Raising Orphaned Kittens Part 3: When to call the Veterinarian

One of the hardest parts about fostering orphaned kittens is that kittens can easily get sick. Sick kittens should be dealt with quickly, because they are small and fragile, especially if they have no mother cat.


If one or more of your orphans becomes sick, you should call a veterinarian and discuss the problem. The veterinarian may or may not advise you to bring the kitten in.

At home, you can take your kitten's temperature, if you feel comfortable doing so. You will need a regular thermometer (preferably one that you will not want to use again!) and some KY jelly.  Put some KY on the tip of the thermometer and stick just the tip into the kitten's anus. The kitten will likely protest. Hold the thermometer there until the thermometer beeps (or for about a minute if it is a mercury thermometer). If the kitten's temperature is over 103 or under 99, it is important to call the veterinarian.

Abnormal signs to watch for in a kitten:

• Discharge from the eyes or nose.
• Poor appetite
• Lethargy (lack of energy)
• Diarrhea 
• Vomiting
• Weight loss or failure to gain weight
• Coughing or sneezing

Emergencies requiring immediate veterinary attention

• Continuous diarrhea
• Continuous vomiting
• Bleeding of any kind 
• Any trauma: hit by a car, dropped, limping, stepped on, unconscious.
• Difficulty breathing.
• A kitten that does not respond or that hasn't eaten for more than a day.

WHAT TO LOOK FOR:

-Watch closely for respiratory signs.  Kittens have weak immune systems, especially when raised away from their mother, as they are not getting any antibodies from their mother. They can easily and quickly succumb to disease and infection if not treated appropriately. 

-Aspiration pneumonia is a concern for bottle-fed kittens; be careful when feeding and give them only what they can swallow at one time. Make sure to feed them in an upright position to decrease risk. 

-Watch stool and urine output closely, and observe for any signs of constipation from the milk formula. Some formulas can increase the risk of diarrhea and some can increase the risk of constipation - either one can be a significant issue for tiny kittens.

-Watch for lethargy/or inappetance.

-If you ever have any questions about kittens’ health please call your veterinarian.

Diarrhea and parasites of the digestive tract
Diarrhea is common in kittens and can have many causes including: parasites, viruses, bacteria, food changes, stress, overfeeding. Because kittens can become dehydrated very quickly, make sure to discuss your kitten's diarrhea with your veterinarian sooner rather than later. If the diarrhea is severe, lasts more than 3 or 4 feedings, or contains blood or obvious parasites, you should call a veterinarian and bring in as much as possible of the feces in a Ziploc bag.

Several causes of diarrhea in kittens involve protozoan (single-celled) parasites, such as coccidia, giardia, and tritrichomonas.  These parasites are common in kittens, and occasionally found in adults.  They are not generally treated with common de-wormers, but antibiotics. For diagnosis of these parasites, especially giardia and tritrichomonas, extremely fresh stool is best for diagnosis.

Most large intestinal worms do not cause diarrhea, but can be very debilitating to kittens in large numbers. Sometimes, if the numbers are large enough, or many worms are dying, the dead worms will pass in the stool. More often, the diagnosis for these parasites is by seeing the microscopic worm eggs in a stool sample. If you see spaghetti-like worms in the stool, you are seeing roundworms. These worms can come up in vomit or stool. The cysts of roundworms can persist for years in soil and be spread to other cats or human children, so it is important to deworm cats as directed by a veterinarian.

If you see rice-like worms on the stool or in the hair around your kittens' tails, you are seeing tapeworm segments. These rice-shaped pieces of the worms are mobile when they exit the body, so they may work their way off the stool or kitten and into the environment. They are not infective at this stage. They are spread by fleas or by eating rodents. Tapeworms do not generally cause diarrhea, but it is advisable to treat your kitten for tapeworms, especially if you know that he has had fleas in the past.

Several types of bacteria, including Clostridium, are potential causes of diarrhea in kittens, and all require microscopic examination, bacterial culture, or PCR testing for diagnosis. These are among the fecal pathogens that can be spread to people if adequate hygiene is not observed after handling sick kittens or litterboxes. Most bacteria respond quickly to antibiotics prescribed by a veterinarian.

