Sally N. knew something was wrong when she noticed that one of her dog Shalo’s puppies was bleeding from under his right front leg.

“He was crying,” Sally said of the pup, named Ethan. “He had a wound that smelled and looked like it was infected.”

Unsure how the injury occurred, Sally suspects that Shalo, a Shih Tzu, may have unintentionally bitten Ethan while trying to groom him or move him.

The runt of an accidental litter of four, the black-and-white Ethan was just six days old and weighed less than one pound when Sally brought him to the ASPCA Animal Hospital.

ASPCA Veterinarian Dr. Mary St. Martin designed a specific anesthesia protocol for Ethan because he was so young and tiny.

“Neonate anesthesia can be quite challenging,” said Dr. St. Martin. “The nerves to their respiratory and cardiovascular systems are not completely developed, and their physiology makes them susceptible to hypoxemia (low oxygen level in the blood). But they can feel pain from birth.” Dr. St. Martin also explained that it takes about three to four weeks for livers and kidneys of neonates to mature so they can adequately metabolize drugs.

 
With an anesthesia and analgesia (pain management) plan in place, Ethel Castillo, an ASPCA Licensed Veterinary Technician, anesthetized tiny Ethan, and Dr. Andra Gordon cleaned his wound, then cut away the damaged tissue and sutured the wound. The following day Ethan was discharged with antibiotics and pain medication.

Three weeks later, Dr. St. Martin removed Ethan’s sutures and noted he had nearly tripled his weight. Sally reports that while Ethan was on the mend, she kept him separated from Shalo to prevent further injuries. She also bottle fed him and carefully socialized him with his littermates.

“We went through so much,” says Sally, a hospital worker, who lives in East Harlem, New York. “We had many sleepless nights, and were up with Ethan every hour on the hour.”

Dr. Martin’s concerns that Ethan's sutures might not hold due to the high tension location of his injury were quelled during his recheck exam. “The injury healed well, and the surgery site looked great,” she said.

Added Sally, who plans to have Shalo spayed in the near future: “I said a little prayer. I knew he was tiny but I also knew he was strong.”