Evidence for the Efficacy of
Udder Health Therapies on
Organic Dairies
Linda L. Tikofsky, DVM
Quality Milk Production Services
Cornell University
QMPS is a program within the NYS
Animal Health Diagnostic Laboratory, a
partnership between the NYS Department of Agriculture and Markets and
the College of Veterinary Medicine at
Cornell University.
What is the evidence?
Very limited
Overview
• Farmers’ motivation
• What conventional practices are
allowed for udder health?
• What is Complementary and
Alternative Therapy?
• Udder Health Therapies
• Our role in Extension
Farmer’s motivation—What is
organic production?
• Holistic system relying on a
symbiosis between soil health,
crop health and animal health
• To use preventive health care is
the key to reducing reliance on
treatments
Farmer’s motivation: What
organic dairying is not
• Input substitution: Cannot simply
substitute alternative therapies for
conventional ones
• Farming by benign neglect:
Organic rule requires that animals
be treated
Farmer’s motivation: The
National Organic Program
Requires that the farm establish preventive
health care practices that address:
• Suitability of the species to the site
• Adequate ration
• Appropriate housing, pasture and sanitation to
minimize disease
• Access to exercise and stress reduction
• Provides vaccination as needed
Farmer’s motivation: The
National Organic Program
• Disallows the administration of
treatments without disease
• Disallows the use of hormones, routine
deworming and administration of
antibiotics and other restricted drugs to
animals whose products will be sold as
organic
Farmer’s motivation: The
National Organic Program
BUT…
Requires that no farmer withhold
treatment from a sick animal just
to preserve its organic status. All
appropriate medications must be
used to restore health
Farmer’s Motivation
• Consumers: Interested in products
without antibiotics and hormones.
• Farmer’s Pride: Keep cows healthy
through management and
prevention rather than relying on
synthetics as a band-aid for poor
management
(Vaarst et al., JDS 89, 2006)
Udder Health Practices
• Prevention: Maintaining a healthy
immune system
• Four of the NMC’s Five Point Plan (teat
dipping, culling, equipment maintenance,
management of clinical mastitis)
• Nutrition: Vitamin E, selenium, other
trace minerals
• Breeding for resistance
(it’s not black & white….)
Udder Health Practices
• Pasture
– Washburn, et al. 2004: Confined cows had
more clinical mastitis than pastured cows
– Waage, et al. 1998: Heifers on pasture were
at lower risk for clinical mastitis than
confined heifers
– Goldberg et al. 1994: Grazed herds had
lower total bacteria counts than confined
herds during grazing season. Trend toward
improved udder health on pastured herds.
Udder Health Therapies
Conventional therapies:
•
•
•
•
•
•
•
Fluids, glucose
Hypertonic saline
Aspirin
Vaccinations
Chlorhexidine
Frequent milkout
Udder liniments
Udder Health Therapies
Complementary and Alternative
Therapies
Complementary and
Alternative Medicine (CAM)
• Usually not therapies that are
traditionally taught in medical or
veterinary schools
• Lack mechanisms of action that can be
explained by traditional science
• Controversial
• No published milk/meat withdrawals
Complementary and Alternative
Medicine (CAM)
• Becoming more commonly used by the public
• US Medical schools offering coursework in
CAM: 77 (including Johns Hopkins and Harvard)
• National Center for Clinical and Alternative
Medicine (NCCAM)
– NIH member
– Research CAM therapies and integrate into conventional
medicine where proven
– Budget (2006): 122,692,000
Complementary and Alternative
Medicine (CAM)
• Acupuncture
• Chiropractic
• Botanicals
• Homeopathy
• Immune Modulators
Why little evidence for
veterinary efficacy?
