Transcript 奶牛乳房炎-Matt Yarnall

Mastitis in Dairy Cattle
奶牛乳房炎
Matt Yarnall BVM&S MRCVS 注册兽医师
China
UK Cattle Veterinary Adviser 英国兽医顾问
May 2013
Who am I? 我是谁？
• Matt Yarnall BVM&S MRCVS 注册兽医师
• Worked in practice as a mixed vet
and dairy vet
曾任职多畜种兽医和奶牛兽医
• Cattle Veterinary Adviser
for the UK and Ireland
英国和爱尔兰牛兽医顾问
What am I here to talk to you about?
和大家分享的内容
• 1. What is mastitis and what is the impact?
•什么是乳房炎，其影响如何？
• 2. What does it look like and what causes it?
•表征及病因？
• 3. Can we prevent it?
•能否预防？
• 4. How do we treat it?
•如何治疗
Mastitis – 1. What is it and what is the
impact?
乳房炎－1.解析和影响？
• An inflammation of the milk secreting tissues of the udder
caused by microbial infections in one or more quarters/teats
乳区泌乳组织的炎症，通常有细菌感染造成，发病于一到多个
乳区
• Affects 25 to 50% of all cows per year
•每年影响25－50%的奶牛
• The most costly disease of dairy cattle
– $2 billion annually
– 奶牛经济损失最大的疾病
– 每年20亿美金的损失
Mastitis is an economic issue
乳房炎是一个经济问题
• The most prevalent disease facing the worldwide dairy
industry 世界奶牛产业最普遍的疾病
– Costs as high as $220 per case, mostly from production loss and
discarded milk 每个病例损失约220美金，损失主要来自产奶量下降和
使用抗生素导致的废弃奶
Mastitis affects profitability
乳房炎是一个效益问题
• Decreased milk production 奶量下降
– 66% of total costs 占损失的66％
– Simple single case reduces
yield by around 250 litres 单个病例约
损失250升牛奶
• Milk disposed of due to treatment 治疗造成的弃奶
- 6%
• Medicine + veterinary costs 用药＋兽医费用
- 4% + 1.5%
• Labour costs 劳动力
- 0.5%
• Culling and death losses 淘汰及死亡
- 22%
• Lost quality premiums 奶品质的下降
Mastitis is a pathogen issue and a quality issue
乳房炎是一个病原问题，也是一个治疗问题
• Involves a variety of pathogens (micro-organisms)
and spread:
涉及多种病原体（微生物）的传播
environmental, contagious and the two combined
环境性，传染性，两者混合感染
• This complicates pathogen identification, treatment and control
•这使得病原鉴定，治疗和防控趋于复杂化
• Bacterial infections have significant adverse effects on milk quality
•细菌感染严重影响牛奶品质
• It is a major concern for both processing efficiency and human health
对牛奶加工效率及人体健康都有很大隐患
Mastitis is not just an issue for vets
乳房炎不仅仅是兽医要考虑的问题
• Veterinary use of antibiotic is increasingly considered in the context of
a larger health picture which includes questions of priority between
animal and human medicine
兽用抗生素应用，逐渐被提高到关乎人体健康、与人体用药的优先选择层面
• A future challenge for the dairy industry?
•未来奶牛产业面临的一个巨大挑战?
Factors linked to mastitis
乳房炎的影响因素
-Lowered immunity
(following calving)
Host
免疫力降低（产后）
奶牛
-Other diseases 其他疾病
-Teat end injury 乳头损伤
-Nutrition 营养
-Stress (bullying,heat)
应激 （争斗，热应激）
Environment
Infectious Agent
环境
传染因素
-Housing/Bedding 圈舍/卧床垫料
-Pathogenicity 致病原
-Equipment 设备
-Virulence 毒力
-Hygiene 卫生
-Number 数量
Mastitis – 2. What does it look like and what causes it?
