Bitch caesars

Re: Bitch caesars

Rob Loxley — Mon, 12 Sep 2011 22:15:01 GMT

[quote user="Clive Ansell"]but should we not be speying all or most bitches that need a CS, to prevent repeats[/quote]

I'll be too busy filling in the forms to report the caesar to the kennel club to spay them

Re: Bitch caesars

Clive Ansell — Mon, 12 Sep 2011 13:07:38 GMT

In some charity clinic and petaid practices where spey and CS together are the norm an are indeed default policy now, I have never encountered any problems at all. I suppose one could give oxytocin to help involute the uterus after puppy removal and prior to spey, as it works almost immediately, but I never have.

Another area for discussion, but should we not be speying all or most bitches that need a CS, to prevent repeats, from a welfare viewpoint?

Re: Bitch caesars

Kate Richardson — Mon, 12 Sep 2011 13:04:39 GMT

[quote user="i am ed"]I think it's much quicker the spay at the same time, but generally I find the recover to be worse (weaker and paler). Isn't it better to let the uterus involute and return its blood volume to the main circulation? Or is that an insignificant consideration?[/quote]

Not an insignificant concern at all, but have personally not had any problems. I often see the uterus involute in front of me as I am operating, and if you even drip some oxytocin on the uterus it will shrink in front of your eyes. I will spey them if a) the owners request/agree to it and b) if it is not going to cause further risk to my patient.

Re: Bitch caesars

Hannah Wynne Richards — Mon, 12 Sep 2011 12:53:00 GMT

I would only spay the same time if the uterus was a real mess

Wynne

Re: Bitch caesars

Edward Jones — Mon, 12 Sep 2011 12:50:55 GMT

I think it's much quicker the spay at the same time, but generally I find the recover to be worse (weaker and paler). Isn't it better to let the uterus involute and return its blood volume to the main circulation? Or is that an insignificant consideration?

Re: Bitch caesars

Clive Ansell — Mon, 12 Sep 2011 12:46:13 GMT

[quote user="Mark Holmes"]

Its far quicker to spay and caesar than to leave them intact. You can unzip the uterus as much as you like, then three ligatures and its out. All the vessels are easy to locate and ligate, I generally transfix at the uterine stump but even so. Still significantly quicker to the point we charge less for the proceedure.

[/quote]

I have never worked anywhere that has charged less for a combined cs/spey than a cs alone. Good idea though, and as you say it is as quick or quicker, plus it encourages owners to spey, plus the "no money-needs CS" gets speyed by default.

Re: Bitch caesars

Kate Richardson — Mon, 12 Sep 2011 11:57:23 GMT

[quote user="Mark Holmes"]Its complete rubbish. Its far quicker to spay and caesar than to leave them intact. You can unzip the uterus as much as you like, then three ligatures and its out. All the vessels are easy to locate and ligate, I generally transfix at the uterine stump but even so. Still significantly quicker to the point we charge less for the proceedure.[/quote]

I agree, its as quick or even quicker to spey at the same time than it is to close the uterus.

Re: Bitch caesars

Mark Holmes — Wed, 07 Sep 2011 21:22:11 GMT

[quote user="Busybee"]

[quote user="Mark Holmes"]You also have the chance to get the bugger spayed whilst the owner is regretting having pups. [/quote]

Do you advocate spaying at the same time as a caesar? My colleague who helped me with my first caesar said not to unless there's a medical reason to. She said she would rather two shorter ops than one long op. Though as a new grad, that might have just been cos I was slow!

[/quote]

Its complete rubbish. Its far quicker to spay and caesar than to leave them intact. You can unzip the uterus as much as you like, then three ligatures and its out. All the vessels are easy to locate and ligate, I generally transfix at the uterine stump but even so. Still significantly quicker to the point we charge less for the proceedure.

Re: Bitch caesars

Busybee — Wed, 07 Sep 2011 21:05:03 GMT

[quote user="Mark Holmes"]You also have the chance to get the bugger spayed whilst the owner is regretting having pups. [/quote]

Re: Bitch caesars

Mark Holmes — Tue, 06 Sep 2011 21:40:23 GMT

[quote user="Stephen Courtney"]In my opinion you will never get a whole litter of pups out manually if the bitch has primary inertia and or is already tired. So long as the owner is sure of dates and the cervix is open and fluids have passed and some sort of straining has been happenening, you are better off going to caesar sooner than later.[/quote]

I would completely agree, there is no point messing about with oxytocin if they have a belly full. The odds are you will still end up doing a caesar just on a knackered bitch and dead (or slow) pups. I will use oxytocin if there is a straggler but not if I suspect primary inertia. You also have the chance to get the bugger spayed whilst the owner is regretting having pups.

