Case Report: Tangled Newborn Kittens

Being a veterinarian can be very humbling, sometimes, because no matter how long a veterinarian practices, there is still the likelihood that each day, they may see something they have never seen before. Exclusively Cats Veterinary Hospital has been around for 25 years, and Dr. Bailey has been practicing even longer than that, and he observed, "In all my years of practice, I have never seen anything like this before!"

Dr. Brooks was presented with 5 kittens that were two days old, born to a feral mother that had been trapped. The foster owner had not been able to access the kittens well, because the mother cat would not let her near them, and she did not want to disturb the litter because all the kittens seemed to be nursing well and appeared active and content. That morning, the mother cat had moved away from the kittens and it became apparent that something was wrong. One of the kittens was nursing on the mother cat, but the other 5 kittens were together in a pile across the cage, struggling and crying. When she reached into the cage to pick up one of the kittens to check on it, she realized that it somehow seemed to be stuck to the other 5 kittens!

Desperately, the foster owner called veterinary hospital after veterinary hospital, looking for help. Time after time, she was told that there was nothing the hospital could offer, or that they didn't work with neonatal kittens. Finally, when she called Exclusively Cats, we told her to rush the kittens in. When she arrived, Dr. Brooks discovered that the kittens were entangled in their umbilical cords. Often, young cats do not know enough to separate kittens from the placenta effectively, and this can cause complications. Sometimes, kittens may end up missing tails or legs because the mother cat is unaware of what she is doing, and in this case, because she only separated a couple of kittens, the rest became ensnared as they moved around. At first, they were happily nursing, but as time went on, they became even more tangled and eventually, the mother cat abandoned them across the cage, because she couldn't figure out what to do.

Immediately, all of our technicians started dropping what they were doing to come to the aid of the kittens. Some held small feet and tails out of the way of Dr. Brooks' work, while she attempted to disentangle them, others weighed, cleaned, fed and warmed the kittens as they were separated. Two of the kittens had hind limbs that were too badly injured to save, and two kittens had umbilical hernias, so Dr. Bailey also jumped in as we cleaned and prepped four of the kittens for emergency surgery. Two leg amputations and two abdominal surgeries later, all five kittens were warm, fed and snuggling in warmed blankets. They received antibiotics and tube feedings because they would not drink from a bottle and the mother had not allowed them to feed recently. At that age, too, kittens cannot urinate or defecate on their own - the mother must stimulate them to eliminate, and so all the kittens were "pottied" as well.

Once all the kittens were recovered, fed and warmed, we taught the foster mom how to tube feed them, if necessary and sent them home. We hoped that they could be re-introduced to the mother so that they could nurse. The prognosis for the tangled kittens is very grave, as there is a huge risk of infection in kittens so small, and with such daunting beginnings. Fortunately, as soon as they were put back with their mother, she accepted them and they started nursing! this is great news, since they will do better with their mother's milk than with kitten milk replacer.




Overnight, one of the kittens who had an abdominal hernia passed away. Two days later, the foster mom brought in the kittens to weigh them. One of the kittens was euthanized due to a septic infection in the leg that was amputated. All the other kittens gained weight, but the kitten that was not part of the entanglement outweighs the others by about 40 grams! Hopefully, with heavy doses of antibiotics and close observation and care, the rest of the kittens will survive this ordeal!

For continued updates on these kittens as we follow their progress, please follow our Facebook page!

Fire Safety for Cats - After the Fire

You and your cat just had a traumatic experience - you lost your house in a fire and fire-fighters pulled your cat from the flames and gave him oxygen to help prevent carbon monoxide poisoning. The fire is out and everyone steps back for a moment to breathe - what next?

Even if your cat looks fine, you should probably take your cat to your veterinarian for an exam, as the negative effects of smoke inhalation may not show up for some time after the fire. Ensure that the attending firefighters or medical personnel at the scene administer at least 10-15 minutes of oxygen before you transport your cat, to help stabilize them for travel. If you are unable to transport your pet to the veterinarian quickly, placing your cat in a steamy room, near a humidifier or offering a nebulizer will help moisturize their heat-damaged lungs.

