Easy isn't always easy....

A client came in last week with her 8 year old chihuahua, who was experiencing tremors, panting, and unable to stand for the last 24 hours.  The chihuahua was an intact female who had just delivered puppies three weeks prior.  History and physical exam confirmed the most likely diagnosis; eclampsia (also called post-parturient hypocalcemia).

This condition results when the body stores are insufficient, or when the bitch's metabolism is not prepared to deliver the high loads of calcium into the breast milk, and as a result, the blood levels dip dangerously low, and muscles can no longer work appropriately. (The physiology is really quite fascinating, but I'm sure my readers would prefer that I skip the nitty-gritty cell and channel physiology!)

The condition is easily treated (injections of calcium, and oral supplementation), and the female goes home the same afternoon. We recommend separating the puppies from the female, and providing them with milk replacer.  If they nurse on the mom, they will continue to deplete her stores, and she is at high risk for a relapse.

Why is an 8 year old dog having puppies?  It was her 7th litter, and her client excused the situation by stating that she "meant" to get her spayed, but it just didn't fit into the schedule.  She also owned an intact male dog, and one might ask - why didn't she separate them?  The answer, as dumb as always, was that she thought he'd leave the female alone, since she was "older."  No.  Dogs don't have social stigmas.


Anyway, the client called later that day to inform us that the puppies weren't nursing, and she also thought that bitch was acting weird.  We asked if the formula was warmed, if the nipples had appropriate openings, and she assured us that wasn't the problem. We urged her to return with the puppies, and to bring the mom at the same time so we could examine her. "I don't think the puppies will use the bottle," she said.  "They are trying to crawl down my cleavage to get at my boobs, but I keep telling them those don't work."

(I tried to refrain from vomiting).

When she arrived, the adorable puppies were strong, bright, and alert with great suckle reflexes.  She handed us the bottles she had been using - and there was absolutely NO opening in the nipples.  We made a hole, and the puppies nursed as if they had been starved all day (they had!)  For some reason, she left the mother at home instead of bringing her in so I could take a look.

I went to talk to the client and give her the great news - the puppies are not sick, just needed to open up the nipples so milk could come out.  She then argued with me for 10 minutes about the seemingly obvious situation.... asking me questions, then interrupting before I could answer.  Exasperated, I excused myself from the conversation.  I encouraged her to get the female spayed, and soon.

Why did such an easy fix have to be so complicated!?