Original Scientific Article
Prevalence of subclinical mastitis pathogens in small dairy farms in republic of North Macedonia
Aleksandar Janevsкi*,
Iskra Cvetkovikj,
Sanja Kiprijanovska,
Aleksandar Dimovski,
Katarina Davalieva,
Ljupco Angelovski,
Miroslav Kjosevski,
Dine Mitrov

Mac Vet Rev 2020; 43 (1): i - viii


Received: 20 October 2019

Received in revised form: 10 January 2020

Accepted: 13 January 2020

Available Online First: 24 January 2020

Published on: 15 March 2020

Correspondence: Aleksandar Janevsкi, aleksandar_janevski@yahoo.com


Subclinical mastitis is an asymptomatic udder infection distributed worldwide with enormous losses in the dairy industry. The study’s objective was to determine the presence of this pathological condition in small dairy farms in the R. of N. Macedonia and to identify the most common associated bacteria. Milk samples were obtained from 96 dairy cows (378 udder quarters) in seven dairy farms, in 3 consecutive samplings 24-72 hours apart. The samples were cultured on routine bacteriological growth media and incubated for 24-48 hours. The isolates were identified by AximaiD Plus MALDITOF MS Platform. Subclinical mastitis was found in 49 animals (51%) and 104 infected quarters (27%). The most frequent isolated bacteria on cow level were Streptococcus uberis (19.4%), Staphylococcus haemolyticus (13.4%), Staphylococcus aureus (7.4%) and Staphylococcu ssimulans (7.4%). On quarter level, the most isolated pathogen was Streptococcus uberis (35.6%) followed by Staphylococcu shaemolyticus and Staphylococcus aureus (10.3% and 9.2% respectively). Subclinical mastitis was found to be highly present in the selected small dairy farms. The most prevalent bacteria identified in the dairy farms (Streptococcus uberis, Staphylococcus aureus and coagulase–negative staphylococci) indicate that poor management and udder health practices, inadequate milking procedures and lack of mastitis control strategies greatly contribute to occurrence and persistence of subclinical mastitis.

Keywords: subclinical mastitis, MALDI-TOF, bacteria, milk


Mastitis is an inflammation of the mammary gland (MG) characterized with physico-chemical and microbiological changes in the milk quality, increased somatic cell count (SCC) and pathologically changed mammary tissue (1). The subclinical mastitis (SM), defined as a non- symptomatic intramammary inflammation (2), is the most common form of mastitis, 15 to 40 times more prevalent than the clinical mastitis (4). It affects 20-50% of cows in given herds (3), with great economical losses, affecting the dairy herds worldwide (5, 6). The economic losses due to SM are: decreased milk production, discarding abnormal milk and milk from cows treated with antibiotics, low milk quality and price due to high somatic cell count (SCC) and bacteria in milk, medication costs, costs for veterinary services, increased risk of developing clinical mastitis (CM), herd replacement, antibiotic residues in milk and milk products etc (7). Moreover, cows with SM are reservoirs for infection, increasing the risk for spreading the infection in the healthy cows within and between herds which emphases the importance of this condition on a national level (5, 8).
The intramammary infection (IMI) can be triggered by more than 135 microorganisms (9, 10). The most prevalent ones can be grouped as (i) contagious/highly pathogenic bacteria: Streptococcus agalactiae and Staphylococcus aureus, and (ii) environmental bacteria: coagulase- negative staphylococci (CoNS), Escherichia coli, Corynebacterium bovis, Streptocococcusuberis and Streptococcus dysgalactiae (6, 11, 12). The average SCC from healthy/non infected udder is around 50 000 cells/ml, and in most cases the value is bellow 150 000 cells/ml (13). The elevated SCC is the most frequently used indicator and internationally recognized standard for determination of subclinical mastitis (11, 14, 15). The SCC can be influenced by: mastitis- related factors (microorganisms, toxinsand mammary tissue damage), physiological factors (lactation stage, race), pharmacological factors (medications) as well as stress (diet change, transport, holding conditions, method of milking, milking machine etc.) (13, 16). However, the greatest increase in SCC is due to mastitis (12, 13, 14) as a result of primary immunological response and entry of polymorphonuclear cells in the milk cistern (11, 13).
The SCC can be performed on udder level - composite milk (from all quarterstogether) and quarter level – from each quarter separately. If the SCC is performed on composite milk, the increase in SCC in one quarter can be overlooked due to the dilution effect of the milk from the other healthy quarters (17). This fact was supported by the finding of Berglund et al. (18), where the cow composite milk samples with a low SCC (<100 000 cells/ml) were hiding more than 10% of individual quarters with elevated SCC and more than 50% of those quarters were infected. This highlights the importance of detecting the IMI on quarter level prevalence. On the other hand, the determination of SCC on cow level is important for individual udder health control, breeding and management purposes (18).
According to our national requirements for hygiene rules for food of animal origin (19) which are aligned with the EU regulation EC 853/2004 (20), the raw milk can contain up to 400 000 SCC and 100 000 colony forming units (cfu)/ml.
The studies on SM in the Republic of North Macedonia in terms of prevalence of SM, determination of the causative agents, their prevalence and average SCC are limited. The objective of this study was to determine the SM prevalence in the corresponding dairy farms as cow-level prevalence and quarter–level prevalence, to determine the causative agents of SM and to determine the average value of the SCC in SM positive and SM negative cows.


