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DYSTOCIA is difficulty giving birth. We see it most commonly in miniature and small breeds of dogs (e.g., chihuahuas,pomeranians, etc.) who have a tendency to have puppies too large to pass through the birth canal, as well as breeds which have a poor design for giving birth (e.g., English bulldogs) who have a broad head but narrow pelvis. Dystocia can, however, occur in any breed of dog, and does occur occasionally in cats. General guidelines for when to contact a veterinarian include if the dog has been straining in active labor for greater than 60 minutes withoutdelivery of a puppy, if more than 2 hours pass between puppy deliveries and you know there are more puppies present, or if there is a puppy visible in the birth canal which is not quickly delivered. When you bring your dog in for dystocia, usually the first thing we will recommend after examining the dog is an X-ray to see how many puppies are still present and if any of them are in the birth canal, which makes the problem even more urgent. The longer the puppies are under stress (and labor is a stress), the poorer the outlook for survival. A long labor also tires the bitch, and makes her a higher anesthetic risk if surgery is needed. A Caesarian section will usually be recommended at this point, although sometimes there are medical alternatives. Dependingon the circumstances, your veterinarian may offer these treatments before proceeding to surgery,or while surgery is being set-up. If a Caesarian section is to be performed, it is the perfect opportunity to have the dog spayed if you do not intend to have any future litters.
ECLAMPSIA is a problem that occurs in lactating (nursing) female dogs when the blood calcium level falls too low due to calcium being used up in milk production. Without enough calcium in the bloodstream, muscles in the body do not work normally. Initially the dog is restless, panting and often whining, then she develops a stiff gait and muscle tremors, which progresses to being unable to stand, with all four legs stiffened out, similar to having “Charlie horses” in all the leg muscles. Her temperature may become very high from the increased muscle activity, and if it goes above 106 or 107 degrees complications may arise from the high temperature. This disorder is more common in small breeds of dogs, especially if the litter is large. Once the calcium is confirmed to be low we give a slow intravenous injection of calcium while we monitor the ECG (the heart is a muscle, too, and it may be affected by low calcium).IV fluids may also be given. We often recommend oral calcium for a few days afterwards. The dog can no longer be allowed to nurse her puppies, as the problem will recur, so the litter needs to be hand-raised until ready to be weaned. Calcium supplementation prior to the puppies being delivered should NOT be given, as this prevents the bitch from being primed to make her own calcium once the puppies have been delivered.
PYOMETRA is a bacterial infection of the uterus in intact female dogs (and less frequently, cats). The most common bacteria causing the infection is E.coli, which contains toxins in the bacterial coat, and makes animals very sick when the toxins are absorbed into the bloodstream. The only way to prevent pyometra is to have female dogs spayed if they are not being used for breeding. There are two categories of pyometras, called open and closed, referring to whether the cervix is open, so that the pus can drain out, or if the cervix is closed, so that all of the pus stays inside the uterus, which gets bigger and bigger. Generally dogs with closed pyometra become more severely ill over a more rapid course, but in both circumstances pyometra is a serious infection and can become life-threatening due to the toxin absorption. Signs of pyometra may include depression and lethargy, poor appetite, and the dog may be vomiting and have a recent history of increased thirst. The abdomen may become distended and uncomfortable, or a vaginal discharge may be present depending again on whether it is an open or closed pyometra. Typically pyometra occurs 1–12 weeks after the dog has been in estrus. To diagnose pyometra, abdominal radiographs and/or abdominal ultrasound may be used to assess the uterus. If there is a vaginal discharge it may be examined under a microscope, and some lab work may be performed, as there is usually a high white blood cell count. Treatment includes IV fluids, antibiotics and surgery, to remove the infected uterus. 
On rare occasion if a client is dedicated to keeping the dog as a breeding female we may try medical treatment, but the problem usually recurs, and there is a risk that the uterus will rupture and the dog may die if surgery is not performed, so this avenue is not recommended. Having an animal spayed when they are very sick from a uterine infection is much more risky for the animal, not to mention much more expensive, so if your female dog is not going to be bred, having an elective spay while healthy is optimal.