22. Cyanosis at the first cut during Caesarean - Chihuahua. Plan B.
This article is written for a boy who will be embarking on a long journey to be a vet.
Intubation --- inserting an endotracheal tube into the chihuahua is the recommended as safest way of delivering anaesthestic gas and oxygen. There is a control of the amount of gas and oxygen compared to a gas mask. During heart failure emergency, oxygen can be delivered quickly through the endotracheal tube.
This is the theory. The 3-year-old Chihuahua came in for an elective Caesarean as she stopped labour contractions despite oxytocin injection being given. It had been 6 hours since 3 pups were born.
The dog was intubated with a 6.0 endotracheal tube. Gas anaethestic at 2% was the normal recommended dosage for "dogs". The tube fitted tightly in the windpipe. The dog was in general anaesthesia.
I felt for the puppies. There were located near the umbilicus. I incised the skin incision. Blood oozed out in dark blue almost black. I looked at her tongue. It was purplish blue. She was breathing.
Veterinary assistant Anna was not saying anything although she was monitoring the anesthesia. She should be warning me, but she had not the experience after graduation. All new veterinary graduates will be in the same shoes.
After all, the dog was breathing and this was the start of the Caesarean.
The surgeon must be aware of the overall condition. Not just focus on surgery. Ideally the surgeon should just do surgery. But in big practices and veterinary schools, this is the practice. Obviously prices of Caesarean would be much higher with more overheads.
In small practices, the veterinarian must be knowledgeable. What to do to prevent death during and after Caesarean.
To gain knowledge, spend time reading and reading. Best is to spend time with a mentor. Most of the time spent seeing practice in general is non productive if you just are not much interested.
In this case, the solution is to disconnect the endotracheal tube from supplying more gas. Quickly. Let the dog breathe in normal air for a minute. Still, the tongue was purplish.
Now, I don't want to dog to wake up. So, there must be a balance of not too much gas or too little. I re-connected the tube to the gas after a minute or two.
The tongue was still purplish. Less deep purple in tone. The gas was reduced to 1 %.
What to do?
Wait. Something is not right. It is hard to tell. This dog had been given oxytocin by the breeder sometime ago. Was it the oxytocin anaesthetic reaction? In many of my normal without-oxytocin Caesareans, no such surprises.
"Maybe the endotracheal tube is too big?" Anna suggested. It was good that she offered suggestions. She is a Filipino veterinary graduate recently graduated.
I was surprised she said that. If the tube was too large in diameter, it would not have got into the trachea (windpipe) and the dog would not now be under general anaesthesia.
I did not think so. As I was a national servicemen, I remember my Plan B. Plan A was not doing smoothly. What is Plan B?
Intubation --- inserting an endotracheal tube into the chihuahua is the recommended as safest way of delivering anaesthestic gas and oxygen. There is a control of the amount of gas and oxygen compared to a gas mask. During heart failure emergency, oxygen can be delivered quickly through the endotracheal tube.
This is the theory. The 3-year-old Chihuahua came in for an elective Caesarean as she stopped labour contractions despite oxytocin injection being given. It had been 6 hours since 3 pups were born.
The dog was intubated with a 6.0 endotracheal tube. Gas anaethestic at 2% was the normal recommended dosage for "dogs". The tube fitted tightly in the windpipe. The dog was in general anaesthesia.
I felt for the puppies. There were located near the umbilicus. I incised the skin incision. Blood oozed out in dark blue almost black. I looked at her tongue. It was purplish blue. She was breathing.
Veterinary assistant Anna was not saying anything although she was monitoring the anesthesia. She should be warning me, but she had not the experience after graduation. All new veterinary graduates will be in the same shoes.
After all, the dog was breathing and this was the start of the Caesarean.
The surgeon must be aware of the overall condition. Not just focus on surgery. Ideally the surgeon should just do surgery. But in big practices and veterinary schools, this is the practice. Obviously prices of Caesarean would be much higher with more overheads.
In small practices, the veterinarian must be knowledgeable. What to do to prevent death during and after Caesarean.
To gain knowledge, spend time reading and reading. Best is to spend time with a mentor. Most of the time spent seeing practice in general is non productive if you just are not much interested.
In this case, the solution is to disconnect the endotracheal tube from supplying more gas. Quickly. Let the dog breathe in normal air for a minute. Still, the tongue was purplish.
Now, I don't want to dog to wake up. So, there must be a balance of not too much gas or too little. I re-connected the tube to the gas after a minute or two.
The tongue was still purplish. Less deep purple in tone. The gas was reduced to 1 %.
What to do?
Wait. Something is not right. It is hard to tell. This dog had been given oxytocin by the breeder sometime ago. Was it the oxytocin anaesthetic reaction? In many of my normal without-oxytocin Caesareans, no such surprises.
"Maybe the endotracheal tube is too big?" Anna suggested. It was good that she offered suggestions. She is a Filipino veterinary graduate recently graduated.
I was surprised she said that. If the tube was too large in diameter, it would not have got into the trachea (windpipe) and the dog would not now be under general anaesthesia.
I did not think so. As I was a national servicemen, I remember my Plan B. Plan A was not doing smoothly. What is Plan B?
posted by Photography by Sing Kong Yuen | 2:37 PM
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