乳房炎－2. 表征如何及病因？
Changes to the cow 对奶牛的挑战
• Udder swelling 乳区肿胀
• Heat 发热
• Pain 疼痛
• Lameness 跛行
• Sickness 病态
Changes to the milk
对牛奶的影响
• Flakes 絮
• Clots 凝块
• Watery aspect 水样
• Blood 带血
• Increased Somatic Cell Count 体细胞升高
(SCC)
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What types of mastitis are there?
乳房炎有几种呢？
Clinical
Subclinical
临床型
亚临床型
• Can be seen 眼观可见
• Cannot be seen 眼观不可见
- Udder shows signs of inflammation
(Redness, swollen, tender, hard, etc.)
乳区炎症（红，肿，痛，硬，等）
• Milk is abnormal 牛奶异常
• May be post-clinical 可在临床乳房炎发病后形成
BUT can be measured via SCC 可通过监测体细胞进行
评估
• Herd Test (BMSCC) 牛群监测（大罐奶体细胞）
(Flecks, clots, off colour, bloody)（片状、块，变色，带
• CMT (California Mastitis Test) 加州乳房炎检测
血）
• Affects milk quality and production and decrease cow value
• Can be severe, moderate or mild
•有 严重，中度和轻度之分
• May differ from bacteriological
•影响牛奶品质、产量，降低奶牛价值
status 不同细菌感染导致症状不同
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Clinical mastitis临床性乳房炎
Abnormal milk and
abnormal udder
牛奶及乳房异常
Abnormal milk,
abnormal udder and
abnormal cow奶牛、
乳房及牛奶异常
Abnormal milk
牛奶异常
GRADE 2二级
GRADE 1一级 - MODERATE中
度
- MILD轻度
GRADE 3三级
- SEVERE重度
Mastitis Terminology乳房炎相关术语
Acute急性
• Rapid and severe onset急性发作
• High temperature高温
• Serious condition症状严重
Chronic慢性
• Persistent subclinical form持续亚临床形式
• With or without clinical flare ups
•有时出现临床症状
Mastitis in a Herd畜群乳房炎
Clinical
临床性
Subclinical
亚临床性
Mastitis pathogens – what are they?
乳房炎致病原－有哪些？
Streptococcus (S.) agalactiae 无乳链球菌
Trueperella haemolytica 溶血链
S. Dysgalactiae 停乳链球菌
球菌
T. Multocida T.巴氏杆菌
Bacillus spp. 芽孢杆菌
B. Anthracis 炭疽杆菌
Mycoplasma spp. 支原体属
Nocardia spp.诺卡氏菌
Tricosporan spp. 诺拉氏菌属
Candida spp. 念珠菌
Cryptococcus neoformans 新型
隐球菌
Saccharomyces 酵母菌
Torulopsis球拟酵母菌
Mycobacterium spp. 结核分枝杆
菌
Fusobacterium necrophorum 坏
死杆菌
Leptospira spp. 钩端螺旋体
Brucella spp.布鲁氏菌
Colostridium perfringens 产气荚
膜梭菌
S. Uberis 乳房链球菌
S. Bovis 牛链球菌
Fecal streptococci 粪链球菌
Group G StreptococciusG组链球菌
Staphylococcus aure 金葡菌
Staph. Epidermidis 表皮葡萄球菌
Micrococci 微球菌
Escherichia coli 大肠杆菌
Klebsiella spp. 克雷伯氏菌
Enterobacter spp. 某些肠杆菌属
Arcanobacterium pyogenes化脓隐秘杆菌
Corynebacterium. Bovis 牛棒状杆菌
C. Ulcerans 溃疡棒状杆菌
Pseudomonas spp. 假单胞菌
Serratia marcescens 沙雷氏菌
Mastitis Pathogens 乳房炎致病菌
Contagious传染性
Environmental环境性
Staph. aureus, Strep. Agalactiae
Strep. uberis + E.coli
金黄色葡萄糖球菌 ，无乳链球菌
乳房炎链球菌与大肠杆菌
Transferred cow/cow at milking
Environmental origin来源于环境
挤奶时在牛群中传播
Come from beddings or faeces来自及粪垫料便
Milking machines and milking management involved
 higher case rate 高发病率
涉及挤奶设备与操作
More noticeable udder response
Often unnoticed常被忽略
乳房反应更明显
 High SCC 高体细胞数
 lower SCC 低的体细胞数
Persistent, difficult to eliminate
Easier treated治疗简便
持久，很难清除
Can be hard to treat治疗困难
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Test! Don’t guess!!!检测！不要猜测
Know the bug
you’re dealing
with!!了解你的敌人
How to take a sterile milk sample
如何无菌采集奶样
1.
