When Things Go Wrong...

"The next moment is as much beyond our grasp, and as much in God's care, as that a hundred years away. Care for the next minute is as foolish as care for a day in the next thousand years. In neither can we do anything, in both God is doing everything."  CS Lewis 

"I believe though I do not comprehend, and I hold by faith what I cannot grasp with the mind."

Saint Bernard

Easter 2011 will be an Easter to always remember for John and I.  And not for the reason one might think.  We will remember spending this Easter at the Maine Veterinary Emergency Center in Scarborough, Maine with Molly and her 6 puppies.  I will jump to the end of the story and say that Molly and her 6 new Brittany pups are all doing fine 24 hours later.  But we experienced a chain of events which did result in Molly having a Ceasarean operation followed by an ovio-hysterectomy.

Experienced dog breeders know to be prepared for literally anything in regards to medical emergencies.  There are text book pregnancies and whelping and then there are those that could not be anticipated.  Even when momma dog is well experienced herself there may come within a fraction of a second the instinctive knowledge that something is very very wrong. And when that awareness rises, there is on time to spare and no chances worth taking.  You simply respond with a sense of urgency knowing full well all that is at risk, most especially the valuable life of momma dog. Every breeder must ask themselves each and every time a decision is made to breed a valuable animal - is the outcome of a litter of pups worth the risk of the mother dying.  A sombering thought and one which I faced this weekend.  Molly whelped her 6 beautiful pups on what was Day 63 of her second breeding with Scooby. Her temperature dropped to below 99 degrees and remained there and stage 1 labor began.  Within 24 hours she whelped her first beautiful pup, who by the way is the only male!  It took her just about 6 hours to whelp all 6 pups.  There was nothing unusual going on although we were not satisfied she was finished. I began to consider the possibility of secondary uterine inertia, when the contractions are no longer strong enough to expel the pup from the birth canal. But it was unlikely because Molly showed no signs of exhaustion herself and the intermittent pushes/contractions were indeed, very strong and forceful. I was also concerned though that we could be dealing with a type of dystocia (difficult delivery.) Dystocia may be due to any number of reasons including uterine inertia, a large fetus, and/or malpostion of the pup. Like most veterinary emergencies, diagnosis is based on the accurate observation of the dog's owner as reported to the veterinaran so we made several phone calls for reassurance, suggestions, etc. 

We did have Oxytocin on hand but as you may know we are not supportive of it's random use.  We recognize the legitimate uses for it but only with a vets supervision.  It is a naturally produced hormone which plays a key role in labor contractions, milk let down, etc. It is also and only available as a veterinary drug via prescription.  Oxytocin (also called a "pit shot") should never be used if the fetus is in an abnormal position or is too large to pass through the birth canal.  It should only be used if the cervix is dilated. It should never be used if an animal has uncorrected low blood sugar or untreated low blood calcium.  If used inappropriately oxytocin can cause uterine rupture or pain from excessive uterine cramping. It's pretty easy to understand the importance of a vets involvement.  We knew the cervix was dilated because Molly had given birth to her 6 pups quite normally. What we did not know was why she was contracting without results.  I'll be honest.  We really considered giving her the shot but with all these unknowns - why in the world would anyone take the risk???  I know there are other breeders who would not hesitate to give the Pit shot for any number of reasons. I have never been one of them.

As late afternoon turned into early evening Molly settled down quite comfortably with her pups and eventually fell into a deep sleep. John remained with her all night long and the only thing she did was come over and bump him to say "hey I need to go pee - NOW!" and they went outside.  No laboring, contractions, nothing else.  She was not acting unusual in any way, everything was pretty normal, or so we thought.

Early on Easter morning we were all sitting together and suddenly Molly Rose began to contract all over again! This was no involuntary expulsion of retained placenta etc.  This was full blown labor. John and I simply looked at each other and knew we must take her for an x-ray so we readied Molly and then placed her 6 thriving pups into the puppy basket with hot water bottles wrapped in insulated towels, a puppy blanket across the top.  Calling ahead, we let the emergency center know we were coming in with a serious situation, asked for reassurance as to what we were facing and soon we were on the road to the emergency center. Something was terribly wrong.  I brought along everything just in case she did have a puppy on the way which was very possible the way she was acting. We were rushed into a prepared waiting room where Molly was then taken for x-rays.  They showed there was a puppy in the birth canal, it looked like maybe there were two, caught up together in a way that made it easy to understand why the difficulty (dystocia).  The secondary uterine inertia was still a concern for me even while Molly was still strongly, actively contracting. God love her. 

