Alexandria with one of her seven kittens, 9 weeks old
many authors believe that problems in parturition are rare
in the cat, others feel that with the progression of selective
breeding these problems are becoming more common. The effect
of this has been shown in a survey of over 700 breeding cats,
which found that cats with extremes of conformation, such
as Siamese and Persians, experienced much higher levels
of dystocia (difficult births), 10 per cent and 7.1 per cent
of births being affected respectively, compared to only 2.3
per cent of births being affected in cats with normal conformation.
It is therefore very important that breeders are aware of
the details of normal parturition, so that they can recognise
a problem when it arises.
pregnancy, the foetuses are spaced along each horn of the
uterus. Each foetus is contained within its own membranes
and has its own placenta through which it derives nourishment.
The uterus may be considered as a muscular, sausage-shaped
bag, capable of contracting both around its diameter and along
its length. To help in its passage, each foetus is contained
within a fairly tough double-layered bag of foetal membranes,
which are filled with slippery fluid in which the foetus floats.
This serves as both protection and lubrication, and provides
a distending, stretching and dilating force when the uterus
relaxes in front of it and contracts behind it during the
course of parturition.
pregnancy and premonitory signs of parturition
the cat pregnancy generally lasts for 63 to 65 days; however,
it is not unusual for some cats to carry a normal litter for
either a shorter or longer time (range 58 to 70 days).
cat's behaviour alters little until the final week of the
pregnancy. During that final week the search for the most
suitable kittening bed becomes the dominant factor. Cats should
be confined from this time to allow for observation of labour.
two types of temperament are seen in cats at kittening: the
independent type which will go to extreme lengths to discover
a dark enclosed space well away from human contact, and the
dependent type which will go to equal lengths to seek comfort
in the presence of its owner and may well choose the owner's
bed as the best place for kittening.
stages of parturition
is generally described in its classical three stages, although
in the cat the second and third stages are repeated with each
kitten and the third stage is brief and nearly continuous
with the second.
is essentially the stage of relaxation of the cervix and vagina
and the start of intermittent contraction of the uterus. Uterine
contractions must always be interrupted by periods of relaxation,
otherwise the foetal blood supply would
be cut off. The pelvic muscles slacken and the perineum (the area between the anus and vulva) becomes
looser and longer. Uterine contractions are not yet observable
as straining, although movement of the foetuses may be felt
through the abdominal wall. There is little else to see at
this stage except repeated visits to the prospective kittening
bed, and in the dependent type cat, an apparent desire for
reassurance from the owner. Some scratching up and bed-making
occurs, and panting may be seen as a late first stage feature.
Vaginal discharge is rarely seen and is usually licked away
promptly by the cat. In the primagravida, or cat kittening
for the first time, the first stage can be very prolonged,
even lasting up to 36 hours without being abnormal.
second and third stages
the relaxation of the first stage, the uterine contractions
become stronger and more frequent and drive the first foetus,
contained within its membranes, towards and into the pelvic
opening. As the first foetus enters the pelvis, the outer
layer of the foetal membranes appears briefly at the vulva
as the 'water bag', which bursts and sheds some fluid which
is usually cleared up by the cat. The inner layer passes into
the pelvis and retains some of the fluid which acts as a continuing
lubricant to assist the passage of the foetus.
pressure plays a very important part in birth. It is this
which causes dilation of the already relaxed cervix and vaginal
passage. As the fluid-filled membranes press onwards towards
the vulva, they are followed by the wedge-shaped head of the
foetus, which, by the time the water bag is at the vulva,
is just beginning to fit into the pelvic entrance in an already
rotated position. During its development the foetus has been
lying on its back within the membranes, whereas at birth the
kitten usually emerges the right way up.
seems that the foetus itself plays a part in this rotation,
which is a simple swing on its long axis together with an
extension of its head, neck and limbs. If the foetus dies
before the moment of engaging the pelvis it remains unrotated.
