Debate around the importance of pain and discomfort in cows with mastitis

Debate around the importance of pain and discomfort in cows with mastitis has been a feature of vet and farmer discussions for some years now, but how much has this moved forward over recent years, and what does today’s dairy farmer know and want from a mastitis therapy? 

To uncover some of the answers to these question, and also to examine farmer opinions, Intervet commissioned a series of farmer meetings earlier this year.  James Allcock BVM&S CertCHP MRCVS of Cheshire practice Lambert, Leonard and May who prepared the discussion guide and attended the meetings, presents some of the findings.

Pain and discomfort are under-discussed when it comes to mastitis management and therapy.  Previously presented work has shown that they are associated with mastitis, along with symptoms such as a swollen or hot udder.  Farm studies have shown that, on the day of diagnosis of clinical mastitis, the average heart rate, respiratory rate and rectal temperature were significantly higher in cows with moderate mastitis compared to cows with mild mastitis and compared to normal cows. In addition, work has shown that the hock-hock distances were significantly higher in cows with mild or moderate mastitis compared to normal cows, indicating that cows with mastitis alter their stance.

So, is pain a factor in a farmer’s decision making process when it comes to mastitis?  Not according to the farmers present at these meetings. They cited anti-inflammatories as important to reduce swelling and improve cow demeanour, but no mention was made of pain control.

Interestingly, anti-inflammatory products were generally referred to as being administered by injection.  There was very limited awareness of them as an ingredient in mastitis tubes.  This could seem at odds with the fact that farmers in all regions named tubes with a steroid component as being better for cows with swollen quarters.

While the statements above show a level of confusion, they also show that there is a clear opportunity for vets to work more closely with clients to educate them on the different approaches available.

Across all the meetings, the awareness of the ingredients in different tubes was extremely limited.  This was both the case for the antibiotic component and whether or not an anti-inflammatory product was included.

The majority of the farmers who attended the meetings said that good stockmanship skills were the first step in spotting new mastitis cases.  Farmers talked about the affected cow coming into the parlour later in the milking period and also mentioned that many cows often show a drop in yield the day before clinical signs become apparent. 

At all the meetings, reference was made to the cows’ general demeanour as being highly significant.  Producers also stated that cow behaviour can indicate the severity of a mastitis infection.  In addition to the hard-to-define aspects of stockmanship, the groups also commented that any swelling in a quarter was more often apparent after milking and that this was then more easily detected when dipping teats than when using teat sprays.  They also said that affected quarters were often detected when dry wiping teats prior to cluster application.

Other major subjects for discussion were  clots in the milk, clinical cure and also bacteriological cure.  The veterinary profession now believes that mastitis is more effectively managed at herd level and that, with tests and planning, a bacteriological cure should be realistic in many cases.  However, many of the measurements and tools that farmers use are at an individual cow level and serve only to deliver a clinical cure.  There will be many occasions where cow-level results are not then interpreted to give a herd level action plan. 

Most farmers used a visible examination of the milk as a test for how well the tube had cleared up a case of mastitis, coupled with an assessment of the cow’s well-being.  CMT tests were fairly common, while monthly herd recording was also well-used, but are the results well-utilised?    In general, it was rare to undertake bacteriology and, in many cases, the way it was used (rarely and seemingly randomly) was less then helpful.

The mastitis tube that a farm uses seemed to have been selected on the basis of a few bacteriological samples done irregularly and probably some time in the past.  The long-standing debate on the difference between clinical and bacteriological cure has gone some way to educating farmers to consider treatment options but, obviously, not far enough.

Without understanding the nature of the infection in the herd – recurring, new infections later in lactation, high cell count repeat offenders etc – and the pathogen involved, farmers understand that broad spectrum tubes and an anti-inflammatory (where appropriate) is about the best you can hope for.  Part of this also means rarely going further than clinical level cures and, unfortunately, a level of recurring infection.

When it came to investigating the role of anti-inflammatory products in mastitis therapy, there were some interesting contradictions and views.  Two key points that came out from the meetings were the relatively widespread use of anti-inflammatory products in cases of mastitis, but no understanding that some tubes contained such a component. 

The summary report from the meetings seemed to show that producers are demanding an increasing level of advice, guidance and information from vets on the subject of mastitis cure rates, tube selection and what they should expect from a course of treatment.

Commenting on the research, Rosemary Booth MA Vet MB MRCVS, veterinary adviser from Intervet said:  “Any increase in bacteriological cure rate reduces the likelihood of recurring infections and effectively cuts the time the milk is out of the tank enabling farmers to take advantage of improved prices.”

Intervet launched Mastiplan LC in September, a new mastitis tube for lactating cows which contains cefapirin, a broad spectrum antibiotic as well as prednisolone.  A broad spectrum antibiotic means it should be effective against most of the common mastitis bugs, while prednisolone is a powerful anti-inflammatory that is used in other tubes, but is included at a higher dose in Mastiplan LC.

“Mastiplan LC is effective very rapidly, relieving painful clinical symptoms (thanks to the anti-inflammatory prednisolone) while its patented formulation means it provides a long duration of action,” Ms Booth explains.

As the farmer meetings showed, a bacteriological cure in combination with a cow that feels better with reduced swelling is the most desirable outcome.  On-farm tests for Mastiplan LC prior to its launch showed favourable results for both a bacteriological and clinical cure against one of the most widely used tubes on the market. 

Rosemary Booth concludes: “Farmers are well served with a range of mastitis tubes that they know and like.  The introduction of Mastiplan LC offers choice and a new combination of antibiotic and anti-inflammatory, which will doubtless find favour.”