TIPS FOR THE
GOOGLE GENERATION VETS
SURGICAL APPROACH 1
When I was an undergraduate in my final year in
1974, I remember that the Caesarean section lecture was
completed in less than 2 minutes as there was so much to
teach. My Veterinary Surgery book and professor had
advised taking out the whole uterus and then
incise it to take out the puppies. In the vet school and
during internships, I had not witnessed one Caesarean
section done in the dog. I did see a Caesarean section
down in a cow. It was dramatic as the cow is such a big
creature and it was a cold Spring dawn in the Scottish
highlands as I helped out the young Scottish vet in the
Caesarean section of a cow.
SURGICAL APPROACH
2
 Is
there another surgical approach that will save time and
stitching? The faster the surgery, the better the
chances of survival as there will be less
anaesthestic time. The approach I use is just to make an
incision into the skin just bigger than the head
diameter of the pup at
midway between the
umbilical scar and vulva. The skin and linea alba
incision could be 4 - 8 cm long. Then I palpate to
locate the bifurcation of the uterus and incise parallel
to the length as shown in the illustration. I had
performed over 200 Caesarean sections and am sharing my
knowledge with the other vets via the internet my
success in the stitching methods I used in the
illustration before I retire and be replaced by the
google generation.
THE HIDDEN PUP
The professional Singapore dog breeder does not
perform any ultrasound scan or X-ray to
 determine
the number of puppies to lower the cost of production.
In Surgical Approach 2, since the whole uterus has not
been exteriorised, there is a possibility that a hidden
pup far up the uterine horn may be missed. This advice
to exteriorise the uterus at the "completion" of surgery
had been written up in one surgery book on Caesarean
section I read many years ago.
Therefore, my tip is that the vet should exteriorise the
whole uterus to check. Sometimes,
the vet has taken out
4 pups and if the uterus has not been exteriorised or
the abdomen palpated, the vet thinks that all pups have
had been taken out. Later, the female dog gives birth
naturally to another pup. This will be not good for the
vet's reputation.
Veterinary
surgery is full of surprises and the "hidden pup" is one
such surprise. Obviously, in surgical approach 1, the
whole uterus is taken out first and there will be no
"hidden pup" surprises. But it takes much longer to
stitch up and there may be more chances of infection in
long incisions.
http://www.sinpets.com/dogs/20111050caesarean-section-schnauzer-2007-dr-sing-toapayohvets.htm
shows more pictures of the Caesarean section of the
Maltese mentioned in my illustration.
 It
was 4 decades ago, but I still remember a case of
uterine prolapse in a Scottish cow after giving birth
and I don't blame any vet who see an "equivalent" case
in the dog mis-diagnosing vaginal hyperplasia and
prolapse as possibly uterine prolapse.
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TOA
PAYOH VETS
