While cesarean section is a common surgical procedure, it may be associated with significant mortality in both dams and puppies. Timing is extremely critical for puppy survival for both emergency and elective c-sections. If delivery is delayed by more than 24 hours after the start of the second stage of labor, the loss of all puppies due to placental detachments usually ensues. Emergency c-section should be performed as soon as possible after it is determined that labor is unproductive, before the occurrence of dam exhaustion or distress of the puppies and/or the dam.
Close coordination of the surgeon, anesthetist, and nursing staff is critical. Good preparation of the dam, correct selection of the anesthesia protocol, fast surgical delivery, and adequate neonatal care are the keys to complete success. Ideally, the dam should be totally awake as soon as possible after the procedure to allow for development of the neonatal/maternal bond and maternal adoption of the neonates. This point is critical when considering anesthesia and surgical protocols.
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