Does My Bitch Need A C-Section?

Questions for evaluation of the bitch at home or at the hospital indicating the probable need for an Emergency C-section:

  1. Has the bitch been in hard labor (abdominal pushing) over 2 hours on the first or 1 hour on subsequent pups?
  2. Did the bitch initially show good abdominal contractions and stop without producing a puppy?
  3. Is there is green vaginal discharge PRIOR to the delivery of the first puppy?
  4. Does the bitch seem distressed? Frantic? Sick? Weak or unable to stand? Tremoring? Repeated vomiting?
  5. Is this labor pattern different than her previous ones?
  6. Has the bitch been unwilling or unable to eat and/or drink for over 12 hours?
  7. Has WhelpWiseR indicated there is a problem with fetal heart rates (<160 BPM) or uterine contraction patterns?
  8. Have any pups been born dead?
  9. Did a previous radiograph or ultrasound suggest there could be a problem? (low heart rates on ultrasound or pups without visible heartbeats?) (Malpresented or very large pups)
  10. Is a pup palpated on vaginal examination and in an unusual position or not progressing through the birth?
  11. Did her temperature drop to 98 degrees and rise to normal (over 101.0) and stay there more than 4 hours?
  12. Has her pregnancy exceeded 63 days?
  13. Does she appear to have a very large or very small litter?
  14. Does she have a previous history of dystocia?
  15. Is she a breed at risk for maternal or fetal causes of dystocia?
  16. Does she have unexplained or unusual discharge from her eyes?
  17. Is she having weak or non-productive contractions with multiple puppies left?
  18. If oxytocin has been used (more later), has there been a minimal or no response?
  19. Does the breeder or veterinary staff member have a feeling that something is going wrong? Trust their intuition.

If the answer to any of these questions is yes, you very likely need to assess the bitch as soon as possible and advise your client that the bitch should proceed to emergency surgery unless you can immediately correct any cause for dystocia.

Courtesy of Dr Marty Greer of Veterinary Village, Lomira WI

Determining Whelping Dates

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Whelp Dates

Patient Name________________  Owner Name_________________ Date__________

The “Whelp Dates” is determined by counting 63 days from the date of ovulation. Ovularion occurs when the progesterone range is between 4 and 6 ng/mls (this may vary in some cases where progesterone “surges” or different test protocols between laboratories). The whelp date is estimated with a typical fluctuation of no more than +/- hours.

If LH testing is done, the Whelp Date is calculated at 65 days from a positive LH test result.

If a vaginal smear is done and show a jump from being “in season to “not in season” (cornflakes w/ nuclei g fried eggs w/ nuclei), the due date is 56 days from the “not in season” smear date.

If no timing was done and we are unsure of a due date, progesterone testing at the end of pregnancy is recommended to determine when the bitch will whelp.

If a c-section is not planned, the owner needs to monitor for temperature drop (3 times a day) and test progesterone level to make sure that we are not taking the puppies out too soon or put the mother and pups in a compromised situation by keeping them in too late.

Progesterone tests performed at the time of whelping are a good idea because the temperature might not always drop as low as desired. The amount of the drop depends on the size of the litter, (cases of only 1-2 puppies typically have smaller drops). This test is also recommended as it helps us estimate when she will deliver. And, in the end, it will cost less to the owner.

Ultrasound(s) or Radiograph(s) can help determine a whelp date if no other options are available.

Ultrasounds help the doctor to determine the age of the puppies and is easier to do around day 25 to 30, but it is possible to do it later.

adiographs can help determine the calcification level of the puppies. If toes, or teeth are present on the radiograph, the bitch is expected to whelp within 1-3 days.

When it comes to bulldogs, it is always better to schedule and perform a c-section 1 day before estimated due date. This prevents putting the bitch in a compromised situation of natural whelping and having an emergency in the middle of the night.

Singlton cases (one puppy litters) are the most challenging to time whelping because it is the puppy that initiates labor, not the mother, If there is not enough stimulation in the uterus due to the decreased levels of hormones from only one puppy, the temperature might not deop and the mother will not go into labor,

____(Owners initials acknowledging receipt and understanding of the above information)

____Tech/Dr. initials

Recommendations for Whelping Bitches

Gestation Time:

  • 63 Days ( + / – one day) from the day of ovulation (or at 56 days from the end of their cycle)

Nutrition:

  • We recommend that bitches in whelp be fed their normal food for the first half of the pregnancy. For the last trimester, we recommend switching to a puppy food or high performance diet which has higher protein levels. No vitamins or calcium supplements need to be given unless your bitch is a toy breed or has had problems in the past.

