How is a caesarean section performed on a female dog?

For information on the normal course of management and parturition in the female dog, you can refer to the article already published on this subject: “How does reproduction occur in the female dog”. In the majority of the cases the birth takes place in a natural way, without the need for human intervention. However, certain circumstances lead to the decision to intervene surgically, both in the interest of the mother and in the interest of the puppies.

When is a decision made to perform a caesarean section?

There are two scenarios. Either the Caesarean section has been scheduled in advance, because it is known that the female dog will not be able to give birth alone, or the Caesarean section is decided on an emergency basis following the discovery of an abnormality.

-The programmed caesarean section :

In certain breeds, a caesarean section is automatically scheduled. This is particularly the case for breeds of brachycephalic dogs, selected for their large head and small body (for example the English or French bulldog). The puppies then have a skull that is too large to pass their mother’s pelvis, which makes Caesarean section unavoidable. This is known as the “fetal-maternal disproportion”. Other breeds are also predisposed to difficult births, such as Chihuahuas and Yorkshire Terriers.

But it’s not only the small brachycephalic animals that are too big to be expelled naturally: this is also the case with single fetuses. When the female dog is expecting only one pup, the pup tends to grow larger than if it were surrounded by siblings, and a caesarean section is often necessary.

Large litters may also require a scheduled C-section, as the birth can be very long and exhausting for the mother.

Finally, the individual conformation of some females predisposes them to have difficulty giving birth, for example because their pelvis is narrow. For female dogs that have already given birth by caesarean section, (and sometimes several times as is the case for breeding bitches), caesarean section can be planned in advance.

The optimal time for Caesarean section is determined from the day of ovulation and progesterone measurements in the blood. The operation takes place before the onset of contractions. A scheduled Caesarean section would not affect subsequent fertility.*

-Emergency Caesarean section

In other cases, the veterinarian decides to perform an emergency caesarean section because the birth does not go as planned (this is called a “dystocia”). Certain signs should prompt you to consult your veterinarian as soon as possible, such as the presence of purulent or hemorrhagic vulvar discharge, an abnormally long gestation (more than 72 days), unsuccessful expulsion efforts on the part of the female dog for more than 30 minutes, or when more than 4 hours elapse between the expulsion of two fetuses. The veterinarian may have recourse to complementary examinations to try to find the cause of the dystocia (radiography, ultrasound…). The problems are related either to the mother or to the puppies. In some cases a medical treatment is possible, in other cases surgery is required.

1) Problems related to the mother

Maternally related dystocia is often due to the fact that the uterus does not contract (uterine inertia). Medical treatment may be attempted, but if it fails, Caesarean section will be necessary. Trauma such as pelvic fractures or tears in the uterus are also indications for surgery. Sometimes, the veterinarian may feel that the female dog is too tired or too ill to be able to bear a birth, which requires a lot of energy.

2) Problems related to puppies

Unfortunately, it also happens that one or more fetuses may not be well (an increase in heart rate). In this case, it must be removed very quickly. Finally, in some cases a dead fetus can decompose in the uterus and endanger the mother’s health. In the case of a serious infection, the uterus may have to be removed during a caesarean section.

Emergency Caesarean section takes place during parturition, when labor has already begun. It is easy to understand that the risks involved are not the same as for a scheduled C-section, at the end of a normal gestation period on a female dog and healthy fetuses (the survival rate is then similar to that of a natural parturition).

In any case, it is a surgical operation, which is never an act to be taken lightly. You must think about it and be aware of the risks before deciding to put your female dog to reproduction, especially in brachycephalic breeds. In the interest of the dog, it is important that breeders also select female dogs that are capable of giving birth easily.

Caesarean section operation

In the absence of complications, a Caesarean section is a fairly quick operation. The veterinarian sets up an adapted anesthesia protocol that allows both to tranquilize the female dog and to manage the pain related to the operation, all without compromising the health of the puppies. As in humans, this can be done through an epidural anesthesia.

This operation requires taking care of both the mother and a sometimes large litter of puppies. It is therefore necessary to be very organized, everything is prepared in advance.

Very quickly the puppies are out and, while the veterinarian stitches the wounds and takes care of the mother, an assistant has to look after the puppies. Depending on the staff available and the size of the veterinary clinic, the owner may be called upon for this task. Breeders, in particular, are often involved in the nursing of puppies. Usually the mother wakes up quickly, so she can nurse and care for her puppies without delay.

The care of the puppies

After removing the puppies from their fetal envelopes, the first step is to help them breathe, by clearing the secretions that clog their nose and mouth. To do this, you can use a baby fly or simply a small moistened compress.

Then the little ones are rubbed vigorously with a hot towel. This operation aims at the same time to dry them so that they do not get cold (the mother’s tongue is replaced), and at the same time to stimulate them in order to accelerate the breathing process. As in humans, the first cry is watched carefully, as it is a sign of the lungs opening and attests that the newborn has taken its first breath. In case of difficulty, certain medications, administered under the tongue, can help the puppy to start breathing.

All this must be done immediately, and on all puppies simultaneously. Several people are therefore often necessary in case of a large litter.

The fetuses are carefully examined and any congenital abnormality is looked for (cleft palate, non-perforation of the anus).

Care may be given to the umbilical cord, and the babies are kept warm (e.g. in an incubator) until the mother wakes up completely. As soon as she leaves the block, the babies are placed with her and have access to the udder. Caesarean section can sometimes interfere with milk production, but this temporary problem does not last more than 24 hours. A replacement milk can be used; follow the advice of your veterinarian. In most cases the maternal instinct is preserved, and very quickly the mother spontaneously takes care of her litter.