Diseases, defects and problems in Neonates

The joyous day has come your kittens have been born. However, it turns out to be less than joyous. You have one or more of the following; stillborns, cleft palates, tiny babies, intestines on the outside of body, chewed off legs or tail and other defects. What went wrong?

Below is a list of diseases, congenital defects, birth injuries or problems that can occur in Neonates (newborn or young kittens). It is by no means a complete list of things that can go wrong, but it is a detailed list of the most common issues.

Fading Kitten Syndrome

The first two weeks of a kitten’s life are the most challenging. This is when the kittens are at the greatest risk. Disease, birth injury, exposure (both to elements and disease), low birth weight all factor into the kitten’s survival.

Fading Kitten Syndrome is a term that is used to describe a kitten that just slowly fades, failing to thrive and may die if proper steps are not taken. Some kittens will fade and die despite early intervention and treatment, the cause may never be known but a necropsy is often invaluable to determine why the kitten died.

Often times, poor preparation is the culprit. The queen was not properly vaccinated prior to pregnancy, not a high enough quality diet before and during pregnancy, improper temperatures in the nursery, queen is asymptomatic carrier of disease, or contracted disease during pregnancy, genetics, medications or vaccines given during pregnancy.

Low birth weight kittens are at the greatest risk. They lack muscle mass and fatty layer.These kittens have a much harder time maintaining body temperature and getting a meal.They are typically weaker and might not be able to fight siblings for a teat, or might not have strong sucking reflexes.

Healthy and content kittens do not cry often. Sickly or hungry kittens may cry plaintively for long periods of time, crawl away from the queen and the rest of litter, are slow, weaker and perhaps cold or lethargic, often times they lay with legs sprawled or head to lolled to side.

Diseases and Infections

Some of the reasons for disease in neonates are; insufficient antibodies from queens colostrum (queen not up to date on vaccines prior to pregnancy), queen is asymptotic carrier of disease, or contracted a disease while pregnant, queen has infection (uterine or mammary), exposure to infected or carrier cats or kittens after birth.

Anemia

Iron Deficiency: If the queen is anemic, not enough iron is passed through the milk to the kittens.
Symptoms: Kittens tire easily, grow slowly, are often undersized, the mucus membranes are typically pale.
Treatment: Have your vet determine that it is iron defiency and then iron supplements for queen and kittens are given.

Parasites can cause iron defienct anemia as a result of blood loss through the GI tract.
Treatment: a fecal float test or microscopic exam of fecal material will determine if parasites are at play. Proper worming or medications will correct the condition.

Feline porphyria

A rare case in which red blood cell formation is compromised.
Symptoms: Brownish discoloration of the teeth and red-brown urine.
Treatment: Consult your Vet.

Neonatal Isoerythrolysis (also known as hemolytic disease)

A more common case of kitten anemia. This happens when the blood types are incompatible (the queen is producing antibodies that destroy the kittens red blood cells). These antibodies are secreted in the colostrum.

Symptoms: dark reddish urine with hemoglobin present, jaundice, weakness, necrosis of tail tip, toes or ear tips, death.

Treatment: Stop all nursing. Blood transfusion of compatible type may be necessary. Kittens may resume nursing when colostrum is gone. If this is diagnosed, future litters of this queen should not be allowed to nurse until the colostrum is gone. Approximately 72-76 hours after birth—consult your vet.

Chlamydia

Acts like a virus parasitizing cells but is more closely related to bacteria. Causes neonatal infectious conjunctivitis in kittens 0-2 week of age and conjunctivitis in post weaning age kittens 6-12 weeks. Also has been known to cause fatal neonatal pneumonia, abortions, stillbirths and possible infertility. Typically this disease effects unilaterally (one eye only), but can infect both eyes, generally if both eyes are infected one eye is generally less infected. In neonatal kittens it is thought to be passed through the nose at birth by contaminated birthing fluids.

