Just BePaws - Drug Alert Part I and Part II

Part I

Two drugs in veterinary medicine have come to my attention during this last year due to some very traumatic circumstances.

The first one was experienced right here at home.

Our Scarlet was due to whelp. She was as big as a watermelon. We went to our vet on the 57th day for a pre-delivery checkup. My vet did an x-ray as she was so huge. The picture showed 6 distinct puppies inside this little Tzu. WOW!!! Six babies. I was excited since four families were waiting, and a litter this size just might produce another S’Dandi champion. There was a slight problem seen in the x-ray. One of the puppies was lying right across the birth canal. Hopefully, it would move out of the way during labor to allow the birth process to begin. If it didn’t, we could be in trouble. However, the vet was worried about the size of Scarlet. She was extremely distended giving concern that she wouldn’t be able to contract enough to push these babies out.

Together, we decided that a C-Section might be in order to save these puppies and Scarlet. We went home to wait for labor to begin. Of course, it began Sunday afternoon. I called my vet even though I knew she wouldn’t be available on Sunday due to the county fair. She was the vet on premise for the week. She returned my call assuring me that the emergency doctor on call was very good, and we should get Scarlet out to see him. We did.

Upon meeting the doctor and after a slight examination of Scarlet, he proceeded to tell me that he would give her a sedative of Valium/Ketamine to insert the trach. I questioned this procedure as this drug hadn’t been used on any of my other girls needing a section. They were masked to sedate them for the insertion of the trach. I was reassured that it was perfectly safe, that he used it all the time and it would be easier on my mamadog. So, I bowed to his expertise and said OK. Looking back, I wish I had let my concern be my guide.
Scarlet was sedated, the trach inserted-although I could hear her fighting the doctor in spite of the sedation. She was put on Isoflourine, and the surgery began. Out came the first baby. It didn’t move even after vigorous rubbing and shaking. I took it and started working and praying. The second one was delivered, same reaction. Now, I was extremely worried. Dick took the second and began working. The third was delivered with the same result. The vet was working on the third baby. There were still three more to go. I was frantic.
We began to see some encouragement in these first three as they attempted to gasp for breath. Rub, shake, pump their chests…but there were still three more in there. “Shouldn’t we get them out of there?” I asked.

“They’re better off in there. They’re getting oxygen. They’ll be OK,” was the vet’s answer. We continued to work on the first three puppies.
After what seemed like an eternity, the vet began delivering the last three babies. Each one was born with the same problems as the first three. Except…these three never took a breath even after an hour of working on them.

Six beautiful, well-formed, perfect puppies but only three that were alive and then, just barely. I was devastated. You expect to have a C-section to save the mama and babies and to bypass whelping complications, not to end up with dead puppies!!! How could this have happened? What went so terribly wrong? I’d been through C-Sections before and nothing like this had ever happened.

The vet was visually shaken. He didn’t know what to say to me but managed to figure out his bill, nevertheless. (I looked at him and wanted to say, “Isn’t there a discount for losing puppies?” I didn’t.) He’d done his job. I did have three that were alive along with Scarlet. We paid the bill and went home. You can’t imagine how my husband and I felt. We laid the small bundle of stillborn puppies on the kitchen ledge not knowing what to do. My mind was filling with questions-a series of what ifs.

Well, first we had to get Scarlet and her small family settled. The night was going to be long. No one slept much. The babies cried, a good sign, I guess. Scarlet was extremely restless. Not a good sign. We were up every 30 minutes or so checking, putting the babies closer to their mama, trying to get them to nurse. They seemed to be doing OK, but I was uneasy. This seemed like a nightmare. I wanted to wake up and find everything back to normal.

The next morning, things seemed to be better. The puppies were beginning to nurse and were filling out. Scarlet had plenty of milk. Mother Nature had provided enough milk for six babies. She hadn’t adjusted the supply for only three, yet. By 7:00 P.M., the slight reprieve of the day was over. Scarlet was in trouble. She was stressed, uncomfortable, panting and restless. I tried cooling her down with cold compresses and expressing some of the extra milk. I placed another call to my vet who was camping at the fairgrounds. She called back saying she’d meet me at the clinic in 30 minutes. It was now almost midnight. We drove the 30 minutes to the vet clinic in a panic. Was I going to lose my Scarlet, too? Please, God, help us.

We managed to stabilize Scarlet after almost three hours of tests, injections, and medications. To this day, no one will admit what was wrong with her. In my mind, she had a delayed reaction to the Valium and stress of the whole experience. She was re-evaluated the next morning with further blood work to make sure she was on the mend. We continued to have some stressful days and nights for the rest of the week. I learned how to tube feed the babies so they weren’t drawing so much from Scarlet. She got them at night but only after I had tubed them at 11:00 P.M. first.

