Teats/Mastitis Flashcards
No of glands/teats and streak canals in cows, sheep/goats, horses, SACs, camels
Cows - 4 glands, 4 teats, 1 streak canal per teat. All 4 quarters separated, no internal communication.
Mares - 2(4?) glands, 2 teats, 2 streak canals per teat
Sheep/goats - 2 glands, 2 teats, 1 streak canal per teat
SACs - 4 teats, 2 streak canals each
Camels - 4 teats, 3 streak canals each
What is the main blood supply to the mammary gland
Comes primarily from EXTERNAL PUDENDAL
Branches of the external iliac (aortic bifurcation) - femoral aa & pudendoepigastric trunk = ext pudendal& caudal deep & superficial epigastric vv. Ext pudendal runs through inguinal canal & gives rise to cranial & caudal mammary branches.
Smaller contribution from mammary branch of ventral perineal aa (branch of internal pudendal from internal iliac)
Surgical treatment options for chronic mastitis
- Hemi-mastectomy or radical mastectomy (more commonly small ruminants) - elliptical skin incision, preserve skin for closure. Dissect down to abdominal wall and & remove ligating vv as encountered.
- Chemical destruction - of the affected quarted when suspensory apparatus (suspensory lgament) still intact. Can use 100ml 10% formaldehyde in 500ml saline, 50-100ml 3% silver nitrate, 20ml 5% copper sulphate, 60ml CHx
- Ext pudendal ligation - susp apparatus intact. Better in small rums (larger supply from ventral perineal vv in cows) - inguinal incision, ext pudendal vv are the only ones coursing thorough inguinal canals. Combine with teat amputation for drainage. Will eventually slough.
Layers of the teat wall (from in to out)
- Internal - teat sinus
- 2 layer cuboidal epithelium
- submucosa
- connective tissue layer
- smooth muscle
- outer stratified squamous epithelium (skin)
Where is the Rosette of Fursenberg?
Junction between the stratified squamous epithelium lining the streak canal & the 2 layer cuboidal epithelium lining the remainder of the teat. ie represents the proximal extent of the teat canal/streak canal
What separates the teat sinus from the gland sinus in cattle?
Annular ring.
Methods of local anaesthesia for teat surgery
- 5ml lidocaine instilled into streak canal
- 20ml lido injected circumferentially around base of the teat in region of anular ring, avoiding vv & teat & gland sinus
Methods of supernumary teat removal
- At 3-6mo old; cut off from cranial to caudal w scissors
- >6mo - remove w emasculator (more profuse haem)
- During gestation/lactation - elliptical incision around junction of prox/middle 1/3 of teat, transect teat wall more proximally. Can have clamp at bast to limit haem. Ligate any vv then oversew with clamp on. Then close subm & m & skin.
- Conjoined teats - supernumart teats attached to side of 1ary teat & have accessory glands of varying volumes. Dissect elliptically parallel to the long axis of the teat. Dissect to its annular ring & transect at junct w teat & gland sinus. Close in 3 layers - subm, intermediate layer (smooth mm & CT), & skin. Use 4-0 PDS not penetrating mucosa.
List of pathologies affecting milk flow
- Partial agenesis of streak canal -
- Tight streak canal - usually 2ary to trauma. Teat passively drained w canula 7-10. If this fails can cut sphincter with Hihgs teat knife, introduced straight & pulled out at 30-45° to spare streak canal, cutting Rosette area. Can repeat at 90-180° until get a fine passive stream of milk for >30secs after cut (indicates adequate flow)
- Obstruction of Rosette of Furstenberg - most common. Self inflicted or milk machine trauma. US for tissue flaps which can be resected blind (not recommended) or visualised w theloscopy. Can cut Rosette area as above also
- Milk stones - dx on palpation or US. Small stones can be ejected w hand milking. Otherwise crushed with small alligator forceps in teat cistern
- Obstructions in region of teat cistern or annular ring: Type 1 = <30% teat sinus mucosa involved, type 2 = >30%, type 3 = between teat & gland sinus, type 4 = extend from teat sinus to gland sinus. Need US to differentiate. Can tx w thelotomy or theloscopy
Procedure for thelotomy
3-4cm longitudinal incision on lateral aspect of teat w prob inserted to prevent damage to medial wall. Remove any obstructing tissue at Rosett of Furstenburg. 2 layer closure - subm & intermediate layer w 3-0/4-0 monofilament. Then skin
Most (73%) will need streak canal cut within 1 week
68% return to normal lactation yield
Indications & procedure for theloscopy
Main indication is removal of obstructive tissue within teat canal.
Only 15% require streak canal cut PO (vs 75% after thelotomy).
- Teat cannula through streak canal to insufflate with air w clamp at teat base
- lateral stab incision 10mm distal to teat clamp
- Introduce scope & use blunt probe through streak canal as instrument. Or can have separate instrument portal cranial or caudal for triangulation & removl of tissue w scissors.
- Portal closure in 2 layers - intermediate layer then skin
- 65% return to normal flow & 76% remain normal at next lactation
- Can return to milk machine milking 4d PO (vs 10d for thelotomy)