Fri, 06/07/2024 - 11:40pm

Nursed Back to Health

Treating and preventing mastitis

What is mastitis?


Mastitis in dogs is an inflammation of the mammary glands. It is most often the result of an infection that occurs in female dogs while they are nursing puppies. However, it can occur in any dogs, including males. Mastitis may involve only one gland or multiple glands. It can develop suddenly, causing the mammary glands to swell and become painful. This condition creates a problem for bitches that are trying to feed hungry puppies.

The most common cause of mastitis is trauma to the teat, which allows bacteria to enter the mammary gland, resulting in infection. In the absence of trauma, bitches that are kept in unsanitary conditions may be exposed to large quantities of bacteria and other irritants, allowing the infection to spread. The bacteria associated with mastitis include E. coli, Staphylococcus and Streptococcus, which are all found in the normal skin flora of the bitch.

In rare cases, mastitis can occur without an infection. This may be the result of direct trauma to the mammary gland, or prolonged periods of milk accumulation without nursing, which can lead to inflammation within the mammary gland.

Mastitis is most frequently seen after the bitch gives birth. Many cases occur after sudden weaning, which can lead to excessive milk accumulation within the glands, or following the death of puppies, leading to decreased milk removal from the glands.


What are the signs of mastitis?


In mild or early cases of mastitis, the first sign of a problem may be that the nursing puppies are not gaining weight as quickly as expected. Careful examination may reveal slight swelling or inflammation of the affected mammary gland. In these stages, the affected bitch often does not show any signs of illness and may show only minimal discomfort.

As mastitis progresses, the infected mammary gland will become increasingly swollen, inflamed with red or purple discoloration, and painful. The mammary glands may also become ulcerated with open wounds and scabs on the surface of the gland. Milk expressed from the affected mammary gland may contain visible blood or pus. The milk may also appear cloudy or thickened in consistency.

In severe cases, the affected mammary gland appears dark purple or black in color, as the tissues begin to die off due to overwhelming infection and decreased blood supply. These bitches will be quite ill. They become lethargic, develop a fever, refuse to eat, or begin vomiting as the infection enters the bloodstream and they develop signs of sepsis, also known as blood poisoning. This is a life-threatening condition and can be fatal if not treated aggressively.


How is mastitis diagnosed?


Mastitis may be diagnosed based on physical examination. Your veterinarian will palpate your bitch’s mammary glands and surrounding tissue to feel for lumps, inflammation and tenderness. Some laboratory tests may be recommended to confirm the diagnosis.

A complete blood count (CBC) assesses the number of red blood cells, white blood cells and platelets in your dog’s blood. Changes in the white blood cell count indicate infection. The magnitude of change in the cell counts will help your veterinarian determine the severity of the infection.

Milk cytology is performed by taking a sample of milk from the affected mammary gland and examining it under the microscope. The presence of pus, which is made up of white blood cells, or bacteria confirms the diagnosis of mastitis. Normal milk may contain low number of white blood cells, but not to the degree seen with mastitis.

In some cases, especially when the mastitis is caused by an infection that is not responding to commonly used antibiotics, such as Clavamox or cephalexin, a bacterial culture may be required. Milk is collected from the mammary gland in a sterile container and sent to the laboratory, where the bacteria is isolated and identified. Once the bacteria are characterized, antibiotic sensitivity testing is performed to determine the most effective antibiotic for treatment.


How is mastitis treated?


Most cases of mastitis can be treated at home with oral antibiotics and anti-inflammatory/pain medications. This treatment is ideal, as it allows the bitch to remain at home with her puppies, although you should check with your veterinarian before allowing the puppies to nurse while the bitch is being treated. Infections and medications can travel through the milk to the puppies and make them ill as well. In many cases, antibiotics are given for two to three weeks.

Your veterinarian may recommend hand-milking the affected gland. This can alleviate discomfort, while also encouraging blood flow and promoting healing. Hand-milking should be done every six hours.

Applying moist compresses to the affected glands helps reduce the swelling and improve milk flow. The best results are obtained by alternating cold and warm compresses on the glands for five to 10 minutes at least four times a day.

Cabbage-leaf compresses can also be used to decrease pain and inflammation. Clean, raw cabbage leaves should be secured to the affected mammary gland using a bandage or fitted T-shirt. Once applied, they should be left in place for two to four hours. After this time, the leaves should be removed for three to four hours before reapplying for another two to four hours. The puppies can be allowed to nurse from the affected gland when it is uncovered.

If the puppies are going to be weaned in order to treat the mastitis, anti-prolactin drugs such as cabergoline can be used to reduce milk production.

Severe cases of mastitis may require hospitalization for intravenous-fluid therapy and injectable medications. In some cases, your veterinarian may recommend surgical removal of necrotic or severely infected glands. When left in place, this gangrenous tissue can cause septicemia and death. For this reason, it is important to treat mastitis as soon as signs are noted and give all prescribed medications as directed.


What is the prognosis for mastitis?


Most cases of mastitis have a good prognosis. Signs typically resolve in two to three weeks with appropriate treatment. In cases of severe mastitis, or when the bitch develops a systemic, blood-borne infection, the prognosis is guarded, even with aggressive treatment.

The prognosis for mastitis caused by drug-resistant bacteria or gangrenous mastitis associated with septicemia is poor. Intensive hospitalization care is needed for these cases and even then, many do not survive the toxic shock.

When the mastitis is resolved, future mammary-gland function is not typically decreased unless glands need to be removed surgically. Mastitis can recur, so bitches may experience it when nursing future litters.


How can I prevent mastitis?


Although mastitis caused by trauma from nursing puppies is rare, it is a good idea to keep the puppies’ toenails trimmed. Ensure that the puppies are nursing from all glands to avoid galactostasis, or milk retention. Keep the environment clean and free of sharp edges that may traumatize engorged mammary glands. Change the bedding in the whelping box frequently and scrub the box often. Check the mammary glands several times a day to detect any abnormal firmness, heat or swelling.

Sunflower lecithin is a supplement that can be given to prevent mastitis. It is a natural fat emulsifier that thins the consistency of the milk. It loosens existing fatty clogs and reduces the stickiness of the milk to keep it from clumping together. The milk then flows more smoothly, making it easier for the puppies to nurse and keeping the mammary glands soft.


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