Inca's Story

Health

Incas's Story

SEPTIC MASTITIS

Inca was a normal developing female Afghan who started to show signs of a pseudo-pregnancy following her first season. The mammary tissue had developed and there was a slight milky discharge from the teats, in addition Inca had become behaviourally quite anxious with an altered character during this time. However she was normal otherwise and after discussion it was elected to allow her to precede through the false pregnancy without giving her any medications to try and shorten it. In this situation the key factors to monitor are that the mammary glands do not become hot and painful and develop into mastitis, which on occasions can be a consequence of milk production in pseudo-pregnancy.

Please click thumbnails

Unfortunately twenty-four hours later the mammary tissue had become hard and painful and Inca had a temperature of 104 f (normal being at 101.5 f) and she was becoming increasingly uncomfortable and distressed. Consequently antibiotic treatment was instigated with a potentiated amoxycillin (Nisamox) and blood-testing and radiographs were performed to ensure there was not any underlying concurrent disease process. The bloods showed a slight rise in liver enzyme levels and a large rise in the white blood cell count (these cells are associated with both inflammation and infectious insult). All other blood parameters and radiographs were normal. Subsequent to this Inca improved initially but relapsed after a further twenty-four hours, whereby areas of very dark pigmented tissue had developed over the mammary chain in two areas.

These changes in conjunction with the generalised deterioration of Inca were consistent with `SEPTIC MASTITIS'. This is usually a condition most commonly seen in agricultural animals such as sheep/cattle. Mastitis develops as a result of a very pathogenic organism, which not only affects the local mammary tissue but can affect the whole body often due to bacteria entering the bloodstream and the release of bacterial endotoxins. Endotoxins are components of the bacteria that can affect the circulation, immune system and the overall demeanour of the affected animal. This condition is VERY SERIOUS and can potentially be LIFE THREATENING.

The key to its treatment and management is to be quite AGGRESSIVE & FAST. Therefore Inca was placed on intravenous fluids, given intravenous antibiotics of metronidazole and potentiated amoxycillin; to ensure a complete spectrum of activity against the potential bacterial cause of the mastitis. In addition to try and combat the effect of the endotoxin a single dose of non-steroidal anti-inflammatory was administered. The condition is also very painful and throughout the subsequent month of treatment, Inca received opoid-based analgesia (pethidine/methadone) dosed according to her requirements.

At this stage of treatment Inca was being given her medications and the areas on her mammary chain were being flushed and dressed 2-3 times daily. The two large areas of darkened tissue on the mammary chain were necrotic, as the invading bacteria in these areas had resulted in them losing their blood supply and the tissue was dying away. The plan was to keep Inca as comfortable as possible and to allow these areas to die until it was clear the margins of healthy and dead tissue. Once this was apparent then surgical removal of the dead tissue could be performed and the underlying skin defect could be repaired and reconstructed. Another complication with Inca was that both sides of the mammary chain were necrotic and if all the tissue were removed at a single surgery it would be nigh on impossible to close skin over the resulting wound. Consequently repair was staged over two surgeries separated by eight days. On both occasions the dead tissue was removed and healthy tissue was reconstructed over the defect. As with any other surgical wound drains were removed after a few days and stitches removed at 10 days.

Throughout this whole time Inca was improving day-by-day and dealt with everything in a very relaxed fashion. At the end of treatment she had undergone nearly 1 month of hospitalisation with at least twice daily dressing changes, antibiotics throughout the whole time either intravenous or in tablet form

It must be said that this was an UNUSUAL CONSEQUENCE OF PSEUDO-PREGNANCY BUT IT IS ONE THAT IS SEEN PERIODICALLY WITH THE BITCH BEING VERY UNWELL FOR A GOOD FEW WEEKS

Long term for Inca this past illness should not hamper her day-to-day activity, and without very close inspection it is difficult to see a scar or any anatomical changes from the surgery. If she is ever to breed, she should still be able to suckle the pups with the remaining glands unless she has a very large litter, or encounters any problems any other bitch would have. The only other area of concern would be after the next season, will she have another false pregnancy and if so will she have similar mastitis problems? This is impossible to answer, I suppose logically she will be more prone to these problems than any other dog, but can lightening really strike twice?? Alternatives would be to suppress her seasons so the hormonal changes are unlikely to give the right conditions for false pregnancy and mastitis, or to have her spayed. BOTH obviously have there BENEFITS and RISKS and it is something which will obviously need careful consideration for EACH INDIVIDUAL SITUATION. There are no absolute answers I am afraid, but in this case the key thing is that despite all the illness, surgery and the need for long-term hospitalisation Inca has made a FULL RECOVERY and bears me no grudges………

Simon Bailey BSc BVet Med MRCVS and Moira Simpson

Health Stories

Health Index

Home