However, endometritis is not always an acute illness after birth. Inflammation of the uterine lining may also cause few symptoms and be associated with fertility problems. A newly delivered mother that is generally unwell still needs urgent assessment, regardless of how extensive the uterine inflammation is later found to be.
When to see a vet urgently
Seek immediate care if a cat that has given birth has any of the following:
- Foul-smelling discharge with loss of appetite, fever or clear weakness.
- Severe abdominal pain, persistent vomiting or rapid deterioration.
- Collapse, difficult breathing or heavy bleeding.
- Failure to care for her kittens while appearing ill herself, with restless or weak kittens too.
When making contact, also arrange safe care and transport for the litter. You can find a vet near you.
Overview
After birth, the uterus is vulnerable to infection. Bacteria entering it cause inflammation that may remain limited to the lining (endometritis) or spread through all uterine layers (metritis). Important organisms include E. coli, staphylococci, streptococci and other usually harmless bacteria. The disease begins suddenly, affects the cat's general condition and can rapidly lead to sepsis.
The uterus gradually shrinks after birth. Normal discharge accompanying this process is different from bacterial infection. Assessment considers the amount and smell of discharge alongside the mother's condition, because colour alone does not determine the diagnosis.
Sepsis means serious organ dysfunction developing in association with infection. It is not identified from a single temperature reading or the appearance of discharge alone. When the mother becomes dehydrated or weak, or circulation and other organ functions are impaired, whole-body support is needed alongside treatment of the uterine infection.
Causes
- Retention of afterbirth or a dead foetus in the uterus.
- Difficult or prolonged labour.
- Birth injuries and damage to the mucosal lining.
- Infection entering the uterus from the vagina or bloodstream.
- Use of non-sterile equipment when assisting birth.
Assisted birth and retained tissue can predispose to infection, but illness does not prove that you did anything wrong. Metritis may occur after a birth that otherwise seemed normal. Tell the vet about all medicines given, any interventions during birth and known complications.
Counting afterbirths can be difficult because the mother may eat them before you see them. Not seeing one does not, on its own, prove that a placenta remains in the uterus. Conversely, uncertainty alongside symptoms warrants examination, rather than pulling out afterbirth or trying to empty the uterus at home.
Risk factors
- Unspayed cats after giving birth.
- Weak or emaciated cats.
- Poor hygiene in the birthing area.
- Repeated births and frequent breeding.
- Previous difficult pregnancies.
This list is not a precise prediction model, and the effects of every aspect of breeding history are not well understood in cats. Difficult birth and the mother's general condition are clinically relevant, but a cat in good condition can also become ill. The need for examination is decided from symptoms, not simply the number of previous litters.
Typical symptoms
- Raised body temperature (fever).
- Lethargy and loss of appetite.
- Foul-smelling vaginal discharge, containing pus or blood and pus.
- Abdominal tenderness.
- Reduced milk production and refusal to nurse the kittens.
- Signs of systemic toxicity: rapid breathing, weakness and dehydration.
Normal discharge after birth may be reddish-brown or dark. It should not smell foul or be accompanied by a mother that appears ill, feverish or unwilling to eat. Increasing discharge, an unusual smell or pain requires assessment even if some time has passed since birth.
A change in nursing or kitten behaviour may also be an early sign of trouble. Kittens may cry restlessly if they receive insufficient milk or maternal care. Painful, swollen mammary glands may instead suggest mastitis, a different disease that can occur at the same time.
There are other causes of weakness after birth. The practice therefore assesses general condition and, when needed, the mammary glands as well as the uterus. Attributing symptoms simply to exhaustion from giving birth may delay necessary treatment.
Complications and consequences
Untreated metritis and endometritis lead to:
- Sepsis and multiple organ damage.
- Infertility.
- Chronic uterine inflammation.
- Death.
These consequences are not inevitable in every mild case of inflammation of the lining. Severe acute metritis can nevertheless endanger the mother and, indirectly, the entire litter. Preserving future fertility must not take priority over life-saving treatment. The prognosis also considers how quickly general condition responds to treatment.
Diagnosis at the vet
- Clinical examination and history, including time since birth.
- Complete blood count, showing raised white blood cells and signs of inflammation.
- Uterine ultrasound for enlargement, fluid or retained foetal or placental tissue.
- Bacterial culture of discharge to guide antibiotic choice.
Tell the practice about the course of labour, the number of kittens, any stillborn kittens and observed afterbirths. Also report when the mother last ate and whether she is caring for the kittens normally. Previous pregnancy investigations may help establish whether a foetus could remain in the uterus.
Examination assesses mucous membranes, circulation, hydration, the abdomen and discharge. White blood cells may be raised, but can also be reduced in severe infection. Metritis is therefore not ruled out simply because the white cell count has not risen. Biochemistry and urinalysis when needed complement the assessment of organ function.
Ultrasound assesses uterine contents and structure and any retained foetuses. Findings are compared with time since birth and the mother's other symptoms. X-rays may also be used when necessary. Feeling the abdomen alone cannot distinguish every cause of discharge.
