To Whelp or Not to Whelp: Planning an Elective C-Section

0:00Welcome to the Good Dog Pod. Join us every other Wednesday when we discuss all things dogs from health and veterinary care to training and behavior science, as well as the ins and outs of Good Dog and how our platform can help you successfully run your breeding program. Follow us and join Good Dog's mission to build a better world for our dogs and the people who love them. Alright, I'm going to officially kick things off. So thank you all so much for joining us today for our presentation on Planning and Elective Sea Section with our guest Dr. Andrea Hester who has joined us for many webinars in the past and we're so excited to have her back with us. She's joining us today for an in-depth discussion of canine elective sea sections to help you understand why this option may be preferred in some cases and in some breeds as well. So together we're going to learn about the process of the planning stages, surgery and post-op care as well.

1:02This is a topic that we've heard a lot of you ask questions about in past webinars and in our Facebook group. So we're really excited to have a focus on it today and cover it. So I mentioned this for every webinar but please continue sending us ideas and things you want to hear from us next, especially as we plan for 2027, which is crazy to say. Of course, thank you to Purina for helping us bring this webinar to life as well and making sure that all of your suggestions help become a reality too. We've of course hosted a ton of webinars this year. So they are stored on the Good Breeder Center. So all of the recordings live there. The recording of today's webinar will be posted there. So in case this is your first time joining us, you have a lot of webinars to look through, hopefully something there for everyone. So we will make sure that's shared so you can look at that after the presentation. We're going to prioritize some of the previously submitted questions that we got from our community first during the Q&A segment today at the end.

2:04And before we kick things off, I just want to share a little bit more about Good Dog in cases this someone's first time joining us. Good Dog is on a mission to build a better world for our dogs and the people who love them by advocating for breeders like yourselves, educating the public and promoting canine health and responsible dog ownership through events just like this, where an online community created just for breeders to connect with Good Dog applicants from across the country and find forever homes for your puppies. We help breeders run all aspects of their breeding programs, everything from getting your new litter of puppies listed and marketed, connecting with applicants, getting to know them, getting payments for your puppies securely and sending them off to their new homes. And kind of everything else that happens in between puppies being born and going home, we're here to support you with all of that. And then beyond that, we also offer a number of educational resources like this, health related discounts so we can make sure your programs thrive and are supported in other

3:05ways too. So if you're not yet a member of our community, we would love to have you learn more about our mission and apply to join at gooddog.com slash join. That's all about good dog and I will just wrap up my spiel is just a little bit about Dr. Hester if you have enjoyed us before and heard one of her amazing presentations. Dr. Hester is a board certified reproductive veterinarian who practices small animal medicine in the Fort Worth area. Her clinical time is spent doing general practice veterinary medicine and reproductive consultations and surgery. Dr. Hester also provides semen collection and health testing services at local dog shows. She's a longtime canine breeder herself and enthusiast with an interest in whippets and bull mass tips and her mission is to serve breeders by helping them achieve their goals with their breeding program. So really no one better than Dr. Hester to be here today to talk about elective c-sections and everything that comes with that. So with that, Dr. Hester, I will pass things over to you.

4:06Thank you Nicole. Welcome everybody. We are so glad to have you and we're going to go through like she mentioned, we're going to talk a little bit about kind of the why is for elective c-sections. Some of the things just to kind of keep in mind considerations kind of before and after surgery. So without further ado, I actually just had an elective c-section on my own litter this week. So I have this very fresh on the mind and I will just say I'm 48 hours from when that c-section happens. So if there's at any point, if there's something that confuses you because my brain might be a little bit on the sleep brain mode, I'm sure you all have been there after you've had your own litter. Fortunately, this is a season damn that's kind of worked out the kink with previous litters as far as accepting puppies and being pretty trustworthy. So I'm doing pretty well. But she had six puppies at Scabana that had the litter and she had six puppies on Monday. And just to mention because we can't introduce without saying hello to zest.

5:07So zest was that singleton puppy from the septic litter that we lost all of her litter mates. And she is still doing great. I just wanted you guys to know that she's still kicking no problem running around. She's still poor legged. She's still doing great. And we'll see what happens in time. But honestly, she was everything I hoped basically to get from that litter. So I'm really hopeful, very quietly hopeful that maybe she's going to be in good shape when she is two or three years old whenever she'd be evaded to potentially be able to breed. I mean, I think we talked a little bit about it's almost like we were just trying to salvage a broodmare at the point where we were at with her leg having all the issues with the contractor that she had from all those abscess and all the things that kind of happened there. But yeah, it's basically at this point. It's just a matter of do her elbows look okay? It could be that her elbows are not in good shape because she's been shifting forward extra weight that she wouldn't if she really had full use of all of poor legs. But she still runs around pain free.

6:07She runs around without being able to flex for me. So she certainly could be shown and things like that can't be an agility dog. But we'll see what the future holds that I'm sure if I see you guys in 2027, 2028 might be that I'm updating you about her having a litter if things go in a positive direction. And if they don't, they don't and she'll be one very expensive singleton pet for me. She's honestly, she's the coolest dog and I'm really glad that she survived all that. So all right, on elective C sections, we're going to talk about indications. So indications being why we would do them. We're going to do a little bit of review just because of the necessity of it. We want to know kind of when we would do the C section in reflection to ovulation timing and when that would make her do date and how we might plan different methods of how we might plan a C section around a due date. And then we'll talk about something called the overcook phenomenon. So basically when puppies go over term, what happens?

7:08And we'll also talk a little bit about puppy care. I did put a little bit on here just as a good review for things like collastrilin pig and supplementation if you find yourself needing so sometimes elective C sections. We hope that they are in good milk. Sometimes they are not in as much milk for a variety of reasons as a GM that's been in labor or had an emergent need for a C section. And then also some things about her post op as well as kind of planning post C sections so that you know for next time, is it do we plan another C section for her? Can we go forward with her with a free wealth next time depending on the circumstances? All right. So I think it's good to kind of be thinking in two directions as far as indications. So one would be reasons that you as a breeder might be thinking, I want an elective C section when you walk in the door. There are kind of overlap to that category versus the category of I might be telling you as your vet, we need to do an elective C section.

8:10I think for many of you guys, if you are experienced breeders, you probably already have a good handle on these lists. And they do have some overlap. Some of you guys are going to be very aware of the reason why as a vet, we might be thinking that. But certainly reasons you might be, and from the times you might be telling us, you need an elective and it might not be a breed that we're super familiar with. So the obvious one, everybody kind of knows and presumed for dogs at least is breakies felt breed. Though breeds that have a shorter muzzle, often times those breeds have been collected, it's not so much the shorter muzzle because you look at things like say, Boston Terriers that free well frequently and have kind of historically not been classic C section breeds compared to say a frenzy might have a little bit more of a width to their pests and an aronis to their pelvis, which we have basically selected for over the course of a long period of time. But we have selected that kind of structure to some of these breeds, even things that aren't in the sprakecy felt like realm, things like Scottish Terriers.

9:10Very common for breeders to elect for C sections in that breed because they're friends are wide and their ears are narrow has a general rule. Though we were actually not worried about head size, we're worried about shoulder or kind of breadth in some of those breeds. There are other breeds that are just considered high risk. I would say things like breeds that are super lazy, though swissies would be a biggie, satsick, stand-yle, things that are just really chill, newfoundlands. A lot of those breeds also come with decent litter sizes or large litter sizes. Sometimes I think we have genetically selected towards dogs that maybe didn't free well upon their own because they had litters of 12 and might be harder for us to know from a parentage side of things how those breeds did. So certainly if you know the breed background, the line background specifically, if they had a lot of dysthesia in the line, I think that that is something to consider with your own decisions. I am one of those stubborn people here who I would really like free well,

10:16some of my bull massifletters and at this point I am over three. Some of those on purpose as a choice and I did electives and I also have seen primary inertia meaning I had a bitch that has never went into labor. That is I think a consequence of generationally a lot of people that have bull massif, just did not free well them. We have large litter sizes, we have small litter sizes, and we have big heads. So there are a number of reasons why we might have that. So every breed kind of has its own tendencies, but I think lines as well. So whenever I got the dogs that I got from the lines that I got them from, I had some kind of red flagged things that I was told. I have had this, I have had like one person behind some of my dogs that said, you know, I've had bitches that lost their litter and they need to protest or infeplementations. So I monitored things a little different for those dogs that came from that direction. It just kind of every breeder will have that knowledge based on their own

