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C-section Aftercare

Written & submitted by Theresa Mullen, Terrylane

The C-Section is the saving surgery for both dam and puppies when problems are anticipated, both planned for and those that occur during the natural whelping process, unexpectedly.

The dam is given an anesthetic and an incision is made in the abdominal wall and then another through the uterus to extract the puppies.  There are minor problems associated with this surgery, as the puppies, also, are affected by the anesthesia.  It is necessary to stimulate the puppies vigorously as they are “born” and to watch for problems associated with the anesthesia.

If a bitch is in labor and has delivered a puppy or puppies and then has to have the Section because of maternal problems or puppy distress, the dam has the advantage of experiencing the labor and birth process and has contact with the newborns and their associated VISUAL and SCENT stimulus BEFORE the surgery.

This situation is most like the normal, natural whelping where the bitch has all the EVENTS of labor and whelping happening to her and can BOND and recognize her puppies because of her INSTINCTUAL response to birth and nursing.  Usually these dams have very little problems being reunited with their puppies, as they are already IMPRINTED on their smells and audio and visual distinctions.  Because dogs are “INSTINCTIVE” in their responses to the labor and birth process, and the response to their OFFSPRING is the strongest behavior that they exhibit—even greater than those to satisfy their own needs….food and water…most of these bitches will not “miss a beat” once reunited with their puppies.

The incision,  is usually in the median line of the abdomen….between the “rows” of mammary glands on each side of the incision. The incision is somewhat protected from the direct contact from the puppies little paws as they nurse because the mammary glands are so enlarged with milk that they lie “on top of ” each other. So this is a benefit for the pain of puppies “pushing” on it directly.  But, the “air” circulation is not available, so pay attention to how it is healing.  The dam will usually not pay too much attention to the incision unless there are problems from pain caused from infection, swelling or oozing, so check the incision at least twice a day to make sure that it is looking like it is healing normally and there is no redness or unusual symptoms going on.

During the normal natural whelping, with all of its associated preparation phase….where the relaxin hormone is softening the ligaments and soft tissues of the body in preparation for the birth….the bitch is being “stimulated” by various hormones.  They are responsible for the labor and birth and the formation of colostrum (first “milk”) and the milk necessary to nourish her puppies….and begins to “kick into gear” the behavior that instinctively will allow her to withstand the birth, bond to her puppies and nurse and protect them.  This begins several days before labor actually begins… she is under the influence of hormones and instinct.  These are all working together to assure a smooth natural birth and allows for the use of the C-Section when needed to save the dam and/or her puppies.

The bitch that has a “scheduled” C-Section which will occur BEFORE any of the labor processes begin will not have the benefit of the hormonal support for her INSTINCT.  But, because of INSTINCT, the transition for the bitch to go from pregnant… to having surgery and “waking up” a mother with puppies….makes it, under most circumstances, a smooth transition.

There are some unique problems associated with a prior to labor, scheduled C-Section and puppies.

The first and foremost of these is that the bitch has not had all the hormonal, audio, visual, and scent stimulation that occurs prior to, during and after the birth of each puppy.  All these stimulus help the dam to BOND and accept her puppies.  So, I have found that it helps the dam to recognize her puppies when she wakes up if you will take a few large towels into the delivery room where the bitch is having the Section and the puppies are being “rubbed and stimulated” when they are being taken from the uterus….and use these towels to “RUB” and dry off the puppies.

All of the amniotic fluid, blood and “birth” fluids and excretions that the bitch won’t be able to respond to and “imprint” on will be on the towels…..which will be used to place the puppies on when they are introduced to the bitch.  The dam is able to SMELL and “take in” and IMPRINT ON these scents and it tells her these are HER babies.  Also….DO NOT wash the puppies off with ANY artificial smell….no soap or baby wipes.  The dam NEEDS to have all the SMELLS of her body and the birth and the puppies to be as strong as possible.  It WILL HELP her adjust.

During a natural whelping…..the uterus contracts because of the release from the brain of OXYTOCIN.  This is a powerful hormone that not only causes the uterus to “push” the puppies through the cervix and through the vagina and vulva and into the “world”…..but it also contracts the uterus AFTER the birth.  It causes the uterus to “clamp down” and close the bleeding placenta attachment areas that are left on the uterus after the puppy is born.  The Vet will remove the placenta from its attachment on the uterine wall when he delivers the puppy.

