When is a Dog Cesarean Section Needed?

As we state above, there are various reasons why a dog may need a cesarean section. One of the most important is due to complications with labor. Complications in labor are those which threaten the health of either the mother or puppies, something which can take many forms. Some of the most common complications include:

• Dystocia: this is more commonly known as obstructed labor, whereby a puppy is unable to travel down the birth canal. It is often due to the positioning of the fetus, but an intestinal obstruction could cause the same problem.
• Uterine rupture: a tear or even a swelling can lead to an inability to proceed with a vaginal birth and necessitate a dog cesarean section. This is something which can happen in larger litters. Also, primiparous (first time pregnancy) older bitches are more likely to suffer complications in labor^[1].
• Underlying condition: if the dog has an underlying condition such as obesity or thyroid dysfunction^[2], then it can increase the risk during canine pregnancy.
• Infection: if the dog is ill during labor, this can increase the likelihood of needing a dog cesarean section. An infection, whether viral, bacterial or fungal can seriously damage the health of mother and puppies. Signs of infection include the presence of blood, mucus or other discharge in during labor.

There are also different risks which might make the chances of cesarean section in dogs more likely to be needed. A major one is the breed of dog. Brachycephalic dog breeds are more likely to have complications, in part due to the strain on their heart and respiratory system. Another issue is the size and shape of the dog's pelvis.

Due to certain breeding practices, there are dog breeds which have essential deformations which prevent vaginal birth. While the Scottish Terrier is not brachycephalic, it is the most likely to develop dystocia during labor. This is due to a dorso-ventrally flattened pelvic canal, although uterine inertia is also prevalent in the breed^[3]. The breeds most likely to require a dog cesarean section are:

• Boston Terrier
• Bulldog
• French Bulldog
• Mastiff
• Scottish Terrier
• Miniature Bull Terrier
• German Wirehaired Pointer
• Clumber Spaniel
• Pekingese
• Dandie Dinmont Terrier

In many of these breeds, the dog will have a cesarean section schedule before the end of their pregnancy. For example, over 80% of all French Bulldogs give birth by cesarean section^[4]. Of course, it is almost impossible to tell with mixed breed dogs if they have a genetic predisposition toward needing a c-section.

If your dog is a breed predisposed to cesarean section, it is something your veterinarian should discuss with you when you take them for their checkup. This is something you need to do when you discover they are pregnant and them you can find out how many checkups you will need during the pregnancy. They will be able to confirm a pregnancy and, after a certain time, can even count the litter size.

Ideally, a dog will be taken to a veterinary clinic to give birth. However, in many cases, this is not possible. The amount of money this costs may also be prohibitive. If a veterinarian decides that a cesarean section is required, it is because they have seen certain signs. When a veterinarian is not present, we need to look out ourselves for any signs a dog needs a cesarean section. These are:

• First stage of labor lasts more than 12 hours: when a dog is ready to give birth, they will prepare themselves. They may become restless, stop eating and look for a safe space to nest and give birth. She may also vomit and/or constantly lick her genital area. However, if this began over 12 hours without starting labor, it is a sign of a problem.
• They are past their due date: if the dog is long past their due date, which should be around 60 to 63 days after inception, they may require a c-section.
• Abnormal discharge: brown or red vaginal discharge suggests there is blood present, something which should not happen before the dog gives birth. Greenish or yellowish discharge may be signs of an infection, but it is important you know the difference between normal and abnormal discharge. Amniotic fluid, fecal matter and other material is quite normal.
• Only one puppy: while it is possible to have a singleton birth (i.e. only on puppy in a litter), it is relatively rare. If the veterinary scan has already revealed there should be more puppies to come, but the second birth has not come after 60 minutes, then a cesarean section may be required.
• Labor is too difficult: if the labor is prolonged, the contractions are very strong and the dog is in obvious pain, then this is a sign there may be something wrong. You should take the dog to a veterinarian to determine whether they will need a c-section.

If you see any of the above signs or are in any way worried your dog will need a cesarean section, you should take the dog to a veterinarian immediately.

When you know your dog needs a c-section, you will need to know what to expect during the surgery. The reason for a cesarean section will have a bearing on how it is carried out. If the dog has a scheduled c-section, the dog will be able to come into the clinic in a calm manner and everything should be prepared for them. If the dog requires an emergency c-section, then timing is even more important. The dog may already be in danger, so getting them out of danger as fast as possible is vital.

