D. Wisconsin Mastitis Test: This is a simple screening cowside test on producer’s milk. When Wisconsin Mastitis reagent is added to milk, the number of inflammatory cells rises high and results in development of a gel.

E. Bromothymol blue test: This test indicates the pH value of milk that has been widely used in the diagnosis of mastitis. The disadvantage is that this may give false positive reaction, when the cow is in later stages of lactation.

F. Hematology and serum biochemistry: In severe clinical mastitis there may be marked changes in the leukocyte count, packed cell volume and serum creatinine and urea nitrogen concentration because of the effects of severe infection and toxemia.

G. Somatic cell counts (SSC): The most significant abnormality in subclinical mastitis is the increased number of somatic cells counts in milk, which is the most common measurement of milk quality and udder health. Now a day, SSC is done by Electronic Somatic Cell Count being used by Dairy Herd Improvement Associations. The limitation is that the Electronic Somatic Cell Count equipment is more expensive and constant monitoring is needed.

H. California Mastitis Test (CMT): The CMT is the most reliable and inexpensive cow side test for detecting subclinical mastitis. The CMT shows changes in cell count when the SSC is above 3,00,000 cells/ml of milk.

I. NAGase test: The NAGase test is based on the measurement of a cell-associated enzyme (N- acetyl-ß-D-glucosaminidase) in the milk, a high enzyme activity indicating a high cell count.

J. Electrical conductivity test: The increase in electrical conductivity in milk caused by the changes in levels of ions such as sodium, potassium, calcium, magnesium and chloride during inflammation is measured in this test.

K. Ultrasonography of the mammary gland: Mastitis produces an increased heterogeneous echogenicity to the milk in the gland cistern, compared to an uninfected quarter.

L. Biopsy of mammary tissue: A biopsy of mammary tissue can be used for histological and biochemical evaluation in research studies.

M. Culture: This is a laboratory-based test uses selective culture to identify different microorganisms involved in causing mastitis.

N. Biomarker for mastitis: Two-dimensional gel electrophoresis (2D-GE) and mass spectroscopy (MS) are used for identification of several new proteins (e.g. neutrophilassociated proteins, cathelicidin, peptidoglycan recognition protein etc.) involved in mastitis.

O. Immunoassays: More than one hundred known organisms can be responsible for causing mastitis, but ELISAs have only been developed for some of the most prevalent pathogens, such as S. aureus, Escherichia coli and Listeria monocytogenes.

P. Nucleic Acid Testing: The genome sequences of many of the major mastitis causing pathogens are now available and can be utilized to develop nucleic acid-based testing methods, such as PCR, real-time PCR [6].

Management

Despite of improvement in the understanding the pathophysiology of mastitis, successful treatment strategies for all organisms has not been achieved. The treatment strategy depends on whether the mastitis is clinical or subclinical, and the health status of the herd, including its mastitis history. Due to the involvement of multiple etiological agents it always remained a challenge to veterinarian all over the globe.

a) Antimicrobial Therapy: The treatment of mastitis is mostly based on hit and trial, it makes condition beyond repairable. Major use of antibiotics in dairy cattle is towards the treatment and prevention of mastitis. Involvement of multiple etiological agents makes it necessary to perform antibiotic drug sensitivity prior to select the final line of treatment [5]. The selection of the antimicrobial for the particular mastitis pathogen is based on culture and antimicrobial sensitivity testing. Reports indicate that 20% of the mastitis affected animals relapsed by 2.36 times in same lactation, suggesting failure to achieve pathogen clearance with the antimicrobials used or resistance of the underlying organism to the antimicrobials used. Several strains of S. aureus isolates from mastitis case have been reported to show resistance against multiple antimicrobials (Table 1).

b) Herbal Therapy: Treating sub clinical mastitis with antimicrobials during lactation is not practiced because of high cost of treatment and poor efficacy. Herbal therapy is gaining much attention now days due to increased drug resistance and in this regard uses of Terminalia chebula and Terminalia belerica are quite significant [8,9].

c) Supportive therapy- The intravenous administration of large quantities of isotonic crystalloid fluids is indicated in cattle with severe systemic illness. In addition to fluid therapy, NSAIDs (e.g.-Ketoprofen, Dipyrone) have beneficial effects on decreasing the severity of clinical signs [1].

d) Dry cow therapy -Dry cow therapy is the use of intramammary antimicrobial therapy immediately after the last milking of lactation [2]. Intra-mammary infusions used for dry cow therapy contain high levels of antimicrobial agents in a slow-release base that maintains therapeutic levels in the dry udder for long periods of time. Intramammary infusions at drying off decrease the number of existing infections and prevent new infections during the early weeks of the dry period [1]. Cloxacillin and cephalosporins are popular for the purpose.

e) Antioxidant therapy- Deficiency of many vitamins and micronutrients mainly vitamin A, vitamin D, vitamin E, selenium, copper in the diet leads to increased incidence of mastitis with infection of longer duration and more severe clinical signs [10]. Free radicals are very damaging to biological systems [11]. Antioxidants serve to stabilize these highly reactive free radicals, thereby maintaining the structural and functional integrity of cells. Tissue defense mechanisms against free radical damage generally include vitamin A, vitamin C, vitamin E and some trace minerals like selenium [12].

