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Veterinary practitioner and breeder, Dr. Elizabeth, had always held the health of her puppies in the highest regard. She still remembers a litter birthed by her cherished Welsh Corgi, Daisy. Even with meticulous precautions in place, two of the puppies were unfortunately stillborn, and another three demonstrated weakness and susceptibility to diseases. The setback was a profound one for Dr. Elizabeth, compelling her to seek the underlying causes. She first turned to scientific literature, pouring over texts that dissected the biology and health of newborns. But the answer eluded her until she happened upon a less-frequented area of study in a research paper: maternal health. The article stressed the significance of the mother’s health and well-being on the puppies’ condition at birth, leading her to the realization that she had overlooked this essential factor. The question that had puzzled her began to take on a new shape: “Why are some puppies born robust and vigorous, while others grapple with life the moment they arrive?” The seeds of this question pointed her not only to the moments just after birth, but even further back, to the mother’s state of health before the breeding process even began.
“Undoubtedly, special attention should also be paid to the breed of the dam and the sire breed. Breed identity determines typical anatomical structure and is closely related to the predisposition to perinatal complications.”
Uchańska et al, 2022
Puppies, those petite bundles of fur, overflow our lives with immense joy and unbounded affection.
But what is the underlying factor that predominantly governs their health and well-being from the start?
Your instinct is correct – it’s their mother!
From my experience in the clinic, I noticed that owners grappling with neonatal problems in their puppies tend to focus solely on the newborns. Rarely did we consider the potential role of the mother in these issues.
One rule of thumb I always impart to those in my care: If your puppies are facing health problems, don’t just bring them to the clinic – bring the mother too. Maternal conditions, such as mastitis or postpartum metritis, can significantly influence the health of the puppies.
However, these factors manifest post-birth.
The crucial aspect to remember is that the journey to healthy neonates starts well before this – at breeding, in fact.

The Health Status and Age of the Bitch
The state of the mother at the time of breeding can substantially impact the outcome. All too often, this is a point overlooked.
A second rule of thumb I share is this: only breed healthy individuals.
Chronic conditions in the mother, such as recurrent urinary stones or enduring gastrointestinal issues, can worsen during gestation, influencing the health of the puppies too.
Hence, before the breeding process begins, it’s vital to evaluate various maternal factors.
Body Condition Score (BCS), for instance, is a significant parameter.
You should aim for bitches in optimum body condition. Current research reveals that overweight mothers are more likely to give birth to low-weight puppies, which in turn increases the risk of neonatal mortality.
This should importantly include verifying her vaccination status.
Dwelling on the importance of vaccination status, it’s vital to ensure the female dog, the future mother, is up to date with her vaccinations prior to breeding.
Firstly, this will guarantee that the puppies receive substantial antibody protection via their mother’s colostrum for canine diseases such as distemper and parvo. It’s crucial to remember that these are not simply diseases of the past – the protection that the mother provides through her colostrum is indispensable for these puppies’ early health.
Secondly, the timing of these vaccinations is of essence.
While there’s evidence indicating that vaccination during gestation is viable, my preference leans towards vaccination pre-breeding.
Here’s why: vaccines stimulate the immune system, which in some individuals can lead to hyperthermia. This increased body temperature is incompatible with a healthy pregnancy, potentially leading to embryonic loss or fertilization failure.
It’s a complex interplay of variables and certainly something to discuss in depth with your veterinarian. However, in an ideal situation, to mitigate any such risks, I’d strongly advocate for vaccinations to be completed before breeding.
The age of the female is also crucial, as it can impact the embryonic and fetal development.
Age is another critical factor that can influence embryonic and fetal development.
Certainly, a notable decrease in fertility and litter size has been observed in female dogs aged over five years, with litter size dramatically reducing in females past seven years. It’s an aspect that is often overlooked but deserves due consideration.
Breeders must strike a careful balance. Breeding too early, especially when the birth canal is still immature, escalates the risk of dystocia – difficulties during birth.
Conversely, breeding too late may result in diminished fertility and smaller litters, which can also lead to birth complications. Another factor compounding this issue is the aging of the uterine muscle, which can further enhance the risk of dystocia.
Therefore, it’s crucial to consider optimal timing for breeding.
As a rule of thumb, I strongly advise initiating the breeding of these animals before they reach five years of age.
This precautionary measure can significantly mitigate potential reproductive issues and promote healthier, more successful litters.

Hematological Changes During Pregnancy
In addition to this, there are other aspects to monitor during gestation.
I’ve often encountered the question – how can we keep track of a canine’s gestation process? Historically, we would perform an ultrasound at three weeks post-breeding, then not see the dog again until labor, leaving a substantial period of uncertainty.
To mitigate this, my recommendation has been to conduct ultrasounds every two weeks, providing an opportunity to monitor fetal health. Additionally, I advise running a progesterone test. The role of this hormone is crucial in sustaining a pregnancy; luteal failure, or a lack of sufficient progesterone production by the ovaries, can result in pregnancy termination. Though not a common occurrence, it’s certainly worth checking, particularly in cases with a history of infertility or pregnancy failures.
However, a recent scientific paper has inspired me to extend this monitoring protocol further.
I now believe it’s advantageous to incorporate a complete blood count, especially in older females. This practice could detect early signs of gestational conditions like gestational anemia and thrombocytopenia, which are known to potentially trigger neonatal complications.
Gestational anemia is a condition in which a pregnant female experiences a decrease in red blood cells, which can lead to a lack of oxygen being carried to the fetus. Thrombocytopenia, on the other hand, is a condition in which there is a decrease in platelets, which are necessary for blood clotting.
Both conditions can lead to serious health problems for the puppies if left untreated.
Gestational anemia is more common in older females, with incidence rates as high as 60% in females over 6 years of age. This can be due to the decline in bone marrow function as the female ages, which can lead to a decrease in red blood cell production. To prevent gestational anemia, it is important for breeders to have their females thoroughly examined and tested before breeding to ensure their overall health and well-being.
Thrombocytopenia is another condition that can be more prevalent in older females, with incidence rates as high as 50% in females over 6 years of age. This can lead to increased risk of bleeding during birth, which can be a serious problem for both the female and her puppies. Treatment for thrombocytopenia during pregnancy may involve the administration of platelet transfusions or other supportive care measures.
Given the potential risks, this is a discussion worth having with your veterinarian, particularly when it comes to older dogs.
The standard ultrasound protocol could be maintained, with blood tests added during the routine ultrasound visits.
In the realm of healthcare, prevention is indeed better than cure. In my view, this additional layer of testing is a sensible, proactive approach to secure both maternal and neonatal health.

