Question: DR Mike This message is to see if you may assist me in my dog's pregnancy, she is 51 days in her pregnancy, and she is very weak, all she does is having certain discharges that look like urine. I am currently living in Puerto Rico and there are no close vet in my area. What could be happening to her? I am worried, how could I assist her in this stage? Please help me! Thank you from Jose
Answer: Jose- If the vaginal discharge has no odor (or a very weak odor) it may be normal. It is not too unusual to see discharges in the last two weeks of pregnancy. It would still be best to have a vet check to be sure that everything is going OK, though. If the discharge has any significant odor then it is possible that a uterine infection is present. This is a serious problem and it really requires the help of a veterinarian, as it would be best to surgically remove the uterus in this case, or to treat with medications that cause strong uterine contractions (prostaglandins) and antibiotics at the same time. If this is the case, it is necessary to make a trip to the vet, even if it is difficult to do so. It would be a good idea to switch to a puppy food gradually over the course of two or three days at this point in the pregnancy. Puppy foods are higher in calories and protein, both of which the mother needs to help maintain the puppies. Mike Richards, DVM 8/11/2003
Question: Hi Dr. Mike, Would this enzyme, or lack thereof, have any affect on pregnancy and whelping? It sounds like possibly it is worthless. My dogs do not tend to have gastrointestinal problems. I feed them a diet of Natural Choice Lamb & Rice Dry Dog Food by Nutro and Pedigree canned food. I have been mixing the regular and lite versions of this dry food 50/50 because I have been "told" that too much protein causes whelping problems. This is a new revelation for me and may be unfounded. I have also noticed that my dogs seem to have more gas since I have started the Prozyme! Not a pleasant experience when you have 15+ dogs (even though they are small). Would that make any sense? Mandy
Answer: Mandy- I do not think that Prozyme (tm) is likely to be helpful, or harmful, during pregnancy. I wouldn't supplement with it strictly from a cost standpoint, since I don't think there is any benefit for the cost. I can't recall anyone mentioning that their dogs had increased flatulence or burping when we were have used it in the past but I haven't used it in any of my own dogs, so I can't report anything from personal experience and people might not mention that sort of effect to me. I think that it is potentially a serious mistake to have a pregnant dog eating a diet with increased fiber and decreased caloric density (typical of most "lite" foods but I don't know the nutritional content of Nutro, specifically), even as half of the dietary base. Almost universally among veterinary nutritionists the view is that you should be trying for exactly the opposite type of diet -- relatively low in fiber, higher in protein content and higher in caloric density. During pregnancy the protein requirements of the bitch increase a little less than 20% over the protein requirements when she is not pregnant. Late in pregnancy (after the fifth to sixth week), the energy density becomes a real issue, because the puppies start to occupy a lot of space and it is harder for the bitch to eat enough to meet the energy and protein requirements unless the food has increased protein and increased calories so that she doesn't have to eat a large volume of food to meet these needs.
This a summary of the dietary requirements during pregnancy, for dogs, that are generally agreed upon:
1) The diet fed during pregnancy should be highly digestible, composed of good quality protein sources and easily available energy sources.
2) It is probably best to start a growth/lactation type diet (a puppy food, or a food labelled for gestation/lactation) at the start of the heat period so that any diarrhea, vomiting, or other symptoms associated with dietary changes occur before the bitch is actually pregnant. This is optional -- some people recommend making the change after the fifth to sixth week (over the course of a few days to minimize problems with dietary change).
3) Do not increase the caloric intake until the fifth to sixth week of the pregnancy (this is where knowing litter size is helpful, since the fifth week is better for big litters and the sixth is better for smaller litters).
4) Provide several small meals a day during the last 3 weeks of pregnancy since most bitches can't store big meals during this time due to the space taken up by the puppies.
