0:00
I am updating you guys with some sleep deprivation, so I apologize if at any point you are at all confused.
0:08
I know since this is going to be recorded and posted after the fact.
0:12
You guys might have a lot of questions and we'll certainly try to tend to those.
0:17
If not this week, we can tend to it at the next installment in a couple weeks.
0:22
So where we last left off, we did her pregnancy ultrasound, her last pregnancy ultrasound on her X-rays and we're talking about preparing for her C-section.
0:36
This week we were planning on doing first week care, which this will still be, but this will also be when things go wrong.
0:44
So Cabana delivered a pregnancy with C-section and things started to go off the rails.
0:51
So I'm going to share all that with you.
0:53
I apologize ahead of time if I at all get emotional because it was a lot.
0:59
So again, where we left off.
1:01
So we basically were looking into where she was going to have her C-section.
1:08
So we started checking her on March 11th, which was on Tuesday of last week.
1:16
So she had a reverse progesterone and an ultrasound scheduled with one of my friends.
1:19
That's another boarded reproduction person in my area because Lord knows I am not making decisions or planning to do surgery on my own dog.
1:29
I have done that previously and I much prefer having other people take the wheel on all of those fronts because it's just much less stressful.
1:37
So my plan was just to focus on puppies at the C-section.
1:42
So on her first check on March 11th, so I should say March 10th, I was a little bit nervous about her behavior at home.
1:51
So it's -3 from her due date was March 11th, so she shouldn't be able to go into full blown labor until the evening if she was going to be kind of an early bird, which would be a surprise with a smaller litter, but could still happen.
2:08
I was super nervous on the 10th watching her like a hawk.
2:12
Every time I left the house, I was worried that I was going to come home to her having tried to whelp a puppy on her own.
2:19
But really just mild stage one kind of stuff in that time frame and leading up to when we had this checked.
2:27
So on the 11th, her ultrasound looked great.
2:30
So the puppies had maximal peristalsis, heartbeats were all strong.
2:34
We didn't have any stressed heartbeats, nothing to indicate any concern or need to urgently go to surgery.
2:40
But her progesterone was three, which at this hospital is in the range where they usually go to surgery as long as they have a good confirmation of timing on the front side, which we did.
2:53
So she also I think had I mean, to be honest, I didn't check her after right.
3:00
We just checked on the front side of things.
3:03
But her temperature had been maintaining around 101 at home and was 98.9 that morning that we went in for that assessment.
3:12
So that would sit in line with kind of everything that had been going on.
3:16
So if you know, in the in that timeline of things, we expected her to basically be in labor before we would see her the next day, which is why we go to elective at that time.
3:28
So it's go time.
3:29
So we were hanging out for a little while and went to surgery in the afternoon.
3:35
So I again, I was cameraman and helping with puppy delivery.
3:41
So these are the four puppies that we delivered.
3:43
So all the puppies resuscitated.
3:46
Well, though to be honest, some of them were a bit slow and concerning.
3:50
So I don't know that I have a good reason for that.
3:53
But the puppies that were struggling a little bit more were some of the puppies that ended up struggling in the end of things.
3:59
The other thing that was weird, which I hate.
4:01
I'll see if I can remember to put a picture on for next time.
4:04
I forgot about it, but they had ear tip vasculitis, which means all the puppies had the edges of the ears were bleeding during resuscitation.
4:15
Like when we would get a new towel, you get a fresh towel, a warm towel, you know, and you switch out the one that was kind of already wet or that you've been working with.
4:25
And you could appreciate that they would have little bits of blood where those ear tips would touch the towels.
4:31
And it wasn't something we're necessarily focused on.
4:34
But Doctor Cohen that I had had worked with on the surgery, she was like, I don't know what that is.
4:41
And at first I didn't really, I just shut it off.
4:44
But retrospectively, it was probably a big red flag that I should have been paying attention to as far as like, you know, concern.
4:51
But they were a little bit weak to nurse.
4:54
We gave them some dextrose by mouth.
4:57
So dextrose is just like a sugar.
4:58
It's kind of like doing Karo syrup.
5:00
So we do that all the time with kind of post C-section puppies, or you can do it with puppies that are whelped naturally as well.
5:08
It just gives them a little temporary boost and sometimes it gives them a little bit more strength to like coordinate to figure out nursing, if that makes sense.
5:16
So the surgery went super smooth.
5:19
Uterus and ovaries all looked normal.
5:20
Placentas seemed normal.
5:23
We did not say placentas because everybody was doing okay.
5:26
Heartbeats were good, lung sounds were good.
5:29
Everything seemed shipshape.
5:31
We did check all these puppies for cleft palates and didn't have any cleft palates which was great.
5:36
This line can produce them.
5:39
Her mom produced one in her litter which was a large litter but statistically, you know, something could pop up.
