Cesarean Sections in Dogs — Guide, Price, Benefits, Risks & Recovery

C-Sections in Dogs

A canine cesarean section is a surgical operation performed to give birth to a litter of puppies without the need for a natural delivery. C-sections in dogs are often used in emergency situations, but can also be prescribed preventively in specific dog breeds, or in common complicated birth scenarios.

A hysterotomy (c-section) is generally a safe surgical operation when scheduled ahead of time. When performed following a series of birthing complications, the cesarean section will generally be safe for the mother but the survival rate of the puppies may decrease.

Dog breeders are very anxious when the time of their first c-section comes. This article is here to tell you what to expect, how much it costs, and how to help the female and her litter recover from a c-section.

What is a C-section in dogs?

A cesarean section (C-section), also called a hysterotomy, is a surgical procedure that manually removes unborn fetuses from the uterus during delivery. Unlike a normal vaginal delivery, a C-section is done by cutting open the uterus to allow a safe and fast delivery without any effort exerted on the pregnant female dog. The mother is put to sleep through the use of general anesthesia, often times coupled with a local anesthetic as well. The uterus is cut open during the surgical procedure and the unborn pups are taken out, one by one, and handed over for care and resuscitation. C-sections in dogs typically last between 45 min to an hour and a half.

A canine C-section allows for more control and precision over the birthing process by giving a visual field for the doctor to operate on. However, there are times in which a C-section is performed and not all the fetuses are there. This is an example of fetal absorption in which the fetus gets reabsorbed inside the dam and is no longer present in the womb. Depending on the reasons for a C-section, this surgery can be a great benefit to the dam as well as for the whelp. This is a great option in the event of an emergency, which is usually the case.

How much do C-sections cost?

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The cost of a caesarean section in dogs varies wildly. Many factors come into play in deciding the final price including the dog’s age, her physical condition, her weight, the time and place of the procedure, and various forms of emergency needs. The more puppies she has could account for a higher price as opposed to just having one or two. Generally, C-section for dogs should cost roughly between $500 to $2,000. However, there have been cases in which a C-section cost as low as $350 and $400 or as high as $5,000. This very well depends on the clinic as every clinic sets their own prices.

If the dam is taken to a local vet clinic the price may be in the lower range whereas taking her to an animal hospital or ER clinic you could end up with quite a hefty bill on your hands. Furthermore, the price is lower if the procedure is done during normal business hours so anything affected during the weekend, holiday, or late night can prove to be quite costly. Keep in mind that some clinics may charge extra additional fees, for example, consultations and office visits, antibiotic use, or unsuspecting emergency situations, like if a pup gets stuck in the birth canal. If the surgery is not an emergency situation then you have the opportunity to plan to take the cesarean route for your dog ahead of time. In this case, it’s advisable that you plan accordingly and call various clinics to get a full price quote.

When is a C-section delivery required?

As a dog owner, there are many reasons why a c-section is required for your dogs. Sometimes, we are not necessarily keen but the choice may be out of our hands. Below is a list of the most common causes of cesarean sections in dogs.

Personal Preference

Although most cases of cesarean sections are performed in emergency situations, a dog breeder can choose to take surgical delivery instead of natural birth for personal reasons. This process of deciding based on personal preference is referred to as an elective C-section.

A dam who already has a history of one or more hysterotomies is an ideal candidate for repeating the same delivery process, and it’s often times advisable. In cases in which the dam has a history of dystocia (birthing difficulties), an elective C-section can prove to be the most viable option for both mum and pups as to avoid similar predicaments. Other reasons in which a dog owner may decide to choose a caesarean section for her dam is the size of the litter expected. Considerably small or considerably large litters qualify for C-sections.

Breed

Another common and non-emergency reason for C-sections in dogs is due to their breed types. Some breeds cannot facilitate a natural vaginal delivery and require a hysterotomy to prevent complications and possible death. A list of the top 10 dog breeds that require cesarean delivery include:

Emergency Situations

Apart from personal preferences and dog breeds, the most common reason for having a C-section in dogs is because of emergency situations that do not allow for a viable delivery done naturally.

Dystocia

Dystocia is a general term used to describe a difficult birthing process and is one of the main causes of neonatal deaths in puppies. It is accompanied by certain signs to determine any risks and complications. Some symptoms of dystocia to watch out for include weak straining, lochia (green and black discharge), toxemia, strong contractions that don’t produce fetuses or more than four hours between born pups. These complications could be fatal and require an emergency C-section to assure survival.

Blocked Head

Some dog breeds have narrow hips that can make a puppy’s head too big to fit through the birth canal or the puppy just may have a disproportioned head. These are incidents in which a cesarean section is needed as the puppy can get stuck during the birthing process. Mastiffs and Bulldogs are often having very bulky heads and such breeds are prone to C-sections.

Breech Births

In addition to the varying sizes of the dam or her puppies that may indicate a need for surgery, another possible consideration is the position of the pup before delivery. A breech birth is when the puppy is in the position with bottom and tail out first and it could result in a difficult delivery, therefore requiring an emergency C-section.

