Salvaging the best of a tragic situation

Salvaging the best of a tragic situation

This morning, Dr. Kowaleski took a phone call from a deeply distraught client. Her beautiful, young male puppy had just been euthanized after he suffered a tragic accident.

To make a long story short, Dr. Kowaleski suggested to her that we could potentially harvest semen and freeze it if she felt like she could brave the thought and transport the patient to make it happen. She said she would speak to her co-owner and make a fast decision. She was able to rally the strength to load her beloved, promising puppy and bring him to us.

We indeed were able to harvest semen – enough to do 2 breedings. Late last fall, we had a similar incident – another young male dog lost much too young in a tragic, unforeseeable accident. Both owners are kind, responsible, experienced, smart, careful breeders. But sadly, despite the care these breeders provided their dogs, accidents happen. She was also blessed to have 2 breeding units collected and frozen. Of course, we still don’t know if we can produce a litter with the semen, but it gives this heart-broken owner a glimmer of hope.

It is not an easy procedure to offer – both emotionally and technically. As unlucky as these breeders were, they were lucky enough to think and act fast, pulling themselves together to make the best of a painful heart-wrenching situation.

My team pulled together to make this all happen with artful scheduling changes, the ability to think outside the box, and the flexibility to fit a highly time-sensitive procedure into an already busy day. Kudos to them for being big-hearted and dedicated to helping clients in deep pain.

So remember, if this happens to you or one of your friends, sometimes the stars align and all the right people are in the right places to make this happen. Do your best to remain composed so you can salvage a terrible tragedy.

Please contact us if you need help.

Progesterone Test Please

Progesterone Test PLEASE!

This has been another busy week at Veterinary Village.
As you all know, we have a large following of breeders, really good breeders who do a really great job of providing well-bred dogs with important and predictable health and behavior qualities.

That being said, some lose track of their breeding timing. Why is that important? If you can get your dam pregnant without progesterone timing, why should you worry about timing her?

We had multiple dams due in the last 2 weeks without good timing.
If you have trouble at the back end of the pregnancy, we can’t predict when she is due.

The following are real cases:
1. Three (no make it 4) dams due with singleton pups. These girls don’t go into labor at the 63 day post ovulation mark. Why? Because labor is initiated by the pups, not the dam. If there is not enough hormone secreted by the pup(s) because there is a small litter and they are not stressed, the dam may not initiate labor until the placentas and pup(s) are more than 65 days along, leading to placental deterioration and fetal death. This is a tragic way to end a pregnancy – with a c-section and a dead fetus. One dam was out of state for her breeding – test anyway (see below).

2. Two dams with exceptionally large litters. These girls were getting into trouble due to the volume of puppies and associated placentas and fluid. We can only safely deliver pups 2 days before their due date, based on ovulation. (Ovulation occurs at 4-8 ng/dl). Without knowing their due date, we could not have safely done a c-section to save not only the pups but the dam as well. No one wants to lose a puppy. But in most breeders’ eyes, saving their dam is even more important. We saved both dams and their pups by early intervention – a c-section at day 61.

3. One dam who should have delivered her pups but failed to progress into a successful labor. We took her to c-section and found the first pup trying to be delivered was heading north in the southbound lane. He blocked the way for other pups making a c-section the only hope in saving the dam and the other littermates. This was an unplanned breeding – well, unplanned by the owner, not the dogs. She had a history of failure to conceive so no one thought she would have a pregnancy. At least, draw and save the blood – see below.

4. One dam with a huge disparity in fetal size and position. She had 6 pups in one uterine horn and 1 in the opposite horn. The first pups that would have been born vaginally in either horn were HUGE. Without a planned and well-timed c-section (Of course, on Thanksgiving day), at least the first pup would have been born so slowly that the pup would have likely been stillborn. Dams weighing 24 pounds should not have 15 oz pups. Because we knew her due date, we scheduled a c-section and saved the entire litter.

5. One dam who lost her entire litter last year to premature progesterone drop. She is being monitored carefully to assure her litter can be saved with supplementation if needed.

Need I say more?

So even if you don’t need to know what day to do the breeding, you do need to know the day the pups are due. At the very least, have a progesterone test drawn, the blood spun in the centrifuge and the serum frozen. In this way, IF she is pregnant and we need to run the blood from the time of the breeding, we can thaw the serum and run the test at the end of her pregnancy.

Why not just run “reverse progesterones” at the end of the pregnancy? Because they require daily trips to the vet. Because you may end up with your dam going into labor after hours and end up at the Emergency Clinic. Because they may drop early in the case of luteal insufficiency or a pregnancy gone wrong. Because, in the case of a small litter, they won’t drop till the placentas have deteriorated and the pup has succumbed to placental failure.

