Caesarean After Care

Once your pups are delivered by caesarean section, the real work begins!

Because of a caesarean, your bitch has had a major abdominal procedure and should be rested for 7 to 10 days. Rested means no running or jumping or playing. Preferably crated and taken on a lead to the toilet. When toileting, take her on a lead. Walking on a lead three times a day for 15 minutes encourages uterine involution and evacuation of residual uterine contents. Oxytocin injections are not required at this stage as the puppies nursing will produce large amounts of oxytocin naturally. Your bitch will also require her abdominal sutures to be removed at your Primary Care Clinic 7-10 days post-surgery. Here at QVS Reproduction we use interrupted mattress stitches which aid to prevent puppies getting caught up in a continuous suture line and if the sutures become inflamed, individual sutures can be examined by a veterinarian. Whilst at home keep the skin wound clean and dry by bathing with plain warm water as needed in first 48 hours after your caesarean. Avoid using cotton wool balls as this can get caught along the sutures, gauze swabs are recommended.

As your bitch has delivered a litter by caesarean section, she may not mother effectively in the first days of lactation. It is at least possible that she will actively reject the pups and could harm them. It is VITAL the interactions between mother and babies are VERY carefully monitored and supervised.  At best, she will form maternal-neonatal bond over the next few hours, at worst she can be aggressive towards pups. Effective lactation and nursing are essential in the first two days and you should do whatever is necessary to encourage and facilitate this process. Pups that do not feed well in the first two days of life may die or be debilitated later. Bottle feeding is not a good substitute for correct nursing in pups.

So please do the following until she shows signs of normal mothering:

• take your bitch home, allow her to urinate and defecate and eat and drink and settle her down and reduce all anxiety and stress so she is well settled before pups are introduced
• separate the bitch and pups between feeds if necessary and put the pups on bitch for supervised feeding every 2 hours
• feeding is accomplished by lying the bitch on her side and assisting the pups to find the nipples as needed. If the bitch tries to move, sitting behind her back, hold her legs closest to the ground, which will help comfortably restrain her for feeding
• after feeding, please hold the pups for the bitch to lick their perineum if necessary and if the bitch doesn’t lick pups then you should stimulate the pup's perineum to induce defecation and urination with lanoline coated tissue or similar
• between feeds, the pups should be kept in tented warmed environment until the bitch mothers properly.

Puppies should be weighed after birth. Weigh the pups twice a day and record weights - pups may lose a little body weight in the first day or so but should gain weight thereafter at a rate of 5-10% of their birth weight daily and have doubled their birth weight by 10 days of age.

If a neonate is not gaining weight, it may need supplementation. There is no better supplementation than mother’s milk, and if your bitch is not producing milk, she may need some assistance to help increase her production. Milk production requires a diet consisting of high protein, fats and carbohydrates. The diet should contain a protein level of 25-35%, a fat level of >18% as well as carbohydrates, vitamins and minerals. This formulation is available in most veterinary puppy diets and supplements should be avoided to prevent dietary imbalances and toxicities. Bitches with large litters for their breeds may also require additional calcium, as body calcium reserves are depleted in lactation. Oral calcium preparations are best as there are risks of overdosing toxicities for injectable preparations and should only be administered under supervision of a veterinarian.

If, after feeding a good quality diet your bitch is still not producing milk (agalactia), she may require medication to help increase her production. Oxytocin does not increase milk production, rather let down what is already being produced. A dopamine antagonist can be prescribed by your veterinarian to help increase milk production. A dopamine antagonist induces a rise in prolactin levels, leading to an increase in milk production at a dose of 2.2mg/kg orally daily. Common toxicities include oral mucosal dryness and gastrointestinal disorders. If this is required, talk to your primary care veterinarian.

If your pups are requiring supplementation, the development, strength and suckle reflex of the pups indicate the primary selection criteria. For example, if pups are weak, bottle feeding may not be the best option as their suckle reflex might be under developed which increases their risk of aspiration. So, a feeding tube might be a better option. To stomach tube a pup, talk to your primary care veterinarian or QVS Reproduction to help with equipment and the correct procedure.

Before supplementation begins, it is vital that the puppies are housed in a warm, tented environment. The pups body temperature needs to be above 35.5° - 36.5°C. If the pups body temperature falls below this, ileus will develop (gastrointestinal motility stops), which results in a bloated and distressed pup.

Normal temperatures for pups are lower than adult body temperatures:

The key to raising a successful litter is attention to detail, and this requires round the clock attention. Prior planning (gathering assistance, taking time off work) is required to ensure that a successful outcome is achieved resulting in a healthy litter with a healthy happy bitch