To intervene or not?

Re: To intervene or not?

mariette asselbergs — Sun, 27 Jan 2013 21:32:16 GMT

Saw a Great Dane last week who delivered 8 pups on Thursday, another big dead one on Friday and another two dead ones on Saturday when she came to check if there were any left (Answer: no). Bitch was fine no fever or malaise, plenty of milk.

My own Belgian Bouvier once delivered 12 live over 24 hours plus 2 more dead 24 hours later,also without showing discomfort.

Mariette

Re: To intervene or not?

Charlotte Marshall — Sun, 27 Jan 2013 16:45:43 GMT

I got called out to a calving once to discover an empty cow with afterbirth present. Cue one search of the field and a live calf eventually found in a ditch (luckily not the pond in the same field!) and a slightly embarrassed farmer.

Re: To intervene or not?

Sarah Keir — Sat, 26 Jan 2013 19:16:50 GMT

A vague recollection that dog sperm lasts 7days? SO 63 days +/- 7days!

I wouldn't of caesared the bitch, despite my nick name (when I was a mixed vet) of 'caesare queen'!

I think my record was the 6th CS on blue cow - and it was a nightmare. No, not a good idea to keep doing this but...

Re: To intervene or not?

bob lehner — Sat, 26 Jan 2013 09:57:23 GMT

[quote user="Elisabeth Knappett"]The bitch was covered numerous times at a breeders and this was the date given to them, I suspect there may have been more than 1 covering[/quote]

A common misconception (ha, ha) amongst breeders/owners is that pregnancy in bitches lasts 63 days frpm the mating date - whereas it is in fact 63 days +/- 24 hrs from the time of ovulation - which may be a completely different from the mating date. Unless the ovulation date is known via progesterone assays then breeder's 'dates' are fairly meaningless.

The really excellent Virbac Webinar by s.a. reproductive specialist Angelika von Heimendahl spells all this out (still available on line).

Re: To intervene or not?

james herriot lied — Fri, 25 Jan 2013 23:00:50 GMT

96 hours? I've had a 72 hour one (see above) with a live pup at the end. And clients - in particular, breeding clients - always tell the truth. Offer to PM or dispose of the dead ones for her, for free.

Just another thought: it's not a traditionally docked breed, is it? No requests for puppy docks as yet?

Re: To intervene or not?

Elisabeth Knappett — Fri, 25 Jan 2013 22:30:38 GMT

Final update on OP - the live pup delivered Monday night unfortunately died the following day, having been a slow goer. However, bitch delivered a further 2 live pups today......I have been chasing the owner all week asking to check the dog over post whelp, got nowhere with her. Called again this evening to be told that she delivered these late afternoon. Now all doing well, pups bright and suckling etc. Hmmm. Has this ever happened to anyone else or is it really a full moon today?

Re: To intervene or not?

Glenn Hodgson — Fri, 25 Jan 2013 22:21:25 GMT

If she was my dog I would not have progressed with a section at that point.

[quote user="Elisabeth Knappett"]

I saw a 2yo maiden bitch this afternoon who was 60 days in pup, with a slight brown vulval discharge. On exam, she was fit and well, her temperature was just 99F and on scan mobile pups with heartbeats were visible. Vaginal exam revealed a closed cervix but soft. I have just had a call to say she is currently whelping - she has passed 4 pups, 3 dead 1 live. My question is this - should I have intervened this afternoon, or let it run its course? Thanks for any responses!

[/quote]

Re: To intervene or not?

Kate Richardson — Fri, 25 Jan 2013 20:27:15 GMT

[quote user="james herriot lied"]Out of interest, were they visible on xray with a finely focussed Retrospectoscope (patent pending)?[/quote]

Only with the imaginoscope (patent also pending)

Re: To intervene or not?

james herriot lied — Fri, 25 Jan 2013 18:41:43 GMT

[quote user="Rajat"]

[quote user="james herriot lied"] the last - live - pup was delivered 72 hours after the first. [/quote]

Amazing!

