Coraline's Triplets Pt. 2 - Life and Death

In part 1 of this post, I covered the happy part of Coraline's birth story -- the labor and delivery. If you haven't yet, go read it first before you start part 2.

Coraline and two of her triplets, the doe (left) and second buck (right).

Late Wednesday morning, after I overslept a bit from having such a wacky sleep pattern in the nights leading up to Coraline's kidding, I noticed that Coraline's afterbirth was still hanging. It had been a bit over 24 hours, which is when it's officially considered "retained" (at least based on what I have read). She was standing eating hay, and seemed just a little bit not like herself. I thought at the time that it was just because the rest of her placenta needed to clear out, so I called the vet's and let them know what was going on. A retained afterbirth had happened with one other doe previously, so I wasn't too terribly concerned at this point. The vet gave us a shot of oxytocin to make her body flush the rest of the afterbirth out.

However, after we gave her the oxytocin, I realized something more was wrong. Coraline was not herself. She was shivering a little, hadn't eaten all of her alfalfa pellets, and just seemed..."off." I find myself using that term a lot. Sometimes it's hard to describe to someone else how a goat is when it's not itself, but not showing overt symptoms. I knew something was up, but the best way I could describe it was "off" and a little listless. So we loaded her up and took her to the vet.

Upon arrival, Coraline passed the rest of the afterbirth. The vet did a check on her and found everything pretty much as it should be. Her heart rate was a little elevated, but she thought that was likely due to stress. Her temperature was normal, her rumen was functioning, her udder was warm and pliable. The vet did an ultrasound to be sure there wasn't a retained fetus, and that was all clear. The only obvious symptom was the "off-ness." A little listless, not interested in food, head hanging a bit, not really interested in walking around. Then she passed a bit of foul-smelling uterine fluid, and we all thought we had our answer -- a uterine infection. The vet gave us the option of having lab work drawn or just administering banamine and Nuflor (an antibiotic). We thought that infection was the culprit, and talking to the vet it seemed like the antibiotic and banamine should clear her up, so we declined additional lab work at that time. I had personally suspected hypocalcemia due to the mild shivering and had already given some calcium drench, so I asked about giving another dose later, and the vet said she thought that would be a good idea. Typically hypocalcemia is associated with a low body temp, so it seemed that it could be ruled out at that point, but I did administer the additional calcium later than night anyway.

After that point, there seemed to be ups and downs. She actually ate a bite of her alfalfa pellets as soon as we got her home, and I thought that was a good sign. When I checked her a little later, she was laying down again, and that is when I unknowingly snapped the last picture I would ever take of her. I could tell that she still did not feel good. (If you have goats yourself, you know how unusual it is for them to lay with their head down like this.) However, she had just recently come in from the vet check and I was still hopeful at this point that the Nuflor would kick in and get rid of whatever was making her ill. I almost wish I hadn't snapped this picture, and I actually almost didn't, but the way her little buckling was standing was so precious that I couldn't resist. But I do hate that my last picture of her was one in which she was not herself.

I checked on her again later that night (I believe it was around midnight) and decided at that point to pull the kids and bottle feed them. I had been wrestling with whether or not to do that from the beginning. Half of me knew that mom's milk is always the best food for babies, but the other half of me was concerned that their nursing would tax her body more and either slow her healing process, or, if she was hypocalcemic, would drain her of more calcium. I finally made the decision to pull them because I noticed her walking away from them after only letting them nurse a couple of seconds. Normally does won't do that until they're starting to wean them. I still didn't know if I was making the right decision, but I thought it would be better to be safe than sorry. I realize now in hindsight that her walking away from them was probably the first sign of discomfort in her udder, but I didn't make that connection at first. I now believe that I did make the right decision in pulling the kids.

The next day my dad fed the kids' their breakfast for me and checked Coraline early in the morning. He sent me a text that she was walking around more than she had been and seemed to be improving, so I went ahead and slept a couple more hours, thinking that the medicine was working. Then I got up and fed the kids their next meal while dad went to check her again, but this time she had taken a turn for the worse. He came in and told me she was just standing and shivering again, and then we switched places and I went to check on her. It was obvious that something was very, very wrong and the medicine was not working. She was just laying down and shivering worse than she had been before. Despite antibiotics and Banamine, her condition had declined rather than improved. (I think the brief moments of improvement may have been her feeling a little better because of the Banamine, but not actually improving health wise.) I called the vet immediately to let her know we were going to bring Coraline back in, and the first thing she said was that she had just talked to my dad, who had already called her while I went to the barn. I had just gotten off the phone and was loading Coraline into the kennel when Dad showed up to help me carry her to the car.