In the normal case, as the foetal head comes fully into the
pelvis, its pressure causes the commencement of voluntary
straining using the abdominal muscles. This 'bearing down'
helps to transit the foetus through the pelvis. This is usually
the point at which the attendant can see that the cat is actually
straining. Normally, delivery of a kitten from the commencement
of the second stage may take from 5 to 30 minutes. Once the
head is out of the vulva, one or two more strains should complete
the passage of the narrower remainder of the kitten's body.
stage follows immediately and is seen simply as the passage
of the membranes, complete with the dark flesh coloured mass
of separated placenta, as the 'after-birth'. It is also the
stage of involution, where the segment of the uterus from
which the kitten came contracts back into shape and shortens.
each set of membranes is passed immediately after each kitten.
However, sometimes a second kitten will follow so quickly
from the opposite uterine horn that the membranes from the
first will be trapped temporarily and the two sets will be
each kitten is born the cat will tear open the membranes and
clear the mouth and nose area of the kitten, biting off the
umbilical cord and subsequently eating the after-birth. Second
and third stages of labour are repeated as each kitten is
born. Intervals between kittens are variable, from as little
as 10 minutes to up to an hour in the average case. Delivery
times vary, with short haired cats generally taking less time
than longhaired cats, especially Persians. While cats usually
have an average of four kittens in each litter, this can range
from one to 12 kittens. Larger litters are seen more frequently
in Oriental, Siamese and Burmese breeds.
interrupted labour is common enough in the cat to be considered
a normal occurrence. In this case, when one or more kittens
have been born, the mother will cease straining and rest quite
happily, suckling those kittens already born. She will accept
food and drink and is in every way completely normal except
that it is obvious from her size and shape, and the presence
of foetal movement, that there are still kittens waiting to
be born. Some rather dependent cats will deliberately delay
or interrupt labour if the owner has to go out. This resting
stage may last up to 24 or even 36 hours, after which straining
recommences and the remainder of the litter is born quite
normally and easily.
of labour - dystocia
(difficult birth) can be classified as either maternal or
foetal in origin, depending on whether it is caused by problems
with the queen or kittens. Dystocia can also be classified
according to whether it arises from obstruction of the birth
canal or a functional deficiency of the uterine muscle.
dystocia is caused by disproportion between the
size of the kittens and the maternal birth canal. Factors
resulting in an inadequate size of the maternal birth canal
may include disorders of the maternal skeleton (healed pelvic
fractures), the pelvic soft tissues (severe constipation),
or the uterus itself (uterine torsion or rupture). Foetal
causes of obstructive dystocia may result from malpresentation,
severe foetal malformation (eg, hydrocephalus, Siamese-twins),
foetal oversize or foetal death.
dystocia is usually termed inertia, and can be either
primary or secondary. Primary inertia is by far the most common
cause of dystocia in cats. It is seen when the uterus produces
none, or only weak, infrequent contractions and there is a
failure of expulsion of normal kittens though a normal birth
canal. Primary inertia may be related to stress, old age,
obesity, ill health or the administration of certain drugs.
It has been suggested that very small or very large litters
may result respectively in inadequate or excessive uterine
distension, and that this may result in primary inertia. However,
recent work found no difference between the litter size of
cats with dystocia due to primary inertia and the litter size
of cats with dystocia for other reasons. Primary inertia due
to stress, also termed 'hysterical inertia', is not uncommon,
and is seen particularly in the Oriental, Siamese and Burmese
breeds. In this condition extreme apprehension during the
first stage causes all progress to cease. The affected cat
is markedly and vocally distressed, crying constantly and
demanding attention. She may be positively hysterical, and
in such cases immediate relief may be obtained by the use
of tranquillisers. In an emergency this would be administered
by a veterinary surgeon by injection, but if the cat in question
is known to behave in this fashion, the breeder may be equipped
with tablets which can be given by mouth at the start and
will be equally effective.
of the first stage
of the first stage can include all forms of primary inertia,
and occasional rare disorders, such as torsion or rupture
of the uterus. These latter two conditions can result in major
emergencies in late pregnancy or first stage labour. Torsion
implies a twisting of the uterus, cutting off its blood supply,
and making delivery of the contained foetus or foetuses impossible.
