All I remember is she was a very big dog. A Great Pyrenees or Saint Bernard. It was back in the day when we almost never referred patients to specialists, and when I still did major surgery. The dog in question, let’s call her Mother Hubbard, was experiencing dystocia — difficulty giving birth. Dystocia can happen for many reasons. Puppies with big heads — a common problem in breeds like bulldogs, pugs, and Boston terriers. Mother dogs with very narrow pelvic canals. Fetuses in the wrong position, such as with the head curled backward. Sometimes the mother’s uterus is just not contracting strongly. Let’s review basic canine reproduction.
Female dogs typically go into heat twice a year, though this can vary depending on breed. The period between heats is called anestrus, during which time Mother Hubbard will not attract males. If any confused suitors approach her, she will reject all advances. Next comes proestrus. Hubbard’s vulva swells significantly, and she has a bloody discharge. She may attract males and even act playful and flirty, but will still reject serious attempts to mate. (Teenagers may now giggle.) Proestrus lasts anywhere from a few days to a few weeks. Then the discharge turns to a clear, straw-colored fluid. This is true estrus, when Hubbard is fertile and receptive to mating. Estrus can persist days to weeks, but typically lasts about nine days. The cycle completes with Hubbard either becoming pregnant, or, if not, going into a period called diestrus, during which everything gradually returns to the resting state of anestrus.
Let’s assume Hubbard’s owners are responsible breeders who would never allow an unplanned pregnancy to occur. They have done all the necessary testing of both Hubbard and her proposed mate to rule out undesirable genetic traits. They have arranged good homes for all the puppies before even breeding Hubbard. Their veterinarian does frequent testing of Hubbard’s progesterone levels, determining the peak time to breed her to maximize the odds of conceiving. Hubbard then has her romantic interlude, either au naturel or via artificial insemination. Now what?
Unfortunately, there is no simple pee-on-a-stick pregnancy test for dogs. Different methods can be used to confirm pregnancy at different times. Around Day 25 your veterinarian might be able to feel by abdominal palpation or see on ultrasound. By Day 30, there’s a blood test for a hormone called relaxin. Day 45, radiographs. By Day 55 to 60, ultrasound or radiographs can get you a fairly accurate head count. An exact due date cannot always be predicted, but typically is 62 to 64 days post-breeding. When Hubbard is close, her owners take her rectal temperature daily. It usually drops below 99°F the day preceding delivery.
In Stage I labor, Hubbard may be restless, and start nesting or hiding. Her cervix is beginning to dilate, and she is having mild contractions. This lasts from six to 36 hours. In Stage II, if all goes well, she gives birth. Each pup should be born within half an hour after the onset of strong contractions, but don’t panic if there is then an hour or two peaceful pause between each pup. I once had a client call me every hour all night long when her dog, Mother Goose, was in labor. Goose would deliver a healthy puppy, then her contractions would stop. Each time Goose’s owner called, I reminded her it can be completely normal to have these rest periods between pups.
Goose was better off staying home in safe, familiar surroundings. Stressing her by dragging her to the veterinarian in the middle of a normal delivery (and the middle of the night) could actually be harmful. So what’s not normal? Once hard labor starts, the first puppy should appear within four hours. After the firstborn, there should be no more than two hours between puppies. Strong, frequent contractions should always produce a pup within thirty minutes. There should not be any weird discharge that is green or black, or excessively bloody.
If a dog is experiencing dystocia, your veterinarian will start by trying to determine the cause. If there is no obstruction, such as a large pup stuck, then medical treatment can be tried, starting with oxytocin injections to stimulate uterine contraction. Sometimes calcium injections are also indicated. If there is an obstruction, anatomical abnormalities, or the mother dog or fetuses are in distress, it’s surgery time. I used to do C-sections here at my tiny home practice. Back then, 30 years ago, owners understood and accepted our limitations, and for Mother Hubbard, I simply had to do what I could.
Puppies born by C-section need fast, aggressive nursing care, with each ideally having its own caregiver to suction mucus from the mouth and nostrils and rub the pup vigorously to stimulate it. We rounded up a team of volunteer “puppy rubbers” and got to work. The uterus of a dog is shaped like a big Y, with a short body and two long horns where the fetuses grow. Once a mother dog is anesthetized and prepped, the whole uterus is lifted out and an incision made in the short body portion. Puppies are “milked” down each horn and out through the single incision. The uterus can then be sutured, or the dog spayed.. If memory serves, Hubbard had eight pups. All survived. Goose delivered 10 at home overnight. The 11 was stillborn at her regular vet’s office the next morning.
Mother dogs almost always survive. Puppies, too, though about 8 percent do not. Nowadays, many small practices like mine cannot offer the level of surgical expertise or experience that specialists do, nor do we have all the bells and whistles considered standard of care. Cases like Mother Goose may be managed medically, and some local practices still do C-sections on-Island. Sometimes, however, owners may be better off being prepared to get dogs like Mother Hubbard on the next ferry to have surgery at a referral center with better facilities, multiple anesthesia options, extensive support staff, and board-certified surgeons.
