A cesarean section (C-section) is the surgical removal of puppies
from the uterus. What Are the Indications For Performing a Cesarean Section?
This operation is indicated when natural delivery is not possible or will risk the life of the mother. Some C-sections are planned, as when a female has a history of delivery problems. In other situations, the operation is done on an emergency basis when natural delivery fails. Many times one or two pups may be delivered naturally, but the next pup cannot be delivered for some anatomic or physiologic reason. While hormone therapy (oxytocin or Pitocin) may stimulate normal delivery at this point, often the bitch is too exhausted or the pup too large to be delivered vaginally. At this point the C-section becomes imperative.
Some owners choose to have the mother spayed following the C-section, but this is not required. Animals with previous C-sections may deliver litters in the future, either naturally or by repeated Cesarean. What Preoperative Examinations or Tests Are Needed Before a Cesarean Section?
Preoperative tests depend in part on the age and general health of the pet. In younger otherwise healthy females, minimal tests are needed. Of course the veterinarian must be certain the pet is pregnant and near full term. This is usually accomplished through x-rays. Often simple blood tests, such as a packed cell volume or complete blood count (CBC), will be done prior to anesthesia. In older or unhealthy animals, it may be necessary to perform a routine blood count, serum biochemical tests, a urinalysis, and possibly a chest X-ray or EKG prior to anesthesia. These recommendations vary on a case-by-case basis, and depend on the overall health of the pet at the time of surgery. What Type of Anesthesia Is Needed For a Cesarean Section (C-Section)?
As in human patients, the procedure in dogs requires significant anesthesia. Spinal anesthesia is more difficult to perform in dogs. Furthermore, the pet will not cooperate and lie still for surgery even if all pain is relieved. Thus general anesthesia is needed to induce pain relief, unconsciousness and relaxation. In the usual case, the pet will receive a pre-anesthetic sedative-analgesic drug to help her relax, a brief intravenous anesthetic to allow placement of a breathing tube in the windpipe, and subsequently inhalation (gas) anesthesia in oxygen during the actual surgery. How Is the Cesarean Section (C-Section) Operation Done?
Following anesthesia, the pet is placed on a surgical table, lying on her back. The hair is clipped over the lower abdomen, the skin is scrubbed with surgical soap to disinfect the area and a sterile drape is placed over the surgical site. The veterinarian then performs a midline incision similar to that used to spay a female; however, the incision line will be relatively longer. A scalpel is used to incise the skin of the lower abdomen and then open the abdominal cavity. The uterus will be exposed and then incised to remove the fetus. The pup(s) is (are) handed to an assistant who clears the airway, stimulates breathing, and gives drugs if necessary. The uterus may be contracted with a hormonal drug and then the incision is closed with sutures (stitches) that dissolve over time. Alternatively, the female may be spayed (this procedure is explained elsewhere on this site). The abdominal incision is then closed with one or two layers of self-dissolving sutures (stitches). The outer layer of skin is closed with sutures or surgical staples that must be removed in about 10 to 14 days. How Long Does the Cesarean Section (C-Section) Take to Perform?
The procedure takes about 45 minutes to one hour to perform in most cases, including the needed time for preparation and anesthesia. In obese animals or animals with large litters, the procedure can take longer and may require two surgeons. What Are the Risks and Complications of a Cesarean Section (C-Section) Operation?
The overall risk of this surgery is very low. The major risks are those of general anesthesia, bleeding (hemorrhage), infection (peritonitis), post-operative infection and wound breakdown (dehiscence) over the incision. Overall complication rate is low, but serious complications can result in death or the need for additional surgery. What Is the Typical Post-Operative Aftercare For a Cesarean Section (C-Section)?
Post-operative medication should be given to relieve pain, which is judged in most cases to be moderate and can be effectively eliminated with safe and effective pain medicines. Generally young dogs act normally within 24 to 48 hours and are released one or two days after surgery. In some situations, the pet is released the same day of surgery. The home care requires reduced activity until the stitches are removed in 10 to 14 days. Since the puppies are allowed to nurse the dog should be given increased amounts of food to maintain her energy needs. Fresh water should always be available and the pups should be confined and kept in the "nest" when the female is taken out-of-doors for mild exercise and elimination activities. The incision line and the mammary glands should be inspected daily by the pet owner for signs of redness, discharge, swelling, or pain. How Long Is the Hospital Stay Following a Cesarean Section (C-Section)?
The typical stay is one or two days but some pets are sent home the same day of surgery.