Doctor Vet inseminates Alixx Amour with a knotted dildo with a tube to inject the semen into her. Here we have another successful insemination and knotting that has occurred. After the bitch's vagina has been filled with sperm, a feeding gag is shoved into her mouth to inseminate her stomach full of sperm, thus completing the double ended bitch insemination. Now the bitch just has to wait 9 months to give birth.