WhelpWise Service

Until recently, the lack of technology, methods, and protocols made whelping a "cross your fingers and hope everything comes out “OK" experience. Whelping management and interventions by yesterday’s standards were frequently based on symptoms rather than accurate information on uterine contractions and fetal heart rates. Whelping decisions, when based on subjective symptoms rather than objective data place the breeder or veterinarian in a passive rather than active role in the whelping process. Using symptoms of panting, nesting, and inappetence to determine that a bitch is in labor is a very inaccurate way to document labor. Physical symptoms of a whelping-gone-wrong may not be present and are often a late indication of a problem. With the WhelpWise service, new standards are being established for canine reproduction that allows proactive decisions to be based on actual uterine contractions and fetal heart rates and encourage early intervention.

Noting this lack of technology and support services available to the veterinary obstetrical community, Karen Copley RNC BSN researched and patented methods of uterine activity and fetal heart rate detection for veterinary obstetrics. This research and database of over 30,000 litters has demonstrated that there is a measurable pattern of uterine contractions as well as a predictable course the contractions should take during normal whelping. Copley also noted that canine fetal heart rates are easily detected at 6-7 weeks of gestation with a hand-held fetal heart rate doppler. Fetal heart rates have a normal baseline range, and a distressed puppy is identifiable in most cases by its heart rate.

This research has been formulated into a service to support canine breeders called WhelpWise. The WhelpWise service provides the breeder or veterinarian easy to use uterine activity and fetal heart rate monitoring equipment that is designed for use in the home or veterinary office setting. This equipment gathers information on uterine contractions and transfers the data via phone to specially trained obstetrical staff to evaluate the data and formulate a plan of care for the bitch using our extensive protocols for whelping management.

Ideally, the service starts 4-5 days before the first due date and continues until whelping is complete. Information on uterine contractions is gathered twice daily, with fetal heart rates checked at least once daily. This information is transferred over the phone line to the monitor center for interpretation. A baseline value for uterine contractions and fetal heart rates is determined in the days prior to whelping. When labor begins, monitoring frequency increases and the equipment is used as often as needed during whelping. The service is only offered with veterinary supervision. WhelpWise orders are sent to the client’s veterinarian for approval to be on our service, and notification parameters and veterinary instructions are dictated by the written veterinary orders.

The WhelpWise service can assist in predicting when whelping will take place, helping prevent surprise deliveries, and alerting the breeder and veterinarian to abnormalities during labor. The service has successfully detected stuck or malpositioned puppies as well as puppies not likely to survive the whelping. This has all occurred in time to treat the problem and have a good outcome. WhelpWise has also been utilized to detect and stop premature labor.

A significant benefit of the WhelpWise service is the ability to identify abnormal labor patterns, such as inertia, versus a mispresented or exceptionally large puppy. Inertia, or lack of adequate uterine contractions, can be easily managed by giving medications in small frequent doses to establish a normal, productive contraction pattern. By simulating a normal labor pattern, unnecessary stress to the mother and the puppies can be avoided. Medication doses that are excessive can contribute to fetal deaths because uterine contractions cause a physiologic decrease in the blood and oxygen supply to the puppies. If medications are overused, the uterus clamps down in a prolonged contraction cutting off the blood flow to the puppies. The WhelpWise service will discourage the administration of medications when a malpresented or "stuck puppy" pattern of labor exists. Administration of Oxytocin in the case of a stuck puppy can cause uterine rupture and/or fetal and maternal death.

Dealing with inertia in the home setting is easily accomplished by providing the breeder with pre-drawn, labeled syringes of medication obtained from the covering veterinarian. Medication is given only when indicated by the monitoring equipment and under the veterinarians’ orders. Dosing is adjusted to gently increase the contraction frequency and strength, thus mirroring a normal pattern of labor. All medication is administered subcutaneously, as this route allows for slower drug action onset and more controlled response. Allowing inertia to go unmanaged can frequently lead to a completed cessation of labor and fetal and maternal compromise.

Monitoring fetal heart rates to make sure the puppies are tolerating labor is easily accomplished by obtaining the pup's heart rates using a hand-held ultrasound doppler. Puppies that are compromised can be documented by specific fetal heart rate patterns. Early detection of problems gives the veterinarian and owner a chance to make decisions about intervening with either medications or a cesarean section before puppies are compromised. While not every owner will intervene if puppies are compromised, owners appreciate having the knowledge so timely intervention can be provided if they choose. The fetal heart rate doppler can also be used around 6 weeks to confirm pregnancy. Doppler’s are also available for purchase from Veterinary Perinatal Specialties.

The WhelpWise service also has its role in the case of a planned cesarean section. Instead of picking a date for surgery, whether correct or not, early labor can begin with surgery scheduled before labor becomes too advanced. Monitoring also helps prevent labor patterns from going unnoticed. It is not uncommon to have a labor pattern detected by the equipment prior to any symptoms or change in temperature. Undetected labor, in the case of a planned cesarean, can be potentially hazardous for the bitch and her litter. Early labor may also help the puppies begin the normal birth transition, as well as promote optimal maternal bonding and milk production, often lost when surgery is performed prior to labor and its corresponding hormonal changes. Reverse progesterone levels to determine the C-section date can be inconvenient and expensive. It is not uncommon for breeders to pay more for reverse progesterone levels than for the entire WhelpWise service. By monitoring uterine contractions at home, early labor can be detected around 8-12 hours prior to active labor, letting the normal process of hormone decline occur before doing the C-section.

Many breeders believe that they know everything they need to know about whelping by monitoring temperature. While the temperature may decrease, the change may be less than 1 degree or may fluctuate, making it difficult to know when or if it occurred. By monitoring only the temperature, the breeder has no information on uterine contractions or fetal heart rates. One can equate whelping management by a temperature drop and the presence of labor symptoms to a cardiologist deciding if you had a heart attack based on your temperature and the presence of left arm pain. While left arm pain and an increase in temperature may indicate a heart attack, it gives no information confirming the problem, the extent of damage, or any life-threatening cardiac irregularities that may be present. To establish specific information on the heart, additional tests such as an EKG, blood work, and treadmills are performed.

Optimal canine whelping management using the WhelpWise service integrates information from the uterine monitor and ultrasound Doppler as well as traditional subjective information to provide an accurate picture of the whelping. Managing the whelping without the use of monitoring equipment may cause decisions to be based solely on symptoms and measurements of vaguely accurate parameters such as temperature change. This subjective approach can cause caregivers to act prematurely or completely ignore the developments of potentially harmful occurrences in the whelping process, all due to a lack of accurate, objective data. Using the WhelpWise service and its specific measurement of the uterus and fetal heart rates allows the breeder and veterinarian to base decisions on accurate, objective data that facilitate timely interventions should they be required.

Quality breeding has become the focus of most canine enthusiasts. Frequently, large sums of money are invested in breeding, and when a poor outcome occurs, the entire investment can be lost. While WhelpWise cannot prevent all whelping complications, it provides the breeder and veterinarian more information on which to base proactive decisions. If the outcome of just one puppy is improved, the cost of the service is more than justified.

For more information, please call Veterinary Perinatal Specialties at (303) 423-3429. Web address: www.veterinaryperinatalspecialties.com. Please visit our website for case studies.