Tuesday, October 26, 2010

Mastitis Update

I took these two new shots yesterday. Vivi's udder is clearly going to come off now. It's obvious. My vet tells me that sometimes with this condition you'll only get tissue loss in parts of the udder and teat, and in that case the whole thing doesn't come off, but is left disfigured and probably unusable. I'd much rather the whole thing comes off like it's apparently doing. The first photo shows the natural color of the whole thing. It has turned pretty leathery but is not completely dried up. It still drains some pretty nasty smelling brownish fluid. The second photo is blurry as she wouldn't hold still for my son to lift her leg up, but you can really see very well the distinct line where dead and living tissue meet.

She's off her meds since last Thursday and is doing well, currently she's in heat. I'm still hot packing her daily, more to clean things up than for any other reason. I'm using Granulex spray along the separation line to reduce scarring and help the healing, and am covering both teats with SWAT to keep flies away.

Monday, October 18, 2010

Gangrene Mastitis

I've resurrected this old blog to chronicle a case of Gangrene Mastitis we are currently dealing with in our 6 year old dry doe, Vivian. This is our second case. Vivian's dam, Samantha, who is the foundation of our herd, came down with Gangrene when she was pregnant with Vivi and her sister Veronica. We let her case get away from us and we nearly lost her and her babies. I learned then a very important lesson. I will NEVER, EVER "wait and see" again when it comes to a goat that I think may be sick. She was desperately ill for weeks, running high fevers in spite of the mega doses of antibiotics she was on. Ulitmately, she survived, kidded two healthy doelings but lost the left side of her udder completely. She nursed Vivian, and we bottle fed Veronica. Samantha was never bred again. We aren't commercial goat farmers. Our goats are all pets, and Samantha has been a treasured member of the family ever since.

Wednesday evening, October 6th of this year, about a week and a half ago, I noticed Vivian hanging back behind our buck's pen. I figured she was going into heat and was flirting with him. The next morning, she was still there and didn't come out for breakfast. Checking on her, I saw that her left teat looked engorged and red and she clearly wasn't feeling well. Some additional background is necessary at this point.

Our line of goats come from a herd of Toggenburgs that was intensively line bred strictly for milk production by the same person for over 50 years. Most of our does are precocious milkers. In addition, they never completely dry off. Vivian was a gorgeous baby. She won a number of kid shows and dry doe shows. Judges raved about her. So much for judging babies as far as I'm concerned. I take any judge's opinion of a young doe with a giant salt-shaker full. You just never know. The ugly duckling story can just as easily work in reverse. We only bred Vivi once. Her udder came in misshapen, with huge pendulous teats and to top it all off, she's a leaker. Once a leaker always a leaker, so we never bred her again. She has a poor topline and is very narrow. No width, no depth, no capacity. She had a very hard kidding and her babies had to be pulled. She looks like a goat put together by a committee that didn't have meetings. She's a good foot longer from chine to tail than her sister Veronica, who's finished her Grand Championships and has a great udder. She's endeared herself to us though; every year at kidding time she tries to steal babies, and once she realizes she can't steal them, becomes a perfect nanny, looking after all the babies like a watchdog and giving the moms a break away from them. About once a year, Vivi and several of the other older dry does get enough fluid built up in their udders that we decide it's time to milk them out and infuse them with Tomorrow. I know this is a controversial practice with some goat people, but especially with a goat who leaks, I think it's important. A semi full udder on a leaker is the perfect medium for normal mastitis, not to mention gangrene. I milked Vivi out about 6 weeks ago and infused both sides of her udder with Tomorrow. Her udder at that time was normal, and all I got out of her was 4 quarts of very thin milk. You read that right. Four quarts of fluid from a DRY doe who hasn't had babies for 4+ years.

