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r/Horses•
shift89

mastitis advice? - mare lactating infection

For starters, I have no background history with this infection. My 16 year old mare has never had a foal either. So I'm not really sure where to go from here.

My mare recently began lactating for the foal at the barn. After we seperated them, my horse got very swollen in her udders a week later. I called the vet out for the diagnosis of mastitis.

I was given anti-flammatory and antibiotic meds, which the doses are nearly finished.

The remaining liquid, does it all need to come out? I sat there for an hour trying to get it out and barely made a dent. But removing the sludge made her more comfortable. What do I do about the remaining liquid?

Additionally, how do I get her stop lactating and not get the infection again, in the same process?

My mare has been pretty quiet and well mannered in the whole ordeal, but she rarely shows pain.

So ultimately, I'm wondering if anyone has any experience with mastitis and where do I go from here?

Edit: I feel horribly lost in this, the vet clearly did not tell me enough. Waiting for them to call me back.. The swelling in her abdomen is now a large bump on the bottom of her barrel, as wide as her stomach is. The swelling has gone down in her udder, but it is still very swollen, and the udder is basically solid. I feel bad trying to get anything out, feel as if it will just make it worse. ...4 more days of antibiotics and I really don't think it will be going anywhere in that time. Any guidance?

Update: for the first time, was able to get ALL the fluid out. Wooh! Got a second round of meds (only 4 more days though) and the other boarders are helping me out. Wooh! ...only three more weeks of this. Good thing I have a job that doeant mind me being late.

Posted Oct 9, 2012, 3:38 AM UTC · edited

421
shanwow88•

We weaned my mare and foal about two weeks ago. The vet told us to keep her out and moving around as much as possible to help her dry up.

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shift89OP•

But she is past that stage, she is infected. Moving around xtensively would be very uncomfortable and painful.

But thanks

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RonRonner•

Can you get another vet out? Otherwise I would call your current vet again for follow up information--EDIT to see you've already done this. Great! I agree that it sounds like this needs more veterinary attention, either for additional antibiotics or to draw a sample of the fluid for better treatment. This study shows that gram negative bacteria occur relatively frequently in equine mastitis cases (small study but still striking results): http://www.ncbi.nlm.nih.gov/pubmed/2776721 Gram negative bacteria may require a different antibiotic than the one initially prescribed.

Here's the Merck Manual's entry on mastitis in mares: http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/110907.htm

This TB Times article says expressing the fluid and encouraging the mare to move are both recommended: http://www.thoroughbredtimes.com/horse-health/2003/june/07/veterinary-topics-mastitis-in-mares.aspx They also suggest using heat to loosen things up, like you've been doing.

The fact that you still have this many questions about how to treat your mare means you need to give your vet another call [Edit: you did! Hope they get back to you soon!]. It's great that you sought treatment and that you're doing such a good job trying to get your horse healthy and comfortable but you shouldn't have to feel like you're in the dark about what to do. The articles I've found seem to indicate that you should keep doing what you're doing in the meantime though. Have you taken her temperature to make sure she's not running a fever?

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shift89OP•

Ok, awesome, thanks!

But what my question is that continuously pops up, is how much fluid do I remove? Because I was sitting for an hour and barely made a dent. I also don't want her to continue lactating, so dunno when the point where I don't get the fluid out is.

I have her in a pen right now, because before the little foal came along she was losing weight for arthritis issues. But I should take her out of the pen then. But I can't, because there is still grass. and she hasn't had any grass in six weeks, so there would be a colic potential. I can't risk that. :S

So i'm pretty much screwed on that front.

Which brings me back to my original question, that I can't find anywhere, exactly HOW MUCH fluid am I taking out?

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RonRonner•

With the disclaimer that I Am Not A Vet, as a lifelong, sometimes-professional horse person, I would keep expressing the fluid as long as the signs of infection (heat, swelling, pus) are still present. In my mind, as long as the infected fluid and milk are still being produced, it needs to be removed. It will make your girl more comfortable and it's doing no good just sitting there. If it were me, I would only back off if milking started to seem acutely painful for her, in which case I would stop and consult the vet again. It's great that she's been so patient while you help her out; mine wouldn't be!