My instincts proved to be accurate as those x-rays revealed an injection of oxytocin would have been the very worst thing for Miss Molly Rose!!   I was fairly certain we were dealing with a pup that was not only stuck, but that was no longer living. Too much time had passed.  I brought up the subject of Molly's calcium level because I was very curious to know if it was low or normal. Calcium plays a real important role in the whelping process among other things. At this point in time we knew we were most likely facing a C-section although the vets always left the decisions up to us. We had tried feathering as well as lubricating the canal and manually manipulating the puppy which could be felt.   (By the way, the very best way to learn the honest opinion of your vet in regards to taking a particular step is to ask them point blank "if this were your dog, what would you do?")    All the necessary blood tests etc. were taken. My specific conerns her calcium level was also addressed which proved to be a very good thing. Molly's calcium level was too low to proceed further in any direction until levels came up. Molly, who had been in the exam room with John and I, her pups and the vets and technicians up to this point, walked happily down the hall with one of her new friends to be hooked up to an IV for her calcium administration. Molly had nursed and cared for her pups herself until she left. All 6 of her babies were safe and warm in her absence, an absence which extended into the early evening hours. 

The staff gave us our own exam room to remain in, made coffee for us, brought us bottled water and even chocolate Easter candy!  In the meantime our whole family had gathered at our home for dinner. The meal was fully prepped and just needed to be cooked but basically they were all on their own.  It was not the way we wanted to spend Easter but it was not all about us.  We could have left, come home, then returned at the end of the day.  Um... errr... I don't think so... Not an option.  Frequent calls in between home and the emergency center kept everyone on board and also grampa offered guidance on the traditional egg hunt.  Staff came in to assist us with stimulating the pups to eliminate and cleaning them, as well as help with supplemental feedings for the pups who needed to be fed every 3 hours. Molly's surgeon sent assistants to update us frequently and eventually returned to say she was recovering well. Thank you God.

We learned there had been one oversized puppy which had started down the birth canal. The puppy was malpositioned in such a way to support the possibility of 2 pups. This big, beautiful liver and white girl had clearly not been alive for quite awhile. John and I were not surprised at the outcome and of course were primarily concerned with Molly.  But the reality was still very, very sad and difficult for us to hear. We asked for the puppy to be brought to us so we could see her, and also requested she be prepared for us to bring home.  John really blessed my heart when he explained our reasons for wanting to do this.  "This is not just a puppy and these dogs are not just dogs... they are our family and we will take care of her the way you take care of your family."  And this means - laid to rest where some of her grandfather's remains are scattered and right next to Timber's tree stump where I often sit with the other dogs.  Yesterday, she ran to greet her grandfather at the bridge and together, they both are running like the wind.

We have now been home for 24 hours.  It's been a challenging, exhausting, and emotional experience with little time to really sit and think about it all.  In these situations you simply - ACT.  Molly is slowly but surely recovering from the surgery and the effects of the drugs used and reacting to the pain she is experiencing.  There is incision care to consider, the well being of the pups in the absence of Molly's complete awareness or ability to fully respond to them, making sure Molly eats something and drinks enough fluids, making sure we get her up to walk around and outside to stretch and eliminate, temperatures and meds, and 3 hour feeding schedules.  Tonight she's in the middle of the kitchen floor laying comfortably upon her quilt with her pups either laying nearby or in their puppy basket under the heat lamp (suspended by our ceiling fan - John is so innovative.) 

In these situations a breeder knows sleep is a non-issue that it is just one of many sacrifices made. I pulled the cushions off the couches last night and spent the night right next to her on the kitchen floor. John and I are her support system and equally sharing the responsibilities. He additionally has the rest of the crew under control including his JackDog aka the Golden Boy who has settled in nicely in the dog house.  Speaking of the crew... I will leave you with this.

Usually when the dogs hear the gate open as a car pulls into the yard there is an abundance of joyful greetings which goes on and on for a few minutes.  Not so when we returned early in the evening last night. John gently and lovingly carried his Molly girl up the walkway and into the house and I followed behind with our precious cargo of 6 pups. Each one of the dogs walked slowly to the end of their run and simply stood there watching us.  I am not kidding and we both noticed this. I began to weep... just to see and experience this.  They KNEW... they knew something very serious was going on.  John also shared with me later on today that when he took Molly out for a walk around the yard that the other dogs just stood and watched her.

All is well tonight.  The pups went to our regular vet for an exam and for tail docking and dewclaw removal.  Molly loved them up when John brought them home. Things are looking brighter here and we hope by sharing our experience it will help others understand there is a lot more to this than meets the eye.  On many levels.  Sometimes, things go wrong but this could have been so much worse, and we are extremely thankful it is not.  Take care and God Bless, John, Ann, Molly, puppies and ATB