Back to the story. I got Vivi onto the milk stand and took her temperature. She had no fever. Her udder milked out about a quart of  puss clotted and very bloody fluid. I infused her with a full syringe of Today. I called the vet and he came to check her. Her udder at that point was warm but not alarmingly so. He advised starting her right away on Naxcel. Naxcel was the drug that saved Samantha's life during her bout with gangrene. He prescribed 2ml daily. I took it upon myself to double the dosage without telling him. He always sticks to bottle dosages and refuses to consider that goats don't respond to antibiotics like other ruminants. We've been round and round about this and no longer discuss it. I'm pretty sure he knows what I'm up to, but professionally can't condone it. That's OK. He's generally a good vet. He came out the next day and swabbed the udder and sent the swab out for testing. Interestingly, the tests came back normal. This may be due to the fact that the early infusion of "Today" coupled with the massive doses of Naxcel effectively killed the bacterin within the udder. A waste of over a hundred dollars, but when you suspect gangrene, there isn't time to wait for an udder test to come back.
Gangrene is caused by a particular strain of Staphlococus Aureus. The bacteria is fairly easily killed by some antibiotics if caught early. What causes the gangrene is the aflatoxin that the bacteria give off, it's a strong vasoconstrictor and cuts off blood flow to affected tissues. This is what makes the animal sick if the infection becomes systemic, which it will do rapidly if not treated quickly and with serious antibiotics. Most over the counter antibiotics won't touch it. Oxytetracycline is recommended by many and might work fine. I don't know. I do know that Naxcel, while not labeled for mastitis, has worked well with one doe and appears to be working this time.
 I also began massaging her with hot packs and peppermint oil and draining her two or three times daily. She never ran a fever, and by Sunday, she was back on her feed and starting to feel like pushing and shoving again, although she was clearly in pain down there. Her udder had also started to turn cool. It gradually started to slough off the outer layer of skin and become very weepy. It's still warm here and we've had a new fly bloom and so in addition to the hot packs I'm now covering her udder and teat with SWAT wound formula daily to keep the flies away from it. SWAT is the only product I've found that will stay on and last all day.
Over the last few days of draining the udder, it has begun to change. The teat and most of the bag are cold. The outer layer of skin is essentially gone. The color, which had turned purplish (the old fashioned term "blue bag mastitis") is now a sort of deathly grey-yellow. Nothing will drain from it as of yesterday in spite of repeated hot packs. I suspect the teat canal has closed or collapsed, which is what happened with Samantha. I can feel fluid inside, but nothing will come out. There is a distinct line which runs all the way around the top of her bag which delineates cool flesh from warm. You can see the line on the pictures. Above that line is living flesh, warm. Below it, cool, flaccid apparently dead meat.

There are two significant differences between Vivi's experience and Samantha's. First, Samantha's udder turned hard and leathery pretty quick. Within a week. Viv's udder is still supple, just cold. Second, and curiously, Vivi keeps licking her teat. She acts like it itches. I keep thinking to myself, "if it itches, how can it be dead?" Samantha didn't start licking until the dead half began to slough off and new skin appeared.
I should mention that there is a distinctive, sweet smell associated with all this. As soon as I smelled it I remembered it from last time. Gross? You bet. Disgusting? Of course.

What I expect to happen over the coming weeks is this: The bad half will continue to decay and harden. Vivi's body will begin to slough it off and it will slowly heal as it turns loose. Very much like a buckling's testicles do after he's been banded, only on a much larger and more worrisome scale. I've read that some people recommend that a vet remove the diseased half. This involves significant cutting, lots of blood and stitches that are guaranteed to itch and the doe won't leave alone, potential for all sorts of infection and complication. My vet thinks it's a bad idea and I agree. I have reduced Vivi's Naxcel to 2ml per day and am making sure she gets plenty of supplements and watching her eating and behavior carefully. She's currently her old, crazy crabby bossy self. I'm also watching her good side carefully, although it's unlikely she'll have any problems with that side anytime soon given all the antibiotics she's getting.
Both of these cases happened after prolonged periods of heavy rain. I've read that others who've experienced it have also seen the same connection. My two cases happened at different times of the year though. Samantha got sick in February, it was cold and wet. Vivi's case has happened during warm and wet. I can't help but think wet is the key. I knew there was a reason I don't like rain.
I'll update this thread and post notices on the goatspot forum when I've updated it, as things progress. PLEASE keep an eye on your girls, milking or not. Catching this early is the key.