This “clamping down” stops any undue bleeding and helps to “push out” any blood and fluids left in the uterus.  It EMPTIES the uterus….cleans it out!   While Oxytocin affects the uterus….it also causes the colostrum (at birth) and the true milk (after about 2 to 3 days) to be “LET DOWN”.  This is where the mammary glands make the milk, then move the milk from the glands down through the ducts so it can be expressed by the puppy by nursing.  Without this “MILK LETDOWN” the milk remains in the glands and doesn’t move to the nipple and the puppies get no milk.

OXYTOCIN is released when the nipples are stimulated by the puppies nursing.  The more they nurse….the more the Oxytocin is released by the brain and the more milk is carried to the nipples.  It’s a GREAT system!

**VERY IMPORTANT**   BUT, one of the symptoms of puppies nursing is not only the milk “FLOWS”…..but the uterus also CONTRACTS, which can cause discomfort to pain in almost all bitches.  This is the NUMBER ONE REASON that bitches CURL UP IN A BALL after they deliver and the puppies start nursing.  They are truly having a “flood” of things happening….and they are happening when the puppies are close by and nursing.

**Often, bitches will get agitated when they are in pain and they associate the puppies with the pain.  So it can set up a bad association that can affect her bonding with the puppies.**

Be patient with the bitch when she is nursing the puppies.  Her tendency is to curl up tightly and bend her body because the “HORNS OF THE UTERUS”… have two horns…. run along the abdomen.  So she wants to minimize stretching out….which is exactly what you want her to do to nurse her litter.  She needs time and patience from you.

You can even split up a litter that is large, and let half nurse at a time.  This is often less “chaotic” for the bitch.  Instead of “10” puppies crying and rolling around….there’s only 5….and much less overwhelming for her after surgery.

You can separate the litter by size….the 5 big ones and the 5 little ones.   This works well…and switch every 2 hours.  You need to remember that new born puppies need to nurse AT LEAST EVERY 2 HOURS!!  They have a very high metabolism and require energy continuously to keep going.

REMEMBER….Reviving weak or sleepy puppies can usually be a
ccomplished by giving them “SUGAR WATER”!!  


Most puppies that are weak at birth can be given a few droppers full of “SUGAR WATER”, which I suggest you make by getting UNCOLORED HUMMINGBIRD NECTAR and mixing it to make a strong syrup….3 tablesp. of water to 1 tablespoon of sugar.  The Hummingbird Nectar is mostly Dextrose which blends instantly and is closer in makeup to Glucose than Sucrose, which is table sugar.  GLUCOSE is the SUGAR the body uses directly for energy….FUEL!  The closer that the sugar is in composition to glucose the quicker it can be used!!


When a puppy is HYPOGLYCEMIC….this can mimic MANY problems.  This is when the “BLOOD SUGAR LEVEL” drops to a level where you see the puppy not able to nurse….falling off the nipple…..sucking a few “sucks”, then letting go.  Often they are so lacking in circulating glucose that they look and act sick.

TRY THIS FIRST WHENEVER YOU HAVE LETHARGIC PUPPIES.  The  dextrose solution goes IMMEDIATELY into the puppies bloodstream and it should be stronger within 5 to 10 minutes.

DON’T LOAD THE PUPPY UP WITH TUBE FEEDING MILK OR FORMULA before you let the puppy nurse.  This is  to get the COLOSTRUM into the puppy’s system FIRST!


It is very important that the dam be introduced to her babies to maximize her acceptance of them.  Take the towels that are full of the “birth” smells and lay them down in the whelping box and put the puppies down…..a few at a time….to allow her to smell, lick, roll around and generally “take in” the puppies by sight, smell and sound.  ALL these stimulus will help her bond.  Talk to her and reassure her that she is a “GOOD GIRL” and that the “BABIES” are hers and “so wonderful”!!   Have her lay down and pet her and reassure her as you put the puppies on her nipples.


The Colostrum is manufactured by the dam for the protection of diseases.  The Colostrum contains ANTIBODIES that the dam has made in her body for ALL the organisms that she has IMMUNITY for.  These include those that she has been exposed to naturally and those that she has been VACCINATED FOR.  The transfer of these Antibodies in the first few days is CRITICAL to the protection from disease for the puppy.

The puppy’s “gut” is only OPEN to receive these antibodies for a few days.  After that brief “window of opportunity”….the puppy’s “GUT” closes and cannot receive the “larger” size molecules of the antibodies.  If for whatever reason, the puppies cannot receive their OWN MOTHERS COLOSTRUM the first or second day,  try to find other CANINE COLOSTRUM source which can be frozen and kept for emergencies.  There are “banks” that some breeders keep for emergencies.

