Dystocia is defined as an abnormal or difficult labour. Causes of dystocia can be classified as maternal or fetal. Some are listed below;

Maternal

• Narrow pelvis.
• Misshapen pelvis (from fracture etc).
• Pelvic obstruction.
• Uterine inertia. This may be primary or secondary (exhaustive). Primary inertia is when the uterus fails to produce any contractions or only weak contractions from the onset of labour.  Primary inertia  may be the result of poor health, obesity, age, stress. Some queens become nervous & highly strung during labour (known as hysterical inertia). This is seen more commonly in oriental breeds such as Siamese, Orientals.   Secondary inertia is the result of a long second stage resulting in uterine fatigue. Contractions start strong but becoming progressively weaker.
• Uterine torsion (twisting) or rupture.

Fetal:

• Abnormally presented kitten.
• Excessive fetal size (often seen in small litters or one or two).
• Excessive fetal head size (often seen in brachycephalic breeds such as Persians).
• Malformation of the fetus.
• Fetal death.

Stages of labour:

First stage labour:

Birth begins with the onset of uterine contractions. During this stage the cervix begins to dilate (open). A clear, odourless discharge from the vagina is usually apparent. This discharge is known as the mucus plug & was in the cervix during pregnancy sealing the uterus from the vagina. As the first stage progresses, contractions will become closer & closer together.

Second stage labour:

Contractions become stronger & closer together & the cervix is fully dilated. The queen is ready to give birth. The kitten moves down the birth canal. Pressure   on the cervix initiates an urge to push from the mother. You may see her visibly straining to push the kitten out.  The kitten's water bag (or bubble) is normally seen at the vulva, these burst & some fluid will be cleaned up by the queen. It takes around three pushes for the kitten to be delivered.

The queen will tear & lick the membranes from the face & body which will stimulate breathing.

Second stage usually takes around 5 minutes to 1 hour. If a hasn't been born after an hour it is time to call your veterinarian.

Third stage labour:

Immediately following the kitten's birth, the placenta is normally delivered. Once the queen has cleaned the kitten & breathing has commenced normally the queen will chew the umbilical cord in two & quite often will eat the placenta.

Note: When the kitten has been delivered it is important that you pay attention to the delivery of the placenta. Even have a pen & paper close so you can make a note of how many placentas have been delivered, if you feel you may lose track due to the excitement of the birth. This is important because a retained placenta will lead to infection which is life threatening.

What are the signs of dystocia in cats?

• Gestation lasting longer than 70 days
• Stage 1 labour lasting longer than 24 hours
• 20 minutes of intense labour without birth.
• Straining for 10 minutes if a fetus or a fluid filled bubble is  visible in the birth canal
• Acute depression
• Fever (above 103°F)
• Sudden discharge from the vagina of bright red blood  lasting longer than 10 minutes
• Thick, black, foul smelling discharge from the vagina.

If any of the above occur, the queen should be examined by a veterinarian immediately.

Interrupted labour:

It should be noted that there can be a significant gap between kitten deliveries. This is known as interrupted labour. The queen  will cease straining & attend to the kittens she has delivered by cleaning & nursing them, she may eat some food if it is offered & will appear to have completed labour. After a period of rest (interrupted labour may last as long as 24-36 hours), labour will resume & the rest of the litter will be delivered. It would be worth speaking to your vet if no kittens have been delivered in 4 hours & you suspect your queen may have gone into interrupted labour.

What is the treatment?

If a fetus can be seen protruding from the vagina & no progress is being made you may have to assist. If the fetus is stuck in the birth canal, apply gentle traction in a downward motion to pull it out.  If the fetus is presenting head first, wipe away the membranes from the nose & mouth first. Once delivered, remove the remaining membranes & aspirate the fluid from the nose & mouth. Then place the kitten in front of the queen.

Obviously, it should be noted that when handling the birthing queen or her offspring, hygiene is a must. Make sure your hands are thoroughly washed.

Veterinary diagnostics:

If it becomes necessary to take the queen to the veterinarian, bring along any kittens that have already been born.

Your veterinarian will perform a complete physical examination & evaluate the situation & establish what the cause of dystocia is so that the appropriate treatment can be given.

He may wish to run some diagnostic tests such as;

• Complete blood count.
• Biochemical profile.
• Xrays to determine fetal size, numbers, position.
• Ultrasound.

Veterinary treatment:

• Oxytocin is a naturally occuring hormone which stimulates contractions.
• Calcium stimulates muscle contractions. If the labour has been long, calcium levels may have become deficient. When combined with oxytocin, calcium gluconate can result in conctactions that are more efficient than with oxytocin alone.
• Anti-anxiety medication if the mother is anxious or stressed.
• Intravenous fluids.
• Caesarian section if strong uterine contractions do not occur following calcium & oxytocin or if the kittens are too large to deliver vaginally or if there is uterine rupture/torsion.
  

Even with an apparent straightforward delivery, it is always important to have the queen & her kittens examined by a veterinarian to make sure there are no remaining kittens, no retained placentas & everything is healing as it should.