Selected congress contribution © Schattauer 2010 S15

Postpartum dysgalactia in sows:

pathophysiology and risk factors
D. Maes; G. Papadopoulos; A. Cools; G. P. J. Janssens
Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium

Introduction in the sow, the piglets and in herd productivity. For the sows: 1)
Local symptoms: absent, mastitis with agalactia, vaginal discharge,
Adequate colostrum and milk production by the sow is essential 2) General symptoms: absent, fever, prostration, anorexia (total or
for the survivability and growth of the piglets. Postpartum dys- partial). For the piglets: 1) < 1 week: increased mortality, diarrhea,
galactia syndrome (PDS) in sows is characterized by inadequate increased heterogeneity among the litter, 2) > 1 week: increased
and insufficient colostrum and milk production during the first heterogeneity among litter, low weaning weight. For the herd: de-
days after farrowing. PDS occurs worldwide and incurs major fi- creased number of piglets/sow/year. In a given herd, not all sows
nancial losses to affected pig herds. Due to the multifactorial na- exhibit the same range or intensity of symptoms, and also the
ture of the syndrome, the identification of the different risk factors number of affected sows may vary.
and their relative impact is not straightforward (15). Logically, also

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the implementation of preventive and therapeutic measures is a
challenge for pig veterinarians. The term MMA, most frequently Pathophysiology
used in (old) literature, is considered nowadays as a subtype of
PDS, as in many instances, there is no true agalactia and the role of The pathophysiology of the syndrome has not yet been fully eluci-
clinical mastitis is of debatable significance. dated. Due to the multifactorial nature of the syndrome, a single
pathway is unlikely to exist. Martineau et al. (14) and Martineau
(13) suggested that interactions between endotoxin produced by
Prevalence and clinical symptoms Gram-negative bacteria in the gut and alterations in the immune
and endocrine functions play a central role in the development of
MMA occurred in 6.9% of 16,405 farrowings recorded over one PDS. This hypothesis is supported by a study of Nachreiner and
year in 31 pig herds in Illinois (1). The prevalence ranged among Ginther (17) that challenged periparturient sows with lipopolysac-
herds from 1.1% to 37.2%. In 27,656 farrowings included in a charide (LPS) endotoxin of E. coli and in which sows generated
study conducted in the state of Missouri, 13% of the sows were af- symptoms similar to postpartum agalactia. de Rijter et al. (3) pro-
fected by MMA. The incidence of MMA in Swedish herds ranged posed that the systemic disease in case of coliform mastitis in sows
from 5.5% in small herds to 10.3% in large herds. A recent study in was a result of the formation of inflammatory endogenous medi-
110 Belgian pig herds showed that 34% of the herds had experi- ators in the mammary gland. Intramammary infusion of LPS in
enced problems related to PDS during the last year before the study lactating sows was associated with an immune activation and
(22). This high percentage is explained by the fact that also herds lower serum concentrations of Ca and P (24). These effects on
with minor problems were considered as PDS herds. inflammatory parameters and macromineral metabolism probab-
The prevalence of PDS either at animal or herd level depends ly provide a pathway by which sows are at higher risk for the
upon the criteria used for assessing the occurrence and the severity MMA syndrome. The hypocalcaemia and hypophosphataemia
of the syndrome. As these vary largely between studies, prevalence could be due to the elevated concentrations of blood cortisol and
data of PDS from different studies are difficult to compare. Marti- proinflammatory cytokines following LPS infusion (24).
neau et al. (14) summarized a list of symptoms that may be present Prolactin in sows is important for initiating and sustaining milk
production. Oral administration of bromocriptine, an inhibitor of
prolactin secretion, to sows during late gestation and the beginning
Tierärztl Prax 2010; 38 (Suppl 1): S15–S20 of lactation significantly reduced weight gain of litters. Further-
Correspondence to
more, prolactin concentrations were lower in sows affected with
Prof. Dr. Dominiek Maes agalactia. In addition, LPS administration caused a decline in the
DVM, PhD, MS, MSc, Dipl. ECVPH prolactin concentrations and in milk production in sows.
Vice-president ECPHM
Comparing relaxin levels during the first days postpartum be-
Ghent University
Faculty of Veterinary Medicine tween good milking, poor milking and hypogalactic sows revealed
Department of Reproduction, Obstetrics and Herd Health no significant differences in relaxin levels among sows. Impaired
Salisburylaan 133 thyroid action is speculated to be linked with the occurrence of
B-9820 Merelbeke
Belgium PDS, since normal postpartum sows had significantly higher thy-
E-mail: [email protected] roid cell heights than either the agalactic or cyclic sows. An expla-