I don't know that I have ever seen an animal as sick as Coraline was at this point. In fact, I have seen animals pass away that appeared healthier than Coraline did. It's hard to explain just how frustrated I felt. I was angry that we couldn't figure out what was wrong with her or how to fix it. That was the probably the worst part about the whole thing -- the not knowing. I felt more confused than I have about any of my goat's health in a long time. I have lost goats in the past, dealt with difficult situations, and experienced the typical steep learning curve of goat ownership. But after several years of being a goatherd, a ton of time spent researching and reaching out to mentors, and a few mistakes, I can now usually make at least a somewhat educated guess when a problem arises. With Coraline, though, I just had no clue. It didn't make any sense to me.

Then, at the vet's office, I finally found a concrete clue: she had mastitis. Her udder was bruised, and when I milked the affected side, nothing but clear liquid came out. At first, I thought the mastitis was a new thing caused by me pulling her kids and bottle feeding them -- talk about feeling like even more of a dunce. Then, when the vet said that it had likely been working from the inside all along, I felt a brief moment of relief. Finally! We had the answer! The mastitis, previously invisible to all of us because it was originating from within her udder, was what was making her sick. We knew what was wrong and could finally fix it!

Then the vet said that it was gangrenous mastitis, and my relief faded. I'd never personally seen gangrene mastitis before, but I had seen pictures of it on the internet. I knew it was the kind that caused the udder to slough off. Coraline had freshened with such a beautiful, soft, capacious udder. My only complaint was that her teats were small. I knew that now there was the chance she might lose her udder. But one thing I did not yet know was that gangrene mastitis could also cause sepsis, and that was what was happening to Coraline. Previously I had believed that gangrene mastitis could be fatal because of the necrosis working its way up the body and away from the udder. I didn't know that the infection actually worked from within the body, sending the infection into the blood and damaging other organs before we could even see or feel it on the outside of her udder. 

The vet told us that the best thing we could do was take her to the "goat gurus" at Mississippi State University in Starkville, Mississippi. That three-ish hour drive felt much longer. Every time I heard Coraline move in her crate I would think, "good, at least she's still alive." I still felt better than I had before, because we at least had a plan of action. But in the back of my mind I knew it wasn't good. 

I do want to pause here and say that I am really grateful that timing worked out the way it did. My dad had just gotten his temporary lay off that his company does once or twice each year, so he was able to help me carry Coraline to and from the vet and do early morning checks and kid feeding after I did the late night ones. It would have been even harder of a situation if I hadn't had his help. I can't imagine trying to drive to MSU on my own having never been there. My navigational skills are not the best to begin with, and it was a little tricky to find. I am not very good with directions, so I probably would have gotten lost. I also normally clean houses on Thursday, but as it worked out my friend/cleaning partner was able to do one on her own and the other person sent a text Wednesday night -- before I even knew what I would be doing Thursday -- that something had come up and she didn't need us to come that week. Everything worked out in the best way possible considering the situation. 

When we finally got to MSU, the staff were all extremely helpful and kind. Perhaps because it is a learning environment, they went above and beyond to explain everything. These are the things I learned about septic gangrene mastitis:

• Coraline had most likely contracted the bacteria during her labor. Often the timeline of the infection is about 3 days post-labor, which is about when Coraline started to get ill. The release of oxytocin that occurs when they give birth causes them to "drop" their milk for the babies and open their orifices to allow milk out, which unfortunately can also allow bacteria in. Then the bacteria grows inside the udder at a rapid rate. The vet at MSU said that he had once done a check on a cow one morning and she appeared fine, but the very same cow was down that afternoon from septic mastitis.
• The bacteria can be found in any organic surfaces, from "clean" straw to dirt to our hands. He said that there is no good way to prevent it, simply because the bacteria is everywhere.
• He said that this is a very rare thing, and we will probably never see it again in our lives. I certainly hope he is right about that!
• In addition to the necrotic infection of the udder, the bacteria that causes septic gangrene mastitis also creates toxins that go throughout the body and affect other organs. Coraline's kidneys and liver were already affected, and it sounded like she had a little fluid or damage in her lungs. Her albumin level was very low.
• Because the infection grows so fast and becomes systemic, it is very hard to treat and the odds, he said, were about 50/50. One of the other people there used the word "grave" when referring to her prognosis. The best case scenario was that she would lose part of her udder. Surgery was not an option because of her septic state. 

