Postpartum Metritis in Queens

Post Partum Metritis in Queens

POSTPARTUM METRITIS IN QUEENS
Carmen Klassen,
Jewelspride Bengals
 
As breeders, we often breathe a sigh of relief when we see the “final” kitten and placenta emerge from our queen after staying up all night helping her deliver her kittens. It is important to remember, however, that this is not the time to grab a shower and head to bed to catch up on your lost sleep, or speed off to work for the day leaving your queen unattended.  Before you consider your part of the job to be over, and pat yourself on the back for assisting your queen in a seemingly uneventful delivery, there are things to watch for and assess with regard to your queen’s continued health and comfort.  It is important to note that complications may arise anywhere from immediately following birth, to hours or even days later. This is why ongoing post-partum care of your queen is so important. In this article, I am going to discuss a serious postpartum complication called “Postpartum Metritis”.


What is Postpartum Metritis and what are its causes?  

Postpartum metritis is an inflammation of the lining of the uterus (endometrium) postpartum which causes systemic illness. Postpartum metritis is usually the result of a bacterial infection caused by retained placentas or fetuses, contamination of the birth canal during delivery (from unsterile hands or instruments), prolonged labour, or unsanitary conditions during delivery. Because septicemia (bacterial infection of the blood) or toxemia (blood poisoning by toxins from a local bacterial infection) can occur if this condition is left untreated, it is critical to keep an eye on your queen’s temperature post delivery to spot any potential problems early.  Other causes of postpartum metritis may include a long, difficult delivery, dystocia (ill positioned fetus often accompanied by a failure of the uterus and cervix to contract and expand normally), or previous miscarriage or abortion. 
 


What symptoms should I look for?

The queen will appear very ill soon after delivery - she will have a distinct lack of energy, be disinterested in her kittens and food, and may also vomit.  In addition, she will have unpleasant smelling vaginal discharge and present with a fever. A heavy, thick, bloody discharge typically appears two to seven days post delivery, and is accompanied by fever, excessive thirst, and vomiting. Palpation of the abdomen will be painful for the queen and her uterus will feel thickened. Her rectal temperature will reach between 103 degrees Fahrenheit to 105 degrees Fahrenheit (39.4 C to 40.5 C).
  
Watch for signs in the kittens as well. Toxic waste may be absorbed into the queen’s bloodstream resulting in secondary toxemia in the kittens. The kittens will show signs of weakness, lack of appetite and weight loss and could die within a day or so.
 
How will my vet diagnose and treat my queen? 

Your vet will diagnose postpartum metritis in your queen by performing a thorough physical exam. This will include a blood profile, complete blood count, electrolyte panel, and a urinalysis to determine whether the infection is still localized or has spread.  X-rays and ultrasound will assist your vet in checking the inside of the queen’s uterus for any retained fetuses or remaining placental matter, accumulation of excess fluid, and uterine tears or rupture. Your vet will likely take a sample of the queen’s vaginal discharge for analysis in order to determine which type of bacteria is at the root of the infection and which antibiotics will be most useful to fight it. 

A queen that has been diagnosed with metritis will likely be dehydrated and will require IV therapy in order to replace the fluids and restore any electrolyte imbalances caused by the infection. IV fluids will help stabilize her while you and your vet await lab results.  If the infection has turned into sepsis, your vet will also want to treat your queen for shock. There is no need to wait for the lab results on the vaginal discharge to begin treatment - broad-spectrum antibiotics (amoxycillin-clavulanic acid) may be started immediately to treat the queen and then be switched to an antibiotic therapy based on culture and sensitivity testing of the vulvar discharge.  Prostaglandin therapy for 2–3 days or oxytocin may help evacuate the uterine contents. This is only advisable in queens under six years of age, in good health, and when no retained fetal material is confirmed by ultrasound. 

Ovariohysterectomy (spay) is ultimately recommended if your queen is extremely ill or if future reproduction is not important to you. Otherwise, this is an elective procedure which can be performed once the queen is no longer lactating. While the queen receives treatment, you should raise her kittens by hand to avoid transmitting the infection or antibiotics via the queen’s milk. 


