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SPONTANEOUS ABORTION AND PREGNANCY LOSS IN CATS
BASICS
OVERVIEW
“ Abortion” is the delivery of one or more fetuses before it is (they are) capable of surviving outside of the uterus
“ P regnancy loss” is the death of the embryo, reabsorption of early fetuses, mummification (shriveling or drying up of the fetus, like a
mummy), abortion, stillbirths, and outcomes of difficult birth (known as “ dystocia”)
T he “ queen” is a female cat
GENETICS
Nonspecific; inbred lines experience higher levels of pregnancy failure than seen in other cats
SIGNALM ENT/DESCRIPTION of ANIM AL
Species
Cats
Breed Predilections
P ersians and Himalayans—difficult birth (dystocia)
M ea n Age a nd Ra nge
Noninfectious causes—more common at the birth following the first pregnancy and in queens greater than 6 years of age
Infectious causes—all ages
Predomina nt Sex
Females
SIGNS/OBSERVED CHANGES in the ANIM AL
May have no clinical signs, especially early in pregnancy or gestation
Failure to litter on time
Decrease in abdominal size
Weight loss
Delivery of recognizable fetuses or placental tissue
Lack of appetite (known as “ anorexia”)
Vomiting, diarrhea
Behavioral changes
Discharge from the vulva that contains blood or pus—frequently unnoticed in fastidious queens (that is, queens that groom or clean
themselves with meticulous attention) or with early pregnancy or gestational losses; the “ vulva” is the external genitalia of females
Disappearance of fetuses previously documented by physical examination (palpation), ultrasound examination, or X-rays
Abdominal straining, discomfort
Depression
Dehydration
Fever
CAUSES
Infectious Disease
Viruses—feline panleukopenia virus; feline herpesvirus; feline calicivirus; feline leukemia virus (FeLV); feline immunodeficiency virus
(FIV)
Bacteria—Escherichia coli; Streptococcus; Staphylococcus; Salm onella; Mycoplasm a; Mycobacterium
Coxiella burnetii (Q fever)
Toxoplasm a gondii (probably uncommon)
Noninfectious—Reproductive Ca uses
Early loss of the embryo
Difficult birth (dystocia)
Disease of the lining of the uterus (known as “ endometrial disease”)—cystic endometrial hyperplasia (CEH), a condition in which the
lining of the uterus thickens abnormally and contains fluid-filled sacs or cysts; very common
Hormonal disorders
Inadequate placenta
Fetal defects—genetic or developmental (anatomic, metabolic, and chromosomal abnormalities)
Excessive or poorly planned inbreeding and/or poor choices of breeding stock—indirect evidence; difficult diagnoses without thorough
family history and test matings
Effects of social hierarchy in group setting; behavioral disorders in individuals
Agents that induce abortion (known as “ abortifacient drugs”)—luteolytics (such as the prostaglandin, P GF2α ); estrogens; prolactin
inhibitors (such as cabergoline); steroids; tamoxifen citrate (dogs); mifepristone (dogs); epostane (dogs)
Page 1
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Noninfectious—Nonreproductive Ca uses
Nutrition— low taurine intake (taurine is an amino acid [protein] that is an important component of the diet of cats; cats cannot
produce enough taurine in their bodies and so, must obtain taurine from their food to maintain health); nutritional fads; some
nutraceuticals
Severe stress—environmental; physiological; psychosocial
T rauma
Some medications
Consequence of severe, generalized (systemic) disease involving systems other than the reproductive system
RISK FACTORS
P rior history of pregnancy loss or poor reproductive performance (may be history of individual queen or the cattery)
Coexistent, severe sudden (acute) or long-term (chronic) disease
Excessive inbreeding
Birth following the first pregnancy or queen greater than 6 years of age
Environmental stress—crowding, poor sanitation, noise, temperature or humidity extremes
Social order in cattery
Exotic breeds—often reproduce poorly in large catteries or high-density environments
Obesity or inappropriate nutrition
TREATMENT
HEALTH CARE
Outpatient medical management—medically stable patients; suspected hormonal disorders; disease of the lining of the uterus
(endometrial disease); noninfectious/nonreproductive pregnancy loss
Inpatient medical management—abortion imminent or taking place; clinical illness; potential zoonoses—diseases that can be passed
from animals to people (unless safe and effective outpatient treatment can be assured); patients being treated with the prostaglandin,
P GF2α
Aborted fetus or discharge may be infectious; isolate patient
P ractice strict sanitation for inpatient or outpatient treatment
Correct dehydration—administer fluids (such as Normosol® or lactated Ringer’s solution)
ACTIVITY
No limitations, unless an infectious agent is suspected or documented for outpatients
Isolate infectious patients (preferred)
DIET
No special dietary considerations for uncomplicated cases
P ersistent diarrhea or other causes of fluid loss—veterinary diet and fluid therapy
SURGERY
Surgical management—spay or ovariohysterectomy (surgical removal of the ovaries and uterus) for stable patients with no breeding
value or if necessary to preserve queen’s life
MEDICATIONS
Medications presented in this section are intended to provide general information about possible treatment. T he treatment for a
particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.
