Dystocia in Dogs and Cats

Ronald M. Bright, DVM, MS, DACVS

BASIC INFORMATION
Description
Dystocia is the inability to initiate the act of labor or the delivery of pups or kittens at the end of a pregnancy. Dog breeds at
increased risk for dystocia include the Yorkshire terrier, miniature
poodle, Pomeranian, English bulldog, dachshund, Chihuahua, and
Scottish terrier.

Causes
The causes of dystocia can generally be classified into those
caused by the mother and those caused by the fetus.
Uterine inertia is a condition in which the uterine muscles
either do not contract (primary uterine inertia) or become fatigued
during labor (secondary uterine inertia) from persistent straining
against an obstruction within the birth canal. Secondary uterine
inertia is almost never the sole cause of dystocia.
A narrow birth canal caused by a previous fracture of the pelvis
can prevent passage of the fetus. The head of the fetus may be too
large to pass through the birth canal, or the fetus may be oversized
or malformed. Sometimes an improper position of the fetus as it
approaches the birth canal makes passage difficult.
Psychological stress can delay the onset of labor. A rare cause
of dystocia is twisting of the uterus on itself (uterine torsion).

Clinical Signs
The following are signs of dystocia:
Active straining has occurred for more than 30-60 minutes
without the birth of a fetus.
Straining for 2 or more hours has not resulted in delivery of a
fetus.
The resting stage between expulsion of fetuses is greater than 4
hours and there is no sign of straining even though it is known
that more fetuses remain in the uterus.
Signs of systemic illness, such as vomiting, weakness, or
fever, are present.
Abnormal vaginal discharge, such as frank blood or pus, is
present.
The pregnancy is known to be a high risk (predisposed breed);
only one, large fetus is present; or narrowing of the birth canal
has occurred from a prior pelvic fracture.
Attempts to expel a fetus are painful.
Obvious signs of distress are present.

Diagnostic Tests
The diagnosis of dystocia is often derived from the clinical signs
and a thorough physical examination. Other tests that may be recommended include x-rays, an abdominal ultrasound, and laboratory tests, such as measurement of blood calcium levels. Low blood
calcium may be associated with uterine inertia. Commercially
available external whelping monitors can be used to detect diminished fetal viability (fetal stress) and abnormal patterns in the uterine contractions.

TREATMENT AND FOLLOW-UP

Treatment Options
The treatment of dystocia varies, depending on the underlying cause.
If a fetus has passed part of the way through the birth canal but is now
caught, it may be possible to dislodge the fetus through cautious use
of fingers or instruments. Administering a tranquilizer to relieve stress
in an apprehensive bitch or queen may be helpful.
If uterine inertia is diagnosed, medical therapy may be attempted,
provided that the birth canal is a normal size, the cervix is open, the
fetus is not too large to pass through the canal, and no other obstruction is identified. Medical therapy involves administration of the hormone, oxytocin, to stimulate uterine contractions. If calcium levels
are low, supplementation of calcium is indicated, because it enhances
uterine contractions and increases the effects of oxytocin.
If medical therapy fails, surgery to perform a cesarean section
(C-section) is indicated. Your veterinarian may discuss the option
of spaying the mother at the time of the cesarean section. If there
are no further plans for breeding the mother or if a uterine rupture
is present, ovariohysterectomy (spaying) may be recommended.

Follow-up Care and Prognosis

Following resolution of the current dystocia, emphasis must be
placed on preventing dystocia during future pregnancies. Such
measures include providing consistent and adequate amounts of
exercise during the pregnancy and making sure the mother is fed
a well-balanced diet.
To increase the chances of an optimal litter size, it is often recommended that bitches be bred 2 days after ovulation. All queens
and bitches should be provided a quiet, dark, stress-free, and sanitary birthing environment.

If you have other questions or concerns about this, or other health topics, please call
McFarland Animal Hospital
608-838-3400
Copyright 2011 by Saunders, an imprint of Elsevier Inc. All rights reserved.