This article from an equine repro vet agrees: http://www.cvmbs.colostate.edu/ns/_docs/departments/bms/ERL/Learnmares46_reprodprob_mastitis_apr09.pdf

This one too: http://archive.ctba.com/husbmgmt/masitismare.htm

This veterinary guide also indicates that treatment includes frequent milking: http://www.vetstream.com/equis/Content/Disease/dis01176.asp

I wouldn't worry about the frequent milking encouraging her body to continue lactating. It seems that that can be addressed later through hormonal treatment if need be, but I would wait until the infection is clear before worrying about it.

Can you handwalk her for 20 or so minutes at a time? I think that kind of low impact movement might be good for her but being in a pen probably offers more benefit than a stall so at least you've got that going for you! Unless she has acute metabolic issues, you should be able to graze her for increments of 15 to 30 minutes depending upon how lush the pasture is. Is she still finishing her regular meals? Keep an eye on her for signs of fever and listlessness that might indicate septicemia.

Please don't take any of this as true medical advice, they're just suggestions based on what I would do if it were one of my horses. Listen to whatever your vet says! However, based on what I've been finding, frequent milking with warm compresses seem to be indicated. I wouldn't worry about taking too much fluid out. Cross that bridge when you come to it, if it happens at all.

Just out of curiosity, has she had any trouble shedding out her winter coat, and is it unusually long or curly? Does she sweat well in the heat? Does she have a floppy, cresty neck?

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shift89OP•

Thanks for the advice. I was just confused as to how I was supposed to get all of it out or at least a lot, considering how slow going it is. But I will just spend a few minutes each day getting a portion out then.

Finally got the vet to call me back, I think that i'm going to end up doing a double course of antibiotics as the swelling her in abdomen has not reduced. But I will spend a good amount of time getting the liquid out each time. Vet also said to her hose with cold water, what would be the opposite of the hot towel i've been doing (although two different purposes).

I just feel so bad putting her through all this; she has been incredibly well behaved with me prodding at her. I feel bad and want to just leave her alone as much as I can, let her be; so I've only been giving her the grain with antibiotics and removing fluid only once a day.

She sweats well during big training sessions at the least, sheds out pretty good, and she a little bit of crest, but weight loss has helped that. Signs of founder?

I feel bad, the vet never originally said anything about removing the liquid, so I was already under the impression to leave it. But at least she got meds as soon as it was infected.

After all this, I signed up for one of the Equine First-Aid clinics coming up. Especially when my horse starts lactating for another foal which isn't supposed to be possible, it shows anything can go wrong with horses.

My horse has been incredibly well behaved in these scenarios, trusts me a little bit too much I think, haha.

The articles you listed make me think that the antibiotics aren't helping. The swelling went down in the first two days (maybe the antiinflammatory that I already finished the course of?). She is allergic to Pencillion so we are on Uniprim, but I will have to discuss another antibiotic with the vet when her dose runs out.

Thanks! edit: The article about a possible fever makes things make a bit more sense. She came in the morning FREEZING. mhm.

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RonRonner•

I'm sure part of the reason she's been so well behaved is that she trusts you and you have a strong bond. I know how you feel about not wanting to poke and prod her more than necessary but it's worth it if it will fix her up quicker. I'm only going off of what I've found online and my gut instinct though--definitely follow your vet's advice over mine!

The reason I asked about her coat and sweating is that I kept seeing references to Cushing's disease in the information I was pulling about mastitis and pseudo-lactation (producing milk without pregnancy). The fact that she's in a dry lot had me thinking maybe she'd had a bout of laminitis, which can occur with Cushing's, coupled with her age and recent weight loss. If she also had long, wavy hair, poor shedding, excessive sweating, a big cresty neck, bulging eyes--all other hallmarks of Cushing's, I would say maybe look into that too. Without other symptoms present though, it could very well just be an isolated thing. Check out these links to see if anything jumps out at you. This link mentions inappropriate milk production in mares with Cushing's: http://www.equine-vets.com/fact-sheets/hormonal-problems/cushings-disease

This link mentions it too, with other symptoms of Cushing's listed: http://www.springhillequine.com/files/Download/August%20Newsletter.pdf

The fact of the matter though is that everything is probably fine, you've already done everything you're supposed to do to appropriately treat your horse. You got the vet out when you noticed there was a problem, she was put on antibiotics promptly, you're getting out there frequently to check on her and her condition is at least holding steady, if not outright improving. If her eyes are still bright, she's still on her feed, she's drinking water and not getting worse from day to day, you're probably on the right track.

