Contributors: Rob Lofstedt, Carlos Pinto
Species: Feline | Classification: Diseases
- Failure of expulsion of fetal membranes during third stage of labor. Occasionally a dead or live fetus also retained.
- Treatment: conservative usually successful; hysterotomy or hysterectomy essential if conservative management fails or if the cat owner has no future breeding plans.
- Prognosis: failure to treat can result in toxemia, metritis and death.
- Sometimes a normal kitten may be present several days after the birth of the rest of the litter .
- May be no clinical symptoms for several weeks post partum if only a small portion of the fetal membranes remains.
- Vulvar discharge.
- If several days post partum, systemically debilitated, febrile, toxemic and presence of dark, foul smelling vulvar discharge.
- Young, pubertal animals becoming pregnant when body size <65% of adult size.
- Little known of the pathogenesis in cats.
Remember that breaks of several days between the birth of kittens can be normal.
- May be an association with large litters (prolonged parturition may lead to partial primary uterine inertia; or fetal oversize or obstruction may lead to dystocia and subsequently to secondary uterine inertia).
- Metritis → toxemia.
- Varies from hours to a few days.
- Post-partum vulvar discharge.
- Recent parturition.
- Persistent copious vulvar discharge post partum.
- Palpable masses (fetuses or fetal membranes) in the abdomen.
- Normal queen.
- Lactation ceases Lactation failure.
- Copious odiferous vaginal discharge.
- Occasionally symptoms delayed for several weeks post partum if only a small amount of placenta remains.
- Abdominal palpation and ultrasonography Ultrasonography: uterus revealing mass consistent with enlarged uterus and retained kitten.
- Will reveal dead retained kitten, or partial uterine enlargement indicating retained placenta.
- Vaginal cytology: may show hairs and striated muscle if a fetus is undergoing autolysis.
- Vaginal abnormalities that cause a discharge, eg tears, tumors Vaginal neoplasia, infection Vaginitis.
- Urinary tract infections Feline lower urinary tract disease (FLUTD).
Initial Symptomatic Treatment
Retained fetal membranes
- Broad-spectrum antibiotics Therapeutics: reproductive system (if no retained fetus).
Retained fetal membranes
- Broad-spectrum antibiotics Therapeutics: reproductive system and oxytocin Oxytocin (2-5 USP units SC or IM, or 0.5-1.25 USP units of a diluted solution slowly IV).
- If this fetus is not born after the usual attempts to stimulate uterine activity are made (3-5 USP units oxytocin IM Oxytocin following blood chemistry for calcium (5 ml of 10% calcium gluconate Calcium gluconate given slowly IV)) it can be monitored until expulsion of fetuses are observed. PGF2alpha (dinoprost Dinoprost trimethamine) 2 mg SC per cat or 0.1 mg/kg can also be used if no response to oxytocin. Caesarean section Cesarean section is a more pragmatic approach if no response is obtained.
- Observation of elimination of fetuses and retained fetal membranes following treatment.
- Implement course of systemic antibiotics.
- Monitor patient overall demeanor, resolution of significant vulvar discharge; watch for signs of toxic metritis (fever, anorexia, purulent vulvar discharge, etc).
- Fair to good, depending on status of overall health (absence of toxemia, etc).
Expected Response to Treatment
- Judicious use of oxytocin and calcium gluconate associated with antibiotic therapy is usually successful; surgical approach (hysterotomy or ovariohysterectomy) is invariably curative.
Reasons for Treatment Failure
- Medical treatment not efficient if obstructive dystocia is present; however, surgical approach will resolve most conditions.