Milk the first three or four squirts of milk onto the floor (these will contain bacteria growing on the teat skin not necessarily
the bacteria causing the problem)
挤出头3－4把奶并弃掉（把附着在乳头皮肤的病原菌弃掉，因其不一定引起乳房炎）
2.
Disinfect the teat with a disinfectant teat wipe
消毒纸巾对乳头进行消毒
3.
Open a sterile plain milk sample pot 打开无菌采样管
4.
Holding the pot at a 45° angle squirt milk into the pot. Don’t hold the pot directly under the cow as dirt and bacteria may fall
down and contaminate the sample
采样管倾斜45度角，将乳汁挤入管中。
勿垂直采奶样，防止脏物和细菌污染样品
5.
Put on the lid and label with the cows number, the
quarter affected and the date
封闭管口并贴上标签，注明牛号、感染乳区及时间
6.
Either refrigerate the sample if it is to be sent off that
day or store the sample in the deep freeze
当天送样，样品可低温冷藏，较长时间送样可冻存样品，
Antibiotic sensitivity testing
抗生素药敏试验
Mastitis Prevention乳房炎预防
Contagious传染性
• Proper Milking Techniques
合适的挤奶技术
• Procedures, training, monitoring
步骤，培训，监控
• Post-milking disinfection挤后消毒
• Maintain milking equipment
挤奶设备的维护
• Milk contagious cows last 病牛最后挤
• Culling 淘汰
• Disease free replacements! 传播容易
Environmental环境性
Keep cows clean! 保持奶牛干净
• Proper Bedding 合适的垫料
• Clean and dry干净干燥
• General farm housekeeping 牧场整体管理
– Manure, water, flies粪便，水和飞蝇
• Cow comfort – Stalls 奶牛舒适度——卧床
• Pre-milking disinfection挤前消毒
• Post-milking standing time 挤后站立时间
All dairy producers should follow the
Five Point Plan 应遵循五点计划
The 5 Point Plan 五点计划:
1)
Teat disinfection - combined with sound housing management
乳头消毒－结合良好的圈舍管理
2）Correct maintenance of the milking machine 挤奶设备的良好维护
3） Prompt treatment of clinical mastitis 合适的临床乳房炎治疗
4） Dry cow therapy 干奶期治疗
5） Culling chronically affected cows 淘汰慢性感染病例
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Teat disinfection 乳头消毒
• Ensure udder is clean and DRY 确保乳区干净、干燥
• Pre- and Post-milking teat disinfection
• Separate wipes for each cow
• 挤前－挤后乳头消毒
• 一牛一巾
• Use of gloves 人员戴手套
• Milk mastitic cows last 乳房炎牛最后挤
• Use of ‘dump buckets’ 使用特殊容器接废弃奶
• Cleaning of plant between milkings 挤奶后要清洁设备
Pre-milking teat disinfection – Environmental
挤前乳头消毒－环境性
• Dirty udders will have over 1,000,000 bacteria on the teat end
•脏的乳房在乳头末端会有超过100万细菌
• Clean udders have around 150,000 bacteria on the teat end
•干净乳房的乳头末端有15万细菌
If udder is clean, dry wipe only