11:16experiences and it's good to try to just keep track of that even if it wasn't your experience. It would be a great assault because sometimes it's not what it seemed. You know, the history might not necessarily mean that you have to do elective c-section, but it just kind of depends on the breeder and how, I hate to say, how skilled they are and how experienced they were if they're kind of giving you some information on the line. Big one for where I live would be a lack of access and confidence in emergency care. So we have fortunately in the Dallas-Bort Worth measure, we've got a couple of clinics that do provide reproductive services and do after hours care like they give out their cell phones still. Not every metro is going to have that type of option, but what I will say is when I practice in both Oklahoma and Texas, we have a ton of people who drive from Arkansas, Louisiana, Oklahoma, who have no confidence in their emergency care, not that their emergency veterinarians are not good, but either they're used to walking in the door and the

12:17clinics are so slammed, they just don't get prioritized because they're so busy, they don't have enough staff and pets to really see the local cases and the c-section gets shuffled to the back. You know, as far as being first in line could get to surgery, I think some of the times it's like a bad experience. There's a lady that had lambers that I saw with some frequency and a breeder that had shepherds from the Arkansas area. It was worth it to them to provide food accessor to Oklahoma for electives because if they had a decent litter size and they had a potential for needing a c-section, it was worth it to them to just have control of it so that they didn't end up at the ER with their dog in an emergency day, some of which was from previous poor experiences that they had at their ERs that were their option. So I think, you know, from that perspective, it really depends on where you are. Sometimes it's because you live super rural and you just don't have a lot of emergency care. It might be the quality of the care that you have available after hours. There's a lot of possibilities. Convenience, I just say that this is one of the

13:22things that will be brought to me as a reason. I do have a breeder that just flat out told me, I mean, it's the same people that say things like, I'd rather do a side-by-side vaginal AI because I don't want to stand there with my dogs in a tie. It's ridiculous. If you want me to say it out loud, it's ridiculous, but you are selecting from thing that is time-based when, I mean, I know time is money, right? Like, we all are busy people, but there's nothing wrong with doing a natural well from a convenience perspective. That's just my two cents. There are plenty of people who that's what they do. They don't want to stay up all night and they don't want to deal with dogs and labor. So that's why they might request it. Cost and loss benefit of a stillborn-off strength. So about 10%, even in perfectly managed cows with bitches with good, kind of well-being progress, 10% of the time is normal to have a stillbirth. So one in 10 puppies is going to be totally healthy. It will always be the perfectly marked female puppy that you were waiting for for your whole

14:26program. And it'll be stillborn and look totally healthy. It might be the biggest birth weight of that whole litter and never show a sign of life. And it's not something that you did. Not something that the bitch did. It just happened. There is a reason why dogs have litters of puppies and not one puppy. So there was benefit to that from a developmental standpoint for the species for dogs and cats. So just keep that in mind. I think for some people, if you have a breed say, I had one of my mentors in Rotweiler years ago that, you know, I used to free well, but now I knew a C-section because if I lose one puppy, if I do a C-section, I have more than compensated for the expense of the section, which was a couple thousand dollars where he was. So in that regard, you know, if I can sell a puppy for $25,000, $3,000, then it makes sense for me to do that because it gives me potentially another option of a puppy to keep. And I think that is a totally logical thought. You know, it's not that C-section. We'll talk about some of those things.

15:31These sections are not without risks. So I think it's good to be careful with that, but I think it's a perfectly reasonable thing to be considering. I mean, sometimes that's still worn puppy, that would have been fine in an elective C-section is that perfect puppy. And I can tell you, like, for me, that cost-loss benefit was more of this special offspring when I'm bred to that really special frozen a couple years ago that you guys watched, of course, you know, that was an epic nightmare septic scenario. But I did an elective as a plan for that later because I wanted to make absolutely sure that I didn't lose them because the digit can go to labor. She had problems with who is well-being, organs, loss puppies because sometimes they just are still worn because we free well. Trends in human medicine, I think, has been a big reason why people have moved toward elective C-sections because it has become very common for human medicine to advocate for electives for the same reason for fetal survival. It is, you know, a pretty known fact that on the human side,

16:32it is more dangerous to have a natural delivery than it is to have an elective C-section from a fetal survivability standpoint. So obviously, it's a, well, I get similarly complicated, but much more intense and complicated if a baby dies than if a litter dies for the majority of people would feel that way. Some people may feel it's equal, but I think that's the reason why a lot of people have culturally lint that direction, at least in this country, in the United States. All right, so additional reasons why we might say clinically, this makes a lot of sense to do it. So, letter size obvious one, I know a lot of people are familiar that single-tens very often, or sometimes two puppy letters will often not trigger labor to go in to effect for that dog. There's just not enough stimulus for her to go into labor, but the puppy says I'm ready. The biggest body doesn't respond in the same way as if he had a letter of six. Also, double digits. So, I think it's breed dependent, it's line dependent, but I think welping more than 10 puppies,

17:35you are running a higher risk. For most breeds, you're running a higher risk. If you breed, field proud golden retrievers, you can also retain it. I'm not that worried about it. There's some breeds that just have a propensity to be incredible, well-versed. If you have a litter of 13 and you have whippets, I'm going to sell you, you can try, so totally fine. If you have a litter of 14 and you have four bulls, you can, and it might go okay, there are plenty of four bulls who can free well-14 puppies and plenty of positive outcomes. I'm only in two rows that direction, but I think it's just you got to weigh pros and cons with your individual bitch and maybe her history, her maternal history, again, we kind of lean on some of those types of notes. Fetal maternal mismatch on X-rays just mean the fetus is not the right size to be able to come through the birth canal, so that just means like the mismatch of size is what that's kind of suggesting. Usually the skull diameters measurements is how we do that. Again, for breeds like

18:35bulldogs and Scottish chariars things that have a broad front, it might not be that the head is the widest point, so it can be a little tricky to predict for some of those breeds. I might also recommend it if we see something unusual to say you came in for your X-ray and you said, you know what? I just want to make sure everything is okay in there and I just want to make sure everybody's viable and it just gives myself peace of mind. And then we go do an ultrasound and we're just checking around and we see something unusual like a water cup, or maybe something that's not structurally normal. Like a gastroskycis is the intestines on the outside, so like a body ball, it doesn't fit and you can see the intestines kind of outside of the body wall. We can see some of those types of things with ulcer found. We can't always catch them, so it's not going to be a hundred percent fail-threat, but if we know they're there, it might be a reason why you might not want to free-welp that litter. It's possible they will, but I think it's a higher risk.

19:35Citrus concern, I think, is a huge one, not often one that the owners decide to make the choice about, but I think the breeds that are obese all the time, and I love you all, and don't hate me, if I pick on your breed, I have volnastis. I'll pick on my own breed. My breed, people have completely no idea that their dogs are morbidly obese. I've shown my dogs at a seven or eight out of nine body conditions for, and I get told my dog needs more weight all the time. So just know, there are breeds that I think our breed standard descriptions are obesity. That is what we are saying. We want them to be as a baseline for what they should be, and that's fine. I mean, well, not fine as a relative term. I'm not going to get into context over whether or not I think your lab needs to lose some weight for the ring, but it is going to affect her ability to free-welp. So if she's heavy and she's not athletic, especially, I think athleticism is a big component of the

20:41generally speaking dogs that are overweight or also the dogs that don't have really good muscle tone and aren't actively exercising or running in a pasture. They're not swimming. They're not actively on a treadmill. They're not doing any of those kinds of things. I think fitness has a huge impact on the ability for dogs to free-welp, because your abdominal muscles are part of the muscles they use when you're exercising. So if you're not using them at all, I think a lot of people make the mistake of, I really want to get this bitch pregnant and go just going to locker and create, and I don't want her to do anything. She's not running agility anymore. She's not going to go to lake with us. She's not doing anything. And I think in that case, one, I think the bitch gets stressed a little bit sometimes, and they're less likely to take, because they need an outlet, but two were just managing them, being able to free-welp if we do that. So just keep that in mind. Age. So I think the age of the bitch can have a big impact and a success, but I think sometimes the impact of age has to do with muscle tone, so how fit she is. I mean, we know in humans, we know that

21:46you're more likely to have a successful pregnancy and a successful natural birth if you are younger. It's just the reality of things, but it's kind of that way with every season. It makes sense. In the younger you are, I think just in general, you tend not to be as obese. You tend to have more muscle for your body composition, as well as for dogs, we see smaller liter sizes once they get older sometimes too. So if you have liters of two or three, it might be that you don't go into labor normally as an older dog. Other things would be like medical things, the status of kind of your metabolic state, though you can become diabetic when you're pregnant. You can have the toxicemic kind of situation where you go into ketosis when you're pregnant. Some of those things might absolutely warrant these sections. Like we need the plan and see section as soon as we can for that particular dog to savor. And then any dogs that are overdue from confident ovulation timing, not from when I bred her in the yard and I know my line always breathed on day 14 and feeble definitely have puppies at ex-YZ day. That I don't care. That it might make you nervous and that's

