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Walkthrough severe mastitis in Cattle - Vetoquinol Symposium Marseille 2013

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Review of the parameters that could have an impact on bovine mastitis treatment and prevention in dairy medicine

Text of Walkthrough severe mastitis in Cattle - Vetoquinol Symposium Marseille 2013

  • 1. European Buiatric Forum Marseille (France) 27th November 2013 Walking through grade 3 mastitis therapy considerations L. Thron; Pr. Ch. Hanzen Ruminant and Swine clinic Service of Theriogenology, Faculty of veterinary medicine, University of Liege

2. Here it begins Sick cow Showing signs of mastitis (or not) Showing signs of pain Just calved Everything good until this morning 3. I WANT TO TREAT IT The animal is sick 4. E. coli??? Klebsiella S.aureus Clostridium Str. uberis E. coli 5. Here it begins Local inflammation Toxins Production Hygiene Calving 6. Here it begins Inflammation Somatic cells? Clinical modification of milk 7. Downer cow Recumbent Lethargic Paretic Hyperthermic/Hypo Ruminal contractions down Other pathologies? 8. Grade 3 specific signs Call : Anorexia Downer cow Clinical exam Weak pulse Tachycardia Tachypnoa Hyperthermia (>39,5) Dilated capillaries Mucosal hyperemia Persistent skin fold +/- Diarrhea 9. Grade 3 clinical signs Clinical signs Stiff and swelling udder Altered milk(+/-) 10. How to approach Septic shock on susceptible animal Shock Infectious Etiology Pain and Inflammation Risk factors Metabolic disorders 11. About timing? E. coli replication : 20 min Surge for an antibiotherapy? In the first hour Technically : The inflammation kills 12. Here it begins Dehydration will modify rehydration procedures : Assessment of dehydration in adult cattle Mild dehydration (6%8%): slight eyeball recession, skin tent slightly prolonged (23 seconds), mucous membranes moist Moderate dehydration (8% 10%): eyes obviously sunken, skin tent obviously prolonged (36 seconds), mucous membranes tacky Severe dehydration (10% 12%): eyes severely sunken into orbits, skin remains tented indefinitely, mucous membranes dry Hypertonic IV + isotonic Per os fluids Isotonic fluids 13. Local and general inflammation 14. Anti-inflammatory drugs Steroids have bad reputation o No solid evidence (?) NSAID have good reputation o Indeed! 15. Etiology Klebsiella S.aureus Clostridium Str. uberis E. coli 16. Complete diagnosis? 17. Evidence-based medicine Though veterinary antibiotherapy is challenged by society o Best use of critical Fluoroquinolones and Cephalosporins on severe mastitis o Though adviced, old molecules suffers from fewer evidence assays o Yet it lies a risk for Streptococci (20-40%) 18. 8) Which antibiotic is the most indicated for the treatment of a severe mastitis? 55 bovine practionners - Journes pluridisciplinaires UPV 1. Fluoroquinolones (marbo, enro, danofloxacine) 2. Aminopenicillins (Ampi, amoxicilline) 3. Polymyxins (colistine) 4. Trimethoprim-sulfamids 5. None 6. All 19. 1. Fluoroquinolones (marbo, enro, danofloxacine) 2. Aminopenicillins (Ampi, amoxicilline) 3. Polymyxins (colistine) 4. Trimethoprim-sulfamids 5. None 6. All 8) Which antibiotic do you use the most for the treatment of a severe mastitis? 55 bovine practionners - Journes pluridisciplinaires UPV 20. Binary approach Main risk : Death from Endotoxemia (Gram-) o Fluoroquinolones High Dose IV/IM o 3rd or 4th generation Cephalosporines IV/IM o TMP-S parenteral, BID o Tetracycline 15 mg/kg at least o Amoxycilline w/wo Clavulanate Secondary risk : Persistent infection with Streps (Gram+) o Local penicillin (G, A or M) o Parenteral Penethamate 21. My pathology and my patient Why is she sick? o 25g IV VitC VitE (and Se) Cu T4 o Propylene Glycol o Curative? Preventive? Helpful? 22. So small, So important 0 10 20 30 40 50 60 70 80 90 7/1/2012 8/1/2012 9/1/2012 10/1/2012 11/1/2012 12/1/2012 1/1/2013 2/1/2013 3/1/2013 4/1/2013 5/1/2013 6/1/2013 7/1/2013 8/1/2013 9/1/2013 10/1/2013 % Lactation contamination risk Lactation cure risk Dry-off cure risk Prevalence First control abnormal Herd status Zn (mmol/L) Cu (mmol/L) GPX (IU/gHb) PII(mg/L) Milk I (mg/L) Se (g/L) Adequate 1421 1318 220600 45650 80 >80 Marginal 814 813 75220 1545 3080 50-80 Deficient

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