When the Blessed Event Doesn't Happen Naturally

by Christopher Forsythe, DVM

There is nothing in the world cuter than a batch of puppies frolicking about, healthy, happy, and full of curiosity and wonder. Mother Nature is a glorious gift, and most of the time a new litter can be an interesting event for family and pet alike. From time to time, however, complications arise, and the pregnant female cannot deliver her puppies. In these cases, the magical time can quickly turn into a nightmare, and the health of the mother and puppies falls into jeopardy faster than the current California housing market. So if your female dog is pregnant or if you are planning to breed her, you need to know about this life-saving procedure that may become necessary if her pups don’t “pop out as planned.”

What should normal delivery be like?

Normal gestation for puppies is two months after breeding, at which time you can expect to see signs of impending “parturition” (delivery). Usually three to four days before she whelps her litter her mammary glands enlarge, and all her pelvic ligaments and abdominal muscles relax making that litter of puppies can resemble a beach ball swinging back and forth in her abdominal cavity. Her vulva begins to enlarge a few days before she gives birth, and sometimes there is a small amount of mucoid evident during the last few days. About 24 hours before she goes into labor her temperature drops one to two degrees, and 12 hours before she gives birth the mother-to-be becomes restless, pants, scratches, chews, licks herself, moans, and howls. One to three hours before delivery she may even hide, curl her tail, show increased swallowing, and show evidence of mild pain in her abdomen.

Are the puppies ready to come now?

Stage one of parturition is characterized by uterine contractions and cervical dilation. This stage averages four hours but may last 6-12 hours or up to 36 hours in first time or nervous moms. Expect her to look at her flank, be restless, anorexic, apprehensive, and frightened. Avoid the urge to call a therapist as this is normal during stage one birth.

State two is characterized by delivery of the fetuses and placentas. Average length for this is three to six hours but it could take 24 in some slow-pokes. Assistance is needed if the uterine contractions occur and the first puppy is not delivered within five hours or if the interval after the last puppy is more than two hours despite lots of pushing. A dark greenish discharge called meconium is an indication of fetal distress and is reason to call the vet for advice. During this phase the female is normally silent, but some dogs, especially those pregnant for the first time, may cry out as they are trying to pass a puppy. Most of the time the female lies on her side and licks her vulva, paddles, pants, and shivers just before delivery of the next pup.

No time to redecorate

It is really important for her to try to deliver her puppies in familiar surroundings. The whelping area should be warm. Your mother dog may arrest the process if you disturb her too much during early parts of the stage before delivery of the first puppy. Some females resent any intervention.

How do I know if she needs a C section?

There are several indications for cesarean section. The most common one is uterine inertia, which means that your female’s uterus has just lost the strength and power it needs to keep contracting and pushing her puppies out. Primary uterine inertia occurs in all breeds and ages but is common in older females. Some of the other causes implicated with inertia appear to be over distention of the uterus, overweight pets, and under exercise during late gestation as well as low calcium levels. It’s just so hard to get some of these girls to do their sit ups and stay fit throughout their pregnancy.

Another common cause for delivery problems is simultaneous jamming of the pelvic inlet with two fetuses. As the little babies vie for an exit strategy things grind to a dead halt like traffic at the MacArthur Maze prior to a Giants game. Puppies can also present as a breech birth (completely backwards) and become stuck in the birth canal. Another potential problem is “fetal dam disparity” meaning the baby is bigger than the mother’s anatomy will allow for normal passage into the world.

When nature simply will not allow natural puppy birth the veterinarian needs to intervene in order to save the lives of both the mother and the litter.

C-Sections: time is of the essence

When a female is presented with a “dystocia” or difficult birth the history taken on the mother-to-be must include information about her including breeding dates, father breed and size, problems during pregnancy, signs of delivery, number of puppies already born, and interval between puppies born.

Your veterinarian may decide that it is time to perform a caesarian section. The purpose of a C Section is to circumvent the conventional birthing mechanics to deliver a healthy litter of puppies. The object is to remove all the fetuses from the gravid uterus as quickly and safely as possible.

Calypso, the Irish Terrier

She had already delivered one puppy naturally earlier in the day, and the puppy was doing well, not really nursing but hanging on. What worried Mrs. Martin the most was that her beautiful Irish Terrier had been struggling for hours and had not delivered another puppy despite continued heavy contractions. Ms. Martin has been breeding Terriers for years so she recognized the signs of a problem and called when she saw the meconium coming out of her girl. Within twenty minutes X rays revealed a very large puppy nestled within a rather small womb. It was clear this puppy was too big to be born naturally. Within another 30 minutes Calypso was being prepped in the hopes that it was not too late to deliver the hefty pup.

A C-section must be planned in as much detail as a Janet Jackson halftime show but with even more breast exposure! We minimized the time spent between induction of anesthesia and surgery by preparing the surgical site ahead of time. With an IV catheter in Calypso’s arm I placed a local line bloc with anesthesia to numb the ventral abdomen where I was going to make the incision to deliver her puppy. We also prepped her body with pure Oxygen via a face mask, and after all the preparations were completed gave her some Propofol anesthesia to induce her to sleep for the surgery.

Within five minutes her very large uterus was exteriorized in the operating room and I was wrangling with a very large and stubborn fetus I had just removed from her uterus. After clamping off her umbilical cord, I passed her to my technician and then began closing up the c section. Our waiting technician began carrying out the well-rehearsed shaking of the puppy and mouth suctioning which produced a puppy whimper and sputter followed by a yip and a yap. This was a happy, plump, wire haired Irish Terrier pup who had things to say already and wanted to nurse as soon as possible. While I sutured up the incision on the uterus and flushed and closed Calypso’s abdomen the technician checked the fat little newborn puppy for any birth defects (none were found). Within minutes of turning off anesthesia, Calypso began waking up as her new little puppy suckled on, oblivious of how he came into the world but very happy to be a part of it.