After giving us all of the information, they quickly wrote up an estimate for us. Then they put her on IV antibiotics and fluids and anti-inflammatory medication. We knew at that time that they were going to keep her for at least 24 hours, but we found out later that they were actually going to keep her at least over the weekend (which was good news, in my opinion, because I knew she would be in good hands and I did not feel capable in the least to treat her at home).

We got back home around 11:30 pm. I knew the odds were not good, but it still felt much better to know that Coraline was in the best possible hands. Our local vet, who is very good but is more of an equine expert, had told us that the people at MSU had much more expertise for treating cases like Coraline's. It was also one of those situations where I could tell the people really cared and wanted to see her get better. Really, if anyone could have saved her, it would have been them. 

The next morning the update was that the IV was helping, but her udder had ruptured (which they expected). They were applying salve to it and had an udder catheter in to drain it. Then the following morning she was still holding her own, but she was not out of the woods yet and still would not eat, though she was drinking. They had taken her on a walk to try to stimulate her appetite. I started to feel a little more hope at this point, just knowing that she was drinking on her own and still able to walk. On Saturday there was a new spot on her udder that they were concerned about, but otherwise she was the same. Then Sunday rolled around. They called with an update that morning that she was still the same. She still was not eating. Then, just an hour or two later, they called to let us know that she was gone.

The whole thing has honestly felt surreal. Part of me still can't believe that Coraline, the first homegrown doeling I ever kept, who had never been sick before in her life, is gone at only four years old and after only kidding one time. Mixed in with the typical sadness and grief associated with death is a profound sense of disappointment. How and why could this rare thing happen to Coraline? She had such a sweet personality. Coraline was always a reserved, quiet doe, and never one to butt her way to the center of attention. Instead, she was the kind who would sneak up quietly while the other goats were distracted and demand scratches or nibble my clothes -- which she is depicted doing in my farm logo picture (featured at the top of this blog and elsewhere). It's just such a shock.

Coraline a week or so before she kidded, wanting some attention.

I typically believe that something can be learned from every bad situation such as this, and that the wisdom gained is one positive thing that comes from the negative. I hate to say, though, that the main thing I learned from this experience is that gangrene mastitis is a horrific illness. 

I don't know how much I can change in the future based on this experience. If the very same thing were to happen again, exactly as it did this time, I still probably would expect it to be something more common like hypocalcemia, ketosis, uterine infection, or even an unborn kid or uterine tear before I would expect septic mastitis. I honestly just don't know how I, or anyone, would be able to diagnose the illness before it showed up physically in the udder. Maybe I could check the quality of the milk sooner, but I don't know that there's any guarantee that it would be abnormal by appearance before the udder itself began to change. Taste wouldn't be of much help, because colostrum (which I have never tasted, for the record) is supposed to have a wonky taste to begin with, so what would that help me? I want to research the topic more, because even after this I honestly feel like there's much about it that I don't know or understand.

I do plan on changing a few things, though. First, as time and money allow, I want to replace the dirt floors of our barn with concrete in the kidding area. This won't remove organic material from our barn completely, because we will still be using bedding of course, but at least I will be able to bleach the floor before the does give birth. There's no good way to disinfect dirt.

Second, I am going to apply a teat dip/udder wash to each doe immediately after she kids. I feel like that would be the best time to do so, because most of the time (though not always) the does lay down to deliver the kids, then stand up to allow them to nurse. I want to catch them right after they stand up and clean their udders then to remove the bacteria they no doubt collected while laying down. It's not a perfect solution, since obviously the does will lay down again, but at least it's something.

And third, if I ever again have a goat that gets very sick, I will take them straight to MSU. Not because our local vet is not good, because she is, but because at MSU they really are small ruminant experts. I don't know that getting Coraline to MSU faster would have changed her outcome, but I also don't find that a very useful question because I can't change the past, so why dwell on "what if's?" But one thing I do know is that MSU is the best place for a sick goat. 

I hope that something in Coraline's story is helpful or useful to you, or maybe just lets you know that you are not alone if you experience something like this. The main reason I chose to share Coraline's story in detail is because there's a chance it might help someone else. There have been so many times that I have known what to do in a situation only because someone else who had been there before was willing to share their experiences, and I feel it's only fair that I pass it on. Plus, it's always nice to know you are not the only one to experience a bad situation. And if Coraline's story helps someone else, that also allows something good to come from her death. 

Rest in peace, Coraline. Tell Clara I said hi.

Left: Coraline and her doeling, Mattie.                    Right: Coraline as a baby with her mother, Clara.