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Hello and welcome to Chattering
with International Cat Care.

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I'm Yaiza Gomez Mejias, iCatCare
veterinary community coordinator

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and host of this month's podcast.

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Our clinical spotlight this
month is focused on fundoscopy.

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I will be speaking with Dr Natalia
Giannakopoulou and Dr Ben Blacklock about

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the review article, Fundoscopy in Cats,
A Practical Guide and Common Findings,

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which they have recently published in the
Journal of Feline Medicine and Surgery.

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But first, I will be interviewing
Dr Petra Cerna and Professor Daniel

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Gunn-Moore about last year's JFMS article.

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Feline Dystocia and Kitten Mortality
up to 12 weeks in Pedigree Cats.

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Thank you very much, Petra and
Danielle, for your time today and

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thank you for writing this article
together with the other co-authors.

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Could you talk about the main
types of, you said dystocia.

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You said dystocia.

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How is it pronounced?

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I think it depends whether
you are Latin based or Greek.

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How do you say it Petra?

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I say dystocia, but I might be wrong.

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Me too, me too.

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I think dystocia is Latin
and dystocia is Greek, right?

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Yeah.

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I think that's the difference.

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Okay.

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That's so revealing.

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I always got confused with
this since I came to England.

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Anyway.

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What are the main types of, dystocia or
dystocia in cats and how are they managed?

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You've got the maternal and the fetal
type of dystocia, and we can all decide

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that any pronunciation is the right one.

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So the maternal ones, the what we see
most, particularly with the, much more the

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oriental cats, and this is just generally
is where you've got the, the myometrium

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just gives up pushing or never started.

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So you can get primary.

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You try an inertia where it never
pushes or sometimes it pushes for a wee

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bit and then it goes, no, I couldn't
possibly, this is all just too tiring.

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Or as we say, the cats are
just too  posh to push.

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And I did, there was a breeder with
the first questionnaire and she filled

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it out and she said she was very proud
of three generations with Siamese

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and she said, yes, none of my girls
are able to give birth naturally.

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And she said they're all
just too posh to push.

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And it was the fact that she'd
got three generations of them.

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And you just think, was there not
a concept that maybe, that breeding

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from cats that can't give birth
naturally might not be the ideal thing?

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So you've got maternal, which
I'll particularly say if a uterine

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inertia, primary or secondary,
it can be that the cat is unwell

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or older, would be other reasons.

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And then you've got the
maternal fetal mismatch.

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So where the kitten is too big, that tends
to be when you've got a small number of

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kittens in the litter, particularly we
see this in Persians classically, only one

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or two kittens and they can get chunky.

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And of course the thing about a Persian
cat, it's got a big  head with no nose

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and the mum cat has got a little pelvis,
and so the, the kitten comes up to the

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internal cervix, and because he's got
no nose, it can't push into the cervix,

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which is what they need to do to open the
inside of the cervix so they can get out.

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So their little faces pushed down the
ways, or they get diverted laterally.

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And so you then can get them presenting
with the back of the head or a shoulder or

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they're just too big and they get halfway
into the cervix and then they're stuck.

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So this fetal, maternal fetal
mismatch, were all one kitten,

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very big, is not uncommon.

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They would be the major ones.

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Petra, what ones would you add?

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I think these are probably the major ones.

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There, of course, I think it's a big
difference and that's how I as a breeder

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decided, when I spay my females and not
breed from them anymore, was actually

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if the kitten has given birth to couple
of kittens and then maybe the third

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one in the litter was stuck, or too
big, we  needed a C-section for that.

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I was willing to try one more litter
with that queen because she already

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delivered multiple kittens on her
own, and it was just, if it's a fetal

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dystocia, I think there is a little
bit more space for potentially trying

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to mate the female one more time.

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But every time I had a uterine
dystocia where inertia, where they

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had no contractions or the mom
just couldn't push the kittens.

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The birth canal was too narrow and no
single kitten was actually born alive.

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That's where I usually combine
my spay with the C-section at the

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same time because I just don't
think it's fair to put the cats

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through that experience again.

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And it's, it was also very stressful
for me, but I just don't think it

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is fair for the Queen to having to
go through that experience again.

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So that's how I usually make the call.

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And your studies about reproduction
of in pedigree cats, what

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changes have you observed?

