Any time a pet undergoes anesthesia and surgery, her owner is nervous. When the pet is pregnant and has decreased respiratory function, the owner is understandably much more worried about the outcome. Anesthesia and surgery can be tricky in the best of circumstances, and more so with compromised pets. But, with our advanced equipment, skills, knowledge, and teamwork, our patients come through procedures healthy and safe, as was the case with Levi.
Levi the French bulldog’s background
Levi the French bulldog entered our hospital heavily pregnant and ready to burst, but she needed some help birthing her babies. French bulldogs often need Cesarean sections (i.e., C-sections) because the puppies’ skulls are usually larger than the width of the mother’s birth canal, and a puppy can become stuck in the canal, which can be fatal for the mother and the puppy, especially if an emergency C-section isn’t promptly performed.
Like English bulldogs, French bulldogs have a flattened muzzle, which can cause extensive breathing problems. Flat-faced brachycephalic breeds often have an elongated soft palate, restricted nares (i.e., nostrils), and inordinately small windpipes, and these three issues can create breathing difficulties, making anesthesia more complex to ensure adequate oxygenation for the mother and babies.
Since dogs are typically pregnant for 63 days, at Animal Medical and Surgical Hospital (AMSH), we usually schedule C-sections at 62 days, to avoid a middle-of-the-night emergency surgery. To ensure your dog doesn’t go into labor unexpectedly, monitor her closely for the last 48 hours prior to surgery.
How did AMSH prepare for Levi’s cesarean section?
Since Levi is a French bulldog, we knew she would require a highly customized anesthetic protocol designed to minimize breathing difficulties, keep her unborn pups safe until they were delivered, and to ensure the mother’s safety. We had to consider multiple variables when formulating our C-section anesthetic protocol, for which anesthetic drugs should:
- Not cross the placental barrier
- Be short-acting and rapidly metabolized
- Not depend on the liver or kidneys for metabolism and excretion, as these organs are not well-developed in newborn puppies
- Be reversible
- Provide adequate pain control for the mother, without interfering with maternal behavior and lactation
Making this anesthesia more complicated, we also had to cater to Levi’s brachycephalic condition, to ensure she oxygenated appropriately before, during, and after surgery.
Once we developed the best anesthetic protocol for Levi, we placed an intravenous catheter to keep her hydrated, and boost her blood pressure while under anesthesia. Fluid therapy also helps to combat the blood loss experienced during a C-section. Before inducing anesthesia, we shaved Levi’s abdomen to minimize her surgical preparations while under general anesthesia. During our preparation, we ensured that Levi was well-oxygenated before induction by administering flow-by oxygen with a nasal tube, since she would not tolerate a face mask. With the IV catheter placed, and Levi’s abdomen shaved, we were ready to induce anesthesia and welcome the puppies into the world.
What happened during Levi’s cesarean section?
We had two teams during surgery to ensure greater, single-minded focus on their patient. Team Puppies, who focused on neonatal resuscitation and warming, was led by our newest team member, Heidi Schwem, who is an AMSH newbie, but has more than 30 years’ experience in veterinary hospitals. Team Levi zeroed in on the mother’s care while under anesthesia, monitoring her vital signs, comfort level, and anesthetic depth. This team was led by Crystal Hayes, another incredibly talented, experienced team member. Dr. Carriere oversaw both teams, whileDr. McSweeney took the surgeon’s role, safely extracting the puppies from their mother, then proceeding to spay her, and recover her from anesthesia. We don’t always remove the uterus after a successful C-section, but we did in Levi’s case, because we did not think she would survive another C-section. Most breeding females undergo only two or three C-sections before being spayed, as the uterus often weakens after multiple C-section incisions, which could create complications for the mother or the puppies.
Levi’s heart rate slowed during surgery, but Crystal was closely monitoring her vital signs, and took appropriate measures with pre-calculated drugs. With each anesthetic protocol, we calculate life-saving drugs to avoid a mad panic during an emergency, always in the hopes that we never have to use them. Levi responded well to the drugs, her heart rate increased, and she recovered safely.
What was the outcome of Levi’s cesarean section?
At the end of the day, Levi was the proud mother of five beautiful, healthy female puppies. Without the AMSH veterinary family’s skills, knowledge, and excellent teamwork, we may have lost a couple of the puppies, and perhaps the mother.
A talented, tight-knit group working together can create incredible results. See the difference the AMSH team can make to your pet’s health and happiness by calling us to schedule an appointment.