Fri, 08/11/2023 - 11:22pm

Mandatory C-Section Spays

Read on for a breeder’s worst emergency-room nightmare

As her 15-inch red-and-white Beagle, “Mairzy” (Ch. Just Wright Mairzy Doats), struggled in stage-two labor late at night, Lindsay Bryson was worried. Despite Mairzy’s heavy panting and contractions, the first-time dam had yet to deliver any of the nine pups she carried.

“Mairzy was getting tired, and I was concerned about her having enough energy and strength to deliver the large litter,” says Bryson, of Modesto, California, who breeds under the Allegro prefix. “We took her to an emergency veterinary clinic for a Cesarean section.

“The first thing they asked was whether it was a planned breeding. Then, they wanted to spay her. ‘We do not allow dogs to go unspayed,’ they said.

“‘We are not spaying her unless it is absolutely necessary. This is a health-tested champion bitch,’ I told them,” Bryson says.

Unbeknownst to the staff of the emergency clinic, Mairzy represented the end of a bloodline (Just-Wright Beagles) that was developed more than 40 years ago by the late Julie Wright. Bryson, a longtime professional handler who had been breeding Beagles since 2002, carefully planned Mairzy’s breeding with high hopes and expectations.


Ch. Just Wright Mairzy Doats, handled by Lindsay Bryson, winning a major at the Del Valle Dog Club under breeder-judge Patricia Healy. Mairzy, who represents a bloodline developed over 40 years by the late Julie Wright (Just-Wright Beagles), was spayed after an emergency C-section in which six of her nine puppies died.


Like Bryson, most dog breeders understand the need for an emergency C-section when a bitch is in dystocia (the technical term for having difficulty delivering puppies), but they tend to balk when a clinic tells them that their policy is to perform an ovariohysterectomy, or spay surgery, with a C-section.

The practice of mandatory spay surgeries for bitches having an emergency C-section generally stirs a rift between surgeons at veterinary emergency and specialty clinics and preservation dog breeders.

The concerns of breeders over this policy recently popped up in discussions in Facebook groups where breeders shared personal stories of losing dams and puppies when both surgeries were performed at the same time. Some traveled hours to reach an emergency clinic on a weekend, holiday or during the night after their bitch went into labor prematurely or endured hours of unproductive labor.

Bryson’s account of her C-section/spay surgery experience with Mairzy in December 2017 is shadowed by the devastating loss of six of the nine pups.

Bryson recalls waiting nervously with co-breeders Danette Wheeler and Angela Wheeler, of Stockton, California, who she was mentoring and who would raise the litter, when the surgeon came out after two hours to tell them that Mairzy’s uterus was falling apart.

“She said, ‘You have no choice but to spay her. You have four dead puppies, two not doing well, and three doing well,’” Bryson says.

“I said, ‘Of course, her uterus is falling apart. You were going to make sure she was leaving here spayed. Go ahead and spay her, as I now have no choice.’”

When taken back to Mairzy afterward, Bryson says, “The most devastating thing was seeing lined up in a row her perfectly formed, beautiful puppies that did not make it. It took us a long time to come to terms with what happened.”


Ch. Ashlan and Allegro's Victory Is Mine, one of Mairzy's three male pups that survived, is shown taking Best of Winners at the National Beagle Club National Specialty in 2018 under breeder-judge Darlene Stewart. "Stewie" was handled by Bryson, who co-bred the litter with Bobby Ott, Danette Wheeler and Angela Wheeler.


C-Sections and Mandatory Spays


Mandatory-spay surgeries for bitches having an emergency C-section are not a recent occurrence in veterinary medicine, say veterinarians and dog breeders.

“As long as I’ve been practicing, this has been going on,” says Cheryl Lopate, MS, DVM, DACT, a 1991 graduate of the Ohio State University College of Veterinary Medicine and a board-certified theriogenologist specializing in small-animal reproductive medicine at Reproductive Revolutions in Wilsonville, Oregon.

“Most ER clinics do not see responsible breeders,” Dr. Lopate explains. “They see backyard breeders and puppy-mill breeders whose bitches typically receive little care until dystocia. They see that as an opportunity to spay a dog.”