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One of the  biggest difference that
we had noticed that in the previous

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studies that Danielle has been part
of, the Persians and exotics seem to

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have higher dystocia rates than these
days, which was very surprising for us

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especially because Persians and exotics
have been quite rapidly changing in

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type and they are now some of them
quite severely brachycephalic cats, and

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there's a lot of discussion about that.

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However, it seemed actually that the
prevalence of them having birth problems

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is decreasing compared to previously.

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So this was one thing that was very
surprising for us, and I think we

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were very excited to learn that.

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I have to say that the Persians and
exotic breeders, they work usually

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quite hard to try to minimise the
risks because they're already aware

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that there are so many problems with
that breed as it is because of its

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extreme features and brachycephalism.

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So a lot of them actually work very hard.

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Look at, for example, polycystic
kidney disease, right?

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We went from crazy high prevalence
to extremely low prevalence

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just because of genetic testing.

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So I think that was one of the
things that really has changed

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the most from the past, studies.

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Yeah.

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And just to jump in there, the,
the numbers really are amazing.

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So when I was doing my residency in say
the early 1990s, then it was 40%, 35

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to 40% of all Persians and exotic and
all of the push face breeds, the, the

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more what we would call ultra types.

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So we put the color point
Persians, whether you call

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them himalayans or whatever.

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Those 40%, 35 to 40% all
over the world had polycystic

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kidney disease, which was huge.

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And it was such a major thing.

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And of course we didn't have
the genetic tests then, so we

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couldn't test them as newborns.

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We had to wait until they were 10 months
old and then we could do the  ultrasound

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to check them, and by that time,
people were really bonded with them.

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And then you discover that no,
they've got polycystic kidney disease.

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The good thing was, of course,
we could then say, no, don't

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breed from the affected cat.

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Or if you must, because it's got a
particular trait that you really want

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to capture, then you need to make sure
that they're bred to a non affected cat.

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Whereas now it's 2%.

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And that shows just how effective the
Persian exotic breeders have been.

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They have just taken responsibility
and gone, okay, we have a problem

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with our breed, this we can mend.

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And so we've taken it from 40% to 2%.

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That is hats off to all those breeders
who've had their cat screened,

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that came from Persians and exotic
cats, by the time they were eight

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weeks of age, 25%, one in four.

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And so many, it was dystocia that
caused them to be stillborn  or they

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were so brain damaged by the whole
birth, birth canal business, that

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they didn't suck properly so that
they were lost as fading kittens,

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but certainly dead by eight weeks.

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So to see the turnaround, where did they
come in the collection of things, Petra?

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Because say, they'd been
the first for so long

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we went down to about 15% now.

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So it has decreased quite a lot
and they were nowhere close to the

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breeds that were the highest kitten
mortality we unfortunately have seen.

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I was also wanna mention that my
biggest message here is that we need

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to start advocating for these cats more
because they can't do it themselves.

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And that's why we are here.

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Danielle and I think this is wonderful and
I can't wait for the Feline World Congress

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in Edinburgh, one of my favourite cities
in the world, and I do hope that, a lot

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of people will join us in Edinburgh and
come to the Congress because I cannot wait

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to actually have, I think three full days

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and I'm actually doing
lecture after lecture almost.

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I hope people won't get bored
of me, but I just cannot wait to

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just talk about kittens and feline
reproduction with a lot of amazing

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speakers, and of course, Danielle.

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And so I really hope I
will see everybody there.

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It's gonna be an amazing conference.

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So definitely big shout out
please, everyone who can get to

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Edinburgh, please come and join us.

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And I think what makes it really
important is there are so few

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meetings that talk about kittens.

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And it is because, yes, as a a general
practitioner, even as a specialist, we

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don't get our paws on that many babies.

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But we have to give a lot of advice.

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And if we don't understand, we
can't give the right advice.

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So I think it is the perfect
opportunity for people to come and

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really get some really grounded,
experienced advice about what can

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and can't be done for these babies,
how to do it right by these babies.

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I'm particularly looking forward to
talking about squitty kitties 'cause

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I get to talk about babies with
squits and they are fun to manage.

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I like those.

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So yeah, we've got a whole series
of lectures on all sorts of aspects.

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So yes to everybody.

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Please come and join us in, in Edinburgh.

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Thank you so much.

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I think, uh, if, if there's a still
anyone there who doesn't want to come

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to the Congress, they will want to come
to the Congress once they listen to you.

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Thank you so much for your time today.

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And now, Dr Natalia Giannakopoulou
and Dr Ben Blacklock will discuss

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fundoscopy in cats, some practical
tips and common findings.

