An Easter Litter

By: Todd D.L. Woods MD

Corbett, Oregon

Having just gone through a horrendous whelping experience, despite my being over 2000 miles away I felt the need to recount the tale to friends to unload the pain of a failed litter and the anxiety of nearly losing Cassie, the mother to be and leased bitch of a good friend. Having told the story several times, it struck me how many friends were surprised at some of the things that were done to monitor Cassie that almost certainly resulted in her life being saved. The lessons that were reaffirmed during this ordeal for me were important and won't be forgotten - they might save the life of your bitch someday. While there are many other experiences that are valuable lessons in whelping, and this story can't include all the signs, smells or clues that could be told in a longer, hook-sized piece, there are some lessons related that hopefully some people won't have to learn firsthand.

Because I had to be in Chicago for sub-specialty boards that are only given every other year, for which I had paid a non-refundable $850 some nine months before the litter was even bred, I asked my close friend Cherrie, who has lots of experience whelping litters, to be on call. Luke, who has whelped one litter solo and witnessed many more, stayed home and watched Cassie until it became obvious she was going to have them.

Cassie's first due date was Easter Sunday so I began taking her temperature five days prior at the same time each day - once at 8 a.m. and once at 8 p.m. As the core temperature varies on a circadian clock (daily rhythm), this would allow me to chart the normal fluctuation of Cassie's temperature before the actual drop to below 99 degrees that would signal the onset of labor. I also began to spend time watching the abdomen for movement and gently laying my hand on the abdomen for the first feeling of movement. I do not manipulate the abdomen at this stage for fear of injuring sacks. I usually can feel puppies move about one week prior to their birth. I also listen for heartbeats - something that is very valuable and extremely easy to do, even for the uninitiated. The puppies' heartbeats are much faster than the dam's and you can hear them in a variety of places as you vary the placement of the stethoscope over the abdomen. Each heart-beat will get strong as you get close to it and then fade away as you move away. I also watch for when milk can be expressed and when the bitch starts to lose her abdominal hair. A combination of these signs leads me to know the likely timing of the coming labor.

Cassie's temperatures on Wednesday to Friday pre-Easter were about 100.4 to 100.8 in the evening and 100.0 to 100.4 in the morning, which I charted. I sensed modest movement on Friday, increased from Tuesday and Wednesday, but Cassie was not losing much abdominal hair and was not behaviorally changed from Tuesday. She remained her very active self, screaming for attention and begging for treats. She did no lengthy resting, which in my experience starts about three to four days pre-labor and certainly showed no nesting signs, which usually follow the resting stage. The heartbeats were strong on Friday, too. Saturday morning I hurried to get to the airport and again communicated to Cherrie all the goings-on over the previous days - facts I had been relating to her as they occurred in case she would need to whelp the litter. I did not feel for movement or listen for heartbeats because of the lack of time (which I now regret). Saturday night I called home and Luke related Cassie's behavior (no change - not even much resting) and temperature (100.2 F.). Easter morning, Luke told me that Cassie had carried on as usual much of the night and her temperature was 99.8. I was hoping that she would start her resting phase and have the puppies when I returned after Tuesday. Luke doesn't know how to feel for puppy movement or heartbeats (something he will learn with the next litter), but everything seemed fine and timing-wise, Cassie was giving me the signs of having the litter in a few days, still. All the signs, when I first felt movement as well as the strength of the movement, the milk production, the beginning, several days prior, of the loss of abdominal hair and the lack of the resting stage, all indicated we were still a few days off. With the slight reduction in temperature that morning, I asked Luke to put some newspapers in with her to see if she wanted to nest.

Luke went off to Easter service, and of course, checked her when he got home a few hours later. He found her resting on her side with infrequent, weak contractions. He said she looked lazy, not standing up and hunching right and that there were some damp chips around her. He thought maybe this was urine, but I assured him that she wouldn't likely lie in her urine and that he needed to check her vulva for discharge. Her vulva had started to soften prior to my leaving the day before but was not the big soft vulva that would signify she was ready - there also was no significant discharge. I do not do internals until actual labor for fear of introducing infection. He checked the discharge from the vulva and said there wasn't much and that it was clear and non-odorous, but I was still sure that she had lost some water, and despite the timing of the signs, that she was going into labor. I started scolding myself for believing too heartily in the signs (mentioned above) that had predicted a later onset of labor and called Cherrie, who dropped what she was doing and headed over.

Luke took Cassie for a walk, which she energetically enjoyed, and put Cassie back in the whelping area shortly before Cherrie arrived. Cherrie also took Cassie for a walk to stimulate some better contractions and then examined her, much to Cassie's displeasure. Bitches don't usually like internals but Cassie was unreasonably protesting which became understandable later. Unfortunately, Cherrie found a footling presentation of a puppy pretty far inside. Cherrie tried walking her again and positioning her to push in a squat before deciding to use some oxytocin to help the efficiency of the contractions and get this puppy out. Unfortunately, the stethoscope was left at work so she couldn't listen for heart tones. She did feel for movement and couldn't find any. She also took Cassie's temperature and found it to be an astonishing 103.2. Once the puppy came down a little further, Cherrie was able to pull it out with one of Cassie's still poor quality contractions and out came a dead puppy, that by the looks of it had been dead for a while - rather than in the last couple of hours. This explained why Cassie was having trouble getting it out - dead puppies don't stimulate the cervix/uterus or bend reflexively to accommodate expulsion and are usually hard to pass. Right after the dead puppy was extricated, there was a rush of foul smelling fluid.

