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Better Milk Quality fromBetter Mastitis Therapy Decisions   Dr. Ron Erskine, Michigan State University
Mammitis:      Inflammation of the BagTreatment : Prevention  •Bichloride of Mercury, 2 grains  •Boracic Acid, 2 drams  •...
XXXAlternative Therapies
Tanker loads with antibiotic residues havedecreased ………• Has the amount of drug use changed ?• Has the amount of Extra Lab...
Antimicrobial Drug Use106 doses/week/1,000 cows       100 doses/week/1,000 cowsAdult cows                      All animals...
Extra Label Drug Use- IMM administration 20 Wisconsin dairy herds• 11 Herds    Ampicillin -   6 herds    Ceftiofur -    ...
Implications for failure of therapy• “Drugs just don’t work the way they use  to……”  • Antimicrobial resistance ?  • Limit...
Is AMR in mastitis pathogens emerging?• ‘scientific evidence does not support a  widespread, emerging resistance among  ma...
AMR in mastitis pathogens emerging ?• Staph aureus• 50 to 60% of S aureus isolates resistant to  unprotected β-lactam drug...
Is antibacterial resistance in mastitis pathogens emerging? Temporal studies: same laboratory              S aureus    Str...
US National Residue Program -2010• Kidney Inhibition Swab test or Fast Antimicrobial  Screen Test• 211,733 Inspector Gener...
2010 Inspector-generated Violations900                                Beef cows800                                Bob veal...
FDA Survey• The long-anticipated drug-residue-sampling  survey by the U.S. Food and Drug Administration  has begun.• 900 m...
FDA Bulk Tank Sampling Program
Mastitis……..• Largest cause of  antimicrobial drug  use in dairy cows
Antibiotics 101 Concentration-dependent inhibition Magnitude above MIC enhances killing  • Peak serum > 10 times MIC Ti...
Antibiotics 101Dose intervals-  • Holstein calves treated with chloramphenicol 4x    more likely to die if treated once p...
Ampicillin Trihydrate (Polyflex)  “3 days treatment is usually adequate, but  treatment should be continued for 48 to 72 h...
Extended mastitis therapy :subclinical mastitis • 125 mg ceftiofur cure rates    • 10 % : control    • 39 % : 2 days    • ...
Is extended therapy right for you?Depends on the herd
Concentration Milk:                    Drug                               PlasmaCeftiofur                                 ...
Making Better Therapeutic Choices• Repeat Offenders  • Duration of infection  • Lactation  • Higher SCC  • Multiple infect...
S. Nickerson
MILD CLINICAL MASTITIS                          CultureCHRONIC ???                                                   Gram ...
Culture based therapy• 3,500 cow dairy - MI (Hess et al, 2003)   • Reduced days withheld by 80%   • Two full time veterina...
Culture Based Therapy Effects on lactation                      Immediate Therapy    Culture BasedBacteriologic cure*   71...
SEVERE CLINICAL                                   MASTITISFluidsAnti-Inflammatory                                      Cul...
It’s not the drugs…….it’s how we use them!
Better Milk Quality from Better Mastitis Therapy Decisions- Dr. Ron Erskine
Better Milk Quality from Better Mastitis Therapy Decisions- Dr. Ron Erskine
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Better Milk Quality from Better Mastitis Therapy Decisions- Dr. Ron Erskine

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Dr. Ron Erskine presented this information for DAIReXNET on Tuesday, February 12, 2013. For more information, please see our archived webinars page at www.extension.org/pages/15830/archived-dairy-cattle-webinars.

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Transcript of "Better Milk Quality from Better Mastitis Therapy Decisions- Dr. Ron Erskine"

