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Diagnosis and treatment of gangrenous mastitis in crossbred cows.

Introduction

Mastitis is one of the most costly disease of dairy cattle resulting in reduction of milk yield and quality (Atakisi et al., 2010). Depending upon the organism involved and the host defense mechanism, the disease may get exhibited in many forms. Gangrenous mastitis, a rare form is reported scantly (Bhojne, 2000) that follows severe acute inflammation, with classical signs of heat, redness, swelling, pain, progression to necrosis with coldness of affected area, blue black discolouration, fluid exudation and crepitation which are histopathologically characterized as progressive swelling, vascular degeneration and focal erosion and ulceration that occur throughout the ductal system (Islam et al., 2008). Gangrenous mastitis has been reported to be caused mainly by S. aureus, Clostridium perfringens and E. coli by different studies (Green and Bradly, 2004; Atyabi et al., 2006; Islam et al., 2008). Treatment of gangrenous mastitis involves antimicrobial and anti-inflammatory drugs associated with fluid therapy, surgical drainage, debridation and demotion of necrotic tissue (Cable et al., 2004).

Materials and Methods History

The study included twelve high yielding crossbred cattle (Holstein Frisian x Sahiwal) in their first to third lactation. Mostly animals were presented with history of sudden onset of anorexia, reduced water intake, fall in milk yield, lameness and swelling of udder. The mammary gland was cold, edematous having varying degree of discoloration ranging from blue, blue-greenish (Fig. 1), blue- black to dark with marked line of affected tissue (Fig. 2), sloughing of teat skin (Fig. 3) and milk discoloured/ serum like fluid milk from affected quarters (Fig. 4), containing flakes and in some cases pussy discharge (Fig. 5). The clinical signs were fever (103.6[degrees]F), severe depression, respiratory distress, decreased ruminal motility, suspended rumination and echymotic haemorrhages on visible mucous membranes. In some cases, that were presented lately for the treatment developed extensive necrosis and sloughing of tissue (Fig. 6) resulting in exposure of underlying tissue parenchyma. The milk sample from only nine cases were collected and subjected to microbiological examination and from three cases no milk sample was obtained due to extensive sloughing of udder tissue.

Isolation and Culture sensitivity testing

Quarter-fore milk samples from intact teats were aseptically collected in sterile 15ml test tubes for culturing and identification of mastitis pathogens as per the procedure described by National Mastitis Council (1990). The organisms were identified on the basis of colony characteristics on blood agar, hemolytic pattern and gram staining. Staphylococcus aureus was further confirmed by clumping factor, tube coagulase test, growth characteristics on Manitol salt agar, DNase agar, Baird parker agar and finally confirmed by biochemical tests viz HiStaph (Hi-Media). The gram negative Escherichia coli was identified on the basis of its growth characteristics on MacConky agar, Eosine Methylene Blue agar and finally confirmed by biochemical tests viz Enterobacteriacae kit (Hi-Media).

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Susceptibility of bacterial isolates from mastitic milk to commonly used anti-microbials (Table 2) was performed using the disc diffusion susceptibility test (Kirby Bauer method) (Quinn et al., 1994) and diameters of growth-inhibition were measured in millimeters and reported as susceptible, intermediate and resistant, as per CSLI guidelines.

Treatment

All cases were subjected to immediate intensive therapy comprising of fluids, broad spectrum antibiotics, anti-inflammatory drugs, analgesics and multivitamins. The antibiotics were then continued as per antibiotic sensitivity test.

Results

The data of twelve cases regarding age, parity, stage of onset with respect to parturition, quarters affected is given in Table 1. Bacterial examination of nine milk samples revealed five Staphylococcus aureus and four Escherichia coli. Antibiotic sensitivity testing revealed that Staphylococcus aureus was most susceptible to Amoxicillin + Sulbactum and Cloxacillin, whereas Escherichia coli showed highest susceptibility to Ceftrioxone + Tazobactum and Ceftriaxone + Sulbactum (Table 2). Both the isolated organisms showed high resistance to penicillin group of drugs and other commonly used antibiotics. Only five out of 12 cases showed recovery after regressive therapy was employed and the remaining 7 cases did not show any sign of recovery (Table 1).