5:47
I did have one puppy with a kink in the tail, which is again not uncommon for this breed.
5:53
But just so you know, so we get did put puppy labels on them meaning collars for me.
5:59
So I like doing those kind of the little Velcro collars so you can see those on the puppies here.
6:05
And then we got on the road to get back to the house and settle in and start nursing and such.
6:15
So let me move this around.
6:17
Hang on just a second guys.
6:23
Sorry, just moving one of my little bars around so I could see better.
6:26
All right, so because of the ear tip vasculitis concern, I asked for Clavamox to go home for them.
6:35
We, we had talked about Ceftiofur if you would be another thing that we've kind of as an industry switched to Ceftiofur over Clavamox drops for reasons of bacterial resistance.
6:45
So Ceftiofur, injectable Ceftiofur is often what a lot of theriogenologists will use in place of that.
6:51
Now, just FYI, but we had access to Clavamox, so that's what we went with.
6:58
All right, so we get home and things seem to be going downhill a little bit.
7:04
So I was not getting any increase in vigor.
7:07
Usually the further out, some puppies will come super hot out of a C section.
7:11
Like sometimes we're holding them in our hand and like they're getting away from us before I even hand them to a tech to resuscitate.
7:18
They were just not starting to kind of scale upwards.
7:23
And usually even if they're a little bit kind of sleepy initially, they'll start to, with a few little nursing sessions with support, they'll start to be a little bit more independent and be a little bit stronger.
7:34
The other thing when I, when I was stimulating these puppies to urinate and defecate, two of the puppies were urinating bloody urine, which is a concern.
7:45
That's definitely abnormal and I took some early measures because of those notes and the ears and just the general vibe.
7:55
I went ahead and Cabana had lots of colostrum like she was dripping on her legs like I had to clean her before I took her in for her assessments.
8:05
So her colostrum I could actually strip by hand and basically milk her.
8:12
So I because we don't have good colostrum alternatives in puppies as far as like powdered colostrum like we might in cattle or people or other options.
8:24
I actually just collected colostrum from her directly collected enough for the four puppies and then gave them all colostrum via a tube since some of them I could have bottle fed on a couple of them probably.
8:40
But it's a little bit more easy, straightforward, quick, fast.
8:44
Like I really wanted to be all hands on deck to be able to do other things here.
8:48
So subcu fluids was another thing that I took home just as a precaution.
8:54
I went ahead and gave them some subcu fluids and then I kept them in a very controlled temperature area.
9:00
So I didn't let them just like mill around the whelping box and find their own temperature.
9:04
I opted to provide their temperature more intensively and within about the first 12 hours I lost two of the puppies.
9:11
So the first two are the two on the left.
9:14
It was actually the largest puppy, the white collar puppy which is the second to the left.
9:20
She was one of the ones that, the blue puppy on the very far left I think was the weakest puppy and I was concerned about that puppy from the get go.
9:28
The white puppy was a surprise.
9:30
So we kept going forward and you know, I'm just doing the best I can with no sleep, right?
9:38
I'm trying to do everything for these puppies that I can, not knowing exactly what's going on yet.
9:42
I didn't do a necropsy on one of those puppies immediately because I was so worried about these two that I did not take the time to kind of stop besides putting them in refrigeration.
9:54
So I continued with assisted nursing.
9:57
I implemented some subcu plasma.
9:59
The white puppy had started showing the same types of signs was urinating blood also the first two puppies didn't defecate blood.
10:07
This puppy started defecating blood and then she started doing this agonal stretching when she was handled, which was a really not a good sign.
10:15
I knew when she started doing that.
10:16
I was hoping that it was just like a discomfort response and that she wouldn't continue to circle the drain, but unfortunately I lost her as well.
10:26
So throughout this, their color was fine.
10:28
Their breathing was consistent and not stressed.
10:34
So, you know, I think it's just we were just kind of in a mystery state at that point.
10:39
The green puppy was still vigorous, which is, you know, obviously a good thing.
10:43
She was seeing positive trends as far as needing less assistance to nurse and being more independent, but had always been, I mean they all vocalized, but as far as you know, normal puppy activity and if you stimulated them they'd cry, etcetera.
11:01
This puppy was just the, she was just so easily mad at everything.
11:07
She was just busy, busy, busy climbing over everyone else hated being on the heat source.
11:13
Just very fussy the whole time.
11:14
Well, that puppy was the tough puppy, apparently.
11:18
OK, so we did some testing in house, some testing out of house.
11:22
So the main thing I wanted to check for immediately after the dust settled with the puppies having passed and once I felt comfortable that the green puppy was stable enough that I could start doing some stuff.
11:37
I'm a one man ship here, so I'm a little bit more limited with kind of my ability to leave and take these puppies to get a necropsy or drive them to a laboratory, etcetera.