Finally, there are a number of viral causes of diarrhea, with feline distemper (also known as panleukopenia or feline parvo virus) being the most devastating. If distemper is suspected, seek veterinary care immediately. Treatment for distemper involves aggressive nutritional supplementation and hospitalization, and you may have a number of kittens die if an entire litter is exposed.This is one of the reasons that you should make sure any older cats in your household are up to date with their annual vaccinations before bringing a kitten into the home. Thoroughly disinfect anything that has been exposed to the sick kittens with a bleach solution.

Ear mite

Ear Mites
Ear mites are tiny arthropod parasites which live in the ear canal. Common signs of ear mites are ears full of coffee-ground-like crumbling debris, itchy ears, head shaking.In very large infestations, you may actually see the pinpoint white mites moving in the debris in the ear. They are highly contagious, but easily treated.

Failure to thrive
Once in a while, one or more kittens in a litter that were healthy and vigorous at birth will begin to "fade" after a week or two of life. They will stop growing, begin to lose weight, stop nursing and crawling. They may cry continuously and lose the ability to stay upright. The mother cat may push them out of the nest, where they often chill and starve to death. Kittens fade very quickly - they will not last 48 hours without veterinary care, and probably will not recover even with intensive care.
There is no clear cause or reason for this condition - it has been linked to birth defects, environmental stress and infectious disease. Early veterinary treatment is imperative, but even with tube feeding, rehydration and monitoring, many, if not most fading kittens will die.

Feline Leukemia (FeLV) and Feline immunodeficiency (FIV)
FeLV and FIV are retroviruses cats get from other cats (or their moms). Testing for disease can help you make the decision whether to foster a kitten, or whether to add kittens to a litter or keep them in isolation. It is often a good idea to have positive test results confirmed.

In the early stages of FeLV, infected cats appear healthy but over months to years, they develop severe, ultimately fatal disease. In very young kittens, it is advisable to test at least twice as some kittens can be transiently positive, or falsely negative.

On the other hand, testing for FIV is more difficult until after a kitten is four months old. The good news about FIV is that it is much harder to transmit than FeLV, and cats that have been infected with FIV can live long, healthy lives, often not experiencing detrimental disease symptoms until the age of 8 years or more.

A flea on a flea comb

Fleas
Fleas are insects that love to feed on kittens. Each flea only consumes a small amount of blood, and most adult cats are relatively unaffected by large flea infestations, however fleas commonly attack in large numbers and an infestation in a kitten can lead to severe anemia and even death. It is essential that your home be free of fleas before bringing home a small kitten.

If your foster kitten enters your home with fleas, it is important to remove them without causing harm.  Fleas can be transported from the kittens isolated in one area to the main part of the house on clothing, shoes, etc. Therefore, it is also important to treat any other animals in the home with monthly flea prevention or a stray flea, flea egg, pupa or larva may cause an infestation in your house - any unprotected animal in the house can then become a reservoir for the infestation.

Check with your veterinarian before applying any commercial flea products to your kitten, as some flea medications can be harmful to cats. One safe way to remove fleas from very young kittens (less than 6 - 8 weeks) is daily flea combing. Keep a jar of soapy water near you to dip the comb into as it comes off the cat full of fleas. Try not to moisten the kitten too much, and make sure to thoroughly dry your kittens after you are done combing.

If the Kitten is 4 Weeks old and over two pounds in weight, Capstar can be given orally up to once a day to kill adult fleas. This product starts to work within 30 minutes and is effective against adult fleas for 4-6 hours. It does not have any affect on, eggs, larva, or other adult fleas in the kittens environment.

If the kitten is 6 weeks old or older, you can use topical monthly applications available from a veterinarian. Despite your best efforts at flea control, you should plan to treat the kittens for a minimum of 90 days to ensure that all the fleas are out of the household. For more information about flea control, please refer to our blog article "Fighting Fleas Fairly...For Good!"

Upper respiratory tract infection (URI)
Upper respiratory infections are very common in kittens, especially if they have been through a shelter situation and exposed to other cats. These infections are caused by airborne viruses and bacteria which are contagious and spread very quickly.

