Dog C-Section: What the Procedure Is and How To Prepare Your Dog

When new puppies are expected, most breeders and pet parents hope to watch the miracle of life in action from the comfort of their homes.

However, a dog C-section (or Cesarean section) may become necessary if your pet has trouble giving birth or belongs to a breed known for difficult deliveries. Read on to learn more about C-sections in dogs.

What Is a Dog C-Section?

A dog C-section (i.e., hysterotomy) is an abdominal procedure in which puppies are surgically removed from the womb (i.e., uterus) of a pregnant dog who is experiencing a difficult birth (i.e., dystocia).

Mother dogs (i.e., dams) need anesthesia or heavy sedation to remain safe and still during the procedure.

An epidural, a local anesthetic that numbs the back half of the dog’s body, can reduce but not eliminate the need for sedation.

1. The veterinary team intubates the pet, placing a tube in their windpipe (i.e., trachea). The tube delivers oxygen, and if the dog is under general anesthesia, the tube also delivers anesthetic gas.

2. The team shaves and cleans the dam’s belly to reduce the chances of infection.

3. The veterinary surgeon creates an incision along the midline of the dam’s belly. Once inside, the surgeon can pull part of the Y-shaped uterus out through the incision.

4. The surgeon then creates another incision, this time in the uterus, and removes the puppies and their placentas one by one, handing them to waiting team members.

5. Once the puppies are out, the surgeon will either close the incision in the uterus and put the organ back or remove the uterus completely (i.e., spay the dog) before closing the abdomen. Your veterinarian will discuss these options with you before your dog’s procedure.

6. While the surgeon completes the surgery, nearby assistants and technicians tie off the puppies’ umbilical cords and stimulate them to help them wake up and begin breathing.
    

Why Would a Dog Need a C-Section?

Dog pregnancies last an average of 63 days.

At the end of each pregnancy, most dogs have a vaginal delivery called whelping.

If complications develop and the dam is unable to deliver the puppies on her own, she may require a Cesarean section.

Difficulty with birthing or delivery is called dystocia, and it’s most common among flat-faced (i.e., brachycephalic) dogs, such as English or French bulldogs.

C-sections may be planned or emergency procedures. A planned C-section may be considered if the dam:

• Is a brachycephalic breed

• Has a history of previous dystocia or C-section

• Has a history of pelvic fractures

• Is pregnant with only one puppy, which may fail to induce labor

Reasons for an emergency C-section include:

• A fetus trapped within the birth canal

• Fetal distress detected on ultrasound (e.g., slowing heart rates)

• Signs of illness in the dam

• A uterine tear during delivery (rare)

• One or more deceased fetuses stuck in the uterus or birth canal

Pet parents of pregnant dogs should watch them closely as the delivery day draws near. Talk to your veterinarian about what to expect and what could indicate a problem.

Contact your veterinarian for an evaluation and potential C-section if:

• The dam’s water breaks, but she hasn’t delivered any puppies after two hours

• More than two hours have passed between puppies

• The dam is straining for more than 30 minutes without delivering a puppy

• The dam is pregnant for 70 days or more without any signs of labor

• You have concerns about how your dog’s whelping is progressing

Benefits of a Dog C-Section

Planned C-sections can prevent dystocia and improve the odds of healthy, live puppies when dams are at high risk of birthing difficulties.

Emergency C-sections are often lifesaving for the dam and her pups. C-section also allows for concurrent spay surgery in dogs with too many risk factors for a healthy future pregnancy, which lowers risks for other reproductive issues too.

Without a C-section, dogs suffering from dystocia and their puppies will likely pass away.

Effectiveness of a Dog C-Section

The C-section survival rate is 99% for dams, whether the procedure is planned or performed as an emergency.

A 2022 study reported a puppy survival rate of around 99% in puppies born via planned C-section and an 87% survival in puppies born via emergency C-section.

Surviving puppies may pass away in the hours, days, or weeks after birth, but this is true for natural births as well.

