Mastitis treatment in cattle

06/09/2022

There are two options: intramammary antibiotics, the classic mastitis tube and systemic antibiotics given by the intramuscular or subcutaneous route.
Intramammary antibiotics should be the first-line treatment for cows with mild uncomplicated mastitis in a single quarter.

23/07/2022

aicalein is a flavone extracted from Scutellaria baicalensis and Scutellaria lateriflora, was claimed to attenuate inflammatory response by suppressing TLR4 mediated NF-κB and MAPK signaling pathways in LPS-induced mastitis in mice [83]. The binding of baicalein with glucuronic acid form a flavonoid glycoside named baicalin. Few studies had been carried out to study the effect of baicalin to combat bovine mastitis. Study performed by Zhao et al [84] showed that baicalin was able to inhibit E. coli strains isolated from mastitis milk samples with MIC of 4 mg/mL. Although the antibacterial activity of baicalin is low, it affects the drug resistance genes of E. coli, indirectly enhancing the sensitivity of E. coli to antimicrobial agents such as ampicillin, penicillin, streptomycin, ciprofloxacin. Before this, baicalin was shown to attenuate inflammation and apoptosis induced by Staph. aureus in mammary gland tissues of mouse model by regulating expression of pro-inflammatory cytokines and TLR2-related apoptotic factors [85,86]. Apart from that, Yang et al [87] also demonstrated that baicalin can attenuate LPS-induced inflammation and apoptosis of cow MEC, by inhibiting activation of NF-κB and up-regulation of heat shock protein 72.
Thymol, a monoterpene phenol isolated from thyme, oregano, and tangerine peel, has shown to have an anti-inflammatory effect on mouse mammary gland. It also reduces the expression of pro-inflammatory cytokines (TNF-α and IL-6) and inflammation mediated proteins iNOS and COX-2 in a dose-dependent manner, by down-regulating the activation of MAPK and NF-κB signaling pathway [88]. Besides, Wei et al [89] demonstrated that thymol can inhibit Staph. aureus internalization in bMEC in a dose-dependent manner. It was suggested that the reduction of Staph. aureus internalization was related to the inhibition of NF-κB nuclear translocation; however, this was not correlated with the ability of thymol to decrease the antimicrobial peptide gene expression such as tracheal antimicrobial peptide and β-defensin.
Resveratrol is a natural polyphenol that is present in various plant species, such as grapevines, berries, and peanuts. It has beneficial effects in protecting MAC-T from oxidative cell damage caused due to hydrogen peroxide [90]. Resveratrol was found to significantly inhibit mitochondrial-related cell death by down-regulating BCL-2-like protein 4 expression and up-regulating B-cell lymphoma 2 (BCL-2) expression. The detoxification of reactive oxygen species by resveratrol was proven through stimulation of several antioxidant defense genes such as heme oxygenase 1 (HO-1), cysteine/glutamate transporter, thioredoxin reductase 1 (TXNRD1), and NAD(P)H quinone dehydrogenase 1, which were up-regulated by activation of nuclear factor erythroid 2. In an in vivo study conducted by Zhang et al [91], resveratrol was able to inhibit LPS-induced mouse mastitis through the MAPK and NF-κB signaling pathways, suggesting that resveratrol can act as a potential therapeutic agent for mastitis.
Curcumin, the major compound of turmeric, was claimed to be one of the best potential therapeutic agent against bovine mastitis treatment [83]. Fu et al [92] injected curcumin 1 h before and 12 h after LPS treatment to mammary gland duct of mouse. They found out that it could attenuate the activity of myeloperoxidase, which was reflected by neutrophil accumulation in the mammary gland. The LPS-induced TNF-α, IL-6, and IL-1β were inhibited by curcumin through decreased expression of TLR4, and phosphorylation of IκBα and NF-κB p65. In addition, nanoformulation of curcumin showed even better effect in attenuating inflammatory responses induced by Staph. aureus in a mouse model when compared with normal curcumin [93]. In another study, the effect of turmeric on udder health of dairy cows was evaluated with a phytobiotics-rich herbal mixture (PRHM), which was made up of 18% turmeric roots, 18% cinnamon barks, 60% rosemary leaves, and 4% clove buds. Results showed that supplementation of PRHM were able to lower the SCC, especially in high SCC cows, demonstrating that PRHM could improve cow’s udder health. In addition, cows supplemented with PRHM also consumed more feed dry matter, which can improve feed utilization efficiency and produce a greater amount of milk, proving to be an effective strategy to enhance performance in cows afflicted with mastitis [