It also causes what is quite obviously an acute emergency
with a very ill and shocked cat. Torsion is usually presumed
to have occurred during jumping or some violent movement which
imparts a swinging motion to the heavily gravid uterus. Rupture
is more usually the result of an accidental blow from a vehicle
or other violent trauma, or can occur from violent straining
upon a complete obstruction. A rupture occurring at the time
of parturition will give rise to the same signs of acute emergency
as a torsion. It has been known for rupture to occur early
in pregnancy and for the foetus(es) to continue to develop
outside the uterus in the maternal abdominal cavity. In these
cases the placenta becomes attached to one of the abdominal
organs but it is unusual for such foetuses to develop to full
term and, of course, impossible for them to be born without
an abdominal operation.
of the second stage
inertia arises after prolonged second-stage labour, and
may be associated with obstructive dystocia, muscle fatigue,
or excessive pain. Obstructive dystocia may occur for many
reasons; but probably the most common causes are maternal
pelvic malformation following a pelvic fracture, and foetal
malpresentation/malposition/ malposture. Interrupted labour,
as already described, is definitely not an inertia, as the
cat is manifestly normal, labour recommences normally, and
kittens are born alive and normal. An important point of difference
between the two is that secondary inertia follows previous
difficulty or delay and the cat is often restless and exhausted.
malpresentations, malpositions and malpostures may all lead
to dystocia. Presentation indicates which way round the foetus
is coming (ie, head or tail first), position indicates which
way up it is (ie, rotated or unrotated) and posture indicates
the placing of the head and limbs (ie, extended or flexed).
Some people believe that foetal malpresentation in cats rarely
causes dystocia, except when combined with other problems
such as poor cervical relaxation or relative foetal oversize.
However, others have found foetal malpresentation to be the
most common cause of dystocia of foetal origin, while relative
foetal oversize was very rare.
presented, or tail-first, kittens occur quite frequently,
so much so that this could almost be considered a normal presentation,
often causing no delay in birth. If, however, the first kitten
comes tail-first there may well be delay owing to the absence
of the wedge-shaped head pushing behind the fluid-filled membranes.
The kitten is usually passed eventually. However, it does
have an increased risk of drowning in its own foetal fluids
if the time from placental separation to when its nose is
free from its membranes is too prolonged.
usually occurs when a kitten has died in utero prior to rotation.
It is uncommon except in cases of illness, infection or prolonged
delay in a late-coming foetus. The presence of a dead foetus
within the maternal pelvic canal can, in itself, result in
functional or obstructive dystocia.
is of most importance in relation to the position of the head.
Brachycephalic cats may have difficulty at the point where
the foetal head first engages the opening of the maternal
pelvis. The lack of a wedge-shaped muzzle increases the risk
of the head becoming deflected to one side, downwards between
the forelegs, or onto the chest. Occasionally, one or both
forelegs may lie back along the body, and in posterior or
tail-first presentation one or both hind legs may be retained
forwards alongside the body to give the breech posture. All
of these situations may give rise to either a temporary delay
and necessitate extra efforts by the cat or, at worst, result
in complete obstruction.
late manifestation of inhibitory hysterical behaviour may
cause delay when the kitten is already through the maternal
pelvis and protruding through the vulva. This may cause some
pain, so at this point the cat appears to give up trying and
waits for, or demands, help. If this is not immediately forthcoming,
the particular kitten involved may die, especially if it is
coming tail first.
above was a rather daunting, but by no means exhaustive, list
of what can, but rarely does, go wrong. Breeders or owners
may want to know what can be done to recognise trouble early
and how it can be avoided or overcome.
cannot be too firmly stressed that a normal cat needs no intervention.
The good midwife is essentially a good and unobtrusive observer
until trouble occurs. Midwives should have provided, as far
as possible, the ideal kittening bed which should be warm,
comfortable and safe, but should also be observable, ie, a
happy medium between confinement and relative freedom within
the confined area. During the first stage of labour they may
need to provide either moral support or remain unobtrusive
as dictated by events. They should have at their fingertips
a history of any previous births by the cat in question and,
if possible, information relating to earlier generations and
related animals. They should have observed the changes during
pregnancy and be aware of the degree of abdominal distension,
amount of fluid, and perhaps have a rough idea of the number
of kittens to be expected. They should have been looking for
behavioural changes in the queen, such as nest-making or visits
to such desirable spots as in the owner's bed or in the airing
cupboard. Facilities for help or examination should be at
hand if needed (convenient table, access to running warm water,
soap and towel). Internal examination is resented by most
unsedated cats and should not be undertaken by the unskilled.
