2 Foster Fails (But not the good kind)

I was asked to take in 2 bottle baby kittens. Very pretty little things, one grey and one brown, looked like marbled tabbies. I was told they were about 3 weeks, but on inspection I found they were likely 1 week tops.

Also upon inspection I realized they were incredibly emaciated. It is not uncommon to feel young kitten's spines, because fat deposits don't tend to deposit on the back unless obese; it is usually our epaxial muscles that cover our spines, and young kittens have very little muscle mass. However, these guys I could feel the wings of their pelvis, then feel that it got even thinner between the hips and ribs, before bulging again at the ribs. If they were any larger, I'd be able to feel each individual rib. I could feel the entirety of their scapula. If it wasn't for their long hair, they would look like skin draped over bones.

On top of that, their paleness worried me. Not just the grey gums, but the white nose and paw pads. That is some severe anemia when you can see the paleness through the paws. That paleness is caused by some kind of blood loss that I would need to find out the source of if I ever hoped to get these guys to pull through.

Adding to our laundry list of issues, I was told that one was having bloody stool, and witnessed it for myself; bright red blood coupled with yellow liquid diarrhea. The bright red indicated bleeding lower down the abdominal tract. Surprisingly, the anus did not seem inflamed or irritated, which is usually the cause of bleeding and often accompanied with watery diarrhea. While on one hand it is nice that the anus isn't raw (at this age they need to be stimulated to eliminate, and rubbing a wet cloth on a raw butt is quite painful), it also raises more red flags - what the fuck is causing the bleeding?

The kittens weighed 5.1oz and 5.3oz, I did not take temps at this age in fear the rectal thermometer would cause anal prolapse. Auscultation of the heart and lungs were insignificant. At this age and size, my feeding goal was 6ml every 2 hours with 4h overnight to give them time to rest, for a total of 7 feedings a day and 42ml a day. They were kept on a heating pad with a stuffed animal, and space to get away from the heat source. 

On first feeding, the grey one needed what I called the fading kitten protocol; rubbing Karo syrup on the gums (or if they have energy to swallow, the tongue) every 3 minutes for 21 minutes to give them sugar so they can get energy to start swallowing. A kitten that is too weak and won't swallow won't eat, and the problem will only compound. He never did suckle, but I was able to slowly trickle milk down the throat for him to swallow. He needed the fading protocol before every single feeding.

Brown one would suckle for a few mls before giving up and I'd have to force feed, but he didn't need karo syrup like his brother. 

'Force feeding' like this, as opposed to the kittens suckling, is a severe aspiration risk. I decided to take the risk as the other option would be to not reach the feeding goal, which would lead to even weaker kittens.

On first feeding I realized they were infested with fleas. First puzzle of why they are pale and anemic is solved. However I found something exceptionally concerning; gray kitten had almost no fleas or flea dirt. That is a problem, as both kittens should be equally infested. Parasites like fleas will feed on their host to survive, but they require a living host themselves to thrive. If their host is dying (low temp, little blood), they will actually flee their host. I suspected the flees knew something about the grey kitten that I didn't, and were saving themselves by leaving the dying kitten.

At this point I decided their best chance of survival was to get rid of the fleas. Unfortunately the organization I was fostering for did not provide flea medication for neonates. The next best thing was a dawn soap bath; the surfactant (a chemical compound that decrease the surface tension between two liquids, a liquid and a gas, or a liquid and a solid) in dawn soap keeps the fleas from being able to breathe through their exoskeleton, effectively killing them through suffocation. There is a huge risk of bathing however; bathing too long can chill the kitten, and is also an aspiration risk. I decided to go through with the risk in an attempt to lessen the flea infestation.

The water should be a little higher than the kitten's average temperature, so slightly hot to the touch or around 101F. Head should never be submerged. I used a 'collar' of dawn soap around the neck to kill any fleas running from the submerging water to the dry head. Unfortunately there infestation was so bad that I was forced to wash the head as well, as there were a ton of fleas hiding around the head. To do this I used a toothbrush that I wetted with the dawn bath water and rubbed it around the head, careful to make sure water would run away from the nose. I used tweezers to pick away the remaining dying fleas.

I was careful to make sure the bath did not last longer than 5 minutes to avoid severe chilling.

They were dried with the help of a second person holding a hair dryer on low heat from a safe distance. While they did that, I physically dried the kittens with a towel, and used a toothbrush and flea comb to comb through and separate wet hair to speed up the process. They were completely dried to the point they were cute fuzzy kittens, the cleanest I've ever seen them.

The next few feedings went fairly well; I chalked this up to them feeling slightly better from being clean and not having biting fleas. The problem came the next morning though.

Their initial morning feeding went more like when I first had them; barely suckling, force feeding, etc. By the 10am feeding, I found grey was stiff - rigor mortis. Still warm due to the heating pad. No corneal reflex. Death was called at 10:07 after 5 minutes of no breathing and no detected heartbeat.

This was also the first time I needed to do the fading kitten syndrome on brown kitten - and also the last. By 9 minutes into the protocol, brown had lost corneal reflexes. 15 minutes in, the kitten stopped absorbing the syrup and I realized it was just piling up on his gums. I ceased the protocol. Death called at 10:30 after 5 minute absence of breathing and heartbeat.

I wrapped them up together in their blanket and brought them to the organization.

Upon return I had learned the history of the two kittens;

The brothers were actually brought in with 2 other kittens; those two were put to sleep on arrival due to opened wounds near the anal region crawling with maggots. I had also learned that the woman who brought them in had told the organization that she had the kittens for 2 days, and during those 2 days she did not feed them at all.

So here's the problem with that -

For a healthy adult cat, going an entire day with 0 calories, not even a single treat or a bite of kibble or accidentally swallowing a fly, is a dangerous situation that can cause fatty liver disease. Fatty liver disease happens when fat builds up in the liver - this happens in cats after just a day because the body tries to mobilize fat for energy reserves quickly, and the liver can not efficiently process the fat, causing a buildup in the liver leading to organ failure.

Now think about 2 days, for a newborn kitten. They were likely undergoing a slow organ failure already. Once organ failure starts, there is not much that can be done to stop it let alone reverse it. Now place that organ failure in a tiny under-half-pound kitten, and there's nothing we can realistically do.

If I would have known about their history before, I probably would have suggest humane euthanasia. But at least I gave them a fighting chance.