Difficult birth in dogs

Overview

Normal labour

During the first stage, uterine contractions dilate the cervix. During delivery, puppies pass through the birth canal. In the afterbirth stage, placentas detach and pass out. Puppy and placenta delivery can alternate.

Dystocia can involve maternal problems or puppy position or size. Different canine populations have recorded difficulties in around 5–37% of births. Prolonged labour reduces puppy survival.

First-stage uterine contractions are usually invisible externally. Abdominal muscle effort becomes visible during delivery. A sharp fall in progesterone, which maintains pregnancy, initiates labour.

Causes

Uterine inertia and obstruction

Weak or absent contractions, called uterine inertia, are the most common cause. Primary inertia means inadequate contractions without obstruction. Large litters can overstretch uterine muscle and weaken contractions. Obstruction can exhaust an initially normally contracting uterus. Low calcium can weaken contractions. Low glucose can accompany inertia.

A healed pelvic fracture can leave insufficient space. Congenital pelvic malformation can prevent passage. A head turned sideways can trap a puppy. Forelimbs folded backwards can also impede delivery. Hindquarters-first delivery can be normal with extended hind legs.

Developmental abnormalities such as hydrocephalus can make the head too large. Severe maternal stress can sometimes halt progress, particularly in first labour.

Risk factors

Large puppy heads can struggle through narrow maternal birth canals in brachycephalic breeds. Boston Terriers and Pugs have increased risk, for example. In small breeds such as Chihuahuas, puppies from very small litters can grow too large for easy delivery. More than eight puppies can predispose to uterine exhaustion. Older bitches have more complications. Overweight or underweight can also increase risk.

UK emergency care records noted dystocia in 3.7% of unspayed bitches treated. One 2020 French Bulldog breeder survey from northern Europe reported entirely natural delivery in around 25% of litters.

Typical symptoms

Normal first-stage behaviour can include nesting. Panting and restlessness may start six to 12 hours before delivery. Actual straining is visible as abdominal muscle effort.

• Repeated visible straining without delivery.
• Weak or infrequent efforts.
• Efforts stop before all puppies arrive.
• Foul-smelling vaginal discharge.
• Severe pain developing during labour.

Labour can begin eight to 24 hours after rectal temperature falls below 37 °C. Contact a vet if it has not started within 24 hours of the drop.

Clear or pale discharge can be normal initially. Call an emergency clinic for weak straining lasting one to two hours without delivery.

Complications and consequences

Prolonged labour consequences

Green discharge before the first puppy can indicate placental separation. Puppies receive oxygen through the placenta before birth. Premature detachment can deprive them of oxygen. Prolonged dystocia can dehydrate the mother. Reduced circulating fluid volume can lower blood pressure. Uterine torsion can threaten the mother's life.

Intervals exceeding 60–90 minutes between puppies have been associated with greater stillbirth risk. At one hospital, 87.1% of emergency caesarean-born puppies survived to discharge. Elective caesarean survival at that hospital was 99.2%.

Uterine rupture can cause severe systemic infection in the mother. Another follow-up of 150 caesareans found at least one stillbirth or early neonatal death in 43% of cases.

A puppy trapped in the canal was associated with increased neonatal death risk in emergency caesareans. In the same 78-mother series, anaesthesia exceeding 80 minutes was associated with threefold neonatal death risk.

Diagnosis at the vet

Labour history and maternal examination

The vet establishes when each stage began. Maternal condition and a possible temperature drop help determine stage. Vaginal examination checks for obstruction. Palpation sometimes establishes a puppy's position. Ionised calcium, the available form, can be measured in blood. Glucose is checked because low levels can accompany weak contractions.

Different roles of X-rays and ultrasound

X-rays show how many puppies remain. They help compare puppy size with the maternal pelvis. They also identify transverse or other difficult positions. Ultrasound assesses foetal viability. Normal foetal heart rate is 200–250 beats per minute. Below 200 can indicate deterioration. Below 160 is serious and may prompt urgent surgery.

