Cats: Birthing Emergencies

Summarized from "Emergency Interception During Parturition in the Dog and Cat," Frances O. Smith, Vet Clin Small Anim 42(2012): 489-499

There are 3 stages of birthing:
Stage 1: uterine contractions and cervical dilation -- usually 6-12 hrs, but maybe up to 36 hrs.  Queen is restless, may pant, refuses food, nests
Stage 2: fetal expulsion -- usually 4 to 16 hrs, with occasionally upto 42 hrs.
Stage 3: placental expulsion -- usually each placenta is passed within 15 minutes of the fetus

Dystocia (difficult birth) occurs 3.3% to 5.8% in feline births.  Clinical signs include:
-- pregnant queen >71 days after breeding
-- straining for 1 hr continuously before delivering
-- green or black vaginal discharge before delivery
-- resting over 3 hrs between births
-- delivery of stillborn
-- protrusion of fetal membranes for over 15 minutes without delivery of fetus
-- vaginal hemorrhage
-- weak or distressed queen

Causes of dystocia can be divided between problems with the queen and problems with the fetuses.  67.1% are of maternal origin and 29.7% are of fetal origin.  [and no the numbers don't add up, but I didn't write the article!]

Fetal causes:
-- malpresentation (the most common fetal problem) -- 70% of kittens are born head first, and while butt-first is not abnormal in cats, it does increase the risk of death.
-- fetal abnormalities
-- fetal death
-- fetal oversize
-- anasarcous fetuses (fluid filled fetuses)

Maternal causes:
-- uterine inertia (the most common maternal problem) -- Primary inertia, the queen has little to no contractions and does not reach Stage 2.  Partial primary, the queen reaches Stage 2 but the contractions are too weak to expel a fetus.  Secondary inertia arises from anatomic problems.  The uterus may become exhausted in the case of obstructed birth canal.
-- pelvic fracture
-- uterine torsion -- Abdomen is very painful with a racing heart beat.
-- vaginal abnormalities such as bands
-- malnutrition
-- parasites

Medical management
If the queen has not been in labor too long, the cervix is dilated, fetal size is appropriate, and the fetal heart rate is normal, then the use of drugs may help.  Drugs should NOT be used in cases of obstruction or when more than 1 fetus remains in utero due to uterine fatigue. 
-- oxytocin increases the frequency and quality of contractions.  Doses range from 2 to 4 U IM, with a recommended dose of 0.5 to 2 U.  The author spcifies an initial dose of 0.1 U/kg, with a repeat dose after 30 minutes, and no further use after that.  (Oxytocin will cause placental separation and lead to fetal distress.)
-- calcium increases the contractions but "in the queen, calcium use is controversial, due to the very strong uterine contractions seen when it is administered".  [I'm planning on looking into this frther.]

Mechanical management
In the case of malpositioning, it is possible to use sterile lubricant and fingers to rotate and extract the fetus.  Otherwise an episiotomy is possible, but with the complication of scarring and increased risks for future pregnancies.

Surgical management
60-80% of all dystocias result in surgery.  Fetal heartrates below 150 beats/min require immediate surgery, and 150-170 should be monitored closely as surgery is prepared for.  The author does not recommend an ovariohysterectomy at the time of a ceasarean, unless the uterus is damaged, due to risk of hemorrhage and loss of fluids. [skipped all the discussion of anesthetics and surgery as this is not a DIY project, hopefully]

The accompanying flowchart shows neonatal resuscitation.  While it is for neonates after a ceasarean, much of it does apply to normally born kittens too.

10 Books Cat Breeders Should Own

Here's a list of 10 books that cat breeders should have in their libraries.  The books range from genetics to care of kitten.  I wish to thank several of my breeder friends for make suggestions and comments on these books.

1. The Cat Breeder's Handbook  -- This is a collection of articles by various experts on everything from selecting cats for a breeding program to showing cats at a cat show.  There is a good article on cattery design.
2. Feline Husbandry -- One of the classics for cat breeders, which is still useful.  It covers diseases in a multicat environment, caring for kittens and mothers, and nutrition among other topics.  The book is fairly expensive as it is out of print, but it is available for free online through the UC Davis website.
3. Practical Guide to Cat Breeding (Royal Canin) -- I have not personally seen this book but it was highly recommended.  From the description, it sounds good as it has sections on genetics, reproduction problems, pediatrics, and even legal matters.  The down side of this book is the price -- it is out of print and routinely sells for over $100.
4. Robinson's Genetics for Cat Breeders and Veterinarians -- This is THE book on cat genetics and how breeders need to consider relatedness among cats.
5. Notes on Feline Internal Medicine -- This is a technical veterinary book, but one of the best books for clearly diagnosing internal problems, explaining bloodwork, and giving medication suggestions.
6. Veterinary Notes for Cat Owners, Cat Owner's Home Veterinary Handbook, or Cornell Book of Cats -- PICK 2 -- These are more user-friendly books that the above book.  They provide the reader with more background information on disease processes without the technical terminology and the medication suggestions.  Each book explains topics in slightly different ways, hence the suggestion for 2 books.
7. Infectious Disease Management in Animal Shelters -- This book is invaluable to understand and help prevent diseases from spreading in a closed environment, such as a cattery.  While it is for animal shelters, and thus includes dogs, it is very applicable to catteries.
8. Plumb's Veterinary Drug Handbook -- This standard reference on veterinary drugs is invaluable for understanding the biochemisty of drugs as well as for dosages.  Sadly, the book is expensive and some newer drugs are omitted until the newest edition is published.
9. The Pill Book Guide to Medication for Your Dog and Cat -- This is a more user-friendly drug book which covers the most commonly prescribed drugs, discusses the pros and cons of using human medications, and provides a simple first-aid guide.
10. Raising Cats Naturally: How to care for your cat the way nature intended -- For breeders interested in feeding raw food, this is THE book to have.  Not only does it provide clear recipes, it provides the rational behind the ingredients with references to literature.