Re: Bitch caesars

bob lehner — Tue, 06 Sep 2011 21:34:05 GMT

[quote user="Stephen Courtney"]I prefer to radiograph - I[/quote]

Also very useful to scan the mother in order to demonstrate viable heart beats (or not) - quick and easy.

If there are viable pups you can demonstrate this to the owner and encourage an early c-section . Equally if you show that they are already dead you avoid any risk of the subsequent caesar being blamed for 'killing the pups'.

Re: Bitch caesars

Stephen Courtney — Tue, 06 Sep 2011 21:05:05 GMT

If there are just one or two pups left, oxytocin has a chance. i usually spike with IV calcium first, then tickle them with oxytocin. If you are heavy handed you just lock the uterus down in front of the babies and they can't come out.

In my opinion you will never get a whole litter of pups out manually if the bitch has primary inertia and or is already tired. So long as the owner is sure of dates and the cervix is open and fluids have passed and some sort of straining has been happenening, you are better off going to caesar sooner than later.

Sitting up all night manually whelping a bitch then caesaring in the wee hours helps nobopdy, and if you charge properly for your time during a whelping, is a waste of the clients money.

I prefer to radiograph - I like to be sure they really are pregnant - can remember some remarkably realisitic false preggers - and i like to know how many babies there are to retrieve - have a horror of leaving someone behind!

Re: Bitch caesars

Mark Hedberg — Tue, 06 Sep 2011 20:56:31 GMT

Oxytocin used alone can certainly have failures; the muscles are ordered to push, but if there's nothing left to push with, that's where the Ca and the dextrose/glucose come in. (And the monzaldon, but if you don't feel like using that, no worries.) Essentially you need to feed the muscles as well as stimulate them.

And yes, after all that, you still sometimes end up Caesaring. I'm not advocating a miracle cure, just a little extra help. :)

Re: Bitch caesars

Busybee — Tue, 06 Sep 2011 18:35:51 GMT

[quote user="robloxley"]Not sure what your xray adds, except to the time and bill.[/quote]

I did in this case as the owners didn't know she was pregnant (she had had Alizin!) and though I thought I could feel a pup on abdominal palpation, I wasn't 100% and would rather check than open up and find her empty. I always give the owners the option to x-ray if we're unsure about numbers etc. This was a collie who had so far only had 3 pups.

Re: Bitch caesars

Rob Davis — Tue, 06 Sep 2011 14:16:32 GMT

[quote user="Mark Hedberg"]Use oxytocin and Monzaldon together, monzaldon dilates the cervix and in combo you get slower, more rhythmic contractions. Also consider calcium and dextrose, exhausted muscles need energy.

[/quote]

I've never used monzaldon - is this something many people find helpful? If I find the cervix is not fully dilated and there has been significant straining, then I would tend to head for caesarian rather than reaching for drugs, but maybe I am too hasty...

Re: Bitch caesars

Rob Loxley — Mon, 05 Sep 2011 23:26:56 GMT

[quote user="Busybee"]What do other people tend to do - how many would wait and give oxytocin injection(s) if indicated, or just go straight for caesarean?[/quote]

Will often give oxytocin if it's what's needed, but I'll start setting up for the c/s at the same time. I find that if one inj doesn't help further ones rarely do, YMMV. Not sure what your xray adds, except to the time and bill.

If it's evening surgery I discuss with the client that if we get into OOH the costs will go up and the number of nurses to help goes down! I think also that the time taken OOH for watching and waiting needs to be factored in and may well influence how much watching and waiting is done.

Re: Bitch caesars

mariette asselbergs — Mon, 05 Sep 2011 22:16:31 GMT

By the time people bring the bitch into practice, I only try oxytocin once at 0.1 unit/kg, after checking for obstruction of course. If I suspect a large pup, then I use the lube bottle with a plastic tube to squeeze lube past the pup, this often helps. But the bitch is often too stressed and under adrenalin influence to go on whelping normally, so I don't faff around too much until deciding for a C section. The client is often ready for it too by this stage.....

Re: Bitch caesars

Helen Wallace — Sun, 04 Sep 2011 18:37:48 GMT

If I haven't seen strong contractions within around 20 min of oxytocin I'd consider going to surgery. If I have seen the bitch contracting well then I'll do my best to monitor the progress of the pup down the canal but if the bitch is pushing and pup isn't shifting then its a section. I'm probably a little less generous with time at 2am than I am on a quiet afternoon, but whelpings rarely show up on a quiet afternoon

Re: Bitch caesars

Busybee — Sun, 04 Sep 2011 17:58:38 GMT

How long would you pursue medical therapy before resorting to a caesar?

Re: Bitch caesars

Mark Hedberg — Sun, 04 Sep 2011 14:23:30 GMT

Use oxytocin and Monzaldon together, monzaldon dilates the cervix and in combo you get slower, more rhythmic contractions. Also consider calcium and dextrose, exhausted muscles need energy.