“For every responsible breeder who takes a bitch in for an emergency, there are probably at least 10 neglected pet dogs needing a C-section, some after 48 hours of unproductive labor and some that are septic,” says Raven Klone, DVM, CCFT, who owns Tomorrow’s Veterinary Care in Waverly, Nebraska, and has a special interest in reproduction.

As a result, breeders sometimes navigate a political minefield in which animal-welfare viewpoints shape not only policy but also the fees charged by emergency veterinary clinics. Paying more money to keep a bitch intact rather than to spay her is common at many clinics across the country, say breeders in the Facebook breeder groups.

“‘Adopt, Don’t Shop’ posters are everywhere in emergency and private practices where I live,” says Arlene Mary Quinn, of Downington, Pennsylvania, who breeds Golden Retrievers under the Golden Glory prefix.

“Adopt, Don’t Shop” is a campaign started by the Los Angeles-based nonprofit animal-advocacy organization Last Chance for Animals. The catchy slogan encourages dog buyers to adopt pets from animal shelters in an effort to combat puppy mills and commercial dog-breeding facilities that practice unethical treatment of animals.

“Once the mantra became popular, veterinarians have either been sold on this philosophy or they don’t want to be labeled as an irresponsible veterinarian who helps bring more puppies into the world,” Quinn says.

“I usually schedule C-sections with my regular veterinarian, a board-certified surgeon who charges $1,800 for a C-section,” says Helen Dunning of Auburn, California, a breeder of Boston Terriers, a brachycephalic breed with a high rate of C-sections.

“The first time we needed a weekend C-section, I had to take the dam to a new emergency veterinarian, who charged $4,000, and all the puppies died. On the second weekend C-section, my options were to delay the surgery, pay $6,000 for a C-section alone, pay $4,500 for a C-section/spay surgery, or pay $5,000 for a rural veterinarian to do the C-section and leave her intact. This is what I chose, though my bitch was over-anesthetized.”

“Reports of this situation are extremely disturbing,” says Brandi Hunter Munden, vice president of public relations and communications for the AKC. “The AKC’s Government Relations is investigating this now and looking at possible legislation to prohibit veterinary hospitals from requiring this unnecessary surgery when taking on an emergency case.”

Reproductive specialists try to avoid spaying a bitch at the same time as a C-section unless it is medically necessary, according to the specialists interviewed for this article. A uterine torsion or severe uterine rupture are examples of when a spay surgery may be medically necessary. If a brood bitch is being retired from breeding, specialists prefer to wait a minimum of two weeks after puppies are weaned to give the bitch time to recover from a C-section and raising the litter before a second major surgery.

“We occasionally get a request to spay at the time of C-section if it is a bitch’s last litter, but we rarely say yes,” says Robert Scott Dove, DVM, the owner of Companion Animal Clinic in Gainesville, Virginia, a small-animal clinic that specializes in reproductive medicine.

Dr. Dove, who has had a special interest in canine reproduction for 42 years, is a breeder with his wife, Cecilia, of Scottish Deerhounds. They bred the Westminster Kennel Club’s 2011 Best in Show winner, “Hickory” (GCh. Foxcliffe Hickory Wind).

“There are more dangers if you perform both procedures at the same time,” Dr. Dove says. “The fluid volume in the birth of the puppies combined with physiological changes are dramatic. Taking out more tissue to do a spay surgery is risky, as leaks of sutures on blood vessels could cause a bitch to bleed out.”

Dr. Lopate has written a handout for breeders titled “Reasons Not to Spay Your Bitch at the Time of Her C-Section.” 

“Hemorrhage is a risk due to the increased blood supply to the uterus during pregnancy,” she says. “Spaying involves tying off multiple vessels when the bitch is under anesthesia and her blood pressure is lower, but sometimes as she awakens and her blood pressure increases to normal, a vessel may leak or a ligature may pop off that results in hemorrhage. If it occurs rapidly and severely, a condition known as hypovolemic shock, in which the heart is unable to pump enough blood to the organs, it could be fatal.

“The ligatures also can form blood clots at the ends, which could dislodge and get into the bloodstream. Another concern is cardiac or respiratory complications from a drop in blood pressure due to the rapid loss of blood that occurs when the uterus is removed.” 


