The placenta is the organ that connects the developing puppies to the mother during her pregnancy. Generally, this is expelled shortly after the pup during the third stage of the birthing process. In certain circumstances, the placenta may not get expelled, which can cause infection within the uterus which can quickly lead to infection and sepsis. This condition is seen most often in dogs with difficulties during birth, in the birthing of large litters, and in toy breeds, and should be addressed as speedily as possible to prevent further damage to the mother or the nursing pups.

The failure of a mother dog to pass all or part of one or more placentas, also known as afterbirth, during the birthing process is called a 'retained' afterbirth.

The most telling sign that there is still placenta retained in the mother is the presence of greenish or dark discharge from the vaginal canal that continues for 24 hours or more after giving birth. Unlike the normal discharges that occur after birth (lochia), the discharge from a retained placenta may have an unpleasant odor. Other symptoms may include:

Cases of retained afterbirth are uncommon in dogs. The most common conditions that would lead to retained afterbirth would be difficulties experienced during labor or a particularly large litter. As the mother dog instinctively eats the afterbirth while caring for new puppies, it may become difficult to keep track of the how many placentas were expelled, especially under stressful circumstances. Toy breeds seem to be somewhat predisposed to retaining placentas.

In order to make a proper diagnosis your veterinarian will start by asking for a full history of your dog’s symptoms as well as give your dog a physical evaluation. He/she will palpitate the abdominal area, paying close attention to any lumps or masses that are palpable as well as examine the vaginal opening and the birth canal. Fatigue, muscle tremors, and other signs of physical distress will also be noted and an ultrasound or X-ray will be ordered to see if there is any retained fetal or placental tissue in the uterus. Blood tests and tests on the vaginal discharge will also be indicated to ensure that any infections are caught and treated in a timely manner. Retained fetal or placental tissue can lead to metritis, a bacterial infection of the uterus. In some cases, the ultrasound or x-ray will miss the tissue and exploratory surgery is required to get a definitive diagnosis.

More often than not the treatment of otherwise healthy canines will be minimal. An injection of oxytocin or prostaglandin is often given to cause uterine contractions. This is to facilitate the ejection of the remaining afterbirth that has been trapped in the uterus. If this treatment is unsuccessful or if there is a uterine infection the surgical removal of the tissue will be required. An ovariohysterectomy may be recommended at this point to avoid future complications, particularly if additional breedings are not planned. This surgery excises both the uterus and the ovaries. Any infections remaining will be treated aggressively with antibiotics, and the full course of the antibiotic medication should be given to prevent relapse. If the infection is advanced when you contact your veterinarian your pet may be admitted to the veterinary hospital for stabilization via IV fluids and supportive care.

As long as the mother receives timely medical intervention the prognosis for retained afterbirth is good for both the overall quality of life and for future fertility. If an infection has occurred, it is essential to make certain that your pet completes the full course of their antibiotic medication to help prevent any relapse.  Once your dog and her pups are able to come home keep them in a clean and quiet area of the home. Carefully monitor the behavior of both the adult dog and her pups for signs of pain, lethargy or unusual aggression, which may indicate that an infection has materialized.  Keep any surgical sites clean and dry and monitor them for bleeding or oozing. Make certain that the mother has plenty of ready access to highly nutritious food i.e. puppy food and clean water as producing milk takes a lot of water and a lot of energy.