Open Access

To comply with antibiotic restriction policies in the European Union, internal teat sealants (TS) are increasingly used at dry off (DO) in selective dry cow treatment protocols to maintain udder health. Postcalving TS residue attachment to milking equipment and associated cleaning difficulties is a reason some farmers stay away from blanket TS use. Our objective was therefore to improve insight into TS excretion visibility and to compare quantity, pattern, and presence versus absence of TS excretion postcalving between the typical 2 cow categories at DO: high (H)- and low (L)-SCC cows, treated with antibiotic (AB) plus TS (H-ABTS) or TS only (L-TS), respectively. In herds in the Netherlands (n = 3), and Germany (n = 4), cows were enrolled at DO, and categorized as H-ABTS (n = 93), or L-TS (n = 99). Postcalving, quarter-level TS visibility, quantities, patterns, and percentage of TS infused and excreted postcalving were recorded from 50 mL of premilk of every quarter at each of the first 15 or 16 milkings. Udder quarter health status was determined by bacteriological culture and SCC of quarter milk samples taken at DO and at d 3 postcalving and by clinical mastitis incidence from DO until 30 DIM. Univariable and multivariable models were created to explore associations of TS excretion presence versus absence at the first 3 milkings. Irrespective of SCC category, both laboratory personnel and farmers saw TS residues at the first milking in an equal 72% of quarters. Compared with laboratory as the gold standard, farmer sensitivity to spotting TS in premilk was 74.5% at the first milking and decreased to a maximum of 8.3% at the last 3 milkings. At the first milking, TS excretion quantities showed a bimodal distribution pattern and the mean percentage of TS infused (3.83 g) that was excreted in premilk at the first milking, was higher in the L-TS cows (45.5%) compared with the H-ABTS cows (32%). At the second and third milking, mean-adjusted TS percentage excreted was higher in the H-ABTS cows (8.5% and 1.8%, respectively) compared with the L-TS cows (4.6% and 0.4%, respectively). The multivariable model of the first 3 milkings showed parity at both the first and second milking, and the study group at both the second and third milking was significantly associated with TS presence. The univariable model showed no association between TS presence at the first milking and udder health. In conclusion, in premilk of the first milking, TS residue excretion was bimodal, higher in L-TS cows, more likely to be present in multiparous cows, and not associated with udder health. At the second and third milking, excretion was higher in H-ABTS cows and TS presence was only more likely in multiparous cows at the second milking.

Mastitis is a major health problem for bovines and can be categorized as non-severe or severe, based on clinical symptoms. A severe case of clinical mastitis is usually defined by the cow being affected systemically. It is important to consider how to handle severe cases because these cases can be fatal and cause high production losses. However, there are generally few detailed treatment guidelines. By conducting a scoping review on the topic, we aimed to synthesize the information that is available on treatment and outcomes, as reported from clinical trials and observational studies. This was facilitated by following the PRISMA-guidelines with a stepwise systematic screening of scientific literature on the subject, retrieved via Pubmed and Web of Science, using pre-defined selection criteria. The results yielded a total of 14 reports of treatment and outcomes in cases of naturally occurring severe clinical mastitis. Cross-trial comparison was difficult due to the different exclusion criteria and outcome definitions. Many studies focused on cases caused by gram-negative bacteria treated with intensive antibiotic protocols, often containing antibiotics that are categorized as critical for human health. Few focused on severe cases caused by gram-positive bacteria or on the relative use of non-antibiotic treatment. In general, only a small number of statistically significant differences were found in trials comparing different treatment protocols, with no obvious trends across trials. Our findings emphasize the need for more research into the treatment efficacy of antibiotic and non-antibiotic options for clinically severe mastitis. Furthermore, consideration of how trial conditions relate to the practical circumstances in a field setting could improve the applicability of reported results. This could help to provide practitioners with the information needed to make evidence-based treatment decisions in cases of clinically severe mastitis.

