EPIDEMIOLOGY & ROLLBACK

OF MASTITIS IN PAKISTAN

Prof. (R) Dr. Ghulam Muhammad

Dr. Imaad Rashid
Department of Clinical Medicine and Surgery,
University of Agriculture, Faisalabad
5-12-2015
What is mastitis?
 Inflammation of the mammary gland in
response to injury for the purpose of
destroying or neutralizing the infectious
agents and to prepare the way for healing
and return to normal function
National Mastitis Council, Inc., USA

Normal Udder Inflamed Udder

How common is mastitis and what
is its significance?
 Every cow or buffalo develops mastitis before she
dies
 Field surveys of major livestock diseases in
Pakistan……… mastitis is one of the most
important health problems of dairy animals.
Nearly 20% of cows and buffaloes at any given
time have mastitis. Probably the most important
cause of poor milk quality in Pakistan
(Cady et al., 1983; Ajmal, 1990; Ali, 2008; Hussain et al., 2005 )
 One of the most important causes of involuntary
culling in Pakistan
How common is mastitis and what
is its significance?
 In a survey conducted in 28 randomly selected villages
in Tehsil Samundri, Faisalabad……… overall prevalence
of mastitis (Clinical and Sub-clinical)……….14.14% in
buffaloes and 20% in cows (Ali, 2009)
 Mastitis causes nearly 25% production losses (Radostits et
al.,2007; Arshad, et al., 1998)

 Clinical vs Sub-clinical mastitis

How common is mastitis and what
is its significance?
 Human health hazard: Brucellosis, TB, Q
fever, Listeriosis, Leptospirosis etc.
 Problems to dairy processing industry
due to increased SCC and antibiotic
residues
What causes mastitis?
“If you know your enemies and know yourself, you will not be
imperiled in a hundred battles. If you do not know your
enemies, but do know yourself, you will win one and lose one.
If you do not know your enemies and do not know yourself, you
will be imperiled in every battle”
(Excerpt from the famous philosophy book “The Art of War” written
by Sun Tzu. This book was distributed by FIFA World Cup 2002
Brazilian coach, Luiz Felipe Scolari to each of his players before the
big match against England)

 Agent – Host- Environment triad

 Etiologic agents:
1) Contagious mastitis pathogens: S.aureus, Str.agalctiae,
Mycoplasma bovis, C. pyogenes (Truperella pyogenes) etc.
◦ The most important etiologic agents in Pakistan
◦ Usually transmitted from infected to healthy animals at the time
of milking
What causes mastitis? ….continued
2) Environmental pathogens: E.coli, Klebsiella,
Environmental streptococci, Pseudomonas etc.
◦ Exposure is round the clock
3)Opportunistic mastitis pathogens: Mainly
coagulase negative staphylococci (CNS); part of
normal flora of the skin of cows and buffaloes

E.coli Klebsiella Pseudomonas

What causes mastitis? ….continued
 Host related factors
1. Old age
2. Species of the dairy animals ……. Mastitis
is much more prevalent in dairy cows than in dairy
buffaloes
What causes mastitis? ….continued
 Environmental related factors
1. Management
2. Nutrition
3. Over crowding
4. Faulty milking practices
5. Incomplete milking
6. Diseases which cause lesions on the teats
e.g. FMD, pox etc.
7. Mycotoxins in feed
Mastitis rollback measures
Basic premise
 Mastitis in Pakistan: Predominantly
contagious in nature

 Transmission of contagious pathogens

occurs primarily by milker’s hand at
milking time
Mastitis control measures
 Objectives of an effective mastitis control program:
 1. New infections must be prevented
 2. Duration of existing infections must be reduced
 MEANS TO REALIZE THESE OBJECTIVES
 1.Post-milking antiseptic teat dipping/spraying:
 “Dipping/spraying of teats in a germicidal solution
immediately after milking”
 The most effective managemental practice to prevent
contagious mastitis, not effective against environmental
mastitis pathogens
Mastitis control measures…..
Teat dip
Classes of teat-dip: Iodophores
◦ Quaternary ammonium compounds
◦ Chlorhexidine
◦ Sodium hypochlorite
◦ Physical barriers dip
◦ Dodecyl benzene sulfonic acid (DDBSA)
◦ ANTISEPTIC AVAILABLE IN PAKISTAN FOR TEAT-
DIPPING
1. Lanodip™
2. Masodine™
3. Fight bac ™
Mastitis control measures ….
2. PRE-DIPPING – Optional: required sometimes for environmental
pathogens in machine milked herds
3. DRY COW THERAPY - The most effective managemental practice to
treat existing infections; also prevents new infections during the dry period

