Beschreibung
The aim of this study was to examine existing data in literature of feline obstetrics, categorize the facts that are evidence-based, and provide recommendations.
Patient data obtained from the Department of Veterinary Obstetrics at the University of Justus-Liebig in Gießen (2000 - 2021) was analyzed and compared with recent literature.
Since there is little evidence-based literature available in the field of feline obstetrics, the recommendations and therapeutic treatments presented in this study need to be critically assessed. None of the literature references was based on randomized or double blinded studies or based on a meta-analysis with high grade evidence.
Presentation of the existing literature on feline obstetrics:
- The literature review shows that the existing literature has low evidence. It is characterized by specialist books and expert opinions that provide help with questions. The lack of randomized, controlled studies is due to the fact that the birth process is difficult to standardize and the management of a control group is not justifiable from an ethical point of view.
Evaluation of the literature according to the standards of evidence-based medicine:
- It is striking that the information on feline obstetrics regarding conservative, surgical therapy and anesthesia procedures are not evidence-based. Controlled, randomized and blinded studies and meta-analyzes cannot be found.
- As an example, the range of the dose of Oxytocin (0.5 - 20 IE/cat) gives the impression that most of the time experience, differing local guidelines, expertise from textbooks, and some common "gut instinct" is consulted for primary decision making.
The following results could be obtained from the patient evaluation:
- The percentage of purebred cats was 54 %. Those cats are affected as often as non-purebred cats.
- The average gestational period was 65 days ± 5.4. It does not differ from cats with eutocia.
- The survival rate of the puppies decreased significantly if the birth lasted longer than 24 hours.
- When evaluating the vital signs, 64 % of cats (n = 64) showed tachycardia and 70 % (n = 49) tachypnea.
- 31 % of cats showed hypothermia. Low body temperature was a negative prognostic factor for the survival of the mother cat.
- Neonatal mortality increased when the mother had fever. Only 7 % of the cats showed an increased body temperature.
- Normoglycemia occurred in 51 % of severe births. Only one animal showed hypoglycemia.
- In 47 % of cats with dystocia, the ionized calcium was in the reference range. Hypocalcemia was diagnosed in six animals (19 %).
- The most common cause of dystocia, 33 % was weak maternal contractions.
- In a total of 77 % of cats with dystocia surgery was performed. Sectio porro was the most common surgical method at 59 %, followed by sectio caesarea conservativa with 35 %. En bloc resection was performed in 6 % of the cases.
- In 77 % of surgically treated cats, 14 % had previously been treated conservatively.
- Successful conservative obstetrics could be performed in only 16 % of the difficult deliveries.
- Newborn mortality was 38.8 %. Maternal mortality was 2.4 %.
- 59 % of newborns with single pregnancy died. Single pregnancy therefore poses a particular risk to the fetus.
The results presented here support the assumption, that there is need for further research to provide evidence-based recommendations for feline obstetrics.