Symptoms: 0-2 week old kittens; Failure to open one or both eyes on time (7-10 days), bulging behind the eyelids, honey like crust around eyelid. 6-12 week old kittens; low grade fever (often unnoticed), conjunctivitis and mild rhinitis.

Treatment: Use warm, wet compresses to the eyes until puss is exuded. Often times copious amounts of exudate is present. Care should be given to disposing of this infectious exudate. Once the eyes are open and no more puss is exuded, an ophthalmic antibiotic ointment. such as Terramycin should be applied to the eyes 3-5 times a day for at least 14 days. Consult your vet for which antibiotic to use, frequency and duration.

Herpes

Herpes is a common cause of neonatal infectious conjunctivitis in kittens 0-2 weeks of age. This virus is typically transmitted from the queen to the kitten at birth or shortly thereafter. This virus typically infects the eyes bilaterally (both eyes equally).

Symptoms: failure for eyes to open on time (7-10 days), bulge behind eyelids, crust over partially opened eyes. Generally bilateral conjunctivitis and rhinitis in post weaning kittens age 6-12 weeks.

Treatment: Use warm, wet compresses to the eyes until puss is exuded. Often times copious amounts of exudate is present. Care should be given to disposing of this infectious exudate. Once the eyes are open and no more puss is exuded, an ophthalmic antibiotic ointment. such as Terramycin, Erythromycin or Gentocin should be applied to the eyes 3-4 times a day for at least 7-14 days. Consult your vet for which antibiotic to use, frequency and duration. We do not recommend Neobacimyx as we have had many reactions to this ophthalmic ointment.

Prevention: Vaccination

Calici

This virus generally infects kittens at 3-9 weeks of age or with use of live vaccines. Calici has been cultured from the throats of normal healthy cats. Some cats are chronic shedders of the virus but are asymptomatic. The disease usually resolves itself in 10 days.

Symptoms: Fever approximately 24 hours after exposure and again 96-170 hours later, lameness in one or more legs, rhinitis, mouth ulcers, pneumonia.Rhinitis and pneumonia are typically from secondary bacterial infections.

Treatment: Antibiotics can help with secondary infections. Supportive care should be given to keep the fever down and the kitten eating and drinking. The mouth ulcers are painful and the kitten often has to be force fed and watered until the ulcers disappear.

Prevention: Vaccination

Toxic Milk Syndrome

The two most frequent causes of Toxic Milk are acute septic mastitis (a breast infection or abscess) and acute metritis (infection in the uterine lining). Bottle fed kittens can get Toxic milk syndrome by improper handling and storage of formula and utensils.

Symptoms: Kittens cry continuously and appear distressed, bloating, diarrhea and red, swollen, raw anus and genital area.

Treatment: Stop all nursing. Treat kittens for dehydration and chilling. Hand feed. It is important that both the kittens and the queen have Vet care. Do not allow the kittens to nurse on queen again until your Vet says its okay.

Septicemia

Blood born bacterial infections affecting kittens less than 2 weeks of age. This is rapidly spread mainly in the abdomen and respiratory tract. Generally caused by infected umbilical cord, toxic milk, as well as other sources.

Symptoms: Crying, straining to defecate, bloating, dark red to bluish color on abdomen (signs of peritonitis), refusal to nurse, chilling, weakness, dehydration, loss of weight, and death. Some kittens just seem to fade away between age 3-7 days.

Treatment: Must be confirmed quickly or the entire litter is at risk. Treat kittens for dehydration, diarrhea and chilling. Should be aggressively treated with injectable antibiotics and infected kittens removed from the littermates and hand raised.
This condition seriously warrants a veterinarians care.

Viral Pneumonia

The leading cause of respiratory induced death in kittens over two weeks old. The herpes and calici viruses cause viral pneumonia, with an overall mortality of about 50 %.

Symptoms: In neonates, the kitten may suddenly stop nursing, cry and weaken rapidly. Often times, the kitten may be found dead with no apparent cause (fine one-day—dead the next). Older kittens may exhibit sneezing coughing, nasal congestion, and fever. Conjunctivitis, if present might be complicated by ulceration of the cornea, also mouth ulcers may be present (tongue and or palate).

