47. Telephone diagnosis in Caesarean can give the vet trouble

"My husband had ruptured the water bag but the puppy could not come out," the 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."

The 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.