Spaying and C-Sections
Is it a good idea to have my bitch spayed when she has a C-section?
Many breeders are choosing to have scheduled C-sections done for their bitches for a number of reasons. The popularity of the French Bulldog and their small chance of delivering naturally have greatly increased the number of C-sections requested.
When you want an elective C-section or there is a chance you may need an emergency C-section — any time there is a pregnancy, there is a chance you may need an emergency C-section — you should check with the surgeon before the scheduled date of the surgery so there is no misunderstanding at the time of the C-section.
If your bitches typically free-whelp but are having a problem delivering the puppies, you may find yourself at the local ER in the middle of the night on a holiday weekend. Prepare in advance and inquire about the range of pricing as well as the capability of the surgeon and staff and their beliefs when it comes to performing a C-section. Not all ER veterinarians perform C-sections and not all will agree not to spay your bitch.
Many veterinarians feel compelled to spay any bitch that is presented for a C-section. I have read statements by many veterinarians who do not see the value in purebred dogs and “will only perform a C-section if the bitch is spayed at the same time.” While there are certain situations where this may be necessary for the health of the mother, in my opinion, it is not usually the best decision.
What are the reasons not to spay at the time of the C-section?
Performing a spay at the time of a C-section prolongs the length of time the bitch is under anesthesia as well as the amount of time her abdomen is open during surgery. Depending on the size and body condition of the bitch, this can be at least an additional 30 to 60 minutes, and even longer if complications arise. This can make the bitch susceptible to infection and hypothermia (low body temperature).
The additional surgical time also delays the recovery time and prolongs the time until the mother can be put with her puppies. Most bitches need time to fully awaken from the anesthesia before they are ready to accept puppies for nursing. Maiden bitches, especially, can be disoriented after their C-section and need time to adjust to the puppies. The sooner this process can start, the better, so the puppies can be fed and get the important colostrum from nursing their mother.
The blood supply to the uterus and its vessels is increased in order to support the pregnancy. When the bitch is spayed at the time of the C-section, the blood pressure is decreased by the anesthesia. In order to remove the uterus, blood vessels are ligated, or tied off, when her blood pressure is low. As she wakes from anesthesia and the blood pressure increases, a blood vessel may leak or a ligature pop off. This results in internal bleeding, which may require another surgery, or if severe enough or not detected, even death.
The bitch shares a third of her blood volume with the fetuses. Most of this blood is within the wall of the uterus and the placental attachment sites. After delivery this blood is reabsorbed by the bitch to help restore her normal blood volume. A spay procedure removes her uterus and all the blood contained in it.
When the uterus is removed, there is a sudden and rapid loss of blood volume. This causes a drop in the blood pressure during surgery, which can result in cardiac or respiratory compromise or a potentially fatal crisis during the anesthesia.
The condition of pregnancy increases the risk of blood clots, which can be life-threatening if they go to the lungs or the brain. During the spay surgery, multiple blood vessels are tied off and form clots at the ends where the ligatures are placed. This increases the risk of a clot dislodging and getting into the bloodstream. The most common deaths in the early post-partum bitch are following C-section spays.
What are some reasons why a spay would be recommended at the time of the C-section?
A recent study published in the AVMA Journal found no difference in the length of anesthesia, surgical complications, post-op problems, mothering ability or puppy survival between groups of bitches that were spayed at the time of their C-section and those that only had the C-section surgery. Bitches that were spayed had longer surgery times and longer interval between delivery to nursing, but this was deemed clinically insignificant. The spayed bitches were found to be in more pain after surgery.
There are some conditions where the removal of the ovaries and uterus may be necessary at the time of the C-section. Uterine disease, uterine rupture or tear, or the presence of dead or decomposing puppies are situations where the uterus and ovaries should be removed. In cases where the uterus is not determined to be healthy enough to remain, ovariohysterectomy would be the best decision for the safety of the bitch.
When the uterus is healthy, some veterinarians will still advise spaying a bitch at the time of a C-section if there are no future plans for breeding her. Some owners like the convenience of having both surgeries done at the same time, but I do not think this is in the best interest of the bitch for the reasons mentioned above.
Can a bitch have a normal delivery if she needed a C-section for her last litter?
The answer to this question would depend on the reason for the C-section. In cases where a puppy gets stuck or there is only a singleton that is too large to deliver naturally, the next whelping may not require a C-section. This is usually true for bitches that have whelped previous litters normally.
Bitches that have a hard time delivering even a small litter in a timely fashion, or have such large litters that the uterus cannot contract strongly enough to get the puppies out, may do better with a C-section. For these girls, the surgery is less stressful than a prolonged delivery and would hopefully lessen the possibility of losing puppies.
Will a C-section affect my bitch’s fertility for future breeding?
In general, a C-section does not cause a decrease in fertility for future heat cycles if the uterus is in good condition and there were no surgical or post-op complications for the bitch. The uterus heals very quickly. I find when doing repeat C-sections on a bitch there is little evidence of the prior C-sections other than scar tissue on the abdomen and occasional adhesions in the abdomen.
If there were significant problems with the prior delivery, perhaps with decomposing fetuses, future fertility may be affected. The offspring of bitches requiring a C-section should also be monitored for similar issues, as good mothers tend to produce good mothers, and the same can be true for those that have trouble delivering naturally.