Mordecai Siegal, June Kirvan-Tuttle
Feline Advisory Council, Cornell Feline Health Center
College of Veterinary Medicine, Cornell University

A pregnant queen should be isolated from other cats for the final three to six weeks of pregnancy and should be fed kitten food for extra nourishment.. A queen can experience a false pregnancy, or can reasorb fetuses, especially if she is old, if she feels overcrowded or disturbed, if she is unable to make a nest, or if a strange male is present. In extreme situation, she may abort and ingest her fetuses. A nest box should be provided for the queen . If she feels secure, "queening" is generally a swift and easy process. The first kitten usually appears within an hour of the onset of labor. However, the entire litter may be delivered within the first hour, or, in some cases, the birth may take up to thirty or forty hours. A dark vaginal discharge indicates placental separation; this persists for only two or three days after delivery, unless there is a problem. Once labor has commenced, the queen should not be disturbed except to check occasionally that all is well.

Newborn Kittens

The new family should be left alone in warmth, quiet, and solitude. Constant crying, kittens squirming around the nest box, and restlessness of the queen are signs of trouble. Young kittens have a normal rectal temperature of about 96, which may rise to about 100 (35.5C to about 38C) during the first week, after which the kittens develop the ability to shiver. Umbilical cords drop off at two to three days, and ears and eyes open at around six to twelve days.

Kittens weigh about 100 grams (3-5 ounces) at birth and gain approximately 7 to 15 grams per day (a quarter to over half an ounce). Thus, they will double their birth weight by seven days and triple it by twenty-one days (males gaining even faster). Large quantities of breast milk are needed, and this is stressful for the lactating mother. if a supplemental food source (e.g., milk replacer) can be provided by three weeks of age, it will lessen the need for milk production and may shorten the time to weaning.

Caring for Orphan Kittens

Occasionally, neonatal or young kittens are left with no queen to nurse them or care for them. If a breeding queen dies after giving birth, reject: her offspring, is unable to feed all of her young, or has a mammary disorder such as mastitis, human intervention becomes necessary if the kittens are to survive. The task of "substitute queen" requires meticulous attention to details and accurate record-keeping. A simple logbook will track the progress of each kitten and provide helpful data if one begins to fail.

Kittens should be weighed at birth on a gram scale (newborns usually weigh between 90 and 110 grams [3.15 and 3.85 ounces), and then on a daily basis for the first two weeks. When properly fed, they will usually double their weight within the first week. In addition to food, warmth is essential to the well-being of newborn kittens. A consistent environmental temperature of 90 to 94F (approximately 32 to 34-5C) is recommended for the first two weeks, then 75 to 80 (approximately 24 to 26.5C) for the third week. A temporary incubator, using a standard household sixty-watt bulb placed approximately two and a half feet above the kittens, should maintain the desired temperature.

When the queen licks her kittens, she is not only cleaning them but also stimulating them to urinate and defecate. Massaging or stroking the kitten's anal area with a warm, damp cotton ball will provide the same stimulus. Massage the kittens after they have eaten and continue the massages for three weeks or until the kittens are capable of urinating and defecating on their own.

Milk Substitutes

Cow's milk. Cow's milk is sometimes erroneously thought to be a substitute for queen's milk However, analysis of cow's milk shows that the calcium-to-phosphorus ratio and lactose levels are too high, and the energy, protein, and fat levels are too low to sustain a growing kitten. Adding egg yolk (cooked over steam while stirring) (creating enriched cow's milk) increases the protein and fat to more reasonable levels, but the calcium level remains four times greater and the phosphorous level two times greater than in queen's milk. Enriched milk is an unsuitable substitute for the long term, though it can be used temporarily until a more appropriate milk replacer is obtained

Human baby formula. Commercial human baby formula, made up at twice the recommended concentration, can be used on a short-term basis for kittens. The percentage of nutrients in baby formula is similar to that of cow's milk, except that the lactose level is lower.  However, baby formula provides less than 50 percent of the protein and fat that growing kittens require.

Commercial feline formulas. The best substitutes are commercial products such as KMR (PetAg, Inc.), Havolac (Haver Co.), or Veta-Lac (Vet-A-Mix, Inc.), which have been specifically formulated to closely match the nutrients found in queen's milk.