Treatment: See your veterinarian right away. Supportive care is needed. Weak, dehydrated kittens need sub-Q fluids asap. Kittens with mouth ulcers might have to be force-fed. Antibiotics to prevent secondary bacterial infections and eye drops to assist in corneal ulcerations.

Bacterial Pneumonia

Bordetella

Kittens with this bacterial induced pneumonia often show no classic signs of pneumonia such as coughing and difficulty breathing. Kittens may exhibit listlessness, anorexia, dehydration, rhinitis, repetitive sneezing, coughing and phlegm (from either coughing or sneezing).

Treatment: Bordetella is susceptible to antibiotics. Consult your vet for which antibiotics should be used and duration (note: in some cases long term antibiotics are required to completely clear up the kitten, cats and cattery) Be aware that some vets still ascribe to the “cats can’t get bordetella” theory.

Prevention: Vaccination

Pasteurella

Frequent secondary infection in cats with primary viral pneumonia.

Symptoms: Similar to bordetella

Treatment: Consult your Vet for which antibiotics are appropriate and supportive care.

Umbilical infection

If a cord is severed to close to the abdomen, infection may occur. A longer cord typically prevents infection by drying up faster than the bacteria can reach the abdomen. Bacteria present in the queen’s mouth or contaminated (fecal and or birthing fluids) bedding is generally the source of infections.

Symptoms: naval area may look red or swollen and might drain puss or form an abscess.
If left untreated, signs of septicemia set in. Some times there are no signs at all and you find the kitten dead with bloated and or discolored abdomen.

Treatment: If the umbilical cord has been cut too short or close to abdomen, gently wash the area with surgical soap (betadine). Apply a triple antibiotic ointment such as Neosporin. You might wish to remove the kitten from the queen and hand raise temporarily so she does not lick off the antibiotic ointment or aggravate the wound by excessive grooming. Contact your Vet. Injectable antibiotics should be administered at first sign of infection. Inspect all littermates as more than one may be infected.

Skin Infections

Poor sanitation in the nesting box can result in skin infections. They are usually on the abdominal area but can be along the inner hind legs, inner forelegs, chest and underneath tail area. These are often caused by urine burns and secondary Staph infections.

Symptoms: Blisters (may be puss filled), scabs, a crusty area akin to healing burns or abrasion type wounds or rash.

Treatment: clean scabs/wounds with surgical scrub (betadine), apply triple antibiotic such as Neosporin, in some severe cases oral antibiotics should be given. Consult your vet for which antibiotic is best. Be sure the queen is not licking the area excessively or licking off all the antibiotic.

Prevention: Keep bedding clean and free of feces, urine and food.

Neonatal FIP

This Virus is suspect for many causes of sudden death in neonate kittens. Other problems that may be the result of this virus are fetal reabsorptions, repeated abortions, deformed kittens and stillborns.

Symptoms: Kittens may appear normal and healthy and then weaken and die within a few days. Kittens may have low birth weight, be weak, cannot suckle and exhibit emaciation. Kittens may have difficulties breathing, turn blue and die within hours.

Treatment: Supportive care. No good prognosis for infected kittens recovery.

Neonatal Panleukopenia

This virus is similar to FIP in that it is suspect for fatal fading kitten syndrome and reproductive disorders.

Symptoms: Abdominal pain upon palpitation, fever (usually undiagnosed), Diarrhea and vomiting (rare), shock with subnormal temperature, sudden death. Other symptoms may be colic, anorexia, vomiting frothy (bile tinged) and fluid, putrid diarrhea. Kittens may also be aborted but still alive at the time of birth. Kittens that recover often have ataxia (inability to control voluntary muscles) which becomes evident when they begin to walk. These uncoordinated kittens can become loving and functional pets, depending upon the severity of the ataxia.

