Glory’s Scheduled Cesarean Section

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We are six days into Glory’s scheduled cesarean section which took place at Veterinary Village on February 6, 2016. I chose to do a scheduled csec after talking in depth with Dr. Greer about Glory and what would be best for her and her puppies. Dr. Greer is my reproduction veterinarian for all my repro needs. I also consult my doctors where I work as a Veterinary Technician at Harmony Pet Clinic between us all we came up with a game plan. This breeding was a surgical AI using frozen semen that was also done at Veterinary Village, you can read that post here.

First we took into consideration that Glory didn’t have a “normal” whelp with her last litter. Glory gave birth to a dead puppy 5 hours after her last delivered live puppy. This puppy looked normal in all aspects except that it was dead. That constitutes not a “normal” whelp.

Second Glory’s due date landed on the weekend. If by some chance Glory had problems with her whelp and became distressed the reproduction clinic or an emergency clinic would be over a hour away that is not a good distance to have to travel with a bitch that is having problems delivering. The percentage of survival of puppies is higher with a scheduled csec than letting the bitch deliver naturally if the bitch becomes distressed and it turns into a emergency csec. This has been proven by Paula Moon et.al study that she did “Perioperative risk factors for puppies delivered by cesarean section in the United States and Canada.” JAAHA 2000, Vol 36, N. 4, p. 359-368.

Third thing we took into consideration was that x-ray showed that Glory was going to have a large litter. Even know the x-ray shown that she was going to have at least 8 puppies Glory was very large which made me think she had more puppies in there than on x-ray for they were 8 really large puppies.

This decision is one that isn’t taken lightly and should be well thought out and discussed with your reproduction veterinarian. You know your dog and you know what you and your dog can handle so you need to do right is right for your pregnant bitch.

Without further adieu let me take you through Glory’s c-section experience.

Date: February 6, 2016 time to be at Veterinary Village 12 pm, time to leave Stancerville 11 am. Friends Tom and Irene (who own Josey from Glory’s last litter) arrived promptly at 10:45 am, we loaded up the van and were off on an adventure that we will never forget.

Supplies we took with.

Supplies we took with.

Supplies we took with: Comforter for Glory to lay on in the van, basket to bring the puppies home in, heating pad to keep the puppies warm, power inverter for the heating pad, blanket for puppies, towels for basket, notepad to keep notes, soda, cookies, camera, chocolate and chapstick for the vet staff.

Blood draw, catheter placement.

Blood draw, catheter placement.

Once we arrived at the clinic we checked in with the receptionist, Glory weighed in at 95.5#, we were then taken to our examination room where the pre-op stuff would take place. First Glory had her blood drawn for her pre anesthetic blood work which will check her internal organs check a complete blood count and a coagulation panel. While the blood work was being run on the in house chemistry analyzers Kassie one of the Veterinary Technicians placed the IV catheter. This would be for IV medications and for IV fluids during the procedure. She then received steroids through her catheter site as well as flush to   make sure the catheter was patient. An Adaptil collar was put on at this time. The collar which is a calming collar should be put on a couple days before any whelp. It has dog appeasing pheromones that help calm the mother.

ECG and shave.

ECG and shave.

While the steroids were incubating (needed at least 45 minutes) a ECG was taken of Glory’s heart to make sure it was beating correctly, they didn’t want any surprises in surgery if there was something that could of been detected before surgery. Her abdomen was then shaved so there could be a sterile surgical field lastly she was given a couple subcutaneous injections which were calcium, reglan and atropine. Calcium was given because it has been anecdotally reported to improve maternal skills and aids in uterine contractility. Reglan has been shown to improve lactation. Atropine will cross the placentas and aid in maintaining fetal heart rates. *taken from the book Dr. Greer wrote: Canine Reproduction and Neonatology. Published by Teton NewMedia.

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At 1:45 pm Glory was induced, intubated, hooked up to general anesthesia and IV fluids and prepped for surgery. When they are prepped a plastic drape is put down and only the incision area is scrubbed so the puppies are more apt to take to the nipples since nothing was put on them. Dr. Greer and Dr. Ahmann performed the c-section while Dr. Griffiths was monitoring the anesthesia as well as Glory and keeping track of the surgery as what puppy came out first and out of what horn of the uterus, what time the puppy came out and who it was given to in what color towel so the puppy could be kept track of from start to finish. Their were 4 support staff members handling the puppies as they came out. Heather and Cassidy are Veterinary Assistants, Cassie is a Technician and Dr. Greer/Griffiths daughter Katie was home for the weekend so she helped out also she is a nurse.

