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Pregnant cat with either missing or inverted nipples
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Pregnant cat with either missing or inverted nipples

My female Foreign White is pregnant with her second planned litter. Last delivery and litter-rearing went fine (12-13-08 was the date of delivery), except for a bout of mastitis, which was treated with a course of antibiotics. My concern is that she is due in about four days, however I have noticed that three of her "flank" nipples (three out of the four closest to her lady bits) appear to be either flat, or inverted.  I do know that the nipples affected were also the ones that were affected with mastitis. She had a vet checkup yesterday and the vet said that either the nipples would "come out" on their own or that they may be able to be coaxed out by a device she gave me. My concern is that even though I am using this device (kind of like a suction device), the nipples still appear flattened and are not taking on an elongated and normal shape. I know that inverted nipples are common in cats and dogs and that they usually resolve, but I have no clue what to do if the nipples do not take the proper shape.The vet did say that it was a possibility, however I forgot to ask how to proceed if that is the case. I guess my questions are:

1. Is there any way to "dry up" the flattened nipples without drying up the entire milk supply? I do want the kits to be able to nurse on momma, however, I do want to decrease the chances of a recurrence of mastitis, if possible. I know she has enough nipples left for her litter (she is expecting six, as of the two x-rays and the early ultrasound).
2. If there is no way to dry up just the three "odd" nipples, what is the proper care for them, in regards to leakage, nursing, etc. Again, I can handle mastitis, but would prefer it did not recur. Which is why I am asking for ways to prevent it.
3. Can kits actually successfully suck on "flat" or inverted nipples? Should I encourage or discourage it? Will suckling of the three affected nipples help return them to shape?
and lastly:
4. Can mastitis actually affect the structure of the nipple? Meaning could the last bout of mastitis have caused injury to her nipples in such a way that they became flat or inverted, whichever the case is?

*Please note that this will be the second and last litter for this particular cat. I normally only allow three breedings before retiring my queens, but due to the problems with her anatomy, the risk to her health is far too great, in my opinion, to allow her a last litter.

Thanks in advance for any input!
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There is no way to dry up milk supply of just three nipples, and if you tried to dry up her total milk supply at the outset you'd have to revert to drugs that would cause more damage than they are worth.  About a day before the kits are due, all the nipples will fill with milk, including the flat ones.  I don't think mastitis is necessarily waiting in the wings to come back, to either the flatter nipples or the others.  It needs a source, staph bacteria, it doesn't just come because there is milk in the nipple.

Nipples won't produce milk if the kittens are not sucking on them, and they keep  producing if a kitten keeps sucking on them.  Kittens get their favorites and generally stick with the same nipple thereafter, since they find it by smell (and the scent they follow is that of themself).  I had a cat who was kept with his mom and just kept nursing until he was 6 months old or more and bigger than she was.  Her one nipple was full and rosy all the time, and all the rest were flat and had disappeared into her fur long ago.

Unselected nipples stop producing milk, so if the flatter ones are not selected they will dry up naturally and mastitis is not much of a risk to them then.  The way to further reduce the risk is to keep the mama and babies' area (especially the floor around the catbox) really clean, preventing tracking of litter and also keeping your own hands washed and removing outside shoes before entering the cats' room.  (I will note, the secretions from birth including blood are sterile, so don't be in a rush to remove blankets again and again, at least after changing the initial wet ones right following the babies' birth.  The smells of the blankets mean a lot to the kittens the first few days, and help them orient themselves.)  Anyway, at the risk of being repetitive, if no kitten picks the nipples you are concerned about, they will stop producing milk on their own, thus reducing the mastitis risk by a long way and also there won't be any continued problem with leakage.  (If there is a little at first, mama cleans it up anyway.)  Try not to interfere too much with the biology of mama's tummy, despite her having had mastitis once, the odds are that left to her own devices she is going to do better than when humans pop in with helpful hands.

The kits will move to the most convenient nipple for their tastes.  If they have a choice of a fuller nipple or an emptier one, they will gravitate to the fuller one.  If for whatever reason they choose one of the flatter ones, it won't be flat for long, their sucking will do better than your little device for stimulating milk production.

Mastitis can give scar tissue or calcification in a nipple.   However, that does not prevent it from producing milk successfully later.
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