Dairy farms and sample collection
The study was carried out in 7 randomly chosen dairy farms in different locations in the Republic of North Macedonia, and the samples were collected in the period of September - December 2018. The average number of cows per farm was 16, with 9 in the smallest and 30 cows in the largest one. All of the farms had similar husbandry practices i.e. the cows are kept and milked indoors in tie-stall system using straw as bedding, with twice-a day milking, poor housing hygiene, poor cow cleanliness and not using disinfection prior to and/or after milking. The number of tested cows and quarters is shown in Table 1.

The milk samples were sampled from every (non- affected and dried) quarter for SCC and bacteriology. Every quarter was sampled three times, in a time frame of 48-72 hours. The samples were collected aseptically according to the recommendations from the Nationalmastitiscouncil (21) andproperlymarked with ear tag number of the sampled cow and udder quarter (front-left/FL, front-right/FR, rear-left/RL and rear-right/RR). The milk samples for SCC were sampled in sterile plastic tubes containing Broad Spectrum MIcrotabs® II (Advanced instruments) as preservative. As cows with blind (dried) quarters were included, those cows contributed with less than 8 samples per cow.
After collecting, the samples were transported cooled on 4°C in the laboratories of the Faculty of Veterinary Medicine in Skopje (FVMS) for further analysis.

Microbiological analysis and SCC

The microbiological analysis was performed in the Laboratory for microbiology in FVMS. Three hundred seventy eight (n=378) milk samples (0,01 ml) were plated on blood agar (Oxoid) with 5% sheep blood and incubated on 37°C for 24-48 hours (10, 21, 22). After the plate inspection, the criteria for positive udder quarter declaration were: two positive out of three consecutive milk samples and >1cfu for Staphylococcus aureus and Streptococcus agalactiae, and >10cfu for other microorganisms. The criterion for SM positive cow was the bacteria’s presence in the sample, regardless which bacteria was isolated (Staphylococci, Streptococci etc) and the presence of one (or more) infected quarters. Samples yielding >3 bacterial species were considered contaminated (5).
After the initial isolation, the suspect colonies were subcultured to obtain pure cultures, and the isolates were then identified using MALDI-TOF MS Axima™ Confidence spectrometer (Shimadzu- Biotech Corp., Kyoto, Japan) in positive linear mode (m/z = 2,000–20,000). This analysis was performed in the Research Centre for Genetic Engineering and Biotechnology “Georgi D. Efremov” - Macedonian Academy of Sciences and Arts in Skopje. In short, a small amount of each pure culture was transferred to a FlexiMass™ target well using a disposable loop, overlaid with 1.0 µl of α-Cyano- 4-hydroxycinnamic acid matrixsolution (CHCA; 40 mg/ml in water/acetonitrile/ethanol (1:1:1) with 0.03% trifluoroaceticacid and air-dehydrated within 1–2 min at 24–27°C (23). The reference strain Escherichia coli DH5α was used as a standard for calibration and as reference for quality control. Protein mass profiles were obtained with detection in the linear positive mode at a laser frequency of 50 Hz and within a mass range from 2.000–20.000 Da. A minimum of 50 laser shots per sample was used to generate each ion spectrum. Spectra were analyzed using SARAMIS™ (Spectral Archive And Microbial Identification System, AnagnosTec GmbH, Potsdam, Germany), a software in which the identification at the species level is based on a percentage of confidence referred to reference spectra (SuperSpectra™) that contain family, genus and species specific m/z biomarkers, as described in the SARAMIS™ user manual (24).
For the SCC, the samples were analyzed in the Laboratory for raw milk quality in FVMS, using the Fossomatic 6000 (Foss Electric, Denmark) according to ISO 13366-2:2006 (25).


