Mini, a 3 year old Shih Tzu X, arrived at our clinic having delivered two puppies on her own and was in the process of having a third one. The first two puppies unfortunately did not survive, making the delivery of the third puppy even more anxious for the owners. The third puppy was still enclosed in the foetal sac and was clearly visible at the vulva. This raised concern for dystocia, which means 'difficult birth'. Dystocia is commonly caused by uterine inertia (the uterus is fatigued and not contracting effectively anymore) and total malpresentation (foetus not facing the right way). In Mini's case, we suspected uterine inertia was the most probable cause. Having delivered two puppies, Mini must have been very exhausted at that stage.
Given the current situation a caesarian section is the best hope to save the puppy. Without hesitation Mini was brought into the operation theatre, and successfully delivered one healthy puppy.
Mini, by the same token, would need to increase her daily food intake by 2 to 3 folds, to keep up with requirements of producing milk.
We are all excited to see both Mini and her puppy again when she visits for her first vaccination.