Your vet will check your cat for burns from the flames, caustic chemicals burns, and check your cat's mouth and lungs for signs of inhaled toxins. Smoke inhalation injury is caused heat injury to the upper airway, including the nasal passages, inhalation of particulates that settle in the lungs and airway, and oxygen deprivation (suffocation), since fires consume the oxygen in the immediate area. Additionally, traumatized lungs can develop fluid accumulation (pulmonary edema) that leads to pneumonia, and can spasm and constrict (bronchispasm and bronchoconstriction) which can cause asthma-like symptoms.

Some of the toxic chemicals that your cat may inhale in a fire are carbon monoxide, excessive levels of carbon dioxide and cyanide, acrolein, hydrogen chloride and aldehydes released as gases by the fire. Inhaling toxic fumes can cause trauma to the lungs, burns to the cat's airway, and death in extreme cases.  Signs to watch for after a fire are:

• Inflamed, red eyes
• Discharge from the eyes or nose
• Coughing
• Weakness/lethargy
• Depression
• Discolored mucous membranes (bright red, blue or pale pink/gray)
• Singed or burnt hair
• Respiratory distress and/or difficulty breathing (rapid breathing, increased effort to breathe)
• Gagging and/or vomiting
• Breathing with mouth open or panting, tongue hanging out
• Raspy respiratory sounds when breathing or a change in voice
• Foaming at the mouth
• Seizures
• Collapse
• Squinting
• Skin and/or burns on or around the eye
• Respiratory or cardiac distress or arrest

Diagnosis of Smoke Inhalation in Cats

Once your veterinarian has examined your cat, he or she may recommend chest x-rays, to look for signs of lung injury or fluid buildup. Depending on the severity of lung injury, x-rays may need to be repeated over several days.


Blood gas measurements may be recommended to determine whether your cat needs additional oxygen support or determine the level of carbon monoxide toxicity.

A complete blood count (CBC) may be recommended to evaluate the level of inflammation or rule out infection, and blood chemistries may be recommended to check for other organ damage from heat injury or toxins, or evaluate your cat for shock.

A fluorescein stain may be recommended to check the surface of the eye (cornea) for damage from smoke exposure, heat damage or particulate injuries.

Treatment of Smoke Inhalation in Cats

 If your cat has inhaled smoke, treament options may include:

• Oxygen therapy
• IV fluids 
• Bronchodilators to help relax the lungs and ease difficult breathing
• Nebulization therapy
• Pain medication for thermal injuries (burns)
• Assisted respiration in cases of acute collapse and respiratory or cardiac arrest 
• Physical therapy for the chest - coupage and positional changes to help prevent lung collapse and help prevent the buildup of fluids
• Eye medications to treat damage to the cornea

 For more information, please read our other blog article on Fire Safety.

Pet Safety Month: Animals in Disaster: Part 4: Preparing a Disaster Kit and a First Aid Kit for your Pet

Planning a disaster preparedness kit for your pet

• One to two-week supply of food. Store it in a water-tight, rodent-proof container and rotate it every three months to keep it fresh. If you use canned food, include a spare can opener and a spoon.
• One to two-week supply of fresh water. If officials declare your household water unfit to drink, it’s also unsafe for your pets. Follow American Red Cross guidelines for storing emergency water for your family and your pets.
• Medication. If your animal takes medication, a replacement supply may not be easily available following a disaster. Make sure to include dosing instructions and refill information for your pharmacy or veterinary hospital
• Copies of vaccination records and/or medical records in a waterproof sleeve (a rabies certificate is extremely important), and information about any special needs for your pet
• Photographs of you with your pets to prove ownership
• Photographs of your pets in case you need to make "lost pet" fliers
• Emergency Contact list  (Veternarian, Emergency Vet, local pet-friendly hotels, and a poison-control center or hotline such as the ASPCA poison-control center, which can be reached at 1-800-426-4435). It is a good idea to include directions to these places as well.
• Pet first aid kit and book
• Temporary ID tags. If you've evacuated, use this to record your temporary contact information and/or the phone number of an unaffected friend or relative.
• One secure carrier for each pet. Carriers should be large enough to allow your pet to stand comfortably, turn around, and lie down. Your pet may need to remain in the carrier for several hours at a time. If you have multiple animals to transport, you can use an EvacSak, which is
  