Depend on underlying causes
Antibiotics—amoxicillin, pending results of bacterial culture and sensitivity testing
P rostaglandin (P GF2α )—may be used to stimulate and evacuate the uterus in cases with non-viable fetuses or significant uterine
contents noted on ultrasound examination; discuss risks and benefits of prostaglandin treatment with your cat’s veterinarian
P rogesterone/progestogens—safe and effective doses for pregnancy maintenance not established; may cause or worsen cystic
endometrial hyperplasia (CEH), a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or cysts
Page 2
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FOLLOW-UP CARE
PATIENT M ONITORING
Re-evaluate 7 to 14 days after completion of prostaglandin (PGF2α ) treatment
Repeat ultrasound examination—evaluate uterine evacuation or fetal viability
PREVENTIONS AND AVOIDANCE
Genetic problems require attention to breeding program
Infectious causes require surveillance and control measures
Spay or ovariohysterectomy for cats with no breeding value
POSSIBLE COM PLICATIONS
Generalized bacterial infection (known as “ sepsis”)
Shock
Uterine rupture
Inflammation of the lining of the abdomen (known as “ peritonitis”)
Inflammation of the lining of the uterus (known as “ metritis”)
Inflammation with accumulation of pus in the uterus (known as “ pyometra”)
Bleeding
Infertility
Obesity following spay or ovariohysterectomy in mid-life queens
Cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or
cysts) following progestogen therapy; progestogen is any substance capable of producing the effects of the female hormone,
progesterone
EXPECTED COURSE AND PROGNOSIS
Symptomatic retrovirus infection—poor prognosis
Long-term (chronic) infertility—common after 6 years of age
Queens not bred prior to 3 to 4 years of age experience higher infertility
Severe cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled
sacs or cysts)—recovery of fertility unlikely; inflammation with accumulation of pus in the uterus (pyometra) is a common
complication
Genetic abnormalities causing difficult birth (dystocia) or loss of most or all of litter—guarded to poor prognosis for further
reproduction
Repeated difficult births (dystocias)—recurrence depends on cause; guarded prognosis if cause not ascertained
Hormonal disorders—often manageable; consider genetic aspects
KEY POINTS
Zoonoses (diseases that can be passed from animals to people) can be causes of abortion or pregnancy loss in cats; discuss the potential
of a zoonosis causing your cat’s abortion or pregnancy loss with your pet’s veterinarian
Maintain careful records of reproductive performance for each queen and for the cattery
Establish disease surveillance and control measures; may require significant changes in cattery management and breeding stock
selection
For breeding cats—consider risks and possible side effects associated with non-surgical solutions, particularly with infectious or genetic
causes of pregnancy loss
Infertility—may result despite successful treatment; may be secondary to conditions pre-existing the pregnancy loss
P rostaglandin treatment—consider risks and possible side-effects
Spay or ovariohysterectomy—indicated for primary disease of the uterus for queens with no breeding value
Page 3
SPONTANEOUS ABORTION AND PREGNANCY LOSS IN CATS
BASICS
OVERVIEW
“ Abortion” is the delivery of one or more fetuses before it is (they are) capable of surviving outside of the uterus
“ P regnancy loss” is the death of the embryo, reabsorption of early fetuses, mummification (shriveling or drying up of the fetus, like a
mummy), abortion, stillbirths, and outcomes of difficult birth (known as “ dystocia”)
T he “ queen” is a female cat
GENETICS
Nonspecific; inbred lines experience higher levels of pregnancy failure than seen in other cats
SIGNALM ENT/DESCRIPTION of ANIM AL
Species
Cats
Breed Predilections
P ersians and Himalayans—difficult birth (dystocia)
M ea n Age a nd Ra nge
Noninfectious causes—more common at the birth following the first pregnancy and in queens greater than 6 years of age
Infectious causes—all ages
Predomina nt Sex
Females
SIGNS/OBSERVED CHANGES in the ANIM AL
May have no clinical signs, especially early in pregnancy or gestation
Failure to litter on time
Decrease in abdominal size
Weight loss
