Homoeopathic Society

Homoeopathica November 2002

Three scientists (M.A Sutherland, S.J. Lacy-Hulbert and M.W. Woolford) associated with Dexcel Ltd, Hamilton, once known as Ruakura Research Centre, investigated the effectiveness of homœopathy in treating udder infections in dairy cows.

Sixty four cases of clinical mastitis, from a commercial herd of 600 cows, were assigned randomly to either a homœopathic or antibiotic treatment regime. Double aseptic foremilk samples were collected prior to treatment and approximately 21 days post treatment for bacteriology and somatic cell counting. The most common bacteriological isolates were Streptococcus uberis (23% of cases) and coagulase negative staphylococcus (20% of cases).

Bacteriological negative results accounted for 50% of clinical mastitis cases. Bacteriological cure (disappearance of original pathogen) was observed in 85% and 81% of antibiotic and homœopathic treated cases respectively. Bacteriological cure rate for Streptococcus uberis positive quarters was 57% and 63% for anti­biotics and homœopathy respectively. The somatic cell count was significantly reduced (P<0.05) to less than 5% of the pre-treatment somatic cell count for quarters treated with homœopathy or antibiotics.
The results to date suggest that cows treated with homœopathy achieved a similar bacteriological cure rate to antibiotic therapy and that homœopathy may be bioequivalent to antibiotic therapy, the scientists conclude.

The following is a condensed version of the very interesting paper the researchers presented . . .

To date there have been few published studies on the use of homœopathy in the treatment of mastitis. The homœopathic studies on mastitis in dairy cows have predominantly focused on reducing the somatic cell count (SCC) or using it as a preventative strategy with mixed results (Day, 1986; Egan, 1995; Barlow et al., 2001). One of the few studies using homœopathy in the treatment of clinical mastitis compared homœopathy with antibiotic therapy in a series of 100 cases. The cure rate for both therapies were similar (Merck et al.1989).
The aim of this work was to determine whether homœopathic therapy was equivalent in efficacy, or bioequivalent to, antibiotic therapy. To test for bioequivalence, a range is selected within which both treatments need to fall. For the purposes of this study a range of +15% around an expected cure rate of 75% for antibiotics was established as the bioequivalent range for the homœopathic regime. An additional treatment, of non-treatment of clinical cases, was rejected on the grounds of animal welfare and ethical con­siderations.
This experiment was designed to test the efficacy of the homœopathic approach to treat a clinical disease rather than the effectiveness of an individual remedy, therefore a selection of six “standard” remedies was chosen.

Cows from a commercial herd of 600 were enrolled into the study at the first appearance of clinical signs of mastitis. This study commenced after calving and continued for the first 3 months of 2001/2002 season. Clinical signs included clots, discoloured or watery milk, blood in the milk, and/or pain, heat or swelling of the udder. Any cows showing additional systemic signs of infection such as high temperature, fever, low appetite were not enrolled into the study.

Double aseptic foremilk samples were collected from new clinical mastitis cases for bacteriology and SCC purposes by the herd manager, using standard aseptic technique. The teat end of the affected quarter was scrubbed with a cotton wool swab soaked in 70% alcohol, the first 2-3 squirts discarded, and then 2-3 squirts of milk drawn carefully into a sterile vial. A second larger sample was collected after additional scrubbing of the teat end. Samples were then stored in the fridge or freezer until collection. Milk samples can be tested for bacteriology and SCC following short term storage at -20 C (Murdough et al., 1996; Barkema et al., 1997).

Using a random sequence supplied at the start of the trial the cow was assigned (by the herd manager) to a particular treatment, either antibiotic therapy or homœopathic treatment. If more than one quarter within-cow (one of the cow’s four teats) was found to be infected at any one time, the same treatment was applied to all quarters, that is, treatments were assigned on a per cow basis, rather than case basis. When a new clinical infection was found whilst a cow was receiving a particular treatment or within the recovery period, the same treatment was applied to the new quarter.
Once the treatment was assigned to a new clinical case, a full course of antibiotic treatment was given or for homœopathy treatment the selected remedy was administered for up to four doses of the preparation, at 10 minute intervals, commencing after foremilk samples had been collected. Subsequent treatment involved giving one dose at each milking, for the next 3 days. Preparations were applied to the nose/mouth or vulva using a spray bottle.

For cows receiving antibiotic, the standard milk and meat withholding periods was adhered to. For cows receiving homœopathic treatments, milk was withheld from the bulk tank for the duration of homœopathic treatment - 3 days from commencement of treatment and longer if gross signs of mastitis persisted.
The herd manager recorded and monitored recovery of clinical signs. Bacteriological cure was determined by aseptic collection of 2 foremilk samples for bacteriology and SCC purposes 21 days after commencement of the treatment, by a trained technician.

It is recognised that homœopathy is the treatment of the individual whereby all clinical and behavioural changes are taken into account and an appropriate remedy is selected to treat that particular animal. Therefore a selection of six remedies was available (Table 1), with associated symptom sheet to enable the most appropriate remedy to be assigned.

TABLE 1: Homœopathy therapies and frequency of use in this study.

