From a pet animal point of view, a caesarean section, or c-section, is a major surgery performed to remove puppies or kittens from their mother’s uterus. This procedure is most commonly performed as an emergency when there is difficulty with natural birth. Successful caesarians in dogs and cats are usually performed in a well equipped surgical theater by an experienced veterinarian and a surgical team.
Why was my pet at risk?
Caesarian sections are usually indicated where mothers are unable to give natural birth (referred to as dystocia). Although the exact reasoning will not always be evident, common reasons include: certain breeds, such as brachycephalic breeds (for example Bulldogs and Persian cats), where there is a more than the breed average amount of puppies/kittens, where there is only one puppy/kitten, where the mother is very young (i.e. their first heat cycle), very small or where the father is much bigger than the mother.
Other reasons include mothers that are sick, obese, emaciated or has a poor body condition. Abdnormally formed offspring can also cause dystocia.
When should the procedure be performed
Dystocia by definition is difficult birth. The longer puppies or kittens stay inside the mother’s uterus after the birth process starts, the bigger the risk of them (and the mother) dying.
Sometimes an owner is very lucky to have healthy offspring even if the birth process took longer than 12 hours, but other times puppies or kittens are already born dead after waiting for as little as three hours.
Although different times are reported, I strongly recommend caesarian sections if a mother is unable to produce any offspring after two hours from the first ‘contractions’, or take longer than two hours to produce the next one. The first stage of giving birth is when a queen or bitch starts to actively contract her stomach.
The caesarian section procedure
Irrespective the cause of dystocia, the end result is almost always the necessity to remove the offspring surgically.
Upon admission mothers are medically stabalised, premedicated, placed under general anaesthesia and prepared for surgery.
A large surgical cut is made on the belly. The cut is made in the direction of the head to the tail and not from side-to-side. No abdominal muscles are cut.
The uterus is inspected and after determining the best place, a smaller cut is made in the uterus itself and the puppies/kittens are removed one-by-one. The uterus together with the ovaries might also be removed at this point.
After all the babies were removed, the uterus, ligaments and skin is sutured up separately and the mother is allowed to wake up.
What to expect after the operation
Most bitches and queens recover quickly from this procedure and are discharge very soon thereafter; however, if the mother was in labour for several hours before surgery was performed, her recovery will be slower and she will stay a day or two in hospital. In these cases the mother and her offspring might also need extra attention and help at home.
For the first 48 hours after discharge, it is expected that some mothers may not eat their normal food at all or eat less than usual. Even so, food and water should always be readily available until she eats well. Where a poor appetite is observed, cooked chicken and rice can be offered to stimulate the appetite a bit, but ultimately new nursing mothers will need good quality food with high energy content – such as a commercial puppy food. We recommend the Hill’s Science Plan Healthy Development food range. These foods should also be offered to the puppies or kittens as soon as their eyes are open (from about two weeks of age).
Contrary to some belief, good mothers should always be willing to nurse their offspring, even after a c-section. In order to minimise the risk of post-partum complications, we recommend earlier than usual weaning, starting at about 2 – 3 weeks after birth. This can be done by gradual separation of the mother and her offspring from the time they start to eat solid food as described above.
Your pet should be kept quiet in a controlled environment for the next week. Running and jumping can result in stretching around the operation wound. Also refrain from swimming and bathing until the stitches are removed.
It is strongly recommended to have at least two follow-up post operative examinations done by your family veterinarian – the first, one week after discharge and the second, two weeks after the operation was done.
During the first follow-up examination, the attending veterinarian will evaluation the mother’s vital signs and take a thorough history of the mother and the offspring to make sure everything is in order.
During the second follow-up examination, the veterinarian will remove the operation stitches and evaluate the history again. The mother and puppies/kittens should also receive their first post partum dewormers.
If a mother is still lethargic a day or two after discharge, has a prominent, bad smelling, vaginal discharge, or where the puppies/kittens are very vocal and not sleeping most of the time, a follow-up examination should be scheduled immediately.
Should the mother be spayed?
It is proven that bitches/queens who needed a caesarean section during any of her pregnancies will have a very high incidence of needing one in future as well.
Permission to do an ovariohysterectomy (the spay procedure) would have been discussed by the admitting veterinarian before the caesarian operation. If the mother was not spayed during the caesarian, it is still highly recommended to get this operation done before her next heat cycle.