If problems are anticipated the veterinary surgeon should
have been alerted and given the probable parturition date
before the event and informed of the start of labour so that
if a call for help becomes necessary it is expected and can
be promptly answered.
from the value of observations and knowledge of the behaviour
of the cat, breeders can, and in some cases must, be responsible
for the treatment of some parturition problems. The secret,
if there is one, of the recognition of trouble lies mainly
in the recognition of delay. The hysterical dependent cat
is obvious enough and easy enough to deal with, provided the
necessary tranquilliser is at hand. Identification of delays
later in the course of kittening will again involve observation
of behaviour. In the case of the normal interrupted labour
it will be evident that the cat is in no distress, has a normal
appetite and is perfectly happy with the kittens already born.
Straining in the course of a normal parturition, while it
may or may not be vigorous, is clearly productive in moving
the kitten along and does not appear to give rise to pain.
Obstruction, on the other hand, shows as a cat that strains
without producing any results, may pant, cry, or appear exhausted,
is restless and unsettled, and finally desists in an attempt
to recover sufficient strength for a further, although decreased
effort. This is the cat that requires help.
from the outside around the perineal area under the tail will
indicate if a kitten is already through the pelvis, and a
view of nose or feet and tail at the vulva indicates that
birth must be imminent if the kitten is to live. If no progress
is being made and the kitten is clearly visible, it is up
to the breeder to give immediate help since, unless the veterinary
surgeon literally lives on the premises, veterinary help may
not arrive in time for that particular kitten. If nothing
can be felt at the vulva and the hold-up is evidently further
forward, then it is time to send for professional help.
and treatment of the serious dystocia must be in the hands
of the veterinary surgeon. Because of the small size of the
cat, manipulative correction of malpostures from within the
vagina is rarely possible and is in any case a job for skilled hands. To compensate for this, manipulation from outside
the abdomen can often correct a malposture such as a laterally
deflected head; again professional skill is needed. Often,
in any real hold-up, a Caesarian operation is the preferred
method and provided that the cat is neither desperately ill
nor very exhausted, it is a safe and routine procedure. Present-day
methods of anaesthesia are much less likely to depress respiration
in the kitten than was once the case, and even in major crises
the cat's ability to survive an acute abdominal emergency
is exceedingly good and surgery is always worthwhile.
case where the breeder has to help is that of the cat who
gives up trying with a kitten hanging visibly from her vulva.
If it is coming head first, the first urgency is to clear
the membranes away from its nose and mouth to allow breathing
to take place. The kitten must then be eased gently out, alternating
the direction of traction, first freeing one side then the
other, and always directing the pull slightly downwards. Since
kittens are slippery and wet at birth, clean pieces of towelling
or soft paper towels may help to get a grip. If the kitten
has only the tail and hind-legs showing, delivery is even
more urgent and the problem of holding the slippery subject
more difficult, but the same principle applies. Hold the hind-legs
above the hocks, ease gently to alternate sides, and if progress
is not made with the aid of a strain or two on the cat's part,
try gentle rotation through a few degrees before continuing
the easing-out process alternating the direction of pull.
Pull and traction are probably misleading words to use here
to convey the sensitivity required to co-operate with the
cat as she strains and rests momentarily in between, so that
progress continues without fear of injury to cat or kitten.
Make haste slowly. Immediately the kitten is out clear the
mouth and nose of all membranes and fluid.
of kitten revival
normal mother cat will generally make a much better job of
cleaning and drying her kittens than any human, so do not
interfere unless necessary. If, however, a kitten has had
to be helped out and is not breathing, or on those few occasions
when the maternal instinct appears to be lacking and the kitten
is ignored, reviving it becomes a matter of urgency. Observation
of the cat's own methods show the order in which to imitate
them to the best advantage. The cat's first act is to see
that the kitten's nose and mouth are clear. Next with a nipping/licking
action the cat picks up, then chews through, the umbilical
cord and in the process provides a stimulation to the abdominal
navel area, getting respiration going. If this is not sufficient,
a vigorous licking massage of this area follows. Finally a
more general drying lick and some attention to the posterior
part of the abdomen and anal area is given to start the bowel
and bladder movement going. Then, if it is needed, a nudge
towards the maternal nipples. The human imitation can follow
much the same plan with additions in real emergency.
