Handling Distokia in Dogs with Sectio Caesaria

Sectio Caesaria is a surgical procedure to remove the fetus from the mother, through laparohisteretomi or surgery on the stomach and uterus (Fossum 2002). The word "Caesaria" comes from the Latin word "matris caeso utera" which means cutting the uterus parent (Johnton, 1968). Caesarean section is an action to terminate the pregnancy period as a result of distokia which can be caused by uterine inertia, rupture, and uterine perforation (Kumar 1996).

Some causes of neonatal mortality are prolonged labor, hypoxia and dystocia. It can be physiological and even behavioral, or even from the environment. Some deaths puppy comes from genetic problems or infection. Studies show that 20 to 30% of all pups born die before the age of six months, largely due to neonatal death. In some cases there is a dog giving birth sometimes have to go through the process Cesar. Many of the reasons that cause the dog to be dicesar.

factors race
There are several types of dogs that had to be gone through the process if the cesarean childbirth. For example: Bulldog, Bulldog anatomy that causes this dog to be in a cesarean. Tillers Bulldog has a larger body than the head, curved legs making it difficult to be born normally. Coupled with Bulldog breeders who do not have a neck that causes shortness of breath is not strong Bulldog dogs for intercourse. Small breed dogs such as the Chihuahua, Pomeranian, Yorkshire, etc. are also often experienced cesarean section because they do not have the energy or the child is too big.

Anatomical and genetic factors
Dogs that have narrow hips usually find it difficult to give birth normally. To find out if our dogs have narrow hips can be examined by a veterinarian. Dogs that have narrow hips and large child conceived certainly can not give birth normally.

Dogs are narrow hipped, also gave birth to a child who is often narrow hipped. Therefore, if you want to buy a female dog to its owner should be asked her if there was generation above the cesarean delivery. Indeed, it is not 100% true to parent their children will also be narrow hipped hipped narrow but at least there is a chance it will lower sires in his ugliness.

health factors
This factor is often the case, the dog is in a state of pregnancy disease. Disease that often causes the dog to be in a Caesarean usually the cervix and vaginal infections. Diseased pregnant dog whitish likely to bear children with the condition because blind chicks that come out will pass whitish fluid that contains bacteria or viruses.

There are dogs that are pregnant appetite decreased thereby disrupting the quality of their health. Usually happens when the older gestational age, the enlarged uterus pressing intestinal digestion so that the dog eating difficult. Pregnant dog eating problems will increasingly come down the level of health and this will affect the health of the fetus as well. The dog did not have the energy to give birth normally to require cesarean section to help his birth.

Dogs who have passed the 60th day of pregnancy but no signs of birth should be brought to a veterinarian for examination. Many cases of cesarean occurs because the mother was not having contractions when the placenta has separated from the uterine wall. This is if it is not immediately performed Caesarean operation would endanger the fetus. Placenta already dislodged no longer distribute oxygen to the fetus. Usually after the escape, the fetus can survive between 3 hours to 24 hours.

Usually the vet will induce oxytocin so that the mother contracted. But, if it is induced by aksitosin contraction in 3 hours yet the mother should immediately carry out a caesarean section. There are some cases, the dog was originally a normal delivery but because of the number of children who should be born or the fetus is too large so that the mother was exhausted. Then the mother must also promptly at fault. If the fetus was already dead in the womb but not removed immediately, the life of the mother would be endangered because the fetus is very fast decay process and will poison all of the existing system.

Indications Sectio Caesaria
Cesarean section should be performed if another handler does not get the fetus. Sectio Caesaria indication of specialty include; Uterine inertia ekbolik failed to respond to therapy. ·
  - Disproportion fetopelvis who failed to respond to other treatment methods. ·
  - Obstruction birth canal ·
  - Malpersentasi fetal apat not corrected ·
  - There is evidence that signs of fetal life in danger ·
  - Removing the fetus from the uterus · mumuifikasi
  - Dilatation of the cervix is not optimal ·
  - Inguinal hernia that contains a part of the uterus ·
  - Ruptured abdominal muscular ·
  - The size of the fetus really large, single puppy syndrome or fetal monstroitas ·
  - Liquid or excessive fetal bit ·
  - Prophylaxis (history of previous births)

pre Operation
Preparation of animals: the emptying of the colon and bladder. Cleaning and washing of the caudal abdominal region. Prior to both, the animals were given a premedication, as soon as the animal is placed on the operating table. Infusion with electrolyte solution so that the effects of the drug more quickly distributed. Final preparations are anasthesi (Archibald.1984).