Intake is limited by the size of the stomach, and excessive fluid intake must be avoided because a newborn kitten's kidneys are functionally immature and have a very limited capacity. Numerous feedings throughout the day, usually every four hours, will prevent overloading the digestive system and kidneys. The number of feedings can be decreased, and the intake per feeding can be increased accordingly, as the kitten matures.

The daily intake of food is based on the kitten's energy requirement. Caloric requirements for the newborn kitten are approximately 420 kilocalories per kilogram at birth, and by five to six weeks of age it needs only 240 to 275 kilocalories per kilogram. (A kilogram is 1000 grams, or 2.2 pounds. A kilocalorie, a term often shortened to calorie by the nonscientific community, is the amount of heat required to raise the temperature of one kilogram of water one degree Celsius.) To calculate the daily amount of milk replacer required for the newborn follow these steps:

  1. Divide the kitten's weight in grams by 1000 to determine the weight in kilograms.
  2. Multiply the answer from step I by 420 (kilocalories). The result provides you with the number of kilocalories needed daily to sustain the newborn kitten.
  3. Find the caloric concentration of the formula on the label. Divide the amount needed by the kitten by the caloric concentration of the milk replacer. Multiply the answer by the quantity of formula (in milliliters) that supplies the specified caloric concentration.
  4. Take the total for the day and divide it by the number of feedings per day.

Some milk replacers provide a feeding chart, which eliminates the need to do any calculations. If KMR is used, do not exceed five milliliters (one teaspoon) of formula per feeding of newborn kittens for the first week. Thereafter, slowly increase the amount per feeding.

Formula should not be fed to a weak and hypothermic kitten. instead, a dilute (5 percent) dextrose solution (sugar water) and lactated Ringer's solution (a sterile, saltwater solution for injection) should be given orally as directed by a veterinarian. Also, the kitten's body temperature should be gradually increased in a warm environment (85 to 90F). Formula can be fed after the kitten's rectal temperature is over 94F

When preparing formula, make up only enough for a forty-eight-hour period and divide it into individual feeding portions. These portions can be stored in the refrigerator. Before feeding, warm the formula to about 100 While warming the formula, sterilize the feeding utensils in boiling water for fifteen minutes to destroy harmful bacteria or viruses. All handlers should wash their hands before feeding or handling the kittens.

Kittens that did not receive colostrum (first milk from the mother) should be vaccinated against rhinotracheitis, calicivirus, and panleukopenia at four weeks of age.

Special animal-feeding bottles are available at pet stores. These bottles have been designed to meet the needs of nursing kittens, but sometimes the nipple openings are too small.  So, if the liquid doesn't drip slowly from the nipple, enlarge the hole slightly. Never force formula by squeezing the bottle while the nipple is in the kitten's mouth. The liquid may be aspirated (inhaled into the lungs), causing aspiration pneumonia, which could be fatal. A medicine dropper can also be used, although the volume will be greatly reduced, making feedings more tedious and time consuming.

The kitten should be fed in an upright position to avoid its aspirating any fluid into its lungs. Bottle-fed kittens must be burped after feeding because of the air they inhale during feeding. Stomach-tube feeding eliminates this step; however, other problems are associated with tube feeding, especially the danger of choking if fluid is directly dispensed into the lungs. Despite the drawbacks, tube feeding is considered the most reliable method for feeding kittens unable to suckle or needing immediate nourishment. Tube-fed kittens should be housed in separate compartments to prevent them from sucking on each other's tails, ears, and feet. A small catheter (premature infant size or 5 French) and syringe work well for tube feeding. The catheter can be purchased in most drugstores and the syringe can be obtained from a veterinarian. Before passing the tube down the kitten's esophagus, carefully mark the tube for the proper length. This is done by measuring the tube from the last rib, behind which the stomach is located, to the opening of the mouth. Tape can be used to mark the section of catheter that reaches to the mouth. This mark indicates the point at which the tube reaches the correct position in the kitten's stomach. Lubricate the tube with warm water or formula before inserting it into the kitten's throat. while the kitten is in an upright position, with its head tilted slightly up, insert the tube along the roof of the mouth. if the kitten begins to gag or you feel resistance, remove the tube and try again. Continue to pass the tube until you reach the mark on the tube. After administering a small amount of warm water to make sure the tube is in the right location, slowly administer the formula over a two-minute period. Each week, remeasure the distance from the last rib to the tip of the mouth and re-mark the tube; the length will increase as the kitten grows.

