Dystocia in Dogs

Written by Shula Berg BVSc CertAVP(GSAS) GPAdvCert(SASTS) MRCVS
Clinically reviewed by Elizabeth McLennan-Green BVM&S CertAVP(SAM) MRCVS

Table of Contents

- Overview
- Symptoms
- Diagnosis
- Treatment
- Outlook

What is Dystocia?

Dystocia is defined as difficulty with the normal delivery of a neonate from the uterus. There are many causes of dystocia. Common causes in dogs include lack of uterine contraction, narrow birth canal, puppies that are too large/in the wrong position, or puppies that are dead. 

Dystocia is more likely in brachycephalic (flat-faced) breeds, dogs who are overweight, very small litters (where the puppies have grown excessively), matings where the sire (father) is much larger than the dam (mother), and older dogs. 

What are the symptoms of Dystocia? 

Dystocia is suspected when whelping is not progressing as expected. “Normal” labour varies from dog to dog, but the following are cause for concern: 

  • Weak, irregular straining for more than 4 hours without a puppy
  • Strong, regular straining for more than 30 minutes without a puppy
  • Vaginal discharge is passed but no puppy follows within 2 hours
  • Second stage labour has lasted for more than 12 hours
  • Green or black coloured discharge before or during whelping

Sometimes a puppy is visibly stuck in the birth canal, but more commonly, labour simply doesn’t progress. 

Which tests are used to diagnose Dystocia?

An accurate history is essential to be certain that the dog is definitely in stage two labour. This will require information about the date of mating, signs of labour and times observed, and any additional knowledge, such as rectal temperature monitoring. 

A physical exam will be performed to feel the uterus and check the birth canal for presence of puppies and contraction strength. An ultrasound or x-ray may be required to see how many puppies are present and whether they are alive. 

Blood tests to check calcium and glucose levels are recommended, as if either are too low, this can prevent whelping progressing and be very dangerous for the dog. 

How is Dystocia treated? 

Once labour has started, failure to deliver the puppies will put both puppies and mum at serious risk. Treatment should be prompt, and can be medical or surgical depending on the suspected cause. 


Medical treatment involves the administration of the hormone, oxytocin, which stimulates uterine contractions. If calcium levels are low, this must be supplemented as it is required for muscle contraction. Oxytocin can be effective if the uterus is not contracting properly, but must not be used if there is a physical obstruction (such as a puppy stuck in the birth canal) as the uterus can rupture. Oxytocin injections can be repeated hourly, but if the first two injections have no effect, it is unlikely to be effective. Several studies report a success rate of roughly 30%. The main disadvantage of oxytocin use is the potential delay if surgery is eventually needed, as the puppies will be more distressed and the mum more exhausted. 


Surgical treatment of dystocia is a caesarean section. This involves surgically removing the puppies from the uterus. The uterus is sewn up, or can be removed (spay) during the same procedure. A caesarean is the only suitable treatment when a puppy is stuck in the wrong position, or is too large to fit through the birth canal. 

Although caesarean sections have good success rates, they are not without risk to both the mum and the puppies. The mum is often already exhausted and her body is under a lot of pressure. A large amount of her blood volume is being diverted to her uterus, rather than supplying her organs, and she may not have eaten or drunk properly for a few days.

Anaesthetic deaths occur uncommonly in healthy animals, however, a caesarean would be considered moderate risk. This risk is increased in brachycephalic breeds such as Bulldogs. The anaesthetic will also affect the puppies, though drugs are chosen to minimise this. Puppies will have often been distressed for several hours by the time the need for a caesarean is apparent, and may have developmental abnormalities that contributed to the dystocia. It is not uncommon that not all puppies will survive surgery. 

What is the outlook for dogs with Dystocia? 

The prognosis for female dogs experiencing dystocia is grave without prompt intervention, and a lack of a treatment will almost certainly lead to the death of both mum and puppies. 

Dogs who deliver successfully after oxytocin injections have an excellent prognosis, and are able to be discharged as soon as the last puppy is delivered. 

Dogs who have caesarean sections have a good prognosis if they come through surgery. There is a higher risk that the mum will reject the puppies due to stress, in which case they will need hand-rearing and the mum will need monitoring for mastitis (infection of the mammary glands). The vast majority of dogs who have a caesarean will do very well, however, it is recommended not to breed from them again. 


Please note that the content made available on this webpage is for general information purposes only. Whilst we try to ensure that at the time of writing all material is up to date and reflects industry standards, we make no representation, warranties or guarantees that the information made available is up to date, accurate or complete. Any reliance placed by yourselves is done so at your own risk.

Last review date: 13th February 2024

Next review date: 13th February 2026