5) From the 5th to 6th week of pregnancy until the puppies are delivered the amount of food should be gradually increased so that the bitch is eating 25 to 50% more (1.25 to 1.5 x normal) at the time the puppies are delivered.
6) Pregnant dogs should not gain more than 15 to 25% over their normal body weight during pregnancy. You might want to weigh your dams after they deliver, as well --- this is a way of checking to see if you are achieving weight control. They should not weigh more than 10% over their normal body weight after delivering the puppies.
7) Do not supplement calcium. Vitamin supplementation should not be necessary when feeding a good quality commercial diet.
Once the puppies are delivered:
1) Stay with the growth/lactation diet until the puppies are weaned.
2) Expect to feed 2 to 3X the normal amount of food when the puppies are 2 to 4 weeks of age (peak lactation) -- feeding free choice is acceptable during lactation if it helps achieve this goal, otherwise several meals a day will likely be necessary. 3) After the puppies are 4 weeks of age (5 maybe for a really big litter), the food intake should be tapered back to normal levels. It can be helpful in reducing milk production to withhold food the day before the puppies are weaned.
I hope that this information is helpful. Mike Richards, DVM
Question: Hello Dr. Richards, I hope you can help me and give some guidance. I breed Cavalier King Charles Spaniels and have done so for over 12 years. Most recently none of my bitches are delivering puppies normally at home. I have had 5 c-sections in a row, mostly due to uterine inertia. Is there anyway to counteract this trend? I love my vet and he is an excellent surgeon. The c-sections are quick and all my puppies and mothers are fine. However, I hate to put the bitches through this. It hasn't always been this way for me. My vet has told me things like "it's in your line", "it's a problem with Cavaliers", "your dogs are spoiled". These don't seem like probable medical reasons to me. After all these dogs are decendents of bitches that DIDN'T all have c-sections. Is there anything I can do with diet, supplements, exercise, etc. that could help correct this? I have heard that excess protein can be a problem. I have also heard that various brands of dog food can cause whelping problems. I would really appreciate some help. I have a bitch due in about two weeks that has delivered naturally one about 3 years ago. But had to have a c-section last litter because she just shut down. HELP! Mandy
Answer: Mandy- There are a lot of possible problems. I am assuming that many of them won't apply to you or your dogs due to your experience with breeding dogs, but I am going to list as many as I can think of, just in case I manage to touch on something helpful. If this continues to be a problem for you there are reproduction specialists in veterinary medicine (theriogenologists) and it may be worth working with one to see if the problem can be resolved. Nutritional problems can play a role in the development of uterine inertia problems during delivery of puppies. Supplementing calcium and possibly Vitamin D during the pregnancy is likely to lead to problems. This seems to run against logic, since the developing puppies need calcium. What seems to happen, though, is that supplemented calcium is used preferentially by the bitch's body, because it is easily available. So she doesn't maintain normal calcium regulatory mechanisms in top efficiency. Then when it is time to deliver puppies and produce milk, she can't meet the sudden large increase in calcium demand because she has been relying on the supplemented calcium. It is possible to accurately test calcium levels using some laboratory instruments that are reasonable for veterinary practices to purchase, such as the iSTAT machine. If your vet has the capability of measuring calcium it may be possible to determine if calcium deficiency is contributing the problem. Administering calcium without knowledge of the calcium levels is a more dangerous approach to the situation. There is an oral calcium gel (Calsorb Rx) that is supposed to be absorbed pretty quickly and may be less likely to cause problems with excessive calcium (which include stopping the heart).
Overweight bitches have more problems delivering puppies. Therefore, it is best to avoid breeding overweight bitches. This is a problem sometimes, but weight gain during the pregnancy is also a problem at times and in a few cases, the puppies gain more weight than they should as they develop even though the bitch doesn't, even though she is being overfed during the pregnancy. A bitch who was at ideal weight at the time of breeding should have an increase in weight of about 15 to 25% at the time the puppies are delivered. Starting to feed additional food prior to the 5th or 6th week of pregnancy is probably the primary cause of bitches and/or their puppies gaining too much weight during pregnancy.
