5 Common Labor Complications in Cats

Giving birth should be an exciting time for cats and their pet parents. Unfortunately, things don't always go according to plan. Birth difficulties, known collectively as dystocia, are estimated to occur in 1 in 30 pregnant cats. They often happen without warning and can put the lives of both the mother and her kittens at risk. We'll discuss the 5 most common labor complications in cats, how to spot them, and how to react if your cat's labor takes a turn for the worse.

Narrowing of the pelvic canal, also called pelvic canal stenosis, occurs when the cat's pelvic canal is unnaturally small, causing birth and defecation problems in felines. Felines with narrow pelvises tend to have a harder time giving birth and are more likely to have a kitten get stuck in the birth canal.

Symptoms

• Long-term constipation
• Difficulty defecating
• Abdominal pain
• Prolonged labor that requires veterinary intervention
• Kittens becoming lodged in the pelvic canal

Causes 

Narrow pelvic canals are prevalent in cats who have suffered injuries to the pelvic area or sacrum in the past. Blows to the hind end are the most common cause of pelvic injuries. However, some cats are born with a narrow pelvis.

Diagnosis

When a laboring cat arrives at the animal hospital showing signs of dystocia, the vet will want to know the cat's symptoms, how long they’ve been in labor, and whether the cat has a history of pelvic injuries. The answers to these questions can help the vet narrow down the possible causes. The vet will then use imaging technology to visualize the animal's anatomy and the position of the fetuses to make a positive diagnosis. 

Treatment

Cats with pelvic stenosis are often unable to give birth naturally and will likely need a Cesarian section. During the surgery, vets will typically spay the cat to prevent labor difficulties and the health risks associated with them in the future.

Vets may also perform a ​​pelvic osteotomy to widen the birth canal, especially if the cat has trouble using the bathroom. Depending on the cat's anatomy and the severity of the stenosis, vets may need to reposition the pelvic bones or remove pieces of bone entirely during the procedure. During the surgery, vets may use mechanical hardware like screws and wires to realign and affix the bones into place.

Cost

Cats with a narrow pelvis will need a C-section, which costs between $800 and $4,000, depending on the facility and the amount of medication the animal requires. If the vet decides to spay the cat during the C-section, that will add $110 to $400 to the total surgery cost. Additionally, if the cat needs a pelvic osteotomy, this surgery will tack on between $1,000 and $4,000.

Primary uterine inertia is the term for when a feline (or any mammal) fails to produce contractions from the start of labor. One study found primary uterine inertia to be the most common cause of difficult birth in 155 cases of labor complications in cats.

Secondary uterine inertia shares many symptoms and treatments with primary uterine inertia, but this type of uterine inertia has different causes. Secondary uterine inertia is a leading cause of dystocia in cats with no pre-existing conditions.

Symptoms of primary uterine inertia

• Absence of contractions
• Pain and discomfort
• Staying pregnant past the expected due date
• Green vaginal discharge with no other signs of labor
• Pale gums
• Shock

Symptoms of secondary uterine inertia

• Cessation of contractions mid-labor
• Fatigue
• Restlessness and anxiety in the mother
• Long periods of labor without the appearance of kittens

Causes

There are two leading causes of primary uterine inertia in cats. Most commonly, cats with this condition do not release enough of the hormone oxytocin, which stimulates the uterine walls to contract. Alternatively, cats with uterine inertia may have exceptionally large litters, and the abdomen may run out of room to contract effectively. 

Unlike primary uterine inertia, secondary uterine inertia is due to exhaustion from labor. Exhausted felines will experience a drop in oxytocin, which can cause the contractions to grow weaker and eventually stop altogether.

Diagnosis

Diagnosis of primary uterine inertia involves close monitoring and a thorough physical and vaginal exam. The vet will observe the cat for contractions and palpate the cervix to check for dilation. The vet will also feel to see if kittens are stuck in the pelvic canal.

Treatment

An emergency C-section is the only effective treatment for cats with primary uterine inertia. Delayed treatment can result in fetal death due to fluid aspiration and uterine infection in the mother, which can be fatal.

Vets will proceed in one of two ways to treat secondary uterine inertia. They will either give the cat intravenous Pitocin to induce contractions or perform a C-section, depending on the status of the kittens and how long the cat has been in labor. 

Cost

Since felines with primary uterine inertia always need surgical intervention, you can expect to pay between $800 and $4,000 for treatment, depending on where you live and your cat's specific needs.

The cost to treat secondary uterine inertia ranges between $400 to $4,000, depending on whether the cat needs a C-section or just IV medication.

Uterine torsion is a life-threatening condition in which the uterus twists 45 degrees or more inside the abdominal cavity. This condition is rare, but it can happen to cats of any breed and reproductive age.