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S16 D. Maes et al.: Postpartum dysgalactia in sows: pathophysiology and risk factors

nation for this phenomenon could be that the secretions of the thy- parturient sows, not only because feed or feeding techniques but
roid gland are involved in many metabolic functions including also parturition itself influences the dry matter content of feces.
stimulating oxygen consumption and protein synthesis by the Hermansson et al. (7) reported constipation to occur in approxi-
mammary gland and concomitantly increasing milk yield. mately 25% cases of agalactia post partum in sows. By increasing
Induction of parturition with F series prostaglandins was ef- dietary fiber content at the end of gestation, there is a decrease in
fective in reducing the incidence of MMA. The exact action mech- the incidence of constipation (20). This may lead to lower intesti-
anism of prostaglandins in relation to reducing the hypogalactia nal microbial growth and less release and absorption of endotoxins
related symptoms is not clear. Farrowing induction potentially af- from the digesta (14). A lower feeding level during late gestation
fects the kinetics of the periparturient cortisol surge in sows, which was beneficial not only for lowering the incidence of agalactia, but
is essential for the maturation of fetal tissues. In another study also for lowering the severity of symptoms. The precise underlying
however, a prostaglandin analogue led to a delayed increase in pro- mechanism however was not clear. A reduced feeding level could
lactin and delayed nest building in sows. Devillers et al. (5) found impair the conditions for bacterial toxin production in the gut.
a significantly lower colostrum yield in sows when farrowing was Göransson (6) reported that sows that are too fat at parturition
induced. were at higher risk for PDS. Neil et al. (18) showed that only 16% of
the sows that were allowed feed ad libitum before or on the day of
farrowing became agalactic, whereas 31% became agalactic when
Role of nutrition and feeding regime the sows were allowed feed ad libitum after the day of farrowing.

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Papadopoulos et al. (22) found that feeding sows ad libitum
During the last days before parturition, sows receive restricted shortly after farrowing increased the risk for PDS (OR = 3.1) com-
amounts of complete diets with high nutrient and energy densities pared to feeding sows restrictedly.
and low fiber content (10). During the peripartal period, the re- Papadopoulos et al. (21) also showed that a lactation diet low in
duced feed intake and low fiber content frequently lead to dryer n-6:n-3 ratio administered to sows from 8 days before farrowing
and harder feces, indicating an impaired passage of chyme and improved feed intake during the first days postpartum and was as-
subsequent constipation. Constipation frequently occurs in peri- sociated with a better metabolic change and inflammatory profile,

Table 1 Risk factors related to nutrition, housing and management for porcine dysgalactia syndrome

Potential risk factor Reference

Nutrition
Constipation Hermansson et al. (7); Martineau et al. (14)
Feeding sows ad libitum shortly after farrowing compared to feeding sows restrictedly Papadopoulos et al. (22)
Feeding sows ad libitum one day before parturition compared to one day after parturition Neil et al. (18)
Sows too fat at parturition Göransson (6)
Low vitamin E level (16 or 33 IU/kg vs. 66 IU/kg dietary level) Mahan (12)
Ergot intoxication Kopinski et al. (11)
Housing
Crates with a width of 60 cm compared to crates of 67 cm width Cariolet (3)
No slatted floor in farrowing pens Hultén et al. (9)
Overheating of mammary glands Muirhead and Alexander (16)
High ambient temperatures and heat stress Quiniou and Noblet (23), Messias de Braganca et al. (15)
Management
Farrowing induction Papadopoulos et al. (22)
No supervision of farrowing compared to frequent supervision (> 50% of farrowings) Papadopoulos et al. (22)
No washing of sows and no use of disinfectants in the farrowing rooms Hultén et al. (9)
Abrupt change from pasture gestation to restraint in crates a few days before farrowing Bäckstrom et al. (1)
Moving pregnant sows to the farrowing unit 4 days before expected farrowing (OR = 6.2) Papadopoulos et al. (22)
compared to moving the sows 7 days or earlier before farrowing