Underweight bitches can have trouble having puppies but they usually have to be severely underweight, or underweight due to a metabolic problem, for this to lead to problems.
If excessive protein is a problem I can't find that information in the nutritional texts that I have. I don't doubt that some brands of dog food contribute to whelping problems -- especially brands that are low in calories in relation to their calcium content, leading to excessive intake of calcium to satisfy caloric needs. A good energy to calcium ratio is the primary reason to use a food made specifically for growth, pregnancy and lactation.
There has been a lot of different advice published about the best way to approach dietary needs during pregnancy. One approach that seems to make sense is to switch the bitch to growth/lactation food as soon as it is obvious she is going into heat, taking several days to make the transition. Then feed her the growth/lactation diet with no increase in caloric intake until the fifth or sixth week of the pregnancy. From this point, gradually increase the food intake until she is eating about 1.25 to 1.5x normal at gestation. The advantage of this approach is that any problems with the food transition occur before she is bred. It is probably acceptable just to wait until the fifth week of pregnancy, gradually transition to the growth/lactation diet and then slowing increase calorie consumption as recommended above -- but if the transition causes diarrhea or vomiting it will occur when she is pregnant which can be a problem. I disagree with the folks who say to stick with regular dog food and just increase the amounts. I think that it is too hard for the bitch to get adequate calories without taking in excessive calcium using this approach. Late in pregnancy it is often necessary to give a number of small meals a day rather than one or two meals because there isn't much room for food in an abdomen full of puppies, so small meals given frequently become important.
Another common problem is failing to know accurate gestation information. A good way to accurately figure the proper date for delivery is to know when the progesterone peak occurred during the heat period. If progrestone is measured daily the most fertile period is usually around 48 hours after the progesterone level rises above 5 nanograms. However, it is usually impractical to measure progesterone daily so most people do it every 2 to 3 days after the first 5 to 7 days after the onset of the heat period. Using this system, it is still possible to come very close to an accurate birthing date, which should be 65 to 66 days after the progesterone rise occurs. Miscalculating the expected delivery date and reacting to false labor contractions definitely occurs and can lead to unnecessary cesarean sections. If progesterone information isn't available, most bitches will go into labor before the 70th day after the first day she would stand for breeding.
Failure to properly recognize the stages of labor sometimes leads to problems interpreting whether uterine inertia is occurring, as well.
Stage I of labor occurs after the progesterone level drops to less than 2 ng/ml, usually accompanied by a drop in temperature to 99 degrees Fahrenheit, or less. The temperature rebounds fairly quickly, so it is recommended that body temperature be measured at least twice a day the last week of pregnancy to try to catch this drop (or to measure the progesterone levels if desired). Labor should begin within 24 hours of the drop in temperature. Stage I labor consists of nesting behavior, uterine contractions that are not visible (but can be palpated in most cases), panting, restlessness and often a decrease in appetite. This stage usually doesn't last longer than 24 hours.
Stage II labor is period of hard contractions that occur after a puppy is in position to be born and the bitch is working hard to deliver the puppy. The contractions usually involve a lot of body effort in addition to uterine contractions so they are usually obvious at this time. Stage II labor should not go on for more than an hour without a puppy being delivered. Stage II labor is repeated each time a puppy is delivered.
Stage III labor is the period between puppies and after the last puppy, when there is some rest but the fetal membranes are expelled with less violent contractions. The interval between puppies should not exceed 4 hours. Most bitches become obviously much more comfortable after the last puppy is delivered but it is helpful to have some idea how many puppies to expect prior to the delivery, just to be sure that the delivery really is over.
The failure of contractions to occur defines uterine inertia. However, there is primary uterine inertia, in which the contractions don't occur at all, for some reason and secondary uterine inertia, in which normal contractions were present for a while and then stopped due to something interfering with the delivery.