Hemorrhages

Some bleeding is natural during the delivery and even expected in most canine pregnancies. However, if you notice an excessive amount of blood coming from the dam it could be a sign of a hemorrhage or internal bleeding. This is a dangerous predicament that can lead to serious complications such as unconsciousness in the mother and will require emergency intervention.

Uterine Inertia

Sometimes the cause of a difficult birth has nothing to do with the fetuses but rather it could be a mechanical issue. Uterine inertia is when the uterus is not able to contract to allow the babies to be pushed into the birthing process. In this case, the uterine muscles are too weak and it stalls the labor thus, requiring a C-section.

Fetal Distress

Various components of the delivery procedure can be generalized as fetal distress such as the terms previously listed. This can be anything that gives off the signal in the mother that something is not well with the pups and it can range from abnormal breathing patterns to dangerous body temperatures as well as monitoring the viability through the fetal heart rate.

Intrauterine Fetal Death

This is what gives babies the name “stillborn” in which the pups die inside the uterus. A C-section will be needed to remove the dead fetus from the womb. Similarly, fetal putrefaction also results in a dead fetus inside the womb in which the fetus breaks down and decays.

Moreover, timing is of the essence when it comes to a successful cesarean delivery. As a rule, a C-section should never be performed before the actual overdue date nor after the dam’s temperature falls under 99 degrees. Furthermore, a dog should not have a C-section until she is actually in labor.

Canine Dystocia and Birth Difficulties in Dogs
Read our in-depth article about canine dystocia and birth difficulties in dogs.

Surgical Procedure of a C-section

A cesarean surgery in dogs follows a direct procedure to assure adequate timing in assuring a maximum success rate and to avoid complications. From the time of arrival to the time of exiting the clinic, many crucial steps are taken.

Arriving at the Vet

Upon arrival at the clinic, paperwork will have to be filled out and all the fees are paid and handled. The dam will have to undergo a series of tests and physical exams to ensure she is safe and appropriately prepared to go into surgery. The owner is then asked to wait outside in the waiting room while the dam gets taken in for prep.

Anesthesia

Before the actual surgery, drugs are given to the dam to anesthetize her. If the dam is not already shaved beforehand, the technician will shave the area where the incisions are to be made and apply an IV catheter. Careful considerations are taken not to give her any harsh or strong medications for anything that the mum is fed passes to the fetuses through the placenta. Although many vets insist on using ketamine valium, some reports have recommended to not use it as this causes a prolonged revival time for the pups (roughly 20 minutes). Anesthesiologists agree that the best agent for inducing sleep is propofol because of its pharmacokinetic properties. Diazepam can be used to avoid the risk of using too much propofol, though, for maintenance and masking, either isoflurane or sevoflurane may be used. In addition, to avoid too much anesthetic inhalation a line block may be administered.

Surgery

A C-section requires two teams of vet technicians to get the job done:

  1. one team will be handling the actual surgery,
  2. while the other team is responsible for taking the newborns into care.

It’s important the area around the uterus is kept warm as to not to cause hypothermia in the mother. An incision is made in the abdomen where the uterus is big enough to allow the pups out. The puppies, along with their placentas, are taken out of the first then second horn, cranial first, and then handed to the resuscitation team. After all the pups are out, whatever is left of the placentas are taken out and the cut is sutured up. The uterus begins to contract after this point and oxytocin may be given to the dam so she can start producing maternal hormones and assist in the milk let-down.

The video below is graphic so only watch it if you have some veterinary interest.

After the Operation

The resuscitation team is required to act quickly in assuring the survival of the newborns. The pups are usually rubbed down to provide body heat and to initiate breathing. Sometimes CPR is required to resuscitate them and the process of getting them to breathe on their own can last up to half an hour. The amniotic sac is opened and the umbilicus is cut. Once the babies are breathing and the mum has awakened the opportunity is set to allow bonding time. The dam is encouraged to nurse right away so that she can start producing milk and get used to her babies before being sent home.

Risks and Complications

Having a C-section, when timed right and for the appropriate reasons, can be a rewarding experience. However, just like any other major surgical procedure, C-sections have risks and dangers too. With decades of perfecting the procedure, risks during C-sections are minimal but must be told. Complications can arise at any time during the surgery and it’s advised that one is fully aware of the risks involved so they can make the proper decision accordingly.

Mother

A number of things can happen to the mother during a hysterotomy procedure whether it is before, during, or after. For example, before the surgery is even performed the dam can have an adverse reaction to the anesthesia or any other medications given before surgery. During the operation, risks such as blood clots, hemorrhaging, wound infections or injury to the uterus can arise.

A dam could be at risk for dystocia especially if she already has a history of dystocia. Uterine inertia is another risk which does not allow for sufficient contractions for the pushing of the whelp. Additionally, incision scars have been known to tear open in some cases. In extreme cases, death can incur from complications of a caesarean procedure.

Puppies

During a cesarean section, unborn pups can experience injury during the delivery. Difficult births can compromise the breathing in the whelps and cause the lungs to restrict the airways and cause fetal death. Other risks include:

  • placental ruptures,
  • fetal putrefaction,
  • fetal absorption, and
  • malnutrition.