Signs of URI to watch out for:

• Sneezing and discharge from eyes or nose
• Congested breathing
• Loss of appetite
• Lethargy
• Dehydration

Vomiting
If your kitten is vomiting, it is possible that the kitten is eating his meals too quickly. You should watch him when he eats and not allow him to eat too much too quickly. If your kitten vomits 2-3 times in a row, it should see a veterinarian. Vomiting can be another sign of distemper in kittens, so it should not be taken lightly.

Case study: Sally - Progressive Retinal Atrophy (PRA) in cats

Sally

 Sally is a 3-year-old Abyssinian cat that was rescued from a hoarding situation. She was one of 84 cats rescued. Eighty of the cats in the household were too ill or debilitated to survive and had to be euthanized. After adoption, it was discovered that Sally was Feline Leukemia positive. She is shy, but sweet, and her owners brought her in to us because she suddenly appeared to lose her sight. She began bumping into things and lost her fear of the dog. If you notice in her photo, her pupils are very dilated, and her owners had noticed this at home, too. Her regular veterinarian sent her to us because high blood pressure was suspected.

What does high blood pressure have to do with eyesight?

The retina lines the back of the eye

The retina is a thin membrane lining the inside of the eye that receives light and translates it into electrical impulses for the brain with special cells called photoreceptors. There are two kinds of photoreceptors - rods that process black and white or dim light vision and cones that process colors or bright light. If the retina or its photoreceptor cells become damaged in some way, the eye has trouble converting waves of light into signals that the brain can understand, interfering with a cat's vision.

 One of the ways that cats can lose their vision is by developing hypertension lesions in the retinas - tiny blood vessels are damaged and regions of the retina lose their ability to function as they lose their blood supply. These lesions look like bubbles in the retina. If a cat's blood pressure remains elevated for a long period of time, the retina can completely detach and lose its connection with the nerves that transmit visual impulses to the brain. Once this has happened, a cat becomes irreparably blind. If the hypertension is diagnosed and treated early, as in these photos, the retinal lesions can heal over time.

Retinal lesions appear like bubbles in the back of the eye

The same eye 2 months after starting blood pressure medication

 Notice that not only are the lesions gone, but the blood vessels appear more visible.

The first thing that we did when Sally came in was check a blood pressure reading. Her blood pressure was 150mmHg, which is a normal pressure in a nervous cat. Hypertension was not the culprit in this case. So, what could be the problem?

The next thing that happened was that Sally received a full physical exam from Dr. Demos, including an eye exam. This is what Dr. Demos saw when she looked in Sally's eyes...

Something very important is missing, here!

There are no blood vessels in this retina!
This is a characteristic feature of something called Progressive Retinal Atrophy (PRA). PRA is a recessive trait in certain breeds of cats such as the Abyssinian, the Somali and the Ocicat. Perisans and Siamese are also often at risk. There are a number of other breeds that have also been identified to carry the mutated gene in small numbers.

Other key features of this disease are a granular appearance to the retina, signs of retinal thinning, and a reduction or thinning of blood vessels. Increased reflectivity of the retina and dilation of the pupils are symptoms that owners can easily see at home. Later stages show pigment changes to the retina and a degradation of the optic nerve. These changes usually happen equally to both eyes at the same time.

Sally's pupils stay dilated, even in bright light

The most common form of PRA in cats is involved a progressive degeneration of the rod and cone receptors in the retina.The cat's eyes develop normally as a kitten, but as the cat gets older, the cat will begin to experience night-blindness and may tend to avoid stairs or darkened areas of the home. It will progress to total blindness by the age of 3-5 years. This is problematic not only for the cats themselves, but for the breeders of high-risk breeds, because often the disease is not apparent until after the age at which many cats have already participated in a breeding program. If you are interested in a purebred cat, it may be a good idea to ask your breeder about PRA and whether their cats have been genetically tested for the mutation.

Unfortunately, this is a problem for which there is no treatment. However, the good news is that cats adapt well to being without their sight due to their superior hearing, sense of smell and sense of touch (whiskers). You can read about the amazing cat, Homer, who caught flies out of the air without the aid of sight!

If your cat starts to show reluctance to move around at night, or has trouble jumping onto furniture, or starts to bump into things, it would be a good idea to have your cat's eyes checked by his or her veterinarian, as well as having a blood pressure exam performed.

Raising Orphaned kittens Part 2: What to do, week by week

You've decided to raise the litter of orphaned kittens you found...

