Common Whelping Problems with Dr. Hutchison, DVM

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Transcript

Laura Reeves Our final topic for today is we’re talking about common whelping problems. These are questions, again, from the audience that have been sent in in advance. The first one: Let’s say we have a successful pregnancy, and the bitch is getting ready to whelp. What are some common causes of dystocia and when should a breeder consider giving calcium or oxytocin?

Dr. Hutchison Well, the biggest problem I see is you’ve got your bitch pregnant, and you immediately switched her to a 30/20 food. The bitch has now gained 11 pounds, and she has 3 puppies. Remember the uterus is a muscle. So when you’re talking about having a breeding bitch, this is something that’s a concern year round. If you were going to run in a marathon, you wouldn’t sit around every day and say, “Oh, geez, today’s the race. I’m going to go run 26 miles.” So, in a uterus, being a muscle, what are some things that can affect the bitch and her ability to whelp? Well, first of all, overweight bitches are going to be poor conceivers, poor whelpers, and poor nursers. So sometimes that lean, mean, breeding machine isn’t a good adage to follow with your bitches. Second of all, a bitch is pregnant—not ill. She can go out on walks, she can run around. I’ve had people field trial bitches up until they were 5 weeks pregnant, until the puppies were putting pressure on the diaphragm. So make sure the bitch gets a good exercise program. Be sure she’s not overweight. Remember: how do puppies affect the bitch? The first 17-18 days, the fertilized eggs haven’t even implanted in the uterus. There’s no stress on the bitch! She doesn’t need increased food at that time. The second 3 weeks is the development. This is when the palette closes, the abdomen closes. The puppy, though, isn’t growing rapidly. He’s just developing. The last 2 weeks the puppies double in size. So, to start over-nutritioning back the first time you find out she was pregnant—it leads to more problems than it does good. The big calorie demand, of course, is when the bitch is nursing the puppies. That’s one thing. Make sure that the bitch is healthy. This is an athletic endeavor, whelping puppies, in all honesty when you think about it (uterine contraction and things like that).

Second of all, there’s no doubt: younger bitches whelp faster than older bitches because the uterus gets thicker over time, the uterus can get cystic over time—it doesn’t contract as easily. That’s a part of it, too. You want to be sure that younger bitches actually are better conceivers, better litter sizes, and better whelpers.

The third thing that you want to do is make sure that you’re aware of how many puppies are coming. Going by the seeing-eye people, who whelp thousands of litters, if you have less than 3 puppies or more than 8, your chances of your bitch free-whelping these puppies all alive is reduced. It doesn’t mean that a bitch can’t occasionally have a 12-puppy litter fine. It doesn’t mean the bitch won’t occasionally have 2 puppies. That’s where you start to play the odds. So why is that? Of course, if you have 1 or 2 puppies, they have no competition for space, no competition for nutrition. They grow larger. Even though the bitch’s due date is 63 days from the ovulation date, the actual whelping trigger is cortisone that the puppies put out. And the cortisone causes the gland to release, which suppresses the progesterone. So 1 or 2 puppies are not going to put out the amount of cortisol that 6 or 8 puppies do. You suddenly have these puppies getting larger, going 1 or 2 days over, and it’s going to make it more difficult for the bitch to whelp. Again, we mentioned the uterus being a big muscle. A bitch that has 12 puppies—the uterus is going to get tired. Even though the puppies are not going to be as large, they’re going to control themselves because of the space the bitch gives, the nutrition is still going to be tiring on the uterus.

So what do I use in signs of whelping problems? One: if the bitch is 1 or 2 days over a known due date (let’s say we know from ovulation she was due Monday and here we are on Thursday), you worry about the puppies outgrowing the placenta. If you reach a certain point, then the puppies start to reabsorb back through the placenta, back into the bitch. These are the puppies that are born scrawny, dehydrated, and they usually don’t survive. You want to be sure you know your due date, and that’s based on knowing your progesterones.