A kitten has received an adequate supply of food when its abdomen feels full, but not distended. Within three weeks, kittens can learn to drink fluid from a dish. The weaning process can be started when they are three to four weeks old by adding small amounts of commercial cat food to the formula.

Feeding problems usually encountered by inexperienced handlers are overfeeding or underfeeding. A sure sign of overfeeding is diarrhea. The intensity of the problem is indicated by the color and consistency of the stool. The color can range from yellowish to grayish. A grayish diarrheic stool indicates a more severe problem and may signal impending dehydration. Failure to gain weight, excessive crying, listlessness, and shivering occur when a kitten is underfed. The best criteria by which to determine if the kitten is being properly fed are a steady weight gain of ten grams, or one-third of an ounce, per day-and a normal stool (firm and yellowish). The number of stools is usually the same as the number of feedings per day.

Kitten Diseases and Neonatal Mortality

Without question, the first two weeks of life are the most perilous for kittens. Almost all kittens that die before weaning succumb during this critical time. Expected preweaning losses range from 10 to 30 percent, with approximately 65 percent of these deaths occurring during the first week of life (about half of which are stillbirths). Deaths after weaning are less common and normally don't exceed 1 to 2 percent.

When less dim two weeks of age, kittens aren't yet capable of regulating their body temperature. Their immune svstems are still underdeveloped, and they are not yet able to maintain normal levels of blood sugar. As a result, hypothermia, low blood sugar, dehydration, and inadequate quantities of oxygen in the blood are common preludes to death for kittens in this age group, regardless of the initial cause. Because of the limited number of ways neonatal kittens can respond to illness, most "fading kittens" exhibit the. following: (1) low birth weight, loss of weight, and/or failure to gain weight; (2) diminished appetite and activity; (3) decreased muscle tone; (4) constant vocalization or restlessness early, but increasing quiet and inactivity later; and (5) a tendency to remain separate from the queen and the rest of the litter.

A number of noninfectious causes of kitten death are most important during the early nursing period. Difficult or prolonged labor, cannibalism, maternal inattention or overattention, and lactation disorders are significant queen-related causes of neonatal mortality. Extremes of temperature and humidity, inadequate sanitation, overcrowding, and stress ultimately discourage nursing or allow hypothermia.

Infectious Dieases

Infectious causes of kitten mortality are more common during the late nursing or early weaning period than during the neonatal period, although there are exceptions. Young kittens are susceptible to a number of viral infections, some of which (feline panleukopenia virus, feline leukemia virus) may be contracted in utero. Panleukopenia virus infection acquired before birth or just after birth can produce changes in the cerebellum (the portion of the brain concerned with motor function, balance, and coordination), intestinal tract, and bone marrow. infected kittens may have lowered resistance to other infections, diarrhea, and a wobbly walk. Feline leukemia virus infections can cause stillbirths and fading kittens, in addition to other signs. Young kittens are also susceptible to infection with viruses that cause respiratory disease (feline herpesvirus and feline calicivirus).

Bacterial infections are usually acquired across the placenta; during passage through the birth canal; via the umbilical cord, gastrointestinal tract, urinary tract, or respiratory tract; or through skin wounds. However, kittens nursing from queens with mastitis (mammary gland inflammation) may become infected themselves, manifesting signs such as fever, lethargy, depression, bloating, and diarrhea. Mastitis in queens can be the result of infection with any of a number of bacteria, but Streptococcus spp. (spp. stands for species, plural), Stapbylococcus spp., and Escherichia coli are the most prominent. Affected animals become feverish and may refuse food; infected glands appearred, swollen, and painful.  It may be necessary to remove kittens of queens with mastitis and let them nurse from another queen or give them milk replacer. Veterinary attention should be sought immediately. Antibiotics may need to be given to the kittens as well as to their mother. In addition, surgical drainage procedures may be necessary to reduce swelling in the affected glands, especially if an abscess has developed.