22:52fine, but medically I'm not worried about it unless I have distinct progesterone timing as long as the fetuses look appropriate for where they are, I will not cut it based on breeding date. All right, so I think we can kind of talk in the opposite direction. If you're the person, you might not be those people if you're here listening, but if you're wanting to optimize the free will, you're going to want to basically select away from all those things that we just talked about, right? So select for good genetics. If you're acquiring dogs for to incorporate in your breeding program and you're struggling with having free wills and it's a breed that can free willt as the regular thing, those breeds I think you ask those who you're buying the bitches from or who you're buying the dogs from and say, you know, what was her success? What did her mom do? Did you have good liter sizes? Were they able to free well? What was her pace between puppies? They should have that kind of information for you if they're taking good notes that they're on program. I know we're not all the most organized people and sometimes we get overwhelmed. I'm that person

23:54right now with this litter. I had some diarrhea in the last 24 hours with my litter and I did not remember this actually happened to her last litter until my friend of mine said, no, I remember this is exactly what happened last time. Do not panic. They're fine. If I had my notes organized from last time, entered somewhere, all I had were weights from last time that I could access like quickly whenever I was sleep deprived in the middle of the night, right? But yeah, good information if you can keep notes on us for two things. Good breeding management. So if you want to avoid a single can puppy, breed with good timing to fertile stud dogs, young bitches, you know, optimize everything that you can. I think ultrasounding for litter size estimation helps with their body scores because it never fails. If I have an ultrasound, now not everybody's going to, I would say for ultrasound, not everybody is going to, as a veterinarian, going to be able to give you enough information to really be able to make adjustments. But if I alter sound, so like my bitch, I alter sounded her and I thought she had

24:57seven to eight with, or she had a couple of resortion sides, he had a history of litter of six. So I expected that maybe she does have an extra one in there, but I knew from her last kind of how she went her last pregnancy, she's a little bit difficult to feed early postpartum, but I was able to optimize her body condition throughout gestation because I wanted to up her food kind of mid-prinancy a little bit more since I knew that she was on a great eater to struggle a little bit with her milk letdown. Like I made some adjustments based on that, but if we're trying to optimize from a litter size feeding perspective, if I alter sound your dog and she has 14 puppies, I'm going to tell you to go ahead and up her food a little bit when we alter sound her. If your dog has three, I'm going to tell you you probably don't hardly need to increase it all until she's turned. Now when she's lactating, she might need a lot more, but I think adjusting so that you don't end up with an obese bitch, the most common thing is people claiming, how did you check under the ribs? Are you sure it's only one?

25:57Are you sure it's only two? And then they'll feed like there's ten. And then they come in for the rectory and the bitch has gained like 15 pounds and she is sure, the owner is sure that there are more than two and there are two. And it's not helpful for her being able to pass puppies through the birth canal, if she's obese for her fitness, et cetera, like we talked about. So I just last ever and saw there's a question about fitness associated with groin injuries. I think it can impact so your pelvic muscles are muscles that you don't, I mean, you could specifically train for them probably with specific exercises on like exercise balls and things, but I think your groin is kind of an extension of your core. So I would say yes, it is possible that history of a so-as strain or a pair could, if it's in active recovery, it might be that she's not as willing to bear down and push as hard or get into physicians that would make it easier for her to help. So I do think that that's an interesting point, but yeah, I think like I said exercise strain pregnancy

26:57is next to godliness and keeping their brains active just as important. Cheating, or we talked about this fat dogs don't like to help. They're not effectively pushed generally. And then certainly, if you're other things, you know, of your optimizing for free, well, x-rays, for confirming a little size, we want to make sure you absolutely know how many you have, no matter how good I am, it'll just sound like don't go off of my estimation as an end all might give you an idea, but give my bitch, my bitch is a great example. I was thinking she was going to have seven and she ended up with six. She was orb another one that I didn't appreciate had any issues, but she was orb connection one from what I expected. And if I had free-welped her and I hadn't x-rayed her, I would have thought, she looked bigger than she was last time, but I fed her a little bit like again, just keep that in mind. And then another tip, obviously, don't let them rest necessarily between puppies. These like statements about welping pauses that have become mainstream, oh, she's having a welping pause. Oh, she had an eight hour welping pause. And then the next puppy was great. Well, that's great for you

28:00that that's how it went, but that's not normal. There are some people who feel very intelligent people from which have spoken to you guys on different topics that feel an hour is sufficient time to act between puppies. I think two is still my opinion because I think one hour between puppies is really unrealistic for a lot of breeds, but I think your breed and your program, what is variant from what you were used to is probably more important than anything. Okay, so let's talk about why we wouldn't want to do an elective C-section, potentially, things to be concerned about. That we are kind of choosing to do that we might not necessarily have to do. Anesthetic and surgical risks are the case for every type of surgery. It does not matter if it's a spay, if it doesn't matter if it's a sedated wound repair that you dog's got in the dog fight, and you know, we sedate them to stitch them up, and they die in recovery. Those things happen. We've changed their body chemistry as temporarily. Some of it has to do with monitoring, some of it does not. Some of it is just innately we've changed

29:04their blood pressure, we've changed how the blood pumps through their body, and I think that is something we have to be very cognizant of. I mean, personally, I had a friend in my area that had a wonderful clinic that does probably three or four C-sections a day oftentimes. They had a totally routine, I think she had 12 puppies, Golden Retriever Bid, who had had an elective C-section before. What I have told her to do an elective C-section for fetal survivability, absolutely. She had 12 puppies and she was like a three or four year old bitch. I mean, she could have planted, but it made sense to do an elective. She did great with her elective last time, and that bitch coated by the induction. It was brain-done. They kept her on oxygen and continued the surgery and delivered the puppies. The puppies were fine. The bitch never recovered, and she died. So I think it's important to think about that because could she be fine and be around now?

30:04It had they free-welt her possibly. What are the odds that's going to happen to you very, very low, but it's still out there. I know a handful of people that that kind of thing has happened to around the country, different, really good deaths. Sometimes it just happens. I think we have the way, you know, is the emergency C-section more dangerous yet? So is she likely to need an emergency C-section? That's kind of why we're trying to think through and work around on these things. There is a discussion about impact on the neonates themselves. So in humans, we know that doing an elective C-section for babies completely changes how their microbiome is. So there is something to going through the vaginal canal that changes what they start with, with their ability to fight disease, the type of bacteria that are in their gut. I mean, all sorts of things like that. And then some of those also have correlated to things long-term things. So for those babies born by elective C-section are more likely to have obesity as human adults, asthma,

31:08allergic disease. So adipi, which is the same type of allergic disease that we struggle with a lot with canine breeding programs, diabetes, as well as behavioral disorders. There's all sorts of stuff that they have tied with really good medical research that says, this is not benign. What we are choosing is not benign. Financial, we kind of talked about that. Keep that in argument. Both ways kind of depends on where you are. If you have potential to have a $7,000 C-section locally, and that's the real figure for some of you guys that live in areas where it's not quite so expensive to be, I'm sure we probably have people in here who might save and hire for their emergency C-section needs in their area. Can those people afford to do that? And if the answer is no, it might be that there's some necessity to planning an elective if they can, because they can't manage to do an emergency in a traditional fashion. And then certainly the obvious one that everybody kind of deals with, maternal acceptance, thondar, love their puppies. Does not matter if they've never had

32:09puppies. Some breeds are surprising to me. How many of them wake up? Scotty's, I know we talk a lot about Scotty's today, but Scotty's as a beautiful example. You would think they are carriers, right? They should wake up and those are rats. They're squeaky if they've never seen them. Sometimes they do get over simulated and farm their puppies, but I would say in general, Scotty's are fantastic mothers. They love their puppies. They wake up and they want to kiss them. And it doesn't make any sense for me, because then you know, you do the same thing who say a bull terrier. And I had to have clients that had to hold their bull terrier down with the muzzle on the entire time they were postpartum, because they never understood that they were dogs. They thought that they were squirrels or little mice because they'd squeak. And they're foreign and they didn't understand what they were. It's just a caution on those notes. We are creating change by selecting this type of method. So, I just want to mention that on the ease of wellping, people get really focused on they should be lined up. Their heads should be facing towards the

33:15back end of the dog for wellping. That is not necessarily something we're going to be all over the place on an x-ray. Size we can appreciate. We can measure. But like in the case of these three puppies, those puppies are not all going to come out head first. So do the math. Somebody is wrapped backwards in that scenario. There's only two uterine horns, right? So there's only a certain way those puppies can lay in there. We just can't 3D print and know who's first, who should be positioned in that way. If we are mid-labor and there's a puppy that has its nose sticking in through the birth canal and it seems like it's not coming through or it's partially through, we can't pull it. And then certainly that's the reason why we might go forward to do a C-section in that case. When we do pregnancy x-rays for in my practice, I like to do this suggestive applying the type of collar, which is a pheromone collar helped with acceptance of puppies because they're less likely to be reactive to their puppies if they have these positive pheromones.