If you happen to have a choice among vets and think you'd want another set of eyes on her, maybe consider calling out another one, especially if your gut says she's not progressing the way you'd like. You seem to be a very dedicated and empathetic owner, trust your instincts! Good luck to you and I hope she starts picking up soon! And thanks for posting too, I learned a lot by reading about this!

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PurpleMockingbird•

Dealing with a similar thing right now with my friend's horse, the vet said to keep milking the infected teat twice a day and to massage the swollen area to help break up the swelling and infection. Hope she feels better soon!

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shift89OP•

But exactly how much do I need to get out? It's really.. full. I'm half tempted to put that little shit (foal thats why she began lactating... I mean that nice horse) to work and get the rest of it out (not that it would be very healthy...). Will it dissolve and come out naturally? Like, how would a horse lose the rest of the leftover milk when their foal is weaned naturally?

I'm really struggling with the concept of sitting there is for like three-four hours trying to remove it. And that point, her body would just produce more as it thinks it is being used.

The vet really told me nothing about the infection, just heres the meds, bye. :S Thats why i'm here.

What I have found though, is that she really enjoy a hot towel (in a ziploc bag) held up to her udders for a period of time. She was doing some deep breathing and licking her lips quite a bit this evening.

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J973•

Okay I have a lot of experience with mastitis, but in dogs. Sometimes it can be really bad and with dogs puss pockets can form and burst in the abdomen area. STRONG antibiotics are the most important thing.

Expressing the milk though, I am sure helps. Take a warm wet cloth and hold it like a compress against the teats. In a few minutes she will be much easier to release the milk.

DO NOT THE FOAL NURSE ON INFECTED MILK. I know people who let puppies nurse from infected milk and they got sick and some even die.

After the mastitis is clearing up, and she is stablized, a way that people use to dry up animals is to withhold water for 24 hours and their bodies start to absorb the milk. Of course ask your vet first.

Good luck!

0
shift89OP•

I haven't seen any pus, so that's a good sign.

But i'm not willing to withhold water, I want her drinking well after going through an infection. But we haven't got that far yet, need to get over the infection.

Interesting ideas though

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bri35•

I agree with milking out the excess, but be careful because every time you milk you open the teat canal to more infection. Just make sure you keep the udder VERY clean! I am sure you are doing so already, but worth mentioning.

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BoondoggleBorderline•

FWIW I work at a cow dairy as a milker and have had quite a bit of experience with mastitis in dairy cows. No experience with mastitis in horses but hopefully this will be helpful to you.

When dairy cows get mastitis we strip (strip meaning hand milk the affected quarter until absolutely no more milk is coming out) the affected quarter 12 times a day for the first two-three days using bag balm to lubricate the teat and then once the quarter is totally stripped out (you will be able to it is empty tell because the stream will slow to nothing and the quarter will seem much emptier) we apply uddermint to the quarter and massage it in to reduce heat and swelling. The uddermint doesn't go on the teat at all, just all up in the udder on the section that has mastitis. After the first days the affected quarter gets stripped out just 3 times a day with the bag balm and uddermint. It usually takes a couple weeks for them to get better.

Some tips: Massage the udder really well and when the stream of milk is starting to slow down really push your fist up into the udder and pull down the teat to make sure you are milking her dry. You have to get ALL of the bad milk out, her mastitis was obviously caused by the milk not being removed and not getting it all out will only make the mastitis worse. When you think she is stripped dry, milk her a bit more. Pushing your free hand into the top of the udder and running it down the side can also help the milk come all the way down.

Most important things: Remove all of the bad milk, make sure she doesn't start running a fever, make sure she's still eating and drinking well and getting plenty of rest, and do not leave her after any milking with any milk left in that udder.