Discussion

The signs of pyrexia, tachycardia, depression, fall in milk yield, respiratory distress and severe inflammatory swelling of udder indicated per-acute type of mastitis (Vijayalakshmi et al., 2004). The present study revealed that gangrenous mastitis has high prevalence around the stage of parturition. Andersen (1987) reported 25 percent acute clinical mastitis in the first 10 days of calving. All cases reported were having parity from 1 to 3 and hind quarters were mostly affected than front quarters. Lalrintluanga et al. (2003) reported that incidence of mastitis in cows was more (51.1%) in 4-6 years age group. The incidence of mastitis was found to be higher in early stage of third lactation (30.6%) and left hind quarters (30.25%) were more frequently affected as compared to other three quarters. The highest prevalence rate during first month of lactation is an indication of infection probably prior to reshening and also gives reflection of important changes in endocrine, nutritional and metabolic status which occur during the peri- parturient period (Rasool et al., 1985).

In the present study, S. aureus was isolated from five cases and E. coli was isolated from four cases. Green and Bradly (2004) and Atyabi et al. (2006) conducted bacteriological examination on gangrenous mastitis and demonstrated that S. aureus, Clostridium perfringens and E. coli were predominat causes of gangrenous mastitis in ruminants. Also an etiological study conducted by Islam et al. (2008) on 7 gangrenous mastitis cases demonstrated that Staphylococcus spp. were present in 3 cases, followed by E. coli in 2 cases and Clostridium spp. and Bacillus spp. were present each in one case. E. coli readily comes in contact with udder due to faecal contamination and thus causing mastitis. Rapid multiplication of coliforms in udder occurs which are subsequently destroyed due to induction of inflammation, thereby releasing endotoxins. The resulting toxemia produces severe local and systemic signs of acute or peracute mastitis including gangrenous one occasionally (Radostits et al., 2007). Singh et al. (2013) observed a case of gangrenous mastitis in HF crossbred cow with extensive subcutaneous edematous swelling in perineal region resulting in sloughing of affected quarter.

Immediate treatment with antibiotics based on CST and supportive care may result in clinical recovery from gangrenous mastitis if initiated early in course of the disease, however decisions regarding management of gangrenous mastitis should be taken keeping in mind its economic costs and benefits. Otherwise options of culling or surgery should be considered, however surgery is indicated only in cases in which it will be economically feasible because it is expensive and takes long time to heal.

Acknowledgement

The authors sincerely acknowledge the Director of Research, GADVASU and Dean, CVSc. for providing necessary facilities to carry out the research.

References

Andersen, N.I. (1987). Acute clinical mastitis in agricultural practice. Dansk Veterinaeriidsskrift. 70: 569-74.

Atakisi, O., Oral, H., Atakisi, E., Merhan, O., Metinpancarci, S., Ozcan, A., Marasli, S., Polat, B., Colak, A. and Kaya, S. (2010). Subclinical mastitis causes alterations in nitric oxide, total oxidant and antioxidant capacity in cow milk. Res. Vet. Sci. 89: 10-13.

Atyabi, N., Vodjgani, M., Gharagozloo, F. and Bahonar, A. (2006). Prevalence of bacterial mastitis in cattle from the farms around Tehran. Iranian J. Vet. Res. 7: 1-4.

Bhojne, G.R., Dakshinkar, N. P., Kalorey, D.R. and Worke S.R. (2000). Gangrenous mastitis in a goat. Intas Polivet. 2 : 262.

Cable, C.S., Peery, K. and Fubini S.L. (2004). Radical mastectomy in 20 ruminants. Vet. Surgery. 33: 263-66.

Green, M. and Bradley, A. (2004). Clinical forum in Staphylococcus aureus mastitis in cattle. Cattle Pract. 9: 1-9.

Islam, M.N., Hoque, M.F., Rima, U.K., Fatema, B.Z., Aziz, F.B., Faruk, M.I. and Akter M.R. (2008). Gangrenous mastitis in cows: pathological, microbiological and surgicotherapeutical investigation. J. Soil and Nature. 2: 29-36.

Lalrintluanga, C., Ralte, E. L. and Hmarkunga, (2003). Incidence of mastitis, bacteriology and antibiogram in dairy cows in Mizoram. Indian Vet. J. 80: 931-32.

National Mastitis Council Inc. (1990). Microbiological Procedures for the Diagnosis of Bovine Udder Infections, National Mastitis Council Inc. 1840 Wilson Boulevard Arlington V.A. 2201, USA.

Quinn, P.J., Carter, M.E., Markey, B.K. and Carter, G.R. (1994). Clinical veterinary microbiology. Bacterial pathogens: Microscopy, Culture and Identification. 1st ed., Mosby, Edinburgh, London, New York, Oxford, Philadelphia, St. Louis, Sydney, Toronto. pp. 21-66.