Rocky Flat's Primrose McDee nurses her 10 puppies from her third litter shortly after an emergency C-section and spay surgery. Subsequently, “Primmie” bled to death when the ligatures did not hold. 


Sue Thelle-Harr of Rocky Flat Kennels in Sevierville, Tennessee, lost her yellow Labrador Retriever bitch “Primmie” (Rocky Flat’s Primrose McDee), whom she describes as her all-time historical best dam, hours after a C-section/ovariohysterectomy at her primary-care veterinary clinic. It was Primmie’s third litter after two natural deliveries of 10 and eight puppies, respectively, each spaced one year apart.

“The ligatures did not hold, and she bled to death,” Thelle-Harr says.

“As the veterinarian started the C-section, one uterine horn was friable, essentially falling apart. After the surgery, we took Primmie and her 10 puppies home. She nursed the pups for about two hours and then she started gasping for air. Her gums were pure white. We took her back to the clinic, but she died shortly after we got there. We never had time to grieve Primmie because we were so busy caring for her pups.”


Primmie with "Glory," a daughter from her first litter.


A contrasting view of C-section/spay surgeries is presented in a retrospective study conducted at the University of Georgia College of Veterinary Medicine and published in the June 2023 issue of the Journal of the American Veterinary Medical Association. The study compared maternal survival between bitches that underwent a C-section alone and those that had a concurrent ovariohysterectomy.

The maternal survival rate was 100 percent through weaning for both groups. The authors found no significant risk of mortality, surgical complications or decreasing mothering ability of bitches that had both procedures. They evaluated the medical records of 125 bitches of 37 breeds that underwent a C-section from October 2014 through December 2021 at the University of Georgia Veterinary Teaching Hospital, an academic teaching hospital with multiple specialists, including board-certified theriogenologists, anesthesiologists and surgeons, to supervise surgical procedures.

Seventy-two bitches had emergency C-sections, and 53 bitches had elective procedures. Eighty bitches had C-sections only. Of the 45 bitches that also had spay surgery, all but two had an ovariohysterectomy that involved removing the uterus and ovaries after delivery of the fetuses via an incision in the uterus during the C-section.

An en-bloc C-section, in which the ovariohysterectomy occurs before removing the neonates, was performed on two bitches after fetal death was confirmed prior to surgery. According to the article, en-bloc C-sections are associated with increased risk of puppy hypoxia, or low-blood oxygen, due to the suppression of uterine blood flow. The procedure also requires a second trained team for puppy extraction and resuscitation.


Glory, a Primmie daughter, is pictured with her first litter of Labrador Retriever puppies.


Despite the risks associated with en-bloc C-sections, it is used at some emergency and specialty clinics, say the breeders posting in the Facebook breeder groups.

“Most veterinarians prefer a technique that they are experienced in,” says Dr. Klone, a 2010 graduate of Iowa State University. “If en-bloc is what they know, it’s what they will prefer. There is little reproductive work to learn on at many veterinary schools. There were no C-sections to observe when I was in school. We were taught to do an en-bloc C-section. You can have all the pups out of the uterus in under 15 minutes.”

Chihuahua breeder Molly Graf, of Newville, Pennsylvania, says, “I’ve had many C-sections and spays done on breeding dogs that were being retired on their last litter. I’ve never had a problem. My veterinarian says it is safer for puppies and the mother to take the entire uterus with the puppies out all at once. I wouldn’t do it if the female was too thin or not in good health, because doing both together causes more loss of fluid from the removal of major organs than doing just the C-section.”


Role of C-Section in Canine Dystocias


Canine dystocias can be life-threatening to the dam and her puppies. According to the retrospective study cited earlier, among the most common causes of dystocia are breed, large fetal size, large litter size, uterine inertia in which the uterus does not contract normally, and fetal malpresentation in which the fetus does not align properly in the maternal pelvis.

The study notes that C-sections are commonly used both as an elective or emergency surgery for the prevention or treatment of dystocia. The highest rates of C-sections are in brachycephalic breeds such as Boston Terriers, Bulldogs and French Bulldogs, with more than 80 percent of dogs of these breeds having C-sections. A singleton puppy also is a reason for a planned C-section.