11:50
But fortunately for me, I mean, I'm lucked out because I can do my own necropsies because I've certainly done them for clients.
11:57
So why not be able to do them?
11:58
It's a little bit traumatic whenever you've tried to help them along and have them pass away, but it's good information for this last puppy.
12:08
So basically there was free bloody fluid in the abdomen in the puppy that I did an in house necropsy on.
12:16
What's curious about that?
12:17
So bloody fluid in an abdomen is very unusual.
12:21
I have not done a necropsy on a puppy that I found that personally there were no clots.
12:27
So if there were clots or like maybe like a liver laceration or a spleen laceration or somewhere where it looked like there was an active bleed and the puppy died from bleeding, perhaps from resuscitation or jostling in the, you know, in the process of moving these puppies around, did mom step on somebody or you know, those sorts of things?
12:51
We would expect clotted blood to be present.
12:56
The other thing that we noted was banding on the spleen.
12:59
I don't know, it just was a difference of color.
13:01
I don't have a good explanation for that, but that was something that I could appreciate on that puppy.
13:09
Had a normal chest, so the heart, lungs, etcetera looked normal in appearance and I did not see any changes consistent with herpes virus.
13:15
So herpes virus was on my mind.
13:18
Herpes virus can cause fetal loss, it can cause stillbirths, which we did not have, can cause lots of different things kind of in that postpartum period.
13:30
Well, in puppies when you do a necropsy, they will have a very typical, we call it a turkey egg kidney.
13:37
They will have a kidney that has dots all over it.
13:40
That is the easiest way to diagnose it.
13:42
It's considered pathognomonic, which means if you see it, it's diagnostic.
13:48
This puppy, you know, these puppies did not, with the blood in the urine and some of this other stuff, the ear tip vasculitis, these puppies did not give me suspicion for herpes virus, but it certainly made me feel better to see that there wasn't an obvious kind of suggestion of that.
14:04
So I went ahead and facilitated getting puppies two and three sent to Texas A&M overnight.
14:10
I was thinking about sending them to Ohio State because I've got a friend there, that Doctor Premanandan that I listed down there, he's the main guy.
14:20
He's double boarded in reproduction and pathology.
14:24
So he's like the best guy to review these cases with and to look at these samples.
14:28
The trick is his office does not take neonates, they take reproductive samples.
14:33
But I am planning on talking with him once we get the histopath results from those puppies.
14:38
We did not see anything on, well, I shouldn't say we, they did not see anything differently on gross necropsy on those two puppies.
14:44
So those other two puppies, same kind of things, had hemorrhagic fluid in one of their body cavities and didn't have any obvious signs of herpes virus or other illness.
14:57
So our presumptive diagnosis at this point with the vasculitis, vasculitis is commonly caused by bacteria, can be caused by fungus.
15:06
Fungus would be a little bit random, you know to have but it's still possible.
15:11
They would be considered failure to thrive.
15:13
Puppies.
15:15
I think septic cause is possible.
15:18
Usually we think about sepsis and causing DIC and adults, but DIC would be a reason basically to not clot your blood and to spontaneously be bleeding places that you shouldn't.
15:30
So hematogenous means that basically the things go through your bloodstream.
15:36
That's usually how you get a vasculitis in a pregnancy.
15:42
Typically we're worried about things like raw feeding, which I don't personally do.
15:47
Compromise of the bitch.
15:48
So if she was sick, if she got a bacterial infection, if she was dealing with something bacterial herself or fungal, then that could be, you know, a cause of puppies to kind of end up like this.
16:01
Dental disease is another one that I think is under discussed as a potential cause for kind of moving bacteria into the bloodstream.
16:09
But the idea is the bacteria goes in the bloodstream, gets to the puppies.
16:12
The puppies are compromised at a certain time point where they didn't die in utero, but they're succumbing to the effects once they're out of the mom, if that makes sense.
16:24
So we're changing our direction here a little bit, right?
16:27
So we're going to be focusing a lot more on things like talking about Singleton management and some of the strategies and approaches to kind of care that is a little bit different for these puppies.
16:39
I think the biggest thing to focus on is their heat sources.
16:43
They can't find litter mates to snuggle up against and especially in my case they also can't unless I'm physically in the whelping box.
16:52
I don't have mom in the box with her because she might squish her so it's a complicated thing to keep her warm, especially since she doesn't want to be so snuggle safe.
17:03
Is a little microwavable disc that I like.
17:05
I also had, I've got some like liter bags of fluid that I had used in the earlier stages of things.
17:13
I've also got a couple of heating pads that are kind of used in the box in her separate space.
17:20
That was like a little incubator setup.
17:24
And then I also had a light source that was an infrared light for the for the box itself.
17:29
I kind of used them together.
17:32
I limited her box range to keep her from getting isolated and getting cold.
