MASTITIS

DEFINITION
• Inflammation of the udder/mammary gland
• Almost always due to infection by micro-
organisms
• Affects different animal species (e.g. cattle,
goats, sheep, buffalo, camels) and humans
Anatomy of the udder & mastitis
Physical appearance
 AETIOLOGY
• Caused by infectious micro-organisms
– Bacteria
– Yeast/fungi e.g. Candida spp, Aspergillus fumigatus,
Cryptococcus neoformans
– Algae e.g. ??? (Prototheca)
• Common bacteria:
– Gram +ve: Staphylococcus (S. aureus), Streptococcus (S.
agalactiae, S. dysgalactiae, S. uberis)
– Gram –ve: Coliforms (E.coli, Enterobacter spp,
Pseudomonas spp. Klebsiella spp etc.)
– Others: Arcanobacter pyogenes (Old
names:Corynebacterium pyogenes/Actinomyces pyogenes)
, Mycoplasma spp., Mycobacterium spp, Brucella spp
etc.)
 CLASSIFICATION OF MASTITIS
CRITERION EXAMPLES

1.AETIOLOGY -Staphylococcal-, Streptococcal-

, coliform mastitis
2.SEVERITY, ONSET & -Peracute, -Acute, -Subacute, -
STAGE OF CLINICAL Chronic
DISEASE
3.CLINICAL -Clinical Vs Subclinical
MANIFESTATION (I.e.
obvious changes of the
udder/milk)
4.MODE OF -Contagious
TRANSMISSION -Environmental
-Minor
 PREDISPOSING FACTORS

• Poor milking hygiene (utensils, milker,

surroundings)
• Teat injuries & sores
• Incomplete emptying of the udder during
milking
• Environmental population of pathogens
• Milking machine faults e.g. vacuum
pressure, pulsation ratio etc.
 PATHOGENESIS

• Coliforms: Clinical signs mediated through

ENDOTOXAEMIA (endotoxin released
from dead bacteria), hence usually
associated with systemic signs
• Contagious: Infection elicits immunological
response ( PMNs), tendency of walling off
leading to Chronic infection
Some organisms e.g. S.aureus produce toxin
gangrene;
 EPIDEMIOLOGY: MODE OF TRANSMISSION

• Contagious bacteria (S. aureus,

S.agalactiae, S.dysgalactiae) present in
infected cows, therefore mastitis is
transmitted from COW to COW during
milking
• Environmental bacteria (Coliforms, S.
uberis) present in the Environment,
therefore mastitis is transmitted from
ENVIRONMENT to COWS between
milkings
 TRANSMISSION OF MASTITIS

• Herd to herd
 * purchasing an infected cow
 * purchasing a suckling calf
 * milker working on more than one farm
 * sharing equipment with another farm
• Cow to Cow/ Cow or Quarter to Quarter
 * Calves suckling
 * Milker hands
 * Cloths used for washing or drying
 * stripping mastitic milk onto floor of banda
 * dirty teat dips or intramammary syringes
 * dirty teat lubricant
 EPIDEMIOLOGY: PREVALENCE & GEOGRAPHICAL
DISTRIBUTION

• A Worldwide problem (dairy industry)

– Developing world:prevalence Contagious
– Developed world: prevalence Environmental
• In Tanzania:
– Clinical mastitis: Incidence risk 1.5-3.2 cases/100
cows/year
– Subclinical (CMT): 60-80% of cows
– Common isolates: S. aureus, S.epidermidis, coliforms,
yeasts
 CLINICAL SIGNS

• I. CLINICAL MASTITIS
• This form is associated with classical signs of
inflammation which are subdivided into:
– A. Changes of the udder
– Hot to touch
– Painful (kick, reduced milk production)
– Skin colour (red, blue e.g. gangrenous
staphylococcal mastitis)
– Swollen quarter (asymmetry of the udder)
sometimes
– Atrophy (hard, lumpy, scars, shrunken)
– Blind teat(s)
Udder asymmetry: one of clinical signs
 I. CLINICAL MASTITIS (CONT’D)