Cytology and bacterial culture of discharge may support the diagnosis of infection and medicine selection. Culture results are considered alongside the other findings, and stabilisation of an ill mother is not delayed while awaiting them. If the problem is poor fertility with few symptoms, investigating endometritis may follow a different route from an acute emergency after birth.
Treatment
Treatment depends on the severity of inflammation and the mother's situation. Where possible, antibiotics are targeted using culture and susceptibility results. Fluids, pain relief and other support may be essential if she is dehydrated or systemically ill. A seriously ill cat often needs hospital care.
In some situations, the vet uses medication to encourage the uterus to empty. This requires examination and monitoring because the medicines have adverse effects and the same method does not suit every situation. Do not give contraction-stimulating medicine at home based on earlier birth instructions or another animal's prescription.
If the uterus is severely damaged or medication is insufficient, surgery to remove the uterus and ovaries may be needed. Surgical timing and anaesthesia are planned according to general condition, and stabilisation may be required first. Further breeding is discussed only after the mother's health has been safeguarded.
Home care for the mother
Discharge instructions cover medication, eating, nursing and follow-up. Monitor appetite, activity, changes in discharge and interest in the kittens. New weakness, worsening pain, breathing difficulty or increasing discharge warrants immediate contact even if medication has already started.
If the mother has had surgery, also monitor the wound for redness, swelling and discharge. Kittens may irritate the incision, so supervise contact according to the instructions provided. Do not leave a mother recovering from anaesthesia alone with her kittens until she is fully awake and can care for them safely.
Caring for the litter
The vet assesses whether nursing can continue during the mother's illness and chosen medication. If milk is insufficient or the mother is in hospital, the kittens need a separate care plan. Use kitten milk replacer when needed, rather than ordinary cows' milk or a homemade mixture.
Record each kitten's weight changes, feeding and activity. A cold, weak or poorly suckling kitten needs prompt help. Do not force-feed it or squeeze milk quickly into its mouth, as food may enter the airways. The practice advises on safe warmth and nutrition.
Prognosis
Prompt investigation and appropriate treatment can allow good recovery, but cannot guarantee it for every cat. Severe systemic infection and organ damage worsen the prognosis. Fertility is assessed separately even after treatment that preserves the uterus: clinical recovery alone does not establish that another pregnancy would be safe.
Prevention
- Monitor birth and check that afterbirths are passed in good time.
- Maintain sterility when assisting birth.
- Reduce the number of pregnancies.
- Have a cat not intended for breeding spayed, a reliable way to prevent uterine inflammatory diseases.
In practice, hygiene means a clean, dry birthing area, clean hands and avoiding unnecessary handling. Inserting equipment or disinfectants into the birth canal does not make a home birth safe. If you are unsure whether afterbirths have passed or labour has finished, ask the practice for assessment.
Removing the uterus removes the possibility of inflammation developing in that tissue. Breaks between breeding and maintaining good condition do not guarantee that metritis cannot develop.
Important for cat owners
Metritis and endometritis are life-threatening conditions requiring immediate veterinary care. Remember that fever after birth, foul-smelling discharge or weakness must not lead to a delayed visit. Prompt treatment saves the cat's life and prevents serious complications.
Not every inflammation of the uterine lining is an acute emergency, but an ill mother that has just given birth needs immediate care. The outcome cannot be promised in advance.
This article provides general information and does not replace veterinary care. Contact a vet if you notice signs of illness in your cat.
Frequently asked questions
Is all discharge after birth caused by infection?
No. Normal discharge may be dark or reddish-brown. However, a foul smell, increasing discharge, pain or deterioration in the mother's condition needs investigation.
Does a missing afterbirth mean it remains in the uterus?
Not necessarily. The mother may eat it unnoticed. Do not pull visible tissue; ask the vet for assessment, particularly if the mother has symptoms.
Does endometritis always mean an emergency after birth?
No. Inflammation of the lining may also be associated with fertility problems and few symptoms. An ill newly delivered mother nevertheless needs urgent examination because acute metritis can become severe.
Can the kittens continue suckling?
This depends on the mother's condition, milk supply and medication. If nursing is unsafe or impossible, the practice plans replacement feeding and care for kittens separated from her.
This article is for general information only and is not a guide to treatment. If you notice the first signs of illness, contact your vet.
Paw4care editorial team
Sources
- Metritis in Small Animals, Merck Veterinary Manual, accessed 2026-11-05.
- Feline postpartum, Louisiana State University School of Veterinary Medicine, accessed 2026-11-05.
- Uterine Dysfunctions in Non‐Pregnant and Pregnant Small Animals, Reproduction in Domestic Animals, accessed 2026-11-05.
- Birth and Kittening, Cats Protection, accessed 2026-11-05.
- Feeding Orphaned Kittens, VCA Animal Hospitals, accessed 2026-11-05.
- Caesarean Sections in Cats, VCA Animal Hospitals, accessed 2026-11-05.
- Sepsis in Dogs and Cats—Consensus Definition and Clinical Criteria, Journal of Veterinary Emergency and Critical Care / Veterinary Emergency and Critical Care Society, accessed 2026-11-05.
- Initial Triage and Resuscitation of Small Animal Emergency Patients, Merck Veterinary Manual, accessed 2026-11-05.