Feb 27, 2011. The following Caesarean case was recorded in 2004, 7 years ago when I was 54 years old. During that year for the next 2 years, I had around 3 Caesarean sections per week from professional dog breeders, located in Pasir Ris, Singapore. Their main vet was suspended from practice for 9 months and I started out with one big breeder first. My fees were unrealistically low at $250 per Caesarean for breeders at all hours including past midnight, public holidays and regardless of how many puppies were delivered. It was crazy but it was an excellent opportunity to further hone my veterinary surgery and anaesthesia. The disadvantage was that I could not build up my Toa Payoh Vets' practice with private patients as so much time was spent on the breeders but that was the price a vet had to pay if he or she does breeder's work. As a routine, I took pictures of pups delivered and kept a record. Since 2008, I have stopped working with breeders as younger vets charge even lower fees than me and so my services were terminated. Veterinary practice with private patients are more satisfactory as there is follow up and great joy in achieving successful outcomes with the owners and their children who become friends over the years. I discovered this case in a asiahomes.com webpage as I used to put one veterinary case with a real estate case in the asiahomes.com website. It is not good practice to do it as it will appear unprofessional. So I have taken out the veterinary case study and publish as this webpage. The pictures of the Caesarean pups taken were not as good as those in 2011. I was using the simple Fuji digital camera and knew nothing about digital photography nor good design of webpages. Start taking pictures of cases and record your Caesarean cases to review and learn about best practices. There is no other way to improve your skills if you don't bother to keep records. I had given the title "Premature Births" in this case in 2004. Let's read and see why.

PREMATURE BIRTHS

"My bitch has passed a dark green vaginal discharge," the home breeder phoned as I was vaccinating the 7-week-old mini-Malteses of a professional breeder. "Something had gone wrong as the bitch is not due to give birth for another 3 days. So, should I wait?"  For the home breeder, every puppy counted as he has only one pregnant bitch, unlike the professional breeder who will have lots of births.  Losing one litter after 2 months of caring pregnancy does not affect the professional breeder so much.

So, should this home breeder wait?  He had one "similar case" in which the bitch gave birth naturally.  Yet, not every case is identical and so, what should the vet advise? 

A dark green vaginal discharge passed out in large amount indicated that the placenta (which is green in canines) had separated and would no longer provide the life support of transporting blood and nutrients from the mother to the puppy.  It was a copious discharge.

The home breeder was an experienced breeder.  He decided not to wait. The emergency Caesarean section delivered 3 pups. The one with the breaking down placenta (green watery, not firm) had a white tongue and was definitely dead. The other two pups were deep inside the uterine horns, one on each horn. They had red noses, tongues and legs.  A deep maroon red not so well captured in the pictures here.  Not a deep bright red. A red colour with added iron?  Exceptionally deep dark red.

The two pups were life-less.  The home breeder would not give up hope. He sucked out the fluid from the nose of the last one. Very few breeders would want to do that.  He rubbed the neck for at least 15 minutes.  "A faint cry," I said as I closed up the uterine wound.  The breeder did not hear it. He rubbed more.  The puppy cried. It was the last and only survivor for now.

This home breeder is an experienced canine breeder, I hope. If he can nurse this pup past 7 days, it might survive. Warmth and two-hour stomach tube feeding. No sleep for him.  It was a matter of life and death.

This was the second Caesarean for the 4-year-old Shih Tzu. The mother looked fit. Was the premature birth a result of the moving to the new apartment and the stream of visitors during Chinese New Year 14 days ago?  Some bitches don't take changes in the environment so easily, like some people, I presume.  The pups were of good size.  Stress could be the reason.  Or a pregnancy too soon?  It is hard to give the correct answer.