UT-VMC emergency room tails: the miracle of life

UTVMC COLUMN HEADER  2By Dr. Amanda Rainey

“Emergency student, call 5655,” the familiar page rang out through the overhead intercom system, alerting us to the arrival of a new patient. “I’ll be right up,” the student said with a hint of excitement in her voice after dialing the receptionist from our triage phone.

“What do we have,” I asked as she slipped out the side door into the hallway, curious after hearing the lilt in this usually quiet student’s voice. “It’s a dog with trouble having puppies,” she called out over her shoulder, pony tail swinging as she marched her way up front.

I wish I could say I was excited too, but instead my heart sank. Most of the time these are not intentional breedings. They happen because the owners lack the funds necessary to spay or neuter their pets. Depending on the case, some animals require an emergency c-section to remove the puppies. In the worst situations, they may have already passed away but surgery is needed to save the mother.

I sighed when I saw my little patient being carried into the room. She was a cute but petite Chihuahua. The student informed me that she had produced one puppy at home after seemingly being in labor since around eight in the morning. It was early evening now and what concerned me more than how long it had taken her to have the puppy was the fact that it was stillborn.

Despite her condition, the dog allowed us to examine her. We placed an ultrasound probe on her abdomen in an attempt to determine how many puppies she might have left inside and to obtain their heart rate, a very important indicator of stress. If the heart rates were low, we didn’t have much time to get them out before it might be too late. The little mother was so small it was quite easy to identify two more puppies present. I was relieved to find their heart rates were appropriate. I discussed with the owners that given her difficulties a C-section was recommended, not only to save the puppies, but to ensure the mother survived as well.

Much to everyone’s dismay, they did not have the finances to perform surgery. I retreated back to triage to check on the dog and figure out a solution for this little family. As I paced the room, suddenly the tiny dog mimicked my actions and began trotting around her cage. I also noticed her abdominal muscles seemed to be contracting, squeezing in and out rapidly. The next thing I knew, a puppy slipped from her hind end onto the mat in her cage!

“Everybody! Come quick! We’re having babies,” I yelled into ICU. My students, the intern and our technician flew into the room. At my instruction the students broke open the sac encasing the puppy and separated the umbilicus from the mother. I immediately began suctioning the airway while gently massaging the puppy with warm towels to stimulate it. Soon, we heard the awaited cry indicating that she was breathing and placed the puppy back with her mother. Not ten minutes later, another puppy shot forth and we repeated the process. I don’t get too ruffled at my job anymore, but that night I found myself shaking from the joy of a situation working out for the best without any real medical intervention. We just had to let nature take its course.

(Dr. Amanda Rainey, DVM, is a clinical assistant professor in the small animal clinical sciences department at the University of Tennessee Veterinary Medical Center in Knoxville.)

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