VETERINARY VOICE — C SECTIONS: WHEN, WHY AND HOW

DR. MARTY GREER, DVM, JD

Welcome to the debut of this exciting monthly feature here at PureDogTalk. Dr. Greer offers outstanding information on a variety of topics. She is a licensed veterinarian and attorney who specializes in reproductive issues at her clinic in Wisconsin.

PureDogTalk listeners are fortunate to have a front row seat for Dr. Greer’s knowledge, experience and compassion, now on a monthly basis.

CEASARIAN SECTIONS

We’re talking today about Ceasarian sections…. the when, why and how of a difficult and emotionally fraught, potentially emergency whelping situation.

“These are scary, tough decisions,” Greer said. “Breeders and veterinarians are often both conflicted.” We’ve provided a graphic in the show notes with excellent information on protocols and a decision making checklist.

Greer discusses the differences between working with your regular veterinarian and an emergency or referral clinic which may not be as familiar with you and your pet.

“It’s the middle of the night, you’re sleep deprived, your dog and puppies are in trouble,” Greer observed. “You don’t always get the response from (an emergency clinic) to promptly intervene.”

PROGESTERONE TIMING FOR PREVENTION

The best cure is prevention, Greer said. Plan ahead and be prepared. Her best suggestion is to do progesterone timing at the outset of the breeding. This timing will give breeders the best information as to exactly when a litter is due and take away a great deal of heart ache and hand wringing on the topic of whether a C section is required.

“Try to be prepared. Do progesterone timing,” Greer noted, “do a pregnancy confirmation ultrasound, do a puppy count xray. Have your whelping supplies together. Put gas in your car!”

Progesterone timing, while perhaps not necessary to get a bitch bred with a natural breeding, allows breeders to be organized and well prepared, according to Greer. If a bitch is bred every other day for a week, the breeder has NO idea when she ovulated. “And, you have no way to gauge if/when she might need a Csection,” Greer added.

Breeder can do reverse progesterone at the end of the pregnancy if needed, but Greer noted this becomes much more costly than simply pulling blood for progesterone at the beginning.

“Losing a litter is very expensive. It’s very emotional for everyone,” Greer said.

She also spends time talking about how and why to build a relationship with your veterinarian. Most particularly breeders are recommended to treat the veterinary practitioner well, bring goodies for the staff, establish mutual respect. It isn’t always easy to find a clinic willing to work with a breeder. Greer recommends taking good care of those folks!

Breeders can also mentor veterinary students in their homes. “Take (baby veterinarians) to events. Invite them to join you on whelp watch,” Greer said. “Its a great way to build a bridge. The more we can do to mentor, help them understand, the better off we are.”

Greer also encourages breeders to play fair with their vet clinic. “Pay for a consultation, sit down with the veterinarian, let them know ‘this is what I do, this is what I need.’ They will know you are sincere. You need to have face to face conversation. “

While we’ll have a checklist from Greer here on the show notes, some specific details from Greer for evaluating a bitch at home as to whether a situation constitutes an emergency.

GREEN MEANS GO!

Her primary commentary is “green means go.” If a breeder sees green vaginal discharge **prior to the delivery of the first puppy** it means the bitch has placental separation and at least one, if not more puppies, are in danger from a lack of oxygen.

A final note from Greer, is that 75 percent of C sections are due to a problem with the bitch i.e. breed specific issues, uterine inertia, the number of puppies and more. The remaining 25 percent of issues are caused by a puppy coming the wrong way, a log jam in delivery and ore in that vein.

Listen today for more absolutely critical, life saving information from an experienced practitioner.

EMERGENCY C SECTIONS QUESTIONS

Questions for evaluation of the bitch at home or at the hospital indicating the probable need for an Emergency C-Section:

1. Has the bitch been in hard labor (abdominal pushing) over 2 hours on the first or 1 hour on subsequent pups?
2. Did the bitch initially show good abdominal contractions and stop without producing a puppy?
3. Is there is green vaginal discharge PRIOR to the delivery of the first puppy?
4. Does the bitch seem distressed? Frantic?  Sick? Weak or unable to stand?  Tremoring? Repeated vomiting?
5. Is this labor pattern different than her previous ones?
6. Has the bitch been unwilling or unable to eat and/or drink for over 12 hours?
7. Has WhelpWise^R indicated there is a problem with fetal heart rates (<160 BPM) or uterine contraction patterns?
8. Have any pups been born dead?
9. Did a previous radiograph or ultrasound suggest there could be a problem? (low heart rates on ultrasound or pups without visible heartbeats?) (Malpresented or very large pups)
10. Is a pup palpated on vaginal examination and in an unusual position or not progressing through the birth?
11. Did her temperature drop to 98 degrees and rise to normal (over 101.0) and stay there more than 4 hours?
12. Has her pregnancy exceeded 63 days?
13. Does she appear to have a very large or very small litter?
14. Does she have a previous history of dystocia?
15. Is she a breed at risk for maternal or fetal causes of dystocia?
16. Does she have unexplained or unusual discharge from her eyes?
17. Is she having weak or non-productive contractions with multiple puppies left?
18. If oxytocin has been used (more later), has there been a minimal or no response?
19. Does the breeder or veterinary staff member have a feeling that something is going wrong? Trust their intuition.

If the answer to any of these questions is yes, you very likely need to assess the bitch as soon as possible and advise your client that the bitch should proceed to emergency surgery unless you can immediately correct any cause for dystocia.