What is a cesarean section?
A cesarean section (C-section) is a major surgery to remove puppies from the uterus. This surgery is usually performed as an emergency procedure when there is difficulty with natural birth.
What should I expect while my dog recovers from a C-section?
A cesarean section (C-section) is a major surgery to remove puppies from the uterus. This surgery is usually performed as an emergency procedure when there is difficulty with natural birth. Most dogs recover quickly from a C-section; however, if your dog was in labor for several hours before surgery, her recovery will be slower, and she will need extra attention and help with her puppies.
Recovery from Anesthesia
The mother will be given an anesthetic that is quickly eliminated from her body. Most dogs recover enough to go home by the time they are discharged, but complete recovery from anesthesia may take 2 to 12 hours, depending on the anesthetic used, the mother's age and physical condition, and how long she was in labor before the surgery.
During the immediate recovery period, monitor the mother closely so she does not fall, injure herself or roll over and crush the newborn puppies. Do not leave the puppies alone with her until she is fully awake, able to stand on her own, and interested in caring for them. The puppies may also be affected by the anesthetic because it can cross the placenta. As a result, they may be sluggish and slow to nurse at first.
Feeding and Nutrition
The mother should begin eating within a few hours after surgery. Offer small amounts of food and water frequently (every 15 to 30 minutes) during the first 24 hours. If she eats or drinks too much or too quickly, she may vomit.
During early nursing, her food intake should be about 1.5 times her pre-pregnancy food intake. By the third or fourth week of nursing, she may require 2 to 3 times her normal food intake. Feed a premium-brand, high quality dog food while she is nursing to provide proper nutrition for both the mother and her litter. While your dog is nursing, she can continue to eat a food formulated for gestation and lactation, or an all-life-stages diet.
Temperature and Medications
The mother's temperature may rise 1ºF to 2ºF (0.5ºC to 1.0ºC) above normal in the first one to three days after delivery, but it should then return to normal. The normal range is 100ºF to 102ºF (37.8ºC to 38.9ºC). If her temperature rises above 104ºF (40ºC), contact your veterinarian as soon as possible so both the mother and litter can be examined.
Do not give your dog acetylsalicylic acid or ASA (Aspirin®), ibuprofen (Advil®), or any other medication, including herbal preparations, without consulting your veterinarian. Your veterinarian will provide pain medication that is appropriate for nursing mothers.
Is it normal for the mother to have bloody vaginal discharge?
A bloody vaginal discharge is normal for three to seven days after birth. It may be heavy for the first one to three days and then diminish over the next few days. If it continues for longer than one week, changes color, or develops an odor, the mother should be checked for infection or other complications. If she had an ovariohysterectomy (was spayed) at the time of the C-section, she should have little or no vaginal discharge.
How do I care for the surgery site?
Inspect the incision daily for signs of complications, such as stitches coming open too early or signs of infection like redness, swelling, and discharge. Nursing puppies may irritate the surgery site. A head collar (Elizabethan collar) is not usually recommended because it can pose a risk to the puppies and prevent the mother from cleaning them. If you have any concerns about the surgical site, contact your veterinarian immediately.
The stitches may or may not need to be removed, depending on the type of suture material used. Many veterinarians use internal, absorbable sutures that are not visible and do not require removal. Generally, visible stitches and skin staples must be removed 10 to 14 days after surgery.
How should I care for the puppies?
The puppies should be ready to nurse as soon as you arrive home. The mother may not be awake enough to nurse alone, but you can help by making the mother lie still so the puppies can nurse. Gently place the puppies near the mother's teats. If a puppy seems reluctant to nurse, you may gently massage the teat to express some milk, which may encourage the pup to begin nursing.
Puppies should sleep or nurse 90% of the time. If they are crying or whimpering, something is usually wrong. The most common causes of restless or unhealthy puppies include uterine infections, inadequate milk production, and poor-quality or infected milk. The litter can die within 24 hours if one of these complications develops. Contact your veterinarian immediately if you have any concerns about the mother or puppies’ health.
If the mother does not have enough milk at first, you may supplement the puppies with milk replacer for the first day or two. Your veterinarian can supply you with a commercial puppy milk replacer, such as Esbilac®, and nursing bottles that are an appropriate size for the puppies' tiny mouths. Many pet stores also carry these supplies.
In an emergency, you can use the following formula until you can purchase a product designed for puppies:
- 1 cup whole milk
- 1 tablespoon corn/canola oil
- 1 pinch of salt
- 3 egg yolks (no whites, and best if the eggs are pasteurized)
Blend the mixture until it is a uniform consistency. Feed 1 oz (30 mL) of formula for every ¼ lb (1/8 kg) of puppy weight every 24 hours. Divide that amount into three to five feedings. The average newborn, small-breed puppy weighs approximately ¼ lb (1/8 kg) at birth, while a large-breed puppy weighs ½ to 1 lb (¼ to ½ kg).
It is best for puppies to begin nursing immediately, but a healthy newborn can survive without complications for up to 12 hours without nursing. However, if the newborn is weak, dehydrated, or cold, it must be fed as soon as possible.
If puppies cannot nurse within the first 24 hours, they lose the immune protection provided by the first milk (colostrum), leaving them more susceptible to infectious diseases. Your vet can administer serum (liquid component of blood) orally from a healthy, vaccinated dog (usually the mother or another dog in the household) if the puppies are less than 24 hours old, or under the skin if older, to try to achieve the same protection the puppies would have received from colostrum.
How warm should the puppies’ room be?
A newborn puppy cannot regulate its body temperature well. If the puppies stay near their mother, the room temperature is not critical. However, if they are not with their mother, the room temperature should be 85ºF to 90ºF (29.4ºC to 32.2ºC). To avoid any chance of hypothermia or hyperthermia (chilling or overheating), keep the newborns inside the house if possible.
