Changes

==Signalment==

==Signalment==

Certain breeds are predisposed to dystocia such as '''brachycephalic''' and certain '''terrier breeds''' in the dog. These breeds have both a '''narrow [[Pelvis - Anatomy & Physiology|pelvis]]''' and offspring with '''large skulls''', making dystocia far more common. Many Bulldog breeders now request an elective Caesarean section - however this raises complex ethical issues and it is up to the individual veterinarian to decide whether they are willing to perform the procedure. '''Siamese''' and '''Persian''' breeds are more likely to suffer from dystocia than other breeds of cat.  

Certain breeds are predisposed to dystocia such as '''brachycephalic''' and certain '''terrier breeds''' of dog. These breeds have both a '''narrow [[Pelvis - Anatomy & Physiology|pelvis]]''' and offspring with '''large skulls''', making dystocia far more common. Many Bulldog breeders now request an elective Caesarean section - however this raises complex ethical issues and it is up to the individual veterinarian to decide whether they are willing to perform the procedure. '''Siamese''' and '''Persian''' breeds are more likely to suffer from dystocia than other breeds of cat.  

==Causes==

==Causes==

'''Medical management''' may be considered when the condition of the dam and fetuses is stable, when there is proper fetal position and presentation, and when there is no obstruction. '''[[Ovaries Endocrine Function - Anatomy & Physiology|Oxytocin]]''' given IM up to 3 times at 30-min intervals, with or without 10% '''calcium gluconate''' given slowly IV in an attempt to promote uterine contractions. If no response follows, a cesarean section should be performed.

'''Medical management''' may be considered when the condition of the dam and fetuses is stable, when there is proper fetal position and presentation, and when there is no obstruction. '''[[Ovaries Endocrine Function - Anatomy & Physiology|Oxytocin]]''' given IM up to 3 times at 30-min intervals, with or without 10% '''calcium gluconate''' given slowly IV in an attempt to promote uterine contractions. If no response follows, a cesarean section should be performed.

'''Caesarean section''' is indicated for '''obstructive dystocia, dystocia accompanied by shock or systemic illness, primary uterine inertia, prolonged active labor if medical management has failed'''. Cases with '''fetal oversize, fetal malformation, non-reducible malpresentation, foetal distress, and uterine damage''' should also be managed surgically. Fluid therapy should be administered throughout surgery and low doses or short acting, reversible drugs should be used in combination with local anaesthetics to minimise the effects on the fetuses. Recommendations are an '''opiod''' for sedation (if required), '''propofol''' for induction and '''isofluorane''' for maintenance of anaesthesia.  

'''Caesarean section''' is indicated for '''obstructive dystocia, dystocia accompanied by shock or systemic illness, primary uterine inertia, prolonged active labor if medical management has failed'''. Cases with '''foetal oversize, foetal malformation, non-reducible malpresentation, foetal distress, and uterine damage''' should also be managed surgically. [[Category:Fluid Therapy|Fluid therapy]] should be administered throughout surgery and low doses or short acting, reversible drugs should be used in combination with local anaesthetics to minimise the effects on the fetuses. Recommendations are an '''opiod''' for sedation (if required), '''propofol''' for induction and '''isofluorane''' for maintenance of anaesthesia.  

==Neonatal Care==

==Neonatal Care==

Dystocia cases run a higher risk of fetal distress and mortality, therefore it is essential to be prepared for the immediate care of neonates after birth.  

Dystocia cases run a higher risk of fetal distress and mortality, therefore it is essential to be prepared for the immediate care of neonates after birth.  

Once to fetal has been expelled/removed from the uterus by C-section, the following steps should be performed:

Once a foetus has been expelled/removed from the uterus by C-section, the following steps should be performed:

* Removal of the '''amniotic sac'''

* Removal of the '''amniotic sac'''

If opiods have been administered in the dam then Naloxone can be given to the neonate to reverse the effects of the drug.

If opiods have been administered in the dam then Naloxone can be given to the neonate to reverse the effects of the drug.

Th puppies should be kept '''warm''' and '''dry''' (normally by placing them in a box with towel-covered hot water bottles or heatpads) until the dam had recovered. With dogs, the dam should be observed closely when first placed with her offspring as bitches have be known to cannibalise their young. They should be discharged from the hospital '''promptly''' to prevent '''stress and disease exposure'''.  

The puppies should be kept '''warm''' and '''dry''' (normally by placing them in a box with towel-covered hot water bottles or heatpads) until the dam had recovered. With dogs, the dam should be observed closely when first placed with her offspring as bitches have be known to cannibalise their young. They should be discharged from the hospital '''promptly''' to prevent '''stress and disease exposure'''.  

{{Learning

{{Learning

|flashcards = [[Small Animal Soft Tissue Surgery Q&A 12]]}}

|flashcards = [[Small Animal Soft Tissue Surgery Q&A 12]]}}

==References==

==References==

Gilson, SD (1998) '''Self-Assessment Colour Review Small Animal Soft Tissue Surgery''' '' Manson''

Gilson, SD (1998) '''Self-Assessment Colour Review Small Animal Soft Tissue Surgery''' '' Manson''

von Heimendahl, A. Cariou, M. (2009) '''Normal parturition and management of dystocia in dogs and cats''' ''In Practice'' 31:254-261

von Heimendahl, A. Cariou, M. (2009) '''Normal parturition and management of dystocia in dogs and cats''' ''In Practice'' 31:254-261

[[Category:Reproductive Diseases - Cat]]

[[Category:Reproductive Diseases - Cat]]

[[Category:Reproductive Diseases - Dog]]

[[Category:Reproductive Diseases - Dog]]

[[Category: To Do - Siobhan Brade]]

[[Category:Expert Review]]

[[Category:To Do - Manson review]]