Delivery of recognizable fetuses or placental tissue
Lack of appetite (known as “ anorexia”)
Vomiting, diarrhea
Behavioral changes
Discharge from the vulva that contains blood or pus—frequently unnoticed in fastidious queens (that is, queens that groom or clean
themselves with meticulous attention) or with early pregnancy or gestational losses; the “ vulva” is the external genitalia of females
Disappearance of fetuses previously documented by physical examination (palpation), ultrasound examination, or X-rays
Abdominal straining, discomfort
Depression
Dehydration
Fever
CAUSES
Infectious Disease
Viruses—feline panleukopenia virus; feline herpesvirus; feline calicivirus; feline leukemia virus (FeLV); feline immunodeficiency virus
(FIV)
Bacteria—Escherichia coli; Streptococcus; Staphylococcus; Salm onella; Mycoplasm a; Mycobacterium
Coxiella burnetii (Q fever)
Toxoplasm a gondii (probably uncommon)
Noninfectious—Reproductive Ca uses
Early loss of the embryo
Difficult birth (dystocia)
Disease of the lining of the uterus (known as “ endometrial disease”)—cystic endometrial hyperplasia (CEH), a condition in which the
lining of the uterus thickens abnormally and contains fluid-filled sacs or cysts; very common
Hormonal disorders
Inadequate placenta
Fetal defects—genetic or developmental (anatomic, metabolic, and chromosomal abnormalities)
Excessive or poorly planned inbreeding and/or poor choices of breeding stock—indirect evidence; difficult diagnoses without thorough
family history and test matings
Effects of social hierarchy in group setting; behavioral disorders in individuals
Agents that induce abortion (known as “ abortifacient drugs”)—luteolytics (such as the prostaglandin, P GF2α ); estrogens; prolactin
inhibitors (such as cabergoline); steroids; tamoxifen citrate (dogs); mifepristone (dogs); epostane (dogs)
Page 1
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Noninfectious—Nonreproductive Ca uses
Nutrition— low taurine intake (taurine is an amino acid [protein] that is an important component of the diet of cats; cats cannot
produce enough taurine in their bodies and so, must obtain taurine from their food to maintain health); nutritional fads; some
nutraceuticals
Severe stress—environmental; physiological; psychosocial
T rauma
Some medications
Consequence of severe, generalized (systemic) disease involving systems other than the reproductive system
RISK FACTORS
P rior history of pregnancy loss or poor reproductive performance (may be history of individual queen or the cattery)
Coexistent, severe sudden (acute) or long-term (chronic) disease
Excessive inbreeding
Birth following the first pregnancy or queen greater than 6 years of age
Environmental stress—crowding, poor sanitation, noise, temperature or humidity extremes
Social order in cattery
Exotic breeds—often reproduce poorly in large catteries or high-density environments
Obesity or inappropriate nutrition
TREATMENT
HEALTH CARE
Outpatient medical management—medically stable patients; suspected hormonal disorders; disease of the lining of the uterus
(endometrial disease); noninfectious/nonreproductive pregnancy loss
Inpatient medical management—abortion imminent or taking place; clinical illness; potential zoonoses—diseases that can be passed
from animals to people (unless safe and effective outpatient treatment can be assured); patients being treated with the prostaglandin,
P GF2α
Aborted fetus or discharge may be infectious; isolate patient
P ractice strict sanitation for inpatient or outpatient treatment
Correct dehydration—administer fluids (such as Normosol® or lactated Ringer’s solution)
ACTIVITY
No limitations, unless an infectious agent is suspected or documented for outpatients
Isolate infectious patients (preferred)
DIET
No special dietary considerations for uncomplicated cases
P ersistent diarrhea or other causes of fluid loss—veterinary diet and fluid therapy
SURGERY
Surgical management—spay or ovariohysterectomy (surgical removal of the ovaries and uterus) for stable patients with no breeding
value or if necessary to preserve queen’s life
MEDICATIONS
Medications presented in this section are intended to provide general information about possible treatment. T he treatment for a
particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.
