Stan Wood, DVM, Diplomate ABVP

Specialist in Canine & Feline Practice

Cesarean Section: Post-Operative Instructions

A cesarean section is major surgery to remove puppies from the uterus of the mother dog. Most dogs recover quickly from this procedure; however, if your dog was in labor for several hours before surgery was performed, her recovery will be slower and she will need extra attention and help with her litter.

Care and Management of the Post-partum Bitch

The Immediate Post-operative Period and Care of the Mother

The mother has been given an anesthetic that is eliminated from her body rather quickly. Most dogs are raising their heads by the time they arrive at home. Complete recovery from anesthetic may take 2-3 hours, depending on her physical condition at the time of surgery and her age.

During the recovery period, she must be restrained in such a way that she does not fall and hurt herself or roll over and crush the puppies. The puppies should not be left alone with her until she is completely awake and coordinated.

The mother should be interested in eating within a few hours after she is completely awake. Allow her to eat and drink all that she wants, being careful that she does not overload her stomach; this can result in vomiting. Her food intake at this time should be about 1 times her food intake before she became pregnant. By the time of the third or fourth week of nursing, her food intake may be 2 to 2 times normal. She should be fed a high-quality puppy food during the period of nursing in order to supplement her calcium intake.

The mother's temperature may rise 1-2 F (0.5-1C) above normal for the first 1-3 days, then it should return to the normal range. The normal range is 100-102 F (37.8-38.9C). If the mother's temperature goes above 104F (40C), she and her litter should be examined by a veterinarian for the presence of serious complications.

Postpartum Management of the Mother

A bloody vaginal discharge is normal for up to a week or so following delivery of the puppies. It may be quite heavy for the first 1-3 days, then should begin to diminish. If it continues for longer than one week, she should be checked for the presence of infection. Also, if the discharge changes color or develops an odor, she should be examined by a veterinarian.

If she was spayed at the time of the surgery, there should not be a vaginal discharge for more than a few hours.

The stitches may or may not need to be removed, depending on the type of suture material used. As a general rule, if the stitches are visible, they will have to be removed. Removal should occur at 10-14 days after surgery.

Care and Management of the Puppies

The Newborn Puppies

The puppies should be ready to nurse as soon as you arrive at home. Although the mother will not be awake enough to handle the nursing alone, it is still possible for you to assist the process by making her lie still so the puppies can nurse.

Puppies should sleep or be nursing 90% of the time. If they are crying or whining, something is likely to be wrong. Uterine infections, inadequate milk, and poor-quality or infected milk are the most likely causes. The entire litter can die within 24 hours if one of these occurs. If you are not comfortable with the way the litter is doing, the puppies and the mother should be examined by a veterinarian.

If the mother does not have any milk at first, you may supplement the puppies for the first day or two. There are several good commercial canine milk replacers available. Nursing bottles are available, made in the appropriate size for tiny mouths. The following formula may be used for a day or two if the other products are not available:

1 cup (240 ml) milk + 1 tablespoon (15 ml) corn oil + 1 pinch of salt + 3 egg yolks (no whites). Blend together until uniform. It should be fed at the rate of l oz (30 cc or 30 ml) per 1/4 # of puppy weight PER 24 HOURS. That amount should be divided into 3-5 feedings. The average newborn, small breed puppy weighs 1/4 # at birth.

Another alternative is canned goat's milk that is available in most grocery stores. It should be fed at the above amounts.

Although we prefer that puppies begin nursing immediately, a healthy newborn can survive nicely for up to 12 hours without nursing. However, if the newborn is weak, dehydrated, or chilled, nourishment must be given very soon.

Environmental Temperature Control

A newborn puppy is not able to regulate its body temperature very well. As long as the puppies stay near their mother, the room temperature is not too critical. However, if they are not with their mother, the room temperature should be between 85 and 90 F (29.4 and 32.2 C). If the litter is kept outside, chilling or overheating is much more likely to occur. The newborns should be kept inside the house or the garage if possible.

The Older Puppy

Weaning the Puppies

Weaning should begin when the puppies are about 3-4 weeks old. The first step is to place a 50:50 mixture of water and milk replacer or cow's milk in a flat saucer. The puppies' noses should be dipped in this mixture 2-3 times per day until they begin to lap. Once lapping begins, a puppy-type canned food should be crumbled in the water:milk mixture. As they begin to eat the solid food, the water:milk mixture should be reduced until they are eating only the solid food. Once they are eating solid food (about 5-6 weeks of age), they may be placed in their new home.

Early Health Care for the Puppies

Puppies can be treated for worms when they are 3 and 6 weeks of age. It is important that accurate weights are obtained for the puppies so that the proper dose of medication can be used.

First vaccinations typically begin at 6-8 weeks of age. If your puppies were not able to nurse during the first 3 days of life, they will not have received proper immunity from their mother. In this situation, vaccinations should begin about 2 weeks of age.