34:17They actually thrive this DAP pheromone that is in these collars that emits her about a month. The pheromone is the pheromone in the welping box that makes her puppies calm, but it also makes her calm. So these are used for other behavioral, I mean, you can see on the rocks, right? Loud noises, people that have dogs that get anxiety for, you know, maybe they're neighbors having some housework done, dogs reacting, or you know, something new is going on, this might be something that their vet has recommended for those reasons, but we actually use it in the scenario too. All right, I think we pretty well talked about some of these guys. So puppy counts C-sections just mean we do a C-section based on the fact that she has a lot of puppies or very few puppies. So this is an example of a dog where I'm counting, so that's two. They're three, four, five, six. This is all one pass. This is a bore-ble bitch. Seven, eight, nine, ten,

35:18eleven, twelve, thirteen, fourteen, fifteen, sixteen puppies. She had seventeen when we cut her, this is from several years ago, I have the image quality could be better, but you can see like, if you're an early and half stage with your ultrasound like this, you can pretty effectively go through and count if you've got a good veterinarian that's confident in doing so I should say. All right, we're going to go pretty quick through ovulation timing. This is in a presentation about ovulation timing. I just wanted to make sure that we were kind of familiar when I say this is how we're going to predict how to do her C-section timing based on her due date. We need to know how to predict her due date, right? So due date classically is technically we can do this just with the cytology. So if you're taking really good cytologies even as an owner, you should be able to, even if you just like screen count things on your phone and like mark them with the day, it might be really helpful information for your vet for timing. If it's maybe over the weekend that you're not really sure what she's doing or when she went out of heat. Basically the day that they go out of heat,

36:21the true kind of time frame not from when they stop bleeding, but when they go out and the males are not generally at the same time frame, the males are not interested. They have this turnover of their cells that go from these big kind of flat cells that have lots of sideoplasms or that kind of surrounding cell that's part of the cell that's around the nucleus to having more like Friday looking cells that are like in little clusters. So that's one way we might be able to define a due date. I would say more commonly it's progesterone, right? So we'll do progesterone timing. Some people will do progesterone with cytology as part of it. Now of course everybody's got a progesterone which is in right now. I'm sure probably what probably a third of you guys I'm just going to guess have progesterone at home in some vicinity. Before like 2020 or so we had about three options. We had a couple of in-house machines. There's mini-veitas and the Toso machines and then there were some send-out options. Downside with the send-out options obviously you don't get results back right away if you're not in major metro. You can't really get quick results which sometimes is important for

37:25your breeding timing and for your planning to get more progesterones run. I think that's really the part of it. But owners really wanted this to be something that was developed. I think sometimes some of it was the veterinarian's putting pressure on the industry but I think it was really the owners that said we want to have results and we want them now. So now we have a zillion tests. This was just like a Google search from a couple years ago. But obviously there's a bunch of the in-clinic options that have come about. Some of which were made by really good companies like iDex, HaskaCube. Like some of those are very common for veterinarians who have thought. There are also all the ones some of those that some of you guys have. Some of you might have these. I know some people who have a mini-veitas in their house right. It's just the new ones when they were making them were like $40,000. So for most people it didn't make a whole lot of sense. Occasionally it does. But the statement I have for you is these are not all accurate right. So is it important that they're accurate? Well yeah it's super important for us to understand

38:25when their due date was we have to know what happened to them. Now the planning the C section for most of the machines in the veterinary offices the lower numbers are actually the numbers that those machines are accurate. So things like the catalyst machine and some of the like cube type machines they don't run very high numbers and the accuracy that we have but proven scientifically outside of the company proving their own research they're accurate at low numbers. And the low numbers are what's important for us to know if these sections are safe. So I think they can be very helpful. Those tasks kind of easy in house machines can't be helpful in those scenarios. But if your progesterone machines are not necessarily like the gold-battered ones I would be careful about your planning of your C section and be open to the fact that it might be off a day and that you need to consider that with kind of when to go forward with surgery. Other modalities we can use to kind of fine tune our breeding timing as well as C section timing. So these are the LHS kits that can be used. So if your LHS is positive it's 65 days from the day of

39:31an LHS surge plus reminds the day is the range so a little bit more of a range for progesterone and a little bit less range for that LHS. So the vaginoscopy appearance I just mentioned is as a this is like supportive information for me. So if I do a TCI on a dog and I think she looks exactly where she should then it just gives me more power to say yes and this is what I think happens. The thing with behavior. So if my owner says oh my gosh the day we went home after you bred I know she's pregnant because the day we went home he wasn't interested anymore. My son dog wasn't interested anymore. That just means for me that we bred your dog properly with frozen seenin. It's supportive evidence it's not 100% but it makes me feel better. I don't think that she was definitely pregnant and that's why he stopped but it was because he should have gone out of season right after we bred her. Okay so I know we just talked through some of those things so these are the ranges of where their C-section windows could or their free-welping windows as well

40:31would be from these different time points. So LHS is 65 days plus or minus a day from if you have an LHS reading most of us are using ovulation so that's kind of our range so we've got a few days that we kind of work with usually and then cytologic diastrous most of us are not doing cytology. It's good to have done it but not all of us are going to have that information. And then for me then if we decide that due date so say we say it's XYZ day then I'm going to start checking her personally. I'll show you a few different methods and how we might check them but I'm going to be checking them associated with litter size to some degree so if she's got a gigantic litter if she has a 14-16 puppy litter size I'm going to start minus three because she could go into labor minus two so we want to be there just before she goes into labor that's the idea. Then you know if she's got a more normal litter size so like for my dog he had a litter of six that is not a big litter for a

41:32mobile mastiff and she historically held with thick two plus one before she went into kind of labor so I felt pretty comfortable with her not checking her till minus one. I probably could inject her on a day zero because he probably would have been fine on that and that's when the other C-section was specifically her due date. It was in it was handed up with. And then a small litter definitely more common for small litter so say two or three puppies to end up pushing past their due date and that can be normal. We want them to cook as long as they would have wanted to cook as long as they are happy and within reasonable range so we don't want them to go beyond that kind of outer window so the top end of all of those ranges we don't want them to go beyond that or else they can't die from being overcooked so I'll mention a little bit about that here in a minute too. So again kind of think to include in your decision timing her litter size her history

42:33is like for mine I felt really good into the weekend I felt really good going into the weekend not checking her mind as to because I knew she wasn't going to go in that early give her history if she's not going to go into labor that early. She could but not likely. If you're a super planner there's nothing wrong with checking them and checking them and checking them but just be mindful obviously you know for a budget perspective we don't want you guys to spend a bunch of extra money if we're pretty confident she's not going to need to be checked on the earlier side of things. Sometimes it's the health criteria thing so like for a gestational diabetic that we're like hanging on by a string and trying to keep her healthy we might go into surgery with her purposely minus two days from her due date as long as her puppies look cooked we want to go to surgery before her progesterone had dropped we want to get those puppies out who say it hurt her in those scenarios. Of course you know things like their progesterone friends daily like if you're checking their progesterone's theory as they go through too closer to their due date we're going to be wanting to keep an eye on that and we're going to check ultrasound daily as well

43:36once we're kind of in that close range fetal stress would be if their heart rate starts to drop so if we start noticing a pain in their heart rate friends or an individual puppy that seems to be really low we might want to go to surgery quickly in that scenario. Sometimes in presence of milk so I'm perhaps there are one of four bitches are not going to have one and I think there are a number of scenarios where owners are sure that they didn't see one as well and that's okay there's nothing wrong with that it's just just no it's not going to always be that helpful and I'm never going to cut 100% just based on a temperature drop. The temperature drop has to do with the progesterone trends but we can check those so that's what we want to check. Temperature is indirect measurement it's dangerous to just go 100% on temperature. Same thing with milk so hum dogs will have milk a week before their due some dogs won't have milk when they're due so I think for some species milk presence it's like what we rely on and it certainly makes my eyebrow raise if you have a bitch that had no milk and goes through a lot of milk probably means