pre medication
Atrophin sulfate (1/150 grams) or morphine sulfate (1/8) - ½ g) was administered sc 30 min before surgery at a dose as small as possible because it is a depressant effect on the fetus possess. 15 minutes after administration of premedication, the parent is more easily handled, after 30 minutes is given in the form of ether anasthesia with inhalation method (Archibald.1984).
Pre medication can be given by using regional analgesia, such as acepromazin 0.01-0.02 mg / kg and oxymorphne 0.03 to 0.06 mg / kg followed by local infiltration line block 2 mg / kg lidocaine (Slatter and Douglas , 2002).

general anesthesia
General anesthesia for cesarean section is rarely used because it can cause anesthesia in puppies. Usually using propofol or isoflurane. Use of Intravenous not harmful to the mother, but the cause of fetal acidosis and hypoxia.
Mixture intravenous barbiturates are relatively safe to use, as lidokaine 0.25-0.5 mg / kg or diazepam0,1-0,4 mg / kg. Anesthetic ketamine 4-6 mg / kg in combination with diasepam 0.2-0.4 mg / kg or midazolam 0.1-0.3 mg / kg intravenously is a rapid induction techniques to suport case of cardiovascular conditions critical.
If bradycardia appear, atropine 0.02 to 0.04 mg / kg intravenous or intramuscular anti-cholinergic be good because glikorolat not penetrate the placental barrier, and ophioid induced bradycardia may occur in the fetus. Xilazin not recommended for sectio Caesaria because it causes high mortality in small animals. Xilazin can lead to fetal bradycardia, hypertension, and hypoxemia after 20 minutes of administration (Slatter and Douglas, 2002).

Mechanical operation
Midline approach to the abdomen in general preferred and on opening the abdomen, the uterus and part of the overall abundance, removed and wrapped to ensure minimal contamination perotoneum by the contents of the uterus.
The uterus was opened on the surface of the corpus uteri vebtral or in connection corpus uteri. (Figure 1.). The treatment is prudent to do when the opening of the uterus so that a fetus that is underneath does not accidentally terinsisi. The first fetus is pulled from the uterus in its amnion (figure 2) after entering his korioalantois bag.

Figure 1. Operation of fault in dogs - uterus was opened at the junction between the body and the cornua.

 Image 2. Cesarean section on the dog - taken from the uterus that the fetus is still closed amniotic

The amnion is then taken from the head and body of the fetus. Umbilical cord is clamped and cut 2 cm from the umbilical artery and fetal forceps held by an assistant for further treatment and resussitasi. Mucus rocked gently from the mouth or be removed by suction (figure 3). fetal dried with a towel or cloth to absorb the material, this activity can stimulate respiration and movement and immediately, in a healthy fetus, a scream was heard. Puffs slowly into the mouth, which increases the carbon content dioksi in the inhaled air, also provide stimulation action. In difficult cases, drug therapy may be required; 1-5 mg of doxapram hydrochloride can be placed under the tongue of each fetus to stimulate breathing.

Figure 3. Operation Fault in dogs - lick cord and sensitize children

 Figure 4. Operation of fault on the dog every effort is made to take the placenta to pull carefully.

Measures taken to take placentas each from each fetus with caution (Figure 4), but if the difficulties experienced or fresh bleeding triggered, the placenta should be left to be pushed back and released later, the possibility of postoperative assisted ekbolik therapy. The next Fetus driven slowly from each cornu uteri uterine incision along the path from which they were taken. In most cases, all of the fetus can be removed from a single uterine incision. Sometimes the vet can find it easy to achieve access fetuses by making an incision to the uterine cornu cornu second after the first closure.

Prior to the uterus is closed, the uterus should be checked to ensure that no child is left behind. Overall genital tract should be examined, including the corpus uteri and vagina intrapelvis caudal. Lembert stitches upside of material that can be absorbed sewing thread used to close the uterus, making sure that no harm at all sections of the placenta wound edges (Figure 5). traces of blood must be cleaned from the outside surface of the uterus in an attempt to prevent postoperative adhesions. The abdomen was closed in the normal way and lining the small wire can be attached to the wound to protect the skin from direct contact with children.

 Figure 5. Operation Fault in dogs - uterus is closed using sutures Lambert.

episiotomy
An episiotomy is an opening of the dorsal wall of the vulva are used to facilitate the repair of vaginal lacerations when it happens, put a catheter in the urethra, to enter the mass when the prolapse. But in general episiostomi used to assist in the birth of the neonate in cases distokia (Arthur, 2001).

