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Date:   26 November, 2011  
Focus:
 Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
Telephone diagnosis can cause trouble to the vet
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case of the Miniature Schnauzer was first written:  7 September, 2007

Updated: 26 November, 2011  
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Be Kind To Pets
Veterinary Education
Project 2010-0129
 
"My husband had ruptured the water bag but the puppy could not come out," the home- breeder's wife phoned me as I was going out for my lunch appointment. "What she I do?"

I asked: "Are you sure the water bag is broken and it is not the watery discharge before birth?"

"I am sure it was the water bag."

"Normally a Miniature Schnauzer has no problems giving birth," I advised. "You can wait for half to one hour."

"Will this puppy die?" the breeder's wife asked.

"I don't know. Perhaps you can wait half an hour. However, the decision to do Caesarean is up to you. Please note that I can't predict whether the puppy will die or not if you don't get a Caesarean done."

This is the type of telephone diagnosis I presume veterinarians all over the world dislike. If the puppies die, the veterinarian gets cursed for incorrect advice.

I got one bad experience of such telephone diagnosis. This Singaporean caller whom I did not have veterinary relationship with wanted free advice over the phone.

The next morning, the government vet in charge of private veterinary matters phoned me to enquire whether I had given advice such as whether the "greenish vaginal discharge had come out or not?" Such experiences harden the attitude of private veterinarians towards free telephone diagnoses.

The breeder came to the Surgery. A puppy was pulled out. In the midst of anaesthesia, a water bag was seen. With some straining, I managed to take out a second puppy. Now what?

Can I just use oxytocin and/or wait? I don't play God. Breeders want one thing --- live puppies. No explanation acceptable if the puppies are dead or stillborn and worse, if a belated Caesarean is done.

Who knows whether the remaining puppies inside the dam would be born easily? I estimated four or five in total. Two had popped out.

The breeder decided on Caesarean. The anaesthesia was smooth. The dam sleeps peacefully but did not strain to pass out more puppies even though I reduced the anaesthesia to 1% instead of 2%. It could be secondary uterine inertia.

I inserted my right forefinger and third finger into the 3-cm incision of the uterine body. I could cut a bigger incision in the skin and then into the uterine horns. However, it would be best to hook out the puppies.

The puppies played hard to get. The mother had stopped contracting. The puppies hid deep inside the horn, near the ovaries. Should I enlarge the skin incision? Try again. With time, the 2 puppies could be fished out without bigger cuts.

All were vigorous and active.

I wanted to take pictures outside the Surgery as there was better lighting. The breeder's wife took pictures with her handphone. She said to the two kids as we crossed the small road to the other side where sunlight fell onto the walls of the building, "Stay inside the Surgery."

"Go and take the kids out," I said, taking over the wife's basket of 4 puppies. "Let them learn about your business."

Teach first-timers what to do after Caesarean. Toa Payoh VetsThe little daughter must have felt nauseous as you can see from a chance picture of her. I appreciate this rare action people and dog photo very much as it is one that tells a thousand words.

 "Why don't you dock the tails now?" the breeder's wife asked.

"Better not," I said. "The mother may be upset. The puppies may not suckle or be stressed."

Some advices on how to care for the puppies were given.

The breeders seemed grateful and most happy. This was the first time they encountered their Schnauzer giving birth during the daytime. This Caesarean was without complications.

The breeder's wife phoned some one hour later, "One puppy is not suckling well. Milk comes out of his mouth."

"I don't know what's happening. Is there a hole in the roof of the mouth. Check the mouth." It was difficult for her to know what the roof of the mouth means.

See what I mean? I hate telephone diagnosis. I asked her to bring the puppy for me to check. She did not turn up. I guessed all would be all right with the puppies.


breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pupsThe above Caesarean section was done in 2007.
I hope my photography skills have improved since then as I read more photography magazines for tips. The picture of the breeder's daughter
responsible pet ownership singapore toapayohvetsshows that Singapore's daughters are brought up in clean environment and the smell of birth must have overwhelmed her. She is a very bright student and is in Primary School now!

Images of two Emergency Caesarean Sections done by Dr Sing in 2011 during after-office hours (one past midnight and one on Hari Raya Haji) are shown
below:

CONTENTS - 2 CASE STUDIES
Timely Emergency Caesarean Section Saves the Mum and Pups - 2 case studies.

Case No 1. Water bag has ruptured. No pups.
Maltese, 2nd litter. An experienced breeder knows what to do
emergency caesarean section, maltese, 2nd litter, toapayohvets, water bag burst, no pups breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pups emergency caesarean section, breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pups breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pups
breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pups breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pups surgical approach dr sing, caesarean section in dog, toapayohvets, singapore breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pups
breeder, singapore, maltese, 2nd litter, toapayohvets, water bag burst, no pups  
   

Case No. 2
 A water bag appears. Poodle.
lst litter
Inexperienced breeder

public holiday emergency caesarean section poodle water bag, no pups, distressed, too long wait. toapayohvets, singapore
  2nd case study
Inexperienced breeder waits and sees - distressed pups, not moving
public holiday emergency caesarean section poodle water bag, no pups, distressed, too long wait. toapayohvets, singapore public holiday emergency caesarean section poodle water bag, no pups, distressed, too long wait. toapayohvets, singapore
Conclusion. Home-breeders  - Difficulty in giving birth >1 hour -- Get a Vet. Know your vet options
Don't wait and see to save money. Puppies die. Toxic blood. Dam dies if >12 hrs. Still need Caesarean section. The above will be presented in a video at the AVA Responsible Pet Ownership Roadshow 2011 Seminar by Dr Sing on Saturday, Nov 12, 2011 at the Changi Expo, 1.30 pm to 2 pm.
  

UPDATE ON NOV 10, 2011 AT 5.51 AM AS I WRITE THIS ARTICLE AT HOME:
On Nov 9, 2011, I spoke to the driver of the breeder 2 days after my Caesarean of the poodle as he brought some dogs for Dr Vanessa to treat. "Everything is Ok," he said. "The poodle and the 3 pups." As for the Maltese, I have no news and no news is good news as far as Caesarean sections are concerned!

As regards my 5-year-old car, it broke down at Basement 2 car park of the National Library Board at 6pm yesterday Nov 9. There was a starting sound but no petrol went to the engine according to a mechanic. The diagnosis was something wrong with the petrol pump. So, this car was towed away. Older cars, like older dogs and people tend to have more health problems! 
 
public holiday emergency caesarean section poodle water bag, no pups, distressed, too long wait. toapayohvets, singapore green pigments due to breakdown of placenta - delay in seeking caesarean section, poodle. toapayohvets, singapore Breeder's considerable delay in seeking caesarean section but 3 pups survived and are well. toapayohvets
  Breeder's considerable delay in seeking caesarean section but 3 pups survived and are well. toapayohvets public holiday emergency caesarean section poodle water bag, no pups, distressed, too long wait. toapayohvets, singapore
CASE NO. 2. The inexperienced breeder

When the breeder delays in seeking Caesarean section, hoping that the poodle with a water bag hanging out will give birth naturally, the placentas of the 3 pups breakdown and detached.

The pups will soon die from toxic products. In this case, the placentas had separated. Another few hours, the dam will die too. 

In this case, the pups were distressed and weak (no immediate cries when taken out). 1/3 had water logged lungs. I swung it 6 times and it was OK. All 3 pups are surprisingly alive and well at Day 3 after Caesarean section!  

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