According to an article titled “C-Section Considerations for Canine Patients” in the Winter 2022 issue of the American Veterinary Medical Association’s Professional Liability newsletter, adverse outcomes for C-section deliveries are a frequent cause of malpractice claims and state veterinary-board complaints. 

The article cites the AVMA Professional Liability Insurance Trust’s data reflecting that C-section complications are the sixth leading cause of companion-animal complaints, and as a top-10 malpractice complaint, C-sections rank highest in cost per diem. The adverse outcomes that trigger complaints include missed puppies, premature puppies, ovariohysterectomy without consent during C-section and delays in surgery due to a lack of monitoring while waiting on a C-section.

“I would argue that C-sections are a specialty surgery rather than a procedure a general practitioner does,” Dr. Dove says.

“At our clinic, it is all hands on deck when we do a C-section,” he says. “We have a veterinarian monitoring anesthesia, one preparing the bitch for surgery, the surgeon and a surgical assistant who focuses on puppy resuscitation, removing the membrane and suctioning the puppies.”

Some veterinarians in practices with mandatory C-section/spays refuse to perform key services related to breeding such as progesterone testing, ultrasounds and radiography, say breeders in the Facebook groups. Breeders have few choices when their bitch is in labor, as some clinics will not treat them unless they agree to spay.

“Breeders may have 50 years of selective breeding invested in a bitch,” Dr. Dove says. “You don’t have to spay a bitch because of your politics, and you don’t turn breeders away just because of your politics.”

“More and more breeders are opting for planned C-sections if a dam hits day 63 post-ovulation on a weekend or holiday, if she is carrying a large or singleton litter, or if her granddam had a C-section,” says Nancy Babyak of Harwich, Massachusetts, breeder of Cardigan Welsh Corgis under the Kidwelly prefix.

“The breeder who mentored me, the late Pat Santi of Rhydowen, developed her line over 40 years. She demanded good brood bitches that whelp easy and are good mothers. Frankly, breeding is expensive. My repro vet when I was getting back into breeding after raising my family spent an hour with me getting to know about the reproductive history of the dam, her mother and sisters. I spoke to the dam’s breeder and the breeder of a half-sister to get their information about how the bitches whelped. There is so much power when you know your maternal bloodline.”

“Most veterinarians don’t know how to screen a breeder as responsible, and even fewer can guide a new breeder on how to do things right,” says Dr. Klone, a breeder of Black and Tan Coonhounds under the Old Soul prefix. “Until I bought my clinic and people learned that I support fellow breeders, I saw maybe one breeder whom I would consider responsible. That skews veterinarians’ perspective and is where issues and biases set in.

“If the local kennel clubs invited veterinary students to a meet and greet, you’d be surprised how far that would go to help relationships. If breeders offered to bring their stud dogs for semen analysis or their bitches for pregnancy ultrasounds or to hold a whelping seminar, it would be wonderful. I didn’t learn these things until later when I was a breeder myself. Those of us with prior interest in purebred dogs get there faster.”



How to Avoid an Emergency C-Section/Spay Surgery


Reproductive specialists interviewed for this story offer these suggestions:

• Establish a good relationship with a veterinarian. This will help you have good options in an emergency, and it gives the veterinarian knowledge that you are planning ahead.

• If you are expecting a litter of puppies, have a back-up plan that includes an emergency veterinary clinic or a veterinarian willing to be on call. Check beforehand to learn their policy for emergency C-sections. A breeder should not assume any veterinarian will take you in an emergency.

• An elective C-section is considered safe for a dam and her pups and is associated with a lower risk than an emergency C-section. Try to avoid an emergency C-section, particularly if you have a brachycephalic breed in which more than 80 percent of litters are born by C-section. If the calculated due date is on a weekend or holiday or if you are having a large or singleton litter, scheduling a C-section before the due date may be helpful.

• Consider delaying spay surgery during a C-section to decrease the risk of hemorrhage and hypovolemic shock. It is safer to have a second surgery than to remove the uterus at C-section due to the extensive vasculature and increased blood volume in the uterus during pregnancy.




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