The vet had given an oxytocin injection. If the dog or cow has dystocia, give oxytocin first. Puppies would then be born naturally. So easy as that?

But you can't tell that oxytocin injections in a heavily pregnant Miniature Schnauzer will lead to natural delivery of 5 pups. So, the vet has to step down from theory to practical aspects. Waiting and waiting will mean some delays and possible deaths of a pup or two. Or even the death of the dam. Only the vet can make a decision as to whether to perform an elective Caesarean section or not. In this case, oxytocin was given. Nothing happened for half an hour. It was wise for the vet to perform the Caesarean section and the outcome was excellent. The white pup was larger and might not be born alive if there was more delay waiting for oxytocin injection to work. The owner wants a happy ending and in this case, all 5 pups were vigorous and the dam was safe.
 
The above reports on canine entropion and dystocias are written primarily for the veterinary undergraduates introducing them to a brand new animal world they don't usually see as Singapore is not an agricultural country. Undergraduates are encouraged to write their medical reports to improve and store their knowledge to make themselves better veterinarians.