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Dystocia: fetal

ISSN 2398-2950

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Introduction

  • Abnormal parturition/prolonged gestation (more than 65 days).
  • Cause:
    • Fetal oversize or deformity, eg hydrocephalus, conjoined twins.
    • Abnormal fetal presentation, position or posture.
    • Single kitten pregnancy.
  • Signs: abnormal parturition/gestation, strong contraction for >1 hour without birth of kitten.
  • Diagnosis: history, clinical signs, vaginal digital examination, ultrasonography, radiography, vaginoscopy.
  • Treatment: dependent on cause of dystocia; most likely will result in a Caesarean section.
  • Prognosis: good for future fertility; guarded for neonatal survival.

Presenting signs

  • Abnormal parturition Parturition/gestation Pregnancy-gestation.
  • Noticeable abdominal contractions for >1 hour without the birth of a kitten.
  • Strong contractions for 2-3 hours after the birth of a kitten.
  • Presence of milk (not always a presenting sign on primparous queens).

Cost considerations

  • Initial examination, radiology and ultrasound plus possible Caesarean section and after-care.

Special risks

  • Inaccuracies in calculating gestation period may cause delivery of premature kittens (but this is much less likely than in bitches as copulation tends to be more closely associated with ovulation in the cat).
  • Usual anesthetic risks for neonates after Caesarean section Cesarean section.

Pathogenesis

Etiology

  • Fetal oversize (genetic predispostion/single kitten).
  • Fetal deformity.
  • Fetal malpresentation/position/posture.
  • Fetal death.
  • Insufficient fetal fluids.
  • Inadequate fetal ACTH stimulus  →  failure to initiate parturition (single kitten pregnancy).

Predisposing factors

General

  • Fetal size.
  • Litter size.
  • Breed (incidence of dystocia more common in brachycephalic breeds than in dolichocephalic breeds).
  • Stress.

Pathophysiology

  • Physiology of feline parturition Parturition has not been well researched, but is likely similar to other mammals.
  • Dystocia may be due to single kitten syndrome, abnormal presentation/position/posture or fetal oversize/deformity. 
  • Single kitten pregnancy  →  primary uterine atony  →  failure to initiate parturition.
  • Posterior presentation is normal in felids - as in other polytocous animals.
  • Fetal malposture (eg shoulder flexion or even breech posture) may not prevent birth in many queens.
  • Fetal oversize/malposture/malposition  →  impacted birth canal  →  myometrial fatigue  →  secondary uterine atony.

Timecourse

  • 3-4 hours after the onset of parturition in cases of secondary uterine inertia brought on by fetal dystocia.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Holst B S, Axnér E, Öhlund M et al (2017) Dystocia in the cat evaluated using an insurance database. J Feline Med Surg 19 (1), 42-47 PubMed.
  • Smith F O (2012) Guide to emergency interception during parturition in the dog and cat. Vet Clin North Am Small Anim Pract 42 (3), 489-499 PubMed.
  • Pretzer S D (2008) Medical management of canine and feline dystocia. Theriogenology 70 (3), 332-336 PubMed.
  • Traas A M (2008) Surgical management of canine and feline dystocia. Theriogenology 70 (3), 337-342 PubMed.