• If udder is dirty, wash and DRY carefully
乳房干净，仅擦干乳头
乳房较脏，清洗并仔细擦干
• Use GLOVES 使用手套
• Use of free iodine prepared product
•使用含游离碘的产品
- Aims to reduce environmental pathogens on teat ends prior to
milking 目的是挤奶前降低乳头末端的环境病原物
- Aims to reduce Bactoscan 目的是降低细菌数量
Post-milking teat disinfection – Contagious
乳头挤后消毒－传染性
• Long duration of activity 作用时间长
- Kills bacteria left on teat from the milking machine
-杀死由挤奶设备带来的细菌
- Emmolient softens teat and promotes healing
-软化乳头防止皲裂、促进愈合
• Correct storage and re-constitution 注意保存和配置药浴液
•  good teat condition 保持乳头良好状态
Combined with sound housing management
结合良好的圈舍管理
Dry cow housing & calving areas 干奶圈舍&产房
• First 2 weeks after drying-off and last 2 weeks before
calving the most vulnerable
干奶后两周、产前两周是最脆弱时期
• Good ventilation, dry bedding, low stocking density
•良好的通风，干燥的垫料，低的饲养密度
• Calving pens/area
•产圈－舒适
well cleaned out between cows
especially if leaked milk
及时更换垫料，尤其是有漏奶现象发生时
Combined with sound housing management
结合良好的圈舍管理
Improve lactating cow environment 改善泌乳牛环境
• Housing design 圈舍设计
• Adequate stocking density 充足的饲养密度
• Ventilation (humidity!) 通风（湿度！）
- 1000 litres of water from breath
produced a day per 100 cows
每100呼吸需要1000升水分
•Good cow comfort 好的舒适度
- mattresses, sand, straw 床垫，沙子，稻草
• 30-60 minutes standing time after milking
•挤奶后30－60分钟站立时间
Maintenance of the milking machine
挤奶设备的维护
• Regular service
- every 6 months 定期维护－每6个月
• Adequate vacuum, good pulsation  good teat
condition
真空充足、良好的脉动好的乳头状况
• Liner renewal – 6 months or 2500 milkings
• 奶杯内衬－6个月或2500次挤奶后更换
Dry cow therapy 干奶期治疗
• Dry cow therapy (DCT) aims to cure and prevent infections 干奶期治疗在于治疗和预防感染
•
Cure – persistent Gram + (S.aureus) mastitis infections
•
•
治愈G －持久G＋（金葡菌）乳房炎感染
Prevent – Gram + and Gram – (E.coli) new infections
•
预防G＋和G—（大肠杆菌）新发感染
•Main risk periods for picking up new infections
(environmental) are:
主要的新发感染高危阶段（环境性）：
- around drying off 在干奶前后
- around calving 在分娩前后
• Success for treatment of
persistent infections is higher during drying off
在干奶期，成功治疗慢性持续感染的几率较高
Culling 淘汰
• Recommendation to cull cow with > 3 incidents of mastitis in same
quarter or > 5 cases of mastitis in same lactation
同一乳区3次以上患乳房炎或在同一胎次发生5次乳房炎，建议淘汰
• Based on bacteriology result 基于细菌学结果:
• type of pathogen present (Staph. aureus, Mycoplasma sp.)