Factors that impact puppy survival after C-section include:

• Length of time the dam is in labor before C-section surgery

• Length of time a puppy spends stuck in the pelvic canal

• Anesthetic protocol

• Total anesthesia time

• Length of time between anesthetic induction and the start of surgery

• Dam’s age

It’s important to note that if a C-section isn’t pursued for a whelping dog who can’t deliver her puppies vaginally, fatality of the puppies is guaranteed.

Without intervention, the mother may also become ill and die.

Risks of a Dog C-Section

Overall, C-section complications are infrequent. The most common complication is infection of the skin incision.

Other possible complications include:

• Anesthetic complications (e.g., medication reaction or, rarely, death)

• Aspiration pneumonia (i.e., inhaling fluid into the lungs)

• Heavy or persistent bleeding

• Infection of the abdomen (i.e., peritonitis)

• Reopening of the abdominal incision

Risks specific to C-sections include:

• Uterine infection or inflammation

• Uterine scarring (may affect future pregnancies)

• Uterine prolapse

• Fetal anesthetic death

Overall, complications for the female dog are uncommon. The most common complication is infection of the skin incision.

Cost of a Dog C-Section

Dog C-section costs can range from $500 to $4,000.

Planned C-sections generally cost less than emergencies, especially if the dam or her puppies need intensive care and monitoring after the procedure.

Some non-profit and low-cost clinics may perform the procedure for less. However, many of these organizations require that spay surgery be performed along with the C-section to prevent future litters.

Most pet insurance companies exclude pregnancy costs—including dog  C-sections—from typical coverage.

Preparation for a Dog C-Section

Here are a few tips and tricks to help you prepare your dog for a planned C-section:

• Bathe her the day before surgery with a dog-friendly shampoo.

• Skip breakfast the morning of the procedure (water is OK).

• Speak with your veterinarian about medications and parasite prevention your dog takes, as some are unsafe for newborn puppies.

• Find a safe way to transport mom and puppies back home. Avoid keeping mom in the same crate with her puppies so she does not accidentally fall or step on them. Use a heating pad for the puppies and towels or seat covers to protect your vehicle.

• Set up your dog’s whelping box ahead of time. Even if the dam doesn’t whelp at home, the whelping box keeps the puppies safely contained while they grow. You can purchase one commercially or use a plastic kiddie pool and line the box with soft, washable bedding or reusable pee pads.

Post-Op Care and Recovery for a Dog C-Section

Monitor your dog as she recovers from anesthesia to ensure she doesn’t accidentally roll over on her puppies. Don’t leave her unsupervised until she is completely awake, walking, and showing interest in her puppies.

Post-operative pain control is tricky in lactating dogs, since some medications can pass through the mother’s milk.

Short-term treatment with a non-steroid anti-inflammatory drug (NSAID), such as carprofen, is usually safe for nursing puppies. Always follow your veterinarian’s instructions regarding post-operative pain control and contact them if your dog appears painful.

A nursing mother dog needs two to three times more calories than usual. Choose a diet for her marked with an AAFCO statement indicating that it’s appropriate for gestation and lactation.

Often, these are puppy foods you can also use for the pups during and after weaning.

Your dog’s abdominal incision will heal in 10 to 14 days, but there is a risk of infection because the puppies will nurse on nearby teats.

The dam should not wear a recovery cone, which could impede her access to her pups. This also means she can lick her incision, so you should monitor the area for signs of infection, such as redness and discharge, and discourage her from licking.

Your dog may have green, red, or brown vaginal discharge (i.e., lochia) after surgery. If the discharge is red, it should turn darker over the first week.

The discharge amount should gradually decrease and disappear within a month of giving birth, but it may be present for up to eight weeks. You can gently clean the discharge from the dam’s hind end.

Do not bathe her for at least two weeks after surgery.

Contact your veterinarian if the discharge:

• Smells foul

• Increases over time

• Becomes bloodier suddenly or over time

You should also contact your veterinarian if your dog is acting sick. Call your vet if you notice:

• Fever

• Vomiting

• Lethargy

• Inappetence

• Weakness

Alternatives to a Dog C-Section

If your dog is unable to give birth naturally and requires a C-section, there are no alternatives.

Failure to pursue a C-section to correct dystocia is likely to result in the death of the remaining puppies and may also prove fatal for the mother.