Singleton puppy syndrome in a bitch and the importance of neonatal resuscitation following cesarean section

Case report

Authors

  • Beatriz Doná Símaro Centro Universitário Católico Salesiano Auxilium image/svg+xml https://orcid.org/0009-0006-6949-5189
  • Beatriz Piva Vicentini Clínica Veterinária Pública Meu Pet, Araçatuba, São Paulo
  • Suelen Lorena da Silva Clínica Veterinária Pública Meu Pet, Araçatuba, São Paulo
  • Luís Guilherme de Faria Clínica Veterinária Pública Meu Pet, Araçatuba, São Paulo https://orcid.org/0000-0002-9563-1870
  • Luana Martins Serra Clínica Veterinária Pública Meu Pet, Araçatuba, São Paulo
  • Fernando Fernandes Marques Clínica Veterinária Pública Meu Pet, Araçatuba, São Paulo
  • Lucas da Silva Gois Clínica Veterinária Pública Meu Pet, Araçatuba, São Paulo

DOI:

https://doi.org/10.31533/pubvet.v20n5e1956

Keywords:

Apgar score, canine obstetrics, uterine inertia, fetal distress, veterinary neonatology

Abstract

Neonatal viability in dogs is directly associated with appropriate parturition management and early intervention in obstetric disorders. Singleton Puppy Syndrome is characterized by the presence of a single fetus, resulting in insufficient uterine distension and failure to trigger the physiological onset of labor, which may lead to primary uterine inertia, fetal distress, and increased perinatal mortality. This study reports a case of Singleton Puppy Syndrome in a bitch undergoing timely cesarean section, emphasizing the importance of basic neonatal resuscitation in reversing neonatal depression. A bitch with prolonged gestation and absence of labor signs underwent cesarean section following ultrasonographic and radiographic diagnosis consistent with a singleton fetus and high obstetric risk. The neonate presented an initial Apgar score of 2, and basic neonatal resuscitation procedures were immediately initiated, including active warming, airway clearance, tactile stimulation, oxygen therapy, and stimulation of the GV26 acupoint. Progressive improvement in neonatal vitality was observed, with the Apgar score increasing to 9 within 60 minutes, ensuring the puppy's survival. It is concluded that early diagnosis of Singleton Puppy Syndrome, timely surgical intervention, and the systematic application of neonatal resuscitation protocols are critical factors for improving neonatal survival in high-risk cesarean deliveries.

References

Barbosa, E. R., Costa, A. S., Napoleão, R. M. S., Ferreira, M. R., & Andrade, K. E. R. (2021). Cuidados básicos e intensivos com neonato canino no parto cirúrgico (Cesariana): Uma revisão de literatura. https://doi.org/10.51161/rems/2397.

Boller, M., Burkitt-Creedon, J. M., Fletcher, D. J., Byers, C. G., Davidson, A. P., Farrell, K. S., Bassu, G., Fausak, E. D., Grundy, S. A., Lopate, C., & Veronesi, M. C. (2025). Recover Guidelines: Newborn Resuscitation in Dogs and Cats. Clinical Guidelines. Journal of Veterinary Emergency and Critical Care, 35(S1). https://doi.org/10.1111/vec.70013.

Cavanagh, A. A. (2017). Neonatal resuscitation in the veterinary setting. Clinician’s Brief.

Davidson, A. P. (2025). Management of the Neonate in Dogs and Cats. In Merck Veterinary Manual (Vol. 1, Number 1).

Doebeli, A., Michel, E., Bettschart, R., Hartnack, S., & Reichler, I. M. (2013). Apgar score after induction of anesthesia for canine cesarean section with alfaxalone versus propofol. Theriogenology, 80(8). https://doi.org/10.1016/j.theriogenology.2013.07.006.

Leite, A. G. P. M. L., Cordeiro, M. L. L., Albuquerque, S. C. M., Dias, F. E. F., Arrivabene, M., & Cavalcante, T. V. (2019). Escore APGAR: Aplicação em neonatos caninos nascidos de parto normal e cesariana. PUBVET, 13(4), 1–5. https://doi.org/10.31533/pubvet.v13n4a318.1-5.

Linklater, A. (2025). Triagem inicial e reanimação de pacientes de emergência de pequenos animais. In Merck Veterinary Manual (Vol. 1, Number 1).

Lourenço, M. L. G., Knupp, F. C., Pereira, K. H. N. P., Fuchs, K. M., Xavier, G. M., Mendonça, J. C., Tsunemi, M. H., Souza, F. F., & Joaquim, J. G. F. (2025). Efficacy of VG26 and K1 acupuncture points in cardiopulmonary resuscitation of neonatal puppies born by cesarean section. Frontiers in Veterinary Science, 12. https://doi.org/10.3389/fvets.2025.1579758.

Mathews, K. A. (2005). Analgesia for the pregnant, lactating and neonatal to pediatric cat and dog. Journal of Veterinary Emergency and Critical Care, 15(4). https://doi.org/10.1111/j.1476-4431.2005.00170.x.

Mugnier, A., Chastant, S., Saegerman, C., Gaillard, V., Grellet, A., & Mila, H. (2021). Management of low birth weight in canine and feline species: Breeder profiling. Animals, 11(10). https://doi.org/10.3390/ani11102953.

Pereira, K. H. N. P., Correia, L. E. C. S., Oliveira, E. L. R., Bouéres, C. S., Cyrino, M. A., Leis Filho, A. F., Cruz, R. K. S., Angrimani, D. S. R., Souza, F. F., Chiacchio, S. B., & Lourenço, M. L. G. (2020). Effects of clamping umbilical cord on the neonatal viability of puppies delivered by cesarean section. Journal of Veterinary Medical Science, 82(2). https://doi.org/10.1292/jvms.19-0078.

Srithunyarat, T., Jitpean, S., Wipoosak, P., Nonthakotr, C., Boonbal, N., Kunkitti, P., & Seesupa, S. (2024). Apgar scores in puppies following the induction of etomidate compared with alfaxalone or propofol for cesarean section. Veterinary World, 17(3), 527–534. https://doi.org/10.14202/vetworld.2024.527-534.

Veronesi, M. C. (2016). Apgar score in puppies delivered by cesarean section: Correlation with neonatal survival. Theriogenology, 85(5), 979–985.

Published

2026-05-31

Issue

Section

Medicina veterinária

How to Cite

1.
Símaro BD, Vicentini BP, da Silva SL, de Faria LG, Serra LM, Marques FF, et al. Singleton puppy syndrome in a bitch and the importance of neonatal resuscitation following cesarean section: Case report. Pubvet [Internet]. 2026 May 31 [cited 2026 Oct. 20];20(05):e1956. Available from: https://ojs.pubvet.com.br/index.php/revista/article/view/4706