•
•
•
•
目前的病原种类（金葡菌或支原体）
response to treatment (chronic, persistent) 治疗效果（慢性、持久性）
farm economics 牧场的经济水平
value of cows 牛只的价值
• Decision to cull should not be based on single sample, whether
individual cow SCC or bacteriology
是否淘汰不能基于单个案例，无论是个体牛体细胞数还是个体牛细菌监测
• Expensive and still need to “sort out the problem on the farm” 昂贵，找出真正的问题
Mastitis – 4. Treatment
乳房炎－4. 治疗
Therapy should:
治疗应该
•
•
•
•
•
解除临床症状
Achieve bacteriological cure
达到细菌学治愈
Restore milk to saleable quality
•
•
•
Stop clinical signs
恢复乳品质
Avoid residue failures
避免过长的抗生素残留
• Be cost effective
•
经济
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Choice of intramammary antibiotic
选择乳注抗生素
•
Pathogens susceptible to antibiotic
(esp. Staph aureus)
病原对抗生素敏感（如金葡菌）
• Proven bacteriological cure in the field 能达到细菌学治愈
• Proven distribution within the udder 能在乳区有效分布
• Cost effective 物有所值
Causes of Therapy Failure
治疗失败的原因
• Ineffective concentration of drug at target sites
• Micro-abscesses, duct blockage, oedema, fibrosis, poor distribution, intracellular bacteria, insufficient
drug, timing
 在靶区无有效药物浓度
微脓肿，导管阻塞，水肿，纤维化，分布不均，细胞内的细菌，药物 不
足，及时
• Bacteria refractory
• Resistant forms, not rapid growth phase, inappropriate antibiotic choice
 细菌复苏
抵抗形式，非快速生长阶段，抗生素的不适当选择
• Re-infection
• Inadequate duration of therapy, hygiene, udder/teat conformation, milking machines
 重新感染
治疗时间不够，卫生，乳区/乳头状况，挤奶设备
Treatment Guidelines 治疗原则
Severity
严重性
Mild 轻度
Moderate
中度
Severe
Acute
重度急性
Toxic 毒性
Symptoms 症状
Abnormal milk
牛奶异常
Abnormal milk
swollen quarter
pain, no fever
牛奶异常，乳区异
常，不发烧
Temp >39.50
pain, swelling
体温>39.50
痛，肿
Severely ill
depressed, off-feed
Dehydrated
严重病态，精神差
不食，脱水
Treatment Plan (general) 整体治疗原则
milk out regularly
IMM (intramammary) antibiotic +/- NSAIDs (E.g.
Metacam) 定期挤奶，乳注抗生素，选择使
用非甾体抗炎药（美达佳）
Antibiotic IMM and/or systemic
乳区灌注抗生素/全身用药
(chronic case or non-responsive慢性局部用药无反
应病例)+/- NSAIDs非甾体类抗炎药
素
Antibiotic (IMM and/or systemic)
Anti-inflammatory drugs NSAIDs
抗生素（乳注和/或全身）
抗炎药（非载体）
Systemic antibiotics 全身应用抗生素
NSAIDs 非甾体抗炎药
Fluids (intravenous or oral) 液体疗法
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Key questions when dealing with mastitis
应对乳房炎时考虑的主要问题
INDICATOR指征
Incidence rate of clinical mastitis (new cases)
新病例发病率
% of cases requiring a treatment change
需要更换治疗方法的比例
% recurrent cases (nb of 2nd case/nb of 1st case)
复发比例
% of severe cases (score 3评分3)严重病例比例
% of cases that result in death致死比例
% of cows with > 1 quarter affected
大于1个乳区感染比例
Nb of days milk discarded / case 弃奶天数
% of herd milking with < 4 quarter
小于4个乳区泌乳比例
GOAL目标
<25 cases/100 cows/year
年发病率小于25％
< 20%
< 30%（二次感染病例数/初
次感染病例数）
5-20% of all cases
所有病例的5－20％
2%
< 20%
Depends on protocol 取决于治疗
程序
< 5%
Summary 总结
• Five point plan 五点计划
•
Teat disinfection and housing
•
•
乳头消毒和圈舍
Milking machine maintenance
•
•
挤奶设备维护
Prompt and appropriate treatment
•
•
合理的治疗方案
Dry cow therapy
•
干奶期治疗
•
Cull 淘汰
•Monitor 监测
• Treat 治疗
• Lactation treatment 泌乳期治疗
• Dry period treatment 干奶期治疗
• Cull chronic cases 淘汰慢性病例
• And purchase uninfected cows 购买未感染牛只
Thank you!
Questions?