[/quote]

You wouldn't be patronising me now, would you?

I wouldn't be giving calcium without a good (bloods) reason to, but diluted 1:10 cow calcium suits the purpose very well (and is cheap) and has a small amount of dextrose in anyway.

Re: To intervene or not?

james herriot lied — Fri, 25 Jan 2013 18:37:15 GMT

[quote user="Kate Richardson"]

That reminds me of a case I saw- xrayed prior to decision to caesar to determine if 1 big pup or multiple pups, no pups seen. For some reason decided to stick ultrasound on as well and obvious foetuses (foeti?), no heart beats. Presumed dead for a while (no signs of vaginal discharge or illness in bitch whatsoever) so resorption was occurring and bones not radiodense enough to show up on xray but visible with ultrasound. I know not everyone (or do they these days?) has access to ultrasound, but just a little warning that xrays aren't foolproof.

[/quote]

Out of interest, were they visible on xray with a finely focussed Retrospectoscope (patent pending)?

[quote user="Kate Richardson"]

I am not a LA vet (no sh1t sherlock! ) but is it really sensible to continue putting cows like this in calf?

[/quote]

No.

Re: To intervene or not?

Rajat — Fri, 25 Jan 2013 13:02:17 GMT

[quote user="james herriot lied"]Just an old throwback for dealing with uterine inertias - giving some glucose through the drip in case of 'exhaustion'. Never been in any way convinced of a benefit and to be fair, haven't done this in a while now - I freely admit that I just tend to get on and caesar.[/quote]

Fair enough - I don't think hypoglycemia is common, but I suppose it wont do much harm (though in people they really try when in hospital not to let you become hyperglycemic, at least in ICU patients the outcome worsens). In my head giving calcium to these bitches makes more sense :)

[quote user="james herriot lied"] the last - live - pup was delivered 72 hours after the first. [/quote]

Amazing!

Re: To intervene or not?

Kate Richardson — Fri, 25 Jan 2013 10:24:20 GMT

[quote user="james herriot lied"]Most memorable whelping(s)? First, the bitch that had nested, come into milk, relaxed at the back end and seemed to be pushing. We'd all talked ourselves into a caesar, but (this was pre-scanner) at the last moment decided on a conscious xray. No pups.[/quote]

[quote user="james herriot lied"]Currently waiting on one that I did yesterday, which was a bought-in Blue that had had a couple of caesars up-country. I would very much like a wee 'chat' with the previous surgeons - two wholly misplaced wounds which didn't take into account any future surgeries and a minefield of adhesions inside. Couldn't exteriorise, but miraculously the uterus opened in exactly the right direction and stitching up was better than it might have been. Will hopefully be in calf to something smaller next year, as the farmer only has a left-opening crush (and I hate doing them on the right side).[/quote]

I am not a LA vet (no sh1t sherlock! ) but is it really sensible to continue putting cows like this in calf?

Re: To intervene or not?

james herriot lied — Thu, 24 Jan 2013 22:53:39 GMT

[quote user="Michael Woodhouse"]

(just had a cow caeser die, maybe my first in the last ~3 years - it had been a good run!)

[/quote]

Tough luck, old man.

Currently waiting on one that I did yesterday, which was a bought-in Blue that had had a couple of caesars up-country. I would very much like a wee 'chat' with the previous surgeons - two wholly misplaced wounds which didn't take into account any future surgeries and a minefield of adhesions inside. Couldn't exteriorise, but miraculously the uterus opened in exactly the right direction and stitching up was better than it might have been. Will hopefully be in calf to something smaller next year, as the farmer only has a left-opening crush (and I hate doing them on the right side).

Re: To intervene or not?

james herriot lied — Thu, 24 Jan 2013 22:45:44 GMT

[quote user="Rajat"]

Why the glucose btw?

