Obstetrical manipulations are very limited in dogs. When medical treatments do not work, or there is obvious obstruction of the natural passages, episiotomy (incision of the superior commissure of the vulva) or Cesarean section are indicated. The main reason to perform a Cesarean is disproportion between the fetus and the mother, a frequently-encountered condition:- in brachycephalic breeds: the large, flattened heads fit poorly through the pelvis and often cause lateral presentation with the head folded against the neck.- when whelping is late or there are only one or two puppies in the litter. The puppies are then too large in relation to the diameter of the birth canal.- in miniature breeds.- when the bitch was mated with a much larger dog.
The viability of the puppies about to be born depends on their maturity (which can be verified by the progesterone level), the duration of unproductive contractions (which cause anoxia and pain in the puppy in the birth canal and also in the waiting puppies), the promptness of the intervention and the type of anesthesia used.
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