44:39he's doing something but not necessarily. What we want to see is we want to see a progesterone that is less than 2.5 nanograms per mill for that those of you guys in Canada I know we had at least one person from Canada I just want to warn you you're going to be using different numbers if you go home or if you're going back through this lecture you can actually go online I mean Google's an amazing thing right convert nanogram to nanomoles per milliliter and that is going to be the numbers that you guys are used to. The nanograms is what we use in the United States so there's some countries that use a different the numbers will look a little bit different. If she's in that range if she's less than 2.5 nanograms he will go into labor within 12 to 24 hours if she is 99.9% of it just so that's a good thing for us to see and feel comfortable yes we're ready to trends can be slow or they can be dramatic so I have had a bitch go from N today who 0.9 tomorrow and she was in labor and trying to have a puppy before we could get her to surgery

45:41I have had one of my own dogs sit at 5 4 3 4 3 4 4 2 weeks doing that it is possible for them to just sit and sit and sit and sit very fresh trading and very expensive when you have that dog but but yeah it's really possible. Elder sound wise we should be kind of older sounding and doing progesterone like I said in relation to day sometimes we're estimating because we don't know the due date we might be older sounding and doing progesterone ahead of time. I just kind of depend on what we have available. Older sound is a necessity if your vet is offering elective c-sections and does not alter sound I mean that from the nicest way possible it's not a good option even if they're very nice people and they mean well. Older sound is the best way for us to assess these guys and know that they're okay. Know that they're term know that they're viable know that there's not any concerns progesterone is nice to have if not as important for me as the older sound is

46:42and then with older sound so like we talked about we're going to look at fetal heart rates we're going to look at peristalsis of the intestines for that means like the intestines twisting food through in the puppies and cells and then also we can see things like kidney development there's some things that'll kind of help encourage us to say yes these look appropriate for where they should be. This first one is a video of a fetal kidney so this is an abdomen that we're looking at right now and on the right you'll see this kind of kidney bean shape pop up it kind of looks like it has like a spider web on the inside of it kind of like a long bean shape that is a term fetal kidney meaning it's either that lead 57 days out of 65 if she looks like that so it might help us get unperspective or again reassurance that we're in the right range and then on this video before I started I'm just going to tell you there's kind of a black circle so if you focus on that black circle look just below that and you'll see these kind of snake-like kind of wrapping back in fourth

47:43shapes that is the fetal intestine for that's what you're going to want to focus on so what we're going to see is things kind of being pushed through so you'll see these little loops kind of kink around and move on their own just kind of focus on one area and you'll see one kind of wiggle a little bit and then another area kind of wiggle a little bit we also are looking at the definition of the layers themselves like I'll be looking at how bright and distinct they look compared to say yesterday if we had looked at you yesterday all right so the scheduling options some clinics take include some clinics will just say we have their due date we are cutting on this day and so that's one way to take the approach there's also something called like I called floating day so a range of time or we think she's going to be ready sometime within this window so we scheduled her for several days so that's another option so for the cut on next day the the nice thing about this is really easy to schedule and plan right you can know I'm going to take off work on Monday

48:47because I know my C-sections happening on Monday it's really nice to be able to feel like that it's really nice for the clinic to be able to schedule so that they know they have the time and the staff to do it but we have to have super accurate ovulation timing and there are some litters that when you cut like this they're a little bit sleepy and they're not quite as term as they should be they also might go into labor before this day so if you're that clinic and it falls on you know her day falls on the week in her holiday or just flat out the bit just goes into labor say they schedule you minus one from her due date it's on her litter size and she goes into labor minus two well what's your backup plan because you might be in a C-section so really simple she's doing the 17th she goes to surgery on the 16th that's how a lot of people will do it some people if their litter size is super big they might stretch to the 15th in the scenario but most people will be planning it for due date or minus one if they do this type of logic floating day is dependent on what she does the business that we look at their ultrasound

49:53we look at what their progesterone is doing this is what I do it does require a lot of time to be blocked for the doctors it does require us to have the staff on several different days maybe to check her on days that we're not even in the office so it can be kind of tricky and there's certainly a possibility for emergency care if we're pushing to wait until we know that she is almost there sometimes we're not right and it's not something that we can be perfect about unfortunately we can't 100% guarantee that she's not going to go into labor if we're trying to wait until the moment before she's going into labor it can be tricky on that front it's certainly it's going to come with a little bit more cost it's tricky with like can we work it in are we going to have time do we have the people there that can be tricky depending on how your clinic plans all right so this is an example of a dog the first day they came in we're older sounding with this as well but just for perspective on what their progesterone did so say they're due on Wednesday with a litter of eight puppies we checked them minus two on Monday

50:53and owner says non-alaborate everything's going well her progesterone was 4.2 we say okay she's not ready and then we go back on Tuesday and she's 1.4 great she's ready to go her ultrasound looks great we go to surgery on the 16th it is also possible that the first day oh she's 10.9 on Monday yeah she looks great no problem and then the owner is panicking because he's already in labor when they're driving here the next day and with their litter of 10 puppies this is the most quick drop that I've ever seen but it can happen and it only takes about 12 hours from when they drop so this dog dropped precipitously on Monday was already in labor by Tuesday so pretty impressive and then of course we have the opposite scenario where they just kind of putth around and they don't really go forward which in some cases we're taking them all week right so this dog got checked Monday Tuesday Thursday and Friday now Friday we were going to go to surgery regardless but it's still important for us to make that just to make sure that we understood what we were going into I know it gets a

51:57little bit academic on that last day but I think it's still important to know this dog played by the rules but there might have been a dog that was three and a half and we might have said you know from her due date we might check a hundred times that her due date really was correct or accurate but we just want to make sure that if she wanted to go till Friday and those puppies wanted to cook till Friday that we let them. Alright so the last possible kind of setup for things is the weight and fill state one labor so this works as long as your dog goes into state one labor and if you have a vet that likes to work you in for these sorts of things in a quick order if you don't it's tricky right so we've got to have a good confidence that we have kind of a good due date for her if you're doing this too it is possible for them to go into labor a week before they're due and well people a bunch of dead puppies because they're not term so it's still important for you to kind of do some of these theme processes with the ultrasound and progesterone and such but progesterone just goes down it doesn't mean that she was too necessarily it means that she's going

52:58to go into labor if we don't have that front-line progesterone testing or opulation timing it can be tricky to know and again not all bitches will go into labor so sometimes these lures just die if you just wait for her to go into labor they just don't go into labor singleton sometimes it's like multiple puppies but they're all in one horn there's something that's weird about the signaling there and how can we help how quickly can we get you in is she really in stage one labor they do in labor also can be there for two days is she actually ready ready I think it's kind of a tricky thing to choose all right so as far as emergency care I just wanted to mention to you guys just keep in mind I know it's frustrating as the owner it's frustrating as the vet too threatening at the ER is my bitch going to be prioritized which ERs are going to spay her and force to stay and we deal with all that kind of stuff too as the third party in that scenario trying to advise our client what to do the reality is is the dog that's in page two labor that had a puppy three hours ago and needs to go to emergency c-section that dog is not in paral that dog

54:03is a puppy might be in paral that dog is not going to die from that the gunshot wound the hit by car the freezing dog both are all going to take priority so if that ER is busy you might be sitting in the parking lot until that dog gets sick from not being able to weld and that is not necessarily unfortunately we have selected these dogs to be completely inefficient at welding compared to what they would do in the wild and I think that it's a dose of reality it's not fun to think about but the reality is we have made our bed with that and the ERs can only do what the ERs can do and I think I can tell you having worked on s mayors even though it feels like if you put pressure on office that they're more likely to see your dog pressure is okay but kindness will get you further and get you in the back faster so just keep that in mind and then we're slipped to bright when we get in these scenarios and it's frustrating because we want to be first but you know sometimes this is just a trinity situation there's not a perfect right or wrong answer I just wanted to say as a reminder be kind I know it's not fun and sometimes these I think the ERs

55:06also tend to see the worst of us and us being a general term for breeders they don't see the ones that have good relationships with the reprova and had after hours care in some areas that have that option they see you know the super sketchy client whose dog was in labor for a few days and has a puppy hanging out of it and the owners don't fear and they don't want her to be spayed even though she's been in labor for a few days and they let her you know sit in the back yard with the puppy hanging out for perhaps that that's the kind of stuff that they also get to see so I think that's why there's some negative or tense reactions to like see sections and insect dogs in that regard all right so just a couple of mentions on you know how these might be different from the ER we do still need to feed them like we would if we wanted them to wealth we want their users to act like it would if they free wealth so as far as the ability can track and kind of expel things after pregnancy those things are important fitness is important from that perspective too it helps

