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Remove the Puppies

Chapter 7: Table of Contents

Remove the puppy located within the uterine body first, then, ‘milk’ puppies/kittens out one by one by externally massaging the horn and pushing each puppy/kitten towards the incision. When the puppy/kitten is close to the incision, the surgeon can also gently grasp it to help retrieval. Once exposed, open the amniotic sac to free up the puppy/kitten.

Milking Puppies out of the Uterine horn

Identify the umbilical structures, double clamp these structures, transect between the clamps to release the puppy/kitten and pass it to a non-sterile assistant for resuscitation and ligation of the umbilical structures. Do not hold the puppy/kitten by the umbilical clamp as you pass it over as this can lead to umbilical hernia.  Then, gently pull on the placenta, using the remaining umbilical clamp, to separate it from the uterus. If the placenta is well adhered or if significant bleeding occurs when separation is attempted, leave the placenta in-utero and move on to the next puppy/kitten. Retrieve each puppy/kitten, one by one, and make sure to palpate the entire uterus from ovary to uterine body to ensure that a puppy/kitten has not been left behind.

Puppy just after being removed from the uterus

< Incise the body of the uterus Close the Uterus in 2 layers >