Difficulty Delivering Puppies (Dystocia) in Dogs

It is best practice for pet parents of breeding dogs to ensure they have reliable access to emergency veterinary hospital services before proceeding with canine insemination and pregnancy.

A normal canine pregnancy lasts just over two months from conception. This can make estimating the exact date of birth difficult, because conception often occurs up to a few days after mating. When ready to whelp (deliver puppies), mothers typically become antisocial, lose their appetite, and look for a comfortable ‘nest’ to await the birth. Contractions (which look like the tensing of abdominal muscles), occur more regularly as the mother prepares to whelp. Green discharge from the vulva precedes birth of the first puppy, and the mother usually expels a placenta between each birth or along with each puppy. The entire whelping process can take several hours. A mother dog may also interrupt labor for several hours (or even a day), showing no contractions and caring for her puppies normally, then resuming labor later.

Mothers and puppies in dystocia for 24-48h have an extremely poor survival rate. Prompt recognition and treatment is key for improving outcomes.

Any of the following indicate a medical emergency:

• Gestation period lasting longer than expected (normal gestation is approximately 63 days).
• Frequent contractions, but no puppies within 15-30 minutes
• No puppies after 24 hours post temperature drop to <100°F (37.7°C)
• Dark green vaginal discharge, but no puppy within 15 minutes
• Heavy bleeding
• Retained pup at the vulva

Given the risk associated with dystocia, it is important to know where the nearest vet with appropriate medical facilities is before a pregnant dog goes into labor. Some breeds of dogs are particularly susceptible to dystocia events, and benefit from a pre-booked c-section appointment. A dog who has experienced dystocia in the past is much more likely to experience it again with subsequent pregnancies.

If dystocia goes unrecognized and untreated, the prognosis is poor for the dog in labor and her pups. Puppies trapped in the uterus are not expected to survive and may eventually be stillborn.

The incidence of dystocia is variable. Smaller dogs, especially those bred to larger dogs, are particularly susceptible. Mothers with either excessively large (or small) litters, inexperienced mothers, and certain breeds of dog are all more vulnerable to dystocia than others.

Causes of dystocia fall into two categories: maternal or fetal.

Maternal factors refer to the mother’s status. Some breeds are genetically predisposed to dystocia. A mother with uterine inertia, an inadequately sized birth canal, or anything else interfering with their pelvic canal (such as an old injury) can result in dystocia.

Fetal factors apply to the status of the puppies being born. An oversized fetus can cause dystocia, as can an unusual physical orientation in the womb or birth canal. Puppies are generally born with either their head and forelegs extended (anterior), or with their rear legs and tail extended (posterior). A puppy which comes out posterior first, but with rear legs extended forwards (towards their head) may become stuck in the vaginal canal, for example.

Gestation lasting more than seventy days is indicative of dystocia. A diagnosis of dystocia is also made if the following symptoms are observed and 24 hours has passed without delivery.

If no puppy is born within 15 minutes of the appearance of green discharge, or within 30 minutes of regular contractions, these also indicate dystocia.

If the symptoms of dystocia are present, diagnosis is suggested, but is confirmed using physical examination, bloodwork, and diagnostic imaging to confirm that the puppies are fully developed and the mother is in labor.

Treatment is either clinical or surgical.

Clinical treatments assist the mother’s natural birth. Oxytocin injections can help stimulate contractions, and a vet may assist by repositioning a pup allowing for easier birth. Lubrication and gentle traction are additional strategies when a puppy appears to be stuck in the vaginal canal. If a laboring mother is deficient in calcium, mineral electrolytes may be administered intravenously.

If clinical treatments are not sufficient to support labor, a cesarean section is necessary.

Dystocia does not typically impact future fertility, but often recurs with subsequent pregnancies.

With treatment, the prognosis for dystocia is fair to good for the mother. Although cesarean sections are risky, the outcome is usually positive. The prognosis for the pups is fair, but it is normal for at least one fetus to not survive a dystocia event.

It is important to monitor a dog during the late stages of pregnancy, as even short delays can indicate an emergency.

Dystocia is not always preventable. Preventing dystocia is often a matter of ensuring that the dog does not meet the vulnerability conditions outlined above.

General strategies to avoid dystocia include:

• Maintaining regular checkups on a pregnant dog to increase the odds of spotting complications early
• Spaying and neutering pets to prevent pregnancy
• Preventing unintended mating
• Avoiding breeding pairs with significant differences in body size (ie. avoid breeding large males with small females)
• Avoiding breeding selection for excessively large litter sizes
• Avoiding breeding dogs that are very young, very old, or that have other illnesses

Some breeds of dog are far more likely to need a c-section, and benefit from having the appointment booked in advance.

Dystocia is not common in dogs, but some breeds (and smaller dogs) are more susceptible

• Oxytocin
• Physical manipulation of fetuses
• Calcium/dextrose injections
• C-section