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S18 D. Maes et al.: Postpartum dysgalactia in sows: pathophysiology and risk factors

when compared to a lactation diet high in n-6:n-3 ratio and/or ad- prostaglandins was effective in reducing the incidence of MMA
ministered from 3 days before farrowing. This means that also the (8).
feed composition and more specifically the type of fat is impor- No frequent farrowing supervision compared to frequent
tant. supervision increased the risk for PDS. Supervision and assisting
Mahan (12) showed that agalactia was a problem in sows fed the sows exhibiting dystocia may help reducing the occurrence of PDS
basal vitamin E level (16 or 33 IU/kg) and to a lesser extent, in those (1).
fed the 66 IU/kg dietary level. Low-grade incidences of MMA oc-
curred in all sow treatment groups, but milk letdown and sub-
sequent milk production was more problematic in sows receiving Conclusions
the diets with lower vitamin E levels.
Grains contaminated with ergot derivatives of Claviceps Purpu- A considerable number of modern pig herds suffer from problems
rea may disturb milk production in sows. Sows fed 1.5% ergot for with PDS. PDS is a syndrome with a complex pathophysiology and
6 to 10 days preceding farrowing produced no milk, while ergot in- with several and different risk factors involved. Control measures
clusions of 0.6% to 1.2% caused lesser problems in milk release should focus primarily on controlling the specific risk factors in af-
and neonatal piglet mortality (11). The effects are likely due to sup- fected pig herds. Although this is not that easy to accomplish, effi-
pressed prolactin secretion by ergot toxins. cient control measures mostly imply optimization of feeding,
Diets containing probiotics given at the end of gestation and housing and management practices.

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around parturition may lead to a reduction in the incidence of
MMA (6 vs. 13%) and higher feed intake during lactation (2). Ad-
dition of formic acid to the diet (10 g/kg) of pregnant and lactating
References
sows showed beneficial effects on performance and agalactia. 1. Bäckström L, Morkoc AC, Connor J, Larson R, Price W. Clinical study of mas-
titis-metritis-agalactia in sows in Illinois. J Am Vet Med Assoc 1984; 185:
70–73.
2. Böhmer B, Kramer W, Roth-Maier D. Dietary probiotic supplementation
Housing and management practices and resulting effects on performance, health status, and microbial character-
istics of primiparous sows. J Anim Physiol Anim Nutr 2006; 90: 309–315.
The incidence of PDS was higher in sows housed in crates with a 3. Cariolet R. Etude des postures en phase de repos chez des truies bloquees en
gestation: Relation entre la largeur de la stalle et la pathologie de la mise bas.
width of 60 cm compared to sows in crates of 67 cm width (3). The J Rech Porcine en France 1991; 23: 189–194.
incidence was also higher in sows subjected to an abrupt change of 4. de Ruijter K, Verheijden J, Pipers A, Berends J. The role of endotoxin in the
environment from pasture gestation to restraint in crates a few pathogenesis of coliform mastitis in sows. Vet Q 1988; 10: 186–190.
days before farrowing (1). Papadopoulos et al. (22) also found that 5. Devillers N, Farmer C, Le Dividich J, Prunier A. Variability of colostrum yield
and colostrum intake in pigs. Animal 2007; 1: 1033–1041.
moving pregnant sows to the farrowing unit 4 days before expected 6. Göransson L. The effect of feed allowance in late pregnancy on the occur-
farrowing compared to moving the sows 7 days or earlier before rence of agalactia post partumin the sow. J Vet Med A 1989; 36: 505–513.
farrowing increased the risk for PDS (OR = 6.2). A period of accli- 7. Hermansson S, Einarsson K, Larsson, Backstrom L. On the agalactia post
matization of the sow to the new farrowing-lactation environment partum in the sow. A clinical study. Nord Vet Med 1978; 30: 465–473.
8. Holtz W, Hartmann JF, Welp C. Induction of parturition in swine with pros-
appears to be necessary. taglandin analogs and oxytocin. Theriogenology 1983; 19: 583–592.
The use of slatted floors in the farrowing pens was associated 9. Hultén F, Persson A, Eliasson-Selling L, Heldmer E, Lindberg M, Sjögren U,
with a decreased risk of chronic mastitis in sows (9). Oliveiro et al. Kugelberg C, Ehlorsson CJ. Evaluation of environmental and management-
(19) showed that duration of parturition was significantly longer related risk factors associated with chronic mastitis in sows. Am J Vet Res
2004; 65: 1398–1403.
for sows housed in crates with no bedding material (311 min) 10. Kamphues J, Schwier S, Tabeling R. Effects of different feeding and housing
compared to sows in farrowing pens enriched with straw bedding conditions on dry matter content and consistency of faeces in sows. J Anim
(218 min). Overheating of the mammary glands by inappropriate Physiol Anim Nutr 2003; 87: 116–121.
placement of heating lamps decreases milk production (16). The 11. Kopinski J, Blaney B, Downing J, McVeigh J, Murray S. Feeding sorghum
ergot (Claviceps africana) to sows before farrowing inhibits milk production.
effects of heat stress in lactating sows include lower feed intake and Aust Vet J 2007; 85: 169–176.
milk production (23). Other studies have suggested that high am- 12. Mahan D. Assessment of the influence of dietary vitamin E on sows and off-
bient temperatures have a direct effect on sow milk production, in- spring in three parities: reproductive performance, tissue tocopherol, and ef-
dependent of the reduction in feed intake (15). fects on progeny. J Anim Sci 1991; 69: 2904–2917.
13. Martineau GP. Postpartum dysgalactia syndrome and mastitis in sows. In:
Appropriate hygiene measurements like washing the sows and Reproduction. The Merck Veterinary Manual, 9th ed. Kahn CM, ed. White-
the use of disinfectants in the farrowing rooms were reported to house Station, N.J., USA: Merck Co, Inc 2005; 1134–1137.
lower preweaning mortality and the incidence of chronic mastitis 14. Martineau GP, Smith B, Doize B. Pathogenesis, prevention and treatment of
in sows (9), respectively. lactational insufficiency in sows. Vet Clin North Am: Food Anim Pract 1992;
8: 661–683.
Farrowing induction has been identified as a risk factor for PDS 15. Messias de Braganca M, Mounier AM, Prunier A. Does feed restriction
(OR = 4.8) (22) as well as for a lower colostrum yield (5). However, mimic the effects of increased ambient temperature in lactating sows? J Anim
earlier studies reported that induction of parturition with F series Sci 1998; 76: 2017–2024.

