Over recent years at LLM we have seen some excellent reductions in the incidence of mastitis on farms, with many units achieving targets of <20 cases per 100 cows per year (half of the 40 cases/100 cows/year of 20 years ago!), whilst a few are managing single figure incidences. This has been achieved largely through the consistent application of good management practices, especially at milking times, coupled with improved focus on milking machine function and hygienic and comfortable housing.

Whilst the improvement in control is commendable, the management and treatment of new and repeat clinical cases also remains an important part of dairy herd health and welfare. Over the last few years, a focus on trying to reduce the use of antibiotics has helped drive case numbers down as clinical mastitis is often the main contributor to overall dairy antimicrobial use.

Selective dry cow therapy has helped here, alongside other responsible steps, including the following:

1. Sampling clinical cases – collecting a pre-treatment sample from every case of mastitis and storing them frozen. These can be periodically cultured to find out the predominant causative pathogens on a unit so that specific husbandry changes and treatment can be agreed.
2. Reviewing chronic cases and treatment failures and considering early dry off or culling. These cases often account for a large proportion of antibiotic use and carry a rapidly worsening prognosis! Reviewing mastitis incidence and/or treatment data can identify these cases earlier, allowing a better outcome.
3. Reviewing the use of injectable antibiotics in cases of clinical mastitis – there is little evidence to support the routine use of injectable antibiotics in 1st line treatment protocols for mastitis, despite this being common practice. Limiting the use of injectable antibiotics to only severe (Grade 3) cases may bring about a significant reduction in farm antibiotic use, as well as cost savings without a reduction in clinical outcome.
4. Considering use of mastitis vaccines (Startvac, UBAC) if there is evidence of Streptococcus uberis, Staphylococcus aureus or severe E.coli mastitis in the herd.
5. Using NSAIDs routinely for treating clinical cases (see below).

Increased awareness in the use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for the treatment of mastitis has allowed more effective reduction of inflammation and for mediating endotoxin-induced effects in severe mastitis such as Grade 3 E. coli cases. The evidence for their use in mild (Grade 1) and moderate (Grade 2) cases to reduce pain on welfare grounds is maybe stronger than the evidence for reducing cell count or reducing the risk of culling, although there is research evidence to support all these arguments, as well as improvements in subsequent fertility.

Cattle are stoical animals that do not usually show obvious signs of pain, probably because they are descended from prey animals, which have evolved to mask the signs of pain (and therefore weakness) from predators. However, numerous established indicators of discomfort suggest that mastitis does cause pain. Mastitis is typically graded on a three-point scale and research has shown that the heart rate and respiration of cows with Grade 2 (moderate) mastitis were significantly higher than normal animals and the hock to hock distance was significantly higher in cows with both Grade 1 (mild) and Grade 2 (moderate) mastitis.

NSAIDs inhibit the enzyme cyclo-oxygenase (COX), which is involved in inflammation by producing inflammatory mediators such as prostaglandins. They also act as potent anti-pyretics, reducing body temperature and increasing appetite, as well as providing pain relief.

Differences in the selectivity of COX inhibition between the different NSAIDs available for use in cows mean that certain products theoretically have fewer side-effects (such as gastro-intestinal irritation, renal toxicity and inhibition of blood clotting). However, the differences in half-life between these products (some last longer than others) mean this may have less clinical relevance and little comparative data exists for their use in mastitis. It’s probably fair to say that using any one of the products below, either with or without antibiotic therapy, is preferable to not giving one.

NSAID choices available
Flunixin (Finadyne/Pyroflam) –
Short acting (24 hrs)
Milk = 24 hrs
Meat = 5 days (Finadyne), 10 days (Pyroflam)

Ketoprofen (Ketofen/Kelaprofen)

Short acting (8-24 hrs).
Milk = zero.

Meat = 24 hrs (i/v); 2 days (Kelaprofen i/m), 4days (Ketofen i/m)

Meloxicam (Metacam)
Long acting (2-3 days).
Milk = 5 days.
Meat = 15 days

Carprofen (Rimadyl)
Long acting (2-3 days)
Milk = zero
Meat = 21 days

There is now good evidence that mastitis is a painful condition at all Grades (1, 2 and 3). Alongside efforts to reduce the overall incidence of cases and antibiotics used, there should be increased efforts to control the pain caused when cases do occur. NSAIDs are currently the only suitable products licensed within the EU to control the pain associated with mastitis and therefore their use for this is encouraged.