Our three live puppies did survive. The two boys have been placed in wonderful, pet homes. However, we have a lovely, little bitch we call Jenna, who should take the ring by storm soon.

Right after this experience, the new issue of the AKC Gazette arrived. Amazingly, one of the articles, “You’re Not Alone,” spoke of working as a team with your vet for the welfare of our animals. It also contained a paragraph warning about the Valium combination given to Scarlet for her C-section. AKC Gazette, September 2000, pg. 56-61.

We were faced with another surgery procedure on our “Orie” in October. When the Ophthalmologist discussed administering this Valium combination drug to him, we again questioned the procedure due to our traumatic experience. Our specialist went to his medical books to check it out. He came back saying that we were right about the drug if used on pregnant bitches. However, it is safe in other circumstances. His medical journal substantiated the facts stated in the Gazette.

Now, here it is for you all to have in your store of facts. “Never use Valium/Ketamine on pregnant bitches. It debilitates the puppies. They are too sedated to begin the breathing process which is necessary to expel the Isoflourine gas-the safest to use when anesthetizing our Tzu. They must be masked down for insertion of the trach tube.” Sally Watkeys, March, 2001.
Please be aware, state your facts if in this situation and stick to your guns. Your bitch’s life, along with the lives of her unborn babies, is at stake.

A working relationship with your vet is very important and should be cultivated carefully. They have the knowledge from their medical education; we have the practical, breed-specific knowledge. These parts must be combined for the betterment of our beloved Tzu and the continuation of solid breeding practices. Respect for each other is the name of the game.

Part II

The first Drug Alert article appeared in the July/August 2001 issue of this magazine. A second potentially fatal drug came to my attention soon after writing about the complications of using a Valium/Ketamine combination on bitches in whelp during a C-Section, the subject of Drug Alert Part I. This second drug is also worth knowing about in case any of you have a Shih Tzu needing sedation.

An Internet friend had the following experience with another drug that should cause concern to all of us.

Her little Tzu was exhibiting some severe scratching and seemed to have an ear problem. Off they went to the vet for blood work to check for allergies. No matter how they tried, this little girl wouldn’t cooperate, and the vet couldn’t draw the blood. These Tzu have a mind of their own and can be very strong. The vet decided to sedate her using a drug called Xylazine.

Care must be taken any time sedation is used on our “furbabies.” They are already compromised due to the structural features of their shortened face and nasal passages. This girl had eaten breakfast and had had water in the morning which meant she had a rather full stomach. Not a good thing when being sedated. Our professionals owe the owners a complete understanding of the procedure to be used before any medication is administered.

In this case, the little Tzu should not have been anesthetized, as she hadn’t been on a fast for at least 12 hours before the sedation. Had the owner been informed of the drug and it’s potential reactions, another course of action could have been taken. We must be sure to ask questions and state the objections we have to specific drugs being used on our animals. Only then, is the choice an educated one.

Xylazine, this vet’s drug of choice, is a drug that usually causes vomiting, according to my vet, but is one of those sedatives that has a fast recovery. There is also an antidote that should be used if a problem arises. According to the April 2002 issue of the AKC Gazette, pg. 27, “Xylazine, also known as Rompun, causes profound sedation and dangerously slows the heart rate…” Is it any wonder why some vets won’t even keep Xylazine in their clinic due to these complications?

This isn’t the drug of choice for our breed as our bracheocephalic faces, with the associated shortened air-passageways, cause medical concern in the best of circumstances. If we compromise their natural structure by giving them a drug that will cause additional problems, we are also compromising their lives.

Be informed. Ask about the drugs administered to your dog. Be prepared to back up your thoughts and concerns with facts. Being informed can only be an asset for you and your dog.

This little girl didn’t go home with her owner that day. It was an extremely sad situation. She aspirated some vomit into her lungs causing her death. The owner was devastated and her family traumatized as they lost an important member of their family as well as a valuable showgirl who was actively competing in the ring.

How can we avoid similar instances?

Don’t be afraid to question. If you seem to offend by your questions, walk out. We all have something to offer any given situation. Be prepared to listen, accept medical facts, acknowledge the experience behind the professional but, using your own judgment based on your experience with your dog, make your own decisions.

Build a working relationship with a vet you trust. I don’t mind paying their bills when I know they are working with me as I build on my foundations. We all need their mentoring, medical expertise and skill. How wonderful when your vet can also be your medical friend.