[/quote]

Just an old throwback for dealing with uterine inertias - giving some glucose through the drip in case of 'exhaustion'. Never been in any way convinced of a benefit and to be fair, haven't done this in a while now - I freely admit that I just tend to get on and caesar.

Most memorable whelping(s)? First, the bitch that had nested, come into milk, relaxed at the back end and seemed to be pushing. We'd all talked ourselves into a caesar, but (this was pre-scanner) at the last moment decided on a conscious xray. No pups. Cue a bit of a search at home, but nothing. As she was a misalliance (pre-alizin days), we spayed her a month later - and uterus was completely clean and virginal. Most convincing pseudopregnancy I ever saw. The other was an older collie bitch who'd had a good few litters and whose owner was happy to keep popping her down, but was adamant that however long it took, she wouldn't need a caesar; in the end, the last - live - pup was delivered 72 hours after the first.

Re: To intervene or not?

Virginia Campbell — Thu, 24 Jan 2013 21:21:19 GMT

[quote user="An On MRCVS"]You may have given her a sweep by accident[/quote]?

Don't think you could make the cervix of a not-ready dam open up and uterus squish out all its contents with a quick fiddle.

(Lambing ringwomb ewes would be SO much easier if this was the case)

Re: To intervene or not?

Mark Hedberg — Thu, 24 Jan 2013 08:31:23 GMT

I like a bit of glucose/dextrose myself; gives the muscle cells some energy to push, so the theory goes.

Re: To intervene or not?

Rajat — Wed, 23 Jan 2013 21:12:27 GMT

We get them second hand (not sure if others do the same) and have a zillion lying around. They tend to beep at the slightest excuse. They have moods of their own. Sometimes, when a lot of them are all plugged in(read mental weekend, on edge vet, suicidal nurse) they start a little symphony of their own. I cannot remember which ones we had at my previous practice (via infusion concepts - used moduflo sets..?) but they were a lot less problematic.

Re: To intervene or not?

Anthony Todd — Wed, 23 Jan 2013 19:40:00 GMT

[quote user="Rajat"]they are a bloody pain in the ass...[/quote]

Why? We find them not as easy as Vetpros [but much cheaper] but work Ok although very sensitive to bubbles on set -up, apart from that OK.

Others on the forum use them too, I think.

Re: To intervene or not?

Rajat — Wed, 23 Jan 2013 19:12:21 GMT

[quote user="Anthony Todd"]

Rajat, how do you get on with IVAC pumps??

[/quote]

they are a bloody pain in the ass...

Re: To intervene or not?

Anthony Todd — Wed, 23 Jan 2013 00:46:18 GMT

Rajat, how do you get on with IVAC pumps??

Re: To intervene or not?

Michael Woodhouse — Wed, 23 Jan 2013 00:07:09 GMT

MMM. I think large and small animal caesers are worlds apart. A lot of bitches presented as whelping are not even properly in stage 2 labour. I am much more likely to 'wait and see' in a bitch. Certainly in the day time small doses of oxytocin can advance things nicely without unnecessary surgery. At 10pm I might be more likely to push on with Sx.

It seems that small animal vets seem reluctant to deliver pups. Obstetric forceps are useful and a vectis a marvel (but a teaspoon will do at a push). Once the big (dead) pup is out the way things will usually progress nicely. I know large animal vets who either do a simple pull or a caeser, people seems to have lost basic obstetric skills. A nice embryotomy can be as satisfying as a caeser.

I do agree that an early decision to get on and caeser, when indicated, correlates with a favourable outcome.

People need to realise that birth has risks and stop counting their chickens before they hatch. You can still end up with everything dead and a bigger bill from the caeser (just had a cow caeser die, maybe my first in the last ~3 years - it had been a good run!)

Re: To intervene or not?

Rajat — Tue, 22 Jan 2013 23:21:32 GMT

[quote user="james herriot lied"]

Saturday afternoon, 10yo primiparous bitch with a head stuck out and some brown discharge. Slight cranial displacement of the foetus and the brown stuff literally poured out.