There are some homeopathic remedies that we recommend & we can discuss them with you. If expecting a very large litter, we recommend “Structure Formula” as a supplement during the last half of pregnancy.

Supplies for Whelping:

  • Whelping Box- Some are commercially made, some are home made designs. You can find designs online or in books. This can be as simple as a child’s plastic pool but we recommend using the ones that have “pig rail” all around. Avoid soft beds or beds that are unable to be washed and disinfected easily. Do not put excessive amounts of blankets in the whelping box to prevent puppies from being entangled and suffocated. It is a good idea to allow the bitch to get used to sleeping in the whelping box during the last week before she is due.
  • Heating Lamp- Pups need to be kept at a room temperature of 80-85 degrees for the first 10 day, then at 75 degrees. The number one reason or pups dying is getting cold. Do not use heating pads. They can become too hot and the pups may be unable to get off the heating pad and become burned. We recommend a ceramic type of bulb as a radiant heat source (you can find them at a reptile store) and protective cover.
  • Thermometer – we recommend a pool thermometer that has a temperature and a humidity reading). Put it on the level with the pups, so you know their  exact environment.
  • Lots of small hand towels used to dry and rub pups.
  • A pediatric nasal aspirator will be necessary to “suck out” any extra fluid or mucous discharge that may be present after birth.
  • Dental floss to tie umbilical cords. Use hemostats Betadine to disinfect umbilical cords
  • Digital kitchen scale
  • Gauze, cotton balls
  • Birth chart
  • Yarn or wrick wrack for puppy identification

Signs of Whelping:

  • Usually, dogs will stop eating about 1 day before or the day of whelping.
  • It is a good idea to learn how to take your dogs temperature rectally. Normal temp for a dog is 100-102 degrees Fahrenheit. In 90% of all dogs, their body temperature will drop to 98 degrees Fahrenheit 24 hours before whelping (this does not apply to a singleton litter). This is an excellent way to monitor when the bitch will initiate whelp. Sometimes a dog’s temperature will vary during the day, it will be lowest in the early morning and creep up during the day. Therefore it is a good idea to take the temp two to three times a day to establish a baseline temperature. When the temp drops and stays low, the dog will whelp in 24 hours. Rarely, the temperature might not decrease to 98 degrees, but a full 1 degree temp drop might be significant.
  • Most dogs will start nesting about 24 hours before whelping. Nesting may include such behavior as tearing up beds, shredding towels or blankets, and sleeping in small areas such as closets or going outside to dig up holes.
  • At the beginning of the actual “birth stage”, most dogs will pant and act uncomfortable or unsettled.
  • If no whelping has started for 24-36 hours past the temperature drop, your vet needs to see you and ultrasound the bitch to ensure pup’s heart rates are okay and they are not in distress.

Whelping:

  • After 30-60 minutes of productive contractions, pups should begin to arrive.
  • Pups are inside of a double-layered membranous sack. This sack should be removed by dam or through your assistance as soon as possible to prevent suffocation. Pups should be dried off and have their mouth and nose suctioned out to help clear the air ways. Most of the time the umbilical cord will be still attached to the placenta. Clamp the cord with hemostats and cut the cord about ½  inch from the pup (where the hemostat is) and tie off with the dental floss if it is still bleeding. Dab the area with betadine. The mother dog will probably want to eat the placenta. It is ok if she eats 1 or 2 but if she eats all of them, it may cause her to vomit. More frequently, eating placentas may cause diarrhea or loose tarry black stools.
  • Pups are usually born every 30-60 mins. If more than 2 hours elapse between pups then there may be a problem. It is a good idea to get the bitch up every 2-3 hours and walk her around. This will stimulate the contractions to become more effective. Make sure when you take the dog out to keep her on a leash or go with her to ensure that no pups are accidentally born outside and left. Car rides work well, as well as feeding her some melted ice cream. If that doesn’t get her going and you are approaching the 3 hour mark, you might need to call the vet’s office.
  • If a pup becomes “stuck” in the birth canal, you may have to gently pull on the pup and help it along. It is normal for some pups to be born hind end first, and do not worry if this happens.
  • When active contractions start and the bitch seems to be straining for longer than 30mins, there may be a problem. Call the office right away, and start packing for the trip.
  • Allowing the pups to nurse on the mom soon after birth during the whelping stages will stimulate further contractions and help the whelping process along.
  • If more than 2 pups are stillborn, call the office, we will need to see you right away.