Despite having an effect on cell’s physiology, plant-derived compounds, especially essential oils, are reported to directly inhibit or kill mastitis pathogens (Table 2). Fratini et al [95] tested 10 commercial essentials oils on livestock mastitis-causing pathogens (Staph. aureus, Staph. chromogenes, Staph. siuri, Staph. warneri, Staph. xylosus, and E. coli) and found out that 3 of the essential oil Satureja montana L., Thymus vulgaris L. ct. thymol, and Origanum majorana L. were able to inhibit the tested pathogens. The study also found out that thymol, carvacrol and p-cymene are the most abundant components of these essential oils. Antimicrobial tests were carried out using both, pure component mixtures, as well as combined mixture of essential oils. In fact, the mixture of essential oils and mixture of pure components exhibited stronger inhibitory activity better than the single essential oil, suggesting there is synergistic effect between the mixtures. Fratini et al [96] further reported that the essential oil mixture of Origarum vulgare and Leptospermum scoparium may be an effective alternative to staphylococcal infections owing to their synergistic effect. In addition, Cho and his co-workers also found out that treatment using oregano essential oil (OEO) can improve physical condition of the udder in tested cows comparable to that by gentamycin. Not only SCC and the number of WBC were significantly decreased, but Staph. aureus and E. coli were not detected as well. This finding suggested that OEO might be an alternative to antibiotics in controlling subclinical bovine mastitis [97]. However, since OEO gave a distinct flavor and aroma to the milk samples of treated animals, long-term and higher dose exposure should be further investigated [98].
Recent studies on plant essential oils against bovine mastitis
Essential oil origin Mechanisms of action
Mixture of Satureja montana L., Thymus vulgaris L. ct. thymol, and Origanum majorana L. [95] Antimicrobial activity against Staph. aureus
Mixture of Origanum vulgare and Leptospermum scoparium [96] Antimicrobial activity against Staph. aureus, Staph. chromogenes, Staph. siuri, Staph. warneri, Staph. xylosus and E. coli
Origanum vulgare [97] Decreased SCC and WBC in cows afflicted with subclinical mastitis, inhibits Staph. aureus and E. coli
Valencia orange [100] Inhibits Staph. aureus growth and biofilm formation, reduced adhesion and invasion in MAC-T
Minthostachys verticillata and Citrus [134] Antimicrobial activity against Strep. uberis
Minthostachys verticillata [140] Attenuate Entero. faecium-induced inflammation in mammary gland tissue of mouse model by activating macrophage phagocytosis and modulating innate immune response
Cinnamon cassia [141] Antimicrobial activity against Staph. aureus, Staph. epidermidis, Staph. hyicus, Staph. xylosus, and E. coli 29
Patchouli, Cedar, Thyme, and Manuka [142] Antimicrobial activity against Staph. aureus, Staph. epidermidis, and Staph. xylosus
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SCC, somatic cell count; WBC, white blood cell; MAC-T, bovine mammary alveolar cells.
Terpeneless, cold-pressed Valencia orange oil was previ ously reported to have an antimicrobial effect on MRSA [99]. Federman et al [100] investigated the effects of citrus-derived oil (CDO) on the interaction between Staph. aureus and MAC-T cells. Growth of Staph. aureus was inhibited in a dose- and time-dependent manner. However only 0.05% CDO was found have a modest effect on the biofilm formation of Staph. aureus. When using MAC-T cells as an in vitro model of bovine mammary gland, 0.1% and 0.05% CDO managed to totally inhibit the adhesion and invasion of Staph. aureus into MAC-T cells. It was found out that major components of CDO, citral, and linalool are responsible for inhibition, owing to their abilities to alter the expression of Staph. aureus virulence genes [101]. On the contrary, CDO has also been reported to not impair the function of polymorphonuclear leukocytes, which play an important role in immune response against mastitis, at the same time inhibiting bacterial growth [102]
Animal-derived compounds
Use of animal-derived compounds in treating bovine mastitis has been concentrated on bee products recently. Bee venom, containing the active component melittin, was administered to LPS-induced MAC-T cells to study its anti-inflammatory effect [103]. Authors found out that bee venom was able to attenuate the LPS-induced COX-2 protein expression, and also mRNA expression of pro-inflammatory cytokines TNF-α and IL-6, by down-regulating phosphorylation of ERK1/2 and nuclear translocation of NF-κB.
Propolis, a resinous substance produced by honey bee, has also been studied for its anti-inflammatory effect on MAC-T cells [104]. Pre-treatment of MAC-T cells with Chinese propolis (15 μg/mL) was able to prevent decrease in cell viability, as well as decrease in pro-inflammatory cytokines mRNA level such as TNF-α and IL-6, when stimulated with various pathogenic factors including LPS, lipoteichoic acid, TNF-α, heat-inactivated E. coli, and Staph. aureus. Besides, Chinese propolis also enhanced the mRNA expression of antioxidant gene HO-1, TXNRD1, and glutamate-cysteine ligase modifier subunit in mastitis infected cells, indicating the anti-oxidative effects of Chinese propolis.
On the contrary, immunomodulators naturally produced by mammals, such as lactoferrin, were preferred as potential non-antibiotic antimicrobial agents for treatment and prevention of bovine mastitis [1]. Lactoferrin is a multi-functional, iron-chelating glycoprotein found in milk, colostrum, and other exocrine secretions such as saliva and tears [105]. As an immunomodulator, it plays an important role in the innate immune system involving opsonization of microorganism for phagocytosis [46]. It was reported to exhibit antimicrobial effect against E. coli, Pseudomonas aeruginosa, Strep. agalactiae, and Staph. aureus, attributable especially to its iron-chelating ability, which can inhibit biofilm production through iron sequestration
Others
