A caesarean section or c-section is major surgery performed to remove kittens from the uterus. This is most commonly performed as an emergency procedure when there is difficulty with natural birth. Most cats recover quickly from this procedure; however, if your cat was in labor for several hours before surgery was performed, her recovery will be slower, and she will need extra attention and help with her kittens.

What should I do for the mother after she gives birth?

The mother has been given an anesthetic that will be eliminated from her body quickly. Most cats have fully recovered from anesthesia by the time they are discharged to go home. Complete recovery from anesthetic may take two to six hours, depending on the anesthetics used, the mother's physical condition and age at the time of surgery and how long she was in labor before the surgery.

"During the immediate recovery period, she must be closely monitored so that she does not fall and hurt herself, or roll over and crush the kittens."

During the immediate recovery period, she must be closely monitored so that she does not fall and hurt herself, or roll over and crush the kittens. The kittens should not be left alone with her until she is completely awake, able to stand on her own, and interested in caring for her kittens.

The mother should begin eating within a few hours. You should offer her small amounts of food and water frequently (every 15 to 30 minutes) for the first 24 hours after surgery. If she eats or drinks too much, or too quickly, she may vomit. Her food intake at this time should be about 1.5 times her food intake before she became pregnant. By the time of the third or fourth week of nursing, her food intake may be 2 to 2.5 times normal. She should be fed a premium brand high-quality kitten food during the period of nursing in order to provide the appropriate nutrition for her and her litter.

"A cat should never be given ACETAMINOPHEN (TYLENOL®) or ACETYLSALICYLIC ACID or ASA (ASPIRIN®)."

The mother's temperature may rise 1-2ºF (0.5 - 1ºC) above normal for the first 1-3 days, then it should return to the normal range. The normal range is 100.5°F and 102.5°F (38.1°C to 39.2°C). A CAT SHOULD NEVER BE GIVEN ACETAMINOPHEN (TYLENOL®) OR ACETYLSALICYLIC ACID or ASA (ASPIRIN®). If the mother's temperature goes above 104ºF (40ºC), she and her litter should be examined by your veterinarian as soon as possible.

Is it normal for the mother to have a vaginal discharge?

A bloody vaginal discharge is normal for up to a week following birth of the kittens. It may be quite heavy for the first one to three days, and then should begin to diminish over the next few days. If the bloody discharge continues for longer than one week, if it changes color or develops an odor, the mother should be checked for the presence of infection or other complication. If she had an ovariohysterectomy (was spayed) at the time of the surgery, there should be no vaginal discharge.

When should her stitches be removed?

The stitches may or may not need to be removed, depending on the type of suture material used. Many veterinarians will use internal, absorbable sutures that will not be visible and do not require removal. As a rule, if the stitches are visible, they will have to be removed, usually 10-14 days after surgery. If skin staples were used, they will also require removal in 10-14 days.

How should I care for the kittens?

The kittens should be ready to nurse as soon as you arrive home. The mother may not be awake or alert enough to handle nursing alone; therefore, you may have to help the mother by making her lie still so the kittens can nurse. Gently put the kittens beside the mother's teats. If a kitten seems reluctant to nurse, you can massage the nipple to express some milk, which may induce the kitten to begin nursing.

What does it mean if the kittens are crying a lot?

Kittens should sleep or be nursing 90% of the time. If they are crying or whimpering, something is usually wrong. Uterine infections, inadequate milk production, and poor-quality or infected milk are the most common causes of restless or unhealthy kittens. The entire litter can die within twenty-four hours if one of these complications develops. If you have any concerns about their health, you should have your veterinarian examine the kittens and their mother.

If the mother does not have enough milk at first, you may supplement the kittens for the first day or two. Your veterinarian should be able to supply you with a commercial kitten milk replacer, as well as nursing bottles that are the appropriate size for the kittens' tiny mouths. In an emergency, the following formula may be used until you can purchase a specific product that is designed for kittens:

1 cup milk + 1 tablespoon corn oil + 1 pinch of salt + 3 egg yolks (no whites). Blend until uniform. It should be fed at the rate of l oz (30 cc or 30 ml) per 1/4 lb. (1/8 kg) of kitten weight PER 24 HOURS. That amount should be divided into 3-5 feedings. The average newborn kitten weighs 1/4 lb. (1/8 kg) at birth.

Although it is preferable that kittens begin nursing immediately, a healthy newborn can survive without complication for up to twelve hours without nursing. However, if the newborn is weak, dehydrated or cold, nourishment must be given as soon as possible.

How warm should the room be where the kittens are?

"A newborn kitten is not able to regulate its body temperature very well."

A newborn kitten is not able to regulate its body temperature very well. As long as the kittens stay near their mother, the room temperature is not too critical. However, if they are not with their mother, the room temperature should be 85º - 90ºF (29.5º-32ºC). To avoid any chance of hypo- or hyperthermia (chilling or overheating), the newborns should be kept inside the house if possible.

When should the kittens be weaned from their mother?

Weaning should begin when the kittens are about 3 ½ weeks old. The first step toward weaning is to place a 50:50 mixture of water and kitten milk replacer (not cow or goat's milk) in a flat saucer near the kittens. The kittens' noses should be carefully dipped in this mixture two to three times per day until they begin to lap it up. After they are eating the milk replacer solution well, you can begin to mix it with some canned kitten food. Gradually, the water and replacer mixture can be reduced until they are eating only canned food. Once they are eating solid food, usually at around six weeks of age, they may be placed in their new home. However, it is much better for their development and socialization if they remain with their mother and littermates until they are 8-10 weeks of age. This may decrease the incidence of behavior problems caused when the kittens are removed from their litter too early.

When are the kittens treated for worms?

"The common intestinal parasites are transmitted to kittens either across the uterus before they are born or through the mother's milk after birth."

The common intestinal parasites are transmitted to kittens either across the uterus before they are born or through the mother's milk after birth. Kittens can be treated for intestinal parasites (worms) as early as two weeks of age but it is more common to treat them when they are three and six weeks of age. It is important that accurate weights be obtained for the kittens so that the proper dose of medication can be used.

When should vaccinations begin?

"Quarantine procedures may be advisable to lessen the chance of disease transmission to the unprotected kittens."

First vaccinations typically begin at six to eight weeks of age, depending on individual circumstances. If your kittens were not able to nurse during the first three days of life, they will not have received proper immunity from their mother. Similarly, if the mother cat was not up-to-date on her vaccinations before giving birth, she may not have passed adequate immunity to the babies. In these situations, your veterinarian may recommend starting their vaccination program earlier, and quarantine procedures may be advisable to lessen the chance of disease transmission to the unprotected kittens. All kittens require 2-3 sets of booster vaccines in order to develop active immunity against the common infectious diseases.

Further information about intestinal parasites, infectious diseases and vaccinations. Your veterinarian can provide you with this information and give you specific advice that relates to your circumstances.