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Man proposes, God disposes "It should be a simple and fast Caesarian section" Breeder Ah Yee said as we put the bitch on the operating table. "Two puppies in a miniature Maltese." He was always early at his kennels to see whether any bitch needed help and at 8 a.m, he phoned me to perform an emergency Caesarian section as his Maltese had a puppy's leg protruding out of the vagina.  The other leg was nowhere to be seen. Compression of the blood vessels caused the stretched leg to swell and become bluish." "No point pulling the single leg," he explained drawing from his over ten years of experience. "The pulling will break off the leg." This was a valuable Maltese and a 3-legged Maltese puppy would not find any buyer.  In 2003, Singaporeans seem to be obsessed with buying phone-book-sized dogs.     "I thought you have planned the Caesarian Section," I asked. "The bitch was eating normally. Usually, the bitch would stop eating for the two days before birth." Ah Yee explained.  "Her temperature was 38.5 degrees Celsius at 7 a.m." A rectal temperature of below 37 degrees Celsius would signal impending birth within the next 24 hours.  38.5 degrees were a normal adult dog's temperature. Ah Yee did not stay in the breeding kennels overnight and therefore would not know the drop in rectal temperature or that the drop might be transient and brief. I could not see the protruding leg when I put the bitch on the operating table. Canine patients have a habit of not confirming what the owners noticed. But t Ah Yee would be correct when he said he saw the leg.  In the standard operating procedure, I  put the scalpel to incise the skin above the junction of the uterine body and uterine horns. I should feel a "V" with the pointed end of the "V" facing the backside.  There, I would make a small cut into the uterine body at "X" and take out the puppies (top drawing).  Only two. Would be as easy as ABC.    As I examined the "V", it was pointing towards the head!  Now, how could this be?  Where should I incise then?  This had never happened before.  Now, where would the uterine horns be positioned in relation to the uterine body, the cervix and the vagina and vulva?  There were two large lumps of two puppies, one above the other.  One puppy should be in the right uterine horn and the other in the left one.  This was academic theory. In the abdomen, one uterine horn was not in the correct situation. One large puppy was inside the vagina and vulva and ws partly trapped inside the left uterine horn. The horn had relocated such that the point of the "V" was facing the head (lower drawing). Its protruding leg was seen by Breeder Ah Yee.  The other puppy was still in one uterine horn, being blocked from moving out. If Ah Yee delayed the surgery, this puppy would have died from stress.  I lengthened the skin incision. Just sufficient to get the pups out. Ah Yee believed that a good veterinary surgeon was one who would not make more than a 8-cm skin incision to deliver a puppy via Caesarian section. A large incision would make it easier and faster.  This was recommended by my professor during class-room lectures.  A longer wound heals at the same rate as a shorter wound. In the real world, a longer wound indicated to Ah Yee an inexperienced veterinary surgeon's artwork.  I found the junction where the uterine horns and uterine body met and made an incision on the womb. The two puppies were large.  Vigorous puppies. This was an strange case. The Maltese had a protruding tummy.  A big puppy seemed to be growing at around 45 degrees to the flat of the tummy instead of being parallel to the tummy if you know what I mean. Imagine a bitch standing with a gun inside the tummy pointing at 45 degrees to the floor.  This was unusual and since Ah Yee did not comment on it, I did not mention about it.  Pregnant bitches have rounded tummies and this was one of the variations of nature.   She was expected to show signs of labour like loss of appetite but did not do so. Her surgery was thought to be straight forward and fast but she made me work for my fees.  Man proposes, God disposes. In this situation, the bitch was the one who disposed of the expectations of the breeder and veterinary surgeon.   INTERNET ADS. PUPPIES FOR SALE Goto: http://www.asiahomes.com/puppy.htm for the latest info on puppies for export sales.

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