Progesterone tests don’t cost that much – not as much as the time it takes you to run back and forth to the vet every day. And not as much as the loss of a pup or dam will. And not as much as it will cost you in heartbreak for losing pups we could have saved with timing on the front end of the pregnancy.

Work with us or your local vet to arrange a way to have a tech at their clinic draw the blood and store it for use at the end of the pregnancy if we need it.

We are pretty good at canine reproduction at Veterinary Village and International Canine Semen Bank – WI/IL but so far, we don’t have a crystal ball to predict when your dam ovulated 2 months ago. Breeding dates are NOT the same as ovulation dates.

Please contact us for information on how we can help your vet or even help you collect and store serum for this important and life-saving testing.

When to C-Section Safely

When is an elective C-section safe?

This weekend, we have had 2 contacts with clients who have had c-sections done prematurely, because the doctors and staff at their veterinary clinics would be unavailable. This leads to unfortunate outcomes for the puppies and their owners. It’s not good for the veterinarians and their staffs either.

Dogs are only pregnant for 63 days. Puppies are not like human babies. There is only a 4 day window when puppies can safely be born.

Timing to schedule a c-section is based on ovulation date, not the breeding date. Puppies can only be born safely 61 to 65 days from ovulation.

Before day 61, puppy’s lungs are immature, lacking surfactant, and if born too early, the pups will gasp a few times and die. These pups often don’t have hair on their faces. In large litters, the mom will often go into labor before day 63. This is usually OK because the pups produce more cortisol when stressed by fetal crowding and their lungs will mature a wee bit earlier than if the litter is a normal size.

On the other end, after day 65 or 66, the placenta fails. Placentas are programed to last 63 days, and can be stretched out to day 66. After day 65 or 66, the placenta will deteriorate and no longer provide the blood flow to the pups necessary to carry oxygen and nutrients. Pups not born by day 66 may die before they are born. Rarely, the females will not go into labor by day 65. If this happens, it is most likely due to a small litter size. Labor in the dog is initiated by the fetuses, not the mother. When there is a small litter, the pups don’t produce enough cortisol collectively to initiate labor in their mother. In these cases, progesterone levels can’t be used to estimate due date. For this reason, we need to know her due date based on progesterone timing at the time of breeding and intervene before it is too late to save pups.

So when you have not done progesterone testing at the front end of the pregnancy, what can you do to time the c-section if you find yourself in need of intervention. Or what can you do to estimate due date if you have a high risk pregnancy?

1. Progesterone timing at the end of pregnancy. A progesterone below 3 ng/dl indicates a c-section is safe, as long as the dog does not have luteal failure. This is most effective when you can get progesterone results back the same day the sample is drawn and sent to the lab. When testing progesterones at the end of pregnancy, we frequently see the progesterone hovering between 3 and 4 ng/ml, sometimes for as many as 10 days. It is NOT safe to do a c-section unless we see the progesterone drop below 3 ng/dl. Don’t be hasty in making a decision based on progesterone drop alone.

In our hospital and a few others in Wisconsin, progesterones can be run in the hospital. We do a “quality assurance program” with our progesterone testing. That means on a quarterly basis, we collaborate with Marshfield lab. We submit samples to them and they submit samples to us. They run our samples and compare their results to ours. In doing so, we are able to assure you that our tests are accurate. I believe we are the only veterinary hospital in the US, not just Wisconsin, that uses this service. Inaccurate progesterone results are worse than no results.

2. Lactation. If the mother is not producing milk yet, waiting may be a great idea.

3. Ultrasound signs. Puppies that are mature enough to be born have active guts and obvious kidney interior structure. This requires a great ultrasound machine and experience.

4. Maternal behavior. Nesting, refusing food, a temperature drop, and a far-away look in her eye are all indicators of first stage labor.

Our doctors at Veterinary Village and International Canine Semen Bank WI/IL are cautious about proceeding to c-section without using all of the above parameters to determine the ideal time to deliver pups. We often agonize over the decision, with the owner involved in making the decision. It is critical to get this right. We make our decisions on the best interest of the mother and baby’s readiness for delivery, not based on a calendar and when it is convenient for us. I will walk through fire to help you make a great decision.

We are not a 24 hour hospital but we are a 7 day a week hospital willing to help you make a great decision on timing a c-section.

We want to be YOUR veterinarians. Call us for assistance at 920-269-4072.