Treatment: Supportive care. IV fluids and electrolytes, food with held if diarrhea and vomiting are present, antibiotics for secondary infections and blood transfusions. These supportive measures can reduce mortality by 50%.

Prevention: Vaccination.

Congenital and Genetic Disorders

Congenital defect and genetic defect are terms that are often confused or misused.

Congenital means, anomalies existing at birth. They may or may not be genetic in origin. Congenital defects may be environmental in nature, or a genetic encoding oops. If you think about the complexity of gene replication and chromosome division, it’s a wonder there are not more mistakes! The defect might also be the result of environmental influences such as medications, vaccines or toxins exposed to during pregnancy. It can also be the result of inadequate diet deficiency in amino acids, vitamins or minerals.

Genetic implies a trait that is inherited, a trait which is carried by one or both parents and can be passed to the offspring whether it is desirable or not. The genetic trait may be inherited as a dominant, recessive, polygenetic, sex linked or a currently unknown mode of transmission.

Imperforate Anus

Birth defect caused by the failure of development of the anal opening. Examination of the perineum will reveal a layer of skin sealing the anal opening, or the anus is absent. This prevents the passage of stools.

Treatment: In some cases surgery can correction this condition.

Tail Kinks/tail knobs

Fusing of the vertebrae in the tail, causing the tail to either have a pronounced visible “kink” or calcified lump or bend when felt. Tail Knobs are calcified rounded or slightly bent over on tail tip. There is also another form called a tension kink. It is suspected this a result of mal formed or attached tendons and or muscles that control the tail movement. As the name implies, the tension kink or fault is noticeable only when the cat is stressed or tense. There is some basis to this disorder being heritable. Many cases are unobserved injuries, either during birthing or after birth.

Cleft Palate

A failure of the hard palate (roof of mouth) bones to grow and fuse. It is a common congenital defect and is also frequently associated with harelip. Kittens have a difficult time nursing and often aspirate through the exposed sinus cavity. Surgical procedures can work in mild cases; the kitten is tube fed until desired weight or size is met for surgical repair. There is some evidence to support genetic heritablitly as inbreeding results in a higher % of cleft palate kittens. However some drugs such as griseofulvin (ringworm treatment) have been implicated in this disorder.

Hair Lip

The upper lip fails to close, forming a split; this condition is purely cosmetic and can be surgically corrected.

Pectus Excavatum

This common condition generally shows up about the time the kitten approaches 7 days old. Affected kittens will exhibit a flattened chest. In some instances the pelvic may be flattened as well. These kittens are unable to keep their legs under them and the movement of the limbs is often akin to swimming motions or “turtle” like movements. Hence the nickname “swimmers kitten”. In mild cases the kitten will outgrow the condition and live a full and normal life. X rays will often show that the cat is a recovered pectus kitten. There is often a pronounced dip behind the shoulder blades in recovered pectus kittens.

In severe pectus conditions, heart and lung compression causes the inability to breathe properly and get blood and oxygen to the heart and lungs and these kittens die. It also restricts the hearts ability to pump normally.

There are surgical, traction suture and casting techniques that can save the live of a severely affected kitten.

There is evidence to support this can be genetic in origin. However, if the queen is not uptaking or utilizing enough potassium and calcium it can also cause pectus, as well as environmental conditions such as diet and drugs given during pregnancy.

Neonatal endocardial fibroelastosis

This condition is often only found by necropsy. Results of necropsy usually show cardiac dialation with endocardial thickening and fibrosis. Kittens effected usually die within the first few weeks to months of life. There is evidence to support it is similar to cardiomyopathy, in that it occurs when queens and kittens are fed taurine deficient diets.

