Canine Parturition and Neonatal Care

Canine Parturition Overview and Endocrinology

  • Parturition and whelping both refer to the process of giving birth to puppies.

  • Progesterone is synthesized and secreted by the corpus luteum (CL) throughout the entirety of the pregnancy (maintains pregnancy)

    • Can test progesterone, if dropping then parturition is imminent

  • Prostaglandin is produced by the placenta as parturition approaches; its concentration increases to induce contractions.

  • Parturition is initiated by a sudden drop in circulating maternal progesterone concentrations, which triggers the onset of labor within 12 - 24 hours.

  • Parturition is divided into three distinct stages:

    • Stage I: Preparatory stage.

    • Stage II: Expulsion stage.

    • Stage III: Cleaning stage.

Stage I – Preparatory Stage

Whelping pen setup with safety rails and washable bedding

  • Set up a dedicated nesting box or whelping area approximately 1 week prior to the anticipated delivery date.

    • Whelping box/pen

    • Small room is unable to have whelping box

  • 6 - 36 hours before delivery:

    • Restlessness, agitation, panting

    • Nesting behaviors

    • Anorexia or decreased appetite

    • Rotation and positioning of fetuses into the birth canal

    • Progressive relaxation and dilation of the cervix

    • Intermittent, non-visible uterine contractions

    • Core body temperature transiently drops to 99°F approximately 24 hours prior to the transition into Stage II labor (down from the normal baseline of 100 - 102.5°F)

Stage II – Expulsion Stage

Puppy emerging in amniotic sac during Stage II expulsion

  • Characterized by strong, coordinated uterine contractions combined with visible, active abdominal contractions that propels each puppy into and through the birth canal.

  • The expected duration for delivering an individual puppy is 20 - 60 minutes

  • May rest up to 2 hours may occur between successive puppy deliveries but does not always happen

  • Total whelping duration typically spans approximately 6 hours for an average litter, though large litters may extend up to 24 hours

Stage III – Cleaning Stage

Expelled newborn pup attached to placenta and fetal membranes

  • Encompasses the expulsion of the fetal membranes and placental units, alongside the initiation of uterine involution.

  • Should be a placenta for every puppy

  • A dark green to black vulvar discharge is normal during this stage

  • Dam will tear open amniotic sacs and ingest placentas

  • Will lick their bodies and faces. Cleans and stimulates breathing.

  • Stage II and Stage III alternate continuously throughout whelping:

    • Pattern A: puppy → placenta, followed by puppy → placenta

    • Pattern B: puppy → puppy, followed by placenta → placenta

  • Ensuring complete expulsion of all placental units is critical, as retained membranes serve as a nidus for severe uterine bacterial infections, systemic toxemia, and death.

  • Involution of uterus = shrinkage and repair of the uterus

Dystocia and Whelping Intervals

  • Dystocia is defined as abnormal, slow, or difficult labor and birth.

    • Intervention could be oxytocin injection up to C-section

  • Maternal anxiety can interrupt normal hormonal cascades and delay labor progression; many complications can be avoided by providing a quiet, familiar, comfortable environment.

  • Client triage protocol: Clients must be instructed to call the veterinary facility prior to transporting a dam in labor to prevent unnecessary transport stress during normal whelping.

  • Emergency veterinary evaluation is indicated if the client reports any of the following whelping intervals:

    • 30 minutes or more of active, strong abdominal contractions without the expulsion of a puppy.

    • Greater than 2 hours of weak, intermittent, or infrequent contractions without the expulsion of a puppy.

    • A resting interval exceeding 2 hours since the birth of the last pup when additional fetuses remain in utero, accompanied by an absence of contractions.

Postpartum Maternal Monitoring and Lochia

  • Normal postpartum uterine discharge is termed lochia.

  • Lochia typically persists for 4 - 6 weeks following parturition.

  • The physical appearance of lochia transitions from an initial dark green/black color to a thin, non-odorous reddish-brown discharge within 2 - 3 days postpartum.

  • Lochia persisting beyond 8 weeks postpartum is abnormal and requires clinical veterinary evaluation.

  • A healthy postpartum dam remains bright, alert, and responsive (BAR) with a robust appetite.

Postpartum Maternal Complications

  • Retained Placenta or Retained Fetus:

    • Etiology: Incomplete evacuation of uterine contents.

    • Secondary pathology: May lead to metritis (uterine infection) and systemic toxemia

    • Clinical signs: Depression, anorexia, hyperthermia (fever), malodorous purulent vulvar discharge, and agalactia (decreased milk production).