56:08with all of those types of features seroid administration has been a component of many species a kind of elective C-section approaches I used to use them as a like if we thought you were minus one from your C-section and we would pre-dose with an infectable seroid that type of seroid it's called folio delta core tough we used to use it all the time and one that went off the market it disappeared like 10 years ago and I never really replaced it and you know I wish that we had it but I think there are still some clinics that are using like dexamethasone or using something else kind of in its place but that might be something that somebody might suggest there's some suggestion that steroids encourage serifactant which is part of your kind of lungs function the last thing that's supposed to develop in kind of neonates when they're almost term and that that helps maximize kind of survival outcomes and then certainly for go-getter type which you guys are obviously you're at a seminar in the middle of the day listening about C-section so

57:09you're going to want to prepare for potential issues with colostrum so for some people that might be say you have a dog that hasn't had a vaccine booster in a while or maybe your minimal acts kind of approach person but you feel confident that you know your dogs tend to retain their December parvo protection for longer term I'm the person I usually just boost if it's like been a recent window of time all booths if it hasn't been before I know a bitch is going to kind of come into heat so that I know she's got a good kind of boost of December at a non-parvo protection but for people that didn't do that or didn't want to do that you can detect their titers mid-restation and decide okay do we think her colostrum is going to have good antibodies to those diseases it's important that they do it's important for a lot of different diseases but those are ones that we can test for you can also check for things like herpes virus titers to an ingestation if you wanted to be kind of gung-ho and be totally aware of what you're getting into

58:10and if you needed support then you could have something provided to them when they're super young and for things like December parvo we could get a donor that we knew had a recent vaccine history or had a high-tider and provide them some plasma when they were puppies so I know I'm already over time this is classic me right Nicole I'm gonna go ahead and skip past a couple of things that aren't directly directly relevant but I just thought we'd have more time to talk about no don't take your time yeah sorry for you guys that are like on a time crunch I'm sure this will be recorded and available later so you guys can always come back in but I had a little bit on kind of the aftermath of the section so like kind of management post and decision-making posts as well as like I said that colostrum mentioned too I just wanted to go through those things so well-wises a company that I think they're based in Colorado area but they are kind of connected cross-country for people that want to do food or in monitoring and they provide after hours

59:14monitoring for that so this can be a super helpful option for people if you live rarely and you don't have really good c-section kind of backup care but you really want to free well and you want to try to do what you can to make sure your bitches free well if they can then I think this is something that can help you it does come a cost and it does require a lot of time so you have to put these little monitor around their belly you need to kind of get used to it and get used to how to kind of fit it around her and get accurate readings and the company kind of works through with you on those things but they mail this kind of set up to you and charge you by the time frame for being able to monitor things and then they'll read it almost looks like an EKG so like a heart monitor but it's for your uterus so it's contractions of your uterus instead of contractions of your heart and that uterine monitor can clue them into who she doing something she shouldn't do do we like the contractions she's having it she having contractions before she's supposed to have contractions those types of things can be very helpful and is what we use on the human thread so if you're in a

1:00:17human hospital that's part of your assessment and some women are monitoring their uterus at home regularly during their pregnancies with these types of machines I don't know if well-fights has switched to anything like that but they've actually got cocoa dynamometers which are the machines and humans you know they've got all these apps and things they've got like ways that you can convert that information onto like handheld devices and be able to get AI software reviews and doctors kind of review them remotely which is super nice and kind of the newer AI version of kind of what this was providing I'm sure that's probably how they're going to convert as well if they haven't already kind of implemented those types of things I haven't personally used it in a long time so I'm not sure on that so keep in mind that this is just like saying the protester is always right the uterine monitor is not always right say that these are term so keep in mind that her due date is the most important thing if you know her due date is not till next week and

1:01:18well-fights says she's acting like she's in labor they're about to save your litter if you send them in and notice that she's her protestor is low and you need supplementation it might actually help you to facilitate kind of preserving her but it can also be helpful just for labor monitoring for understanding is she going to go on labor before she gets her elective c section is there a reason to be worried for potentially to cut today versus tomorrow because she's already doing something with her well-plies it might help with something along those lines for the right scenario and I think sometimes it's like the priority of that litter if that litter is from 40-year-old frozen semen and it is two puppies and you will do anything to make those two puppies live like this is just one of those extra cool stuff out there I mentioned the overstepping snap issue because a lot pros with well-fights there's a like a running joke but kind of a running joke in medicine I'm sure we all have our own things but veterinarians tend to get bulldozed by human nurses more than

1:02:18physician truly it's always nurses this was started by a human nurse group right and they're the experts right they're the experts in tokeninomometry because that's what they were they were infirpreting and helping women monitor their pregnancies because some of those nurses who are human nurses look on the technology tried to apply to dogs and then tried to market it and it has been a partnership with veterinarians and they do have us involved but there are definitely scenarios especially with novice that novice that's being doctors that are younger even if they're boarded doctors that are persuadable or pushable that there are some super bossy women I say women as a woman there are some super bossy women in this group who will convince that owner on the phone overnight before I talk to them that they need to go to c-section immediately or they need to give these drugs in this way right now when it is my license and my opinion that really should be

1:03:19driving the bus so sometimes the bus gets driven by well-plies in those scenarios and sometimes it's not a good outcome because they were put into due excellence. Sometimes though like I said the technology can completely save your bit and your litter in some scenarios too so it's not perfect and you know it'd be great if there was more veterinary involvement on this but I think it's one of those I don't know that it's going to happen because there's enough people that struggle with the relationships that they have with this company and we'll confront them about that they're over-depping and practicing medicine without a license and that it kind of makes people butt heads so I think it's more information for you and do the best you can to kind of use the information that you get with your kind of support pain in your bit and you know your breeders information there's lots of people who can contribute to decision making but I'm just be careful. So the overcooked phenomenon is when we let litter's go beyond terms so if we know their

1:04:23due date is today and we let them go past Friday, the day's Wednesday for perspective so if we let them go beyond two days past their due date and we know their due date was Wednesday they are very often they comment on Saturday for another assessment and those puppies have low heart rates we get them out of surgery immediately and they crash and they all die or they all are weak and then they go home and they're sleepy and they don't provide that is for kind of normal litter sizes that's the kind of scenario that we would protect the same exact outcome can happen to singletons if you do not cut them on their due date but if you have a singleton or a two puppy pregnancy that is at their due date as long as their ultrasound looks appropriate and they look term I will often encourage them to cut on those days because sometimes we just come back tomorrow in those puppies who are dead and we don't have a good reason for it medically and we didn't go into labor right there's just lots of risk all the way around right we just have to make the best decision that we can

1:05:26sometimes we don't have the specificity to know that that singleton is due today right so like sometimes we're just we have to deal with this if it happens it happens but I always tell people if they don't have a due date if we don't know that this dog is due today and we're checking the singleton pregnancy for a mystery due date every day I am nervous when I go to ultrasound at dark because it is possible that she is one day past when I thought she was and that we didn't get that puppy out when we could have we can also do the same cutting them early right so we're just playing a balance on that all right so as far as when puppies come out during the section usually we nurse them like right away so we want these puppies to get the benefit of kind of nutrition colostrum just helps their internal like function to have a little bit of glucose kind of in their system and that will benefit them you know tremendously sending them home with you if they've had a little bit of them before they go home keep puppies warm during nursing incubators are wonderful tools if you have a clinic that has an incubator you don't have to have one certainly I

1:06:31would just say they're they are worth their weight and gold once you get one you never look back I used to be one of those stubborn people who said I don't need one I can make an incubator out of everyday materials and I did but man it's much easier if you can just edit and manage other things and have them in a very safe contained environment and just like lands over a real one for a while to say yep the temperature looks great for lazy puppies we might use a lock zone if there was any opioids in the protocol with the puppies like if mom had a pre-medication like a hydromorphone or methadone something like that sometimes I'll give vectors like the injectable ductrose which is basically like syrup with sugar water essentially fancy sugar water that comes in a medical out we can use that for other things in the clinic but we'll often use it for this purpose drop in a regular syringe and I'll just rip in their mouth before we start nursing them if they need a little bit of a boost and we'll stimulate them to make sure that they're warm before the nurse obviously don't have a nurse a cold puppy it's not going to be successful they're also not

1:07:32going to be able to digest the milk that they obtain prime nipples just means nipples that puppies have already nursed on but if you have a puppy that was super vigorous and you got one that's a little bit sleepier pull your vigorous one off give him on a different nipple and use that used already kind of worked on nipple for the brand new puppy because they're going to like the kind of sensory elements the teeth like everything will just be easier for them to attract to and to understand what they're doing and certainly we will too feed if needed as well so just mentioned I know we're talking to our dear but there is a exception to the rule for some scenarios we will not nurse kittens that have blood depending on their blood types sometimes we can't nurse kittens right away because they're not going to be nursing on their mom at all in the case of condition called neonator usury withdrawal system which you guys don't need to worry about but if you wanted to get a jeopardy kind of quiz for yourself go google that later and read about it

