Kittening/queening in cats - potential problems

There are three recognized stages to the term "queening" or "kittening" that cats go through after giving birth:

• Stage 1:
  Stage 1: the queen may exhibit behavioral changes during this phase, which typically lasts between two and twelve hours but can last up to thirty-six hours in first-time kittening queens. The queen gets agitated, licks her posterior, kneads the bedding, and vocalizes. She might choose to withdraw or crave extra care. Panting could happen at this point. During this stage, the cervix is dilation and the uterus (womb) is contracting. Occasionally, movement of the kitten is visible through the abdominal wall. There are no obvious abdominal contractions, even though you might notice a mucus-like discharge from the vulva (the area around the back of the queen).
• Stage 2: this begins when you can see the queen starting to strain. These contractions will eventually result in the delivery of a kitten. The queen may alternate between lying on her side looking at her back end, and standing in a squatting position. She may vocalize. The first kitten should be born within about 30 minutes of active straining, and further kittens then born every 10 to 60 minutes. Cats, however, can have long periods of rest between kittens, during which the queen is feeding and suckling the kittens in a normal manner. This can take up to 36 hours. As long as there has been no straining since the previous kittens, this can be allowed to continue. Discharge from the vulva during this time may be clear or bloody and this would be normal. Once a kitten is born, the queen may remove the membrane over it's head, if not then you should remove it to save the kitten. Healthy kittens should be noisy, moving vigorously and looking for a teat.
• Stage 3: the placenta is delivered at this point. Cats typically give birth to both kittens and placentas in turn until the delivery is finished, yet occasionally they will give birth to two kittens and then two placentas. Make every effort to ensure that the final delivery count includes the same amount of placentas and kittens. The queen has the option to chew the umbilical cord to break it off and consume the placenta directly from her posterior. If not, you should rip the umbilical cord between two fingers, around 1 cm below the attachment to the kitten's tummy, breaking it rather than severing it.

"Dystocia" is the inability to extract a kitten via the birth canal. Most cats do not have as many problems as women do when they are pregnant, but problems may happen, and some breeds—like Persians, who have flat faces—may have more problems than others. The queen can be in danger if she strains for more than thirty minutes and no kitten is born, or if she strains for some time and then gives up without producing a placenta or kitten. You should seek rapid consultation from your veterinarian if you feel that your queen is experiencing difficulties giving birth to a kitten. Treating dystocia early on can save the kittens and possibly even the mother.

The diagnosis of dystocia can be based on the presence of any of the following criteria:

• Prolonged gestation: if the pregnancy lasts longer than 65 days from the first mating, then this is abnormal. Prolonged pregnancy results in oversized kittens that will not fit through the birth canal. This is more common in single kitten pregnancy.
• Failure of delivery of all kittens in a timely fashion: delivery should occur within 30 minutes of active visible abdominal efforts. Call your vet for advice if there is:
  • 20 - 30 minutes of strong contractions with no kitten born.
  • 2 - 3 hours of strong contractions after a kitten has been born.
  • If a kitten is visible but hasn't been born within 10 minutes.
  • Obvious problem (kitten hanging out, etc).
  • Foetal distress: if stillborn kittens are delivered then concerns must be raised for the remainder of the litter as yet unborn. If the unborn kittens have slow heart rates (your vet will be able to detect heart rates) this can also indicate distress.
  • Maternal distress: the kittens are also at risk if their mother becomes ill before delivery. If they are nearly at full term they may stand a better chance of surviving if they can be delivered and cared for outside the womb. If a queen develops green or copious discharge and/or substantial fresh blood from her vulva during pregnancy then veterinary advice must be sought immediately.

Dystocia is caused by issues with the mother or the size or positioning of the kitten.

• Kitten abnormalities: include overly large kittens as well as those with unusual posture, appearance, or position. A common cause of dystocia is kitten enlargement, which can happen with protracted pregnancy in abnormally small litters. Typically, kittens are presented posteriorly, with their rear feet first. Additionally, malformed kittens could get trapped in the birth canal.
• Abnormalities of the uterus (womb): They are unusual in cats, but they can occur in older queens who are above 5 years old (if this is their first pregnancy) or 8 years old (if they have had numerous pregnancies). Abnormalities include poor contraction of the uterine muscles, abnormalities pertaining to the mother's or fetus's fluids, and twisting or rupture of the uterus. In certain situations, the uterine muscles never fully contract, necessitating a Caesarean procedure to deliver the kittens. Sometimes the contractions stop but the labor continues as usual. A Caesarean section might still be necessary even if intravenous glucose and pharmaceutical solutions might help to trigger uterine contractions.
• Disorders of the birth canal: previous damage to the pelvis such as healed fractures, or developmental defects can make the birth canal narrow, which can cause obstruction particularly with large kittens.

Together with a thorough medical examination, your veterinarian will want to know exactly when your cat was bred, as well as any events pertaining to labor. Examining the birth canal for anomalies or the possibility of a kitten being lodged there will be part of this procedure. The detection of fetal heartbeats may be possible with a hand-held ultrasound, and the assessment of kitten viability, litter size, and kitten position can be greatly aided by abdominal ultrasonography and X-rays. Measuring blood levels of glucose and calcium can also be useful in identifying metabolic diseases that are linked to dystocia. Your veterinarian can advise you on whether a Caesarean section is likely to be in the mother and kittens' best interests based on this information.

The term "uterine inertia" refers to inadequate womb contraction. The uterus never contracts when there is primary uterine inertia. In this instance, a queen will exhibit the initial indications of labor but never go past them. In order to induce uterine contractions, your veterinarian would need to provide an injection. If this doesn't work, a Caesarean delivery might be required.

The queen experiences secondary uterine inertia following childbirth. The contractions may stop before the entire litter is delivered, but it is likely that one or more kittens have already been born.A possible cause of this could be muscle fatigue or obstruction. Veterinarian treatment should be sought as soon as possible because this sickness usually requires a Caesarean delivery and may improve with intravenous therapy, depending on the underlying cause.

With the help of your veterinarian surgeon, your queen should be able to give birth to a healthy litter of kittens. By providing the kitten or queen with proper and fast care, early diagnosis of concerns can help prevent any life-threatening emergency.