Nothing can top the experience of a normal whelping: where everything goes smoothly and according to the textbooks. The only problem is, most bitches don't read the books!!! When working with live animals, almost anything can and will go wrong. It's a known adage.........the longer you stay "in dogs" and the more dogs you breed, the more problems you will run into! Sooner or later, most breeders will face the prospect of a Caesarean Section. Special note: my first litter was whelped in 1970 and sometimes I feel, over the span of forty-one years, I have seen it all.....
A Caesarean is nothing to be ashamed of,
as it has saved the lives of many a bitch and their offspring.
Supposedly it is not common in our breed, however, the need for
one can occasionally arise in the best of families. The argument
is heard that C-Section dams would die in the wild. The "survival
of the fittest" theory definitely has its merits. The only
drawback in this day and age; few of us adhere strictly to this
principle. Today, little remains in the sphere of breeding dogs
that is totally natural and without our intervention. In any case,
regardless of your philosophy, if whelping problems arise, you
must act quickly as there is a fine line between dead and live
puppies or worse yet, a dead or a live bitch.
WHY A C-SECTION?
A Caesarean can become necessary for a variety of reasons, but the most common one is uterine inertia. This is a condition in which uterine contractions are either too weak or altogether absent. Uterine inertia can come before any puppies are whelped or can occur following the birth of any number of puppies. If there is a long duration between puppies and contractions are light and puppies are coming out of the sac gurgling, with poor color and barely breathing, you may have a problem.
Other problems can arise when a bitch has strong contractions for hours on end with no resulting puppy. Or a bitch will have strong contractions and then for no apparent reason, just stop. Either one can occur due to a variety of reasons: a puppy is too large and cannot be delivered through the birth canal and/or the pelvic area or a puppy can overshoot the birth canal and end up blocking the entrance. Heavy contractions with no results will end up with an overly tired bitch and possibly dead puppies. If a bitch's water breaks and no puppy is presented in a reasonable amount of time, there may be problems. Also, a green discharge before any puppies are born can indicate problems (but not always), because there has already been placental separation. The best advice is..... if you think problems are developing, consult your veterinarian.
C-sections can also arise if the litter contains just one puppy (or dead puppies). Sometimes the one puppy does not provide enough stimulation for the necessary contractions that are needed to get the puppy out. An even bigger problem can result when that one puppy is so large, it can't be passed anyway. I can't tell you the number of breeders I have known over the years that have lost "litters of one" due to uterine inertia. This is one of the reasons some breeders opt for an elective C-section prior to the due date, when it's known there is only one puppy. I did this in 2004 when Xrays and an ultrasound showed one very large puppy. Even though I had no reason to think the dam would have whelping problems, I elected to do a section two days before the first due date (when her temperature dropped). A beautiful tri bitch puppy was the result. Initially her dam wanted nothing to do with her (this is a common phenomenon following a C-section, until the anesthetic completely wears off). However, within 8 hours, she took over completely and raised the very spoiled puppy completely on her own with no intervention. In fact the bitch turned into one of the best moms I have ever had the pleasure to know!
AFTER THE C-SECTION!
C-Sections provide their own particular set of problems, not only for the bitch and puppies, but also for the owner. This is especially true for the first couple of days following a section. Immediately after the surgery, the most important task is the care of the puppies. Most veterinarians allow the puppies to return home as soon as possible. Meanwhile the bitch is left at the hospital to recuperate. Standard procedure is the bitch must be up on her feet and fairly steady before being discharged. A C-Section is considered major surgery and the recovery period can vary, depending on the age, condition and health of the bitch, and sometimes more importantly, on the type of anesthetic used. Anesthetic for the C-Section bitch can be extremely challenging for the veterinarian because most anesthetics cross the placental barrier, thereby anesthetizing the puppies. The veterinarian must choose one that will have minimal effects on the puppies, but at the same time, keep the mother comfortable. Sometimes it is a fine line between the two. The choice of anesthetic is left up to the veterinarian and each one has his own particular favorite. Some veterinarians avoid using barbiturate injections in combination with gas because either one or both in combination can severely depress the puppies. They may be delivered alive, but become so anesthetized they are unable to breathe. I have learned the hard way with Collie puppies, that when they come out, you cannot simply dry them off and then put them in a box and forget about them. You have to continue to dry and rub them so they resist the urge to just fade away. Following the surgery, however, gas does have a quick recovery rate for all concerned. On the other hand, a narcotic such as Innovar can take a full eight hours for the puppies to recover and possibly 1 to 3 days for the bitch. It's a balancing act that requires a certain amount of expertise on the part of the veterinarian and a good one will know exactly what he/she is doing.
It is important to get the puppies home as quickly as possible to a safe and warm environment. It could be hours before the mother is released and until that time, the puppies will require a bit of care. A word of warning: if they seem fussy, continually crying and whimpering, it is more than likely the residual effects of the anesthetic. Depending on what was used on the mother, the symptoms may vary and sometimes can be very pronounced. The pups may continue to fuss for several hours, even refusing to nurse. (NOTE: following my first C-section, I was worried sick that there was something wrong with the puppies). Generally about 8 to 10 hours following the surgery is a magical number and all puppies will be completely recovered.
