difficult delivery

Question
We have a 1 1/2 yr old cat who has given birth one time before and is now having difficulty with her second delivery.

To give you a little history... We live in South East Asia where the vet care is questionable.  Because of the cats age we asked a vet to give her a "birth-control" shot in September of 2008.  He said he would need to come back in Feb to give her the second shot.  In the meantime, she came into heat, mated and became pregnant without any of the usual "mating behavior".

We suspected she was pregnant because of her size,.......but without the mating behavior and in light of having received the "pregnancy shot", we were not sure.  I was not here when the vet came back in February, last month and thus couldn't discuss the hazards of giving a pregnant cat another "pregnancy shot".  We guess the vet just thought she was a fat cat and gave her the shot.

At the present, our vet came over and gave her what we think amounted to a Petosin shot to help her with her contractions.  That was 12 hours ago.  Patches (our cat)broke water 2 days ago and has still not given birth to her kittens.  She doesn't appear to be in distress other than being exhausted. Her contractions are about 5 minutes apart now.  Again, no difficulty at all with her first delivery and the kittens were all healthy.  

What is your advice as to what to do for our sweet Patches?  

Thank you for your help!!!  We greatly appreciate any advice.

David  

Answer
Hi David.  Unfortunately, I think at this point, a cesarean may be the safest way to go.  You could have her spayed at the same time if you like.  This does not generally interfere with lactation as long as the kittens begin nursing.  I know a surgical delivery is always a last resort because we hate to have an incision around where the kittens are going to be nursing, but if the Pitocin has failed to induce delivery and has only resulted in exhaustion, there is little else to choose from.  If the kittens have entered the birth canal, the vet can try to help maneuver kittens and deliver them manually with forceps, etc., but there is a great potential for injury to both mom and kittens this way.

A cat's uterus is oddly shaped.  It's divided into two horns, which are tapered toward the ends, and the kittens are lined up, sort of like peas in a pod.  Because of the shape, the kittens closest to the birth canal are often able to grow a little larger than the kittens toward the back of the horns.  If mom isn't able to deliver these first big babies, none of the others can be born, either.  It may be possible that no matter how much Pitocin she's given and how strong her contractions are, she just won't be able to deliver the babies.  If they're available to you, an x-ray can tell the vet if it appears the babies are too large to be delivered naturally, and that would be confirmation that a cesarean is the only choice.