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Fundoscopy is such a relevant tool in our
routine physical examination, especially

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in senior cats and those with eye
problems ophthalmoscopes are available

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in most practices,  but still some vets
may need advice to use them correctly.

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So what main tips would you recommend
for them to gain confidence when

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performing a basic ophthalmologic

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I think for me, my biggest tip would
be, which could sound quite basic,

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but to just pick up the ophthalmoscope
and use it as much as possible.

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And also not to use it only for cases
that have eye problems, but also

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to examine a lot of normal eyes.

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And I think clinicians would
benefit in many ways by doing this.

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First of all, they would familiarise
themselves with the ophthalmoscope better,

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and they would learn what different
settings do on the ophthalmoscope.

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Let's say you have the diopter
wheel that you can use to focus

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on different parts of the eye.

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That can be helpful to know that, but
also by examining a lot of normal eyes,

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because it's a lot of different variations
in what a normal fundus looks like.

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You are almost able to build
this like mental reference

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of what  normal looks like.

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So then when you're examining an
eye with ocular pathology, you're

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able to identify that easier.

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Technique-wise with your ophthalmoscope
it always helps if you have a fully

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dilated pupil, because with the
direct ophthalmoscope you get this

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almost keyhole view of the fundus,
your field of view is quite narrow

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and the image is quite magnified.

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So if the pupil is not fully mydriatic
it can be quite challenging to have

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a good view, especially because
with our patients, they don't tend

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to stay still for long enough.

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So I would always recommend
dilating the pupil before you

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start doing this technique.

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Great.

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And I also, I really liked the
part of the article where you

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recommend a methodic approach to
the different parts of the fundus.

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Yeah, definitely.

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And this is something that we teach
our students at the vet school, and

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we normally tell them to follow the
systematic approach where you would

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try to  find the optic nerve yet
first and use it as a reference point.

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And then I would recommend assessing
the retinal blood vessels next, then

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splitting the fundus into quadrants
and try to examine each quadrant

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as efficiently as possible, as to
not miss any little subtle lesions.

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If these ophthalmoscopes are not
routinely used in your practice, just

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make sure the batteries are fully charged.

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Make sure they're nice and clean.

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'cause all the little lenses get dirty.

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Make sure you can look through
it without, without any major

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opacities on all the lenses.

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And then when I was in practice, the
cats that I used to love practicing

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this on was those that'd had triple
anaesthetics for routine neutering.

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'cause the pupils are widely
dilated, they've got a central eye

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and you can spend a minute just
practicing your ophthalmoscopy

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on these anaesthetised kittens.

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That's brilliant advice.

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I love it.

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Thank you.

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And besides the ophthalmoscope, is
there any other equipment that we

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could use or that we should be using?

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Definitely there's  a lot of
different options that you can use for

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ophthalmoscopy and they all can give
you like a different perspective and

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they have their pros and their cons.

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Another ophthalmoscope that you can
use is the panoptic ophthalmoscope

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that basically can attach to the
standard ophthalmoscope handle.

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With this ophthalmoscope you get, you
still get an upright view of the fundus,

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but your field of view is wider, so it
can be more easy to see more of the fundus

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at once, which is helpful for someone
who's just beginning and might struggle

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with the direct of ophthalmoscope.

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I wanted to ask you about the
lens.Which lens do you recommend for

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vets working in general practice?

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So I think if you're a
general practitioner, you only

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want to invest in one lens.

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We tend to recommend The Pan Retinal 2.2
because I feel like that lens is a good

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choice because it gives you a wide field
of view, but also good magnification.

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And in general, the higher the diopter the
lens is, the more  wide the magnification

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you're gonna get, the more wide the
field of view is gonna be, but the

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less magnification you're gonna get.

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So for example, if you're gonna
buy a 30 D lens, it's gonna give

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you a wide field of view, but less
magnification compared to a 20 D lens.

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But with the the pan retinal, it's
basically between these two lenses,

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so you get the both of those worlds.

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So I think it would be the
one to invest if you're

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considering buying only one lens.

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Thank you so much for writing
this article 'cause it will be

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extremely helpful to practitioners.

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Thank you for listening.

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00:15:27,788 --> 00:15:31,198
If you are an iCatCare Veterinary
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If you’re looking for more free CPD from
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portal because on the 2nd of June Kelly
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will talk about ‘Cat Friendly Procedures’.

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