The Importance of Breed Identity
The breed of the dam and sire indeed plays a significant role in newborn puppy health, which we’ve not yet addressed. Breed determines not only the typical anatomical structure but also potential predispositions to perinatal complications.
Take brachycephalic breeds like English Bulldogs for example. Their predisposition to perinatal complications is 11 times higher than other breeds due to the disproportionately large fetal head compared to the size of the birth canal. . CT pelvimetry studies have shown that English bulldogs have a significantly smaller pelvis and pelvic canal compared to non-brachycephalic dogs of the same weight.
Similarly,other medium-sized breeds, such as Scottish terriers and Boston terriers, have also been reported to have problems with pelvic anatomy. X-ray measurements in bitches diagnosed with birth complications due to fetal-pelvic disproportion showed a smaller pelvis and dorsal-ventral flattening of the pelvic canal, whereas in Boston terrier bitches, the problem was caused by a combination of the pelvic shape and the relatively large head size of mature fetuses. This significantly increases the predisposition to obstructive dystocia and secondary uterine inertia. A study conducted on a population of 200,000 bitches registered with the Swedish Kennel Club between 1995 and 2002 showed that Scottish terriers were the most susceptible to dystocia resulting in an emergency caesarean section.
This often leads to the necessity for elective caesarean sections, as natural delivery can present an elevated risk.
However, while acknowledging these risks, I urge caution in the consideration of elective C-sections.
Let’s be clear, I’m not advocating for all canine pregnancies to end in a C-section.
This tool isn’t universally required, and it should not be the default choice. For instance, a healthy Labrador that has previously delivered two litters without any complications should not require this intervention.
Remember, even a minor surgical procedure comes with risks.
Moreover, studies in human medicine suggest that babies born via C-section have a higher likelihood of developing asthma and allergies due to their lack of exposure to their mother’s vaginal bacterial flora.
The potential parallels in canine births remain unclear. Still, it serves as a reminder that the birthing process is not just about the delivery itself, but also the long-term health of the offspring.
Indeed, elective C-sections can serve as a valuable tool for circumventing the negative effects of dystocia, thereby enhancing neonatal health.
However, like all tools, they have their pros and cons.
We must exercise discretion, ensuring they don’t become a routine response, but rather a carefully considered choice used when necessary to safeguard the health of both mother and puppies.
Soft Tissue Structure in the Birth Canal
The soft tissue structure of the birth canal, a factor often overlooked, can also pose significant challenges.
Abnormalities in vaginal anatomy not only affect fertility but can also inhibit natural mating. Issues like adhesions, septations, or double cervical orifices should ideally be identified before a female dog is chosen for breeding.
If detected, it may be wise to exclude these females from the breeding program, as these defects could potentially be passed down to future generations.
To help identify such issues, I strongly advocate for the use of vaginal endoscopy.
This technique, similar to the one employed for transcervical inseminations or TCI, leverages a small fibre optic camera to explore the vaginal cavity, providing a clear view of its structure.
I frequently used this approach during breeding soundness examinations prior to breeding, or in cases of infertility, as it’s the most effective way to thoroughly investigate the vaginal cavity.
Bear in mind, a canine’s vaginal cavity can be anywhere from 15-30cm long and even longer in giant breeds. Manual palpation alone is insufficient to investigate its entire length. The ability to visually explore from the vulva to the cervix can only be accomplished today with an endoscope, such as those used for TCI.
It’s worth noting that research comparing fertility rates between bitches undergoing surgical vaginal correction and those without surgery has shown a non-significant effect on overall reproductive performance.
However, pregnancy rates were significantly lower, and predisposition to dystocia and caesarean sections was notably higher in bitches with severe abnormalities compared to those with milder ones.
Endoscopy technology has been at our disposal for nearly two decades now. Its introduction has been one of the greatest advancements in the field of canine reproduction. It’s an invaluable tool, well worth leveraging to ensure the health and success of our breeding programs.

The Role of Veterinarians and Dog Breeders
The welfare of breeding dogs has gained increased interest in recent years, and improved understanding of the risk of dystocia in specific breeds can help veterinarians and kennel clubs to better focus their resources. By recognizing the crucial maternal factors that affect puppy health at birth, veterinarians and dog breeders can work together to create healthier and happier litters.
Puppies’ health at birth is impacted by a variety of maternal factors, from the health status and age of the bitch to the breed identity and structure of the soft tissues in the birth canal. By recognizing these factors and making informed decisions, veterinarians and dog breeders can play a crucial role in ensuring the health and well-being of puppies.

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