TIME IS OF THE ESSENCE
The long-coated chihuahua had heart problems. No other dams had breathed "har, har, har" throughout general anaesthesia. The endotracheal tube passed in the anaesthetic gas and she was not feeling any pain when I operated and took out her first pup. But she was having noisy sounds from her nose. Her lungs were not in top form. She could die anytime. The secret of success was to operate in less than 15 minutes, as short a time as possible. Long-coated Chihuahuas were extremely rare in Singapore and very valuable.
This was her first birth. She had not been able to put on weight till now, 2 years later and Mr Formicelli was worried that she might die on the operating table. He had called me personally to explain her medical background. "She has a heart problem diagnosed," he said. "Should I do the Caesarean or not? I doubt she can give birth naturally. She is panting and her rectal temperature is 37.8 deg C."
"Has she got milk?" I asked. He said yes. Well, this is a very risky elective Caesarean. If we don't operate, the pup might die and still we had to operate to save the mother from a decomposing pup. So, what was the choice?
I knew I would not be blamed if she died on the operating table. But words of death under the operating table spread fast amongst the breeding fraternity. No excuses. Death meant incompetence. Mr Formicelli nor his experienced assistant could come.
But his father, the pet shop girl and her husband were present. I put the dam under gas anaesthesia. The whites of her eyes reddened as if she had high blood pressure. I put the breathing tube into her lungs. First time lucky as I could not see her epiglottis. She was just not fully anaesthesized. But time was of the essence.
Under surgical anaesthesia, she still "har, har, har," Like a person snoring in the sleep. She had breathing difficulty too in addition to a heart murmur. Would her stressed heart now failed?
When I took out the sole pup, it was enclosed in a cloudy amniotic sac. Few clumps of white stuff, probably its stools (meconium) floated inside the water. The placenta was normal and in top condition. However, the pup was limp.
I wanted to finish the operation fast. Mr Formicelli was a top breeder and the seventy-five year old father had been active in the breeding operations. "You know what to do?" I asked as I handed him the most precious pup in the world. Maybe in Singapore for Mr Formicelli. A chocolate long-coated chihuahua. He nodded.
I could not hear any puppy cries for 2 minutes. I saw him rubbing gently its neck as the pup laid on the towel, outside the surgery room. "Swing it," I shouted. He still rubbed.
I had just inserted one stitch to close up the womb. There were 2 pups but one had broken down into a pulpy yellowish brown sticky mass from the right uterine horn. The normal pup was now life-less.
Should I continue stitching the mother? Time is of the essence for the puppy. 2 minutes had passed and I had been presumptuous. This pup needed more than rubbing its neck. Should I stop stitching? What if the mother died due to prolonging of the general anaesthesia. She was still breathing nosily and her maroon red tongue had dried up. Well, her tongue was not cyanotic and should I take the chance?
The mother is more important than the puppy to the breeder. Yet, this was a most beautiful chocolate chihuahua. A difficult to conceive. Much effort and time and expenses. All the hope. If Caesarean had taken place 6 hours earlier, it probably would be vigorous.
Now, there was a decision. To stop stitching and maybe the mother would just collapse of heart failure. To revive a puppy that might not live and sacrifice the mother? What was the best course of action. There was no time to think through. There was no plan B. It was now or never. Time was of the essence for the puppy.
I took the puppy outside the surgery. To the walk way. It was a fine August evening. I had more space there to swing it. I swung it in an arc. From the top of my head down to between my stretched out legs. 5 times I swung, 5 times yellowish white foam came out of its nostrils. The lungs must be water-logged.
I thought 5 times was sufficient. Still no life. Used the hair-dryer to warm it. Pinched its neck skin 3 times, tickled its hard palate and tongue with the tissue paper. Wiped its nose.
No life. No hope. It was past 5 minutes. I swung at least 3 times inside the consultation room. Instructed the pet shop girl what to do. She was a novice. The pups' tongue suddenly changed to a dark maroon red colour. Was this a sign of blood flowing through the body or my hard powerful swings? It was not crying. I saw the tongue moved a bit. A glimmer of life.
I just could not wait any longer. Any time, the mother might just die of heart failure. It must have been 5 minutes of attending to the pups but it seemed that time was at a standstill. Cry, puppy cry. No sounds.
There was one procedure I had to do. This was the last trick up my sleeve. It was the mouth-to-mouth resuscitation. Was it a bit too late now? Better late than never?
I extended my neck. Held the pup high above my head. Inserted its nose and mouth between my lips. Sucked hard to pull out the water from its lungs. No water was seen from its nostrils. I asked the pet shop girl to continue nursing. It was time for the mother.
I could see that the pet shop girl and the patriarch hard at work. Pinch its neck skin, I demonstrated with my fingers as I saw the pet shop girl not doing that, from the window pane separating the consultation from the surgery room. I had changed gloves and was stitching up the mother. She was normal but breathing harshly.
"Reduce to 1 percent gas (instead of the usual 2%) I told my assistant James. "You go and pinch the puppy's neck. You have strong fingers and had done successfully before." James went to help.
It seemed like an eternity. James' magic fingers worked. The pup gave one loud cry. I thought that was sufficient. It cried again and again. A voice of protest against being pinched? It was as if a dam of silence had burst. We knew it was great but we do not express our happiness like hugging each other or clapping.
The puppy was alive. The mother was well. I am sure Mr Formicelli was a satisfied customer.