Cat dystocia is a condition where a cat experiences abnormalities or difficulties during labor, resulting in the inability to deliver kittens successfully. This can be caused by factors related to the mother cat or the kittens themselves. The birthing process in cats is divided into three stages:

Stage 1: The uterus begins to contract and the cervix dilates, typically lasting several hours. The mother cat will feel uncomfortable and may vocalize, pace around, search for a comfortable resting place, and begin licking her abdomen or vulva.
Stage 2: The kittens are born, usually lasting 4-24 hours. The mother cat will exhibit strong contractions and adopt a squatting posture, starting to discharge fluids, and ultimately deliver the kittens. Dystocia commonly occurs during this stage.
Stage 3: The placenta is expelled, usually shortly after the kittens are born.

Understanding the symptoms and diagnostic methods of cat dystocia is crucial for prompt intervention to ensure the safety of both the mother cat and her kittens.

1. Differential Diagnosis

Cat dystocia needs to be differentiated from other illnesses and abnormalities, such as:

Pyometra: A uterine infection that causes the uterus to accumulate pus.
Uterine Torsion: The uterus twists, leading to compromised blood circulation.
Uterine Rupture: The uterine wall ruptures, causing internal bleeding.
Fetal Death: The kittens die inside the uterus and cannot be delivered naturally.
Fetal Malposition: The kittens are positioned abnormally inside the uterus, making delivery difficult.
Pelvic Narrowing: The mother cat's pelvis is too narrow to allow the kittens to pass.

2. Preliminary Diagnosis

Suspect cat dystocia when the following symptoms are present:

Discharge of black or green discharge (uterine green) exceeding 2 hours before kitten birth;
Weakened or absent Ferguson's reflex (feather-like appearance of the dorsal vaginal wall);
Continuous strong abdominal contractions exceeding 30 minutes without kitten delivery;
Intermittent abdominal contractions exceeding 4 hours without delivery;
Kittens remaining in the birth canal for more than 10 minutes with continuous contractions;
Kittens born more than 2 hours apart;
Vocalization and continuous licking of the vulva during contractions;
Acute depression during stage 2 (often associated with uterine rupture);
Fresh vaginal bleeding lasting more than 10 minutes;
Gestation exceeding 68 days after breeding.

In addition to clinical symptoms, palpation and radiography can help with the preliminary diagnosis of dystocia:

Palpation: While less accurate, it can provide an initial assessment of kitten size.
Radiography: It allows evaluation of kitten size, number, and position, as well as the size and shape of the birth canal. It can also determine if kittens have died, for example, by identifying in-utero gas, fetal skull collapse, or other bony malpositions.

3. Further Diagnosis

Ultrasound is the most accurate method for determining fetal viability, as it allows for observation of fetal movement and heartbeat. Fetal distress is defined as a fetal heart rate below 195 beats per minute or above 260 beats per minute. Successful response to oxytocin treatment for uterine inertia can also confirm fetal distress.

It's worth noting that both radiography and ultrasound often underestimate kitten size, with radiography being more accurate.

4. Primary Treatment Methods

Treatments for dystocia include:

Calcium: For hypocalcemia, 10% calcium gluconate (0.2-1.5 ml/kg [5-15 mg/kg] intravenously, slowly) can be administered, monitoring for arrhythmias, especially bradycardia.
Oxytocin: Dosage is 0.25-4.0 U intramuscularly, every 20-30 minutes, with a maximum of three injections. Increasing the dosage is not recommended. It can be repeated after 60 minutes or longer after kitten birth.
Cesarean Section: Surgical removal of kittens is recommended in the following situations:

Oxytocin and calcium treatment are ineffective;
Uterine disease is present (e.g., uterine inertia, torsion, or rupture);
The ratio of the pelvis to the kitten size hinders delivery.

Pre-Cesarean Section Anesthesia:

Pre-medication can be administered with Glycopyrrolate (0.01 mg/kg IM) or Atropine (0.02-0.05 mg/kg IV, IM, SC). Atropine is preferred for treating fetal bradycardia.
µ-opioid receptor agonists are also preferred for pre-medication.
Regional analgesia techniques can be used, such as lidocaine (2-4mg/kg) linear block.
For the benefit of the mother cat and kittens, rapid-metabolizing anesthetics are recommended (propofol induction [4-6 mg/kg intravenously], sevoflurane or isoflurane maintenance).
Intravenous fluids should be administered to prevent hypotension and reduced fetal blood flow.

5. Treatment Precautions

Cesarean section is a life-saving procedure for both the mother cat and kittens. Do not hesitate, intervene promptly.
Mother cats can control labor independently, so environmental stress can prolong or delay delivery.
Provide a quiet, safe, and comfortable environment for the mother cat to help her deliver successfully.

6. Prognosis

With timely medical or surgical intervention, the prognosis for both the mother cat and kittens is good.

Conclusion

The treatment of cat dystocia requires professional veterinary care. Owners should never attempt to handle the situation themselves. It's recommended to schedule regular prenatal checkups at the veterinary clinic during the cat's pregnancy and monitor her health to ensure timely intervention if necessary.

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