Other than bee products that are directly obtained from bee itself, lactic acid bacteria (LAB) found in the honey have been a new source of antibacterial agent [106]. LAB play an important role in honey production and protect the honey bees from different pathogens in hives and during nectar foraging [107]. Mixture of 13 species of LAB previously isolated from honey, from genera of Lactobacillus and Bifidobacterium, have shown to have an antibacterial activity on tested bovine mastitis isolates [106]. In fact, intra-mammary infusion of probiotics has emerged as a potential alternative in preventing and treating bovine mastitis, especially during dry-off period. Lactococcus lactis subp. lactis CRL 1655 and L. perolens CRL 1724 isolated from bovine milk can inhibit bovine mastitis pathogens. These species were able to adhere to teat canal, therefore hypothesized to have a role in prevention of bovine mastitis during dry period [108]. Apart from the milk, LAB isolated from bovine mammary microbiota also exhibit beneficial properties to udder. Nine of the LAB species isolated exhibited anti-inflammatory response in bMEC stimulated by E. coli. In addition, both L. brevis 1595 and 1597 and L. plantarum 1610 showed high colonization capacities towards bMEC, suggesting they can be good candidates to compete with pathogens in mammary gland colonization [
Bacteriocins, antimicrobial peptides produced by bacteria, have emerged as potential alternative for bovine mastitis One of the most studied bacteriocin in bovine mastitis is nisin, which is a lantibiotic, containing 34-amino acid residues, produced by L. lactis. Nisin form a complex with the cell wall, thereby inhibiting cell wall biosynthesis. The complex then aggregates and further incorporates into the cell wall, finally forming a pore in the bacterial membrane Nisin is used as an active agent in teat wipe named Wipe Out [113], however, Staphylococci were reported to have nisin resistance, therefore, discovery of new bacteriocins, alone or in combination with nisin, are highly desirable Field et al reported that nisin derivatives in combination with antibiotics, namely, nisin V and I4V, significantly increased biofilm inhibition activity against Staph. aureus and Strep. pseudintermedius than wild-type and antibiotics combination. Besides, combination of nisin and dioctadecyldimethylammonium bromide nanoparticles increased the susceptibility of Staphylococci to nisin [116]. Another bateriaocin, lysostaphin, isolated from Staph. simulans, either treated alone or in combination with nisin, can inhibit biofilm-forming Staph. aureus [117]. Taken together, combination of nisin with other antimicrobial agent can overcome the issue of nisin resistance.
Bacteriophage are viruses that specifically infect bacteria and are harmless to humans, animals, and plants; thus, bacteriophage and their derivatives (i.e., endolysin, exolysin, and depolymerase) are being deemed as valuable antimicrobial alternatives with a potential to reduce the current use of antibiotics in agri-food production, increasing animal productivity and providing environmental protection Varela-Ortiz et al isolated 4 phage lysates from an apathogenic Staph. aureus strain and tested on 36 Staph. aureus subclinical mastitis strains. They found out that all the tested strains were susceptible to all phage lysates. Other than Staph. aureus, bacteriophage was reported targeting E. coli too. Porter et al separated bacteriophages from 36 clinical coliform mastitis isolates and selected 4 phages in combination with distinct broad host range as candidates to evaluate its antibacterial activity against mastitis-causing E. coli. Bacteriophage cocktail had same effect as ceftiofur (10 μg/mL) in inhibiting E. coli growth. It also significantly reduced adhesion and invasion of E. coli. In addition, combination of bacteriophage with a non-antibiotic bismuth-based intra-mammary teat sealant, E. coli growth was inhibited, therefore, phage cocktail was suggested to have a potential to control E. coli infections in farm [120]. Moreover, bacteriophages also showed the potential to be suitable for vaccination when engineered with genes of interest, thereby, can be useful against bacterial and viral infections [118]. For instance, treatment using recombinant endolysin Trx-SA1 to mild clinical Staph. aureus mastitis quarters showed significant reductions in pathogen levels and SCC [12
Chitosan is a natural polysaccharide derived from chitin, proven to have broad spectrum of antimicrobial activity against fungi and bacteria. It was majorly reported to inhibit growth and biofilm formation of Staphylococcus spp. causing bovine mastitis Chitosan in nanoparticle form exhibit higher antimicrobial and anti-biofilm capacity than the native chitosan . Intra-mammary infusion of chitosan can boost up the mammary gland involution and activate host innate immunity, associated with an increase in SCC, bovine serum albumin and lactoferrin concentrations. It also increases lactate dehydrogenase activity in mammary secretions, which consequently reduce the possibility of getting new IMIs during the dry period
CONCLUSION
In conclusion, effective mastitis control programs rely more on prevention rather than treatment. Currently, antibiotic treatment is still an established component in mastitis control programs. Antibiotics are often coupled together with others therapies; yet the effectiveness is still not satisfying. Therefore, searching for new therapeutic alternatives is necessary. A wide variety of natural products derived from plants, animals, and bacteria were investigated and reported to have potential in controlling bovine mastitis. Field studies should be considered to reassure the outcome of the alternative therapies before commercial applications.