Depend on underlying causes
Antibiotics—amoxicillin, pending results of bacterial culture and sensitivity testing
P rostaglandin (P GF2α )—may be used to stimulate and evacuate the uterus in cases with non-viable fetuses or significant uterine
contents noted on ultrasound examination; discuss risks and benefits of prostaglandin treatment with your cat’s veterinarian
P rogesterone/progestogens—safe and effective doses for pregnancy maintenance not established; may cause or worsen cystic
endometrial hyperplasia (CEH), a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or cysts
Page 2
, ABC Amber Text Merger Trial version, http://www.processtext.com/abcmerge.html
FOLLOW-UP CARE
PATIENT M ONITORING
Re-evaluate 7 to 14 days after completion of prostaglandin (PGF2α ) treatment
Repeat ultrasound examination—evaluate uterine evacuation or fetal viability
PREVENTIONS AND AVOIDANCE
Genetic problems require attention to breeding program
Infectious causes require surveillance and control measures
Spay or ovariohysterectomy for cats with no breeding value
POSSIBLE COM PLICATIONS
Generalized bacterial infection (known as “ sepsis”)
Shock
Uterine rupture
Inflammation of the lining of the abdomen (known as “ peritonitis”)
Inflammation of the lining of the uterus (known as “ metritis”)
Inflammation with accumulation of pus in the uterus (known as “ pyometra”)
Bleeding
Infertility
Obesity following spay or ovariohysterectomy in mid-life queens
Cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or
cysts) following progestogen therapy; progestogen is any substance capable of producing the effects of the female hormone,
progesterone
EXPECTED COURSE AND PROGNOSIS
Symptomatic retrovirus infection—poor prognosis
Long-term (chronic) infertility—common after 6 years of age
Queens not bred prior to 3 to 4 years of age experience higher infertility
Severe cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled
sacs or cysts)—recovery of fertility unlikely; inflammation with accumulation of pus in the uterus (pyometra) is a common
complication
Genetic abnormalities causing difficult birth (dystocia) or loss of most or all of litter—guarded to poor prognosis for further
reproduction
Repeated difficult births (dystocias)—recurrence depends on cause; guarded prognosis if cause not ascertained
Hormonal disorders—often manageable; consider genetic aspects
KEY POINTS
Zoonoses (diseases that can be passed from animals to people) can be causes of abortion or pregnancy loss in cats; discuss the potential
of a zoonosis causing your cat’s abortion or pregnancy loss with your pet’s veterinarian
Maintain careful records of reproductive performance for each queen and for the cattery
Establish disease surveillance and control measures; may require significant changes in cattery management and breeding stock
selection
For breeding cats—consider risks and possible side effects associated with non-surgical solutions, particularly with infectious or genetic
causes of pregnancy loss
Infertility—may result despite successful treatment; may be secondary to conditions pre-existing the pregnancy loss
P rostaglandin treatment—consider risks and possible side-effects
Spay or ovariohysterectomy—indicated for primary disease of the uterus for queens with no breeding value
Page 3
