In a normal birth, the contractions of the uterus detach the placenta, and vaginal contractions move the puppy in its amniotic sac through the birth canal. The puppy is delivered in the amniotic sac, and the placenta is expelled. The bitch then tears the sac open and licks the puppy to stimulate it. This helps the puppy remove the fluid from its lungs and start to breathe air.
If the delivery is prolonged or the puppy is weak, it may not respond to the mother’s attempts to revive it. My preference when whelping a litter is to stand by and have the bitch handle everything. However, if the puppy is not moving or coming around quickly, I don’t hesitate to take the puppy and get it going before giving it back to its mother.
The first step is to clear the fluid from the lungs and airways. We used to cradle the puppies head down in both hands and swing the puppies between our legs. The centrifugal force would force out the fluid. This method is no longer recommended since too much force can cause brain damage and there is the risk of dropping the puppy.
A better method of cleaning the airway is to use a clean towel or washcloth to wipe away any fluids or membranes from the puppy’s nose and mouth. I buy a large bag of the carwash towels at the big box stores. They are the perfect size for cleaning puppies. Gently hold the puppy’s head downward for five to 10 seconds. Gravity will help drain any amniotic fluid or mucus from the mouth, throat and lungs.
Another key piece of equipment to have on hand is a rubber suction bulb syringe. You can find them at the drug store in the baby department. Sometimes they are called nasal aspirators or ear bulb syringes. I like to have several in different sizes. Squeeze the bulb and insert the tip of the suction bulb into the puppy’s mouth. Once the syringe is positioned, release the bulb and the suction will draw the fluid from the throat into the bulb. Repeat two to three times and use a smaller bulb syringe to clear the nostrils as well.
Once you have cleaned the airways, if the puppy is still not breathing on its own, you can try blowing into the puppy’s nose and mouth. Making mouth-to-mouth contact opens up the chance of the puppy transmitting illnesses like brucellosis to you. The odds are low that you would catch any type of serious illness from the puppy, but it is a risk. You could position your hand around the puppy’s mouth so you are not in direct contact.
Gently breathe small puffs of air into the puppy’s nose and mouth, two to three breaths, to fill the lungs with air. The amount of breath needed to blow out a match should be sufficient. Do not breathe too deeply since the newborn’s lungs are tiny and fragile. If the chest is not moving, the puppy’s airway may still be blocked. Use the bulb syringe again to clear the throat.
Once you have given two to three breaths, check the puppy’s chest for a heartbeat. Place your thumb and forefinger on either side of the puppy’s chest above the elbows and behind the armpits. A strong heartbeat will be easy to feel. If you have a stethoscope, you can place it on the chest wall and listen for a heartbeat. A newborn puppy will have a heart rate between 120 and 180 beats per minute. Use a clock or watch to see if the heart is beating two to three times per second.
If you cannot feel or hear a heartbeat, you will need to perform chest compressions to circulate blood and hopefully restart the heart. Place your thumb and first two fingers on either side of the chest over the area where you were feeling for a pulse. Gently squeeze the chest quickly to stimulate the heart. Squeeze firmly enough to move the ribcage, but not full force or you could bruise the heart and lungs. Do the compressions in rapid succession at a rate of two to three per second.
You will need to switch between mouth-to-mouth resuscitation and chest compressions until the puppy shows signs of life. After each minute, check for breathing and a heartbeat. If there is no response after five minutes, it is unlikely the puppy can be revived.
As soon as you can feel a heartbeat, stop the chest compressions. Continue giving breaths until the breathing is regular and strong. There is a pressure point on the front of the nose between the nostrils. Applying pressure with the tip of your finger in the area can stimulate a reflex to breathe.
Start stimulating the puppy by rubbing it with a towel. Use light, careful pressure all over the puppy’s body. Pinching the scruff of the neck several times mimics the mother’s actions.
One of the most important things to keep in mind when reviving puppies is to keep them warm. All the rubbing, pinching and breathing can lead to a loss of body heat. When puppies get chilled, their metabolism slows and makes reviving them even more difficult. Puppies are not able to regulate their own body temperature until they are seven weeks old.
There are many ways to provide heat sources for puppies. Heating pads should only be set on low and monitored carefully. Heat lamps are safer, but still can be dangerous if not watched. Hot-water bottles are also safe, but will cool over time and need replacing. I like the SnuggleSafe pink plastic discs that are heated in the microwave and stay warm for six to eight hours.
A client showed me a good idea. She filled a plastic water bottle with hot water and placed the bottle inside a fluffy sock. It provided nice heat for several hours and was easy to refill. We send our Caesarian-section puppies home with a few of these in their box. Blankets and towels right out of the dryer are good for short-term warming.
The importance of keeping puppies warm was made clear to me with a case from the emergency clinic. After trying unsuccessfully for 15 minutes to get a puppy breathing, it was decided the puppy was a lost cause. Perhaps by accident, the puppy was wrapped in a towel, placed under a heat lamp and we turned our attention to the mother and other puppies. At least 10 minutes later, we were all shocked to hear crying coming from the presumed dead puppy. Somehow the heat was enough to bring him back to life.
Last week, a client passed an interesting bit of information on to me. While whelping her litter of German Shepherds, she had a puppy that was very slow to come around. She gave the puppy a couple of drops of 5-hour ENERGY and the puppy perked up quickly. The main ingredients in 5-hour ENERGY are B vitamins, caffeine as a stimulant, and the psychoactive dopamine precursor amino acids tyrosine and phenylalanine. Obviously, this product is not labeled for use in dogs, but it might be worth having on hand when whelping a litter. I would place a couple of drops under the puppy’s tongue when other methods of revival are not working.