23/07/2022

Bovine mastitis, an inflammation of the mammary gland, is the most common disease of dairy cattle causing economic losses due to reduced yield and poor quality of milk. The etiological agents include a variety of gram-positive and gram-negative bacteria, and can be either contagious (e.g., Staphylococcus aureus, Streptococcus agalactiae, Mycoplasma spp.) or environmental (e.g., Escherichia coli, Enterococcus spp., coagulase-negative Staphylococcus, Streptococcus uberis). Improving sanitation such as enhanced milking hygiene, implementation of post-milking teat disinfection, maintenance of milking machines are general measures to prevent new cases of mastitis, but treatment of active mastitis infection is dependant mainly on antibiotics. However, the extensive use of antibiotics increased concerns about emergence of antibiotic-resistant pathogens and that led the dairy industries to reduce the use of antibiotics. Therefore, alternative therapies for prevention and treatment of bovine mastitis, particularly natural products from plants and animals, have been sought. This review provides an overview of bovine mastitis in the aspects of risk factors, control and treatments, and emerging therapeutic alternatives in the control of bovine mastitis.
Keywords: Bovine Mastitis, Dairy Cow, Bacteria, Antibiotic, Alternative Bovine Mastitis Treatment, Natural Products

05/07/2022

05/07/2022

Visual examination and palpation of the udder prior to putting on the clusters should be part of all milking routines. Mastitis causes udder swelling, reddening, hardness, heat and pain which can often be detected even with a fairly cursory examination.
The problem with relying on udder examination as the first line of mastitis detection is that udder changes are detectable fairly late in the process, so by the time disease is detected considerable losses have occurred. Later identification also means delayed treatment, which tends to be less effective than early treatment and increases the risk of disease spread

05/07/2022

Stripping milk from a cow and examining it, prior to milking, is still the best method for detecting most early cases of clinical mastitis. This is because changes in the milk are often the first sign of mastitis. Milk changes (clots, flecks, changes in colour or consistency) can be seen when milk is stripped on to a dark surface. The changes in milk are related to the causal organism with clots and flakes tending to be more common in mastitis due to Staphs and Streps, while straw-coloured milk is typically associated with E. coli. There is considerable overlap and other factors need to be taken into account when deciding what treatment to use.
Examination of the foremilk is easy to do and requires no specialized equipment, so is available to every stockperson. Nevertheless, probably less than 10% include it in their milking routine, mainly because of the time it takes.