Colostrum from OTHER SPECIES….goat, cow, etc. are NOT EFFECTIVE in producing immunity for dogs.  The Colostrum is SPECIE SPECIFIC!!     Goat Colostrum has “goat disease immunity” in it…..NO CANINE DISEASE IMMUNITY.

With bitches that have scheduled C-Sections and don’t get the lengthy exposure to the continuous release of OXYTOCIN during the labor and whelping process….the Colostrum and Milk letdown may be slow in happening.  Watch for problems nursing…puppies trying to nurse but no milk able to be “squeezed” out.  The dam may need some Oxytocin to get the “MILK FLOW” started.  Once the milk is there at the nipples for the puppies to get out….they will suck harder and “stimulate” the further release of the milk.  I have had to use Oxytocin to start the “cycle” of milk production….milk letdown….then the puppies suck and keep the cycle going.


When bitches go through a natural labor and delivery, it has been by observation over the years that they are carried along in this most natural of happenings by a “quietness and calmness” that overcomes them once true labor begins.  It’s been my observation that they almost appear to be “tranquilized” and I do believe they are under the influence of natural “endorphins” when in labor and giving birth and for a few days after.  I’ve observed this with other species…large animals….horses, cattle…and in watching my cats over the years….most cats giving birth “PURR” throughout like they are enjoying the process.

Being a mother myself…..I KNOW those animal mothers should be hysterical during the labor and birth process….after all….they’re giving birth to multiples!!!!   And if not hysterical… least crying and jumping around a lot!!  But animal mothers  are very quiet and focused and relaxed…..a MARVELOUS THING TO WATCH…..TRULY A MIRACLE!

Most problems with bitches and poor behavior usually don’t happen until AFTER a few days…..interestingly enough…when I’ve observed the “endorphins” are no longer being excreted.

My point in bring this “endorphin” subject up is that bitches that go in for scheduled C-Section don’t have the opportunity to go through the “LABOR AND DELIVERY” and so don’t have the tranquility right after the surgery like a naturally whelping bitch.

She goes in for her Section with no signs of impending labor…..and an few hours later….she’s got a litter of puppies in front of her….with NO HELP from all the hormonal influences….visual stimulus….audio stimulus…olfactory stimulus….and all the TOUCH sensory stimulation that occurs during the process.  She has not had the benefit of the Oxytocin pushing and cleaning out the uterus and “jump starting” the MILK LETDOWN… she is already way behind her naturally whelping counterpart.

IS IT NO WONDER SHE CAN HAVE SOME UNIQUE PROBLEMS??  These can manifest themselves as BEHAVIORAL PROBLEMS AS WELL AS PHYSICAL PROBLEMS.  We must be EXTRA AWARE of her condition….mentally and physically.  If she were a “human”, all of this could be EXPLAINED to her….but alas, she is a dog and driven by INSTINCT….but in this case without the benefit of the sensory and hormonal exposure that just ENHANCES INSTINCTIVE BEHAVIOR.

Behavioral problems…..growling and snapping at the puppies….need to be quickly assessed and a plan devised.  If a bitch is growling it can signal PAIN that she is experiencing…..from the incision, from the uterus contracting…from the puppies scratching her and nursing which causes the uterus to contract…..from having no milk…..from being uncomfortable in the whelping box….from being “worried” because she wants you in there….worried about other dogs in the household….to insecurity……to truly being a poor mother.

Poor maternal instinct is HIGHLY HERITABLE in other species.  It is my personal opinion that it is HIGHLY heritable in dogs, also.  So, be aware that if the dam comes from a family of poor mothers and she is exhibiting like behavior….it may have NOTHING to do with the C-Section and everything to do with what she has been programmed by her “genetic” inheritance.

So, be prepared if there are inherent mothering problems in her background….BOTH SIRE AND DAM.  Determine if the problems relate directly to the dam not adjusting to having the C-Section and not able to nurse and take care of the puppies.   You may have to SUPPLEMENT what milk the bitch has…OR you may have to “raise” the puppies by “TUBE FEEDING” for the first three weeks, until the pups can eat solid food.


Of course, success with the bitch and puppies after a C-Section is thankfully the usual out
come.  But, hopefully some of the topics I’ve covered here will help if you and your bitch have to undergo this life saving surgery.  Being prepared and having alternatives when problems arise are the breeders greatest assets.

All the best in your breeding endeavors.