  1. 1. Better Milk Quality fromBetter Mastitis Therapy Decisions Dr. Ron Erskine, Michigan State University
  2. 2. Mammitis: Inflammation of the BagTreatment : Prevention •Bichloride of Mercury, 2 grains •Boracic Acid, 2 drams •q.s. One quart water, intramammary infusion CJ Korinek, The Veterinarian, 1915
  3. 3. XXXAlternative Therapies
  4. 4. Tanker loads with antibiotic residues havedecreased ………• Has the amount of drug use changed ?• Has the amount of Extra Label Drug Use changed?
  5. 5. Antimicrobial Drug Use106 doses/week/1,000 cows 100 doses/week/1,000 cowsAdult cows All animalsSurvey Trash CollectionPol and Ruegg, JDS, 90:2007 Saini et al, JDS, 95:1209, 2012
  6. 6. Extra Label Drug Use- IMM administration 20 Wisconsin dairy herds• 11 Herds  Ampicillin - 6 herds  Ceftiofur - 3 herds  Gentamicin- 3 herds  Penicillin- 1 herd  Miconazole- 1 herd  Tetracycline- 1 herd  Veterinary Magic Bullets- 2 herds  Sulfamethoxazole/Trimethoprim – 2 herds Pol and Ruegg JDS 90: 2007
  7. 7. Implications for failure of therapy• “Drugs just don’t work the way they use to……” • Antimicrobial resistance ? • Limited drugs for use in dairy cattle ? • Immune stress ? • Higher milk production?
  8. 8. Is AMR in mastitis pathogens emerging?• ‘scientific evidence does not support a widespread, emerging resistance among mastitis pathogens to antibacterial drugs’
  9. 9. AMR in mastitis pathogens emerging ?• Staph aureus• 50 to 60% of S aureus isolates resistant to unprotected β-lactam drugs • Numerous studies • Forty years • No evidence of any change
  10. 10. Is antibacterial resistance in mastitis pathogens emerging? Temporal studies: same laboratory S aureus Strep E. coli Coagulase negative staphMackie, et N/C ---- N/C ----al. 1989 (coliforms)Erskine, et N/C N/C N/C ----al. 2002Makovec Erythromycin N/C Erythromycin Lincomycinand Ruegg, Lincomycin Pirlimycin2003
  11. 11. US National Residue Program -2010• Kidney Inhibition Swab test or Fast Antimicrobial Screen Test• 211,733 Inspector Generated Samples • 7,000 positive samples • 2,043 confirmed violative residues (1,609 animals) 2012 Residue Sampling Plans, USDA FSIS
  12. 12. 2010 Inspector-generated Violations900 Beef cows800 Bob veal700 Bulls600 Dairy cows500 Formula fed veal400 Goat300 Heavy calves200 Heifers100 Market hogs Non-formula fed veal 0 Steers
  13. 13. FDA Survey• The long-anticipated drug-residue-sampling survey by the U.S. Food and Drug Administration has begun.• 900 milk samples from dairy farms had a cull dairy cow residue violation• 900 milk samples from dairies at large.• 26 different drugs Dairy Herd Network, Jan 10, 2012
  14. 14. FDA Bulk Tank Sampling Program
  15. 15. Mastitis……..• Largest cause of antimicrobial drug use in dairy cows
  16. 16. Antibiotics 101 Concentration-dependent inhibition Magnitude above MIC enhances killing • Peak serum > 10 times MIC Time-dependent inhibition Time above MIC, not peak concentration • All labeled drugs for use in lactating dairy cattle
  17. 17. Antibiotics 101Dose intervals- • Holstein calves treated with chloramphenicol 4x more likely to die if treated once per day as opposed to twice per day (Waltner-Toews, Can Vet J, 1986)Duration • 2 days after clinical and microbiological resolution, severe cases: 7-10 days, chronic: may involve months (Giguere, et al. Antimicrobial Therapy in Veterinary Medicine, 4th edition, 2006, pg 113)
  18. 18. Ampicillin Trihydrate (Polyflex) “3 days treatment is usually adequate, but treatment should be continued for 48 to 72 hours after the animal has become afebrile (up to 7 days)”
  19. 19. Extended mastitis therapy :subclinical mastitis • 125 mg ceftiofur cure rates • 10 % : control • 39 % : 2 days • 54 % : 5 days • 66 % : 8 days • Staph aureus 36% • Strep uberis 67% • Strep dysgalactiae 80 % • CNS 86 % (Oliver, et al, JDS, 2004)
  20. 20. Is extended therapy right for you?Depends on the herd
  21. 21. Concentration Milk: Drug PlasmaCeftiofur <1%Sulfadimethoxine 18%Penicillin 19%Ampicillin 27%Spectinomycin 75%Tetracycline 140%Tylosin 250%Lincomycin 450%Erythromycin 650%Adapted from Langston, Antimicrobial Use in Food Animals, in Howard &Smith ed., Current Veterinary Therapy food animal practice, IV.
  22. 22. Making Better Therapeutic Choices• Repeat Offenders • Duration of infection • Lactation • Higher SCC • Multiple infected quarters• Non-responsive pathogens • Mycotic organisms (Candida), Prototheca, Pseudomonas, Mycoplasma, Serratia, Nocardia, Proteus, Pasteurella, etc.
  23. 23. S. Nickerson
  24. 24. MILD CLINICAL MASTITIS CultureCHRONIC ??? Gram Yeast, Pseudomonas, etc Coliforms Positive No organism isolated ???? Administer IMM antibioticsNo antibiotictreatment Records
  25. 25. Culture based therapy• 3,500 cow dairy - MI (Hess et al, 2003) • Reduced days withheld by 80% • Two full time veterinarians • Laboratory• 4 herd study - SD and MI (Wagner, et al, 2007) • Bacteriology skills highly variable among herds• 8 herd study - MN, WI, ON ( Lago et el, JDS, 2011) • Reduced antibiotic use 50%
  26. 26. Culture Based Therapy Effects on lactation Immediate Therapy Culture BasedBacteriologic cure* 71 % 60%Milk discard days* 5.9 5.2Herd removal 28% 32%Days at removal 160 137Relapse of clinical 35 % 43 %mastitisDays at relapse 78 82LSCC 4.2 4.4 * 21 days Lago, et al JDS, 2011
  27. 27. SEVERE CLINICAL MASTITISFluidsAnti-Inflammatory CultureIMM and Systemic antibioticsColiforms Gram PositiveContinue antibiotics Continue IMM antibioticsSupportive care Unusual Pathogens (e.g., Pseudomonas, Prototheca) No antibiotics, Supportive care
  28. 28. It’s not the drugs…….it’s how we use them!
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