What is the prognosis for my breeding queen after diagnosis and treatment for postpartum metritis?

With early detection and intervention a favourable prognosis for your queen is likely, depending on factors such as her response to antibiotics and prostaglandin therapy, the return of her appetite and maternal behaviour, and the lack of fever.  The prognosis is not so favourable if your queen has become septic, developed peritonitis (inflammation of the peritoneum), fetal or placental retention, concurrent disease affecting the immune system, or concurrent mastitis.


What can I do to prevent postpartum metritis from happening in the future?

While you obviously do not have control over many of the incidents leading up to a case of metritis in one of your breeding queens, there are certainly some things you can do to help prevent it or at least detect it early for treatment. For instance, keep your kittening quarters and tools meticulously clean, carefully count placentas after the delivery of each kitten, watch your queen’s behaviour very carefully during the entire delivery as well as in the hours and days following delivery, and keep a detailed record of her temperature readings as well as the kittens’ development and growth.  The most important thing to remember as a breeder is that the apparent successful delivery of your queen’s kittens is not a guarantee that everything went well for your queen and that she’s not in danger of developing a serious postpartum complication like metritis in the hours and days following delivery.
 
 REFERENCES
 
“Acute Metritis in Cats”. Retrieved February 23, 2017 from http://www.cat-world.com.au/acute-metritis-in-cats    
 
“Metritis in Small Animals”.  Retrieved February 23, 2017 from http://www.merckvetmanual.com/reproductive-system/reproductive-diseases-of-the-female-small-animal/metritis-in-small-animals
 
“What is Metritis”.  Retrieved February 23, 2017 from http://itchyfish.com/what-is-metritis-in-cats/
 
Little, Susan. DMV  (2009). Cystic Endometrial Hyperplasia and Pyometra in the Queen. The Cat Breeder’s Handbook,  p, 99. Retrieved February 23, 2017 from https://books.google.ca/books?id=A5SYfsnxbM4C&pg=PA99&lpg=PA99&dq=metritis+postpartum+cat&source=bl&ots=oW1oRPQyga&sig=u-
 
“Cat Birth - When to Wait and When to Worry”.  Retrieved February 23, 2017 from https://icatcare.org/advice/my-cat-having-kittens/cat-birth-%E2%80%93-when-wait-and-when-worry
 
Davidson, Autumn. “Acute Metritis”.  DVM, MS, DACVIM (Internal Medicine) Clinical Professor Department of Medicine and Epidemiology School of Veterinary Medicine, University of California, Davis.  Retrieved February 23, 2017 from http://d1uhp0uy75me04.cloudfront.net/mmah/a1/0459c9b25444659237a86c6a9ae97f/fileSOC_10_11_7.pdf
 
Rice, Dan.  “The Complete Book of Cat Breeding”. Google Books. Retrieved February, 28, 2017 from https://books.google.ca/books?id=x2nsW3dNnasC&pg=PA99&lpg=PA99&dq=queen+with+metritis&source=bl&ots=8wPCUZdQUb&sig=xGb-ZtNrHY9SPBQKMgqmcGfQMAA&hl=en&sa=X&ved=0ahUKEwjd6_fb9rvSAhUCyGMKHQg7Aw8Q6AEIRDAH#v=onepage&q=queen%20with%20metritis&f=false
 
“Metritis”. Retrieved February 27, 2017 from http://m.petmd.com/cat/conditions/reproductive/c_ct_metritis
 
“Metritis in Cats”. Retrieved February 28, 2017 from http://www.petplace.com/article/cats/diseases-conditions-of-cats/reproduction/metritis-in-cats
 
Forsberg, Catharina Linde; Axner, Eva; Rungsipipat, Anudep; Chatdarong, Kaywalee (July 1, 2005). Hysterographic Appearance and Uterine Histology at Different Stages of the Reproductive Cycle and After Progestogen Treatment in the Domestic Cat. Volume 64, Issue 1, 12–29.
 
“Common Cat Illnesses”. Retrieved March 2, 2017 from  https://www.vetinfo.com/common-cat-illnesses-after-giving-birth.html
 

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