28/06/2022

WHILE EXTENSIVE MASTITIS RESEARCH EXISTS, THERE IS LIMITED DATA REGARDING THE WHOLE GENOMES OF PATHOGENS THAT CAUSE THE INFECTIONS, AND THUS LARGE GAPS IN OUR UNDERSTANDING OF THE BACTERIA AND HOW OR WHY THEY LEAD TO THE DISEASE.

Mastitis, which is an infection of the milk-producing mammary gland, is one of the most prevalent and costly diseases in dairy cattle, with an estimated worldwide cost of an average of $2 billion a year. Even with this major cost, there is limited information about the genetic makeup of the bacteria that cause mastitis.

Researchers at the New Hampshire Veterinary Diagnostic Laboratory at the University of New Hampshire in collaboration with colleagues at Cornell University have received a four-year $650,000 grant from the USDA National Institute of Food and Agriculture (NIFA) to conduct genetic analysis and research to unravel how these bacteria cause these costly infections. The grant is part of the federal agency's $14 million research investment to protect agricultural animals from disease.

“Animal health is critically important to farmers and ranchers,” NIFA Director Carrie Castille said. “This research will help better understand, diagnose, control and prevent diseases in agricultural animals.”

Senior veterinary pathologist David Needle said scientists noted a distinct difference in the types of bacteria causing mammary gland infections on conventional versus organic dairies. A specific set of bacteria were identified in 3% to 5% of mastitis infections found on organic farms, but in 35% to 45% of mastitis infections found on conventional farms. These findings are consistent over years and across state boundaries, and Needle and his collaborators at UNH and Cornell theorize that there may be a relationship between the prevalence of mastitis-causing bacteria and the differences in the environmental microbiome of conventional and organic dairies.

Needle and collaborators NHVDL managing director Robert Gibson, the UNH Hubbard Center for Genome Studies, and Laura Goodman, Michael Stanhope and Paolo Moroni from Cornell, plan to genetically sequence bacteria from the milk cultures from nearly 800 conventional and organic cows in New Hampshire, New York, and Vermont. These sequences will be paired with sequencing of barn floor environmental samples from participating farms.

While extensive mastitis research exists, there is limited data regarding the whole genomes of pathogens that cause the infections, and thus large gaps in our understanding of the bacteria and how or why they lead to the disease. The bacterial genomic information is basic to understanding the bacteria as pathogens – the ability of any single bacterium to cause disease or resist treatments is based on whether or not that bacterium has specific genes that give them these capacities. These genetic differences may be related to differences in management and medical practices across dairy farms. If the researchers are able to identify correlations between management and medical practices and a more or less aggressive genetic makeup of the mastitis-causing bacteria, then there could be much more targeted and specific management and medical approaches developed to decrease the incidence and severity of mastitis.

“What we learn from this work could help producers and veterinarians decrease the incidence and severity of mastitis on both conventional and organic dairy farms, thus making healthier and more comfortable cows with increased milk quality and milk yield, and increased quality and length of life,” Needle said. “Our completed work also will improve our understanding of the evolution of bacteria on different farms and how these bacteria change to impact the health of lactating cows and the quality of their milk. In combination with results of a husbandry and medical care survey, our findings could lead to recommendations about farming practices that reduce mastitis-producing bacteria on farms.”

This material is based upon work supported by the NH Agricultural Experiment Station, through joint funding of the National Institute of Food and Agriculture, U.S. Department of Agriculture, under Agriculture and Food Research Initiative award number 1025988, and the state of New Hampshire.

Founded in 1887, the NH Agricultural Experiment Station at the UNH College of Life Sciences and Agriculture is UNH’s first research center and an elemental component of New Hampshire's land-grant university heritage and mission. We steward federal and state funding, including support from the USDA National Institute of Food and Agriculture, to provide unbiased and objective research concerning diverse aspects of sustainable agriculture and foods, aquaculture, forest management, and related wildlife, natural resources, and rural community topics. We maintain the Woodman and Kingman agronomy and horticultural research farms, the Macfarlane Research Greenhouses, the Fairchild Dairy Teaching and Research Center, and the Organic Dairy Research Farm. Additional properties also provide forage, forests, and woodlands in direct support to research, teaching, and outreach.