17:37
So she basically the first week she was in a kind of an oversized Tupperware container that had heat sources within it.
17:45
And I kind of tried to keep a range in there so that she could find a space that she was more comfortable in and didn't have to be hot necessarily.
17:52
And then the other thing I've been trying to kind of stimulate her so that she has to work because a lot of these singletons, they get kind of lazy and fat because they just can sit there and nurse and they don't have to do anything.
18:02
They don't have litter mates climbing all over each other.
18:05
So I use these they also for her, she needed like a little bit of something to kind of kick off on so that she could latch because she would she gets so excited about latching that she would throw herself off Normally there's somebody next to her that prevents her from being able to really rock herself off of it so much so.
18:25
So we use some of these little I have some little Kong stuffs that were perfect sized to just kind of stick around her.
18:32
As far as Cabana goes, her maternal behavior took a few days.
18:36
She was not the picture of motherhood.
18:39
For a little while she was tolerant, but I would say her motherhood genes did not kick in until maybe the last couple of days.
18:46
She actually really cares now.
18:48
She was interested in her even right after surgery.
18:50
I mean, interested in all the puppies immediately whenever she woke up, but she doesn't really want to stimulate.
18:56
She doesn't lick.
18:57
She's not really involved.
18:58
Some of that's still my job.
19:00
But she does kind of roll over for her a little bit when she feels like she's nursing, she's like kind of pays attention and starts to shimmy herself so that she's presenting things a little bit more, which is very much maternal.
19:12
I will consider there is a treatment with oxytocin that you can give in an intranasal form, which you have to get compounded.
19:21
It's not the same stuff that you get from the vet for like clean out shot stuff, but I might consider that for her it has been very successful for some dogs as far as just making them a lot more maternal immediately.
19:35
They actually took the technique from a study that's in sheep that has been kind of adopted by some of the therio crowd.
19:46
So she's also struggled with her weight, which is kind of an opposite from a Singleton problem, but she had a big drop right away.
19:52
So she went from about 17 oz down to about 13 oz and then she kind of hovered at 13 for a few days.
20:00
So I started supplementing her pretty aggressively, probably pushed her a little too hard between nursing and I was supplementing in addition to nursing, but especially overnight.
20:10
Was really leaning on using either a tube or a bottle depending on what.
20:16
Stage of things we were at and how strong she was she got pretty colicky she got a little bit of diarrhea from the transition between the formula and the bitch.
20:26
So I implemented some Gas X drops, which is just something you can get over the counter that use for babies for colic and that improved in about probably 24 hours or so.
20:37
I also gave her some Propectalin gel every 8 hours, which is a probiotic gel that can help with kind of firming up stools and provide some probiotic benefit if you've kind of run their GI tract off.
20:48
On mom's side, I've been trying to focus on keeping her in good milk.
20:51
She is in good milk, but the problem is, is she doesn't have a bunch of puppies to stimulate her.
20:54
So she's at higher risk to dry up.
20:56
So I've been pretty aggressive on that front as well.
21:02
All right, so other normal 1 week things or week 1 things.
21:05
So we've been doing ENS and daily scent exposures and I've been doing weight monitoring probably more frequently than that, driving myself crazy.
21:15
She's plump, she's happy.
21:16
I mean, you can see her on the left, she's fat as a tick, but she's not growing as much as I want her to.
21:21
I'm just trying really hard to kind of edge her forward so that she's on the same course that she would typically have been.
21:28
I know she had a really tough couple of days the first couple of days, but seemed to survive her litter mates, you know, whether or not she just wasn't affected or if treatments were helpful and she was just a little stronger, we won't know.
21:41
Her dewclaws were removed at about four days postpartum.
21:48
I am drying those for submission to DNA to paw print.
21:51
So she's got some Cabana’s clear across the board.
21:54
But the sire of this litter has some carrier statuses of a few things.
21:59
So I'm just curious.
22:00
And that's one way you can do submission before they're kind of done with the nursing side of things.
22:07
So we're monitoring glands, I'm monitoring her discharge, which has all been fine.
22:11
Mom's been doing great.
22:12
She's getting a little bit fussy with what she wants to eat because she thinks that I'll keep giving her more delicious food, which is working.
22:21
And I do, I keep doing it.
22:22
So hopefully she doesn't train herself to the point where I have to go every day to the store and get her something new.
22:28
So I think for two weeks from now, just so you know, we're going to do puppy socialization kind of plans for her.
22:37
I'm not going to have implemented that as far as like exposing her to other dogs or those sorts of things.
22:42
But we're going to talk about like adventure toys and boxes, getting weaning materials ready.
22:48
She'll still be in the whelping box at 3 weeks.
22:51
She'll be right under 3 weeks the next time we see you.
22:55
So we'll see how far along we are, but we can talk a little bit more about just Singleton things in general and have more of a Q and A next time perhaps.