Homœopathic remedies	Frequency of use
SSC (Silica, Sulphur & Carbo veg)	15
Phytolacca	15
Bryonia	1
Belladonna	0
Urtica urens	0
Hepar sulph	0

The Helios company, in England, provided 29c potencies in a diluent of 96%-98% ethanol. To generate the working dilutions, stock solutions were prepared by diluting the medicated potency by 1:100 in 50% ethanol with succussion (vigorous shaking) to make 30c.

From these solutions, the working dilutions were prepared for distribution to the farm, by diluting the 30c preparation by 1:100 in 25% ethanol. Distilled water was used to dilute the ethanol. Working solutions were stored on farm in sterile, brown glass bottles at room temperature, out of sunlight. When required, 5-10 ml of the solution was decanted into a plastic spray bottle and used to treat the cow. Separate spray bottles were used for each preparation and were emptied and refilled at least once every 2-3 days. All working dilutions were prepared by Tineke Verkade, a qualified homœopathic practitioner operating through Homœopathic Farm Support, Hamilton.

The two antibiotic therapies used in this study were Lincoln® Forte (Pharmacia & Upjohn, Purrs, Belgium) and MasticillinTM (Stockguard Laboratories (NZ) Ltd, Hamilton, New Zealand).
If there was no improvement or a severe worsening of the infection once therapy with either treatment (antibiotics or homœopathy) had commenced, the treatment was discontinued and an alternative therapy allowed. Unless the clinical signs of mastitis worsened to the point where the cow became visibly sick the chosen therapy was continued for a full 48-72 hours. The change in treatment and reason were recorded.

Analysis of variance was carried out on log10 transformed SCC data to compare pre and post treatment SCC and effect of treatment, using GenStat (version 4.2). Chi-square analysis was used to compare bacteriological cure rate between homœopathy and antibiotic therapy.
Results

Thirty-three cases of clinical mastitis were treated with antibiotics and 31 cases were treated with homœopathy. The pathogens most commonly isolated in this study were Streptococcus uberis (Str uberis) (23%) and coagulase-negative staphylococcus (CNS) (20%). However, 50% of the pre-treatment milk samples were bacteri­ologically negative (Table 2). A quarter was diagnosed as being infected with a particular pathogen when the same organism was cultured from both of the foremilk duplicate samples.

TABLE 2: Distribution of major and minor pathogens isolated from foremilk samples of clinical cases of mastitis.

Pathogen	Antibiotics (%)	Homœopathy (%)
Str uberis	21	26
Staph aureus	0	3
Coagulate negative Strep	21	19
Other	12	3
No growths	45	48
Total (cases)	33	31

A quarter was considered to be cured clinically if the symptoms resolved within 3-5 days of treatment commencing and considered to be cured bacteriologically if the original mastitis causing pathogen was not present in the duplicate post treatment samples.
Clinical cure occurred in 100% of antibiotic cases and 94% of homœopathic cases. Only two cases of mastitis did not improve within 3 days of treatment with homœopathy and were re-treated with antibiotics.

The bacteriological cure rate of mastitis cases treated with antibiotics was 85% and 81% for homœopathy (Table 3). There was no significant difference in the cure rate between antibiotic and homœopathy treated cows (P>0.05). Antibiotics and homœopathy cured 57% and 63% of Str uberis infections respectively and 100% and 67% of CNS infections respectively. There was no difference in the effectiveness of antibiotics and homoeopathy in treating Str uberis or CNS infections (P>0.05).

Both antibiotics and homœopathy significantly reduced the SCC to less than 5% of the pre treatment SCC (Table 4). Within 21 days of commencement of treatment the post treatment SCC of cows treated with antibiotics was 2.2% of the pre SCC and homoeopathy was 4% of the pre treatment SCC. There was no significant difference between treatment regimes (P > 0.05).

TABLE 3: Bacteriological cure rate for cases treated with antibiotics or homœopathy.

Treatment	Pathogen	Bacteriological	Total	%cured
Antibiotics	Str uberis	4	7	67
	CNS	7	7	100
	Total	28	33	85
Homœopathy	Str uberis	5	8	63
	CNS	4	6	67
	Total	25	31	81

Discussion

The clinical cure rates of 100% and 94%, and bacteriological cure rates of 84% and 81 %, for antibiotics and homœopathy respectively were similar to rates observed by Merck et al. (1989). They treated 50 cases of clinical mastitis with homœopathy and 50 cases with antibiotics and observed bacteriological cure rates of 34% and 26% respectively (Merck et al., 1989). They also found that homœopathy was more successful in curing infections caused by Gram negative bacteria and conversely antibiotics were more successful in curing Gram positive bacteria. There were too few Gram negative bacteria isolated in this study to compare with these results.

The bacteriological cure rate for Str uberis positive quarters was 63% for homœopathy and 57% for antibiotics. In previous studies the bacteriological cure rate, using antibiotics, for Str uberis has ranged from 58% (Deluyker et al. 1999) to 83% (McDougall, 1998b). Therefore, the bacteriological cure rate for Str uberis for antibiotics or homœopathy observed in this study is comparable to other studies using antibiotics.

