Uterine inertia in the queen: oxytocin and calcium
2-year-old Persian queen that has delivered 2 kittens and has had no contractions for 3 hours. She is calm, in good general condition, and more fetuses are palpable in the abdomen.
What is the most appropriate next step?
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A. Rule out obstruction with vaginal examination and radiography, assess fetal viability with ultrasound and, if there is no obstruction, give calcium gluconate and low doses of oxytocin
Correct. Oxytocin with an obstruction can rupture the uterus. Calcium improves the strength of contractions and oxytocin their frequency; if there is no response, proceed to caesarean.
B. High-dose oxytocin repeated every 30 minutes until all kittens are delivered
High doses produce tetanic contractions that reduce placental blood flow, cause fetal hypoxia and can rupture the uterus. If there is no response to 2–3 low doses, a caesarean is indicated.
C. Rapid intravenous bolus of calcium gluconate to restore contractions
Intravenous calcium must be given slowly with heart rate or ECG monitoring, because it can cause bradycardia and arrhythmias. Many clinicians prefer the diluted subcutaneous route.
D. Wait another 24 hours, as long pauses are normal in queens
Queens can have a normal interrupted labour, but only in a cat without signs and after assessing the fetuses. Without examination, waiting 24 hours risks the death of the kittens.
lightbulb Key takeaway
Before giving oxytocin, confirm three things: no obstruction (large fetus, malposition, narrow pelvic canal), live fetuses and a stable dam. Primary uterine inertia is common in pedigree queens; secondary inertia appears through exhaustion after a long labour. In brachycephalic queens, consider a caesarean early.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.