Nightmares

Sometimes things will go bad. I wish that I could tell you that you will never have problems in whelping. But I can’t, all I can do describe some of the problems and solutions that might fix the problem. Most importantly of all may be I can help you prevent some of the problems. If the solutions described here don’t work, you are going to be in the same position that I and other breeders have been in. The text book picture perfect whelping didn’t scare me to the point where I was driven to learn all I could possibly learn. It was rushing to an 24 hour ER vet with a dead puppy with her head sticking out and having a vet not willing to listen to me. The whole time at the vet it was more than cold. I didn’t know them and they didn’t know me. My vet was out of state so I had no other choice. The little girl was a water puppy. (Puppy born with severe Edema (swelling, water retention). I use to breed cats and never had any problems so this was very frightening to me.

Well before your bitch is ready to whelp prepare yourself for an emergency.. Here are some things that you can have nearby to be prepared to help your bitch should you run into difficulties. First of all read all you can, talk with your vet and other breeders. Next get your supplies together. If the vet agrees that you may have a need for it, get instructions for the use of oxytocin which is a very dangerous drug. You should have your

veterinarian help you understand its administration and dosages. Here is a list of supplies that you will need to be prepared for the whelping that may present problems.

- You will need a warmed box for your puppies. Check the Warming Box of my site for supplies.

- You will need oxytocin and syringes with needles and very clear instructions from your vet as to dosage and mode of administration.

- Calsorb and a stethoscope to check mom’s heart rate.

- Oxygen and a regulator with tubing. I will be covering this in the New Born Intensive care on my site. Oxygen is synonymous with strength and endurance. Giving a laboring bitch that is fatigued will give her strength and increase the oxygen available to the pups in utero. It will protect your bitch and it can save your puppies. Turn the oxygen to 2 litters per minute and hold the end of the tubing near her mouth and nose.

- Large tube of K-Y Jelly, 20 cc syringe with a luer slip tip and a size 8 French Feeding tube.

- Lots of warmed white wash clothes. (Place them in warming box and turn on heating pad to warm wash clothes).

- Latex gloves that fit your hands and Betadyne solution.

- Nutra Sata or another sweetened product that your bitch will eat in small quantities from time to time while in labor. (Ice Cream, Pediatlyte, honey)

- Rectal thermometer. Mom’s temperature will drop to an average of about 98.6 degrees Fahrenheit and somewhere between 8 to 24 hours prior to whelping. This drop in temperature is thought to coincide with a sharp drop in progesterone levels. Arise in the maternal temperature during labor over 103.5 should be reported to your vet, as it could be a sign of infection. Whatever has caused this temperature increase may be infecting the puppies as well. As soon as whelping is complete, notify your vet of the temperature increase.

- Keep on hand a good oral antibiotic such as Keflex or Baytril. In the event of an infection you can start the bitch on it until you can get her to the vet.

Now I will cover some basic information about whelping. I will keep terms in layman’s terms. The three stages of labor for a bitch approximate the three stages of labor in humans.

Stage one.

The first stage of labor is the time during which she will fail to eat her meals, be restless and anxious, pant continually, dig and want you near by her. Don’t worry if she throws up, this is normal. I think this is because she is in pain. During this first stage the cervix is thinning and opening. This stage may last from 4 to 12 hours but can extend to 24 hours. As long as you don’t see green discharge you will know that none of the placentas have separated and things are just fine. If she isn’t pushing you will know she is still in stage one of labor. If your bitch has exhibited all the signs of stage one but never produces a puppy, she is experiencing Primary Uterine Inertia.

PRIMARY UTERINE INERTIA

Primary Uterine Inertia means that the bitch has exhibited the behaviors of a normal stage one of labor but she never pushes or delivers a puppy. Contractions but never pushes and no pups. There are several reasons for primary uterine inertia:

- Some breed have a genetic pre-disposition to primary uterine inertia.

- Some bitches have a genetic pre-disotion to primary uterine inertia.

- Litters containing only one or two puppies can cause primary uterine inertia. Whatever it is that stimulates the labor to begin and finish is sometimes lacking or inadequate to finish the job when only one or two puppies are in the uterus.

- Litters that are large can also cause primary uterine inertia. The uterus is stretched so much by the large litter that the muscle fibers are to thin to contract efficiently.

