Now most female canine patients are spayed; it comes as no surprise reproductive emergencies are not as common.
One area of confusion seems to be not knowing how to determine a true dystocia emergency from the process of normal partuirition, especially when having discussion over the phone with an owner who’s pet is going through the process.
Another concern is what diagnostic pathway to follow to determine the cause of dystocia, especially for reasons other than obvious physical abnormalities (for example, fetopelvic disparity and fetal malposition).
Often, once we decide to go down the medical treatment pathway, whether the result of findings or owner/financial constraint, no one is confident as to what medication should be used and how often drugs can be given safely.
This series of articles will address these issues in a step-by-step manner. Hopefully, by the end, you will be confident in the diagnosis and management of dystocia.
Before moving on to the signs of dystocia, let’s go through the signs of labour.
First stage labour
First stage labour is characterised by panting, tremoring, nesting behaviour, a drop in core temperature, usually a drop by almost 1°C 24 hours before second stage labour and a drop of progesterone to below 2mg/ml.
The duration of first stage:
Second stage labour
Second stage labour is landmarked by the water breaking, visible abdominal contractions, and the allantoic/amniotic sac or fetal parts visible from the vulva.
If vulval discharge is present, it should be clear. Excessive amount of bright red haemorrhage, green or black discharge before delivery or purulent material can indicate a pathological process requiring immediate veterinary attention.
The duration of second stage:
Third stage labour
Third stage labour is when passage of all the placenta has occurred, generally within 15 minutes after passing a puppy or kitten.
Now we understand the normal progression of parturition; a few clues exist in the history that could suggest dystocia may be present.
Some breeders will often know the ovulation timing of the patient, especially if AI was performed. Tests such as progesterone levels, luteal hormone (LH) levels, cytology, and vaginoscopy are some ways where it can help time the ovulation.
The normal gestation length should not be any longer than 66 days from the LH surge or, if the ovulation history is unknown, 72 days from the last known breeding.
History of prior dystocia is a warning, as most animals with prior parturition difficulties are more likely to develop dystocia again.
The same goes for animals that have previously required a caesarean. Their risk of requiring future caesareans is high, with possible further risk of uterine rupture if dystocia happens again.
Owners often telephone after the failure of the normal progression of the delivery of a puppy/kitten. The signs that always require immediate intervention are:
Any of these signs require immediate presentation to the veterinarian. Delivery of stillborn puppies is also an indication where veterinary attention indicated.
Finally, if owners are concerned, it is best to advise veterinary assessment rather than try to convince them everything is okay based on what they describe over the telephone.
Once the bitch presents to the clinic, a few basic diagnostic checks need completing to determine the status of the bitch/queen and the fetuses.
The first is a thorough physical examination, starting with the bitch or queen:
Panel 1. Heart rate ranges to help indicate stress of fetuses
Normal – 180 to 220 beats per minute (bpm)
Stressed – 160bpm
Real concern – less than 160bpm
Normal – more than 220pbm
Fetal stress – less than 180bpm
The second important diagnostic tool is ultrasound.
Fetal heart rates are good indicators of fetal stress. Some heart rate ranges that can help provide information about the status of the fetuses are detailed in Panel 1. These ranges vary between sources but are good guidelines.
Ultrasounds can also help visualise the maturation status of the fetuses. At-term fetuses should have normal hepatic, renal, and intestinal development. Intestinal peristalsis should be evident in at-term fetuses.
Other diagnostics may be indicated for patients, depending on the status of the bitch/queen:
Part two will briefly look at the medical management of dystocia and when surgical intervention is required.