Ojitos, a one-year-old female Maltese, presented to the Animal Medical Center of Seattle emergency service as dystocia (difficult birth) on the evening of July 9th. This was no ordinary dystocia, though. Ojitos had previously presented to us in June at around 53 days pregnant after she experienced unknown trauma in her driveway, which led to pelvic fractures and a sacroiliac luxation. Balancing adequate pain management while maintaining fetal viability can be very difficult, but our doctors worked out a plan that would help keep her comfortable until her due date. Her family was made aware of the risks associated with trauma, pregnancy, and ultimately, the likelihood that she could not deliver her puppies naturally. 

When she presented in dystocia, one of our licensed veterinary technicians, Natalie, performed an AFAST (Abdominal Focused Assessment with Sonography for Trauma) to check fetal heart rates. The puppies had heart rates less than 180 beats per minute, which indicates fetal distress.

With knowledge and experience of neonatal care and anesthesia, Natalie and our emergency veterinarian, Dr. Shane Turner, quickly devised a plan to get Ojitos into surgery to prevent further distress to her and her puppies. They worked to initiate a balanced anesthetic plan that would keep mom safe and comfortable while she was having surgery and give the puppies the best chance of survival. By utilizing TIVA (total intravenous anesthesia), they successfully delivered all four puppies, who, after some TLC by the emergency staff, were pink, squeaking, and ready for their first meal.
We are so happy that Ojitos and her puppies continue to do very well at home after being discharged from the hospital!