  easy to store and use for transport, but if your pet needs to be contained for several hours, a carrier is a better choice. In an emergency where time is of the essence, a pillowcase will do for short periods of management, if nothing else will suffice.
• Favorite toy, treats, beds, blankets - small creature comforts to help de-stress your pet
• Small litterbox, litter scoop and litter
• Paper towels, pee pads, pet cleaner
• Garbage bags
• Roll of tape and permanent marker
• Flashlight with spare batteries
• Radio and spare batteries

What should be in your pet's First Aid Kit? Most of the items in a pet first aid kit can also be found in First Aid kits geared towards humans. It is a good idea to bring along a First Aid kit if you are traveling with your pet. Assemble the following in a zippered tote bag or plastic box. A fishing tackle box might do nicely!

Activated charcoal

Adhesive tape - do not use Band-Aids on pets! 1/2 - 1" tape is a good size for cats

Anti-diarrheal medication

Antibiotic ointment for wounds (neomycin, polymixin B, bacitracin)

Antibiotic ointment for eyes

Baby Wipes

Bandage scissors

Bandage tape

Betadine (povidone-iodine)

Blanket - foil emergency blanket

Chlorhexidine scrub and solution

Clippers for grooming - battery operated

Corn syrup (Karo) for hypoglycemia

Cotton balls and/or swabs

Cotton bandage rolls

Dawn dish soap

Ear cleaning solution

Elastic bandage rolls (such as VetWrap or Coflex) For cats, we are fond of 1.5". Do not wrap this too tight; preferably, loosen it from the roll, then wrap with it, just tight enough to stay on.

Eye rinse - sterile (not contact lens solution)

Flea and tick prevention medication

Gauze pads and rolls (2")

Hydrogen peroxide 3%

Ice pack

Large tongue depressors or ice cream sticks (can be used as splints)

Isopropyl Alcohol or alcohol wipes

Latex or nitrile gloves

Measuring spoons

Muzzle - this may be necessary if your pet becomes injured and is in extreme pain, but do not use it if your pet is vomiting, choking, coughing or otherwise having difficulty breathing

Medication - 2 week supply

Nail clippers

Needle-nosed pliers

Non-absorbent wound pads, Telfa or other

Pedialyte

Penlight

Saline solution for rinsing wounds

Sterile lubricant/petroleum jelly

Styptic powder

Small syringes and eye-droppers

Thermometer (digital) - your cat's rectal temperature should be between 99.9-102.5

Tourniquet

Towel and washcloth

Tweezers

You can also purchase pre-assembled Pet First Aid Kits at many Pet Stores and online retailers.

Always remember that any first aid administered to your pet should be followed by immediate veterinary care. First aid care is not a substitute for veterinary care, but it may save your pet's life until it receives veterinary treatment. Please consult with a medical professional before using any home remedies, or in any case where poisoning is suspected. Do not induce vomiting in a suspected poisoning case unless instructed to do so by your veterinarian or the Pet Poison Helpline - in some cases, vomiting can cause additional trauma and complications.

There are many pet first aid books that you can purchase for reference, as well. This one is produced by the Red Cross.

  Cat First Aid book from the Red Cross

Disaster/First aid recommendations for small animals, reptiles, horses and livestock

Pet Safety Month: Animals in Disasters: Part 3: After the Emergency

photo by Stan Carroll

In honor of Pet Safety Month, here are some suggestions to help you weather an emergency with your pet.

3) AFTER THE EMERGENCY

A snake takes refuge during a flood

Depending on the level of damage to your area, your home may be a very different place after the emergency is over, and it may be hard for your pets to adjust.