Radostits, O.M., Gay, C.C., Hinchcliff, K.W. and Constable, P.D. (2007). Veterinary Medicine. A textbook of the diseases of cattle, horses, sheep, pigs and goats. Mastitis Pathogens of Cattle. 10th ed., Saunders Elsevier, Edinburgh, London, New York, Oxford, Philadelphia, St. Louis, Sydney, Toronto. pp. 697-700.

Rasool, G., Jabbar, M.A., Kazmi, S.E. Ahmad A. (1985). Incidence of sub clinical mastitis in Nili Ravi buffaloes and Sahiwal cows. Pakistan Vet. J. 5: 76-8.

Singh, S.T., Gupta, D.K. and Singh N. (2013). Gangrenous mastitis in a crossbred cow: a case report. Progressive Research. 8: 145-46.

Vijayalakshmi, P., Rao, V.N. and Pillai R.M. (2004). Gangrenous mastitis in a cow--a case report. Indian J. Vet. Med. 24: 115-16.

T.A. Shafi, D.K. Gupta (1) and B.K. Bansal

Department of Veterinary Medicine

College of Veterinary Science

Guru Angad Dev Veterinary and Animal Sciences University (GADVASU)

Ludhiana--141004 (Punjab)

(1.) Assistant Scientist and Corresponding author. E-mail: drdhirajvet@yahoo.co.in
Table 1: Details of affected animals, organisms isolated and recovery
status

                                            Onset of clinical signs
Case                       Age     Parity      with respect to
No.        Organism      (years)              parturition (weeks)

                                             Before     After
1         S. aureus         3        1         --         2
2         S. aureus         4        2         2          --
3         S. aureus         5        2         --         2
4         S. aureus         3        1         --         3
5         S. aureus         6        3         --         3
6           E.coli          3        1         1          --
7           E.coli          6        3         12         --
8           E.coli         2.5       1         --         7
9           E.coli          6        3         15         --
10      No milk sample      4        1         2          --
11      No milk sample      5        2         --         2
12      No milk sample     4.5       2         2          --

Case    Quarter    Recovery
No.     affected     status

1          RH       Recovered
2          LH       Recovered
3          RH       Recovered
4          LH       Recovered
5          LH      No recovery
6        ALL 4     No recovery
7          LF       Recovered
8        RH,LH     No recovery
9        RF, RH    No recovery
10       ALL 4     No recovery
11       ALL 4     No recovery
12       ALL 4     No recovery

Table 2. Antibiotic sensitivity test of isolated organisms against
common antibiotics

Organism      A    AM    AS    AC     P    COX   CI    CIS   CIT   EX

S. aureus     R     R     S     S     R     S     R     R     R     S
S. aureus     R     R     S     R     R     S     S     S     S     R
S. aureus     R     R     S     S     R     S     R     R     R     S
S. aureus     R     R     S     S     R     S     S     S     S     S
S. aureus     R     R     S     R     R     S     R     S     S     S
E.coli        R     R     R     R     R     R     R     S     S     R
E.coli        R     R     R     R     R     R     S     S     S     R
E.coli        R     R     R     R     R     R     R     S     S     R
E.coli        R     R     R     R     R     R     R     S     S     S

Organism      G     N     S     T

S. aureus     R     S     R     S
S. aureus     S     S     S     R
S. aureus     R     S     R     S
S. aureus     R     R     S     S
S. aureus     S     S     S     S
E.coli        R     R     R     R
E.coli        R     R     R     R
E.coli        S     R     R     R
E.coli        S     S     S     R

A: Ampicillin (10 mcg), AM:    Amoxycillin (10 mcg), AS:
Amoxycillin+Sulbactum (30/15 mcg),
AC: Amoycillin + clavulanate (30 mcg), P: Penicillin (10 units), COX:
Cloxacillin (10 mcg), CI: Ceftrioxone (10 mcg), CIS: Ceftrioxone +
Sulbactum (30/15 mcg), CIT: Ceftriaxone + Tazobactum (30/10 mcg), EX:
Enrofloxacin (10 mcg), G: Gentamicin (10 mcg), N: Neomycin (30
mcg), S: Streptomycin (25 mcg), T: Tetracycline (10 mcg) S: Sensitive,
R: Resistant
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Article Details
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Title Annotation:Clinical Article
Author:Shafi, T.A.; Gupta, D.K.; Bansal, B.K.
Publication:Intas Polivet
Article Type:Report
Date:Jul 1, 2015
Words:1965
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