Most bitches have normal Stage I labor but have problems when the need arises to go to Stage II labor.
Primary uterine inertia can occur just because the bitch is nervous, anxious, or upset for any reason. This is most common in first time mothers but can occur in later pregnancies. Low calcium and low blood sugar levels can cause primary uterine inertia. Very small litters (one or two puppies) seem to fail to initiate Stage II labor in some cases.
Secondary uterine inertia occurs for a number of reasons. Unfortunately, low blood sugar and low calcium levels also occur after some puppies are born, in some cases, making them a cause of secondary uterine inertia, as well as primary uterine inertia. Obese dogs or dogs with heart failure or other health problems can simply tire out and not be able to complete the delivery. In some cases there are uterine obstructions (scarring or tumors, especially), vaginal obstructions (scarring, bands of tissue, tumors) or pelvic obstructions (previous fractures, small pelvic diameter). The uterus is working normally but can't overcome the obstacle in this case.
The puppies can cause secondary uterine inertia by, too. The uterus can be working normally, and working hard, to deliver puppies that can not be delivered due to positioning, fetal size (especially when small litters are present), fetal shape (large headed breeds, for instance), abnormal fetuses or due to premature rupture of fetal membranes causing a lack of lubricating fluids to help the puppies move through the uterus. After a while, the uterus just tires out and uterine inertia occurs.
In veterinary medicine there is probably a tendency to go to surgery quickly when difficult deliveries are occurring. There are a lot of factors in this decision making but the fact that puppies are born in litters instead of one at a time is probably a big factor. It just seems to make sense that if a puppy is having a hard time being delivered and there are more to follow, that they have a higher chance of having problems, too.
There is a company WhelpWise (tm), www.whelpwise.com, that makes fetal monitoring devices for dogs. I have not used their equipment or their services but it does add a different dimension to the thought process when it comes to delivering puppies, because the ability to monitor the puppies for distress should help in making decisions about the necessity for surgery right at that time, if the equipment and monitoring procedures are good. This may be very helpful in managing delivery if your vet is right and your dogs are contributing to the appearance of uterine inertia because they are nervous, have low pain thresholds or prolonged State I periods that are fooling you.
It is not really all that often that medical treatment for uterine inertia works but we often try it, anyway. There are a lot of different ways that veterinarians use oxytocin to induce contractions, from slow intravenous drip of oxytocin containing fluids to injections of bolus doses of oxytocin at 20 minute intervals (usually no more than two injections total). If calcium levels are low, administration of calcium (again there are several ways this is done) may be helpful. Once in a while administration of pain relievers (these do affect the puppies too and can suppress respiration) or using spinal anesthesia will allow a bitch who is inhibiting labor to relax enough to allow delivery.
Those are the factors that relate to the bitch and the puppies. It is important to realize that there are also factors that relate to the breeder and the veterinarian.
Veterinarians may be very inexperienced at recognizing the stages of labor, just like breeders may be.Veterinarians rarely see the initial stages of labor and often haven't even seen really good Stage II contractions, because the lack of these contractions is the primary reason vets see bitches that should be giving birth. This means that your vet might be easy to talk into surgical delivery when it might be more appropriate to wait, because he or she isn't sure where in the delivery process your bitch is. Vets also have time constraints. Letting nature take her course isn't an attractive option at 5PM when the vet is looking at the potential for a later cesarean delivery with no staff support, for instance.
Even some experienced breeders have trouble identifying when Stage II contractions have really set in and may wait too long to seek veterinary attention (puppies should be delivered within 1 hour of hard contractions) or may go to the vets thinking these contractions have been going on when they have a bitch who has a low pain threshold and is sounding like she is having hard painful contractions when she really isn't, yet. An awful lot of breeders keep no records, or poor records, of breeding dates, access to the male or anything that might hint at when puppies should really be due. Help your vet out by keeping good records of the breeding dates, good records of body temperature the last week of delivery and good observations of behavior around the time of whelping.
