Risk factors for dystocia include gestation longer than 68 days, past history of needing a C-section and breed (Bull dog or other brachycephalic breed).

Early intervention with medical treatment or C-section will help to increase the survival of the puppies.

What is it?

• Dystocia means difficulty giving birth
• Signs of a normal delivery (parturition) include
  • Mammary gland enlargement (turgidity) and milk secretion - 1 to 2 weeks prior to delivery
  • Restlessness, seeking seclusion, anorexia, nesting - 12 to 24 hours prior to delivery
  • Rectal temp decreases to less than 99F - 8 to 24 hours prior to delivery
• Risk factors for dystocia
  • Gestation longer than 68 days
  • Past history of needing a C-section
  • Bull dog or other brachycephalic breed

Anatomy

• Uterus
• Ovaries
• Cervix
• Vagina

Clinical signs

• Typical patients having dystocia include
  • Any brachycephalic breed (stub nosed breeds) - such as bull dogs, pugs, boston terriers
  • first litter of puppies
  • cats infrequently have dystocia
• Strong abdominal contractions for greater than 30 minutes with no delivery of puppy
• Weak straining for greater than two hours with no delivery of puppy
• Greater than four hours between delivery of puppies
• Prolonged gestation greater than 68 days
• Retained pup at the vulva
• Lochia (green/black discharge from vulva) present for 3 hour with no delivery of puppy
• Copious clear discharge
• Bloody discharge

Diagnosis

• The diagnosis is generally based on clinical signs, however some testing is usually also done
• Complete blood count
• Calcium blood level
• Potassium blood level
• Glucose blood levels
• X-rays to check size of puppies and number of puppies

Treatment

• Medical treatment of dystocia
  • Oxytosin - stimulates uterine contraction
  • Calcium injection
  • Dextrose injection - likely to effective
  • Intravenous fluid therapy
• C-section
  • The patient is shaved prior to anesthesia
  • Anesthesia is induced with safe anesthetics to both the mother and her unborn puppies
  • A midline incision is made to expose the uterus
  • The puppies are removed from the uterus
  • The uterus, abdominal wall and skin are sutured
  • The sutures on the skin are all internal so that the puppies are not irritated by the knots

Home Care

• Bitch
  • Check incision for signs of infection which includes: redness, swelling, pain, discharge
  • Limit exercise for 3 weeks
  • Administer antibiotics if prescribed (usually none needed)
• Puppies
  • Keep in warm environment
  • Ensure nursing
  • Supplemental feeding if mother is not nursing
  • Swab perineum to stimulate urination and bowel movements

Potential Complications

• Anesthetic death of mother or puppies
• Still born pups - due to prolonged dystocia prior to treatment
• Subinvolution of the uterus - evidenced by bloody vulvar discharge for weeks after surgery
• Profound bleeding of the uterus

Prognosis

• Early treatment gives the best chance for high survival rate of puppies
• Mother typically has a good prognosis unless she is experiencing toxemia

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