My girl is 2.5 days post whelp. She gave birth to 7 puppies but 2 were stillborn ☹️ Yesterday we noticed her mammary tissue around her very back nipples was quite swollen and hot to touch. I took her to the vets yesterday and they gave her a shot of a Metacam and noroclav. I’ve noticed the puppies are not feeding from these nipples. They are flatter and a different shape to the rest of the nipples.  I’ve tried expressing some and putting the strongest puppies on those nipples but they don’t want to know. The puppies are gaining weight- the smallest was born at 291g, 322g on day one and 340g on day two.  I don’t know what to do. Should I express for her? Should I use warm flannels? We went back to the vet today. She was a bit clueless to be honest. She has prescribed oral antibiotics and metacam which says on the box ‘not for lactating animals’. Any advice would be very gratefully received. Thanks

Please don't give Metacam to your lactating bitch.  I would be very worried if they have given her a shot of it and the puppies are nursing from her.  FFS.  I think you need to find a different vet who has knowledge of reproduction - OR really research things yourself, so that you can be more judicious about when to use the vet.  Most vets know absolutely nothing about reproduction and nursing and so really you need to have the majority of the information and know what to request and what to refuse.  Sorry that it is this way, but really that's how it is.  You need to empower yourself with knowledge and information.  Turning to the vet as the first port of call frequently is only going to see more and more invasive and unnecessary things 'done'.  Vets are great when there really is something which needs to be done, but they are very interventionist and WILL do something.... anything... if you go to them.

Are you sure these last two nipples are 'real' functioning nipples?  A lot of dogs have a 'fake' pair nearest their vulva which don't actually work - they are like 'dummy' nipples.  Are you certain these are functioning glands?  You can express milk through them?  If the puppies don't want to feed off them, my bet is that they are not functioning nipples??

The swollen tissue could just be the nipples in front of those and normal bagging up of milk as it comes in.

It DOES get hot down there, heck, it has to be a heat pad for the puppies naturally to keep them at the right temperature and it IS hot and sweaty.  I would not try to feel them and determine anything from that.  Instead, you should be taking your dog's temperature twice a day, to ensure it is not above normal - NB that the normal temperature for a bitch who has recently whelped is slightly higher than a regular adult dog's temperature:  Normal after whelping is 100.5 to 102.9F - (38-39.3C).

As I said in another post, at the first suspicion of mastitis, you should get cabbage leaves - large ones - in the freezer and be alternating between cold cabbage leaves and hot compresses (tea towel heated up or one of those sports heat packs you can heat up and put in a tea towel).  You should be getting the pups to drink from the affected glands as they will clear them if it is early stages of mastitis. 

You should be supplementing with sunflower leicithin as this helps avoid mastitis - works in humans as well.

I’m not going to give her anymore metacam. Unfortunately there is nothing I can do about the shot she’s already had. The posterior nipples are definitely functional - I can express plenty of milk from them. The pups just won’t or can’t latch onto them - I’ve tried several times with different pups. I had been placing some warm compresses on there already but will try cabbage leaves too

My girls temperature was 38.9 yesterday and 39.3 today. I do feel the vet was a bit useless. She said at one point “I don’t know what to suggest

> You should be getting the pups to drink from the affected glands as they will clear them if it is early stages of mastitis.

On the other hand if the milk gland has become infected they will quite rightly refuse to feed from it.  Try drawing of the milk, if it's colour is normal then it is likely the teats are just too big at this point, but they will be able to latch on in a day or two especially as they get hungrier.

A lot of my pups have liked the nipples virtually under the armpits, even though they never look very productive.

Lactation is a demand and supply thing, so if they don't use those nipples, then the milk supply will even out after a few days.

Noraclav AB is fine with pups, and is prescribed for mastitis (have used it), but certainly would not give the metacam.

Thanks Barbara. The milk I express is a creamy/very pale yellow colour. It’s not blood stained or anything. I’ve spoken to a breeder friend and she said the same as you - the posterior nipples will be too large for the pups at the moment. She’s advised me to express the milk from them until the pups mouths are big enough to feed off them. I’ve not given my girl the Metacam but am worried about the shot of it the vet gave her yesterday morning. She has also been given Kesium (Amoxicillin) 200mg tablets. Do you know if these are safe to give her Barbara? Thanks for your help.

I personally would hold off on any ABs (whether or not they are safe) until you know you need them.  Slightly warm and red boobs is definitely not a sign to reach for the antibiotics yet - not till you've tried all the above we've suggested.  Keep them aside if things don't improve.  Amoxi is safe for her and the pups - but it's still an AB.

>My girls temperature was 38.9 yesterday and 39.3 today.

This is a perfectly normal temperature, so nothing to worry about there.

With the nipples, can you hold a puppy right on the nipple you want them to drink from - will they latch on?  At what point are they giving up?  Are they just not trying in the first place or latching and then giving up?

Morning

I managed to get one pup to latch - it took a couple of sucks and gave up. The others won’t latch at all even when I express some milk and hold them in position.

Classic for a vet who has all the theory but none of the practical knowledge - many don't even HAVE a dog, let alone have dealt with a nursing bitch.  Yes with the hot compresses.   NOOOO with the Metacam and you just hope any injection of this will be ok. 

Newborn puppies can't and won't deal with lashings of milk and that includes the bigger back teats most bitches have.   What you are able to express sounds normal however so I'd keep trying to get the puppies to take from those back teats, or maybe express them yourself, for now (what a waste!!).  And switch vets. 

Do you have somebody experienced in caring for a nursing mum you can come in and take a look for you?

Oh my goodness I just managed to get a pup to latch onto one of the very back teats and stay put. So happy I’ve been trying for days!!

Good, it's probably just that they were a bit big for little mouths then.