Maternal Recovery Following Medical Treatment and Assisted Vaginal Delivery in a Queen with Suspected Uterine Inertia: A Case Report

Abstract

Feline dystocia is an obstetrical emergency that requires prompt assessment of the queen, the birth canal, and fetal viability. A 1-year-7-month-old indigenous domestic shorthair queen of local Indian origin was initially examined during late pregnancy and was re-presented 15 days later with anorexia, restlessness, vaginal discharge, and ineffective straining. Vaginal examination identified a dilated birth canal without a fetus at the pelvic brim, while ultrasonography demonstrated three fetuses: one with a heart rate of 225 beats/min and two without detectable cardiac activity. The findings were considered consistent with suspected uterine inertia in the absence of an obvious vaginal obstruction, although a positional or more cranial obstructive component could not be completely excluded. Following lubrication of the birth canal, a slow intravenous infusion containing oxytocin (5 IU), 5% dextrose (350 mg/kg), and a combined calcium gluconate-calcium lactobionate preparation (50 mg/kg) was administered. Approximately 30 min later, the fetal head and forelimbs became digitally accessible, and one non-viable fetus was removed by gentle forceps-assisted vaginal extraction. Two additional non-viable fetuses were expelled within the subsequent 2 h. The following day, the queen had fever, dehydration, dullness, and depression. Abdominal radiography showed no retained mineralised fetal skeletal structures, and empirical antimicrobial and supportive treatment was administered for 5 days. The queen recovered without reported postpartum complications, but none of the fetuses survived. This case documents maternal recovery after combined medical and assisted vaginal management; however, it does not establish the efficacy or safety of the treatment regimen. The absence of pretreatment biochemical testing, complete exclusion of obstruction, and serial fetal monitoring limits causal interpretation, and the reported oxytocin dose should not be generalised to routine feline dystocia management.