I hope that something in this information is helpful. If it raises more questions, please feel free to ask them. Don't forget that there are specialists in breeding difficulties if this problem persists. Mike Richards, DVM
Question: Dear Dr. Mike,
I recently subscripted to your service. I am living in Malawi where vet care is not good and I have a pregnant Rottweiler. I believe she is about 4 weeks along. This morning she had a small amount of vaginal discharge. It was dark red, mucusy blood. She does not seem to be affected by it and is eating well. Is this "normal" during pregnancy or should I be looking for a more serious cause?
I look forward to your response. Sincerely, Laura
It is not unusual for dogs to have a vaginal discharge during the first week or so after breeding and late term discharges are not unusual, either. There is less written about the early pregnancy period, though.
Some dogs develop vaginitis during pregnancy. This produces discharges that vary in color depending on what is causing them. Most of the time the bitch appears to be unaffected by this condition and treatment is usually not necessary.
Cystitis (bladder infection) is not unusual in female dogs and can occur during pregnancies. Blood in the urine sometimes looks like a vaginal discharge but dogs with cystitis are usually bothered by the condition, urinating frequently and straining as if there is a need to urinate but not producing urine. The straining can be severe enough that some people think their dogs are constipated. Based on your description, this seems unlikely.
The most serious cause of vaginal discharges in early pregnancy, or within the first month or so after a heat period, is uterine infection (pyometra). Uterine infections can become life threatening but many dogs do not show much sign of problems until the infection becomes very severe. Any change in her behavior that makes you think that she may be sick should be taken seriously due to this possibility. An increase in drinking and urinating should prompt an immediate visit to the veterinarian, as this occurs as toxins build up in the uterus.
You have to keep a close eye on her. Watch for signs of lethargy, loss of appetite, increased thirst, increased urination and any other sign of illness. Most discharges during pregnancy turn out to be unimportant but they are worrisome and they do have to be taken seriously.
Mike Richards, DVM 9/8/2000
Q: How preterm may puppies be and have a chance of survival? Female I have with the low calcium is not due until 3/5 (63 days from first breeding). Thanks
I have had difficulty finding information on how premature puppies can be and survive. This may be due to the difficulty in determining whether or not puppies are premature due to the unusual nature of the canine reproductive cycle. There are a number of ways of calculating gestation length in dogs due to the difficulty in establishing when fertilization occurs. It is considered acceptable to calculate gestation length as 63 days +/- 7 days from the first breeding, 65 days +/- 1 day from the peak of lutenizing hormone during estrus, 57 days +/- 3 days from diestrus (the three previous calculations come from Essentials of Small Animal Internal Medicine by Nelson and Cuoto) and I have also seen 58 days +/- 3 days from the last day the bitch will stand and allow breeding.
The last time I remember hearing or seeing anything about premature puppies it was estimated that survival chances were pretty compromised if a puppy was born more than 5 days premature. I can not say what this was based on because I can't remember where that information came from. I will keep trying to find something about this for you and let you know if I come up with anything.
Mike Richards, DVM
Q: We just returned from vacation, and the guy house sitting and caring for our 8 Alaskan Huskies says he thinks Skeeter, a 5 yr. old, is pregnant. For the past 3 years, ever since I got her from a friend in town, she has seemed almost to go into estrus, but never any discharge, and only mild interest from the males in the kennel. This February the same thing happened at the right time. Then early March she began shedding. (It was still getting down to -15 F then and she's kenneled outside, so definitely not normal.) We left home March 20, and quite soon after her appetite, which has never been subdued, became ravenous. Our sitter has been around several sled dogs thru pregnancies, and became suspicious, and thought her belly felt a bit full also, so he started giving her extra rations to be on the safe side. To my palpation, I can't definitely feel an enlarged uterus yet, but her teats are definitely more prominent than previously. If she is pregnant we're happy, and the only male in the kennel who could realistically reach her is the one we intended to breed her with. (yeah, I know anything can happen.)