Control

Programs for the control of mastitis involve improvements in hygiene and disinfection. In addition, methods to eliminate infected cows involve antimicrobial therapy and the culling of chronically infected cows. The ten-point mastitis control program by NMC (National Mastitis Council) of USA has been highly successful for the control of contagious mastitis as well as for environmental mastitis [1].

a. Udder hygiene and proper milking methods

b. Proper installation, function, and maintenance of milking equipment

c. Dry cow management and therapy

d. Appropriate therapy of mastitis cases during lactation

e. Culling of chronically infected cows.

f. Maintenance of an appropriate environment

g. Good record keeping

h. Monitoring udder health status

i. Periodic review of the udder health management program

j. Setting goals for udder health status.

Hygienic

Most of the cases of mastitis are due to the injury of the udder followed by microbial infection. The portal of entry of pathogens is mainly through open teat canals. High yielding animals with soft opening and delayed closing of teat canal during the milking, or the delayed milking leading to dripping of milk from teats might the route of infection from soil, contaminated water or litter. Good hygienic practices and better animal husbandry way of animal handling can reduce the chances of mastitis. Use of antiseptics post milking and at the opening of teat also reduces the chances of microbial entry. Regular screening of milk and milk samples always reduce the number of infected animals. Commonly used practices to strain milk, observation of color and consistency improves the chances of early diagnosis of mastitis. Measures aiming at preventing new cases of mastitis include breeding; fly control; optimal nutrition; improvement of milking hygiene; avoidance of inter-sucking among young ones; implementation of post-milking teat disinfection; regular control of the milking equipments; implementation of milking order; improvement of bedding material.

Vaccination

As such no effective vaccine is available against all possible pathogens due to multiple etiologies however various vaccines have been attempted against bacterial pathogens. Commercial vaccines against mastitis caused by S. aureus and E. coli are available in USA. The J-5 type of vaccine is being used to protect against intramammary infection caused by coliform (E. coli, Klebsiella species, Citrobacter sp, and Enterobacter sp)[13]. When given to adult cows during the dry period, it has been shown to reduce the incidence of coliform mastitis. Some vaccines are already in field trial against bovine mastitis: inactivated, highly encapsulated S. aureus cells; a crude extract of S. aureus exopolysaccharides; S. aureus CP5 whole cell vaccine; inactivated and unencapsulated Staph. aureus as well as Streptococcus spp. Cells based vaccine developed for controlling bovine mastitis [14], recombinant staphylococcal enterotoxin type C mutant vaccine [15], recombinant Streptococcus uberis GapC or a chimeric Christie Atkins Munch-Petersen (CAMP) antigen; pauA; live S. uberis 0140J stain and bacterial surface extract [16,17], DNA vaccine containing clumping factor A of S. aureus and bovine IL18 [18], DNA-Protein vaccine against S. aureus [19]. “MASTIVAC-1”, a vaccine against S. aureus composed of three different field strains initially showed promising results in field trials [20].

Quorum Sensing

It is the regulation of gene expression in response to fluctuations in population density of cells based on the principle of release of auto-inducers by bacteria that increase in concentration as a function of cell density. A number of them have been intensively studied in S. aureus and S. uberis. As these two bacteria in particular have the ability to grow in infected tissues on biofilms they develop an innate resistance to almost all therapeutic agents. The quorum sensing might be useful in effective treatment protocols against mastitis [21,22].

Disease Resistant Breeding

With the advancement of molecular genetics, marker-assisted selections are one of the novel ways for selecting disease resistant breeds for mastitis. Candidate genes can be chosen on the basis of physio-biochemical processes as well as production traits i.e. Quantitative Trait Loci (QTL) [23]. A variety of novel genes have been identified and their association analysis with SCC revealed mastitis resistant biomarkers e.g. TLR2 [24], TLR4 [25], IL8 [26], BRCA1, [27], CACNA2D1 [28].

Conclusion

Mastitis is a most important disease of dairy cattle causing huge economic losses worldwide. For the management of mastitis, the random use of antimicrobial agents with inappropriate dose is a major concern as it leads to the emergence of bacterial resistance to antibiotics. Therefore, continuous monitoring of mastitis, and its management, is essential for the well-being of a dairy herd, which can be achieved through the detection of mastitis in its early stages and treatment of the mastitis infection.

Acknowledgement

Authors’ deepest gratitude forwarded to those who had participated and supported this work to become available worldwide.

Authors Contribution

Neelam Kushwaha: - Retrieved all the materials and drafted the manuscript.

Anand Mohan: - Further reviewed the article and got to be published.

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