• Love of Evidence-Based Medicine
• Fear of the unknown
• Lack of funding
• Farmer treatment without
veterinary/extension involvement
Botanicals (Phytotherapy)
• One of the oldest form of therapy
• Until the 20th century, often the most
commonly used medicine
• Still used extensively in non-Western and
indigenous populations
• Natural substances basis for modern
synthetics
• Dosages: older veterinary texts
• Toxicity can be a problem
Commonly used botanicals in
udder health
• Garlic (allicin)
• Ginseng
• Sage
• Cayenne
• Liniments: Peppermint
Belladonna-Phytolacca
Calendula-Echinacea
The Evidence …Garlic
• Sulfide compounds (allicin)
• in vitro efficacy against yeasts and
fungi Shams-Ghahfarokhi, 2006
• Antimicrobial activity of fresh garlic
paste against E. coli H1:O157 Gupta
and Ravishankar, 2006
• Effect of garlic extract on MRSA
Cutler and Wilson, 2004
Garlic and Bovines
• Calves fed milk replacer containing
either oxytetracycline or Enterogard
(probiotic with allicin) had similar
weight gain, fecal scores and feed
efficiency Donovan et al., 2002
• Allicin did not alter fecal scores or
weight gain of calves infected with
Cryptosporidia although second part of
study showed promise for prophylactic
administration of allicin Olson, et al., 1998
The Evidence…Ginseng
• Ginsenosides: anti-inflammatory,
anti-oxidant and anti-cancer (Kiefer
and Pantuso, 2003)
• Ginseng increased production of
Interleukin-12 by monocytes (Larsen,
et al. 2004)
• Ginseng reduced number of cold,
recurrences, duration and severity
(Predy, et al., 2005)
Ginseng and Bovines
• Ginseng treated cows (chronically
infected with S. aureus) had increased
phagocytic and oxidative burst activity
(Hu, et al., 2001)
• Cows were injected with S. aureus
bacterin alone, with crude ginseng
extract and bacterin or purified
ginsenoside and bacterin. Ginseng
compounds acted as adjuvants and
increased antibody production and
lymphocyte proliferation (Hu, et al., 2003)
Evidence….Sage (Salvia)
• Essential oils of certain spices and
herbs had potent antimicrobial
effects (Kalemba and Kunicka 2003)
• Solvent extracts of sage exhibited
anti-oxidant, anti-malarial,
antimicrobial and antiinflammatory effects (Kamatou, et al.
2005)
Evidence…..Cayenne
• Antimicrobial effects of capsicum on L.
monocytogenes (Leuschner and Ielsch, 2003);
E. coli (Molina-Torres, et al. 1999); bacillus and
clostridial spp (Cichewicz and Thorpe, 1996)
• Clemson Study: control heifers, heifers
on diatomaceous earth and natural
wormers (garlic and cayene or ration
with tannins. Both treatment groups
had decreased FEC over control group
(Bertrand, 2004)
Evidence….Calendula
• Calendula ointment applied to
venous leg ulcers improved healing
over control (Duran, et al. 2005)
• Calendula extract decreased postradiation dermatitis in breast
cancer patients (Pommier, et al. 2004)
Homeopathy
• Samuel Hahneman: German
botanist, chemist and physician
• Early 1800’s
• One of the most controversial
sectors of CAM
• Attempts to stimulate the body to
heal itself rather than treat
symptoms
Law of Similars
• Like treats like
• Find the single substance that, if
given to a healthy person, would
cause the same symptoms seen in
the sick person
• The more dilute a substance is, the
more potent its healing effects
Homeopathic remedies
• May be diluted 10 times, 100
times or 1000 times
• After each dilution, the solution is
shaken or ‘succussed’ to activate
the energy
• Holistic approach: assesses not
just the symptoms but personality
and behavior
Homeopathy in Cattle
• Administer usually in the mouth or
the vulva
• Because it is designed for
individualized treatment, can it be
effective at the herd level?
Common Homeopathic
Remedies for Udder Health
• Pulsatilla: Thick, creamy discharge
• Apis: hard, swollen quarter
• Bryonia: mastitis in fresh cows,
firm quarters
• Belladonna: hard quarter, off-feed,
fever
Evidence…..Homeopathy
Comparison of homeopathic treatment, placebo
and antibiotic
57 cows in 39 Norwegian herds; measured both
acute and chronic changes
Homeopathy did not differ from placebo or
antibiotic
But…
Low cow numbers in each group
Inordinate amount of S. aureus cows were
randomized to the antibiotic group
(Hektoen, et al. 2004. J Vet Med A 51)
Evidence…..Homeopathy
• Evaluated effect of homeopathic nosode
on subclinical mastitis
• 250 cow English dairy, cows were
randomized to two groups
• Treated for six milkings and sampled 3
days before tmt and six times in the
subsequent month
• No significant difference in SCC
between the two groups
(Holmes, et al. 2005. Vet Rec 156)
Evidence…..Homeopathy
• Compared effect of homeopathy
(Phytolacca, phosphorus, Conium
maculatum) with placebo
• 13 cows in each group, treated over 30
days
• Homeopathy cows had lower CMT
scores than placebo cows after
treatment
(Searcy, et al. 1995. Br Homeo J. 84)
Evidence….Homeopathy
• Evaluation of Homeopathic
nosodes for mastitis vs. placebo
• Mastitis nosode created from
common mastitis pathogens
• No differences between treated
and control
• ?Herd homeopathy?