When the dam finally returns home, it is not a good idea to put her with the puppies right away. She could still be slightly groggy, so she should be kept apart from the pups, until she gets her wits about her. A good rule of thumb is, if she appears unsteady, don't trust her alone for even a second. When the dam isn't sure of what she is doing, an accident can easily happen, resulting in a crushed or flattened puppy. It is best at this time to do supervised nursing, by keeping the pups in a separate box and allowing them to nurse only when someone is present. Some mothers, especially first time ones, can be so out of it, they don't want the pups anywhere near them. It may take time for the maternal instincts to take over. Some bitches never get with the program, deciding mother-hood is not for them. Luckily with most, it does finally register and they go onto make just as good mothers as bitches who delivered naturally. It simply takes time, patience and a watchful eye.
There is absolutely no substitute for natural nursing or for that matter, mother's milk. The first 24 to 36 hours are extremely important for colostrum, but if the pups aren't nursing or the mother refuses to let them nurse, it is time to step in with supplemental feeding. The alternative can be starved or dehydrated puppies. The key is knowing when to intervene.
One phenomenon following a Caesarean is around the second or third day, the mother's milk disappears, even though she may have been loaded the day prior to the section. The first sign is puppies tugging and pulling at a nipple, crying in frustration. Fortunately, this phenomenon seems to only last a day or so, and then the milk magically reappears. Supplemental feedings may be called for until that time.
There are several methods of feeding available. Personally I am not a fan of bottle feeding or feeding with eyedroppers. For me, tube feeding is the only way to go, as it can be done quickly and safely if you know the procedure and are aware of the pitfalls. If you don't know how to do it, have someone teach you before an emergency situation arises. It is guaranteed, that if you breed enough litters, sooner or later you will need to do supplemental feeding. Sometimes it can be the difference between puppies living or dying.
There are many good commercial milk replacers
on the market, and several "tried and true" homemade
formulas. I have used both. In a pinch I have used Esbilac with
good results and I have also used my own favorite homemade formula.
Another potential problem following a C-section is "elimination" since puppies cannot go to the bathroom on their own. There is no substitute for the dam's ability when it comes to elimination. Urinating is easy, but most breeders discover getting a stool out of a pup is tricky at best. How many of us have stroked puppies in frustration, with no results? It is especially important that the wax-like plug (that puppies are born with) is removed in its entirety as soon as possible. Some C-section dam's natural instincts to perform this act are slow following a C-section. Generally once the anesthetic wears off, they get the hang of it! If they refuse, you will have to do it, since elimination is as important as eating. Warm water on cotton balls, used in a sweeping motion, will usually do the trick. A rule of thumb is 1 stool per 4 urinations.
Once the puppies and bitch recover from the anesthetic, the entire experience should be similar to a natural born litter, with a couple of exceptions. It is necessary to check the mother's incision and stitches frequently, making sure everything is clean and the sutures are holding. In a rare occurrence, the act of the puppies nursing can reopen the incision. Fortunately this does not happen often, as the incision is in a natural fold thanks to the breasts being loaded with milk (hopefully). Check the stitches every couple of days for any discharge or abnormal swelling. Stitches are removed in 12-14 days. Usually the Veterinarian will prescribe an antibiotic for several days following the surgery. It is very important that these instructions be followed, due to the possibility of infection in the bitch. A serious infection could forever ruin her breeding days or worse yet, kill her or the puppies. When in doubt, check with your Veterinarian. In true times of need, he can be your best friend and experience has taught that it does not pay to be "penny wise and pound foolish."
Monitor the bitch's temperature for a few days following the surgery. Anything higher than 103 degrees could mean a potential problem.
Personally from experience, I am not a fan of spaying a bitch during a C-section. If the Vet honestly feels the dam's life is at risk, this leaves no alternative. However, I feel it is too risky to spay the bitch at that time. It can be too much for the bitch's already overly tired system. I would rather put the bitch through this surgery at a later date when her system is fully recovered and I speak from experience on this. I have personally lost a bitch from this set of circumstances and also know others that have had a similar ending. It's no fun .
If everything goes well, in two to three
days you will totally forget that the bitch had a Caesarean. It
is not something to be desired due to possible risks or complications
in the bitch, but overall the puppies shouldn't suffer any ill
effects. Sometimes the worst part is that you miss out on the
fun of whelping.
The best advice for all litters, whether they are C-Section or natural, is to realize that each one is different; just as all dams are different. Do not become trapped by preconceived notions or tricked into thinking that "all my bitches do such and such." What all your bitches have done in the past does not mean a thing with the present litter. In some cases even bitches that have had multiple litters will do something different with each litter. Just because Aunt Nellie or Mother Em did something a certain way, doesn't mean much either. Each litter is a unique experience and should be treated as such.
Some excellent rules of thumb are:
1. Everything can and will go wrong.
2. Always expect the unexpected.
3. Never under any conditions become complacent.
4. Do not cut corners.
*A bit of useless trivia, if anyone has ever wondered where the word Caesarean came from - it is supposedly named after Julius Caesar, as legend has it, that is how he was born.