Visiting Veterinarian : Easter emergencies
I wasn't expecting many emergencies. People would be busy with Easter egg hunts, church, Easter dinner. Even my fellow Jews probably wouldn't call, preferring a quiet Sunday recovering from two Seders the week before. So I was surprised when the phone rang early that morning. "Our dog, Blossom, is in labor and seems to be having trouble," the worried voice reported. Oh, great. "What kind of dog is Blossom?" I asked, trying to sound cheerful, while visions of pregnant St. Bernards flashed before my eyes. "A Lhasa Apso," the voice replied. I relaxed a little. It wasn't a huge dog, and litter size was likely small, but a few more questions made it apparent Blossom should be seen immediately.
A family of four arrived with the dog, squeezing into my minuscule exam room. Blossom had been in labor for hours without producing a puppy. Her belly was huge. A small greenish mass protruded from her vulva.
"Did you have an X-ray or ultrasound to tell how many pups?" I asked, pulling on a sterile glove. "They said maybe eight or nine," the owner answered. Wow. That's a lot. Average litter size for a Lhasa is four or five. Probing with my finger, I felt one tiny leg in the birth canal. That was it. I tried to manipulate the pup but it was soon evident something was drastically amiss with the positioning. The pup was stuck like a cork in the neck of a bottle. It was C-section time.
Blossom didn't have time to go off-Island to a special emergency clinic with a board-certified surgeon, ICU, anesthesiology technician, and round-the-clock care. We needed to make do with what we had. I called in my assistant, Elise, then rounded up my husband and daughters, and Blossom's four family members. One of the major concerns with a caesarian section is that when you anesthetize the mother, you end up anesthetizing the fetuses, which may already be compromised from prolonged labor. "When the pups come out, clear any fluid out of their mouths and noses, towel them dry, keep them warm, and rub them to make sure they keep breathing," I instructed, setting up piles of towels and hot water bottles.
Soon Blossom was anesthetized, on intravenous fluids, and prepped for surgery. Even asleep, contractions rippled across her belly as her body kept trying to expel the obstructing puppy. As I opened her abdomen, she pushed again. The enormous uterus spilled out onto a waiting surgical drape. "Get ready," I shouted, incising the uterine wall. Puppy one. Two. Three. Four. Each placed on a towel and delivered to a person in the back room. Dogs have a bicornuate uterus with two horns like an elongated letter Y. I moved to the other horn. Puppy five. Six. Seven. Eight. Some were breathing sporadically - some not at all. I called out instructions. Elise gave medications as directed to stimulate the ones in need. I reached for Puppy nine who was lodged at the base of the Y, the cervix, its head twisted sideways, one front leg extended forward. A few firm tugs dislodged the pup. I moved it back into the uterine horn and out the incision. The family had wisely agreed to have Blossom spayed, so I then turned my attention to finishing her surgery.