 You have all your supplies, you're ready to go, but just like caring for a 2 day old human infant is different than caring for a 9 month old human baby or two year old toddler, the age of your orphaned kittens is crucial to deciding how much to feed and how often.

0-7 days:

Feeding: 1/2 tablespoon formula every 2 - 3 hours with a kitten bottle.
If the mother, or a surrogate mother is available and healthy, the kittens should nurse vigorously and compete for nipples. Newborns can nurse up to 45 minutes at a time. When the mother cat settles down in the nest box, the kittens should bee-line to the nipples and begin to feed with minimal fussing. If the kittens wander excessively or cry excessively, there could be a milk supply issue. Check at least once daily to make sure all the kittens are nursing, if not more frequently.

Environment: Keep the nest box temperature at a toasty 85-90 degrees. The number one danger to newborn kittens is hypothermia, or a low body temperature. They cannot keep themselves warm on their own (thermoregulate).

Behavior & Training : By one week of age, the kittens should weigh 4 oz. (1/4 pound), and will be sleeping 90% of the time. They will eat the other 10% of the time. Handling should be minimal to allow babies to sleep and eat in their snug, warm nest.

1-2 Weeks of age:

Feeding: Bottle-feed formula every 2 - 3 hours until kittens are full but not bloated- usually kittens will eat at least 1/2 tablespoon of formula per feeding.

Environment: Keep the nest box temperature at a toasty 85-90 degrees.

Behavior & Training : Kittens at 2 weeks of age will weigh about 7 ounces (just shy of 1/2 pound) and have pink skin, and round bodies. If you pinch their skin gently, it should spring back into place quickly. Kittens should wiggle energetically when picked up, and should migrate towards its mother when placed back down. Healthy kittens rarely cry.

To tell whether kittens are male or female, look under the tail. Females will have two holes close together - the vulva is a vertical slit or teardrop below the anus. Males will have two holes farther apart - the opening for the penis is separated from the anus by a little bump (the scrotum) which may be difficult to see or feel at a young age. The best thing to do is find two kittens who look different under the tail and compare. By the time the kittens are ready for forever homes, it should be much more obvious, so don't despair if you can't tell this early what you have.

2-3 Weeks of age
Feeding: Bottle feed formula according to the manufacturer's instruction about every 2 - 3 hours until kittens are full but not bloated- usually kittens will eat at least 1/2 tablespoon of formula per feeding.

Environment: Floor temperature of the nest box can be a little cooler, now - about 75-80 degrees.

Behavior & Training : If there is a mother cat (queen), she will begin to spend more time out of the nest, though she won't wander far.

Kittens should weigh about 10 oz (about 2/3 pound). Their ears will start to stand up. Kittens will start to crawl around day 18 and can usually stand by day 21. Kittens will start to play with each other and explore their environment. Their baby teeth will start to come in (erupt) during this period.

The next six weeks are a critical socialization period. Kittens will learn how to act like a proper cat by watching their mother and interacting with their litter-mates. Additionally, human handling during this period is very important, too. Interaction with children may be too frightening, since even gentle children can be awkward with tiny kittens, so should be supervised closely while visiting. 

3-4 Weeks of age
Feeding: Bottle feed formula per manufacturer's instruction every 2 - 3 hours until kittens are full but not bloated- usually kittens will consume at least 1/2 tablespoon of formula per feeding. At this stage kittens may start lapping from a bowl.

Environment: Floor temperature of the nest box can be much closer to normal room temperature - 70-75 degrees from this point onward.

Behavior & Training: Kittens should weigh about 13 ounces (0.8 pounds). Their eye color will start fade from blue to the adult color, but may not reach its final color until 12-16 weeks of age. Kittens can now focus on the world with an ability similar to adults. They will start to groom themselves, though their mother will continue to do most of the serious cleaning.

4-5 Weeks of age
Feeding: By 4 weeks, your kittens should be eating and drinking from a saucer. Now is the time to start gradually weaning them. Introduce solid food by warming some pate-style canned food and mixing it with a small amount of water or formula to create a soupy gruel that they can lap at.

