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The Shih Tzu puppy showed a leg to the vet! The fat Shih Tzu bitch was anaesthesized for an emergency Caesarian section after a prolonged contraction of over two hours.  The breeder saw a clear watery vaginal discharge indicating that the water bag had broken and he rushed to the veterinary surgery.  This would be a routine Caesarian, I said to myself. The first puppy bulged out easily from the incision. A big and vigorous one.  The bitch started to "breathe" faster and faster. As if the general anaesthetic gas was insufficient. Her head moved.  Her mouth clamped onto the breathing tube which connected the oxygen and anaesthetic gas from the machine to her lungs.  Her omental fat inside the abdomen emerged from inside. I put a sterile swab to push it back. Was she going to wake up or was she have labour contractions?  Or both?  This was a difficult situation to handle.  The anaesthetic was set to a minimum as she was a fat bitch so that she would not be stressed out.  And died on the operating table.  "Increase the gas to 5% now!" I said to Nurse Ann. Was it too late? The bitch was contracting strongly. I could see a water bag (amniotic sac) which enclosed and protected the foetus appeared as a small bulge. It contained a yellowish brown fluid instead of the usual clear type. This suggested that the puppy had been stressed and had passed meconium (stools). The water bag just would not come out further. As if there was an obstruction preventing the smooth flow of the puppy to the birth canal. What could I do in this dystocia (difficulty in birth)? I thought this was a routine Caesarian section. I used a pair of forceps to break open the water bag. There was no other simple option.  A big brown leg protruded out from the incision.  The bitch breathed faster and faster as the anaesthetic dosage had been reduced to 2% after 1 minute of the 5% dose. "Increase the gas to 5% for one minute!" I said to Nurse Ann. Would the mother just get up from the operating table and spill out her guts? The bitch was in deep anaesthesia. Yet she could feel my tugging of the puppy's leg. I put my forefinger into the opening of the uterine horn to hook out the other leg. It was not possible. I could feel the body of the puppy was bent double like a hunched back. The bitch was contracting strongly.  What should I do?  The breeder frowned as he watched me from the consultation room which had a large glass pane to view the surgery room next to it. In routine Caesarians, I would hand to him every pup within ten seconds as each one popped out easily from the womb.  Sixty seconds had passed and the manipulation could not bring forth this puppy. Should I make an incision on the uterine body to get the half bent puppy out before she was stressed out and would die?  That would mean two incisions on the womb. Bigger wound and a longer time to operate as I would need to stitch up two areas. What should be done in this one leg stuck situation? Was it the front leg or the back leg? How does one differentiate the front from the back? The loud ticking of the clock on the wall reminded me that I had no time to vacillate. To make another incision or not? The bitch was now in a deeper anaesthesia and was not contracting.  I bent the leg and pushed it back into the uterine horn. This was the third endeavour. It sounded an easy procedure in the  canine obstetrics book. The leg went inside. Was the puppy dead now as the water bag had been broken for over one hundred seconds? I expressed the womb and the puppy came out in breech presentation. So, the puppy was showing her hind leg then! The other puppies came out easily. All survived as at the tenth day when I asked the breeder.  If the breeder had not opted for a prompt Caesarian section, some of the puppies would not survive because the one who showed a leg to the vet at the Y-junction would have obstructed the other puppies from passing through the birth canal.     ______________________________________________________________________   DANDRUFF IN A DOG July 14 2000.  A full coated snow white Maltese terrier cross was brought to the vet for a check up although there was "nothing wrong". Thousands of fine dry scales scattered over the examination table and if the dog had  stayed longer, it would amount to a spoonful of dry skin flakes. This 5-year old had dry skin under the neck and the lower body, not noticeable until you part the hair.  The ear flaps were rough and scaly too.  Elbow skin were red and dry. What was the cause of this skin irritation?  Was it the contact floor?  Was it the ear itchiness and scratching? The dog was clipped and the ear hairs were removed.  Skin mites would be a cause of this problem.  There would be other causes. Skin diseases are not easily treated by one veterinary visit in many cases.

The Shih Tzu bitch passed dark green discharges "What should I do?" the breeder asked over the mobile phone on this bright sunny August morning. "What should I do? My Shih Tzu had a dark green vaginal discharge over-night. Lots of thick greenish discharge!" It was hard to diagnose over the phone. It was harder advising what to do over the phone. Would the bitch need a Caesarian delivery?  Would it be too late to save the puppy now? Would there be other puppies that would have been saved if she rushed to the surgery to perform an emergency Caesarian section? All breeders don't like Caesarians. The veterinary fees cut into their profitability. If there was one dead puppy, the breeder actually lost money on this bitch. The bitch might not be able to give birth the next time.  The bitch might die and to the breeder, the bitch is more important than the puppy. I never asked why.  Probably, the Singapore breeder had reared the bitch from young and would like to see her grow old and produce beautiful progeny. "You have to decide whether you want a Caesarian section for your bitch," I replied. "I am operating on a Chihuahua now!" It was one of those rare days when I would have two emergency Caesarians. And rarer to have two on a Sunday morning. Like all vets in general practice, I prefer not to perform Caesarians on Sundays. They take up at least one hour per surgery. The other clients who had made appointments had to be kept waiting. Caesarians are rare in Singapore as the vast majority of bitches give birth naturally.  Now, there would be two emergencies whereas in the past month, there were no Caesarian deliveries!  I could not do any faster. The 2nd breeder had to wait for fifteen minutes, hanging onto her basket.  Sundays are bad vet days for Caesarian sections.  Sep 21 03. 2 Shih Tzu puppies for sale at a pet shop now. The first of 3 puppies was dead and taken out during an emergency Sunday morning Caesarian section. These 2 puppies were weak but alive. I felt happy for this breeder. I hoped she would be able to rear these two well. Now, they are ready for a good home. Email judy@asiahomes.com or tel: +65 9668-6468 to make appointments to view.

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