A Guide to Mastitis Treatment Options and Effectiveness for Dairy Cows


Mastitis is a major challenge for dairy farmers, both from a cow health and economic perspective, with recent figures from Kingshay estimating a cost/box of £386 – based on a price of 50 pence/litre milk.

Although progress has been made in managing udder health – and therefore the onset of mastitis – in recent years, there is still a need for treatment of clinical cases of mastitis.

Jude Roberts, Map of Ag, authored a recent article on the options and effectiveness of various mastitis treatments.

See also: 6 ways to reduce the risk of high bactoscan in bulk milk

Jude Roberts © Jude Roberts

Current outlook

The main option for treating mastitis is with intramammary antibiotics.

Three category D and four category C antibiotics are currently available, each with different tubing intervals and treatment times. This can affect product choice, Roberts says.

It is good practice to use antibiotic treatments alongside non-steroidal anti-inflammatory drugs (NSAIDs), of which there are four active ingredients licensed for use in the UK: carprofen, flunixin, ketoprofen and meloxican.

The actions of these are anti-inflammatory, antipyretic (reducing fever), anti-endotoxic (combats bacterial toxins) and analgesic (pain relief).

“We use them [NSAIDs] much more than we were. Because bacteria cause the release of pro-inflammatory mediators, which cause multiple effects, we really depend on the use of non-steroids to minimize these effects.

There are positives and negatives to their use, but the literature skews in favor of the benefits, she adds. “There is evidence that NSAIDs are beneficial in all cases of clinical mastitis – mild, moderate and severe.”

Corticosteroids are another option. Three of the current intramammary preparations contain corticosteroids and there are also injectable options.

However, due to the implications for the broader immune system and the non-specific nature of these treatments on reducing inflammation, there should be a move away from the use of these injectables in treatment protocols, she says.

Intramammary preparations, especially when the treatment is localized, can still be useful.

Alternative therapies

Alternative therapy options include three products licensed for extended therapy.

For Staphylococcus aureus, it is Synulox LC and Combiclav which do not have a maximum duration of treatment. For streptococci – or staphylococci during breastfeeding – Ubropen can be used.

Looking at the evidence behind these treatments, Ms Roberts says there is no benefit to using prolonged therapy over conventional therapy.

Therefore, when the pathogen is unknown, the normal treatment periods are more than sufficient.

The exception is cases of Streptococcus uberis, where research has shown that increased bacteriological cure is demonstrated with prolonged therapy, she explains.

This has also been shown in cows with consistently high cell counts when treated for subclinical mastitis caused by Strep. uberis.

Bolusing is also gaining popularity as an alternative therapy, including one that uses the “active” ingredient in garlic, called allicin.

It’s been shown to have anti-inflammatory and antioxidant benefits, says Roberts.

Use is only advised for high somatic cell counts (over 500,000 cells/ml), but one of the big advantages is that there is no waiting time for the milk.

The downside to allicin is that it has a chemical half-life of only three hours. Ms. Roberts adds that great care should be taken if you are using an alternative therapy such as a bolus instead of an approved and licensed option.

Future therapies

Innovation in the treatment of mastitis is growing. Potential new treatments include immunomodulators, which are designed to boost the immune system and therefore aim to prevent mastitis.

These products are already approved for cats and dogs.

Bacteriophages can also be used for future treatment. These are viruses that target specific bacteria.

“They look extremely promising, in terms of what they could do, but the downside with them is that you can still get resistance and evolution of the virus, so over time they could lose their integrity,” warns Ms. Roberts.

Antimicrobial peptides are another possible future therapy, which are described as “next generation antibiotics”.

Although they are unlikely to be on the market soon, they are currently the subject of intense research.

Treatment with lactic acid bacteria is being tested by several breeders who use it as a probiotic – either as a teat dip or as a post-milking spray – to reduce colonization.

“There’s a bit of literature on it, but really no good comparative studies in terms of what it does and whether it shows a reduction in mastitis.”

Treatment tips

Ms Roberts recommends using intramammary options to treat new cases quickly, as well as using NSAIDs in all cases.

“Don’t rush for injectable antibiotics – use them in severe cases. Research new technologies, especially bacteriophages and antibody therapy.

“Whenever you switch treatments, monitor your own healing rates and your response to the therapies and changes you make.

“The easiest way to do this would be to look at the proportion of cows that are only infected once, or the proportion of cows that no longer show clinical signs and remain at low cell counts.”

Benefits of Devon Dairy Bolus

Sam Wakeham runs a 600 cow dairy farm near Barnstaple in Devon. He has tested using garlic boluses to manage mastitis and so far has had good results.

After facing challenges with cows calving with high cell counts, Mr Wakeham was approached by a company that marketed the boluses and set about testing the treatment on his farm.

“I did my own trials on 12 cows because I was very skeptical about how it would work. After the first milk recording, we looked at the data and it proved that it worked. »

Since the first trial, Mr Wakeham has continued to use the boluses and says they have continued to improve cell counts – more than the use of antibiotics.

This is part of a broader move away from the use of antibiotics for the treatment of mastitis where possible, he adds.

“We now use non-antibiotic treatments and boluses to treat mastitis, unless it’s a chronic cow, then we’ll use antibiotics. We also try to knock down hard.

With milk prices currently inflated, the ability to incorporate therapies such as boluses also offers a huge benefit in terms of cost reduction, adds Mr Wakeham.

“Our mastitis has never been a major problem, but like all dairy farms it is a problem, so we just try to use as little antibiotics as possible, especially when the milk is near 50p/ liter.”

Jude Roberts speaking at the British Mastitis Conference, held at Sixways Stadium in Worcester on November 9, 2022


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