Second of all: if the bitch starts trying to have puppies, pushing down, baring down, for over a half hour… then your concern is if the puppy’s too big? Is the puppy head-back? Shoulder-back? Many times, getting this checked out—whether it be straightening the puppy out, whether it be doing a C-section—might save the other puppies. Because the uterus is going to be pushing that puppy, trying to get it out, and it can cause separation in the placentas of the other puppies. Other thing that I’d look at: if we’re going longer than 2 hours between puppies, and we know there are still a lot left, then you start saying, “Should I use oxytocin?” Oxytocin is a dangerous drug. You have to be aware of how it works. I’ll say yes, we know you give oxytocin to cause calcium to go into the cells and cause the uterus to contract and pop the puppies out. But if you use oxytocin at too high a dose or too frequently, it causes the puppies to be clamped on by the uterus, not pushed along. Oftentimes, giving oxytocin may actually shrinkwrap the puppies in the uterus, rather than moving them along. So, how much should you use if you’re using oxytocin? Well, small animal oxytocin is 20 units per ml, 20 units per cc. What I use is 2 units (1/10 of an ml) per 10 pounds of bitch body weight, pre-breeding. So if you have a bitch who weighed 10 pounds when she was bred, we’d only give her 1/10 of an ml. If you have a 40 pound bitch, you’re probably going to be giving her 4/10 of an ml, something like that. Because you want to be sure you’re not overdosing it. And if you’re using oxytocin, I’d probably never give more than 1 1ml, even if it’s a 200 pound bitch. You give the dose and if nothing happens within 20 minutes, you give a second dose. You have no active labor—no sign of active labor for 2 hours. We give 1 dose. Either A) POP! Out comes a puppy. Or B) nothing happens in 20 minutes, we give a second dose. If the second dose doesn’t do it, then we’re not giving more oxytocin because we’d shrinkwrap the puppies in. There’s some other issue going on. The first injection or two oxytocin actually increases the blood flow to the uterus. We said before: that’s one of the two things keeping the puppies alive, so that’s the advantage. But if you continue to use it, it causes the blood vessels to dilate, lowering the blood pressure to the uterus and starting to put the puppies in jeopardy. So if you use 1 dose, nothing happens, and use the second dose, there’s something wrong. It is not that you are oxytocin-deficient and need a third, tenth, fifteenth dose.

I went to a spell—a great question was asked. Myself and a third genealogist, at one of the universities said, “If oxytocin works, and it does, by causing calcium to move into the cells—are we better off giving just the calcium? We went through a period of time where we did that, saying maybe it’s the calcium that’s the problem and not oxytocin. It really wasn’t that successful, so I am not a huge calcium-giver. If I use calcium, it’s only the oral gel that’s absorbed almost as quickly as injectable. But calcium is even more dangerous than oxytocin, because it can have an affect on the heart. Oftentimes, what may be an overdose in a German Shepherd may be an underdose in a Cocker Spaniel. That’s why I like the oral, where you give small amounts more frequently. I don’t use injectable calcium anymore. But now in our practice, we check what is called ionized calcium. That is the true calcium in the bitch, whereas if you’re running your chemistry panel that the veterinarian runs because your dog isn’t feeling well, the calcium on there is what is called non-ionized calcium. It can be affected by some of the other chemicals. So now that we’re checking ionized calcium, it’s pretty rare to a bitch that is truly calcium deficient. Back in the old days when we used to pump everybody with calcium tablets while they were pregnant, we were creating our own problems by the negative feedback. The body says if you’re doing it, I’m not. Now that we’re looking at calcium levels—the ionized calcium—it’s pretty rare to find a bitch that’s truly low on calcium and probably not something where you’d need to be pumping calcium into her. Probably, if anything, where you’d see it are some of the ones that go through puerperal tetany, eclampsia, milk fever, names have been put on, where the puppies just start draining the milk and sucking the calcium out and the bitches start rubbing their face and twitching a little bit. There’s places where you may the need calcium, but as far as whelping, calcium is usually not an issue.

Laura Reeves Right, right. Calcium after, not before. So we’ve got this bitch that’s going long. What I just went through—13 puppies—and it’s 20 hours. Anything that we can do on our end to make her life easier, other than have kept her in good weight and good fitness prior to getting started?

Dr. Hutchison If I had a Clumber bitch that had 13 puppies, there’s no way in the world I’d free whelp them.

Laura Reeves It was a Wirehaired Pointer, that one.

Dr. Hutchison I’m sorry. If there’s a bitch that I have that’s a medium-size dog with 13 puppies, I’ll tell you: I do a lot of C-sections. Three reasons. One: some bitches need C-sections. You have a puppy stuck or something. But there was a study done at Cornell, where they looked at whelping all over North America, and they found out one of the main things was you actually get more live puppies from a C-section. The reason being the number one cause of lost puppies is prolonged labor, uterus getting tired, the puppies with the placenta separating them, they’re losing oxygen, and the puppies die. Many times in a huge litter, those last 2 puppies are way up there in the horn don’t come out alive because they started breathing about the point of the left kidney and by the time they got out… So does every bitch need a C-section? Absolutely not. But then the third thing is I’m looking at these seeing-eye studies of thousands of whelpings and they’re saying if you have a litter that’s 5 bigger than 8, at least consider it. Let’s say your bitch starts out—we’ll use you as an example since you brought it up—

Laura Reeves It’s good. That’s what I’m here for!