It’s show time, at 1:54 pm the first puppy was born, the last one was born at 1:59 pm.

The video shown what a well oiled team this is. Everyone had their duty and place.

Surgery report.

Surgery report.

Another puppy coming out.

Another puppy coming out.

The puppies were popping out like popcorn so more hands were needed on deck to help stimulate the puppies and get them warmed up and breathing good. The first stop for the puppies was at the puppy resuscitation center.

The more hands the merrier.

The more hands the merrier.

I thought the rubber maid container with heating pads inside of it was most clever. That way if you needed to let go of the puppy there was no chance of it falling off the table. There were heating pads in the bottom with a towel over it to keep the puppies warm. Each puppy came out and was put into a specific colored towel so they could keep track of who was who. At this table was where the puppy’s throat got suctioned out with a DeeLee Mucus trap, caffeine was given to help stimulate them, dopram was given if needed help breathing where oxygen was given too if needed. They stayed here until they were stable then were transferred to another table where another team member did their work on them.

Weight, id, umbilicus table.

Weight, id, umbilicus table.

At the weight, id and umbilicus table where the Dr’s daughter Katie was tying off the umbilical cords from the placenta using a sterile hemostat and suture material. Once tied off then the placenta could be cut off and the umbilical cord dipped in iodine. The puppy was weighed and a small spot of nail polish was placed on the head before it headed to the incubator to stay warm.

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The supervisor.

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Another puppy coming out and resuscitated.

The surgical suite.

The surgical suite.

While Dr. Greer was overseeing what what going on in the treatment room with the puppies Dr. Ahmann was suturing up Glory. Glory was done at 3 pm.

Glory in recovery.

Glory in recovery.

While Glory was in recovery the puppies were all doing well so I asked if the Dr. could remove their dewclaws right away so I didn’t need to make a trip back with them since I live a hour away. Each puppy had rear dewclaws that needed to be removed along with the fronts.

Removing dewclaws.

Removing dewclaws.

The technician holds the puppy pressing on the cephalic vein that goes down the leg at the elbow while stabilizing the leg for the doctor. A sterile surgical scissors is used to remove the dewclaw, kwik stop is applied and surgical glue is used to seal the incision. Once done the puppy was given to me to see if they wanted to nurse on Glory.

Trying to nurse.

Trying to nurse.

The puppies and Glory wanted no part of nursing. It was too soon for them so instead of taking any chances that they might not get Glory’s colostrum which is a valuable part for puppies to develop adequate passive immunity and should be given within 12 hours of birth Dr. Greer decided to get them started on fresh frozen plasma.

Giving plasma via tube feeding.

Giving plasma via tube feeding.

Since I needed to give the plasma once we were home via a feeding tube I needed a refresher course on tube feeding. I learned it in technician school but I haven’t had to do it in a very long time. Dr. Greer was explaining to me what I should do. You take a feeding tube and stretch the end of it to the last rib and the nose. You put a mark on the tube where the end of the rib landed. You then tip the head of the puppy down and insert the tube into the left side of the puppies mouth and guide the tube down the esophagus, once you get to the mark you made on the tube you hold the head in your hand while holding the tube and using your other hand you pinch the puppy to get it to cry, if it cries then the tube is in the stomach and not the trachea and then it is ok to administer the fluid. If you can’t get the puppy to cry then reinsert the tube.

That is a video of me tubing the puppy and giving it the plasma. Fresh frozen plasma can be purchased through HemoPet. The donor dogs have their health screenings so they are disease free so you don’t have to worry about introducing diseases. The tube feeding went well. Glory was recovered enough to go home with her pups so it was time to pack them up.

Time to go home.

Time to go home.

We took the puppies out of the incubator, placed them in their heated blanket and into the van we went.

Ice Cream for the ride home.

Ice Cream for the ride home.

On our way home we stopped for ice cream and of course I was busy texting my friends telling them all was well with everyone.

So far I am very pleased with my decision to do a scheduled c-section. I have the best well organized repro clinic a breeder could have. Since I am a technician and know how a facility should be run it was so nice to see this clinic being run that way. Everyone was so professional and took such good care of Glory and the pups. They all had their jobs and they did them well. I can’t thank the staff at Veterinary Village enough for allowing Tom, Irene and I to partake in such an amazing delivery. So far all 9 puppies are doing very well and so is Glory.

THANK YOU!!!

Barks And Bytes

We are joining Linda at 2browndawgs and Jodi at Heart Like A Dog for this great blog hop.