Did you go out to dinner? See a blockbuster movie? (I am envious if you did; if you read my bio, you know I LOVE movies!) Maybe go out to a club for music and dancing? Well, I think I have you all beat.
Just as we were closing up shop, one of our long time clients called and said one of their beautiful, sweet Pitbull's, Butterfly, had been in hard labor all day and hadn't yet produced any puppies. She was panting and circling, couldn't get comfortable, and seemed exhausted to her owner, so of course we were concerned about dystocia, or difficulty giving birth. We told her to bring Butterfly right in. Ordinarily an end of the day emergency elicits groans and grumbles from the staff, especially on a Friday night, the end of an emotionally draining week. The possibility of brand new puppies causes exactly the opposite effect-jostling for who gets to stay for the overtime and help with delivery or a possible C-section (surgery to remove the puppies from the pregnant bitch's abdomen) and revival of the newborns.
Butterfly presented in pretty good condition overall, leaking milk from engorged (full and tight) mammary glands, restless, but no signs of abdominal contractions. Her gums were slightly pale pink and a bit tacky, probably from the panting. I assumed she had uterine inertia, a condition where the smooth muscle tissue is simply "worn out" from contracting over and over and using up vital nutrients like calcium and glucose. I put on gloves and lubed up my fingers and did a digital exam of her birth canal. There was a fetus in its membranes just within the birth canal with no indication of blockage, but I couldn't be sure. I also did not get the blackish green discharge on my gloves that comes from disruption of placenta from fetus, so I assumed the fetus still had nutritional and oxygen support from Butterfly. I thought it would be worth trying medical management of her dystocia rather than jumping right into surgery, although I let her owner know that might be a possibility later on.
Oxytocin or pitocin is a hormone produced in the hypothalamus of the brain and is used as an injection for inducing or enhancing uterine contractions at partuition (birthing), or post-partum (after birth) for retained placentas or aglactia (non-production of milk.) It can also help to involute or shrink up the uterus if it doesn't do so naturally after birth or after a prolapse (protrusion out of the vulva.) It is important to know that oxytocin will not work if the muscles are depleted of calcium and glucose, as I mentioned above, so correcting for these defecits are essential before giving oxytocin. We placed an IV catheter in her cephalic vein (front arm) and gave Butterfly a medication called calcium gluconate, which has both calcium and glucose. This was given very slowly to have the least effect on her heart muscles as possible. We then gave the oxytocin subcutaneously (under the skin.)
About 15 minutes later a slimy, wiggly (thank God!) light brown puppy made her presence known. Butterfly showed herself to be an excellent momma, licking vigorously to help clear the fetal membranes from the puppy's head and stimulate respiration efforts. We clamped off the umbilical cord, suctioned out her airways, gave her a very brief exam, weighed her and examined the placenta for any abnormalities (of which there were none.) Butterfly would have eaten the placenta if given the chance but she didn't NEED to do so as some breeders believe. Butterfly's owner took over the job of showing the pup where the milk was. Newborn puppies usually start to nurse on their own with the first 2 - 3 hours, but MUST do so by 8 hours or so. Colostrum, or the first milk, is rich with maternal antibodies and without these, puppies or kittens will have virtually no chance of fighting off infections from bacterial and viral invaders they face everyday. It wasn't long before a second puppy was delivered. She was screaming loudly, so we knew breathing wasn't a problem!
Things were progressing just fine. Butterfly was acting very maternal, delivery was going normally, the pups were of a good size for their breed and the owner knew just how to handle their care and what to watch for in case of trouble. Butterfly would be much less stressed at home, so I gave her owner my cell phone number "just in case", lined up a crew of my staff who wouldn't mind being called on the spur of the moment if there was an issue, and sent the happy family home to finish the job.
I got a nice email over the weekend with pictures of 5 healthy puppies (so far?) and will see them and Butterfly later today for a brief post- partum exam.
Something must be in the air; we just got a call that another of our patients, Mia, a lovely Bassett Hound with awesome owners, had 8 puppies yesterday! We get to see that happy family tomorrow...oh boy! I do love my job most days :)
Peace,
DrReneigh
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