Dr. Hutchison So your bitch, probably the few just popped out. There’s so much pressure in there, that they probably came out pop, pop, pop. But then you suddenly get that uterus in. When I’ll do a C-section on some of these big litters—I mean, that uterus is like cellophane. It is stretched so much. And then you’re thinking where is the recoil going to be? As far as getting that involution and moving those next puppies out. So, I would go back to my original things, the things I use. You call me up and say, “It’s been 3 hours since puppy number 6, and we know there’s 7 more to go.” I try one injection of oxytocin, even though if there’s 6-7 puppies, we’re not going to deliver them all with oxytocin. I guarantee it. Those are almost Powerball odds. I’d handle it a lot differently. If you say, “Hey, we’ve got 3 more and we’ve had 10,” then I would be an oxytocin guy. If it’s been 5 puppies and we’ve got 8 more to go, then I’m probably saying, “You know you’re going to start losing puppies.”

One of the things I would probably do is say, “Hey, let’s take a look. If you have a doppler at home, can you get a fetal heart rate? Bring her in. I’ll put the ultrasound on.” If the fetal heart rates are still 200, that means the puppies are healthy. Then we may give her a little more time. If we’re starting to see the fetal heart rate starting to slow down, then we start to say, “Are we jeopardizing the puppies?” This is my philosophy, and it’s probably different than other people’s. Mine is: we bred this bitch. It is not greedy for you and I to think we have the right to every puppy conceived that made it to term. It could be a puppy we could hold, we could pet, we can sell, we can show, whatever. There’s so many statistics, and these have been repeated multiple times by different veterinary schools, that probably 20-30% of all the puppies that reach term are not alive at 6 months of age. Sure, some of those are going to be genetic defects. You can’t get away from that. Occasionally, the bitch lays on a puppy. Sometimes it’s bad luck; it happens. The main thing is these puppies were normal puppies but then they just didn’t get born because the uterus got tired, the puppy went overdue, so sometimes I’m probably a little more aggressive on getting the puppies out, rather than saying, “What can we do to avoid it?” Mine is: hey, let’s follow the signs and let it tell us what we should be doing.

Laura Reeves Excellent. Very good. So, we’ve got our puppies out.

Dr. Hutchison Isn’t it wonderful?

Laura Reeves It is! It’s fabulous. The best.

Dr. Hutchison The greatest thing in the world.

Laura Reeves But then the greatest thing in the world is now we have a puppy that’s not doing very well. And we’re freaking out, right? So, how long do you work on a puppy that isn’t breathing? Do you have any suggestions for people for that? Like, I’ve got these puppies—how do I keep them going? What are your tricks?

Dr. Hutchison The thing is this. You need to know what is actually wrong with the puppy. There are certain puppies that are born that have some condition that just can’t live outside the bitch. This happens in all other species, too. But there is a difference in fetal hemoglobin as opposed to adult hemoglobin. Puppies can survive a lot longer without breathing than what an adult can. How long do you work on them? Boy, it’s tough to give up. Things we look at: I’m a big user of the Jenchung acupuncture point. You take a needle and—

Laura Reeves I’ve used it!

Dr. Hutchison You stick it right down to the bone. I did that the other day on a puppy, and that puppy’s going to grow up and probably be at least a group winner and your hole would’ve been 5 feet deep looking at the puppy’s chances of survival. So I do that. We’ve gone back to using a product called Dopram. Dopram is the respiratory stimulant; it causes the puppy to breathe. They don’t use it in humans. We went through that phase, probably in the ’90s when humans didn’t do it, we weren’t going to do it. Humans don’t have 13 babies, but it was thought of the same way. A number of us that deal in reproduction (it’s not just me) have gone back to using it. You just put a drop or two on the tongue. In some puppies, it helps.