Without a mother cat to show them what to do, kittens will invariably walk, sit, play, slide in and track food everywhere. Offering gruel on the tip of a finger or wiping a little across a kitten's lips or teeth will help them associate the smell of food with eating behavior. Because it will take several meals before the kitten will end up with more food in its stomach than on its fur, you should continue to offer a decreased amount of formula by bottle-feeding - about 3 tablespoons (1-1/2 oz.) formula every 8 hours. This will simulate the weaning process.

This is a critical time to continue watching the kittens' weight. They should continue to gain weight through the transition from milk or formula to solid food.  If a surrogate mother or the actual mother is present, the kittens will continue to try to nurse, but she will become more and more agitated by this process. Just like small children who gain comfort from pacifiers or thumb-sucking, kittens will continue to perform nursing behavior even after they no longer gain any nutrition from it. Most cats will eventually grow out of this behavior, but it can persist long term in some cats.

Fresh water in a stable, shallow bowl.

Behavior & Training : This is the age that you can also start litter training. Make sure to provide a low sided box, as kittens are not very big. Use a low box with one inch or less of litter. As mentioned in our previous article, a disposable cake pan is perfect. Cut-off cardboard boxes also work well.

Most people think that cats need to be trained to use the litterbox, but in fact, it is an instinct for them. Even kittens raised without a mother cat will gravitate towards a box full of sandy litter and figure out what to do pretty quickly. You can speed the process by placing a kitten in the box after a nap, after meals, and after play, and (the first time or two) guiding him gently to dig in the litter. However, even if you don't do this, they will discover the box on their own.

Just like young children who are potty training, it is good to make sure that wherever the kittens are, a litter box is handy. Otherwise, they may get distracted and find themselves too far from the box with a very insistent need to go! Since most kittens are born with some type of intestinal parasite, make sure to keep the litter box very clean to prevent cross-contamination and re-infection. Cats also do not like their litter to be near their food, so make sure there is a good amount of separation between the two.

5-6 Weeks of age
Feeding: Feed four times daily, gradually thickening the gruel. At this age, you can introduce dry food and water. If your foster litter has a mother, she will continue the weaning process. If your kittens are reluctant eaters, you can try mixing any non-onion-containing meat-flavored human baby food with a little water, but this is not a long term solution, because cats need taurine in their diets or severe developmental issues of the heart and eyes can occur.  

Behavior & Training:  A good rule of thumb from this point forward is that a kitten should gain one pound a month. At 4 weeks, they should weigh about 1 pound, at 8 weeks (2 months) they should be about 2 pounds and at 12 weeks (3 months), they should weigh about 3 pounds. At this age, kittens can start to roam around the room, under supervision. The strongest, most curious kitten will figure out how to get out of the nest. The others will quickly follow. Male and female cats should start to become more easily distinguished as male anatomy develops.

Play with your kittens daily! Kittens love to climb and explore, so sit on the floor and allow them to get to know you. This game allows them not only to get exercise and develop muscle coordination, but to become comfortable with humans. Some kittens may be fearful at first; do not force yourself upon them. You can sit in the room and read or watch quiet television or listen to quiet music, and allow shy kittens to become desensitized. This is a very important step in allowing kittens to develop a confident, social attitude. As they become more adventurous, you can start to introduce other sounds, such as vacuum cleaners and dishwashers. Many very shy and secretive kittens were not abused as kittens as so many people believe, but were just never introduced to the normal noises and activities in a human home at an early age.   


6-7 Weeks of age
Feeding: By this age, your kittens should be eating canned and dry food well. You should offer food to them at least three times daily. Watch for any bullying among littermates, and ensure that all kittens are getting their fair share. They may not eat much at a single sitting, because their tiny stomachs are acorn-sized, but they like to eat at frequent intervals throughout the day. This is how a cat instinctively wants to eat, even as an adult - they spend most of the day hunting and only eat for a few minutes at a time. Frogs, bugs, rodents and birds do not make large meals.

Behavior & Training: By this time, you have "mini-cats." They will wash themselves, use scratching posts, play games with each other, their toys, and you, and many will come when you call them.

7-8 Weeks of age

Feeding: Offer wet food 3 - 4 times a day (each kitten will be eating a little over one can of food per day). Leave down a bowl of dry kitten food and water for them to eat and drink at will. If you have a litter with a mother, she will allow very little nursing.



8+ Weeks of age
Feeding: Offer wet food twice daily. Kittens should have free access to dry food and water all day.