The cow-level prevalence of SM in the corresponding dairy farms was 51% (49/96). The most prevalent bacteria in these cows were Streptococcus uberis, Staphylococcus haemolyticus, Staphylococcus aureus and Staphylococcus simulans (Fig. 1)

Figure 1. Percentage of isolated bacteria on cow level

Figure 2. Percentage of isolated bacteria on quarter level 

Figure 3. Representative spectrum of identified bacteria

The quarter level prevalence was 27% (104/378). The most prevalent bacteria on quarter level were Streptococcus uberis, Staphylococcus haemolyticus and Staphylococcus aureus (Fig. 2).
In total, eighty seven isolates were identified on species level using the spectral analysis of the SARAMIS™ database (Fig. 3). Most of the infections were only by one pathogen species, and mixed one with two pathogen species (Staphylococcus haemolyticus and Aerococcus viridans) was diagnosed in one quarter only. The quarter – level prevalence for FL, FR, RL and RR was 27%, 23%, 22% and 28% respectively. Therefore, statistical significance was not determined between the infected quarter and quarter-level prevalence (χ2 (3,N=104) =1.55, p> 0.05).
Regarding the SCC, this value varied between 11.08 x 103 cells/ml and 1092.22 x 103 cells/ml with average number of 153.39 x 103cells/ml in cows without SM. In cows with SM, SCC varied between 445.83 х 103 cells/ml and 2868.25 х 103cells/ml, with average number of 724.83 х 103 cells/ml.


