A randomized clinical trial of topical treatments for mild and severe udder cleft dermatitis in Dutch dairy cows

Abstract

Udder cleft dermatitis (UCD) is a skin lesion in dairy cows affecting the anterior parts of the udder, with the lesions often needing a long time to heal. The lesions can be characterized as mild or severe. The etiology of UCD is not fully understood and studies on the effectiveness of topical treatments have not been published. The objective of this study, therefore, was to conduct a randomized clinical trial to investigate the effectiveness of 2 different topical treatments, one for mild and one for severe UCD lesions, compared with untreated control groups. The treatment and control groups were randomized within herd for mild and severe UCD. The treatments were applied for a maximum period of 12 wk on 8 Dutch dairy farms. Mild UCD lesions were treated once a d 3 times a week on fixed days with a non-sting barrier film. Severe UCD lesions were first stratified into class A (lesion length <5 cm) or class B (lesion length ≥5 cm) and then randomly allocated to treatment or control groups within herd. Both severe lesion classes were treated once per day every day with an enzyme alginogel. Every week, the lesions of affected animals were inspected and photographed by the investigator. These photographs were reviewed weekly by an external wound expert who classified the lesions as mild, severe class A, severe class B, or healed. Based on this classification, the investigator judged weekly whether the lesions had improved compared with their classification of the previous week. For mild UCD lesions, improvement was defined as occurring when lesions were healed. For severe UCD lesions, improvement was defined as a transition from class B to class A, transition from any severe UCD lesion (class A or B) to a mild UCD lesion, or when the lesion was defined as healed. Data were analyzed using a discrete time survival analysis with time to first improvement as dependent variable. In total, data from 214 animals were analyzed to estimate the effectiveness of treatment. Results showed that treatment of mild UCD lesions had no influence on improvement compared with untreated lesions. Treated severe lesions, however, showed 3.4 times more improvement compared with the untreated controls. Improvement varied between herds, and cows with a parity of 5 or higher showed significantly less improvement than first parity animals. Early identification of severe UCD lesions followed by prompt treatment with an enzyme alginogel supports the healing process.

Bacterial flora associated with udder cleft dermatitis in Dutch dairy cows

“…In our study, udder cleft dermatitis lesions were histopathologically often characterized by a chronic or chronic active inflammation. This chronic character is in line with the studies of Bouma et al (2016) andvan Werven et al (2018). This last study showed that even intensive treatment for a long period had limited results.…”

“…However, this was not supported by a recent study by Sorge et al (2019), in which the authors concluded that it seemed unlikely that spirochetes play a major role in the development of UCD. Although a bacteriological cause of UCD lesions is not yet known, farmers often treat the lesions with sprays or ointments containing antimicrobial agents (van Werven et al, 2018). Presence of bacteria other than treponemes in UCD lesions was described in a recent study using a metagenomic approach (Sorge et al, 2019).…”

M-score and wound healing assessment of 2 nonantibiotic topical gel treatments of active digital dermatitis lesions in dairy cattle

“…All treatments were applied by trained veterinary students. Upon recruitment (d 0), on all farms but one, the hind feet of all lactating cows were given a foot trim according to the Dutch 5-step method (Toussaint Raven, 1989) by the herd's regular hoof trimmer, and all feet of these cows were given an M-score by a trained veterinary student. On one farm (farm 1), the farmer selected 43 cows (out of 118 lactating cows) for foot trimming, because they were lame, likely to have an active DD lesion, or both.…”

“…Since its first introduction, novel products and strategies have emerged to aid in achieving the TIME principle, with enzymatic alginates being one of them. Recently, an enzyme alginogel has appeared effective in the treatment of udder cleft dermatitis, an ulcerative dermatitis, in dairy cows (van Werven et al, 2018). Alginates are known for their capacity to absorb debris and exudate (passive debridement) and for keeping wounds moist through their gelling capacity (moisture balance; Strohal et al, 2013;Jacobsen, 2017;Jones and Oates, 2018).…”

Recovery from udder cleft dermatitis in dairy cows

“…According to anecdotal reports, treatment strategies for severe UCD tested by Swedish farmers include cleaning with soap, iodine, or hydrogen peroxide; application of potato flour or honey; and spraying with chlortetracycline spray, as well as various combinations of these methods and other wound products (L. Ekman, unpublished data). A recent Dutch study that tested a topical enzyme alginogel on severe UCD lesions found that the alginogel improved healing of the lesions (van Werven et al, 2018). Enzyme alginogels are used in the care of human pressure ulcers, which, not unlike UCD lesions, often have a long duration and delayed healing (van Werven et al, 2018).…”