Questions -- 1. How do I prove pregnancy? 2. How do I establish gestational age and estimated whelping date? 3. The alternative explanation is, I believe, false pregnancy (Hysterixis?) -- When should that be a concern, and how is it diagnosed. I have a total kennel immunization appointment with my vet the end of this week, but there probably won't be time for a complete exam of the involved dog, and my wife is dying to know in the mean time. Thanks!
A: False pregnancy symptoms are normal in dogs that have an estrus and do not get bred, due to the way in which they cycle. It is not usually necessary to treat for symptoms of false pregnancy but they can be so close to those of a real pregnancy that the two can be very confusing.
It is usually possible to feel distinct lumps in the uterus representing individual embryos from about the 28th day of pregnancy to about the 35th day of pregnancy. Before and after that it can be hard to identify a pregnant uterus easily. After 45 days or so when the skeletons begin to calcify it is often possible to feel the distinct hardness of a puppy skull when palpating the abdomen or to identify the puppies on an X-ray, if you wish to take her to the vet's office prior to the home visit, or if your vet has a portable X-ray machine. By now, if your dog is NOT pregnant, your vet will probably be able to tell you that, since she should be pretty far into the pregnancy and at least uterine enlargement should be palpable.
Aging the puppies exactly is probably possible but I do not know how to do it. I think you may be stuck with making your best guesstimate of breeding date and allowing a little leeway on either side.
Mike Richards, DVM
Q: Dear Dr. Mike, My Rhodesian Ridgeback is now 18 months old and ended her first heat over two months ago. She still has enlarged nipples and appears to have lost a lot of the muscle tone around her abdomen. Our vet, here in Santorini, does not appear overly concerned and has told me she is probably experiencing an hysterical pregnancy -- as I have written in the past, we do not always trust her medical opinion, so I thought I'd turn to you once again. I know that she was never approached by another dog while she was in heat (thanks to me, my big stick and my insistence that she remain a virgin, perhaps indefinitely), so she couldn't possibly have become pregnant. Is this just a hormonal explosion? Should I be attempting treatment of some sort? She hasn't actually begun lactating, but our vet said she might, in which case she would give her something to stop milk production. Confused, as usual, in Greece, Thanks again for your help, Majda
If you think about it, dogs have a different estrus cycle than most mammals. Instead of cycling every few weeks like most species, they cycle a little less than twice a year. The reason for this is a difference in the length of time the corpus luteum (lysed egg) provides progesterone, which supports pregnancy. Most mammals lyse the corpus luteum and it stops producing progesterone, which causes the animal to have a new heat cycle in order to reproduce. In dogs the corpus luteum is not lysed, so progesterone is produced for around 80 days, whether dogs become pregnant or not. So a state of false pregnancy due to sustained progesterone production is actually normal for a dog. Probably most female dogs that are not spayed show some signs of pregnancy and many exhibit a lot of signs of false pregnancy, including nesting behavior and "adopting" toys. There may be milk production along with enlargement of the mammary tissue. Many owners would like to limit this behavior or the other signs of false pregnancy such as mammary gland enlargement but I do not know of a safe and effective way to do this.
Mike Richards, DVM
Q: Hi, I have had two female yorkies with false pregnancies with complete with milk. What is the treatment for this? How serious is this? One is 6 years old and the other is 9 years old. Would spaying in these girls need to be done on a emergency basis? Are some breeds more susceptible to false pregnancies?
