Welcome to the World

What should I do when my dog is delivering puppies?

Delivering a litter of puppies is always challenging. Newborn puppies must quickly modify their physiology to survive outside their mother’s womb. Within minutes, they must inflate their lungs to allow gas exchange to switch from the placenta to the lungs. They must also profoundly adjust their circulation to increase blood flow to the lungs and form separate lung and body system circulations.

These first few minutes of life are the most fragile. It is not surprising that the mortality rate for newborns during this transitional period is very high. As breeders and veterinarians, we need to be able to efficiently and effectively support these tiny creatures during this critical period.

What do I need to do as each puppy is delivered?

Your course of action depends on the bitch and the delivery. Many times, our assistance is not needed. The contractions of the uterus propel the puppy into the birth canal and out into the world. The compression of the contractions helps to expel fluid from the lungs, which enables the puppy to breathe on its own.

Each puppy is enclosed in a sac that is part of the placenta, or afterbirth. This sac is usually broken during the birthing process and passed through the vulva after each puppy is born. Following delivery, the mother will lick and chew at the puppy and often appears to be treating it quite roughly. In most cases, this is normal behavior and stimulates the puppy to start breathing.

During the licking and chewing, the bitch tears the birth sac and exposes the puppy’s mouth and nose so that the puppy can breathe. You know all is well when the puppy starts to whimper or cry within a minute or so after being born.

If the puppy is not crying or moving, you will need to step in and investigate. Especially in the case of first-time mothers, they may be overwhelmed or lacking strong enough maternal instincts to guide their behavior toward the puppies. As in other forms of cardiopulmonary resuscitation (CPR), the basics of puppy resuscitation follow the mnemonic “ABC”: airway, breathing and circulation (cardiac).

Airway — When the puppy is delivered still in the sac, you should tear open the sac as quickly as possible. Clean the puppy’s face and nostrils. You can use a soft rubber bulb syringe to gently suction fluid from the nostrils and the throat.

If the afterbirth is still intact, with the puppy resting in the palm of your hand hold the umbilical cord between your finger and thumb, and cut the cord with a pair of scissors in a shredding motion. Leave about one inch of umbilical cord. Applying pressure to the end of the umbilical cord for a few seconds will usually stop any bleeding. Otherwise, tie off the cord close to the puppy’s belly with clean thread or dental floss.

Tilting the newborn so that the hindquarters are slightly raised and vigorously rubbing with a warm dry towel provides stimulation to encourage breathing and helps clear the airway. Rubbing the fur “against the grain” in the lumbar area stimulates crying and helps airway clearance.

We all used to swing the puppies by holding them with their heads down and flinging them sharply to expel fluid from the lungs. This practice is now contraindicated as it is thought to remove the surfactant, which is a wetting agent in the lungs necessary for the lungs to inflate. Swinging may also increase the risk of brain hemorrhage, traumatic brain injury and aspiration of stomach fluid.

Breathing — Gasping is common in weak newborn puppies. Breathing can be encouraged with stimulation of the genital and umbilical areas. Acupuncture of the Jen Chung (GV 26) point in the nose has been described as a respiratory stimulant. This is performed by piercing the nasal philtrum with a 25-gauge needle and rotating it once bone or cartilage is contacted. The nasal philtrum is the groove in the center of the nose between the nostrils.

The drug doxapram (Dopram) is a respiratory stimulant. Its use to stimulate breathing in weak puppies is questionable. My understanding is that for doxapram to be effective, the puppy has to have been breathing on its own. It will not help puppies that have not taken a breath, but may be helpful to puppies that develop breathing problems later in life.

Circulation — Check for a heartbeat by placing two fingers on the puppy’s chest. If there is no heartbeat, place your thumb and forefinger over the puppy’s chest and perform gentle cardiac compressions once per second. Compress the chest by one-third to one-half of its width. While compressing the chest, gently exhale into the puppy’s nose every six seconds.

Hypothermia means low body temperature and is an important consideration when reviving puppies. Chilled puppies have slow heart rates, low oxygen levels and metabolic acidosis, which will make them difficult to revive. Making sure the newborns are rapidly dried will limit heat loss by evaporation. Warm dry towels, “hot hands” (latex gloves filled with warm water), hot water bottles, heating pads and heat lamps, and hot-air devices such as hair dryers can all be used.

Newborn puppies should be warmed to a body temperature of 37.2 degrees C (99 degrees F). Immediately after birth puppies are unable to control their own body temperature and are dependent on external sources of warmth. Be careful to monitor any heat device, as weak puppies may not be able to move away from a source of heat that is too strong. Use a thermometer to measure the air temperature, especially if you are using heat lamps. The area the puppies are kept in should be around 30 degrees C (100 degrees F).

It may not be necessary to provide external heat if the mother is properly caring for the puppies and the whelping room is warm. If a heat lamp is used, extreme care must be exercised; otherwise the mother and puppies can easily become overheated. Room temperatures of 26.7o C (80 degrees F) are adequate to prevent the puppies from getting chilled when they are with their mother.

Hypoglycemia, or low blood sugar, is common following a stressful delivery and can hamper breathing efforts. A few drops of glucose syrup placed on the gums or tongue can be helpful. However, the puppy will not be able to absorb the glucose if it is cold. It is important to correct any hypothermia at the same time.

Newborn resuscitation should be continued for at least 30 minutes in spite of a slow heart rate and no spontaneous breathing. Heat is vitally important. I left a puppy that I was unable to revive under a heat lamp and it miraculously came to life after about 20 minutes! It has only happened once, but is always worth a try.