    • Treatment: Immediate diagnosis and intervention using systemic broad-spectrum antibiotics, intravenous fluid therapy, and surgical intervention (ovariohysterectomy) if medically indicated.

    • Neonatal impact: Puppies vocalize constantly due to maternal neglect and inadequate lactation; neonates must be bottle-fed.

  • Mastitis:

    • Pathophysiology: Bacterial infection of one or more mammary glands.

    • Clinical presentation: Affected mammary glands become swollen, firm, hot, and painful; milk may appear purulent or discolored.

    • Maternal and neonatal signs: Dam may show signs of depression, pain, and reluctance to allow nursing; neonates fail to gain adequate weight.

    • Medical management: Antibiotics

    • Nursing protocol: Puppies may generally continue nursing unless abscessation or gangrene occurs; keep puppy nails trimmed to prevent injury to mammary glands and ensure neonates nurse evenly across all mammary teats to promote drainage.

  • Subinvolution of Placental Sites (SIPS):

    • Sites of placental attachments in the uterus are not healing properly

    • ± blood-tinged discharge; owner may not be aware

    • Typically will resolve and repair sites by next estrous cycle; however, if signs persist, further evaluation by a veterinarian may be necessary to prevent complications.

  • Eclampsia (Puerperal Tetany, Hypocalcemia, Milk Fever):

    • Pathophysiology: Severe acute depletion of circulating extracellular calcium levels driven by high demands of lactation.

    • Timing and predispositions: Occurs most commonly during peak lactation (2 - 3 weeks postpartum); highly prevalent in small-breed dogs nursing large litters.

    • Clinical progression: Begins with restlessness, pacing, panting, and muscle stiffness/tremors; rapidly progresses to high fever and seizures

    • Emergency treatment: Slow (20 - 30 minutes) intravenous infusion of calcium gluconate; follow with daily oral calcium supplementation and Vitamin D.

    • Concurrent disturbances: Hypoglycemia can occur concurrently; treat with intravenous dextrose.

    • Neonatal management: Remove puppies immediately from the dam and transition entirely to artificial bottle-feeding. Dam will go back into eclampsia if continues to nurse.

    • Prevention guidelines:

      • Never administer high-dose calcium supplementation during pregnancy, as it down-regulates parathyroid gland activity and significantly increases the incidence of eclampsia

      • Feed a high-quality, growth/lactation commercial puppy diet ad libitum (free-choice feeding) throughout gestation and nursing.

      • Initiate oral calcium supplementation exclusively during peak lactation in high-risk bitches or those with a history of eclampsia.

Neonatal Resuscitation and Immediate Care

  • Dam assistance: Dams naturally rupture membranes and sever cords, human intervention should occur only if needed

  • Membrane removal: Immediately open the amniotic sac and strip all fetal membranes clear of the mouth and face to prevent asphyxiation.

  • Physical stimulation: Vigorously rub the dorsal spine and thorax with a warm, dry towel to stimulate breathing.

  • Airway clearance: Aspirate fluid, mucus, and amniotic debris from the oral cavity and external nares using a bulb syringe.

    • NOTE: Slinging puppies is no longer recommended, can be dangerous for the puppies

  • Umbilical management: Double-clamp or securely ligate the umbilical cord with suture material; transect cleanly with sterile scissors distal to the ligature and apply povidone-iodine (Betadine) to the umbilical stump.

  • Technician: these are items technicians are responsible for during C-section

Neonatal Assessment and Development Milestones

  • Clinical Markers of Neonatal Health:

    • Healthy neonate puppy: Warm to the touch, firm and rounded abdomen, displays twitching during sleep (activated sleep), nurses rhythmically every 1 - 2 hours

    • Sick neonate puppy: Hypothermic/chilled, flaccid or limp muscle tone, weak or absent suckle reflex, continuous high-pitched vocalization (crying), aimless crawling, or rejection by the dam.

      • Contact veterinarian at earliest sign of problem with pups or dam

  • Growth and Monitoring:

    • Puppies must ingest maternal colostrum within the first 12 - 24 hours of life for passive transfer of maternal immunoglobulins.

    • Measure body weights 1 - 2x: ~10 days daily using an accurate gram or ounce scale.

    • Healthy weight gain benchmark: Puppies’ weight should increase 5 - 10% per day throughout the first several weeks.

  • Elimination Reflex:

    • Neonates cannot voluntarily urinate or defecate; the dam must stimulate elimination by vigorously licking the perineum.

    • Normal neonatal stool should be fully formed but soft in consistency.

