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Carprofen in dairy cattle with toxic mastitis

Clinical Scenario

During a visit to one of your dairy farms, the owner Steve Jones comments that he has had a number of cows sick with mastitis, which he thinks are caused by E. coli. He finds these cases very difficult to treat.

He has recently seen an advert for an anti-inflammatory containing carprofen which claims that it will improve the recovery rate. Over the years, you have had a number of conversations with Steve about the relative merits of different treatment options for cases of toxic E. coli mastitis. You wonder if carprofen makes a difference to recovery...

3-Part Question (PICO)

In [dairy cattle with E. coli mastitis] does [the administration of carprofen compared to no anti-inflammatory treatment] [improve clinical recovery]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(dairy cow.mp. OR dairy cows.mp. OR dairy cattle.mp. OR cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR exp Cattle/)

AND

(e coli mastitis.mp. OR escherichia coli mastitis.mp. OR coliform mastitis.mp. OR toxic mastitis.mp. OR systemic mastitis.mp. OR exp Mastitis, Bovine/)

AND

(carprofen.mp. OR rimadyl.mp. OR norophen.mp. OR norocarp.mp.)

CAB Abstracts 1910 to Present using the OVID interface

(dairy cow.mp. OR dairy cows.mp. OR dairy cattle.mp. OR cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. Or exp Cattle/ OR exp Dairy cows/)

AND

(e coli mastitis.mp. OR escherichia coli mastitis.mp. OR coliform mastitis.mp. OR toxic mastitis.mp. OR systemic mastitis.mp. OR exp bovine mastitis/)

AND

(carprofen.mp. OR rimadyl.mp. OR norophen.mp. OR norocarp.mp.)

Search Outcome

MEDLINE

  • 3 papers found in MEDLINE search
  • 1 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 1 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 6 papers found in CAB search
  • 4 papers excluded as they don't meet the PICO question
  • 1 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Vangroenweghe et al. (2005) Belgium

Title:

Effect of carprofen treatment following experimentally induced Escherichia coli mastitis in primiparous cows.

Patient group:

Primiparous cows with experimentally induced E.coli mastitis

Study Type:

Placebo controlled clinical trial

Outcomes:
  • Clinical severity score (published adaptation of Wenz by authors)
  • Physical parameters: Rectal Temperature, Heart Rate, Respiratory Rate, Reticulorumen motility, Skin turgor, Faecal appearance, Appetite, Attitude, Body Condition Score
  • Mammary gland parameters: abnormal milk, swelling, temperature, leakage, teat relaxation, pain.
  • Milk composition parameters: Somatic cell count (SCC). Fat, protein, lactose, albumin, sodium, chloride and potassium content. IL8, C5a, sCD14, LPS binding protein, PGE2, Thromboxane B2
  • Blood parameters: Packed cell volume, Blood leucocyte count, Plasma levels of LPS binding protein, PGE2 and TXB4
Key Results:
  • Clinical severity score was significantly lower in carprofen group 6 hours post treatment (p<0.01).
  • Rectal temperature was significantly reduced at 3 and 6 hours post administration of carprofen compared to pre-treatment levels (p<0.0001), and did not relapse.
  • In placebo group rectal temperature returned to normal within 9 hours but relapsed at 15 hours post treatment.
  • Heart rate immediately reduced following treatment administration in the carprofen treated group.
  • In the placebo group heart rate returned to pre-treatment levels slowly over 133 hours and rectal temperature reduced over 9 hours, but spiked again at 15 hours post treatment.
  • Reticulo-rumen motility was returned to normal more rapidly in carprofen treated animals.
  • Quarter swelling decreased more quickly in the carprofen treated group. Maximal quarter swelling scores were lower in the carprofen group (p<0.05).
  • Milk appearance, quarter milk leakage scores and maximum milk leakage scores were significantly higher in the carprofen group (p<0.05).
  • No significant differences in SCC between the groups over the experimental period.
Study Weaknesses:
  • No randomisation of cows to treatment groups undertaken.
  • Inclusion criteria were clearly stated but not enough basic data were given about the two groups to allow for direct comparison, e.g. how were they grouped and how were their ages/days postpartum spread between the two?
  • Small sample size (12 in treated group, 13 in placebo)
  • No sample size calculation.
  • No p value level for significance stated in the statistical methods.
Attachment:
No attachments.

Comments

Cows in the study were experimentally induced with E.coli mastitis and only developed mild to moderate clinical signs. None of the cows became toxic, so the cows in this study may not be comparable to cows with toxic mastitis seen in practice. The adapted clinical severity score used in this paper was adapted from Wenz et al. (2001).
Extracting data from this study was difficult due to the poor reporting of the methods.
Pfizer Animal Health are mentioned in the acknowledgements but no indication of their level of involvement is given.

Bottom line

In dairy cattle with mild to moderate E. coli mastitis the administration of carprofen compared to placebo improves some of the clinical parameters associated with recovery.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Vangroenweghe, F., Duchateau, L., Boutet, P., Lekeux, P., Rainard, P., Paape, M. J. & Burvenich, C. 2005. Effect of carprofen treatment following experimentally induced Escherichia coli mastitis in primiparous cows. Journal of Dairy Science, 88:2361-76.

Wenz JR, Barrington GM, Garry FB, McSweeney KD, Dinsmore RP, Goodell G, Callan RJ. 2001. Bacteremia associated with naturally occuring acute coliform mastitis in dairy cows. Journal of the American Veterinary Medical Association, 219:976-81.

About this BET

First author:
Rachel Dean
Second author:
Kathryn Wareham
Institution:

CEVM, University of Nottingham

Search last performed:
2016-10-28 12:19:40
Original publication date:
2013-09-13 12:19:40
Last updated:
2016-10-28 12:19:40
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