Diagnosis. The diagnosis is extremely simple.
In a general sense the prognosis is favourable, but nevertheless the local infection may extend and become generalised, thus giving rise to interstitial mammitis, sometimes of a very grave character. On the other hand, the sensitiveness may of itself render milking difficult or impossible, and thus cause serious distension of the gland with milk.
Treatment. As both sucking and milking aggravate the lesions, they should be prevented by the insertion of a milk catheter.
The surface of the udder and the wounds should be cleansed with an antiseptic solution and be dressed with a 20 per cent. camphorated vaseline or with carbolic or iodoform ointment, to favour healing. If the cracks produce excessive sensitiveness a small quantity of orthoform may be added to the camphor ointment. Before the milk catheter is inserted, the teat should be very carefully cleansed with boiled water and the catheter sterilised by boiling. Neglect of these precautions may result in infection of the galactophorous sinus and mammitis.
MILK FISTULÆ.
Causation. Any accidental injury to the udder which establishes connection between the galactophorous canals or the galactophorous sinus and the exterior may give rise to milk fistulæ, if the injury occur during lactation.
Apart from lactation these wounds may be grave, though if carefully treated they heal without complication. During lactation, on the contrary, the milk escapes permanently from the injured spot, cicatrisation cannot occur, and a fistula forms.
Fig. 238.—Milk fistulæ. 1, Deep suture—schema showing the course of the suture; FL, base of the fistula; S, suture; 2, superficial interrupted suture.
Symptoms. The principal symptom is the permanent discharge of milk. The fistula may be large or small, according to circumstances. In rare instances it is situated on the udder itself, but it is commonest on the teat. Milk may escape in mere drops or, on the other hand, in considerable quantities.