Your Trusted Expert in Safe, Successful C-Sections

C-Section Expertise

Delivering Safe, Healthy Births

We have come a long way in our performance of cesarean sections. It used to be understood that the decision to move forward with a c-section was when the mother was not expected to survive and it was an emergency effort to save the fetuses. Now we routinely plan c-sections and fully expect the mother and puppies to all survive and thrive. Many consider a c-section a superior choice to natural whelping. Certainly every bitch does not need to have a c-section. As with anything else in medicine, each case should be considered individually.

Know When to Seek Help

Emergency C-Sections

Allowing a bitch to whelp naturally is usually a responsible, appropriate choice (in many cases). If you have elected to allow your bitch to whelp naturally, you should identify a reliable emergency veterinary clinic within a short distance from your house and contact them a couple days ahead of time to confirm that they will have overnight veterinary coverage on the small chance that you will need to come in for an emergency c-section.

Dr. Christensen cleans a newborn pup.

Dr. Christensen monitors a puppy’s heart rate.

A puppy is shown after a successful c-section.

You should attend the whelping and watch for signs of dystocia (difficult birth). If any of the following occur, you should seek veterinary assistance, which might mean an emergency c-section:

Whelping does not start withing 24 hours after a documented drop in rectal temperature

Whelping is does not start within 12 hours of a documented “reverse” progesterone drop

Time after the first abdominal contractions is >30 minutes without visible progression into the birth of puppies

More than 15 minutes of abdominal contractions are noted without visible progression of a puppy being born

Resting without contractions between puppies for more than 2 hours

Entire duration of whelping is >24 hours, regardless of litter size

Clear manifestation of pain during whelping

Profuse vaginal bleeding

Signs of shock (not aware of what is going on, not paying attention to the process)

Minutes do matter in an emergency. Consider the time frames given above and don’t allow too much time to pass before seeking help. Waiting too long will make losing puppies likely. Eventually, waiting too long will also put the bitch in danger.

Safe Deliveries for moms and their pups

Planned C-Sections

Natural whelping usually has a very low rate of complications. Some situations, however, raise the risks high enough that scheduling a planned c-section makes sense.

The following are situations that should cause you to seriously consider a planned c-section:

Very large litter

What is considered a large litter varies by the breed and size of the bitch. The larger the litter, statistically the more likely that one or more puppies will have a problem during whelping. Large litters also make the possibility of secondary uterine inertia rise. This is the situation where the bitch just gets too tired to proceed. Her muscles are exhausted and she can’t push anymore. Typically what happens in this situation is that the bitch will have some of the puppies without problems, but then stops giving birth while some are still in her uterus. Hours pass with no further contractions. Eventually she might start pushing again, once she has recovered energy enough, but then the next puppies are stillborn. When a bitch has a very large litter for her size or breed, we often discuss the option of a planned c-section.

History of stillborn puppies in the past

This may indicate that this particular bitch is prone to secondary uterine inertia (as described above) or premature placental separation. A planned c-section will avoid these problems.

Very small litter (1 or 2 puppies)

Two possible problems can arise with singletons or twins. The first is that the fetus(es), in the absence of competition, may grow too large to be born naturally. The second problem is that there are not enough fetuses to trigger the bitch to go into labor. She stays pregnant beyond her due dates and then the placentas detach without whelping, resulting in the puppies dying in utero and needing to be removed via c-section.

Brachycephalic breeds like French Bulldogs, English Bulldogs, and Pugs (among others)

These breeds have a much higher incidence of difficulty in natural whelping due to their altered anatomy with large heads and shoulders of the fetuses along with the smaller pelvis of the bitch. While some individuals in these breeds have been known to whelp naturally, the incidence of dystocia is so high in these breeds that we always recommend planned c-sections.

Planned C-Sections at Kokopelli Veterinary Center

All About Our Approach

The timing, the technique, and careful attention to detail are critical to achieve consistent success. We are proud to have a long track record of successful c-sections. While certainly anything can happen, we do not expect to lose any puppies, and certainly not the bitch, when performing a planned c-section.

In order to ensure the highest likelihood of sending everyone home healthy and happy, we do the following:

Choose the right day for the surgery

Take the fetuses out too early and the puppies will be too premature to survive. Plan to wait too long and the bitch may either go into labor on her own and have a dystocia at home, or the placentas may separate without stimulating whelping and the puppies die in the uterus. We use a combination of progesterone and LH assays, along with ultrasound evaluation of the fetuses, to determine when the end of gestation is reached and the fetuses are fully mature and ready to be born.

Use the right anesthetic protocol for the patients

We are not just treating the bitch. Everything we give to her will pass to the fetuses and affect them. Choosing the appropriate drugs to relax the mother and treat her pain without depressing the breathing and heart rates of the newborns is critical to neonatal survival.

Practice appropriate surgical techniques

In many circumstances, we are performing a c-section on a bitch who will be having additional litters in the future. Whether those future litters are destined for natural whelping or another planned c-section, leaving the uterus and abdomen in the best possible shape is critical. Knowing exactly where and how to cut, and how to best suture the tissue, is critical to proper healing and future function of the reproductive tract.

Have the right equipment and staff to wake up the puppies

Warmth, stimulation, and oxygen are all critical. Staff should be well trained in how to handle the neonates. Not too rough. Not too gentle. Know when to switch out a cooling towel for a warm one. Suction out fluid from the airways. Use supplemental oxygen when needed. Apply acupuncture to stimulate first breaths. Tie off and disinfect the umbilical cord. Monitor the incubator to make sure the temperature and humidity stay appropriate. It’s a lot to keep track of and requires experience and good supervision. But done appropriately, you should not lose puppies.

Perform an exam on each puppy

We also assign an APGAR score to each pup to give the clients an idea of which puppies may need extra attention. Provide a way, if needed, for the clients to differentiate puppies (colored collars).

Monitor nursing of each puppy before they go home

We will make sure they are able to nurse and get their first meal (and colostrum) before leaving.

Know what to do if the bitch is not producing milk

Provide hyperimmunized serum to administer to the neonates to prevent future infections. Teach the clients how to safely tube feed the puppies at home. Administer and send home medications to stimulate milk production so that supplemental feeding is not long-term.

Set the family up for success

Make sure that the family has all that they need for success at home by way of supplies, skills, and a plan for success. Double-check the heating source and plan to weigh puppies twice daily.

Follow up the next day

We will reach out to make sure that everything is going well and everyone is thriving.

Dew claw removal & tail docking (if needed)

When appropriate, remove dew claws and/or dock tails when pups are 2-4 days old.

Performing c-sections is one of our most favorite things to do at Kokopelli Veterinary Center. The miracle of life is real. Sometimes it just needs a little help.

A Closer Look at Our Proven Technique

Inside a C-Section at Kokopelli

Curious about how we perform c-sections at Kokopelli Veterinary Center? Watch this video to see our skilled team in action, expertly managing every detail to ensure the best possible care for both mother and puppies. We’re dedicated to providing a safe, compassionate, and supportive environment throughout the procedure.

Ensure a Smooth Delivery with Kokopelli Veterinary Center

Looking for top-notch care for your dog’s c-section? Contact us to see how our expertise and careful planning can provide a successful delivery for both mother and puppies.

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