Another thing that they don’t do in humans is—one of the things of the puppy heart, remember now, that’s the only thing keeping the blood circulating. So a puppy’s heart rate—when it’s first born—should be fast. You should put your finger on it, and it should be going boop, boop, boop, boop. If the heart rate is boop...boop… This is a puppy in the process of dying. There’s a product we use called atropine. There’s debate on whether it works on puppies. To me, it isn’t me saying it does or doesn’t. I’ve seen the response in puppies. But you’ve got a slow heart rate. I remember when I first used it because they always told us it didn’t work because human babies can’t respond until 7 weeks to atropine. So we said, if it can’t work on a human, it sure as heck can’t work on a dog. I had a lady—I can picture this like it was yesterday—who had a Yorkie puppy, and his heart rate was slow. Every time you said it was dead, you could feel the heartbeat. The lady said, “Isn’t there something else you can do?” I went and gave it just a little bit of atropine to the heart and that sucker went boop… boop boop boop boop boop. All of a sudden, it was like it woke up. We’re pretty aggressive on puppies. Those of you who have been to my office, we have a nursery where the people are, where we’re doing C-sections or delivering puppies. We’ll use oxygen, we’ll use the acupuncture point, we’ll use Dopram, we’ll use atropine. Occasionally, epinephrine. We do that. We do probably 300-400 C-sections a year. Plus we also whelp bitches for clients. My staff, they’re the best. These puppies the other day—they were dead puppies and now they’re normal because of what my people did. Again, we used some drugs, we used some oxygen, we also realized puppies aren’t fragile. Stimulating on them, we’re pretty aggressive. Sometimes it comes around. For some, it doesn’t. When do you quit? I don’t know. When you finally say, “It can’t be.” But I’ve had some puppies that didn't’ have a chance that came around. And others that you do the exact same thing to, and it doesn’t make a difference. There’s always biochemical issues, congenital issues that affect puppies. Being aggressive I guess is the honest answer.

Laura Reeves Absolutely.

Dr. Hutchison One last thing! If you whelp a number of litters, it probably behooves you to have some oxygen at home. The best way to do it is just take a 5-10 gallon aquarium, something that has solid. Run the hose in there at a low flow and just put a towel over the top. All puppies benefit from a little bit of oxygen. I mean, that’s one thing that might be worthwhile having at home. Some of the drugs I mentioned—anybody can do the acupuncture point.

Laura Reeves Somebody I saw actually asked specifically about that. Judi, I’m sure you saw this as well. Dr. Hutch, can you show us on the screen specifically what you’re talking about and how you do that and what gauge needle and all of that?

Dr. Hutchison The exact point when you were going to sneeze and you put your finger up there—that’s the point you’re pressing. That’s the acupuncture point you’re using to stop you from sneezing. What you do is you take any type of needle. I usually use a 16 gauge hypodermic needle—very small. Some people put it right in that spot. There’s actually that cleft under the nose. You can see it in the puppies. Some people put the needle in and twist it. You go down to the bone. You feel a twisting Other people do what’s called chicken pecking, just boop boop boop boop. I’m honestly probably more of a put-in-and-twist-er. There’s something about the chicken pecking that gets all over. It’s the same spot that you use when you’re going to sneeze—that’s the point you’re pushing. That’s the same spot on the puppy. There’s that cleft. You put the needle in, you twist it, and you can actually leave it in while you’re massaging the chest and stuff like that.

Laura Reeves Judi, we have about five minutes left on this segment.

Dr. Hutchison A lady just asked: Can you use a sewing pin? You can use anything! If you’ve got a puppy and you’re laying there and this puppy’s life and death is there—anything you have. I use a hypodermic needle, but you can use a sewing pin, a needle, anything where you’re stimulating that acupuncture point to get the puppy to take a breath. That was a good question. Go ahead, Judi!

Judi Stella One question that I think would help everybody is what would you suggest to have on-hand for a first-aid kit for puppies? Just so that we have a complete list. Can they get Doxapram and oxytocin and all these different things from their vets? What should they have on-hand?

Dr. Hutchison You know, that’s a good question. It depends on the veterinarian. Things that everybody should have at home is an oxygen source. If you’re whelping a couple of litters, an oxygen source. People say, “I did artificial respiration,” and they opened the puppy’s mouth up and blew, that’s not artificial respiration. It gives the puppy coffee breath when it dies. You need something that’s going to expand the lung, so having an oxygen source. The fluid that the puppy’s in (the amniotic fluid) is positive. You aren’t flinging the puppies like we used to do 30 years ago. You want a syringe because you want to suck the mucus out of the back of the throat. Sometimes just having the puppy downhill so gravity helps. Some of these real fluidy puppies—I’ll take a yard stick and just put a little vet wrap around the puppy and stand him upside-down. You’ll see. The amount of fluid that drains out of this puppy is amazing. Removing the fluid from the back of the throat, the nose. You’re not trying to dehydrate it because the amniotic fluid stops the lungs from sticking together. Doxapram—it’s who you deal with on that. It’s not a dangerous drug. There are veterinarians that are reluctant on oxytocin because if a puppy is stuck, if you’ve misinterpreted what goes on (it’s not that the uterus is tired; the uterus just can’t get the puppy out), you rupture the uterus. And also the dosing on it. The oxygen, a little Doxapram if you can get it, possibly an oxytocin of the correct dose that we talked about. You don’t want to overdose it. The environment where the puppy can get more fluid out of it. You have a needle. You have your veterinarian give you a 20 gauge needle or a pin or something like that that you’re going to use for the acupuncture point.