•  Keep your pets confined indoors or out with leashes only. Depending on the type of emergency, familiar landmarks and smells might be gone, and your pet could be disoriented. If pets are allowed to roam loose during this period, they could easily get lost.
• Keep cats in carriers inside the house, until you have finished assessing the damage. If there are broken windows or loose doors, your pet could escape your home.
• Be patient with your pets after a disaster. Most pets thrive on routine, so try to return to a normal daily schedule as soon as possible. High levels of stress can cause behavior problems. Do your cats tend to fight after one cat visits the veterinarian? Cats especially depend on scent to identify familiar people and animals as well as places. Your cats may not get along after the disaster for the period of time that it takes to re-establish the "family scent". In some cases, a traumatic event can cause two cats that get along very well to completely disassociate with each other. Prepare for the fact that your terrified cats may be too stressed to be re-introduced right away, and let them re-acclimate to each other gradually. If these problems persist, or if your pet seems to be having any health problems, talk to your veterinarian. 
• If there has been a flood, make sure to check your house and yard for wild animals that may have taken refuge there. Stressed, displaced and injured wildlife can pose a threat to you and your pet.
  

Pet Safety Month: Animals in Disasters: Part 2: During the Disaster

In honor of Pet Safety Month, here are some suggestions to help you weather an emergency with your pet.

2) DURING THE EMERGENCY

Evacuate early. If a serious emergency is on its way, don't wait for a mandatory evacuation order. Leaving in a calm, controlled fashion is not only better for your pets, it is better for you, too, especially since many pets can be stressed by the smell of smoke, the sounds of high winds, or flashes of lightning. Some people who have waited until emergency officials evacuated them have been told they had to leave their pets behind.

Identify a safe area of your home where you and your family can stay together, if you must wait out a storm or other disaster at home. Make sure that the safe area is animal-friendly:

• Close off or eliminate unsafe nooks and crannies - Frightened cats may try to hide in small spaces when they are fearful, and may become trapped in areas where you cannot reach them if you eventually end up needing to evacuate.
• Move dangerous items - Any tools or toxic products that have been stored in your safe area should be relocated, in case there is a possibility of a leak or spill.

Be sure to close your windows and doors, stay inside, and follow the instructions from your local emergency management office.

• Stock your emergency supplies in your "safe room" in advance - Have your pet's medications and a supply of pet food and water inside watertight containers, along with your other emergency supplies, as well as a pet carrier or crate for each pet. Close off any open fireplaces, vents, pet doors, or similar openings in the house, with plastic sheeting and strong tape.

Listen to the radio periodically, and don't come out until you know it's safe.

(from Universal-radio.com)

Fresh water is particularly important. If power outages are a possibility, fill up bathtubs and sinks ahead of time to ensure an adequate supply of water.

If flooding is expected, make sure that your safe area is in the highest location in your home, or in a room that has access to counters or high shelves where your animals can take shelter. Your pets are closer to the ground and will be affected by high water sooner than a human.

Pet Safety Month: Animals in Disasters: Part 1: Plan Ahead

 In honor of Pet Safety Month, here are some suggestions to help you weather an emergency with your pet.

1) PLAN AHEAD

- Make sure your pet is microchipped. Collars and ID tags are important, too, but if your cat is wearing a safe break away collar, the collar could be lost and your cat's identification would be lost with it. Most of the lost cats that we hear about are not microchipped. If your pet has a chip with current registration information, they have more than 70% chance of finding their way back to you, compared to only a 10% chance if they have no identification. Onlyabout 1-2% of dogs and cats that appear in shelters as "found pets"have any kind of identification. Reasons that microchip identification fails to work include: unregistered chips, disconnected phone numbers, failure of the contacted owner to respond to phone calls or letters about their pet.

- Even if a collar could become lost, training your cat to wear a safe, break-away collar is a good idea, since that is the first form of identification that rescuers will look for. It is also more obvious that your pet has ID if they are wearing a collar, than if they are only microchipped, even if the only tag on the collar is the one that indicates your pet has a microchip! You may want to make sure that the phone number on your cat's ID tag is a cell phone and not a land line in case you need to relocate and cannot be reached at your home number.