Tear the membranes from the nose, wipe the nose and open the
mouth, tilt the kitten head down and clear away any fluid.
If the cord has not broken on delivery, tear it a good inch
from the kitten and remove the membranes. Complicated cutting
and tying of the cord are not necessary. The cat would chew
it through, providing a blunt crushing action to prevent bleeding;
tearing it between the first two fingers and thumb does
much the same thing. The kitten should be supported and the
cord held at the kitten end so that the risk of pulling on
the kitten is minimised.
If the kitten is not breathing and obviously vigorous, or
if it has come tail first and possibly inhaled fluid, it is
necessary to clear debris and fluid from the air passages.
If gentle suction equipment is available this can be done by sucking
debris out of the airway. This can also be achieved using
a Jackson cat urinary catheter attached to a 5-10ml syringe.
This can also be used to induced the kitten to sneeze and
cough by stimulating its nose/throat. One of the traditionally
used methods involves swinging the kitten. To do this, place
the kitten in the palm of the hand, its back towards the palm
and neck between forefinger and third finger, its head protruding
between the fingers. Enclose the kitten in the fingers and,
turning the hand palm downwards with the arm extended, give
a very gentle swing; make quite sure first that you
are not too near the table or other protruding edge or disaster
will follow. The swing will have the effect of forcing fluids
out of the air passages and a further wipe of nose and mouth
will clear it away. The swing will also serve to stimulate
respiration. Take care; if performed too vigorously this method
can result in brain haemorrhage.
The next move imitates the licking of the abdominal wall and
stimulates respiration. It comprises a stroking, rubbing movement
with a clean towel. Assuming that the kitten is by now showing
regular breathing, this can be followed by a brisk general
rub dry. If the kitten is not is not breathing, some form of artificial respiration may be necessary. Mouth-to-mouth
respiration can be useful, but only if very carefully carried
out. There are several essential points to remember. It is
no use blowing fluids and debris further down; these must
be cleared away first (see above). Secondly, the capacity
of kitten lungs compared to the human is minute. Blow
very gently and allow a pause for expiration. Repeat this
cycle every three to five seconds. Breathing into the kitten's
airway through a small endotracheal tube or drinking straw
may help to reduce the risk of over-inflating the kitten's
lungs, and be more hygienic than direct mouth-to-mouth. Various
other methods have been used to make the new-born animal gasp.
Among these may by listed brandy or other spirits transferred
via a fingertip to the tongue, flicking the chest sharply
but gently with a fingertip, and alternate hot and cold water
some of these techniques may work, a more reliable treatment
is the application of a drop of doxapram to the underside
of the kitten's tongue. If in doubt persist with stimulating
the kitten; some can still be revived over 30 mins from birth.
That said, the longer the duration before breathing, the higher
the risk of hypoxia causing brain damage or blindness.
is a primary essential for the newborn. The kitten cannot
react to cold by shivering and cannot control its own body
temperature. Normally, warmth would be obtained by direct
body contact with the mother and conserved by the maternal
choice of an enclosed kittening bed. The first point to remember
if help is required is that a newborn wet kitten loses heat
very rapidly, hence the brisk rub dry. Follow this, if the
mother is ill or not co-operative, by contact with a warm,
well-covered hot water bottle and conserve heat with a covering
blanket. Great care must be taken not to inflict contact burns
by having the bottle too hot. An acceptable alternative is
the infra-red lamp widely used for pigs and puppies and readily
obtainable. Its disadvantages are that many cats dislike the
open bed required for its use, and that it may make both mother
and kittens too hot and lessen the close normal nursing contact
between cat and kittens.
significance of congenital defects
defects that are obvious at the time of birth, and may be
involved in dystocia, include:
Severe hydrocephalus with marked skull enlargement.
Anasarca or generalised oedema (waterlogging of the tissues).
Spina bifida or incomplete development of the dorsal body
Hernia or incomplete development of the ventral body wall.
Gross deformity or absence of limbs.
serious inherited abnormalities are not obvious at birth and
abnormalities of eyes, hearing and heart fall into this category.
