For information on the normal course of management and whelping in dogs, you can refer to the article already published on this subject: "How does reproduction occur in dogs?". In most cases, whelping occurs naturally without requiring human intervention. However, certain circumstances lead to the decision to intervene surgically, both in the interest of the mother and the puppies.
-Scheduled Caesarean:
In some breeds, a Caesarean is planned by default. This is particularly the case for brachycephalic dog breeds, selected for their large head and small body (for example, the English or French Bulldog). The puppies then have a skull too large to pass through their mother's pelvis, making a Caesarean unavoidable. This is called "foeto-maternal disproportion." Other breeds are also predisposed to difficult births, such as the Chihuahua or Yorkshire Terrier.
But small brachycephalics are not the only ones too large to be expelled naturally: this is also the case for single foetuses. When the dog is expecting only one puppy, it tends to grow more than if surrounded by siblings, and a Caesarean is often necessary.
Too large litters can also lead to a scheduled Caesarean, as whelping can last a long time and exhaust the mother.
Finally, the individual conformation of some females predisposes them to have difficulties giving birth, for example, because their pelvis is narrow. For dogs who have already given birth by Caesarean, (and sometimes several times, as in the case of breeding dogs), the Caesarean can be planned in advance.
The optimal timing for the Caesarean is determined from the day of ovulation and progesterone levels in the blood. The operation takes place before the onset of contractions. A scheduled Caesarean would not affect subsequent fertility.*
-Emergency Caesarean
In other cases, the vet decides to perform an emergency Caesarean because the whelping is not going as planned (this is called "dystocia"). Certain signs should prompt you to consult your veterinarian as quickly as possible, such as the presence of purulent or hemorrhagic vulvar discharge, an abnormally long gestation (more than 72 days), unsuccessful pushing efforts by the dog for more than 30 minutes, or when more than 4 hours pass between the expulsion of two foetuses. The vet may use additional tests to try to find the cause of the dystocia (X-ray, ultrasound…). The issues are related either to the mother or the puppies. In some cases, medical treatment is possible; in others, surgical intervention is required.
Mother-related dystocias are often due to the fact that the uterus does not contract (uterine inertia). Medical treatment can be attempted, but if it fails, a Caesarean is necessary. Traumas such as pelvic fractures or uterine tears are also surgical indications. Sometimes, the vet may decide that the dog is too tired or too ill to undergo whelping, which demands a lot of energy.
Unfortunately, it also happens that one or more foetuses are not doing well (this is indicated by an increase in its heart rate). It then needs to be extracted very quickly. Finally, in some cases, a deceased foetus can decompose in the uterus and endanger the mother's health. In case of significant infection, removal of the uterus is sometimes required during the Caesarean.
The emergency Caesarean takes place during whelping, once labor has already begun. It is understandable that the risks involved are not the same as during a scheduled Caesarean, after a normal pregnancy with a healthy dog and foetuses (the survival rate is then similar to that of natural whelping).
In any case, it is a surgical operation, which should never be taken lightly. It is important to consider and be aware of the risks before deciding to breed your dog, especially in brachycephalic breeds. In the interest of the dog, it is important that breeders also select bitches capable of giving birth easily.
In the absence of complications, the Caesarean is a fairly quick operation. The veterinarian establishes a tailored anesthesia protocol that both calms the dog and manages the pain associated with the operation, all without compromising the health of the puppies. Like in humans, this may involve an epidural anesthesia.
This operation requires taking care of both the mother and sometimes a considerable litter of puppies. Organization is crucial, and everything is prepared in advance.
The puppies are quickly delivered and, while the veterinarian sutures the wounds and attends to the mother, an assistant must take care of the puppies. Depending on the available personnel and the size of the veterinary clinic, the owner may be asked to assist with this task. Breeders, in particular, are often used to participating in the nursing of puppies. Generally, the mother recovers quickly, allowing her to nurse and care for her puppies without delay.
After freeing the puppies from their fetal membranes, they must first be helped to breathe by clearing the secretions that block their nose and mouth. To do this, a baby nasal aspirator or simply a small moistened gauze can be used.
Next, the puppies are vigorously rubbed with a warm towel. This operation aims to both dry them so they don't get cold (thus replacing the mother's tongue) and to stimulate them to speed up the onset of breathing. As in humans, the first cry is eagerly awaited, as it signals the inflation of the lungs and confirms that the newborn has taken its first breath. In case of difficulty, some medications administered under the tongue can help the puppy start breathing.
All this must be done immediately, and for all puppies simultaneously. Therefore, several people are often necessary in the case of a large litter.
The foetuses are carefully examined and any congenital anomalies are sought (cleft palate, imperforate anus).
Care is occasionally provided at the level of the umbilical cord, and the puppies are kept warm (for example, in an incubator) while waiting for their mother to fully awaken. As soon as she comes out of the operating room, the puppies are placed with her and have access to nursing. Caesarean may sometimes impair milk production, but this temporary issue does not last beyond 24 hours. A milk replacer can be used; follow your veterinarian's advice. In most cases, the maternal instinct is retained, and the mother quickly takes spontaneous care of her litter.
Pauline Denoeux
*LEVY X., MIMOUNI P., Caesareans in dogs can be scheduled, La Dépêche vétérinaire n°1072 from March 27 to April 2, 2010,
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