Symptoms

• Painful and prolonged labor with no kittens
• Lethargy/extreme fatigue
• Vaginal bleeding
• Refusing to eat
• Swollen belly
• Pale gums
• Collapse

Causes

Experts aren't entirely sure why uterine torsion happens, but some theorize that certain environmental, anatomical, and physiological factors can put cats at higher risk. Below are some risk factors that experts believe contribute to this condition.

• Abuse or mishandling of the mother cat
• Fetal crowding on one side of the uterus
• Weakened uterine muscles
• Increased fetal activity
• Uterine malformations
• Maternal overactivity

Diagnosis

Uterine torsion can mimic other conditions, particularly pyometra. For this reason, vets must perform blood tests, imaging scans, and physical examinations to make a definitive diagnosis. X-rays are particularly useful in diagnosing this condition since they can show the abnormal placement of the fetuses within the twisted uterine horn.

Treatment

Cats with this condition will need surgery immediately to access and correct the torsion and remove any damaged tissue. Kittens trapped in the twisted horn of the uterus have little to no chance of survival, but the kittens in the healthy portion of the uterus may survive.

Depending on how far the cat is in her pregnancy, the vet may choose to remove the kittens via C-section during the surgery or sew up the uterus and allow the pregnancy to continue until the kittens are full term.

If the kittens are full-term and can be removed safely, vets will typically recommend spaying the cat at the same time. Cats recovering from uterine torsion surgery will need IV fluids and antibiotics to stabilize them and prevent infection.

Cost

An exploratory laparotomy to access and correct the torsion will cost $900 and $2,000 depending on the severity. 

Uterine ruptures are an extremely rare, life-threatening labor complication in which the uterine wall bursts open, causing internal bleeding. Sometimes, uterine ruptures are so severe that the fetuses can be forced out of the uterus and into the abdominal cavity.

Symptoms

• Weak contractions
• Severe abdominal pain
• Swelling of the abdomen

Causes

Experts are unsure of the cause of uterine rupture in otherwise healthy pregnancies; however, there are some known risk factors. Having a prior C-section can put cats at a much higher risk of uterine rupture. Likewise, trauma to the abdomen can also cause the uterus to rupture abruptly during pregnancy.

Diagnosis

Diagnosing a uterine rupture is tricky since there are no outward signs that distinguish this condition from other labor complications. There's no way to know that a cat has a uterine rupture without the vet performing an exploratory laparotomy.

Treatment

The first step in treating a uterine rupture is starting an IV and administering fluids and antibiotics. From there, the vet will administer anesthesia and make an incision in the abdomen to assess the problem. If the problem is indeed a uterine rupture, they will remove the kittens and perform a complete hysterectomy.

Cost

The combined cost of an exploratory laparotomy and a hysterectomy averages between $1,100 and $2,400. However, the exact cost of these procedures will depend on your city and the facility you use. 

Malpresentation occurs when a kitten is born in any position other than headfirst. The most typical form of malpresentation is when the kitten enters the birth canal tailfirst, which puts the kitten at risk of drowning in fetal fluids. Malpresentation, and improper kitten posture and position, don't always cause labor complications, but if the kitten becomes stuck, it can put the lives of the mother cat and the other kittens at risk.

Symptoms

• Contractions that last longer than 60 minutes without expelling a kitten
• An unusually long gestation period
• Visually seeing a kitten stuck in the birth canal

Causes

Malpresentation is caused by the positioning of kittens in the womb. The most common malpresentation is the breech presentation (where the legs and tail appear first).

Other forms of malpresentation are traverse presentation (when the kitten enters the canal side first), when two kittens enter the birth canal at once, or kittens entering the birth canal with their legs up or head contorted.

Factors that can increase a cat's likelihood of malpresentation include having abnormally large kittens and being a brachycephalic or dolichocephalic breed.

Diagnosis

If a pregnant feline comes into the vet showing signs of malpresentation, the vet will ask about the cat's symptoms and proceed with a few different examinations.

Vets will first perform a digital exam of the vagina to check for kittens lodged in the birth canal. If the vet is unable to tell the kitten's orientation by the digital examination, they will typically do an ultrasound or X-ray to visualize the kittens' placement.

Treatment

Mothers unable to dislodge a kitten from the birth canal will need immediate veterinary assistance. Vets will have to manually dislodge the kitten or perform an emergency C-section since there's a high risk of fetal and maternal death when a kitten becomes wedged in the birth canal.

Cost

Malpresentation can be costly to diagnose and treat, and you can expect to pay between $150 and $250 just for X-rays alone. The cost for treatment skyrockets if the feline requires an emergency C-section, which averages between $800 and $4,000. 

Caring for a pregnant or breeding cat can be expensive. Most accident and illness policies don't cover costs related to pregnancy. But some providers, like Trupanion, offer add-ons that reimburse vet care costs. Start comparing pet insurance plans today to find the right fit for your fur-baby.