Additionally, survival rates in fetuses are substantially lower if the mother undergoes complications on her behalf. That’s why it’s imperative to keep the mother in a healthy state in order to assure survival for all the pups. Some breeds are known to be more susceptible to fetal injury or death due to peculiar physical structures or prone to dystocias such as chihuahuas and bulldogs.

Planning and Preparation

Preparing for a cesareando section is an exciting time for a pet owner filled with anticipation for the arrival of newcomers, however, it can also bring anxiety if the person has no idea what to expect. Having a definite plan, or backup plan for emergency situations will make the entire process more manageable. This article should have given you a lot of pointers already.

Do some research and ask your vet about the procedure, how it’s done and your responsibilities as the owner so that you get the full scope of what to expect. This will help put your mind at ease. The first step that goes into preparation is setting the due date, which is normally 63 days after ovulation. This can be checked and confirmed by a vet specialist.

Preparing the Home Space

After the due date is set and the C-section is scheduled, you can now plan accordingly. You need to set up a comfortable whelping box to welcome home the mum and her new litter. Choose a safe spot in the house to create a nesting atmosphere away from noise and distractions where the mother will be doing her bonding and nursing.

The pups need to be kept warm so be sure to heat up the area before arrival and keep it warm. Having certain tools required for whelping will help greatly and save you time and energy of running to the store such as bulb syringes, mucus traps, feeding tubes and scales for weighing the puppies. Having formula prepared and feeding bottles for when the pups can’t nurse will aid greatly in the process.

Before Surgery

Many vets recommend applying an Adaptil Collar on the mum several days prior to surgery to help with adaptation and the release of pheromones. Prior to surgery, it’s not obligatory to shave the surgical area of your dam, but it is a great recommendation and will save time for the surgeon. You can give her a bath the day before so she will be clean for prepping time.

The day of surgery, she shouldn’t have anything to eat unless otherwise permitted by the vet, but she can eat a normal dinner the night before. If she takes medications those can be taken the morning of the surgery as well. She can drink water the morning of the surgery unless the vet says otherwise. These are matters that need to be discussed with the vet specialist prior to the day of surgery.

Make sure you arrive early, about 1 to 2 hours so that nothing gets missed and all preparations needed for surgery are handled in time. Be gentle with your dog so that she stays calm before the procedure. Having a stressed and scared dam before delivery will only worsen the situation and make the process more laborious.

What to Bring

You can’t always be sure what’s going to happen from the moment you walk out the door to the moment you arrive at the clinic. In the unfortunate case that your dam goes into labor in the car, it’s always best to bring additional supplies to assist in the delivery such as the mucus trap and the bulb syringe. Bring towels and blankets for both mom and pups and you’ll need a crate or basket to bring the babies home in. Additionally, make sure you bring your own essentials such as cell phone and emergency contact phone numbers in case you need to contact someone for assistance or call the ER.

Recovery & Homecare

The recovery and subsequent homecare of the dam and her pups are one of the most crucial elements for a successful restoration and healthy turnaround. The return home often poses a substantial amount of anxiety in the dog breeder because he knows he now has taken full responsibility for the dogs. Without proper medical attention and the immediate response from experienced staff, the risks increase. It is crucial to know what to do and how to act in the case of an urgent dilemma.

Mother

After the dam has recovered from the anesthesia and is able to walk, she will be sent home. You will be given certain medications to give the mother for pain and to assist in lactation. Additionally, because it still takes several hours for a complete recovery from the anesthetics, she should be monitored and not left alone with the pups lest she rolls over them or falls and hurt herself. It is normal that she may still feel muddled from the experience and if she eats or drinks too much she may vomit, so feed her about half the amount you would normally feed her at regular intervals. It is recommended she eats quality brands of food as to give her the proper nutrition for replenishment.

Other normal signs to watch for that are not causes for alarm are a bloody discharge from the vagina that may last up to a week, and also fluctuations in her temperature. If the dam starts to run a fever call your vet immediately. Never offer her medications without consulting the vet. As for the stitches, sometimes the dam is stitched internally in which case it will not require you to do anything. In the case that she was externally stitched you will have to take her back to the vet to get them removed within a week to two weeks.

Puppies

It is pivotal that you never leave the puppies alone with the mother during the first few weeks and give them sufficient care and attention. Because a C-section procedure doesn’t offer a natural whelping experience for maternal bonding, she may at first reject her babies. This is normal as she just needs time to get used to being a mom. In rare cases, dams have been known to eat her pups so this is a situation that requires your full participation in protecting them.

The puppies need to be kept warm because they lack the ability to regulate their own temperature, and they also need to be fed. Gently place the pups on the dam’s teats and let them suck. In the event that nursing becomes infeasible, vets may offer milk replacements or you can make your own milk supplements using a homemade formula. Read our guide on bottle feeding puppies for an in-depth article.

After a couple weeks it is advisable that the puppies get checked for worms and also get vaccinated once they have reached about 8 to 10 weeks. Most importantly, encourage a happy and healthy relationship between mum and babies and enjoy your new bundle of puppy love!

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