I don't know if uddermint can be used on horses but the bag balm is safe for horses. Uddermint: http://www.uddermint.com/UDDERMINT.com/UDDERMINT.html Bag Balm: http://bagbalm.com/horses.htm

I hope I've helped! Also, any questions, feel free to PM me. I don't log on much but I'll try to in case you had any questions. Good luck! She sounds like an amazing horse. =)

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shift89OP•

This uddermint sounds really curious to me. The temperature in that area has been incredibly hot, so I believe she running a fever. Is this something I could use that will bring down the temperature? I have just been using a cold towel (vet said will also help bring down swelling).

This is actually really informative. I wasn't told anything about stripping the fluid up front so I was a few days late to getting on top of that. I have been stripping the fluid until the drip gets slow, but I haven't been able to completely strip her. I have also only been doing this once a day (I don't live with my horse so this has been a little bit more difficult, asked the other boarders for help though). But I try to get as much liquid out as I can until my arms run sore and my horse runs out of patience (it is at the slow drip rate). There was a lot of red (vet said it is tainted with blood vessels) in there today, so I got to the point that it was losing the red this morning.

The two-three weeks to heal time info really helps, I keep getting 4 day doses of antibiotics and such and the impression that it should be healed up in a week (hope I don't have to pay for three weeks of antibiotics, I've already run up to $470 on those). But a few weeks worth of stripping the fluids before I can think about finally weaning her?

This has been very informative. Thanks!

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BoondoggleBorderline•

Uddermint is very cold like linament so it should help cool down the udder. If you try any out make sure you wear gloves or you'll have really cold hands for a long time! Best way to check for sure whether she's running a fever is to take her temp.

That's fantastic that the milk is starting to get less red! I hope she'll heal faster than a few weeks though! When we dry off cows we use a teat injection called ToMorrow that fights mastitis over a long period of time which is why we can dry off mastitis cows without completely healing them. After they are injected we don't milk them again, maybe they have an injection like that for horses. You will definitely want to talk to your vet when the antibiotics run out to find out your options for drying her off.

Also, in case your vet hasn't mentioned it, it's important that you are dipping her teats in some sort of iodine solution to help kill any bacteria on the orfice before and after milking. We usually use a specially formulated teat dip but I'd think you could probably just water down some regular iodine or betadine and dip the teats without any issues.

Glad I've been able to help!

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shift89OP•

Okay so here is where I'm at now. She stopped lactating on Friday, and ive been doing an iodine wash and bag balm every day since then with antibiotics and antiinflammatories. The swelling went down a fair bit in the past few days.I have two days of antibiotics left and the swelling increased, and she seems rather sore today. I turned her out to pasture yesterday to get her moving.

When you say two to three weeks, can I expect her to be swollen for awhile yet?

I called the vet when she stopped lactating, they said swelling should come down a lot in next few days.

Maybe she just sore because of the extra movement, but that shouldn't increase swelling? :/

Edit: ok, crap. Apparently I was wrong and she didn't stop lactating she looks as if shes about to explode. Waiting for vet to call me back to get more meds. ...damn, thought I beat this.

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duckduckmoosesTWH/MFT and OTTB•

Well, all you can really do is keep her cleaned off and keep her medications going as long as the vet recommends. You can't make her -stop- lactating. Keep her cooled down, stalled, and fed well. You mentioned that it's hot outside.. if it's possible, try and get a fan in her stall. If there's any open wounds, keep a disinfectant on it.

Keep massaging and getting out what you can, at least. If you can, get another vet to look at her. If you didn't ask your vet these questions, see if you can get the answers from them as well.

It's always easier to see what's wrong when you're there with the animal.

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shift89OP•

It's not hoy outside, her udders are hot. It's pretty cold out. I don't want to keep her stalled, she needs to keep moving around to reduce swelling.

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duckduckmoosesTWH/MFT and OTTB•

Ah, I read wrong. Sorry about that.

And stalling more for supervision than keeping her stationary, so mo more damage gets done from other horses or her going crazy.

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shift89OP•

She is in a pen on her own. :)

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