Tierärztliche Praxis Supplement 1/2010 © Schattauer 2010

S20 D. Maes et al.: Postpartum dysgalactia in sows: pathophysiology and risk factors

16. Muirhead M, Alexander T. Mastitis, lactation failure. In: Managing Pig 21. Papadopoulos G, Maes D, Van Weyenberg S, van Kempen T, Buyse J, Janssens
Health and the Treatment of Disease. Muirhead MR, Alexander TJL, eds. GPJ. Peripartal feeding strategy with different n-6:n-3 ratios in sows: effects
5M Enterprises Limited, UK 1997; 236–239. on sow's performance, inflammatory and periparturient metabolic para-
17. Nachreiner R, Ginther O. Induction of agalactia by administration of endo- meters. Br J Nutr 2009; 101: 348–357.
toxin in swine. Am J Vet Res 1974; 35: 619–622. 22. Papadopoulos G, Vanderhaeghe C, Janssens GPJ, Dewulf J, Maes D. Risk fac-
18. Neil M, Ogle B, Annér K. A two-diet system and ad libitum lactation feeding tors associated with postpartum dysgalactia syndrome. Vet J (in press, Jan
of the sow 1. Sow performance. Anim Sci 1996; 62: 337–347. 2009).
19. Oliviero C, Heinonen M, Valros A, Hälli O, Peltoniemi O. Effect of the en- 23. Quiniou N, Noblet J. Influence of high ambient temperatures on perform-
vironment on the physiology of the sow during late pregnancy, farrowing ance of multiparous lactating sows. J Anim Sci 1999; 77: 2124–2134.
and early lactation. Anim Reprod Sci 2008; 105: 365–377. 24. Wang J, Wang M, Ma J, Jiao L, Zhou X, Lindberg J. The influence of intra-
20. Oliviero C, Kokkonen T, Heinonen M, Sankari S, Peltoniemi O. Feeding sows mammary lipopolysaccharide infusion on serum Ca, P, Vitamin D, cytokines
with high fiber diet around farrowing and early lactation: impact on intes- and cortisol concentrations in lactating sows. J Vet Med 2006; A 53: 113–118.
tinal activity, energy balance related parameters and litter performance. Res
Vet Sci 2009; 86: 314–319.

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