28/06/2022

Bovine Mastitis
Mastitis in cows is one of the most common diseases plaguing the dairy industry. Bovine mastitis is an inflammation of the mammary gland caused from trauma or an infection, leading to abnormal and decreased milk production.
Apart from antibiotics, dairy farmers have few tools to treat the common and costly udder infection mastitis. To add to their tool kit, a team led by Dr. Gerlinde Van de Walle of the Baker Institute is exploring compounds secreted by stem cells as a potential therapy that may kill the bacteria while healing the damage they leave behind.
Dr. Gerlinde Van de Walle in her Baker Institute Lab photo by Rachel Philipson
The new project stems from a unique collaboration between the Baker Institute for Animal Health, part of the Cornell College of Veterinary Medicine (CVM), and Elanco, a leading animal health company. Funding for the work comes from the Foundation for Food and Agriculture Research (FFAR), the New York Farm Viability Institute (NYFVI) and Elanco. All together, the project will receive $1.38 million, with about half coming from FFAR. While the research is still in early stages, the team hopes it will provide proof of concept that stem cell compounds have potential for treating mastitis and perhaps other diseases as well. “The long-term goal would be a natural product that could be an adjunct or even a replacement for antibiotics,” said Van de Walle, “that in itself would be huge.”
In addition, Dr. Laura Goodman of the Baker Institute is collaborating with scientists at the University of New Hampshire to study genetics of this costly dairy cow disease. Even with this heavy cost, there is limited information about the genetics of the bacteria that cause mastitis. Now researchers at the New Hampshire Veterinary Diagnostic Laboratory at the University of New Hampshire in collaboration with colleagues at Cornell University have received a four-year $650,000 grant from the USDA National Institute of Food and Agriculture (NIFA) to conduct genetic research to unravel how these bacteria cause these costly infections.
"I’m looking forward to continuing this partnership to characterize genetic patterns in mastitis and develop better molecular characterization tools that can help us understand antimicrobial resistance in a One Health context. This work will have excellent synergy with my project on natural diets and antimicrobial resistance with the Cornell Feline Health Center," states Goodman.
See the latest developments
Dairy Global - August 5, 2021 - A cure for mastitis?
"By and large, however, it is antibiotics that veterinarians and dairy farmers have historically relied on to treat mastitis – and they still do. But while antibiotics do work, any treated cow must be taken out of the milking pool for a period of time to prevent contamination of the milk supply with antibiotic residues. Antibiotics also do nothing to repair the tissue damage caused by the infection.
And with bacterial resistance to antibiotics growing each year, it is critical that a new solution be found to treat mastitis." READ MORE
UNH Scientists Receive $650,000 Grant to Study Genetics of Costly Dairy Cattle Disease - August 23, 2021
Dr. Laura Goodman is one of the Cornell
researchers collaborating on the NIFA grant.
Researchers at the New Hampshire Veterinary Diagnostic Laboratory at the University of New Hampshire in collaboration with colleagues at Cornell University have received a four-year $650,000 grant from the USDA National Institute of Food and Agriculture (NIFA) to conduct genetic analysis and research to unravel how these bacteria cause these costly infections. The grant is part of the federal agency's $14 million research investment to protect agricultural animals from disease.

12/03/2022

Examining the udder
Visual examination and palpation of the udder prior to putting on the clusters should be part of all milking routines. Mastitis causes udder swelling, reddening, hardness, heat and pain which can often be detected even with a fairly cursory examination.

The problem with relying on udder examination as the first line of mastitis detection is that udder changes are detectable fairly late in the process, so by the time disease is detected considerable losses have occurred. Later identification also means delayed treatment, which tends to be less effective than early treatment and increases the risk of disease spread

12/03/2022

Stripping milk from a cow and examining it, prior to milking, is still the best method for detecting most early cases of clinical mastitis. This is because changes in the milk are often the first sign of mastitis. Milk changes (clots, flecks, changes in colour or consistency) can be seen when milk is stripped on to a dark surface. The changes in milk are related to the causal organism with clots and flakes tending to be more common in mastitis due to Staphs and Streps, while straw-coloured milk is typically associated with E. coli. There is considerable overlap and other factors need to be taken into account when deciding what treatment to use.

Examination of the foremilk is easy to do and requires no specialized equipment, so is available to every stockperson. Nevertheless, probably less than 10% include it in their milking routine, mainly because of the time it takes.