Dystocia in Small Animals

Dystocia in Small Animals

• Dystocia is a difficult birth or the inability to deliver a fetus naturally
• Causes of dystocia can be categorized as maternal or fetal
  • Maternal causes include uterine inertia, breed predisposition, and psychological stress
  • Fetal causes include malposition, fetal oversize, and fetal death
• Diagnosis of dystocia requires a thorough history, physical examination, and radiographic imaging
  • Physical examination includes palpation of the abdomen and vagina
  • Radiographic imaging evaluates pelvic abnormalities and fetal size and location
• Treatment of dystocia focuses on stimulating uterine contractions or surgical intervention
  • Medical management includes the use of oxytocin and calcium to stimulate uterine contractions
  • Surgical intervention in the form of a caesarean section is indicated when medical management fails or when fetal distress is present
• Indications for a C-section include:
  • Systemic illness in the dam
  • Dystocia that has not been addressed
  • Blackish-green vaginal discharge prior to whelping or queening
  • Profuse vaginal hemorrhage prior to or after the onset of whelping or queening
  • Intense myometrial contractions for > 30 minutes without delivering a puppy or kitten
  • Complete primary uterine inertia that does not respond to medical treatment
  • Partial primary uterine inertia that is refractory to medical management
  • Secondary uterine inertia with inadequate resumption of labor
  • Abnormalities of the maternal pelvis or soft tissues of the birth canal
  • Relative fetal oversize, especially if considered likely to be repeated in several fetuses
  • Fetal malposition not amendable to manipulation
  • Fetal death with putrefaction
• Prognosis for dystocia depends on the severity of the condition and the timely intervention provided
  • Prompt recognition and treatment are crucial for improving the prognosis
• Important factors in the management of dystocia include:
  • Accurate diagnosis of the underlying cause
  • Appropriate medical or surgical intervention
  • Prompt delivery of the fetus
  • Adequate postpartum care

Uterine Inertia

• Uterine inertia is the most common cause of dystocia in dogs
  • Primary uterine inertia occurs when the uterus fails to respond to fetal signals
  • Secondary uterine inertia occurs due to exhaustion of the uterus caused by obstruction of the birth canal
• Treatment:
  • Medical management includes the use of oxytocin and calcium
  • Surgical intervention may be necessary if medical management fails or when fetal distress is present

Fetal Malposition

• Fetal malposition is a common cause of dystocia
  • Malposition can refer to the position of the fetus in the uterus or the presence of a fetus in the birth canal
  • Common malpositions include breech presentation, transverse presentation, and prolapse of the umbilical cord
• Treatment:
  • Surgical intervention is often necessary to correct fetal malposition
  • Obstetrical manipulation may be possible in some cases to reposition the fetus

Fetal Oversize

• Fetal oversize can occur when the fetus is too large to pass through the birth canal
  • Factors that contribute to fetal oversize include breed predisposition, nutritional imbalances, and multiple pregnancies
• Treatment:
  • Surgical intervention is often necessary for fetal oversize
  • Obstetrical manipulation may be possible in some cases to reposition the fetus

Fetal Death

• Fetal death can occur during pregnancy or labor
  • Causes of fetal death include infection, trauma, and placental insufficiency
• Treatment:
  • Surgical intervention is often necessary to remove the dead fetus
  • Medical management may be possible in some cases to prevent infection

Breed Predisposition

• Certain dog breeds are predisposed to dystocia, including:
  • Bulldogs
  • Pugs
  • Boston Terriers
  • Chihuahuas
  • Persians
  • Siamese

Management of Dystocia

• Accurate diagnosis of the cause of dystocia is crucial for effective treatment
• Appropriate medical or surgical intervention should be provided based on the diagnosis
• Prompt delivery of the fetus is important to minimize the risk of complications for the dam and the offspring
• Adequate postpartum care is necessary to ensure the health of the dam and her offspring