 Cure rates higher than during lactation

 Conventional dry cow therapy: infusion of Long-acting antibiotics at

drying off into all four teats

 Pakistani farmers generally averse to intramammary infusion – they think

that intramammary infusion leads to mastitis

 Systemic dry cow therapy ( = dry cow therapy by injection) a suitable

alternative to intramammary infusions
(Soback et al., 1990; Tarabal and Canavesio, 2003)

 Lincomycin-Spiramycin (Inj. Lincospira, Selmore Pharma) probably a

good preparation for systemic dry cow therapy – two intramuscular
injections; one at drying off & second 7-10 days before calving
Mastitis control measures ….
4. Use of teat sealers at drying off
 Being intensively investigated in New
zealand, UK, and elsewhere as alternative
to conventional dry cow therapy
(Huxley et al., 2002; Woolford, et al., 1998)

 Teat sealers – 65% w/w Bismuth

subnitrate in a paraffin base
 PROMPT TREATMENT OF
CLINICAL CASES
 Use macrolide/lincosamide antibiotics (e.g., tylosin,
lincomycin, spiramycin) by parenteral route × 4-5 days; they
tend to concentrate in the udder
 Antibiotics like gentamycin, kanamycin, not effective in
mastitis
– they do not diffuse from blood into the udder
 Give first generation cephalosporins e.g., Inj. Velosef™ 500
mg/affected quarter/day in 30 mL water by intramammary
route aseptically using branulla 22 G
 Ideally, antibiotic therapy should be based on the results of
antibiotic susceptibility testing; MIC90
 MIC90 – the best guide for selection of dosages
 Always give some immuno-activators (e.g., Lisovit –
50gm/animal/day for 4-6 days; PO) or Nilverm –
80mL/animal/day for 3-5 days (PO), Zinc Sulfate 3 grams PO
daily for 8 days
 PROMPT TREATMENT OF
CLINICAL CASES….
 An extremely cheap prescription Rx:
4 grams of boric acid
120 ml of sterile distill water or boiled water
Sig: Infused aseptically into the affected teat with the help
of brannula 22 G. Allow to remain in the mammary gland
for 3-4 hours and then milk out. Unless absolutely
necessary, the infusion should not be repeated, otherwise
milk secretion is liable to be permanently diminished
(Wooldrige, 1917)
 PROMPT TREATMENT OF
CLINICAL CASES….
 Increasing the citrate contents of milk together with
decrease in pH of milk:

Trisodium citrate @ 60 mg/kg or roughly about 30 grams

plus water PO X 4days

Trisodium citrate 30 grams PO plus Trisodium citrate 5%

b.i.d. IV better than Trisodium citrate orally only

Trisodium citrate therapy very effective; no antibiotic

residues (Singh et al., 2007; Dhillon and Singh, 2009)

Evaluation of Trisodium citrate therapy in progress at

CMS
FAQ about mastitis treatment
 Fibrosis of teat (Naurh par jana)
1. (a)DMSO-iodized oil containing 375 mg iodine S/C in the
brisket region X 3 days

(b) Penicillin 20-40 lac IU plus 30ml distilled water for injection
intramammary infusion with the help of branulla 22G X 5 days

(c) Injection Linco-spira 25 ml IM X 4days

(d) Zinc Sulfate 3 g PO X 8 days

2. a + c and d + Mastiveex-1™ intramammary tube

(marketed in Pakistan by BinSadiq International) containing
Cloxacillan sodium, Framycetin sulphate, Sulfadimerazine and
Chymotrypsin X 4 days
FAQ about mastitis treatment
 Efficacy of homeopathic mastitis
preparations ……. Questionable efficacy
 Indigenous mastitis treatment …… most
preparations particularly those based on
Tartree, lemon, ammonium chloride, red
chillies, Kali zeeri make sense
OTHER MANAGEMENTAL PRACTICES
TO CONTROL MASTITIS
◦ Segregation of healthy & infected animals and
◦ Milking of healthy animals (SURF Test negative)
before milking SURF Test positive animals
◦ Culling chronic cases
◦ Purchasing healthy (mastitis-free i.e. SURF Test
negative) animals only
◦ Mastitis control in heifers
◦ Proper treatment of teat and udder wounds
◦ Fly control, feeding balanced ration
◦ General cleanliness at the farm
◦ Proper disposal of mastitic milk of clinical cases
◦ Prepartum milking (Animals which develop mastitis
close to calving)
Why Pakistani farmers do not adopt
mastitis control program?
 Incentive-penalty programs lacking
 Dairying is a way of life rather than an
enterprise
 Most herds are very small