KPI. How long to do a French bulldog caesarean section? 47 minutes for 7 pups

Jan 27, 2016

A very smelly vaginal discharge. A dead pup was born 3 hours earlier at 8 am. The breeder phoned me for an emergency Caesarean section at 9 am.

The black and white French Bulldog, F, 4 years appeared normal, with normal rectal temperature at 38.4. This was her 2nd Caesarean section.  Her swollen body looked symmetrical and I predicted 4-6 puppies.  Copious amount of dirty reddish brown vaginal discharge flowed onto the operation table of Toa Payoh Vets.

The dam was lethargic. "Probably all puppies are dead," the breeder said. "She's 60th day pregnant and I don't expect a dead smelly pup to be born naturally."

ANAESTHESIA AND SURGERY

B: Isoflurane gas given by mask: 10.12 am
C: Isoflurane gas stopped: 11.07 am
D: First skin incision: 10.20 am
E: Skin stitched: 11.07am

C-B = 55 min
E-D = 47 min.

7 puppies distressed. 3/7 are dead. 
Of the 3 dead pups, one was a shrivelled foetus, the other two showed yellow meconium covering the body. All pups were handed to the breeder to revive. He and his assistant had 4 live pups revived. The dam was alive and this made the breeder happy.



Details of surgery
10.23 am   incise uterine body (small incision)
10.29        4th puppy out
10.32        5th puppy
10.33        6th puppy
10.35        7th puppy to breeder.
10.36        stitch uterine body. 2 rows inverting sutures
10.49 - 10.58  stitch linea alba and muscles. lst row simple interrupted. 2nd row continuous.
10.59 - 11.07  stitch skin horizontal mattress and walk-in muscle suture

Blood test was done.
IV dextrose during operation.
IV Hartmann's + 5 ml Theracalcium to give at home. Dog vomited at the beginning of IV drip of Hartmann's.  This happened to the pre-partum Pomeranian yesterday too. She vomited yellowish brown fluid when first given the Theracalcium 1 ml but was OK subsequently and gave birth to 4 pups naturally 24 hours later.

Breeder said that the dam looks much more "solid" after the drip and would continue the drip in his place.

Surgical Technique
1. Skin incision around 6 cm. I did not exteriorise the whole uterus and hence the skin incision is shorter.

2. Finger inside abdomen to feel for bifurcation of uterus. This permits me to identify uterine body.
3. Incise uterine body of around 6 cm.
4. Milk out the pups.
5. Clamp umbilical cord with 2 forceps. Cut between forceps. hand pup with one forceps to breeder. 6. The shrivelled and another dead pup had dark brown colouration and were detached from the placenta.

Conclusion
Early foetal death of one pup. A mummified foetus. This could have become decomposed and spread the toxins to the other puppies nearby. So only 4 of the 7 puppies I took out were alive after revival by the breeder.  I advised him to use good quality commercial diet which is balanced nutritionally for pregnant dogs as he had been feeding his own chicken and fish meat mixture. Some dams would not have a balanced calcium intake.


Reference:
https://www.merckvetmanual.com/metabolic-disorders/disorders-of-calcium-metabolism/puerperal-hypocalcemia-in-small-animals