– B. Changes of the milk

– May be associated with presence of (in the
milk):
• flakes and clots
• Blood
• pus
 II. SUBCLINICAL MASTITIS
• The udder is normal and milk looks normal
• However,
❑i)There is chronic loss of milk production not explained
by other reasons e.g management, other diseases
❑ii)Presence of somatic cells (epithelial and
inflammatory/leucocytes cells) in milk is a good
indicator of this form
❑iii)Bacteria may be present in milk.
This form is not normally recognised by farmer (has
hidden effects), though it has higher prevalence than
clinical mastitis.
Somatic cells in milk smear
 DIAGNOSIS OF MASTITIS

• I. CLINICAL
❖Based on history and clinical signs
(changes of the udder and in the milk)
❖Should be supported by bacteriology
(isolation and identification of causative
agent).
II. SUBCLINICAL MASTITIS
• A) History of reduced milk
• B) Measurement of somatic cells which can be:
• I) Indirect tests such as
 California Mastitis Test (CMT)
 Whiteside test
 Litmus paper
• II) Direct Cell Counts
❖ Using an electronic counter (e.g. Direct Microscopic Somatic
Cell Counting (DMSCC); Coulter Counter, Fossomatic): gives
exact number of cells per ml of milk.
• C) Bacteriology
D) Other tests
– Milk ELISA e.g. ProStaph (detects S.aureus antibodies in milk)
– Milk electrical conductivity test: Mastitic milk has higher
electrical conductivity (measured by sensors) due to increased
Na+ and Cl- ions.
Use of CMT to diagnose subclinical mastitis
IMPORTANCE OF MASTITIS
• Direct AND Indirect losses associated with the
disease
DIRECT INDIRECT COSTS
COSTS
1. Discarded milk 1. Decreased milk yield (udder damage &
2. Drug and subclinical mastitis)
veterinary 2. Extra labour involved in treating and
costs nursing sick animals
3. Death of sick 3. Higher culling and replacement rates
animals (acute leading to loss of genetic potential
form) 4. Decreased milk quality
5. Penalties due to increased SCC
 TREATMENT OF MASTITIS
emphasis should be on:
• Early detection, reporting and intervention
(the role of milker/farmer)
• Prevent transmission of infection to other
cows/quarters
• Separation of the mastitic cow (if possible)
and milked last
• As First Aid: frequent milking of affected
quarter (s): every after TWO hrs
 TREATMENT (cont’d)
▪ Chemotherapy: use of antimicrobial agents →
Efficacy differs with type of pathogen involved
(Table 1)
▪ Supportive treatment (e.g. coliform mastitis)
▪ Fluid therapy
▪ Non-steroidal anti-inflammatory drugs
▪ Oxytocin (20 IU) at each treatment/milking to aid
removal of infected milk
▪ Milk from treated cow(s) should be discarded
according to the recommended withdrawal time
 Table 1: Antibiotic spectrum
GROUP OF PATHOGEN(S) ANTIMICROBIAL AGENTS
Gram +ve bacterial Penicillins, Aminopenicillins,
1st generation cephalosporins
Both Gram +ve and Gram –ve Tetracyclines, Second
(i.e. Broad spectrum) generation cephalosporins (e.g.
cefuroxine)