  • Developmental Milestones:

    • Opening of eyes: ~ 10 days

    • Opening of ear canals: 7 - 10 days

    • Ambulation and environmental exploration: Begins around 3 weeks of age.

    • Weaning window: 4 - 6 weeks of age.

      • Some dams may wean on their own, but can assist with initiation

      • Reduce dam’s food when weaning to reduce chance of mastitis

  • Preventative Parasite Control:

    • Administer Pyrantel pamoate to puppies at 2, 4, and 6 weeks of age.

    • Deworm the dam with Pyrantel pamoate immediately following delivery, and simultaneously at each scheduled neonatal deworming interval.

Neonatal Complications and Thermoregulation

  • Primary Neonatal Emergencies:

    • Hypothermia

    • Poor weight gain / failure to thrive

    • Dehydration

    • Hypoglycemia

    • Septicemia

  • Hypothermia:

    • Puppies unable to thermoregulate and maintain appropriate body temperature

    • Environmental Temperature Requirements:

      • Week 1: Ambient room/box temperature maintained at 90°F

      • Week 2: Ambient temperature maintained at 85 - 90°F

      • Week 3: Ambient temperature maintained at 75 - 80°F

    • Normal Neonatal Body Temperatures:

      • Week 1: Normal core body temperature is 95 - 99°F

      • Weeks 2 and 3: Normal core body temperature rises to 97 - 100°F

    • Chilled puppies cannot digest food

    • When bottle feeding, milk/formula must be warmed

    • Heating pads are NOT recommended to prevent burns

Orphan Puppy Nutritional Management and Feeding Guidelines

  • Nutritional Replacer:

    • Utilize a species-specific commercial canine milk replacer formula (e.g., Esbilac).

    • Always reconstitute exactly according to product labeling; never alter the specified powder-to-water ratio.

  • Preparation, Storage, and Sanitation:

    • Store opened powdered formula containers in the refrigerator or freezer.

    • Prepare only enough liquid formula for a single 24 hour feeding cycle to prevent opportunistic bacterial multiplication; refrigerate unused mixed portions.

    • Warm formula to 95°F prior to feeding, ensuring even heat distribution without hot spots.

      • No microwave to avoid hot spots and inconsistent heating

  • Feeding Administration Methods:

    • Pet Nurser Bottle: Puncture the rubber nipple with a flame-heated needle to create 1 - 2 small openings that release formula drop by drop when inverted.

    • Orogastric Feeding Tube: Indicated for runts, weak puppies with absent suckle reflexes, or large litters needing efficient feeding.

  • Post-Prandial Care:

    • Hold the puppy upright and burp gently after feeding.

    • Manually stimulate micturition and defecation by gently stroking the perineal region with a warm, damp cotton ball after every meal.

  • Feeding Frequency and Volumetric Standards:

    • Divide daily requirements into smaller, frequent meals rather than large boluses to avoid gastric distention.

    • Commercial packaging often overestimates required feeding volumes; overfeeding neonates leads to vomiting and fatal pulmonary aspiration.

Age of Pup

Number of Feedings per Day

Fluid Volume (mL\text{mL} per oz\text{oz} Body Weight)

Birth to 2 weeks2\,\text{weeks}

8–128\text{--}12

0.625 mL/oz0.625\,\text{mL/oz}

1–3 weeks1\text{--}3\,\text{weeks}

6–86\text{--}8

1.0 mL/oz1.0\,\text{mL/oz}

2–4 weeks2\text{--}4\,\text{weeks}

4–64\text{--}6

1.5 mL/oz1.5\,\text{mL/oz}

Weaning Protocol and Maternal Ration Management

  • Timeline: Weaning at 4 - 6 weeks of age.

  • Diet Transition:

    • Week 4: Prepare a gruel combining 2 parts warm water or liquid milk replacer with 1 part high-quality dry puppy food; allow to soak until softened.

    • Week 5: Progressively reduce liquid content to thicken the mash.

    • Week 6: Puppies transition completely to unsoftened dry puppy kibble.

  • Maternal Dietary Management During Weaning:

    • Day of separation (6 weeks): Withhold all food from the dam for 24 hours (maintain access to fresh water) to abruptly down-regulate mammary milk synthesis.

    • Day following separation: Provide ½ of the dam's normal maintenance food ration.

    • Day 3 post-separation: Return dam to normal baseline maintenance feeding schedule.

    • Rationalization: Sudden dietary restriction during puppy separation halts lactation and prevents the clinical onset of engorgement and mastitis.