Signs of Trouble

  • If longer than 3 hours in between pups, call the office.
  • If blackish-green discharge appears, call the office.
  • If hard pushing and no pup is produced in 30 minutes, call the office.

Post-Whelping:

  • Monitor bitch’s temperature and consistency of mammary glands.
  • The pups should be monitored closely for the first 24-72 hours to ensure that the mother is being careful and not lying on the pups in the whelping box or showing any aggressive behavior (especially in first time mothers).
  • The mother will have a brownish to red discharge for 6-8 weeks after whelping. If the discharge seems heavy or has a foul odor, then there may be a problem.
  • While the mother is nursing pups, she should be fed a puppy food or high protein diet at least 150-200% more than usual. Small but more frequent meals are recommended. The amount should be at least 1 cup for every 20lbs of body weight.

Signs of Trouble

  • Fever of greater than 103 degrees Fahrenheit
  • Strawberry and cream or green-yellow discharge
  • Lethargy, non-interest in puppies
  • Hot, red or firm mammary glands

Other Helpful Facts:

  • Pups usually open their eyes at 10-15 days.
  • Most pups should be started on solid food at 3-4 weeks of age.
  • Pups should be weaned at 5-6 weeks of age
  • Pups should remain with their litter mates until 8 weeks of age
  • Pups need to be de-wormed at 3, 6, and 8 weeks of age
  • Vaccinations need to be started at 6-8 weeks of age.

 

 

Source: Reproductive Resources + NOAH

Labor and Delivery

PRIOR TO LABOR:

Several days before delivery, her vulva will enlarge, the tail head may become prominent, and watery milk may be present. Bitches with large amounts of hair on the abdomen should be shaved to assist the pups in nursing. Twenty-four hours prior to delivery, she may nest, stop eating and may vomit. Eight to 12 hours before delivery, the rectal temperature may drop by 2 to 3 degrees, to below 100 degrees, then rises back to 102 degrees as whelping approaches. At this time, she should be housed in a quiet warm room with suitable flooring or plastic sheeting and absorbent blankets. If not already done, her whelping box should be prepared. An inexpensive, easy to clean whelping box can be made from a child’s round swimming pool lined with towels, blankets, or a fitted carpet to improve footing for the pups to aid in their development.

LABOR:

As with all mammals, there are 3 stages to delivery. The first consists of mild uterine contractions, and may last 6 to 12 hours, during which milk is present and the bitch is restless. At this point, you may notice that she passes a plug of mucus, called the cervical plug. The second stage is true labor (abdominal and uterine contractions) and delivery. In hard labor, the bitch will visibly strain and groan – she may lay down or stand.

DELIVERY:

In the uterus, each pup is surrounded by fetal membranes known as allantoic and amniotic membranes, their associated fluids, and a placenta. Delivery is  preceded by passage of dark amber allantoic fluids. The amniotic sac passes into the cervix and anterior pelvis, resulting in abdominal straining and panting. Next, the perineum (skin around the vulva) distends as the amnion and pup is delivered. The first fetus should be delivered within 2 to 3 hours after the beginning of the start of hard labor. As long as the bitch’s vaginal discharge is clear and she is not in hard labor, she should not be disturbed. Puppies can live in the uterus for up to 24 hours after labor starts. Dogs in labor for 3 hours without delivery of the first pup should be examined for evidence of complications. If you are comfortable with this, you may don a glove and do a vaginal examination to assess position of the puppy. If there is a puppy in the pelvic

canal, you can help her by massaging the roof of the vagina (called feathering). You may be able to feel the pup’s head or legs and assist the bitch by pulling the puppy out and down (toward the bitch’s feet). Labor should be progressive and productive. If you are uninterested in intervening yourself, the bitch is weak and seems to you to be in danger, or you unable to assess the situation, this is the time to contact a veterinarian for assistance. Subsequent pups should be delivered within 45 to 60 minutes of hard labor.  Often the first 2 pups are born close together, and then a pause of up to several hours can occur. As long as the bitch is not in hard labor, or there is not excessive blood or green color to the discharge, there is no need to intervene.  (Green color is normal AFTER 1 or more pups have been delivered as this signifies placental separation). Frequently, the first and last pups are the largest, due to position in the uterus and optimum nutrition. It is not abnormal for pups to beborn tail first (up to 40%). As long as the delivery is short, the pup should survive. Regardless of presentation, if the delivery is slow or difficult, the bitch can be assisted by gently grasping the pup with a towel or gauze and pulling with gentle traction downward between her rear legs.