Behavior & Training:  If all your kittens are two pounds in weight, you can start to consider finding them homes at this point, however, a large amount of social development occurs in the next 4 weeks, so the longer the kittens can remain together, the better it will be for their long-term happiness. At 3 pounds in weight, we recommend early spay or neuter surgery. It is much easier to find homes for kittens that have already been spayed or neutered and have had some vaccines and a clean bill of health from a veterinarian.

Remember: A healthy kitten is playful, has bright eyes with no discharge, a sleek coat, and a plump belly. Younger kittens are content to sleep between feedings. Normal body temperature for a kitten is 100 - 102.5. Unfortunately, kittens do become ill and sometimes die while being fostered, so it is important to take steps to prevent disease and treat it appropriately as soon as it appears.

Feline Medicine without Borders!

Jeremy Campbell BVSc MACVSc (Feline Med) MRCVS (and friend)

One of the interesting things about having an ABVP veterinarian at Exclusively Cats Veterinary Hospital is that we get to meet and work with a large variety of other veterinarians who love working with cats as they come to visit and study for externships, internships, or just because they want to know more about all-cat practices. 

This past month, we were thrilled to have Dr. Jeremy Campbell rotating through our hospital on a tour of US feline veterinary hospitals. He is very enthusiastic, friendly and very obviously and genuinely cares about cats. We invited him to share a little more about himself, and why he was here.

**************************** 

Hi, my name is Jeremy Campbell, and I am a New Zealand qualified veterinarian who is spending time at Exclusively Cats to get experience with how things are done in Feline-only practices in this part of the world. I have been fortunate enough to meet some of you and your lovely cats in my two and half weeks here which has been fantastic. Interestingly, my professional career started off at the complete opposite end of the scale both in size and location. I began life in New Zealand working only with horses in a specialty hospital. Over the years as my skills and interests have developed I realised that there was really only one species that presented me with the personal challenges and rewards as a Veterinarian, and that is of course, the cat. 

Why do I like working with cats?

"Cats don't have owners: they have staff." "Dogs look up to us, pigs treat us as equals and cats look down on us." Basically, I love their independence, their ability to train us and the fact that they can convert the most determined/adamant dog-lover (usually men) into a lifelong cat lover with a swish of their tail and a carefully calculated show of affection..... They are such subtle creatures in their manifestations of illness and pain it is a challenge to understand that, then solve their problems. The rewards of making a sick or painful cat better is the thing that motivates me and drives me to enhance my knowledge.

I currently work in a very busy 3.5- 4-vet practice in South London; the practice is 70% cats so I am in my element. However, unlike your lucky cats, ours still have to deal with the day-to-day stress and the constant racket provided by the lesser species! We do have one evening a week which the cats can call their own and this is bliss. Bliss for the cats and bliss for me.

Guppy

Before settling back in the UK two and a half years ago, I spent three years working for the Society for Prevention of Cruelty to Animals (SPCA) in Hong Kong which was a very interesting time with some pretty crazy diseases and manifestations of disease. The SPCA is one of the busiest practices I have worked in with about 21 Veterinarians in total and runs very much like a human hospital being the size of a city block! It was here that I picked up my current cat Guppy. She was dumped on the doorstep of the hospital aged only 3 weeks with a nasty shoulder abscess. I intended to foster her for a short period until she was well enough to be rehomed but (not surprisingly) 4 years later she is still with us.  I have yet to rehome her………although her 3am shouts for attention sometimes tempt me!!

I am spending time in three different feline practices in the US before heading back to London in November (managing to hold the winter at bay for as long as possible…..the other two practices are in Texas!!). I am intending to use this experience as a jumping-off point to doing a speciality qualification in Feline Practice in a couple of years.

Already time is flying as my first placement here at Exclusively Cats is drawing to an end. I have learnt a lot and really enjoyed the warm hospitality and friendliness of everyone here in Waterford and Milford.

Jeremy Sept 2013

Meet Mr. October!

Bear!

Age: 4 years

Weight: 7.7 pounds.

Gender: Neutered Male

Demeanor at the vet's office: Nice boy!
Feline Friends: Riley (14y) and Mowgli (4y)

Bear says "Boo!" and declines to comment further. :)