McCrory and Barlow, 2000
Evidence…..Homeopathy
Evaluation of homeopathic metaphylaxis vs
antibiotic metaphylaxis
• 1440 piglets on one farm; medication groups
of 20; homeopathy, placebo or antibiotic
• Homeopathic treatment was better than
placebo at preventing respiratory disease and
slightly better than antibiotic at prophylactic
doses.
• Only when antibiotic was increased to
therapeutic doses did it outperform
homeopathy
(Albrecht and Schutte, 1999. Alt Ther Health Med. 5)
Immunomodulators
• Vaccines
• Colostral-Whey Products
• Immunoboost®
• Hyperimmune Serum
Immunomodulators
• Activate the innate immune
system
• Non-specific stimulation
– Macrophages
– Neutrophils
– Killer Cells
– Complement
– Acute phase proteins
Immunomodulators
• Colostral-whey products from
hyperimmunized cows
• Biocell-CBT
• Crystal-Whey
• IMPRO
H.Karreman
Evidence….Immunomodulators
Enhancement of neutrophil function by ultrafiltered
bovine whey
• Evaluated whey in vitro on neutrophils from
normal and immunosuppressed cows and in
vivo in periparturient cows
• Results:
– increased neutrophil random migration and cellmediated cytotoxicity
– No change in WBC counts in vivo but increased
neutrophil iodination (bactericidal mechanism)
(Roth, et al. 2001. JDS 84)
Evidence….Immunomodulators
Effects of colostral whey on WBC from cows
+/- S. aureus mastitis
• Increase in WBC cells, increase
random migration
• Increase in S. aureus shedding
infected cows
• No adverse effects
(Kerhli, et al. 1989 Vet Immuno Immunopath. 20
in
in
Evidence…Immunomodulators
• Evaluation of effect of Mycobacterium
cell wall fraction stimulant on diarrhea
in bull calves
• 200 neonatal bull calves on calf ranch
received product or assigned to control
• No difference between treated or
control calves
(Kirk, et al. 1998. JAVMA. 213)
Evaluation of an Alternative
Treatment Regimen for S. aureus
1. To evaluate the efficacy of a
recommended treatment protocol
for contagious mastitis
2. To better characterize S. aureus
mastitis epidemiology on New York
organic dairy farms.
Materials and Methods
Herds:
Known history of S. aureus
Owner willingness to participate
Herd One
Herd Two
100 Holstein
Friesian
300 Holstein
Friesian
Round the barn
pipeline
Freestall-Double
Six
100% pasture, NZ dbl 10
2X milking
3X milking
2X milking
Organic since
1998
Organic since
2000
Organic since 1998
Herd Three
70 Holstein Cross
Materials and Methods
• Cow selection: Hx of S. aureus infection or two of
past three DHIA LS > 4.5
• Randomized in blocks of fifteen by farm
Ten treated, five controls per block
• Cows were quarter sampled weekly 3X before
treatment and biweekly 3X post-treatment for
aerobic culture (NMC, 1999) and SCC (Fossomatic
methods)
• Cure rates (Fisher’s Exact test)
Change in LS pre and post treatment (ANOVA)
Results
• Herd Three dropped out after 2nd
day of treatment
• 32 S. aureus quarters and 80 nonaureus quarters
• Most cows infected in one quarter
• Five quarters “cured”
• No effect on quarter level LS
So, What works? (at least for
now….)
• Prevention
• Good management
• Healthy animals
• Motivation and attention to detail
• Botanicals
• Immunomodulators?
What do We Need From
Extension and Universities?
• More clinical research on CAM
• Scott Haskell (Maine): looking at in
vitro and in vivo efficacy of
alternative mastitis treatments
• Danish Agriculture Institute: will
explore efficacy of botanicals and
homeopathics
Questions?