What should be done prior to to do epistomi which aim to deal with cases other than distokia is the broad spectrum antibiotics such as cephalosporins induced first group of 2 to 6 hours before surgery. Then anesthesia using local anesthetic, the epidural anesthesia. If an episiotomy is done quickly anatesi can be done on the skin and muscular block using lidocaine or bupivicaine at a dose of 0.2 mL / kg bw. Part perineal given antiseptic such as povidone iodine or chlorhexidine. Animal is attached position perianal (Tobias, 2010)

The location of the episiotomy incision is on the external part of the dorsal commissure of the vulva to get into the lining of the vagina, the urethra passes through the tubercle. Before icisi network, vestibular should be palpated with the fingers to distinguish urethral tubercle. To avoid damage to the anus. Incision with a scalpel cutting the cutan, subcutis, musculus, and the mucosa of the dorsal midline to the ventral with a scalpel, and then ligated with scissors. After it is sewn using a predetermined standard sutures (Tobias, 2010).

Postnatal Care
Protection should be given antibiotics and anlgetik and preferably started before surgery. Parent dogs should be allowed to recover from anesthesia before the introduction of the puppy. Full recovery from the surgery is usually quick format without extraordinary events.

Postopearsi analgesic can be administered with NSAIDs administration after recovering from anesthesia. Reach NSAIDs available for dogs. Giving preoperative safe in most cases. Carproten can be used in dogs at a dose of 2-4mg / kg by subcutaneous injection. The drug can be given orally if necessary. If the patient has severe pain, a veterinarian should try to ascertain the cause and treatment of it. Opium can be used to provide additional anigesia.

Butorphonal at a dose of 0.2 to 0.6 mg / kg may be administered by subcutaneous injection or given intarmukular in dogs. Pethidine and morphine can also be used in dogs. The owner should be encouraged to monitor the progress of these animals in abundance near, and to monitor the children's animal kennel postoperative initially should be given small amounts of food with good quality at frequent intervals and should be encouraged to leave their children to exercise moderation at intervals throughout the day.

Water should be available ad libitum. Laparotomy incisions usually heal quickly and not damaged due to the activity of feeding the puppy. Postoperative problems that occur after a normal birth can also occur following cesarean section.

The puppy should be dried carefully and resolved before being placed in the stable, with the optimum temperature 29OC to wait for the recovery of its parent. Korda umbilicus should be cut or sewn at the time of surgery; they should be observed frequently to observe signs of bleeding and giving jahitanlagi when needed.

Usually not necessary to feed the puppies because they receive colostrum before its parent. Artificial milk can be given to the parent dropper tool if recovery is delayed. The puppy should be introduced slowly in the parent, in this case by disclosing signs unexpected aggressiveness in children. Injury can be caused by damage to the child if the parent has not been firmly standing on her feet. Dairy products are usually good after a cesarean section. Supplementary feeding should be introduced if there are signs of starvation or poor growth among puppies.

Histeroktomi
It proved to be necessary if the uterus is found defective or if the contents of the uterus rot. The owners were not expecting to breed their pet again can ask ovarohisterektomi, which was performed during cesarean section. This procedure can be well received by most of the animals are healthy and the patient is usually awake milk supply. However, some veterinarians prefer to limit cesarean surgery, to follow, after the pups are weaned, with ovarohisterektomi.
In cats with distokia which has not been observed, the fetus can be found wedged inside the uterus and cervix korpud. Death and fetal damage can occur and are indicated hysterectomy. The existence of a kitten cause cervical ligation is normally not possible. Fluid therapy before and during surgery is important. In cases like this, with regard to the circumstances, should be removed and the uterus should be opened to allow for this, with careful treatment to prevent contamination of the peritoneal trained (Figure 6). When the kittens have moved carefully ligated and legs cervix can be good. The uterus was taken after ligation of ovarian srteri. Although difficult, these cases usually give a good prognosis, if the cat is assisted when necessary, with appropriate fluid therapy. A course of antibiotic therapy and protection of non-steroidal anti-inflammatory should be started before surgery.

Figure 6. Children who die sandwiched cauda pussy cats. Pubic bone the cat has been taken for clarity of illustration.

conclusion
Distokia pregnant animals with abnormalities can be treated with therapy Caesarean section to save the fetus and the mother with a chance of healing up to 90% if handled quickly, accurately, good and true.