Hi Sharon,
She might have another pup, probably not alive however. But I doubt that has anything to do with her anxiety.
First, consider how she must have felt, first to start delivery without understanding what was happening, and then to discover she was no longer alone, and not realizing where all the others came from. Instinct kicks in, but it takes a while. She rapidly gets into the role of Mother. Then, her nest is invaded, her babies separated from her and taken to the vets, where she has to endure the half hour of puppy screams and whines. Then it's back home and into the nest.
The toy is not being mistaken, it's a substitute. It is crying, maybe not too unlike the pups at the vet's? Why would she not 'count' the pups?
She still hasn't figured out what has happened today, and probably isn't too sure it won't happen again tomorrow. Why don't you leave her alone with her babies, with the lights off, or dimmed, and let her settle back into motherhood, and put the home defender mantle away. Pop in and say hi occasionally, fuss over her and leave the pups alone, then leave her alone.
If there is a retained pup, it will need to be taken surgically. Give the pups a few days more to get a good start. Mom won't begin to suffer ill effects from a couple days rest (if new mom's get much rest). You may be able to feel a retained pup, even. The contracted uterus is often mistaken for a pup, but it doesn't have any bones in it. You may have to press hard. You won't hurt anything.
If you are not satisfied, then you may go to the vet's. By now, she will have forgotten her last trip there, hopefully. And the pups won't be screaming as before.
I hope this answers your questions, if not, feel free to ask.
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