The responses of the professionals.....

After much thought and second thought and second guessing my second thoughts, I sent the following email to one of the professors at Washington State University who specializes in small ruminants.

From me:
I have a dairy goat with arcanobacterium pyogenes in one half of her udder, and she is due to kid on May 15.

The Merck Manual online makes mention of this bacteria becoming systemic and causing abortion and " It gains entry to the bloodstream and causes an endometritis and placentitis, which is diffuse with a reddish brown to brown color. The fetus is usually autolyzed, with fibrinous pericarditis, pleuritis, or peritonitis possible."

The doe is not running a fever, but she has lumps in the affected half of her udder. How can I find out if the bacteria is in her bloodstream and if the kids will be carriers of this bacteria?

My husband has had a kidney transplant, and I can't risk keeping the kids if they will pose a danger to him.

Should we deliver the kids by cesarean so they don't come in contact with the dam's mucous membranes? Can the blood of the kids be tested?

Thank you for any help you can offer in making a decision about the fate of these kids.

I received a very quick reply from Dr. Parish:

Good morning – As you have found out from your reading on the internet that Arcanobacterium pyogenes is a common cause of abscess problems in all ruminants including goats. When it gets into the udder of a cow or doe it generally leads to a series of abscesses forming in the tissue of the mammary gland. In the case of the mammary gland we believe that most infections into the gland are via the teat. Unfortunately there is not simple treatment and in the case of cattle, most of the affected cows would be culled from the herd. The organism is frequently associated with abscess around the head of ruminants as the organism can be cultured from the oral cavity. It also can gain entrance to the internal aspects of the animals in some cases and is one of the common organism that is isolated from internal abscess and other infected sites. I assume that her udder was cultured and that is where you found the organism.

Although Arcanobacterium could be isolated from an abortion issues in goats, it is not considered a common cause of abortion although it is very common in the environment of animals. I would like to refer you to Dr. Tom Besser, who is our director of bacteriology in our diagnostic lab tbesser@vetmed.wsu.edu who has a greater knowledge than I regarding the other questions that you have and the risk to the does’ pregnancy and the kids.
Hope this helps -

Steven M. Parish DVM

He also forwarded my plea for help to another veterinarian, and I got this reply:

I will give you the microbiologists point of view and hope that will help you make some management decisions for your goat. Disease caused by A. pyogenes is what we call sporadic and opportunistic…so it is not a bacteria that means to cause disease but will take advantage of breakdown in normal barriers of protection like broken skin, puncture wounds, etc. I would certainly watch the doe for any signs of systemic illness but there is no data about how often mastitis is determined to be the source of A. pyogenes in an abortion. You could do blood culture on the doe to determine if she has an infection in her blood, but typically she would be quite ill if she had A. pyogenes circulating in her blood stream, and it sounds like she is doing fine besides the mastitis. Likewise, you could do blood culture on the kids if they appear to be ill.

The kids will probably have A. pyogenes colonization because it is normal flora on mucous membranes of goats so once they are out they will have it shortly (along with numerous other bugs). Unfortunately, your husband is exposed to many types of bacteria that are normal colonizers of goat mucous membranes as well as in feces so I don’t think this one bacteria should be of more concern then others that are present. He should always be very careful handling any of the animals regardless of if they are sick or not, as I assume he is on immunosuppressive drugs. I should mention that A. pyogenes is a rare cause of disease in humans.

I would not recommend a c-section in this situation but I would defer to Dr. Parish’s experience. I would advise not to let the kids nurse due to the mastitis.

If you have any other questions let me know.
Thanks!


Claire Huntsberry, DVM
Microbiology Resident
Dept. of Microbiology and Pathology
Washington State University
Pullman, WA

And this response from another:

Hi, Alice – I have asked one of our microbiology residents, Kerry Sondgeroth, to respond to your query. She will be closer to Dr. Besser’s level of knowledge than I. I did a quick literature search and found some case reports of human infections with Arcanobacterium pyogenes. So you are right to be concerned about your husband in general with respect to bacteria that he could get from animals, including A. pyogenes. I will defer to Dr. Parish’s opinion on this, but I don’t think a C-section will necessarily prevent the kids from getting exposed. I imagine it would be good to prevent them from suckling the doe.

If you don’t hear from Dr. Sondgeroth soon, please let me know.


Margaret A. Davis, DVM, MPH, PhD
Paul G. Allen School for Global Animal Health
Veterinary Microbiology and Pathology Department
Veterinary Teaching Hospital
College of Veterinary Medicine

I also emailed the veterinarian at the LSU Mastitis Clinic. Here is the reply:

In cattle this organism often causes a chronic form of mastitis that persists and will not respond to therapy, it normally does not go systemic from the mammary gland in cows in my experience, however, I have little experience with goats, I recommend you cull the animal and keep an eye on the others. She will likely not ever cure from this infection and will always be a source of new infection. Flies are often responsible for spreading this organism.
The only way to check the blood is have a veterinarian collect blood and culture it and it is difficult to do properly. However, it think it unlikely that is needed and it will be expensive.
Good luck,
Bill

William E. Owens, Ph.D
Professor
Hill Farm Research Station
Mastitis Research Laboratory

So.... the consensus right now, including the advice of my local veterinarian is to let her kid out (we are going to induce) remove the kids from her presence immediately so they don't contact her udder at all, and then put her down.