The most commonly isolated bacteria were Str uberis (23%) and CNS (20%), but bacteriological negative results accounted for 50% of clinical mastitis cases. In a study of the prevalence of clinical mastitis in 38 farms in the Waikato, an average of 22.3% of clinical cases were bacteriologically negative, but ranged up to 50% in some herds (McDougall, 1998a). McDougall (1998a) suggested that some herd managers may be more sensitive in their diagnosis of clinical mastitis than others, resulting in a higher number of bacterio­logically negative cases in these herds. This may have also been the case in this study.

The somatic cell count was significantly reduced to less than 5% of the pre treatment SCC for quarters successfully treated with homœopathy or antibiotics (Table 4). The foremilk SCC of quarters that were bacteriologically cured was reduced from 7,549,000 to 108,000 cells/ml. Since the foremilk SCC is usually higher than the composite cow milk SCC (Woolford et al., 1998) this reduction in the SCC would help to maintain the bulk tank SCC below 400,000 cells/ml, the level that attracts financial penalties. The reduction in SCC observed in this study was comparable to the reduction in SCC of clinical cases of mastitis treated with antibiotics carried out by Deluyker et al. (1999), where the SCC for bacteriologically cured quarters was less than 10% of the pre-treatment fore milk SCC, 20­22 days post treatment.
Oxytocin, another alternative therapy for clinical mastitis was found to have a bacteriological cure rate of 49% (Guterbock et al., 1993). The results to date suggest that cows treated with homœopathy achieved a bacteriological cure rate greater than oxytocin and that homœopathy may be bioequivalent to antibiotic therapy. However, more cases (say, another 75 cases per treatment) will be required to examine bioequivalence between homœopathic and antibiotic treatment strategies.

The results reported here are from the first stage of a larger trial to examine the efficacy of homoeopathy in the treatment of clinical mastitis compared to antibiotic therapy and to determine whether it could be used as a viable alternative on New Zealand dairy farms.

Tineke Verkade, the homœopath consulted for this study, is the author of Homœopathic Handbook for Dairy Farming (now in its second edition). The new edition is almost double the size of the first, with suggestions for the treatment of several conditions not previously covered. A study like the Dexcel one gives support to some of the book’s ideas, and Dexcel may carry out more experiments of this type.

References

Barkema, H.; van der Schans, J.; Schukken, Y.H.; de Gee, A.L.W.; Lam, T.J.G.M.; Benedictus, G. 1997: Effect of freezing on somatic cell count of quarter milk samples as determined by a Fossomatic electronic cell counter. Journal of Dairy Science 80: 422-426

Barlow, J.W.; McCrory, L.; Mulloy, E.; Bahrawy, D.; Woodard, S.; Craft, L.; Murdough, P.; Pankey, J.W. 2001: Evaluation of a homeopathic nosode for mastitis prevention. Proceedings of the 2nd International Symposium on Mastitis and Milk Quality. 258-262

Day, C.E.I. 1986: Clinical trails in bovine mastitis - use of nosodes for prevention. The British Homoeopathic Journal 75: 11-14

Day, C.E.I. 1995: “The homoeopathic treatment of beef and dairy cattle.” Beaconsfield Publishers, Beaconsfield, Bucks, England. 142 pp

Deluyker, H.A.; Chester, S.T.; Van Oye, S.N. 1999: A multilocation clinical trial in lactating dairy cows affected with clinical mastitis to compare the efficacy of treatment with intramammary infusions of a lincomycin/neomycin combination with an ampicillin/cloxacillin combination. Journal of Veterinary Pharmacology and Therapeutics 22: 274-282

Egan, J. 1995: Evaluation of a homœopathic treatment for subclinical mastitis. The Veterinary Record 137: 48

Guterbock, W.M.; Van Eenennaam, A.L.; Anderson, R.J.; Gardner, I.A.; Cullor, J.S.; Holmberg, C.A. 1993: Efficacy of intramammary antibiotic therapy for treatment of clinical mastitis caused by environmental pathogens. Journal of Dairy Science 76: 3437-3444

McDougall. 1998a: Prevalence of clinical mastitis in 38 Waikato dairy herds. The Proceedings of the New Zealand Society of Animal Production 58: 76-78

McDougall. 1998b: Efficacy of two antibiotic treatments in curing clinical and subclinical mastitis in lactating dairy cows. New Zealand Veterinary Journal 46: 226-232

Merck, C.C.; Sonnenwald, B.; Rollwage, H. 1989: Untersuchungen uber den Einsatz homoopathischer Arzneimittel zur Behandlung akuter Mastitiden. Berliner und Munchener Tierarztliche Wochenschrift 8: 266­272

Murdough P.A.; Deitz K.E.; Pankey J.W. 1996: Effects of freezing on the viability of nine pathogens from quarters with subclinical mastitis. Journal of Dairy Science 79: 334-336

Woolford, M. W.; Williamson, J. H.; Henderson, H. V. 1998: Changes in electrical conductivity and somatic cell count between milk fractions from quarters subclinically infected with particular mastitis pathogens. Journal of Dairy Research 65: 187-198