Scanner on, only saw another pup and a mess of mixed echogenicity. No heart beats.

Caesar. Uterus full of brown stuff - think pyo but without the smell. Spayed, obviously. Two pups, development consistent with about a week off full term, so they were obviously alive a week ago. Still not sure what happened there - as it was Saturday night and we're mixed on call, I didn't have the time / inclination to make smears. Bitch was fine at poc yesterday.

Brown stuff is, for me, a reason to caesar. As is green and red stuff, or intractable pushing for more than about 40 minutes. Ditto non-responsiveness within about 30 minutes to oxytocin +/- glucose. I think those of us in mixed practice are probably more likely to caesar earlier - with cows, you rarely turn around for half an hour, or give drugs: if it doesn't want to come out at the visit, you caesar it. That perhaps informs approach to bitches and queens.

There aren't many things better in practice than finishing a cow caesar with a live calf and a cleanly closed cow.

ps I heartily agree with earlier comments, Elisabeth - nothing you should be beating yourself up about. There are always some good tips to be had on the forum, but most of us would have done just the same - home under close observation and even closer communication.

[/quote]

Interesting to hear the LA experience. Why the glucose btw?

Personally, I see little repro stuff. I am inclined to caesar earlier rather than later. But tough to do so without signs of labour...

My most memorable whelping lasted about 7 hours. I got a call for a GSD bitch, been in labour for > 2 hours with straining.She was dilated on arrival and not pushing much any longer. Gave oxytocin, fluids, small amount calcium, checked electrolytes etc and then get her ready for a GA and into prep room.

So propofol in hand, I advance towards her IV catheter with a nervous owner hanging by, wiping the vomitus from the corner of her mouth (she had just thrown up in my corridor, and I had to warn her not to do that in prep or she'd have to leave) when the bitch decides to give birth on the table literally seconds away from being GA'd. How she got a pup out when minutes earlier there was nothing in the canal, I do not know.

Anyways this palaver was repeated twice, as I knew there were more pups to come, and each time we got her on the table she gave birth again.

Pup no 4 was born with a massive midline abdominal defect - my eagle eyed nurse caught it literally as soon as he came out and luckily we managed to anaesthetise him with iso and suture him up immediately. The owner immediately named him "Sutra" and he did just fine!

No caesarians involved, but 6 hours later it was a very happy bunch of mum, pups and owners. We all had fag breaks biscuits and coffee every hour. It was knackering but fun! Lots of foetal heart rates were listened to that night!!

Here's a pic of mom and pups (7 in total)

And Sutra post op - just a few minutes old !

Re: To intervene or not?

Stephen Courtney — Tue, 22 Jan 2013 23:16:26 GMT

Good advice on foetal heart beats - and another is to consider measuring blood calcium in bitches that aren't getting on with the job - primary inertia as opposed to just being knackered.

Re: To intervene or not?

Elisabeth Knappett — Tue, 22 Jan 2013 22:25:31 GMT

Ooops - meant also to say that I would have intervened if the discharge had been red or green - obviously to me - also if there had been obvious signs of labour. Has anyone seen coloured discharge from bitches prior to a normal parturition?

Re: To intervene or not?

Elisabeth Knappett — Tue, 22 Jan 2013 22:22:20 GMT

Thanks all - appreciate the info and advice.

Rajat - heartbeat count was above 200 - more like 250bpm, so like you said, I didn't suspect foetal distress at that point.

JHL - I am in mixed practice and yep, would usually jump for the caesar earlier than some of my SA only colleagues, but didn't see any reason to rush to one at that point as no obvious distress/issues other than the discharge, but will definitely now probably push more for section sooner rather than later.

However, all that said, mum is doing fine today, single pup coping but seems a bit dim, fingers crossed for the little one! Having spoken to the other vets in the practice, consensus was that we would have likely all done the same....but still doesn't stop me wondering......