- Not enough calcium present to create strong enough contractions to expel a puppy.

- Obesity in the bitch.

- Illness or infection in the bitch.

If the bitch has failed to respond to oxytocin and calcium you may need to take her to your vet. Some of the causes of primary uterine inertia can’t be fixed. A c-section will be required to save her and the puppies life. Some causes could have been prevented and some can be helped along by the addition of oxytocin and calcium.

Stage Two

Stage two of labor is the time when the puppies are moving from the uterine horn into the birth canal and out into the world. The birth canal is the cervix, vagina and the vulva. As the puppy passes through the cervix, the cervical stretching causes a natural pushing reflex. The bitch will begin her short little pushes as the puppy passes through the cervix. Once the puppy has reached the vulva and the tissues have begun to bow outwards, the bitch will often but not always will stand up on all fours and lift her tail, hunch her back and push harder and for longer periods. If your bitch has pushed for two hours without a puppy , you are very most likely looking at a secondary uterine inertia. After one hour of pushing without a puppy you should call your vet and let them know what is going on. Take notes, describe what you are seeing and what steps you have taken to improve the quality of the labor. Your vet will appreciate the heads up and so that they can be ready for your visit. After two hours of pushing with no puppies means you need to take her to your vet. She is suffering from Secondary uterine inerita and dystocia: Contractions, pushing, no puppy.

Your bitch may have passed through stage one of the laboring process and may even have delivered some of the puppies, but has reached a point where she has pushed for one or two hours without a puppy. This is called Dystocia. The puppy simply can’t get out. Sometimes you can reach with a gloved finger rinsed with Betadyne up into the birth canal and feel the puppy. Sometimes you can see the puppy’s feet, nose or even the entire head or half the body, but the puppy is stuck. It can’t get out. Welcome to the hell known as Secondary Uterine Inertia and Dystocia and it really can be hell because you can witness the death of your puppy if you can not get the puppy out. This has happen to me and it was hell to watch. This is caused sometimes on the mother’s end and sometimes on the puppy’s end.

Here are some reasons of maternal (mom) causes of dystocia:

- Genetic pre-disposition.

- Genetic pre-disposition in specific breeds, some terriers and breeds with large heads and small pelvis size.

- Immaturity, bitch to young to have puppies.

- Previous injury to the bitch.

- Nutritional status.

- Obesity.

- Calcium Deficiency (may have been caused giving your bitch to many calcium supplements, read about calcium in the Oxytocin, Calcium and Glucose section)

- Vaginal strictures.

Sometimes the puppies are the cause and just get stuck and can’t get out. Some of the causes of fetal Secondary Uterine Inertia and Dystocia:

- Litter too large

-Litter too small

- Puppy to large

- Hydrocephalus (water on the brain has caused the head to be too large).

- Abnormal presentation: transverse(sideways), neck flexion(nose tucked into the chest instead of nose first. There are others but the result is the same.

- Two puppies trying to come down the chute at once.

- Breech (rear end firs with legs folded up toward the chest)

- CPD: Cephalopelvic disproportion: puppy’s head is too large for the bitches pelvis, this can happen in any breed but more than likely in breeds with large heads and small pelvic size.

Okay you have established that your bitch has either primary or secondary inertia. The uterus either isn’t contracting often enough or hard enough or both and we know that we have fetal dystocia. We know the puppy is there but can’t get out. What do you do?

1. Administer Calsorb orally. Three to four mils every half an hour or so as long as the bitches heart rate and rhythm are normal. Heart rate should be 130 to 150 per minute and has regular with no skipping beats.

2. Administer oxytocin by either an injection into the muscle of the back rear leg (IM) or subcutaneous under the skin around the neck and shoulders(SQ). Oxytocin has a half-life of a couple of minutes but even so it is critically important not to exceed the recommended dose of your vet. Too much oxytocin can cause uterine tetany (contraction that doesn’t end) or fetal distress by the continual squeezing of the placenta that will cut off the oxygen to the puppy’s brain.