- Know where the pet-friendly hotels are located in the near (and far) vicinity. If your house loses power and you need to relocate, you may not know how far you need to go to reach an area that is safe. You may also want to make an agreement with a distant friend or relative who will allow you to come stay at their house with your pets (or allow JUST your pets) in exchange for you agreeing to allow them to do the same. If you have multiple types of pets, you may need to make separate arrangements for each species (or even each pet!).

• Make sure your back-up caretaker knows your pets' whereabouts and habits.

Let your back-up caretaker know where your pets' food is and where you normally feed them and keep their water bowl, and if they need any medication.

If you need help locating pet-friendly hotels, there are a number of online resources that can help you:

• DogWonderful.com
• BringYourPet.com (United States and Canada)
• PetTravelCenter.com (United States and Canada)
• Pet Friendly Hotels (United States)
• PetsWelcome.com (United States)
• DoginMySuitcase.com (International)
• PetTravel.com (International)
• PetsWelcome.com (Canada)
• Gopetfriendly.com (United States)
• Tripswithpets.com
• Pets-allowed-hotels.com
• Doginmysuitcase.com
• Bringfido.com 
• Dogfriendly.com

If you know that severe weather is approaching and that you may need to relocate, you may want to Michigan State Animal Response Team (MI-SART) is equipped to set up several animal shelters located near human shelters and is partnering withthe Red Cross to assist people in evacuating and caring for their pets.  

call ahead for reservations. Currently, Red Cross shelters do not admit any animals other than designated service animals to their shelters, however, the

- You may also want to locate emergency veterinary services outside your area, in case your pet is injured in a disaster and cannot be treated by your regular veterinarian. Also keep a list of boarding facilities or veterinary offices that plan to function in emergencies. Be aware that animal shelters bear most of the brunt of housing found pets in emergencies and will be stretched to the limit during these times, and may not be able to accommodate you.

-Exchange pet information, house keys and emergency information with a trusted nearby friend or neighbor. If you are unable to return to your home in an emergency situation, your friends or neighbors can evacuate your pets for you. If you have a regular pet sitter, he or she may be able to help, but it is a good idea to make plans in advance. Plan where to meet in case of emergency, in case power and phone communication is interrupted.

- Have an emergency kit for your animals with some important supplies and information that is ready to grab and go. We will be posting some emergency kit tips in our next article.

- Be aware of your cat's favorite hiding places so that you can locate him quickly in case of emergency. If you know ahead of time that severe weather is approaching, you may want to close off areas of the home from which it is difficult to retrieve your cats. 

- If an emergency does occur, remain calm. Your cats can sense your stress level and if you are upset, they will be, too. Some pets will feel comforted by interactions with you in a stressful situation and others will prefer to be left alone, or may benefit from being placed in a pet carrier with a blanket over the top, simulating a secure, cozy nest. Be aware that some pets may experience dramatic behavior changes during times of stress - a loving cat may become aggressive. 

- If your cat is used to going outside in a fenced yard, have a plan for the possibility that your fence might be damaged or destroyed in a severe storm. Make sure that your cats have been brought inside if a severe weather warning has been issued. Some cats may become disoriented if severe weather has affected their normal scent "directional markers" and may not be able to find their way home. Additionally, high winds or flooding may spread or spill chemicals that may be dangerous to your cat, such as chemicals, fertilizers, or other dangerous substances.

- If your cat becomes lost during an emergency, they will likely end up at an animal shelter. Keep a list of the local shelters in your area and their phone numbers and locations.

Mobile Animal Shelter Trailer

- Make sure to keep your cat's vaccinations up to date, since many emergency shelters will require vaccinations prior to admitting pets for sheltering, or will require special sheltering care, such as quarantine, for animals with no proof of vaccination.

- The most important rule: If it is not safe for you, it is not safe for your pets! Even if you think you will only be gone a short time, take your pets, since you may find that even after the emergency has passed, travel may be restricted due to road damage, downed power lines, or other post-emergency problems. In addition, if they are left behind and your house is damaged, your cats could become injured or escape from your damaged home.

Additional Resources

USDA Animal Disaster Preparedness resources

HSUS disaster checklist

National Association of Professional Pet Sitters (NAPPS) Emergency Planning Guide 

CDC Disaster Preparedness information