With those things, they’re either going to make it or they aren’t. Other things that you have in your kit, of course: If you tear an umbilical cord, you don’t have to tie it. If you cut it, you’re supposed to tie it. A little dental floss to tie that off. Always check and make sure the rectum’s open. Always check to make sure there’s not a cleft palate. Things like that.

Laura Reeves Dr. Hutch, that’s great. I’d like to just stop right there and give people a description. Because I think people hear that, but then they don’t understand what that feels like. When I put my finger in that puppy’s mouth, what does that feel like if it’s correct and what does it feel like if it’s wrong?

Dr. Hutchison Basically what you’re doing when you look: the normal roof of the mouth comes together at the top, and it looks just like this. There’s the little ridges that go across. A cleft palate basically is where the bone didn’t come together. It’s a midline defect. It’s a recessive genetic trait. Basically what you see is you look up and you see the septum of the nasal passage up above. What you feel in a normal one is you’re feeling across, it should be continuous. It should be bumpy, but it should go across. If you come to that dip in the middle, that’s where the problem is. That’s why cleft palates are such difficult things to try to correct. Many people don’t. Because it’s a bone defect. It’s not just a soft tissue defect. You can’t just suture it across. Probably one of the most common defects that are seen, but also probably the most severe. As far as the tying off the cord and that, or if the mother tears it, not a big deal. People think that causes hernias. It doesn’t. Hernias is also a recessive genetic trait. Make sure the rectum’s open. My philosophy—something you mentioned—is if all of the puppies in a litter are doing poorly, then you say, “Wow, are they too hot?” People have a tendency to overheat puppies. A whole nother talk would be what’s the normal temperature of a newborn puppy. Body temperature is only 96-97 degrees. If it’s 101, then you’re overheating them. If all the puppies are looking bad, then I’m worried about if they’re getting enough nutrition, being overheated, is there something else going on?

Laura Reeves Or are they cold? One or the other.

Dr. Hutchison Overheating is much more common than cold. But anyway, on those litters, I’m really aggressive. But if you bring me a litter of 9 puppies and 8 of them are thriving and there’s one that’s half the size (scrawny), it doesn’t mean we shouldn’t try. But I’m probably not going to be as heroic when everything you’re doing is working on the other 8. This was just bad luck. Or is there something wrong with it? Always remember, too, that when a human baby is born, they prick the heel and test the blood for all the biochemical problems. Puppies probably get all those biochemical problems; we just can’t test for them. To me, if the whole litter’s having problems, we’re really aggressive on those ones. On the other hand, if there’s 1 out of 8, we’ll try but probably not as aggressively.

Laura Reeves Right, right. Okay. Alright, well, Dr. Hutch, we appreciate an hour and a half of your time. It is a gift from the theriogenologist gods. We are super, super grateful for it. Thank you, everyone. We had well over 700 people watching live from around the world. Everybody, thank you so much for your participation today. It was a wonderful conversation. Please feel free to reach out, as I mentioned earlier, to our team at GoodDog.com any time, if you have questions. And make sure you visit GoodDog.com/join-us-breeder. Again, thank you, Dr. Hutch.

Dr. Hutchison Thank you for all the kind thank yous that are going past. I know a lot of you people, so thank you! I hope we all get together sometime. Thank you!

Cat Matloub Dr. Hutch, you’ve made everybody’s 2020 with this, so thank you for giving us such an awesome experience. For those asking questions about if we’ll be circulating a recording and transcript and answering questions, we are going to dive into all of that. We’ll make sure we get this to you with a recording. We’ll pull out links when people ask about where they can get things and see if we can get you guys answers to the questions that you asked live, because we are so grateful to you for asking and engaging. Keep an eye out. We’ll follow up with an email. Dr. Hutch, thank you, thank you, thank you.

Dr. Hutchison Thank you! Bye now!