Vet Times The website for the veterinary profession https://www.vettimes.co.uk Confronting the ethical dilemma of breeding from bulldog Heidi Author : NICK MARSH Categories : Vets Date : June 9, 2014 NICK MARSH BVSc, MRCVS reflects on a case where a bulldog he believed should not be bred from underwent her third caesarean, only to give birth to non-viable puppies HEIDI, a three-year-old bulldog, waddles across the floor of the prep room. She tries to sit, but her hugely distended abdomen makes that uncomfortable, so instead she stands, and pants. Her thick eyelids droop with weariness. Sam and I lift her on to the prep table with some difficulty. Heidi gurgles and splutters as we set her down, then starts panting again. Green viscous fluid drips from her vulva on to the table. We haven t much time. Sam raises Heidi s vein with some difficulty; this is uncomfortable for Heidi too. Not because of her distended abdomen, this time, but because her elbow dysplasia makes it hard for her to stretch her leg forward. Bizarre anatomy I look sadly down at her. Her whole life is a struggle with her own body whenever she tries to walk, or eat, or defecate, or breathe, she has to wrestle against her own bizarre anatomy. I inject the propofol into her vein, her eyes roll downwards and she starts to sink to the table. We ll take it from here, love, I say and Sam smiles. Placing an endotracheal tube is difficult 1 / 6
too Heidi s soft palate is too long for her mouth, and it takes some searching before I manage to locate her epiglottis but the moment the tube is in place, Heidi s tongue loses its alarming bluish tinge and turns a reassuring pink. Probably the best lungful she s had for a while, Sam says, as she ties the tube in. We roll Heidi on to her side and start prepping her abdomen for surgery. I don t want to roll her on her back until absolutely necessary; her abdomen is so bloated I m worried what the weight of it would do to the spine, and the blood vessels that run below it. We can t support her blood pressure nearly as well as I would like Heidi s owner has declined intravenous fluids on cost grounds and so I just want to get on with the caesarean as quickly as possible. It s late on Monday night. Heidi was booked in for an elective caesarean this Thursday, which would have been her 63rd day of pregnancy; a sensible precaution, because fewer than 50 per cent of bulldogs manage to give birth without the operation, but in the past few days Heidi s abdomen has swelled to alarming proportions, and over the course of the day it s become clear the pups need to come out, ready or not, or Heidi isn t even going to make it to Thursday. The green discharge, which started in the last hour, generally indicates the placentas have started to separate from the wall of the uterus. Sam and I carry the now extremely heavy dog into theatre, and I only swear and complain about my back once; something of a record, as Sam, who is just over half my size, politely points out. I look at Heidi s immense abdomen, and suggest there is probably more swearing to come. I m right. Dismay As I scrub, my mind wanders back to a consultation I had with Heidi and her owner three years ago. It was her first adult vaccination, when she was about 14 months old. Heidi s owner, a short, likeable man, told me he was thinking of breeding from Heidi and wanted to know what I thought. I glanced at Heidi s clinical notes and tried to hide the expression of dismay that must have crept across my face. Despite her tender years, Heidi has had surgery four times twice to replace prolapsed tear glands, once to correct her entropion, and once to surgically remove her tail, which was so deformed it had formed a tight-corkscrew shape, leading to repeated severe infections around her back end and, again, chronic pain. I wondered how I could delicately state Heidi is about the worst candidate I can imagine to have 2 / 6
more progeny. I wanted to grab her owner by the lapels and scream No, no. A thousand times, no. Can t you see how much she is suffering, just trying to walk? but I feel that s not very professional. While I am thinking, the hitherto likeable owner, who seemed slightly surprised I was not immediately excited at the prospect of Heidi producing puppies, said: I ll have all the tests, you know. I want to make sure I m doing the right thing. Poor choice This gave me an in. I calmly, and, I think, quite logically, explained I didn t need to do any tests to tell me Heidi was a poor choice of mother, both medically and genetically. All the conditions she has had surgically corrected, as well as the many she has that can t be, are heritable conditions, and any puppies she has are likely to suffer from them too. I further explained The Kennel Club, finally drawing a line in the sand long after the country behind the line has been invaded and razed, wouldn t allow any pups to be registered, due to the number of corrective procedures Heidi has had to endure. As I talked, I could see Heidi s owner s attention start to wander. I wasn t saying what he wanted to hear, so he stopped listening. I said it again, in a slightly different way, and then again, finally ending with an extremely strong recommendation that Heidi is spayed as soon as possible. This last suggestion is too much for Heidi s owner. At reception, I heard him asking never to see that vet again. Third caesarean Now, three years later, Heidi s owner doesn t have much choice, because I m the vet on duty tonight. When I admitted her this time, he didn t mention his request not to see me, and I didn t mention my advice never to breed from her. There didn t seem much point. Scrubbed up, I enter theatre and don my surgical gloves. Heidi s abdomen already has a long scar along it; this isn t her first caesarean. In fact, it s her third. Heidi s owner says he won t let her have another litter after this one. He said that last time, too. I open her abdomen with a large incision, cutting through the scar tissue of her previous surgeries, and ease the huge, bloated uterus out of the wound. Enormous 3 / 6
Incising it, I remove the first puppy in its amniotic sac. It is enormous truly a camel would have more chance of passing through the eye of a needle than this puppy would have had of passing through Heidi s pelvis. I hand the puppy to Sam, who quickly breaks the sac, clearing the fluid, while I start to milk the next puppy towards the incision in the uterus. Nick..., Sam says. I look up and understand why Heidi was so bloated. The puppy looks like someone has been at it with a bicycle pump, bearing more resemblance to a hippo than a bulldog. The skin is thickened and distorted with fluid, and has torn in a number of places around the mouth. As Sam gently shifts the puppy s position, its abdomen splits open and she gasps in dismay. Fortunately, it was dead before I ever removed it from the uterus. Anasarca, I mutter. Also known as water or walrus puppies a condition of bulldog pups that causes severe oedema in the days leading up to birth. Mild cases might, just might, survive. The pup I have so far removed is not a mild case. So it goes for the remaining four puppies that I extract. All of them are severely affected. Two of them have weak heartbeats, so I ask Sam to euthanise them for me. Heidi s colour has improved dramatically now we have reduced the load on her uterus. I wish, once again, that we had her on fluids, but she seems to be doing well now all the puppies are out. Valuable bitches I start to suture up the uterus. When I admitted Heidi, I asked the owner if he would like me to spay her at the same time, as he already had suggested that Heidi wouldn t have any more litters. He declined. Suturing up a caesarean is often done to the noise of puppies crying for their mum s milk, but tonight Sam and I finish the operation in silence. Afterwards, Sam stays with Heidi while I telephone the owner with the news. He s annoyed and depressed. Of course he is a single live puppy would have recouped double the cost of the caesarean. He wants to know how many of the pups were female. We didn t think to check at the time, and I do so now. Only one of the five was a bitch, which seems to be some comfort to Heidi s owner. Bitches are worth more than dogs. Finally, with genuine concern, he asks how Heidi is. I reassure him she s fine, and he sounds relieved. He thanks me for my help. 4 / 6
I put the telephone down, and sit in the dispensary, looking up at all the medicines I have at my disposal to treat sick animals, and wonder just how complicit in Heidi s suffering I am. 5 / 6
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