3. If you can reach a puppy part and you feel that you can apply some traction to remove the puppy safely you can try this. Open a 20cc syringe. Pull the plunger part completely out of the syringe. Fill the syringe with K-Y Jelly. Reinsert the plunger part of the syringe and attach a size 8 French feeding tube to the end of the syringe. Gently thread the feeding tube up the vagina until you are behind the puppy. Push the plunger and insert all the K-Y Jelly into the vagina and hopefully behind the puppy. Hold your bitch up on her back legs for about 30 seconds to allow the K-Y Jelly to start down the birth canal. After this brief period, stand her with her rear end facing you and with an assistant holding her head. Then using a washcloth to give you traction, lift the puppy UPWARD to lift it over the pelvic bones and out. If the puppy is alive and the head is out you can be giving it oxygen during this entire procedure.

4. If you lived a good distance from a vet you may want to have your vet teach you about episiotomies. I would never try this. It is an extremely drastic and invasive measure, but if for some reason you can not get your bitch to your vet it may be the only way to save the puppy. Talk with your vet about this.

5. Walk your bitch. Often walking will increase the quality and quantity of uterine contractions.

6. Gently massage the uterus. GENTLY, using no more pressure than you would if you were giving a newborn puppy a back massage. Massaging the uterus will always create a contraction. If oxytocin is present and calcium levels are appropriate, massaging the uterus will set up a series of useful contractions. Remember no harder than if you were massaging the back of a new born puppy.

7. Using a gloved finger rinsed with Beadyne, reach into the vulva of the bitch and rub her vagina particularly around the area of the spine. If you reach her public bones , reach your finger over them and very gently pull them toward you. This will also stimulate a very, very strong contraction in a bitch. Stroke the top of the birth canal. This is called “feathering”.

Keep in constant contact with your vet. Your vet will appreciate being kept informed about what is happening and can give you instructions and suggestions for solutions. Tell your vet which of the seven things listed above you have tried. Describe the response you have gotten. He will know that if you haven’t gotten a response to those things then his office will have to be prepared for the emergency c-section that may be one the way. Your vet will advise you when to come in for the c-section. I think we need to cover fetal distress at this time. Myths and misconception abound about this topic. It is necessary to have a very full and correct understanding of the fetal monitoring before you utilize those techniques.

With the advent of the fetal monitoring came the term fetal distress. True fetal distress is next to impossible to detect using a stethoscope or even using a hand held Doppler. A decrease in fetal heart rate alone is not always a sign of fetal distress. In fact it rarely is. The next sections describe the things that can cause a decrease in fetal heart rate.

Variable Decelerations of Fetal Heart Tones

If the umbilical cord is compressed during the contractions, the fetal heart rate will drop dramatically. It comes right back up and is not a sign of fetal distress. These drops in fetal heart tones are called variable decelerations and they are relatively harmless. They are not subtle, they are drastic. Usually changing the bitches position for a while will make them go away. Very common, very normal, no reason for alarm. If by chance you hear these during a contraction, walk the bitch, turn her to another side and hold her with her legs in the air for a couple of minutes, a slight reposition of the puppies will help.

Early Deceleration of Fetal Heart Tones

As the contractions squeezes on the puppies head the fetal heart tones will decrease. This sort of a deceleration will mirror the uterine contraction as viewed on a monitor. The deceleration will start when the contraction starts and end when the contraction ends. Very normal, very harmless, no reason for alarm.

Late Decelerations of Fetal Heart Tones: Now this is genuine fetal distress…

The only kind of deceleration of fetal heart tones that is considered dangerous to the fetus is the kind caused by squeezing of the placenta during the contraction. If the placenta is compressed to hard for to long the puppy’s brain becomes oxygen deprived and the fetal heart rate will decrease. This decrease will begin to happen shortly AFTER the contraction has started. These decelerations of fetal heart tones end several seconds after the contraction has ended. The decrease is usually much too subtle to catch with a stethoscope or a Doppler, particularly when you are listening to the hearts of several puppies at once. I would consider it an impossible task. Sometimes it is even too subtle to see on the monitor strip without quite a lot of experience reading and interpreting fetal monitor strips. You simply cannot make important judgments based on the rate of the fetal heart tones on a litter of puppies. This human science isn’t necessarily applicable to the canine. It simply doesn’t translate well from human use to dog use. Without a fetal monitor for each puppy and a monitor strip that we can read and interpret, we can’t really and truly diagnose fetal distress in a litter of puppies.

Stage three

Stage three is the expulsion of the placenta.