Hernia

A protrusion of fatty tissue or intestines through a hole in the abdominal wall. It is most common in the naval region. If the protrusion can be pushed back in, its is called reducible. If it cannot be pushed in it is called incarcerated. An incarcerated hernia becomes strangulated if the blood supply to the tissues in the sac is pinched, this is a painful hard swelling and is an emergency, seek veterinarian help. Both conditions can be surgically repaired. There is a genetic predisposition for the delayed closure of the abdominal ring in most cases. It is suggested that the mode of inheritance is polygenetic. However, there is condition in which the queen can cause damage to the naval area by chewing to close to the abdominal wall. (See Birthing Trauma)

Micromelia

A condition in which the long bones of the forelegs are shorter than normal, the bones are often thicker and might even appear bow legged. There is evidence to support this is an inheritable trait however mode of inheritance is unknown.

Frosted Kitten (fever coat)

Kittens are born with a whitish (frosted looking) fuzzy coat. Typically the legs and face are unaffected. It is thought that queen has had an unnoticed fever during gestation. This is a temporary condition and affected kittens are generally in normal looking coat by 12 weeks of age.

Club Foot

Kittens are born with curled hind feet (may be one or both), legs might be extended out and behind the rear end with feet and toes curled upward, the hind limbs may be grossly twisted and appear broken. It is thought to be caused by cramping or poor position in utero. The flexor and or extensor muscles and tendons are not functioning or fighting with one another. This condition is temporary even in grossly distorted legs.

Treatment: Most kittens recover just fine on their own, it is not known just how active a role physical therapy plays in the recovery of affected kittens.

Birthing Trauma and Other Afflictions

Tail and limb injury

Inexperience, nervous or overly enthusiastic queens will often mistake extremities for the umbilical cord. They might chew off the tail, feet or hind legs (rarely the front legs).

Tails: If the tail is cleanly severed, use a betadine wash and then superglue to close the wound (or throw two stitches in). Be Sure to pull the skin up and over the slightly exposed tail vertebrae. In the case of partially severed tails, careful examination and watching is necessary to determine if the ventral vein and artery have been comprised (severed). IF the artery is severed it will not pump blood to the severed end, the severed end will be cold, necrosis will follow (tail tip will wither dry up and may fall off on its own). If the artery is intact but the return vein is not, the severed end will engorge and be warm. It is not uncommon for the severed ends to appear bruised. There is a 2-3 day window for docking the severed tail. The nerve endings become active and the cartilage starts to calcify. If you deem it necessary to dock the tail because vein and or artery are severed, please consult your vet. If your vet is not available, it will require two people.

One to hold the kitten still and one to crop the tail. The person holding the kitten should pull the tail skin towards the butt as best they can, holding along the sides. A very sharp pair of scissors should be used to cut as close to the severed end towards rear as possible.

DO NOT use blood stop powders or other styptic blood stops, have the person holding the kitten pinch the tail off to help staunch the blood. Use superglue or two stitches to close the wound. Pull skin towards end of docked tail and try to pinch the area together and add the superglue or sutures. Be sure the glue is good and dry before returning kitten to queen and be sure NOT to get any on your fingers or come in contact with the glue on the tail with your fingers. This procedure should be preformed by a Vet and should only be used in real emergency situations.

Feet or Legs: if only one foot or leg is involved, it is necessary to quickly stop the blood loss with pressure or small tourniquet until you can reach the vet. Kitten should be kept warm to help prevent shock along with IV therapy. The vet will need to assess the damage and corrective measures to save the kitten. (this is much more complex than tail severing). If more than one limb is severed, it might be best to euthanize the kitten.

Umbilical injury

The result of an overzealous or inexperienced queen chewing to close to the abdominal wall. They can pull too hard on the umbilical and cause the intestines to become exposed and or just a navel hole without the cord. If intestines are out and not severed a quick ER trip to have the intestines cleansed and replaced with sutures to close the opening and antibiotics to help combat peritonitis. If there is just a hole, it should be cleaned with betadine and two sutures to close the wound. Antibiotics are warranted to avoid peritonitis. It is not uncommon to have an umbilical hernia if the queen pulled to hard on the cord of the cord was ripped free from the navel area.