1:08:34it's the problems for cats and the horses actually can do it as well we want to make sure you guys know how to stimulate your puppies you might have to be mom for a period of time or all the time to stimulate them so usually if I use like wet wipes the easiest thing for me because my breed almost never wants to lick their puppies and clean their puppies we get to be their moms from up to their lives so if you have a I got super good at cleaning great but make sure that you're inspecting things it's actually more common than you think for people that bring puppies in for say do claw and teal docs or just from neonatal exams how often their butts are caked with feces and the owner said no idea because they thought their mom was cleaning their puppies and they worked so just good to keep an eye on this for varnish more of a thing with electives because they don't instinctively clean and necessarily like they would if they had come out naturally obviously for elective c-sections any c-sections if that damn is post surgery it's gonna be a

1:09:35little bit gorked right she's gonna be a little bit weird and not in her head also she might not know what they are if she's never seen puppies or if this is a new experience for her she's never had a litter even if she has a litter be very careful if you aren't careful they can hurt their puppies it can be benign like they push on them with their nose or they step on them or you know try to smother them because they're not sure what they are but they're really excited about them sometimes it's some putt and tocks that actually genuinely are like this is a mouse i'm gonna kill it so just know there's a range to it and sometimes it'll settle down with time and patience most dogs will accept puppies with will a bit of time if they don't have great milk post c-section so usually we will give oxytocin in surgery we will give that as a general rule and then if she doesn't have great milk and she's got a big litter size i will often send the owner home with lots of small doses of oxytocin for the postpartum interval so try to chump start her milk production it's just going to help get everything kind of brought in also there was a drug that we loved called

1:10:41dump heredones not on the market right now so you can disregard that as an option if you have some in your stockpiling it we probably could sell it on the black market for a pretty penny right because we all miss it it was great minimal no-side effects does not have any negatives just would help with milk letdown it was an oral pace that we could use that's a horse product metaclopromide has similar effect and these can come with side effects if you use it at too high of a dose can cause some really serious kind of drooling and weird effects called extra pyramidal effects that are not good to have happen to you so people ask all the time about antibiotics i want antibiotics because she has surgery so we don't do that anymore it's not really a thing we used to think it was a thing there's absolutely funics that still do interop antibiotics and post-op antibiotics or you know have some kind of a protocol that they've been very comfortable with i think going with what your vet has been comfortable with is a good idea but is the sterile procedure even if we have placental material splash of the abdomen is the sterile procedure

1:11:44the uterus itself is sterile there's no reason to be concerned you know for a routine c-section we can see negative effects from antibiotic use in causing neonatal diarrhea can also cause resistance can change their microbiome we don't want to affect their little debts and how well they're able to absorb things and how well they can protect themselves from infection because the good bacteria get killed with the bad bacteria so it's not a benign thing to be using if we don't have an indication but we might say think that he has a concurrent piosay or had another infection if she has what's called an infectious loop gram which just means her white count or that she has an active infection maybe a really long like that puppy that's been hanging out of the dog for a day and she's been labor for two days that dog is getting in for sure but not going to be the scenario that you guys bring up usually right so the well-meaning kind of thorough client it's going to be things like if they had a dead fetus that had decomposed and we had some concern when we

1:12:47were in search of all this reek of hi heaven when we pulled it out and worried that there's going to be some cross contamination maybe if you reported it would be a post for like a free well but if you maybe had a ton of retainful centers I'd be more apt to send you with a moxytocin than I would to send you with antibiotics but sometimes they can get infections from extra handling when they're having problems with delivering puppies or from retaining components during labor. When you're home make sure you monitor for at least 24 hours ideally 48 hours there are some people who will say 72 on this for especially for a maiden postpartum for an elective c-section no matter how much they convince you that they like their puppies and they're going to do everything just there's an anesthetic fog for like well the 24 hours for sure like just be aware of that they're still just weird stuff that goes on and I think it's just harder when they don't know what their puppies were and they just were given their puppies right we don't usually use an e-collar

1:13:53like a typical firdery they are really good about leaving their skin symptoms alone I really I can think of zero cases personally where I've had a dog go after its incisions right now of course that's an an ideal scenario with me doing their surgeries I mean not thinking about my the gift to surgery but it's maybe different than an ER setting or you know something different where we're not handling it in the exact same way that kind of the theory of group have encouraged us to do and some of that is things like pain is managed I usually use interdermal suturing so puppies don't kind of get tangled in the suture or she's not interested in something to do with the puppies relating to the suture getting kind of hung up in it I don't know just kind of thought pain management wise no see it is the injectable medication that you might be aware of that we can put in fit use themselves it's basically like doing a local block but it's because of the too useful for a little while that has changed the approach for a lot of people that have access to

1:14:56that it's expensive so it might not be something that everybody chooses to incorporate in their practices you might not see it or know that it's being used but very very common super helpful for pain management and lessen the need for things like incidences opioids and gavitat I'm personally an n-fed person I usually don't use opioids and gabapentin I'm in unless I need it for post-ut pain usually it's just and said so things like car profen or medocham is what I usually will use and infordry and post-surgery if you think too when you're bringing all your things who for your elective c-section a don't forget the box of things that could bring there's a lot of people who come and they forgot all their things at home enough fine and we'll help you find a box of things but it's great if you have the things that you were hoping to have prepared for the kind of go home so we can make these little gloves up with some hot water it's like a little hot water bottle stick around in the box underneath blankets I love these snuggles they've just they're at the

1:15:57bottom there that's actually what I use personally you can pop the inside you pop in the microwave the outside you can wash in the washing machine and clean between litters and things which is great and they'll retain heat for like six hours they're great and then cervix wise we usually prepare our owners for expecting a lot of discharge certainly if you have labor overnight and it's 12 hours long you're gonna see discharge all throughout that process we have pulled plug on everything at once right so they're going to have discharge most likely kind of in a large quantity right away and sometimes that can be kind of impressive to owners so for maiden they're more likely to be entrance right the maiden's being dogs that have not had puppies before we talked about the collars so the agapezing fermo and collars or da p collars which are those adaptable collars those are kind of first line of defense and I think are good for anybody it doesn't necessarily have to be a maiden but the other thing that people have started to try is intranasal oxytocin spray so it's

1:17:04in an aerosol spray kind of like an intranasal spray that you'd actually have compounded through a human pharmacy they don't like this so you have to give it in their nose every couple hours a little breeze that there's not a small version of it but really is pretty limited to just larger sized dogs but there's some really positive success with this for kind of breeds that wouldn't be typically great c-section breeds things that have like pretty high prey drive and aggressive tendencies towards puppies I've had a lot of positive responses from plants when we have prescribed these I have tried just the drip in method meaning like just putting in raw oxytocin injectable oxytocin in the nostrils and I'm not convinced that I think it really I think it's just placebo I think it's got to be the aerosolized version the idea is it's supposed to be the aerosolized version is what kind of interacts with there's a part in the back of your nose that kind of is intimately related to your brain and it's got to be the aerosolized type to be able to really integrate in there that's the thought and then calcium is another thing I would say just be

1:18:09very aware that you know we should be giving lots of calcium forces kind of in the post-op period sometimes we'll give so much that we create kind of diarrhea and some other problems but I think it's good to be you know mixing in calcium sources using a full type calcium other oral like tablets or capsules if you feel like your dog is having some anxious changes at home I think a lot of time to tell him goes a long way all right and then just a mention about colostrum so let's do that colostrum they kid colostrum by both transplicental and transmemory meaning across the placenta and across the mammary glands methods which was great some species are really only dependent on the milk and the colostrum that's in milk and not getting any kind of antibodies across the just being in the uterus so it's not a complete loss cause if you have a dog that has never gotten or exposed to colostrum orally but it is still good for them to get it it's still going to protect them at the kind of the maximum amount of protection compared to not being able to

1:19:11get that sort of exposure to antibody protection so gut closure is thought to be between 12 and 24 hours meaning that's when the body can no longer kind of have more of that positive intake of those types of things across the gut and all the gut's going to be able to do that and just metabolize it as milk we do know and dogs there are differences to the actual glands themselves so like the back teeth that puppy A focuses on and hordes and doesn't let anybody else touch it might have the lowest quality immunoglobulin levels or levels of those protective bits that we want in colostrum so it might benefit you to move him around and I just try to move everybody around a little bit in that first 24 hours for sure just so that they kind of get the average if that makes sense of exposure to the different glands so we can supplement milk after the colostrum one that was over hopefully you don't need to do this and your bitch has decided to accept her puppies but we