(Both girls were going to be spayed next month but did not know if it needed to be done right away with a emergency charge/visit). Thanks, B
A: False pregnancy is probably a normal outcome for an estrus period in which mating does not occur, in dogs. Unlike most species, dogs produce progesterone at levels sufficient to maintain pregnancy whether they get bred or not. Therefore, it is likely that many dogs experience at least some degree of "false pregnancy" after an estrus period. It is not an emergency situation. There are medications to suppress the symptoms of false pregnancy but there tends to be a rebounding of signs once the medications are discontinued, so I favor not treating this condition if possible. Most bitches will stop having signs about 80 days after the estrus. They often will produce milk and there can be signs such as nesting behavior or mothering of inanimate objects. If milk production causes discomfort an analgesic such as aspirin may be helpful. Do watch for signs of pyometra (uterine infection), including drainage from the vulva, increased drinking and urinating, inappetance or lethargy. If these signs occur it would be a good idea to see your vet. Pyometra is more common after estrus than at other times. I don't think that false pregnancy makes a bitch more likely to have pyometra, it is just something to watch out for in any intact female dog. I am not aware of a breed predilection towards false pregnancy but can't say there isn't one, either.
Q: Dear Dr. Mike, We had our sheltie, Molly, breed on the 6th and 9th of December,1997. About 13 days after the 6th breeding date, she began to vomit a little bit for a week. We thought for sure that she was expecting. I am wondering when she will start to look pregnant and what special care I should be aware of for her in the next 4 to 5 weeks, and for the babies she might have. I really want to be an informed breeder. The person we used to have our Molly bred, is never around for my questions. I would be very grateful for some help, as I feel the other breeder isn't going to be of much help. Thanks in advance. If you know of any reading material I could use for general breeding purposes, etc., please let me know.
A: "Morning sickness" hasn't been well documented in veterinary patients but I do know a couple of breeders who are sure that they see vomiting early in the pregnancy. I know of no reason to doubt them. I would be cautious about just assuming the vomiting is from pregnancy if it continues, though. Talk to your vet if this happens.
The best days to palpate (feel for) puppies are about day 28 to day 35 of the pregnancy. Usually it is best to count from the last breeding day as most dogs actually ovulate shortly before they quit standing for the male. X-rays can confirm pregnancy after 45 days. Sometimes it is worthwhile to take X-rays to get an idea of the number of puppies -- usually we do this only if we suspect that there are problems or if the bitch has had trouble delivering puppies previously.
It is best to gradually change the bitch to a puppy formula dog food at about 35 days of the pregnancy (take about a week to slowly make the change, mixing in small amounts of puppy food with normal food the first day and gradually increasing the amount). Most bitches require about 1.5 times the normal amount of food for their maintenance at the time of birth. As the puppies grow, she may require as much as 3 times normal amounts of food to support lactation. You should continue to keep her on a puppy formula until the puppies are weaned.
Do not supplement calcium during the pregnancy. This seems to lead to problems with uterine inertia, increasing the probability that a cesarean section may be necessary. It may also contribute to the frequency of seizure problems associated with low blood calcium levels during lactation (milk tetany).
Know your veterinarian's emergency procedures before the delivery. If your vet refers emergencies to an emergency clinic, make sure you know where it is and how to call if you need help. If your veterinary hospital staff covers its own emergencies it is still important to know the procedure for contacting someone before the need arises. Ask about this. Write the phone numbers down where you can easily find them.
Your vet is likely to have some references that cover construction of breeding boxes to protect the puppies. I can not remember the titles of the ones we have, offhand --- they are from Purina, though. Providing a safe environment for the puppies is important. More puppies die from hypothermia than anything else, probably. Making arrangements to ensure the puppies will stay warm is important. On the other hand, you can't just warm up a whole room to 80 degrees because Mom has to be willing to stay with the puppies. The puppy heating pads are nice and sometimes other arrangements can be made to safely supply a warm spot for the puppies without making it too hot for the mother.
Breeders are a good source of information in most cases and it would be a good idea to continue to try to talk to yours. They often have practical information that vets don't have experience with.
Mike Richards, DVM
Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...