Mating and fertilisation dates can differ, complicating pregnancy dating. With known ovulation, delivery averages 63 days later. More than 70 days from known mating without labour prompts assessment for prolonged pregnancy.

Blood testing can assess maternal anaemia. Foetal measurements can help estimate gestational stage.

After labour, X-rays can confirm no puppies remain. Blood progesterone can help predict delivery. It falls sharply within the preceding 24 hours in most bitches.

Treatment

Assisted delivery and medication

A vet can provide gentle manual assistance if the puppy is reachable. Medication can treat inertia without obstruction. It is considered with a stable mother and healthy puppies. Oxytocin increases contraction frequency. Calcium can strengthen contractions. Glucose can correct low maternal blood sugar.

Oxytocin is not used with a puppy obstructing the canal. It can prematurely detach placentas. Maternal rhythm is monitored during calcium treatment for inertia.

Caesarean section and immediate puppy care

An uncorrectable puppy position can require caesarean section. Severe maternal illness may prompt rapid surgery. It may also be essential if medication fails to restart labour. Foetal tooth mineralisation on X-rays can help time elective surgery.

A limp, silent puppy may need immediate resuscitation. Staff dry the puppy immediately. Airways are checked and cleared when needed. Resuscitation aims to maintain normal body temperature. Positive-pressure breathing assistance may be used for absent breathing or gasping.

Prevention

Some countries prohibit breeding bitches unable to deliver without caesarean section because of their own or expected offspring's conformation. Some kennel clubs register no more than two caesarean-born litters from one bitch. Some recommend a first litter before six years. One registration scheme requires a veterinary health certificate before mating bitches aged eight or older.

Good pre-pregnancy body condition reduces weight-related delivery risks. Litter size is most accurately counted on X-rays after day 55.

Foetal skeletons can become visible after day 45. Pregnancy ultrasound estimates litter size less accurately than X-rays.

Important for dog owners

Monitoring labour at home

Choose familiar surroundings because unfamiliarity can disrupt progress. Provide a quiet, warm, easily cleaned whelping box. Keep fresh water available during the first stage. Record straining onset so the vet can assess progress. Record each puppy's birth time to identify stalled delivery. Report the X-ray puppy count if known.

Do not give oxytocin yourself: obstruction must first be excluded. Do not pull forcefully on a stuck puppy. Immediately contact a vet if the mother is weak and uninterested in puppies after delivery.

The mother after birth

Greenish or reddish-brown discharge can be normal afterwards. Its quantity should gradually decrease. It usually lasts around three weeks. It can persist for up to eight weeks. A foul smell can indicate infection. Contact a vet for renewed increase. Retained placenta can cause postpartum uterine infection.

Weigh puppies once dry to track growth from the start. Weight loss after the first 24 hours warrants prompt veterinary contact. Continuing labour-like straining after delivery can indicate uterine infection.

Frequently asked questions

How long can the interval between puppies be?

With puppies remaining, call an emergency clinic after two hours without renewed contractions. Four hours has also been used as an upper limit for non-straining intervals. Call sooner for fruitless strong straining or maternal deterioration.

How long can strong straining continue?

Call after 20–30 minutes without a puppy. Sixty minutes has also been used as an upper limit for unsuccessful strong contractions. Deterioration warrants an immediate call regardless of duration.

What does green discharge before a puppy mean?

Dark green discharge can indicate premature placental separation. Call immediately if it precedes the first puppy. A puppy receives oxygen through its placenta until birth and breathing begin.

Can a puppy be born hindquarters first?

Yes, with hind legs extended in the birth canal. Hind legs folded forwards instead create malposition. Manual examination helps assess position and assistance needs.

Will the next litter also need a caesarean?

One previous caesarean does not automatically require another. Some countries prohibit breeding when conformation necessitates surgery. Some kennel clubs allow registration of no more than two caesarean-born litters per bitch.