In this study, the cow level prevalence of SM and quarter level prevalence of SM were 51% and 27% respectively with S. uberis found in 35%, CoNS in 30% and S. aureus in 9%. In this research CoNS are identified on species level, and the most frequent isolate was Staphilococcus haemolyticus (10.34%), followed by Staphylococcus simulans and Staphylococcus epidermidis (both by 6.90%).
In the study of Sylejmani et al. (26) in Kosovo, the cow level and quarter level prevalence were lower (25,6% and 12.2% respectively) but the prevalence of contagious pathogens was higher. In that study S., aureus (28.6%) and S. agalactiae (14.3%) were the most isolated bacteria, and the environmental pathogens were identified to a lesser extent probably due to the targeted farms with smaller number of cows. Similar results were reported by Abdel-Rady and Sayed (7). In their research, they detected cow and quarter level prevalence of 19% and 5.7% respectively, with highest prevalence of S. aureus (52.5%) and S. agalactiae (16.25%). The difference in the results may occur due to the different sampling and interpretation of the results. Namely, in both studies the milk samples were from California mastitis test (CMT) positive quarters. According to Dohoo et al. (27) the cut-off for the CMT is 150.000 – 400.000 cells/ml and the weak positive sample is characterized by 300. 000 - 1.000.000 cells/ml. This implicates that grading the CMT test as negative or weak positive is solely based on the experience of the assessor and can easily lead to misinterpretation. Tomazi et al. (28) found that the average number of the SCC in quarters infected by CoNS was 306.106 cells/ml, while Djabri et al. (29) demonstrated that the average SCC in quarters infected with Corynebacterium bovis and CoNS was 138.000 cells/ml and 105.000 cells/ml respectively. This implicates that а CMT negative quarter can also be infected, so by culturing milk only from a CMT positive quarter, the intra- mammary infection from CMT negative quarters (quarters infected with environmental pathogens or newly infected quarters) can be easily overlooked.
The results of Pitkala et al. (22) demonstrate an overall quarter level prevalence of 33.5%, with CoNS, Corynebacterium bovis and Staphylococcus aureus isolated in 49.6%, 34.4% and 10% of quarters respectively. These authors used single sampling method but with lower bacteriological threshold of 5cfu/0,1ml and high SCC threshold of 300.000 cells/ml. However, they speculate that because of their SCC threshold that could be high and not sensitive enough, as well as the used single sampling method, some of the results could be misclassified.
The low sensitivity of a single sample method is also emphasized (5, 27). Persson et al. (5) concludes that the sensitivity of the detection of SM could be higher if cows are sampled repeatedly within a few days. This claim is in accordance with the guidelines of NMC for double or triple sampling in order to minimize the false positive and false negative assessment of the milk samples.
Regarding the quarter location and quarter level prevalence, this study found some differences which were not statistically significant. This is similar to the findings of Kocygit et al. (30) which determined higher prevalence of the rear quarters due to their lower set but with no statistical significance. However, these data are in concordance with the study of Slyzius et al. (31) where statistical significance among quarter location and quarter level prevalence was determined only when the difference in quarter milk production was above 11%.
As the primary aim of this study was the estimation of SM prevalence and the determination of the microbial panorama in SM infected quarters, the SCC was not considered as a crucial factor in the estimation of a positive and negative quarter. Nevertheless, the ranges and average values of SCC were determined in the bacteriologically positive and negative quarters. The SCC is the simplest, cheapest and most used method for estimation of SM in dairy cows (4, 7, 30) and international standard for estimation of milk quality/quarter health status (12). Generally, most of the authors indicate that quarters with SCC above 200.000 cells/ml can be considered as SM positive (4, 30, 32, 33). In our study, the SCC below 200.000 cells/ml was not always associated with culture negative quarter, and vice versa. According to Gianneechini et al. (1), the impossibility to isolate pathogens from quarters with SCC above 200.000 could be due to: spontaneous healing, the presence of few viable bacteria, used antibiotic therapy and loss of bacterial viability prior culture. According to our experience, this reason on our farms could be the lack of monthly records for SCC, absence of data for udder and/or quarter disease history, as well as prescribed and applied antimicrobial therapy. In addition, another reason could be that the microbiological analysis (in this study as well as general in our country) was conducted for the most common bacterial species affecting the udder, but not Mycoplasmas, viruses, Prototeca etc., as well as the impossibility to isolate the pathogendue to other reasons (for example lower bacterial counts).
The quarters with SCC below 200.000 cells/ml and culture positive could be latently infected or infected with CoNS (26). Forsback et al. (3) demonstrated that there is a reversible pattern between isolated bacteria and SCC value during mastitis caused by Staphylococcus aureus, where low bacterial counts can be associated with high SCC and vice versa. This fact implies that low bacterial count below detectable numbers can lead to false negative results.


Although the results of this study represent a small scope of the herds and dairy cows in the Republic of North Macedonia, the high prevalence of SM in investigated farms could be some general indicator for the similar small farms. The displayed microbial diversity indicates lack of good farm management practices, housing hygiene, as well as health status and proper hygiene of the udder. Additionally, the high SCC in SM positive quarters could be a crucial factor in loss of milk quantity and quality. Therefore, further studies with bigger scope should be carried out in order to have better estimation of the SM prevalence in the country determining the significance of the SM in dairy sector on national level.


The authors declared that they have no potential conflict of interest with respect to the authorship and/or publication of this article


We would like to thank Angelce Todorovski from Pro-Infovet Skopje and Filip Bozinovski DVM for the assistance in the sample collection.


