Kittening/queening in cats – potential problems

Giving birth is a completely natural process for female cats, just like it is for women. In most cases the delivery will go smoothly and your cat will manage without any interference. However, you should keep a watchful eye on the labor as problems can occur. If your cat is having problems, then early intervention could save her life as well as that of the kittens.

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When cats give birth we say that they are ‘queening’ or ‘kittening’ and there are three recognized stages:

• Stage 1: this can last up to 36 hours in first time kittening queens, but usually lasts between 2 – 12 hours, during which time the queen may show changes in her behavior. The queen becomes restless, vocalizes, kneads bedding and licks her back end. She may want to hide away or want more attention. Panting may occur during this stage. In this phase the uterus (womb) is contracting and the cervix is dilating. Sometimes you can see kitten movements through the abdominal wall. Although you might see a mucus like discharge from the vulva (around the back end of the queen), no visible abdominal contractions are evident.
• 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: this is the delivery of the placenta. Cats often deliver kittens and placenta alternately until the delivery is complete, but sometimes 2 kittens will be born and then 2 placentae. Try to keep a check that the same numbers of placentas and kittens have been delivered at the end. The queen may eat the placenta straight from her back end, and she may chew the umbilical cord to sever it. If not, you should break the umbilical cord by tearing it (rather than cutting it) between 2 fingers approximately 1cm below the attachment to the kitten’s abdomen.

‘Dystocia’ is the inability to expel a kitten through the birth canal. Most cats have relatively few problems compared to women and give birth without a problem, however problems can arise, and some breeds, eg flat faced breeds like Persians can have more problems. The queen may be in trouble if she is straining for a long time (more than 30 minutes) and no kitten is born – or if she strains for a while and then stops straining without producing a kitten or placenta. If you think that your queen is having trouble delivering a kitten you should contact your veterinarian for advice immediately. The early diagnosis and treatment of dystocia can prevent the loss of kittens, and perhaps 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 veterinarian 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).
  • Fetal 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 veterinarian 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 due to either a problem with the mother or with kitten size or position.

• Kitten abnormalities: include kittens that are too large or in an abnormal position, presentation or posture. Kitten oversize can occur with prolonged pregnancy in abnormally small litters and is a common cause of dystocia. Kittens are normally born in posterior (back feet first) presentation. Deformed kittens may also become stuck in the birth canal.
• Abnormalities of the uterus (womb): this is rare in the cat but can be seen in older queens over 5 years old (if first pregnancy) or 8 years old (had multiple pregnancies). Abnormalities include poor contraction of the muscles of the uterus, abnormalities associated with fetal or maternal fluids or twisting or rupture of the uterus. Sometimes the uterine muscles never start to contract properly and a Cesarean operation must be performed to deliver the kittens. In some cases labor may develop normally but then contractions cease. Intravenous solutions containing glucose and drugs may help to stimulate contractions of the uterus, but a Cesarean operation may still be necessary.
• 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.

Your veterinarian will want to have an accurate history about when your cat was bred, as well as any events surrounding labor and will perform a careful physical examination. This will include examination of the birth canal for any abnormalities or the presence of a kitten stuck in the birth canal. A hand held ultrasound may allow detection of fetal heart beats and abdominal ultrasound and X-rays can be very helpful in assessing kitten viability, litter size and kitten position. Blood tests to measure calcium and glucose levels are also helpful in identifying metabolic disorders contributing to dystocia. With this information your veterinarian will be able to advise you on whether a Cesarean operation is likely to be in the best interests of the mother and the kittens.

Uterine inertia simply means that the womb is not contracting adequately. Primary uterine inertia means that the uterus never starts contracting. In this case a queen will show the first signs of labor but never progress beyond this. Your veterinarian may need to give an injection to try to stimulate uterine contraction or, if this fails to work, then a Cesarean delivery may be needed.

Secondary uterine inertia occurs after the queen has been in labor for some time. One or more kittens may have been born but then contractions stop before all kittens have been delivered. This may occur due to obstruction or muscle fatigue. Veterinary attention should be sought immediately as depending on the cause, this condition may respond to intravenous treatments but often means that a Cesarean delivery is needed.

With help from your veterinarian, your queen should be able to produce a healthy litter of kittens. Early diagnosis of problems will help prevent any life-threatening emergency, to kitten or queen by suitable and timely treatment.