The bacteria agent Chlamydia can produce signs ranging from mild conjunctivitis (inflammation of the eyelids to life-threatening pneumonia. Infection with Bordetella bronchiseptica, another bacterial agent, is being reported with greater frequency than in the past. Respiratory tract signs predominate in infected kittens, with pneumonia being the most serious.


           Congenital Defects

Defects present at birth may affect any organ system, with grossly apparent anatomic birth defects occurring in up to 10 percent of nonsurviving neonatal kittens. Birth defects that are not grossly obvious (microanatomic birth defects) also occur. Although many defects are apparent during the early stages of the kitten's life, some may not manifest themselves until later in life. Congenital defects are often inherited, so breeding of cats with such defects should not be considered, unless it is known with certainty that the defect is not inherited.

Some of the more common birth defects involving the nervous system include cerebellar hypoplasia (usually caused by feline panleukopenia virus infection of the queen or kitten), spinal cord defects like Spina bifida (especially in tailless cats), and various storage diseases caused by inborn errors of metabolism (e.g., GMI/GM2-gangliosidosis, mucopolysacchiaridosis, mannosidosis, and globoid cell leukodystrophy). Congenital cardiovascular diseases reported in cats include various septal defects, valve defects, aortic stenosis, patent ductus arteriosus, and tetralogy of Fallot. Portosystemic or portocaval shunts are being diagnosed more frequently than in the past. This defect allows blood flowing from the intestinal tract to bypass the liver, resulting in a variety of clinical signs such as drooling, behavior changes, increased thirst and urination, stupor, incoordination,   and stunted growth.  
Except for cleft palate, congenital defects of the gastrointestinal tract are fairly uncommon and include failure of normal development of segments of the intestine, abnormal development of the anus (atresia ani), megaesophagus, and pyloric stenosis, Craniofacial malformations occur primarily in Burmese cats but occasionally are seen in other breeds as well.
Respiratory system defects include chest wall abnormalities and pectus excavatum. Hereditary deafness, affecting either one or both ears, is common in white cats. Congenital hernias (especially diaphragmatic, peritoneopericardial, and umbilical) are fairly common defects in cats.

Hemolytic Disease of the Newborn
    (Neonatal lsoerythrolysis)

The two most common blood types in the cat are type A and type B, with the allele (one of a pair of genes for a given characteristic) for type A blood being completely dominant over the allele for type B blood. As a result, cats with type A blood may be either homozygous (genotype AA having the same two alleles at a given location on a chromosome) or heterozygous (genotype Ab, having two different alleles at a given location on a chromosome), but blood type B cats must always be homozygous (genotype Bb). Approximately 95 percent of type B cats have high levels of antibody directed against type A blood cells. Therefore, when a type B queen gives birth to type A kittens (as can happen when bred to a type A male), antibodies in her colostrum destroy her kittens' red blood cells, resulting in a profound anemia, This condition, termed neonatal isoerythrolysis (NI), usually becomes apparent within one or two days after birth and can be rapidly fatal. Severe depression, anemia, jaundice (yellowing of the mucous membranes), brownish-red urine, necrosis of the tail-tip, and respiratory difficulty may be seen. The diagnosis of NI is confirmed by blood typing. Affected kittens should be removed from the mother as soon as signs are seen, foster-nursed or fed feline milk replacer, and given supportive care. Because passage of antibody in the colostrum is transient, affected kittens can be returned to their queen after twenty-four to forty-eight hours. Neonatal isoerythrolysis can be prevented by avoiding the mating of type B females to type A males.

Parasitic Diseases in Kittens

Acute toxoplasmosis, a disease caused by the protozoan parasite Toxoplasma gondii, may occur in young kittens, producing a rapidly fatal illness. Cats are the natural hosts for Toxoplasma gondii and, in most cases, are resistant to its disease-producing effects. Under certain conditions, however, the parasite can cause fever, pneumonia, diarrhea, depression, and neurological abnormalities. The prognosis is very poor in such cases. There are other parasites that more frequently cause disease in young kittens, such as roundworms, coccidia, and Giardia. These are much more common problems than toxoplasmosis and, in general, are much easier for the veterinarian to treat.


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