  1. Gianneechini, R., Concha, C., Rivero, R., Delucci, I., Moreno López J. (2002). Occurrence of clinical and sub-clinical mastitis in dairy herds in the west littoral region in Uruguay. Acta Vet Scand. 43, 221-230. https://doi.org/10.1186/1751-0147-43-221 PMid:12831175 PMCid:PMC1764198
  2. Gonçalvesa, J.L., Kamphuisb, C., Martinsa, C.M.M.R., Barreiroa, J.R., Tomazia, T., Gameiroa, A.H., Hogeveenb, H., dos Santos, M.V. (2018). Bovine subclinical mastitis reduces milk yield and economic return. Livest Sci. 210, 25-32. https://doi.org/10.1016/j.livsci.2018.01.016
  3. Forsbаck, L., Lindmark-Mansson, H., Andren, A., Kerstedt, M.A., Svennersten-Sjaunja, K. (2009). Udder quarter milk composition at different levels of somatic cell count in cow composite milk. Animal 3(5): 710-717. https://doi.org/10.1017/S1751731109004042 PMid:22444450
  4. Sharif, A., Muhammad, G. (2008). Somatic cell count as an indicator of udder health status under modern dairy production: A review. Pakistan Vet J. 28(4): 194-200.
  5. Persson, Y., Nyman, A.K.J., Grönlund-Andersson, U. (2011). Etiology and antimicrobial susceptibility of udder pathogens from cases of subclinical mastitis in dairy cows in Sweden. Acta Vet Scand. 53(1): 36. https://doi.org/10.1186/1751-0147-53-36 PMid:21649936 PMCid:PMC3118135
  6. Tongel, P., Broucek, J. (2010). Influence of hygienic condition on prevalence of mastitis and lameness in dairy cows. Slovak J Anim Sci. 43(2): 95-99.
  7. Abdel-Rady, A., Sayed, M. (2009). Epidemiological studies on subclinical mastitis in dairy cows in Assiut Governorate. Vet World. 2(10): 373-380. https://doi.org/10.5455/vetworld.2009.373-380
  8. Sanotharan, N., Pagthinathan, M., Nafees, M.S.M. (2016). Prevalence of bovine subclinical mastitis and its association with bacteria and risk factors in milking of Batticaloa district in Sri Lanka. IJSRIT 3 (6): 137-150.
  9. Botrel, M.A., Haenni, M., Morignat, E., Sulpice, P., Madec, J.Y., Calavas, D. (2010). Distribution and antimicrobial resistance of clinical and subclinical mastitis pathogens in dairy cows in Rhone-Alpes, France. Foodborne Pathog Dis. 7(5): 479-487. https://doi.org/10.1089/fpd.2009.0425 PMid:19919286
  10. Tenhagen, B.A., Koster, G., Wallmann, J., Heuwieser, W. (2006). Prevalence of mastitis pathogens and their resistance against antimicrobial agents in dairy cows in Brandenburg, Germany. J Dairy Sci. 89, 2542-2551. https://doi.org/10.3168/jds.S0022-0302(06)72330-X
  11. Sharma, N., Singh, N. K., Bhadwal, M. S. (2011). Relationship of somatic cell count and mastitis: an overview. Asian-Aust J Anim Sci. 24(3): 429 - 438. https://doi.org/10.5713/ajas.2011.10233
  12. Hristov, S., Relich, R., Stancovich, B., Vukovich, D. (2006). Influence of individual factors on somatic cell count in cow's milk. Proceedings of Scientific Papers, 12 (3-4): 47-57. [in Serbian]
  13. Bojkovic Kovacevic, S., Lazarevic, N. (2009). Correlation between CMT test, subclinical mastitis and somatic cell count. Proceedings of Scientific Papers, 15 (3-4) 29-37. [in Serbian]
  14. Manzi, M. de P., Nуbrega, D.B., Faccioli, P.Y., Troncarelli, M.Z., Menozzi, B.D, Langoni, H. (2012). Relationship between teat-end condition, udder cleanliness and bovine subclinical mastitis. Res Vet Sci. 93, 430-434. https://doi.org/10.1016/j.rvsc.2011.05.010 PMid:21669449
  15. National Mastitis Council (2012). Interpreting bacteriological culture results to diagnose bovine intramammary infections. Research Committee Report. [Internet], Verona, Winskonsin, USA. [Accessed November 2018] https://www.nmconline.org/wp-content/uploads/2016/08/Interpreting-Bacteriological-Culture-Results.pdf
  16. Katic, V., El Tayeb, H., Babic, L., Popovic J. (1994). Effect of mastitis on milk quality. Vet Glas. 48(3-4): 171-176. [in Serbian]
  17. Knight, CH., Peaker, M., (1991). Mammary gland physiology. Flemishe Vet J. 62, (Suppl. 1): 33-41.
  18. Berglund, I., Pettersson, G., Ostensson, K., Svennersten-Sjaunja, K. (2007). Quarter milking for improved detection of increased SCC. Reprod Dom Anim. 42, 427-432. https://doi.org/10.1111/j.1439-0531.2006.00803.x PMid:17635782
