A. EXAMINATIONS
Bitches are not seen routinely throughout gestation as pregnant women are.
This is because the cervix is not palpable by digital vaginal examination and no specific changes occur in blood pressure, nor are other problems routinely identified. It generally is considered best to leave the bitch at home rather than potentially expose her to disease that might affect her or the puppies, such as canine herpesvirus.
Bitches often develop inappetence at about 3 weeks’ gestation. Many bitches can be enticed to eat by adding canned food to the diet or a small amount of human food, such as cottage cheese or cooked chicken. The bitch should be seen by a veterinarian if she exhibits any of the following:
• Complete lack of appetite for more than 2 days
• Increased thirst and urination
• Weakness, wobbly gait, or disorientation
• Vulvar discharge of any kind

B. NUTRITION AND BODY CONDITION

Bitches should be fed their normal maintenance diet in the first half of gestation but need a higher calorie diet for the latter half of gestation as the pups grow . It is very important that bitches be in normal body condition at breeding and be maintained in good body condition throughout pregnancy. Exercise is beneficial for maintaining the bitch in good body condition and maintaining the tone of the abdominal muscles she will use during whelping. Appropriate exercise includes swimming and walking. Exercises that could traumatize the abdomen and stress the fetuses should be avoided. These
include herding, agility, field work, and fly ball.
If the bitch is obese before breeding, it is best to get her in good body condition before breeding rather than try to promote weight loss during gestation or to allow her to carry the pregnancy while obese. Little is known about obesityChapter 10 Pregnancy 157 related pregnancy problems in dogs, but in humans obesity is associated with longer labor, a higher rate of uterine infections after labor, a higher probability of requiring cesarean section for delivery, gestational diabetes mellitus, and birth defects in offspring.
Herbal therapies described for use in women during pregnancy are not well described in dogs. Nothing is known about appropriate doses or side effects of most hormones described, and available products often are unregulated and might be adulterated with other compounds or bacteria. The most common herbs described are blue cohosh, black cohosh, and red raspberry tea leaves.
Blue cohosh and black cohosh are supposed to help stimulate labor, but there are no reports of these drugs inducing labor in dogs. In humans blue cohosh is associated with heart failure and shock in neonates. Use of any uterine stimulant during pregnancy risks pregnancy loss. Although it is normal for the uterus to contract throughout pregnancy, severe or prolonged contractions could be associated with direct fetal stress or lack of blood flow to the placenta and indirect fetal stress from lack of oxygen and nutrients. Other drugs described as uterine stimulants that must be used with caution, if at all, include mugwort, tansy, scotch broom, goldenseal, juniper berry, pennyroyal oil, rue,
mistletoe, and chaste berry.
Red raspberry tea leaves are reputed to decrease pain from uterine contractions and to act as a smooth-muscle relaxant. In women, red raspberry tea leaves are used to decrease nausea (“morning sickness”). The active compound in red raspberry tea leaves can cause nausea and diarrhea in some patients.
Reports also document a stimulatory effect of red raspberry tea leaves on the uterus. Little is known about appropriate dose, if any, for this herb during pregnancy in bitches.

C. DISEASES OF PREGNANCY

1. Gestational Diabetes Mellitus
Progesterone, which is required throughout pregnancy, may cause alterations in the uptake and effect of insulin in the cells of the body. If insulin is not taken up and used, sugar cannot be taken up into the cells to be used for fuel, the concentration of sugar in the blood rises, and sugar is dumped through the kidney into the urine. Diagnosis is by demonstration of high concentrations of sugar in the blood and urine. Regulation of diabetes mellitus during pregnancy with insulin is difficult but must be attempted. If left unregulated, the bitch loses weight and the pups grow to a very large size, which may predispose to dystocia. Diabetes mellitus that develops during pregnancy may or may not resolve after parturition.
2. Pregnancy Toxemia
Pregnancy toxemia is an uncommon condition in bitches. Dogs carrying a large litter late in gestation may find it difficult to eat because of compression of the stomach. If the bitch does not take in enough calories, her body starts to break down fat. Some of the metabolites of fat breakdown, called ketones, are toxic and worsen her lack of appetite and depression. Diagnosis is by identification of ketones in the bitch’s urine. Incidence of stillbirths is increased in dogs with pregnancy toxemia, and the bitch may undergo life-threatening drops in blood sugar. Force-feeding the bitch or intravenous feeding may be attempted. The condition resolves completely only when the pregnancy is completed. Cesarean section may be required to save the bitch’s life, even if the pups are not at term.

D. PREPARATION FOR WHELPING

1. Whelping Area or Box
A whelping area should be prepared that is out of the mainstream of traffic in
the house but not so secluded that observation of the whelping bitch is difficult. Use of a whelping box or enclosure is recommended. It also is recommended that the whelping area be prepared and the bitch habituated to it well
in advance of whelping to prevent her choosing a place that is inconvenient to
the owner, such as a closet or bed.
Many commercial whelping boxes are available (Figure 10-7). A children’s
hard plastic swimming pool also can be used. The whelping box should be easy
to assemble and disassemble, easy to store, easy to clean, and lightweight. The
sides should be high enough to prevent escape of 3-week-old puppies but low
enough to allow the bitch to come and go easily; a good average height is 12
inches. The sides should be solid to prevent the puppies from exposure to
drafts. It should be large enough to allow the bitch to lie on her side comfortably. A heat source should be provided in one corner, preferably radiant heat,
so that pups can move to and away from warm areas but do not risk being
burned. A “pig rail” should be installed low on the four walls after whelping is
Chapter 10 Pregnancy 159 Figure 10-7. Whelping box.
completed. This is a piece of wood or tubing that sits up about 4 to 6 inches
from the floor and about 3 inches away from the wall. This provides a place for
pups to crawl under and away from the mother, preventing her from smothering them accidentally.
The whelping box should be lined with a disposable or washable substance.
Newspaper can be used but may stain the bitch or pups with ink. Towels or
commercially available washable pads also can be used.


2. Preparation and Monitoring of the Late Gestation Bitch
Bitches should be wormed in the last 3 weeks of gestation .
Bitches with long hair should be clipped in the perivulvar area and over the mammary glands. Late-gestation radiographs to determine litter size may be of benefit for owners assisting a bitch with whelping for the first time or for bitches with high-risk pregnancies (a prior history of dystocia, concern about small litter size, and subsequent large pups).
Commercial systems are available that allow the owner and veterinarian to assess the changing pattern of labor and assess fetal stress level by use of an external abdominal monitor and handheld Doppler unit (WhelpWise, Veterinary Perinatal Specialties, 1-888-281-4867 or www.whelpwise.com;
WhelpWatch, Vet Watch Corporation, 1-888-200-8044). Rectal temperature also may be monitored late in gestation to permit recognition of onset of labor