The third and final stage of labor is the delivery of the placentae, which frequently occurs with each delivery. The amniotic sac is may be intact and the umbilical cord is unbroken. The bitch will normally remove the amnion and chew through the cord after each birth, then lick the pup to stimulate breathing. Do not interfere unless she is not interested, too aggressive or too weak. Try to account for one placenta per pup and allow her to eat only a few. Too many may cause stomach upset.

If the bitch fails to clean up the pup within 30 to 60 seconds of birth, you may need to intervene. This is best accomplished by tearing the sac off the face with a terry towel and rubbing the pup vigorously. A bulb syringe or DeeLee mucus trap can be used to suction excess fluids from the back of the pup’s throat. (Never swing the pups as this causes brain damage.) The pup can be held at a 45 degree angle with the head down to allow drainage of fluids from the airways if necessary.

If the pup does not start to breathe promptly, an acupuncture point (25 gauge needle inserted in the center of the upper lip, below the nostrils, insert to bone and rotate) or a caffeine solution (1 caffeine tablet crushed in 1 cc of water) dropped on to the pups tongue can be used to stimulate the first breath. Mouthto-mouth and chest compressions can be attempted if the pup fails to respond to the above measures.  If the umbilical cord tears too short and bleeds, immediately clamp the cord and tie dental floss or thread around it to control blood loss.

Whelping is best accomplished at home and without intervention if possible.  Disrupting the bitch can stop or delay delivery of the pups. Occasional walking to allow the bitch to urinate may assist with delivery. Be sure to accompany her and take along a towel (and flashlight if in the dark), just in case she delivers a pup while outside. Allowing pups to nurse between deliveries will aid in uterine contractions. Ice cream (for calcium and energy) can be fed to her (and you) throughout labor to aid in keeping her contractions strong and effective. If indicated, oxytocin use MUST be done very conservatively to avoid endangering the health of the bitch and puppies. Only very small doses, if any, should be administered without veterinary or Whelpwise® oversight and should NEVER exceed 2 injections. The more oxytocin most experienced breeder-veterinarians use, the more respect they have for it’s misuse.

UTERINE CONTRACTION MONITORING:

The WhelpwiseTM uterine contraction monitor (tocodynomometer) can be used to monitor pre-labor and labor and allow for early intervention if premature delivery or dystocia is diagnosed. As in human obstetrics, insightful monitoring of labor can significantly improve neonatal survival. The equipment for this service needs to be ordered in advance. They may be reached at 1-888-281-4867. The fetal Doppler included can be utilized to assess fetal heartbeats and detect fetal distress.

DYSTOCIA:

There are 2 basic causes for dystocia or difficulties with deliveries: those caused by the bitch and those caused by the pups. Maternal causes included obesity; voluntary inhibition if interrupted or overly sensitive; abnormally small litters (1-2 pups); exhaustion; or small pelvic or vaginal diameter. Fetal causes are large head, malposition or malpresentation, large size, other structural defects, and 2 pups being delivered simultaneously. To help alleviate exhaustion in the bitch you may wish to offer vanilla ice cream to provide energy, fluids and calcium without causing vomiting.

Under some circumstances, the bitch will need assistance and should be taken to the veterinarian. Corrections of dystocia (performed by your veterinarian) include manipulation and traction on the pup, episiotomy, drug therapy (oxytocin, calcium and glucose) and Caesarian section. Each case must be considered and  treated individually.

CESARIAN SECTION (C-section):

At times, a C-section may be scheduled prior to the onset of labor. These reasons  include small litters of 1-2 pups, larger litters of over 10 pups, or a breed at risk.  On occasion, surgical intervention may be necessary to save the bitch and/or  puppies. DO NOT DELAY HERE.

Any bitch that is too weak to stand, has an unexplained discharge from her eyes, unrelenting vomiting, has severe abdominal pain, is greater than 68 days postovulation, has a history of dystocia unrelated to fetal malposition, is having severe tremors, has green vaginal discharge without a pup delivered, has signs of fetal distress, has failed to respond to oxytocin, has weak contractions, has had her temp rise Without labor starting, or is in hard labor 2 hours without presenting a pup needs immediate veterinary attention.

