Saturday, 18 July 2015

FELINE DYSTOCIA AND CESAREAN SECTION


I am sharing some insights on the Feline Dystocia and C- Section in this segment .
Many times we get cats presented in advanced stage of dystocia. It is very important for the cat owners, Paravets to understand the stage of birth which clearly indicates the time for intervention by the vet.
Cat’s labour signs are very interesting and much more unique compared to canine labour stages .

STAGE -1 First stage labour begins with the onset of uterine contractions. During this stage the cervix begins to dilate open with clear , odourless discharge from the vagina - mucus plug during pregnancy sealing the uterus starts. As the first stage progresses, contractions will become closer and closer together.

STAGE -2 Second stage labour is characterised by contractions much stronger and closer together and the cervix becomes fully dilated. When the queen is ready , kitten moves down the birth canal. Pressure   on the cervix initiates an urge to push from the mother. It takes around three pushes for the kitten to be delivered. The queen will tear and lick the membranes from the face and body which will stimulate breathing. Second stage usually takes around 5 minutes to 1 hour.
MORE THAN ONE HOUR OF SECOND STAGE OF LABOUR NEED VETERINARY HELP!

STAGE -3 Third stage labour: Immediately following the kitten's birth, the placenta is normally delivered. Once the queen has cleaned the kitten and breathing has commenced normally the queen will chew the umbilical cord in two and quite often will eat the placenta.

CAUSES OF DYSTOCIA IN CAT
 There  are a number of causes of dystocia which can be classified as maternal or fetal. Maternal causes include  Narrow pelvis. Fractured pelvis ,Pelvic obstruction and Uterine inertia uterine torsion (twisting) or rupture. This may be primary or secondary . When the uterus fails to produce any contractions this is regarded as Primary inertia This can be from  poor health, obesity, age, stress.Fetal causes include abnormally presentation of  kitten, oversized foetus , Excessive fetal head size and malformed fetus, Fetal death.

A CASE OF UTERINE TORSION LEADING TO DYSTOCIA AND REVIVAL OF LIVE KITTEN BY CESAREAN SECTION 
PLEASE WATCH THE VIDEO BELOW .

                                      

We had handled a very challenging case of feline dystocia this week. three year old cat was presented on 71 day of gestation with history of delivering still born kitten 11 hrs prior to presentation of case 
.The case was tried to manage medically with oxytocin but the  total uterine inertia was evidentThe cat was very dull and depressed.  An abdominal ultrasound revealed two more kittens on the right horn. One dead and another alive. An emergency  C- Section was planned .
On laprotomy , uterine torsion of gravid  right horn and pale purple color of the uterine mass was suggestive of putrefaction . On opening the uterus a very foul smelling foetus was removed and  a live kitten was carefully taken. 


Upon removal the kitten had gone for apnoea which was successfully retrieved by cardio pulmonary resuscitation .
THE JOY OF SAVING A MOTHER AND A KITTEN WAS BEYOND WORDS TO EXPRESS .


SIGNS OF DYSTOCIA IN CATS
·         Gestation lasting longer than 70 days
·         Stage 1 labour lasting longer than 24 hours
·         Straining for 10 minutes if a fetus  is  visible in the birth canal
·         Acute depression and 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.
Significant gap between deliveries is very common in cats . If the fetus is stuck in the birth canal, apply gentle traction is needed . An ultrasound scan can precisely diagnose the live kitten in the abdomen . In my experience I had found that If the labour has been long, calcium levels may have depleted. When combined with oxytocin, calcium gluconate can result in contractions much more efficient than with oxytocin alone. Adequate hydration with Intravenous fluids is a must to combat the stress of dystocia.
And when the queen is not responding to medical treatment a Cesarean section is the only resort.

Anesthetic combination of Ketamine @ 15 mg / kg bw and diazepam @  0.6 mg/kg bw gives very good result during the procedure. Ketamine in a slight higher dose were found to be showing prolonged recovery period and catalepsy. In case of Dystocias delivering one dead foetus and mother still straining .. An ultrasound scan is an excellent tool to identify the live foetus if any and in that case only an emergency C  Section can save the life of the mother and kitten.
                                                   

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