Bovine mastitis is one of the most important diseases in modern dairy farming, as it leads to reduced welfare and milk production and increased need for antibiotic use. Clinical mastitis in Denmark is most often treated with a combination of local and systemic treatment with penicillin. The objective of this randomized clinical trial was to assess whether worse results could be expected with local intramammary treatment with penicillin compared with a combination of local and systemic treatment with penicillin in terms of the bacteriological cure of mild and moderate clinical mastitis cases caused by gram-positive bacteria. We carried out a noninferiority trial with a noninferiority margin set to a relative reduction in bacteriological cure of 15% between these 2 treatment groups to assess the effect of reducing the total antibiotic use by a factor of 16 for each treated case. Clinical mastitis cases from 12 Danish dairy farms were considered for enrollment. On-farm selection of gram-positive cases was carried out by the farm personnel within the first 24 h after a clinical mastitis case was detected. A single farm used bacterial culture results from the on-farm veterinarian, whereas the other 11 farms were provided with an on-farm test to distinguish gram-positive bacteria from gram-negative or samples without bacterial growth. Cases with suspected gram-positive bacteria were allocated to a treatment group: either local or combination. Bacteriological cure was assessed based on the bacterial species identified in the milk sample from the clinical mastitis case and 2 follow-up samples collected approximately 2 and 3 wk after ended treatment. Identification of bacteria was carried out using MALDI-TOF on bacterial culture growth. Noninferiority was assessed using unadjusted cure rates and adjusted cure rates from a multivariable mixed logistic regression model. Of the 1,972 clinical mastitis cases registered, 345 (18%) met all criteria for inclusion (full data). The data set was further reduced to 265 cases for the multivariable analysis to include only complete registrations. Streptococcus uberis was the most commonly isolated pathogen. Noninferiority was demonstrated for both unadjusted and adjusted cure rates. The unadjusted cure rates were 76.8% and 83.1% for the local and combined treatments, respectively (full data). The pathogen and somatic cell count before the clinical case had an effect on the efficacy of treatment; thus efficient treatment protocols should be herd- and case-specific. The effect of pathogen and somatic cell count on treatment efficacy was similar irrespective of the treatment protocol. We conclude that bacteriological cure of local penicillin treatment for mild and moderate clinical mastitis cases was noninferior to the combination of local and systemic treatment using a 15% noninferiority margin. This suggests that a potential 16-fold reduction in antimicrobial use per mastitis treatment can be achieved with no adverse effect on cure rate.

Lactational treatment of bovine mastitis is a major contributor to antibiotic consumption in dairy cattle and is, therefore, important to address in light of the increasing problem of antibiotic resistance. In this large-scale database-based retrospective observational study, we combined electronic health records and routinely measured somatic cell counts from individual cows to create an overview of lactational mastitis treatment in Danish dairy herds from 2010 to 2019. Furthermore, posttreatment somatic cell count was used to approximate treatment success in terms of cytological cure. A generalized logistic regression with mixed effects was performed to combine knowledge on cow-level factors (treatment-, pathogen-, and cow-related) with the new infection risk at the herd level, and to explore the relative effect on cytological cure. The investigation revealed that the total number of lactational treatments appears to have decreased steadily over the study period, whereas treatment duration increased slightly. The proportion of cases treated with penicillin-based protocols and the proportion of milk samples sent for pathogen analysis also decreased. Meanwhile, results from the statistical analysis confirm the importance of cow-related factors, such as parity and lactation stage, for the probability of cytological cure following lactational treatment of mastitis. However, they also disclose that factors that are easier to adjust, such as optimizing treatment duration, including knowledge on causative pathogens and improving the herd-level new infection risk that can be used to positively influence the outcome. Application of this knowledge could potentially assist in promoting a more prudent use of antibiotics for dairy cattle in the future.

Ischemic teat necrosis (ITN) is a growing problem in the dairy industry characterized by teat lesions, necrosis, pruritus and automutilation. Despite the economic and welfare consequences, there is no treatment, and the etiology of the disease remains poorly understood. The aim of this study was to investigate ITN by analyzing its clinical presentation, potential risk factors and microbial involvement. Methods included collection of milk and swab samples from affected cows over a period of one-and-a-half years and completion of questionnaires by veterinarians and farmers. Microbial testing included PCR testing for Treponema spp. and cultural testing by anaerobic and aerobic incubation on blood agar. The results showed a high and significant prevalence of Treponema spp. and Staphylococcus aureus in affected teats compared to non-ITN-affected control teats, indicating their potential role in the development of ITN. Other factors such as edema and milking practices also appear to contribute to the tissue damage. First-lactation and early-lactation heifers are particularly at risk. In conclusion, ITN appears to have a multifactorial etiology with both infectious and non-infectious factors playing a role. Further research is needed to better understand the complex interplay of these factors and to develop effective prevention and management strategies.