DIFFICULT DELIVERY (DYSTOCIA)
Difficult deliveries are usually caused either by obstruction of delivery of the fetus, or by uterine inertia (see below). Dystocia must usually be treated with the help of a veterinarian. If any of the stages of labor seem abnormally long, if large amounts of fresh blood and/or blood clots are expelled from the vagina for more than ten minutes, or if your cat shows signs of excessive discomfort or extreme quietness, call your veterinarian.
If you can see a kitten at the vulva, but delivery seems slow or the kitten appears and disappears, you may be able to help delivery. Wash your hands and lubricate a finger with a lubricant such as sterile petrolatum or sterile water-soluble jelly. Insert your finger into the vaginal canal and move it around the kitten, trying to determine where the head and the front and rear legs are. You may be able to hook a front leg in an abnormal backward position and bring it forward. If the kitten seems fairly normally placed (see illustration), grasp him or her with a gauze pad, clean cloth, or your fingers and gently pull with each contraction. It is best to try to grasp the kitten around the shoulders to avoid excessive pressure on the head, and it is best to pull downward because the vagina is angled toward the ground.
Do not pull on the amniotic sac surrounding the kitten. If the kitten’s head just seems too big to fit through the vulva, you can sometimes gently manipulate the edges of the vulva around the head. A veterinarian will sometimes make an incision at the upper part of the vulvar opening to enlarge it. It is not advisable to perform this procedure at home unless it is impossible to get veterinary help.
If a retained placenta blocks delivery of a kitten, you can often reach it.
Grasp it with a gauze pad or clean cloth and gently but firmly pull until it passes out of the vaginal canal. Once an obstruction to delivery is relieved, a female will often have a prolonged rest period before the next kitten is delivered.
Failure of the uterus to contract efficiently (uterine inertia) may occur following prolonged straining to deliver a kitten or may be a primary problem, as in the case of an obese or older cat. A form of uterine inertia can be caused by excessive excitement, or by other psychological stresses during delivery. This is why it is important to familiarize your cat with the maternity area well before delivery. It is also why strangers should not be present during delivery unless the cat is extremely calm about them.
A labor inhibited by psychogenic stresses can often be helped by having only one or two familiar people remain with the cat during delivery. Rarely, tranquilizers will be necessary. If you suspect uterine inertia, call your veterinarian for advice.
If no obstruction to delivery is found, your veterinarian may have to administer a drug called oxytocin to initiate new uterine contractions. Other drugs may be administered as well. If medical therapy does not initiate proper birth or there is some other problem that cannot be relieved with external manipulations, your veterinarian will want to perform a cesarean section—surgery in which the kittens are removed through incisions in the abdomen and uterus. It is usually possible to spay your female at the time of such surgery. Unless the difficult birth is solely attributable to the kittens’ abnormalities it is probably best to have the spaying done. Mothers who have difficult deliveries tend to repeat them. Most queens are able to nurse and care for their kittens normally following cesarean surgery.