The veterinarian will need to administer an anaesthetic to save the dog from pain. This needs to be carefully considered as the drugs will enter the placenta and, therefore, the unborn fetuses. The most common anaesthetic is a mixture of diazepam and propofol. A local anaesthetic may also be used for the incision site. The dog's vital signs should be monitored so they can ensure nothing goes wrong.

An incision will be made in the dog's abdomen above the uterus. This incision needs to be large enough for the puppies to be pulled through without tearing the tissue. There should be two teams at a cesarean section, one to work on the mother and the other to take care of the puppies as they are birthed. The puppies will be brought out in an amniotic sac which needs to be broken open for them to breathe. Any placenta which did not make it out when taking the puppies will need to be removed before the incision can be stitched up. If not, it could lead to metritis.

Getting the right about of anaesthetic is also important as the mother needs to be revived and be able to take care of the puppies immediately. This will not be the case if the mother has certain infections as they can pass them on to their offspring. The puppies may need to be administered certain drugs to combat the reason for the cesarean, but this will be on a case by case basis.

If the owners do not want any more pregnancies or there is a medical reason for it, the veterinarian will also likely carry out an ovariohysterectomy (i.e. spaying). This will also help keep them safe as any birthing material left after a cesarean can cause serious problems.

Usually a cesarean section lasts about 45 minutes, regardless if it has been scheduled or it is an emergency. The wound after a c-section is something which needs very specific care. The mother will require two days of observation in the clinic before she can be taken home. This will be to monitor for any complications or problems which may arise. When the mother is emerging from her anaesthetic it is also important we monitor them in case she rolls over a crushes the puppies.

Even while at home, the c-section scar will need to be monitored to ensure it does not rupture. It will need to be cleaned regularly with a little iodine or similar disinfectant, before being dried with gauze. The puppies will likely accidentally interact with the scar while they are searching for a teat to feed, so be extra careful during feeding.

In some instances, it may be necessary to attach an Elizabethan collar to prevent the mother from licking or irritating her stitches. You may need to remove it at certain times for feeding, but ask your veterinarian for their advice.

After their cesarean section, a dog should be feeding after only a few hours. They will need to eat to get their strength back, but they also need to take it slow. If they eat too fast, their system may not be able to take it. For this reason, they should be fed i small portions every half hour or so for the first 24 hours after surgery. They should eat about one and a half times their normal diet.

Eating more than usual is important to get enough strength to produce milk for their puppies. After about a month, the dog's food should be about 2 or 3 times greater than her usual amount. Most dogs will be able to self-regulate what they eat, but make sure it is available to them. Also ensure the dog is provided with high quality commercial feed. While we may have previously fed them alternate diets, such as the BARF diet, they are not recommended for a mother feeding her puppies.

We also need to ensure the dog is not given anything which hasn't been approved by the veterinarian. This includes medication or any natural remedies you may think to give them. Antibiotics are not usually administered after a dog c-section unless there is some specific reason for it. If the dog needs any specific treatment, the veterinarian will provide the information you need.

Since the mother will need some time to recover after her cesarean section surgery, the puppies will need to be fed by caretakers. During the 2 day observation, the puppies will be fed specific puppy formula. Artificial colostrum will be administered first to provide the dogs with antibodies and a dose of strength to help them through their vital first days. Your veterinarian should provide formula, but artificial formula can be made in emergencies.

The veterinarian will need to assess whether the mother is fit to breastfeed. Ideally, this should be the case, but it may be that rambunctious pups are too much of a threat to her abdominal scar. If this is the case, then you will need to continue feeding the puppies yourself. In most cases, the mother will be able to breastfeed.

If the mother is not very alert when you come home from the clinic, you may need to help the puppies by placing them closer to the teat. Once the mother dog has recovered, she should be able to continue looking after the puppies just as she would after a vaginal birth. This will involve the weaning and socialization periods necessary for the dog's to survive as healthy adults.

Aftercare for a cesarean section in dogs will be similar to looking after any newborn puppies and their mother. This means they need to be kept warm, hygienic and monitored for any changes to their health. Practical consideration of the cesarean scar is one of the specific things to look out for.

If for any reason the mother does not feed her puppies, you can take a look a our article on how to feed them yourself. It is normal for a dog to have bloody discharge after a cesarean section surgery. However, if it lasts for longer than week or if it starts to smell particularly bad, then you will need to take them to the vet. It is possible there has been an infection or some other complication.

Now you know when a dog cesarean section is needed, you can take a look at our puppy care guide for further information:

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