Suspected abnormalities of joints and limbs should be viewed
with caution unless utterly self-evident such as severe shortening
of a limb. Joints at birth are very incomplete structures
and most apparent 'double-jointedness' or rotation of limbs
right themselves by the time the kitten is really becoming
mobile. The most difficult decision usually concerns the kitten
persistently rejected by its mother, despite its apparent
normality. The choice in this case lies between hand rearing,
fostering or destruction, and in this connection it should
be remembered that the completely hand-reared kitten will
be at a disadvantage in its behavioural responses to its own
species (see Hand rearing kittens). The decision can only be made by the breeder after
full consideration of the circumstances. An additional consideration
is that the rejected kitten may well be a defective kitten
('mother may know best') in which case hand rearing will not
or puerperal complications
of foetal membranes
a cat may fail to pass the final set of foetal membranes after
parturition appears to be complete. She will probably show
some signs of restlessness and of abdominal discomfort and
may be unwilling to settle with her kittens during the 24-72
hours after parturition. Her appetite will probably be poor
and a brownish vaginal discharge may be seen. Examination
will show a raised temperature and palpation through the abdominal
wall will disclose a thickened lumpy area of womb containing
the membranes. Broad-spectrum antibiotic cover is necessary
and prostaglandin F2-alpha may help to induce expulsion of
the retained membranes. If this fails, an emergency ovariohysterectomy
(spay) may be required.
(inflammation of the uterus) occurs occasionally, usually
within three days of parturition. The cat is much more obviously
ill than with simple retention of foetal membranes. She will
be dull and lethargic, ignore her kittens, refuse food, become
polydipsic, and may vomit. A purulent, foul-smelling vaginal
discharge is present along with fever. Abdominal palpation
may cause the queen pain and the uterus usually feels thickened.
Antibiotics should ideally be chosen according to culture
and sensitivity. However, first line treatment usually consists
of a broad-spectrum antibiotic, eg, amoxycillin-clavulanic
acid, or a cephalosporin. If this fails, an emergency ovariohysterectomy
(spay) may be required.
prolapse describes the telescoping of the uterus which then
protrudes from the vulva. It occurs rarely, where it is seen
as an acute post-parturient emergency. The appearance of the
invaginated uterus at the vulva is self-evident. Initially
the cat is noticed to be straining and uncomfortable despite
the completion of parturition. If treatment is delayed the
cat will rapidly become dull, shocked and lethargic, in a
similar manner to the animal with a uterine rupture. Uterine
prolapse constitutes an emergency requiring immediate medical
support and surgical intervention.
(inflammation of the mammary glands), as an acute suppurative
form, sometimes occurs during early lactation. It is usually
confined to one gland and may follow a simple congestion or
overstocking. The affected gland will be tense, hot, painful
and enlarged. If it is only congested, the application of
heat and subsequent gentle massage will bring normal milk
out of the teat orifice, and the situation may be speedily
relieved by milking the gland concerned. If an abscess is
present, the cat will become anorexic, dull and feverish,
and in addition to pain and swelling in the gland, a pointing,
or purplish area of fluid pressure from the accumulation of
pus will be seen. Antibiotics are essential. While, ideally,
they should be chosen according to culture and sensitivity,
first line treatment usually consists of a broad-spectrum
antibiotic, eg, amoxycillin-clavulanic acid, or a cephalosporin.
tetany could, in theory, occur during, or at any time after,
parturition. Early cases are well known in the bitch. However,
in the cat, most cases have been recorded later in lactation,
17 days to eight weeks post-kittening being most typical.
While the precise causes of the condition are not known, it
involves a sudden drop in the amount of calcium circulating
in the blood stream. It is undoubtedly connected with the
demands of milk production and the affected cat usually has
a fairly large litter to suckle. The first signs of the onset
of the condition usually include incoordination and tetanic
muscular spasms with later collapse and coma. Treatment by
the intravenous injection of calcium preparations leads to
a spectacular reversal of the condition. A later subcutaneous
injection may be required to maintain the recovery. Kittens
should be removed from the cat if old enough, otherwise their
numbers must be reduced or supplementary feeding given. Any
affected cat should only be allowed to rear a small number
of kittens at any subsequent litter. Lactation tetany often
occurs after each kittening so this fact must be remembered
when considering the advisability of breeding again and taking
prophylactic measures, or alternatively of neutering.
The late Jane Burton of Warren
Photographic, supplied the beautiful pictures.
Updated November 2008