  19. Food and Veterinary Agency of Republic of Macedonia (2012). Rulebook for specific requirements for safety and hygiene and the manner of conducting official controls of milk and milk products. Official Gazette of Republic of Macedonia No. 26/2012. [in Macedonian]. [Accessed November 2019] http://fva.gov.mk/images/stories/zakoni/pdf/2012_026%20pravilnik_posebni_baranja_sluzbeni_kontroli_mleko.pdf
  20. Commission of European Communities: Council regulation 853/2004/EC on laying down specific hygiene rules for on the hygiene of foodstuffs (2004). Official Journal L139/55 [Accessed November 2019] https://eurlex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2004:139:0055:0205:en:PDF
  21. National Mastitis Council (2004). Microbiological procedures for the diagnosis of bovine udder infection and determination of milk quality. microbiological procedures for the diagnosis of bovine udder infection and determination of milk quality. [Internet]. Verona, Winskonsin, USA. [Accessed November 2018] https://extension.umaine.edu/veterinarylab/wp-content/uploads/sites/23/2014/07/Procedures-for-Collecting-Milk-Samples-NMC.pdf
  22. Pitkala, A., Haveri, M., Pyorala, S., Myllys, V., Honkanen-Buzalski, T. (2004). Bovine mastitis in Finland 2001 - prevalence, distribution of bacteria and antimicrobial resistance. Dairy Sci. 87, 2433-2441. https://doi.org/10.3168/jds.S0022-0302(04)73366-4
  23. Wilkins, C. L., O Lay, J. (2006) Identification of microorganisms by mass spectrometry. Hoboken, New Jersey: Wiley-Interscience. https://doi.org/10.1002/0471748641
  24. AnagnosTec [Internet]. Potsdam, Germany: Spectral archive and microbial identification system user manual (2009). Availlable from: http://www.anagnostec.eu/products-services/reference- databases.html
  25. ISO 13366-2:2006 Milk-enumeration of somatic cells, Part 2-guidance on the operation of fluoro-opto-electronic counters. 2nd ed. Geneva: ISO; 2006. 15p.
  26. Sylejmani, D., Ramadani, N., Robaj, A., Hamidi, A. (2015). Prevalence and antimicrobial susceptibility of bacterial isolates from subclinical mastitis in dairy farms in Kosovo. BJVM 9(4): 299-307. https://doi.org/10.15547/bjvm.938
  27. Dohoo, R., Meek, A.H. (1982). Somatic cell in bovine milk. Can Vet J. 23, 119-125.
  28. Tomazi, T., Gonchalves, J. L., Barreiro, J. R, Arcari, M. A., dos Santos, M. V. (2015). Bovine subclinical intramammary infection caused by coagulase-negative staphylococci increases somatic cell count but has no effect on milk yield or composition. Dairy Sci. 98, 3071-3078. https://doi.org/10.3168/jds.2014-8466 PMid:25726098
  29. Djabri, B., Bareille, N., Beaudeau, F., Seegers, H. (2002). Quarter milk somatic cell count in infected dairy cows: a meta-analysis. Vet Res. 33, 335-357. https://doi.org/10.1051/vetres:2002021 PMid:12199362
  30. Kochyigit, R., Yilmaz, O., Ozench, E., Uchar, M. (2016). Effect of some risk factors on subclinical mastitis in dairy cows. Vet J. 9(3): 185-193. https://doi.org/10.5578/kvj.27875
  31. Slyzius, E., Juozaitiene, V., Juozaitis, A., Zilaitis, V., Slyziene, B., Cereskiene, E. (2014). Udder quarters morphological and milking traits risk factors influencing productivity and subclinical mastitis in dairy cows. Bulgarian Journal of Agricultural Science 20(6): 1502-1507.
  32. Мalik, T.A., Мohini, M., Mir, S.H., Ganaie, B.A, Singh, D., Varun, T.K., Howal, S., Thakur, S. (2018). Somatic cells in relation to udder health and milk quality-a review. J Anim Health Prod. 6(1): 18-26. https://doi.org/10.17582/journal.jahp/2018/
  33. Čačić, Z., Kalit, S., Antunac, N., Čačić, M. (2003). Somatic cells and factors affecting their number in milk. Mljekarstvo 53(1): 23-36. [in Serbian]


© 2020 Janevski A. This is an open-access article published under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Conflict of Interest Statement

The authors have declared that no competing interests exist.

Citation Information

Macedonian Veterinary Review. Volume 43, Issue 1, Pages i-viii, e-ISSN 1857-7415, p-ISSN 1409-7621, DOI: 10.2478/macvetrev-2020-0010, 2020