Aspiration

This condition is when the lungs are fluid filled (such as unexpelled amnion fluids), formula or vomit is taken into the lungs. If the kitten is just born and not breathing well or gasping hold kitten head down and pat gently the back and sides of kitten. Use an infant suction bulb to clear nose and mouth of fluids. If the kitten has inhaled formula or vomit, use same procedures above and contact your vet immediately. Oxygen and antibiotics may need to be administered to save the kitten.

Temporary Mal formed head

In the event of a hard, prolonged delivery or over large kittens, sometimes the kittens head may be misshapen (elongated) and the muzzle appears swollen. This is a temporary condition, which begins correcting itself within the hour of birth.

Low birth weight/premature appearance

Kittens that appear significantly smaller than their littermates, may have very little to no hair and translucent appearing eyelids. This condition is often mistaken by breeders as kittens conceived later (typically if the queen has been left with Tom for more than 3 days)

While it is possible for kittens to be conceived at a later date it is rare. The uterus typically sends a hormone signal once the fertilized egg implant, which inhibits further ovulation. Kittens have been known to survive at early gestations of day 57-58. The cause of some of these low birth weight kittens, is improper attachment of the placenta to the uterus, poor placental development, and poor nutrition of the queen and large litters or over crowding. It is not uncommon to have one or two smaller kittens born especially in large litters.

Diarrhea

Is primarily caused by overfeeding, intolerance to the formula, parasites, and bacterial or viral infections.

Mild overfeeding: a loose yellow stool is observed, dilute the formula by 1/3 with water. As the stool returns to normal, gradually return formula to full strength.

Moderate overfeeding: a loose greenish stool is observed. This is a result of more rapid transit through the intestines. Dilute the formula by ½ with water and gradually resume full strength as stools improve.

Severe or unchecked overfeeding: stool is loose and grayish and can become white (curdled milk). The digestive enzymes are depleted. No nutrition is being uptaken and chances are the kitten is very dehydrated. Discontinue formula feeding and give warmed Pedialyte at the rate of I cc or ml per 2 oz of body weight per hour. Consult your Vet. Sub-Q fluids may have to be administered. The gray stools are also indicative of infection. When the above measures do not correct the stools in 12 hrs, have your vet perform a fecal examination to rule out infection, parasites, bacteria and viral infestations.

Minor bowel bleeding

It is not uncommon in bottle fed kittens to notice a small amount of rectal bleeding. This bleeding is minute and fresh red in color and typically follows near the end of the bowel movement but can occur in the middle. The reasons are, improper stimulation regularly to relieve the bowel, irritation from stimulating the anus or hard stools/constipation. Corrective measures include, vitamin E oil to the exterior of the anal region, more regular anal massages after every feeding and relieving constipation.

Constipation

If the kitten has not had a bowel movement in a 12-hour period, the abdomen appears distended and they are not consuming as much formula or actively nursing on queen. Try first diluting the formula or adding a few drops of mineral oil or Milk of Magnesia to the formula. If the bowel does not move within the next 4-8 hours, try a warm soapy water or mineral oil enema using an eyedropper. Lubricate the eyedropper with KY jelly and gently insert tip no more than 1/8 to ¼ inch, gently apply the soapy water or mineral oil into the anal canal. No more than 1 cc should be applied to kittens less than 2 weeks old.

Stillborn

Stillborn means the kitten is born not moving or breathing and typically without a heart beat. It most often means dead at birth. There are many reasons a kitten may be “still born”. Most are covered in text above on Disease and Genetics. If the labor is long and difficult, the kitten is breach and or the amnion sac breaks early, all can cause the kitten to have birthing trauma or appear to be dead upon delivery. However, sometimes these “stillborn” kittens may be revived. Proper rubbing, warming and removal of amnion fluids from mouth and lungs can bring them around. It is important to get the kitten breathing as soon as possible to prevent or minimize oxygen depletion brain damage.

This is only intended as a guide to be aware of symptoms that might occur in your young kittens. It is not meant to take the place of Veterinarian consultation. ALWAYS consult your Veterinarian when problems arise.

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