Caesarian/cesárea

Uterus of a pregnant bitch, caesarean

A 3 y.o. pug had been whelping for 12 hours, without successfully producing any puppy, and now she was showing signs of tiredness. Although she had a previous litter of 6 without any of the issues she was having this time, her owner wanted some phone advice as to what she could do at home. Because Matilda was still pushing, I advised her owner to keep her in a quiet place, not to stress her to prevent any dystocia, and close monitoring if there was any progress. In case no puppy were produces in half hour, my best advice was to bring her down to our hospital (read more)

We received a second called about 20 minutes later, as there was some green discharge and now she was also bleeding through her vulva. At this stage I did recommend to bring her to us asap.

On a clinical examination, I noticed her temperature was slightly low, and in effect there was some blood dripping from her vulva along with some green discharge and placenta tissue protruding. On a vaginal palpation with vaseline I realized that her pelvis were not dilated enough to allow the foetus passing out.

I pointed out that medical treatment was unlikely to work in Matilda’s case (uterine stimulation with calcium and oxytocin), and my best advice was caesarean for two reasons: it was cruel leaving her in agony knowing it was very unlikely she would naturally whelp successfully, and there was some internal bleeding either from the foetus or Matilda’s womb, that can potentially be life-threatening.

The bitch had had a scanning in which 4 puppies were seen, though scanning is not a reliable technique to count puppies, and a radiography would give more accurate figure. However, the smaller the litter, the bigger each puppy is likely to be, and that can be an issue when labouring starts.

She was left into the oxygen case, while the operation room was set up for a caesarean. Most of the drugs needed to perform the surgery are not licensed for this condition, and risks are unknown.

Once in the theatre room, I could rule out any uterine rupture, or abdominal bleeding. However, the blood was coming from one of the puppies. None of the two puppies were in a position to come out, and the one who had been bleeding, was not breathing for well over 15 minutes.

In any case, there were much less puppies than those expected, based on the scanning performed during her pregnancy.

She was not producing too much milk, and her owner would bottle milk them at home. After whelping or caesarean, some vaginal discharge was expected some days.