1:20:12certainly want to use a canine milk supplement initially if we're adding this on and trying to implement it we want to start with a little bit more of a diluted solution compared to what the product will either come in or suggest the mix up to be so I usually just make it in its normal formula and then dilute it a little bit with water just tap water is fine I'll sometimes also add a probiotic like the powder probiotics that are out there you can just like mix them into that slurry when you're about to give it the things that are out there there's all sorts of things that are out there some of which can be helpful for weight gain that are high concentrated like they even will say oh if it comes out and it seems like it's too thick just add a little bit more liquid to it but it's like yogurt and raw eggs and vitamin drops and all sorts of stuff it's not that those things I have used some of those formulas and there's a lot of them out there that they can be very helpful for putting on weight or turning around puppies that aren't thriving but as far as being a

1:21:14supplement that completely replaces milk replacer I don't think that that's really the right brit milk kind of a lot of different formats with a lot of different concentrations and components to them so I just share this to say dogs are so different from our common milk types they're so different in makeup so they're much more concentrated and just have a completely different kind of design than all of these ruminant milk that we use right cow's milk goat's milk, beef's milk what have you they're made for very different animals so they're just going to be different in what they can provide so you know a puppy is not the volume of what a goat kid is going to drink from his mom is totally different from the volume of what a puppy is going to drink and how concentrated that liquid is the reason the goats have been such a focus on goat's milk is great for puppies I mean it's been marketed so beautifully but the reason is because it doesn't give diarrhea it's not because it's made well for them it's just because it doesn't

1:22:14cause them to get sick whereas like cow's milk will cause them to have diarrhea so anapid goat's milk is perfectly fine if that's what you have access to that's great make sure that it's pasteurized I know there's probably going to be a lot of people up in arms when I say that but there are many diseases that the point of why we pasteurized was to prevent those diseases from being a problem for people the same thing goes for dogs and there are some diseases that are very scary that are in unpasteurized specifically in small ruminant milk goats and sheep specifically so long term consideration the fans of having an electricity section they you have a new Finland bit and you'd love to be able to free well for next time but she had a litter of 13 and you just really didn't want to risk her this time can you breed her again of course you can there is no compromise to the uterus when we do with the section properly and I think free wellping on other litters is fine as long as the reason that you feed the elective or the murder of the section potentially was not something that's going to rear it's head again if it is then you might

1:23:19end up doing another elective but if it's something where you can free well for them I think it's great to try and I think again encouraging all of you guys you know I'm here I'm the one doing the elective c-sections right it benefits me to have more of them but I'm just here to say I think it is great to strive towards minimizing that if you don't need them and that includes breeds that we wouldn't traditionally free wealth or we think we shouldn't be free wellping but a lot of them can if we give them a chance I think a lot of it is if your management improves then sometimes they do better than you think not all of it genetics all right so I know I went way over there are so many dovetails that we could go with this lecture and I know we're going to talk about singleton separately another time later this fall so it might be I can kind of address some of those things then if it's related to that and then I know they had some questions already kind of pre planned I'm happy to answer as many as we can get to amazing we will just do a few because I

1:24:19want to be conscious of your time and thank you so much for going a bit over to make sure everyone was able to get the full presentation we had a question from Natalie about Stahl's past an hour would you start oxytocin before that or at the one hour mark so I'm a two-hour person but if you are the client of a one-hour person I think the answer is yes we won't reach for drugs at least for now for me I don't reach for them for at least an hour the argument against that one-hour rule even if it's real is is it realistic especially depending on how far you live most of my clients live an hour for me so how could they plan if they're supposed to just be in the core come to me the moment their puppy is born for the next puppy to maybe be able to be well to the clinic it's just tricky I think depending on your distance but yeah I don't act before an hour for sure I'm usually too is my rule amazing and then we had another question someone recently

1:25:20had a C section and the vet left the placenta in is this a new normal practice is there a reason for that great question I didn't mention that so typically we will remove them all if they leave and I'm glad that they told you because there are some I would say it's usually scenarios where their placenta won't come with us so there is concern for hemorrhage so if they felt like they had a lot of bleeding in surgery and the placenta did not want to come with them after they pulled the puppies the placenta just continued to want to hang on those placenta have to release like when we start to kind of tell on them they shouldn't actually kind of give and we don't put like a ton of pressure but if you put up kind of the little sustained pressure they will release over like maybe 10 to 15 seconds with it on a clamp on it but I think the occasional scenario you know I can't say that I've ever had one but I know they do exist where you have a dog that like hold on to their placenta I think the radiance or can be to preface the owner she could end

1:26:24up needing you know management for having a uterine infection if we can't release these but there's just no good way to get them out without causing her to hemorrhage sometimes. Great thank you for answering that one another one I see from Kristen who's asking how long should you let a free-welting bitch go trying to have her first pup. The general rule for me is four hours if she is doing normal behavior so if she's not bearing down like she's trying to actively have a puppy right this second and she's just having occasional contractions and panting I think four hours is a reasonable range to decide that there's potential that something's not going right it sometimes those dogs get in the car and they're driving to us and they have a puppy on the way and by the way that's the best way to get a puppy to help is to get in the car it's a joke but it never fails when we're coming in for I mean I'd say a third of the time we come in for an emergency fee section overnight or something and they get in the car and the puppy will be born

1:27:24because they're driving in the car. Oh crazy let's do just two more we had a few of these questions I wanted to make sure we got answered clearly it's a common one how many C-sections can a dam safely have over her breeding career and how do you decide when it's time to retire her from breeding? That's a great question so there's kind of two directions you could answer this one would be is there an ethical line? Is it all medical or is there an ethical component? I would tell you that I think that in the United States there's a preference by people to not have as many litters as you might with an elective section or a free wealth because it makes you a puppy male and I don't think that's necessarily true it's just where do you draw the line? I think the line is different for every person for me I think medically if we're doing C-sections we generally

1:28:26go through the same incision site and if it's done well and it's emergency or elective if it's done properly and you minimize your incision size and it's done smoothly and she recovers smoothly we don't have any issues and we go right through that same site over and over so it doesn't change anything as long as the uterus doesn't start looking stretched to us in surgery so sometimes we'll start to have these like almost like window effects where a puppy kind of laid down near one of those sites and spread the tissue a little bit I've had a couple of dogs where when we manipulated them out to do their elective C-section just the manipulation by itself caused that tissue rupture and so for that to basically have a uterine rupture which can happen when they are pregnant as well so I think I caution people if I don't personally tell you I won't do it I just will say I think her uterus is done I would say for most of the frequent flyer breaky syphalic say elective

1:29:29C-section clients that we have I'd say most don't push past four or five would be like max that I really watched medically for me but I don't think that there's necessarily a specific number great thank you for answering that one I think this last one kind of ties all of this up with a bow but what would you say is the most common mistake you see breeders make around C-section planning that leads to a worse outcome and how can they avoid it I think we are our own worst enemies and I think for elective we're our own worst enemies and we're worried we're all worried about I mean that's the whole lecture right like we're minimizing the likelihood of a bad outcome and I think the reality is as you can't sometimes we get in our own way and in the same way that I didn't do my own dark elective C-section for example because I shouldn't be making decisions because I have too much kind of personal stake in what's going on and I won't be able to think

1:30:33super clearly and so I think sometimes when we trust our veterinarians to make those decisions and everything goes smoothly I think it can feel like very natural and very normal but sometimes when things go wrong the tendency is the panic we need to cut we need to go away to it now and sometimes patience it's hard to feel comfortable with patience but I think patience is like patience is a virtue right so like sometimes if if the owners like really wanting to go forward with a C-section a day and I'm like I don't think we should do it today and they wait until tomorrow they're like well you were right she didn't go into laborer I think there's probably scenarios where other veterinarians might cave to well this is what my owner wants and she's not a doodoo Monday but she really doesn't want to risk the C-section over the weekend so we're just going to cut them on Saturday and then when we do they're sleepy coming out and they're not super vibrant and they go home and it's a huge pain for that owner to try to keep them going because they were early I think that's the scariest scenario

1:31:34for me is the early cut. Great well I think that is all of the questions we have time for thank you so much for staying on a little later to answer those as well and thank you for such an amazing presentation on behalf of all of the viewers who joined us today thank you so much this was so great and clearly we have just scratched the surface on this topic which I had a feeling about so we'll have to have you back to cover this even more of some follow-up say no you mentioned singletons as well so lots for us to cover which is always a good thing thank you so much to our community for joining us today if you're not yet part of good dog you can apply to join at gooddog.com slash join so you can stay up to date on all of our future webinars and events but until then thank you all so much for being here thank you again Dr. Hester and we'll see you at our next webinar bye everyone thank you you guys