Sunday, 23 May 2010

Bittter Sweet

We had a 7year old Labrador brought in with end stage heart failure and end stage pregnancy. Mum had less than a week to go and the pups should survive although it was doubtful if she would.
The idea was to stabilise her and then see about a caesarian the vet gave the owners very low to negative odds of her surviving. She was placed on oxygen and given medication.

The theatre was set up for an emergency caesarian and l also set up the medical prep for an emergency “cut and grab” if the bitch crashed. If she crashed before the operation then there would be no attempt at saving her she would not come off the table alive all efforts would go to saving the puppies the correct assumption being to save her they would die in the time it took to revive her and the odds of her pulling through revival attempts with pups in her were non existent, they placed to much stress on her body.

After about 1.5 hours there was no visible signs of improvement and her stats, were slightly worse. The vet called me over and said that when he finished his present consult we would go ahead. He would give her propofol(to induce anaesthesia)and l would tube her (a tube placed into the trachea to maintain the airway and provide 02 and anesthetic gas and remove said used). We would place her straight onto her back no clipping or cleaning just go straight in and get the pups out and she may survive via crash kit and luck.

I was giving a last check to see that everything was right in theatre. Kit open, crash kit open and ready, tube to hand all plugged in ready to roll when the auxiliary called the bitch had crashed in her kennel.
We shot through. The other vn and l grabbed her and placed her upside down on the medical prep table. She was starting to chain stoke which is dying gasps. We did not tube her the vet gave a “now” and l put the propofol into her. If she was still alive she would feel nothing.

The vet made a long slice midline and pulled open her abdomen. Blood flowed out as arteries and veins were left unclamped pooled then ran and dripped off the table. The vets hands gripped and rolled out the slippery uterus and he sliced through horn one. Fluid now joined the blood the table and floor became a red green slippery pool and the golden body of the mum became red green merging with the table.
The vet pulled out neonate pup’s and started to shove them into waiting hands. I pulled up a syringe full of euthatol. A long slice through horn 2 and those neonates pulled out and passed over.
By now the prep area was awash with blood and fluid. Apart from the pool on and under the table it was up the walls from flip back pulling out the neonates, and feet were walking through the pool to and from table 2 where neonates were taken a few paces for reviving, cleaning, drying and checking (cleft palette and anus present) table 2 also had discarded placentas thrown onto the floor mingling with dirty towels from drying the neonates.
As the vet was about to get the last one l was told get ready and as he pulled the last pup out l injected the euthatol. Mum had probably already gone by this stage but we were not taking any chances.
It had only taken minutes for the procedure; from the original “crash” call to euthatol was about 5minutes.

There was 6 live pups all strong and screaming no deaths there. The vet went back to his interrupted consult and the other vn sewed up the mums abdomen while l did a quick tidy up of the area. As soon as mum was sewn up l placed the pups back onto her dead body to try and see if they could get any colostrum out of her. They got some out but as usual with newborns it took time for the idea of suckling to sink into their little brains and the time meant that it was drying up fast within their dead mum.

An hour later the pups went home, it was a bitter sweet moment we saved 6 lost 1. By the time the pups left the building medical prep was shining and clean. No signs of the life gained and lost that had happened such a short time before.


Joker the Lurcher said...

this is very moving - you write in a way that gets across the factual stuff as well as the emotional impact.

JuliaM said...

Very sad but at least the pups were saved. Is heart failure an expected complication of pregancy, or just an unfortunate occurrence?

Vetnurse said...

Thanks Joker am glad you you like it :-)

No Julia it was the first case like this l have seen. The mum was to old at 7 to breed from. Non of us believe the owners comment it "She had started to get poorly 2 hours before arriving with us".

Boatwoman said...

That has been the most moving thing I have read for a long time. I agree with Joker you write in such a way, that you can see yourself in that situation. I so hope that the pup's grow strong and prosper. How very sad that their mum died.

Anonymous said...

What a sad case - but at least with happy outcome for the pups. I can't imagine the emotion in the surgery. Sad for the mother - I wish owners would be more responsible!

Vetnurse said...

Welcome BW and Wisdom Cafe :-)

Yes l agree BW l hope the pups do well in their lives, they deserve it.

Vet Wisdom you are right we were very flat the auxiliary was in tears as it was very brutal.
Pulling neonates out of dead/dying mothers is common amongst farm stock but they do not have the emotional tug as pets. I have only been involved in one other cut and grab many years ago.
I agree on the responsible part and wonder how much money motivated the breeding in a 7year old bitch!

Nikki said...

Hi, I'm new to your blog, but I've read a good deal of the older posts and I must say, I admire your writing style. This story was very moving...