Done prior to the bitch and puppies developing extreme distress and done well by an experienced team of veterinarians and veterinary staff, C-sections can be highly successful, often producing 100% puppy survival rates. This is done with general anesthesia using PropofolR for induction followed by isoflurane or sevoflurane. The bitch is monitored during anesthesia with a pulse oximeter and is given IV fluids. A spay should only be performed at the c-section under extraordinary circumstances due to the associated risks. The puppies are rapidly removed from the uterus and revived. As soon as the puppies and bitch are medically stable, they are sent home in your care.

Courtesy of Dr Marty Greer of Veterinary Village, Lomira WI

List of Items to Bring for Your Bitch’s C-Section

List of Items to Bring for Your Bitch’s C-Section

  • The pregnant dog in need of the C-section
  • Cell phone
  • Tarp, shower curtain, or vinyl tablecloth to cover the seats or floor of the car
  • Crate large enough for the pregnant bitch to travel in
  • Large Vari-Kennel crate with top ½ removed, which easily gives you access to the bitch or preferred a baby pool
  • 3 Blankets for inside crate or pool (One for the way down, then a clean one for the return home, and a smaller one that will go on top of the heating pad- So that heating pad is between the blankets.) Or you can use large towels. I cover the bitch and puppies with a large towel on the return home- everything covered except the bitch’s head so there are no drafts on the puppies.  Or you can clip a towel over most of the crate, allowing room for easy access if needed
  • Heating pad – take two, one for the crate/pool for the return ride home and one for in the basket. Don’t forget the adapter to plug into
  • Hot water bottle – take one just in case something happens and the heating pads don’t work
  • Plastic laundry basket – to use after puppies are cleaned up and getting ready to leave the clinic
  • Towels – plenty of them!! Hand towels and full size bath size towels
  • Small garbage bag
  • Paper towels
  • Kleenex – especially good for pooping puppies
  • Cotton balls, Q-Tips, and cotton gauze squares
  • Nolvasan (properly diluted and ready to use)
  • Puppy formula mixed – in a seal tight container and enough to feed litter if needed before leaving the clinic. If bringing a premixed can, remember a container to heat the formula in, and a lid for the remaining unused portion in the can.
  • French feeding tube and syringe (sterilized and ready to use)
  • Bulb syringe and Dee Lee mucus trap – for suctioning puppies if needed
  • Hemostat
  • Dental floss – in case you need to re-tie an umbilical
  • Water
  • Water dish for bitch, and or a squirt bottle of water
  • Cooler
  • Ice (I bring ice just in case you have a bleeding dew claw) or Quick-Stop or
  • Antiseptic powder, or all of the above
  • Normal first aid

Determine Whelping Dates

DETERMINE WHELPING DATES

The “Whelp Dates” is determined by counting 63 days from the date of ovulation. Ovularion occurs when the progesterone range is between 4 and 6 ng/mls (this may vary in some cases where progesterone “surges” or different test protocols between laboratories). The whelp date is estimated with a typical fluctuation of no more than +/- hours.

If LH testing is done, the Whelp Date is calculated at 65 days from a positive LH test result.

If a vaginal smear is done and show a jump from being “in season to “not in season” (cornflakes w/ nuclei g fried eggs w/ nuclei), the due date is 56 days from the “not in season” smear date.

If no timing was done and we are unsure of a due date, progesterone testing at the end of pregnancy is recommended to determine when the bitch will whelp.

If a c-section is not planned, the owner needs to monitor for temperature drop (3 times a day) and test progesterone level to make sure that we are not taking the puppies out too soon or put the mother and pups in a compromised situation by keeping them in too late.

Progesterone tests performed at the time of whelping are a good idea because the temperature might not always drop as low as desired. The amount of the drop depends on the size of the litter, (cases of only 1-2 puppies typically have smaller drops). This test is also recommended as it helps us estimate when she will deliver. And, in the end, it will cost less to the owner.

Ultrasound(s) or Radiograph(s) can help determine a whelp date if no other options are available.

Ultrasounds help the doctor to determine the age of the puppies and is easier to do around day 25 to 30, but it is possible to do it later.

Radiographs can help determine the calcification level of the puppies. If toes, or teeth are present on the radiograph, the bitch is expected to whelp within 1-3 days.

When it comes to bulldogs, it is always better to schedule and perform a c-section 1 day before estimated due date. This prevents putting the bitch in a compromised situation of natural whelping and having an emergency in the middle of the night.

Singlton cases (one puppy litters) are the most challenging to time whelping because it is the puppy that initiates labor, not the mother, If there is not enough stimulation in the uterus due to the decreased levels of hormones from only one puppy, the temperature might not drop and the mother will not go into labor.