Cassie seemed unbothered by it all, as chipper as usual and seemed content to entertain her visitors (Luke and Cherrie) rather than have any more puppies. She begged for cookies and was her normal, running-around self. She neither acted tired nor interested in her vulva, except when Cherrie went to examine her, which Cassie strenuously protested. Cherrie tried to call the vet, but because it was Easter Sunday, this was not about to be accomplished without some significant delay. The next couple of hours were very long. The temperature of 103.0, the absence of puppy movement and the absence of feeling heartbeats (which can be felt at this stage if your fingertips are in the right place - it just takes some gradual, gentle roaming of the finger tips over the abdomen) all signaled probable trouble. I cursed myself for not having the stethoscope at home and not asking Cherrie to bring hers, which she normally would have had. Luke looked furiously for an old one that I might have had laying around. Nevertheless, the sign most breeders use and most vets are interested in was - how was Cassie acting? She didn't have a care in the world. She continued to follow Luke and Cherrie around playfully and looking for cookies. When taken out for walks, she was quite content to break into a fast waddle on the flexy. Had we not taken the temperature, or known of the absence of movement and probable absence of heartbeats, the death of the first puppy would have been the only sign. As it was, Cherrie and I were very worried. This worry increased when Cassie decided to do a little pushing again, and while Luke was holding her head, Cherrie did a manual exam and felt a nose and lips of a puppy presenting through the cervix. Some oxytocin was given with little response and we worried some more.

Cherrie continued to try her vet's home and finally reached the vet's wife who said she'd go out to the farm, where he was with in-laws, and find him. Cherrie headed for the clinic, determined to wait outside the clinic with her cellular phone on, until he arrived. The temperature, which had dropped to 102.5 after the dead puppy's birth, was back up to 103.0 and while Cassie gave every sign of nothing being wrong, everything except her behavior told us she was in trouble.

Three hours after the extrication of the dead puppy, the vet met Cherrie at the clinic. He looked at Cassie running around his clinic, greeting his technician, him and running around Cherrie and felt Cassie looked good. Cherrie took a stethoscope, though, and confirmed that there were no heartbeats. The temperature was 103.2. The vet did a manual and said there was no way to get that puppy out with Cassie awake. He decided to sedate her and see if her cervix would relax or if he could get higher up inside her and get the puppy out. If not, he was prepared to section her. He prepped her with fluids over the next hour.

DURING THIS HOUR, CASSIE FINALLY DECIDED TO DEMONSTRATE THROUGH HER BEHAVIOR HOW SICK SHE REALLY WAS. She started to demonstrate systemic toxicity with increasing lethargy and a glassy-eyed expression. It became obvious that she would have to go to section and when the vet opened her up, Cherrie and the vet could hardly believe how bad Cassie's uterus was. It was full of pus and the two puppies inside were literally falling apart. When the vet pulled the puppy back into the uterus from the cervix, the skin and muscles overlying its rib cage came off in his hands - the bony skeleton still wedged in the cervix. The other puppy was a monstrous, edematous blob, without form or recognizable extremities. It came out in pieces. The vet was amazed that Cassie was alive, stating that he had never seen such a bad uterus or puppies. He also could hardly believe Cassie's behavior only hours before. In constant contact by phone, I SHUDDERED TO THINK THAT ONLY TWELVE HOURS EARLIER HER TEMPERATURE HAD BEEN NORMAL AND UNTIL THE LAST HOUR, HER BEHAVIOR GAVE NO SIGN OF HER BEING SICK. Had we not taken her temperature, felt for puppy movement and heartbeats, but instead relied on her behavior, Cassie would have crashed at home and most assuredly died of toxic shock before we could have gotten her to the vet. I was disturbed at the loss of the puppies, though the vet said that the puppies certainly died at least a day before. Because I had felt them move two days before, I was sure he was night. I wished I had listened and felt on Saturday because I might have known they were dead then and saved Cassie the delay and development of such rampant toxicity. Nevertheless, the puppies couldn't have been saved. We'll never know what cataclysmic accident led to the puppies' deaths.

The vet said that the puppies and the uterus, the cervix especially, were not ready to deliver. The puppies should have stayed inside a little while longer and that this contributed to Cassie's having trouble passing them and not going into productive labor. My estimation of her day of labor onset agreed with this - she should have had them in a couple of days. She never went through the resting stage, the puppies weren't kicking hard enough, and abdominal hair was still quite present. All of these signs aren't independently reliable and Cassie was a maiden bitch, but they were in such agreement that the vet's saying Cassie had delivered early was very credible. He added that because of the toxicity, Cassie started to pass the puppies but that the combinations of dead puppies and an undilated cervix meant that she would have died prior to being able to rid her body of the toxins.

I have for some time, watched for all the signs including what I now know are signs watched by few breeders and only some vets (heartbeats, fetal movement). The taking of the temperature during the birth of the puppies, rather than just before, is also standard protocol. It usually goes back up, but not to the point of a fever. If Cherrie hadn't done these things, which she always does, too, we would not have known about Cassie's imminent deterioration until it might have been too late. The symptoms (outward expression, like behavior) of the bitch in whelp may not tip you off like the signs (the information you get from examining and cataloguing the changes) do.

I am very grateful that Cassie made it with only a large, probably slow to heal, section scar. I am even more grateful for Cherrie, a dear friend, expert whelper, and giving spirit who was so instrumental in Cassie's life being saved. The lessons we reaffirmed through this experience should be known by all breeders, for whelping puppies is a tremendous responsibility - to the breed and to the individual bitch asked to produce for us.

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