Gram –ve bacteria Third generation cephalosporins

(e.g. cephoperazone; added
advantage against
Pseudomonas)
 PROPERTIES OF ANTIMICROBIAL AGENTS
PENICILLINS e.g. Penicillin G,
Penethamate, Cloxacillin, Nafcillin
SYNTHETIC PENICILLINS e.g.
Ampicillin, Amoxycillin
CEPHALOSPORINS
1st Generation: e.g. cephalexin,
cephalothin, cephaloridine, cefazolin
2nd Generation e.g. cefuroxine
3rd Generation e.g. cephoperazone
AMINOGLYCOSIDES
e.g. Neomycin, kanamycin,
Streptomycin
TETRACYCLINES
-Effective against Staphs and Streps
-Penetrate the udder well
Disadv: Many strains (>70%) of Staph aureus are
RESISTANT to penicillin;Cloxacillin and Nafcillin
are effective (DCT)
Increased spectrum (i.e. also effective against
coliforms)
Disadv: not effective against resistant Staph aureus
* Moderate penetration of udder
-Effective Vs Gram +ve
-Not effective Vs resistant strains
-Broad spectrum (Gram +ve & -ve)
-Effective against Gram –ve (with moderate efficacy
against Gram +ve)
-Effective against coliforms & resistant Staph aureus
-Good penetration of udder
-Broad spectrum
-Limited penetration of the udder tissue
 DO and DON’TS: during
chemotherapy
➢ If combination of drugs is to be used, try to keep drugs
within one of the following groups:
❖Penicillins, Penicillin-Streptomycin, Cloxacillin, Amoxycillin,
Ampicillin
❖Tetracycline, Gentamicin
❖Cephalexin

➢ Only USE injectable antibiotics if the cow is SICK

➢ If the cows is sick, DO NOT use Penicillin
➢ For persistent cases, USE Amoxycillin or cephalexin
 CONTROL OF MASTITIS

• Eradication of mastitis NOT possible

• c.f. Streptococcus agalactiae: highly susceptible
to penicillin (90-95%) and is an obligate
intramammary pathogen
• Can use BLITZ therapy (elimination of S.
agalactiae from an infected herd through treating
all cows by infusing short withdrawal-antibiotic
into each quarter at consecutive milkings during
lactation period)
• Observe hygiene
 CONTROL OF MASTITIS

• Other contagious organisms (S. aureus) difficult to

control
• Post-milking teat dipping (to prevent spread of
disease within infected herd) e.g. Iodophors
(iodine 3-5 ppm release), hypochlorites (chlorine
at 4% conc=40,000 ppm)
• Cull chronically affected cows
• Use Dry Cow Therapy (DCT): long-acting
antibiotic preparation applied at drying off. DCT
reduces bacteria in udder and prevents re-infection
 CONTROL OF MASTITIS
• Environmental/coliform mastitis
– Improve hygiene (environment) e.g. scraping
all soiled and damp areas at least twice daily
– Sprinkle hydrated lime [Ca(OH)2] or limestone
[CaCO3] on the rear of sleeping cubicle i.e. to
dry and disinfect the sleeping area
– Regular renewing of bedding material e.g.
straw, sawdust replaced daily
– Pre-milking teat dipping e.g. Iodophors
– Vaccination??
 CONTROL OF MASTITIS
• C.f. the FIVE POINT PLAN (UK)
– Treat and record all clinical cases
– Use teat disinfectants e.g. hypochlorites,
iodophors (Pre- and Post-milking teat dipping)
– Use of Dry Cow Therapy (DCT) at the end of
lactation
– ?? Culling of chronic mastitis cases
– ?? Regular milking machine maintenance
 TEN POINT PLAN (modification)
▪ 1. Early detection and treatment of clinical mastitis cases
e.g. fore-milk inspection (Strip cup) & udder palpation
▪ 2. Use of Dry Cow Therapy
▪ 3. Teat dipping (pre- and post-milking)
▪ 4. Culling chronic mastitis cases
▪ 5. Maintenance of a clean environment (hygiene)
▪ 6. Good record keeping
▪ 7. Monitoring udder health : Clinical exam, CMT, SCC
▪ 8. Regular maintenance and inspection of the milking
machine
▪ 9. Setting targets for mastitis control
▪ 10. Review mastitis control programmes
 CONTROL OF MASTITIS
(cont’d)
• Observe HYGIENE
– Hygiene of milker
– Hygiene of cows
– Hygiene of environment
– Hygiene of milking equipment and other
materials e.g. cloths, teat lubricant