Expert: Jessica - 4/14/2010

Question
Hi Jessica!

I'm fostering a litter plus their queen from the local SPCA for the first time. When I picked her up, she seemed healthy, but a little skinny. The kittens still had their umbilical cords attached and were very small. She started eating well on a mixture of max cat kitten food with 21st Century kitten milk replacer powder mixed in. A few nights ago, she started showing symptoms of an upper respiratory infection along with a decrease in appetite. I bottle fed her 8 ounces of milk replacer and the next day her appetite returned. She seemed in better health as well. When she began to show more URI symptoms and a sharp decrease in appetite again, I took her to the SPCA veterinarian. They gave her a shot of B vitamins and sub cutaneous fluids. I was given clavamox suspension and an ophthalmic antibiotic ointment which she has been on for approximately 36 hours. Her symptoms have not improved and she hasn't eaten anything by her own free will. The veterinarian told me to offer her anything that will tempt her appetite. So far, I've tried beef gravy, all kinds of wet cat food, warmed deli beef in water and kitten milk replacer. She has flat out refused everything. I used a syringe to force feed her some of the gravy to give her some calories. In addition to the normal URI symptoms, she has started coughing more.

Should I be separating the kittens from her? They are doing fine and developing normally, including increased crawling, meowing and fully opened eyes. I'm afraid she's nursing herself to death. Is there any way to get her to eat? Should I give her more subcutaneous fluids? I have the medical skills to do so. Everyone I've spoken to wants me to play the way and see game, but I'm afraid she'll be too weak to recover if I wait for things to go terribly wrong.

Answer
Hi Aleicia.  The best one to check with on this is the vet who has been overseeing her case, but in my experience, kitties undergoing this kind of situation can usually use some extra fluids.  A combination of nursing, decreased water intake and increased energy usage by the immune system usually leads to dehydration.  My vets tend to advise 100-150 units Lactated Ringers Solution a day, but remember, this can vary considerably depending on the cat's weight and condition.  Overhydration is just as dangerous as dehydration.

I would also recommend that you ask the vet about a prescription food such as Hill's a/d or Royal Canin's Recovery RS.  These are both calorie dense and are good foods to feed nursing mothers, and they are of a creamy consistency, easy to force feed with a syringe if necessary.  They also have an appetite stimulating aroma, so hopefully they will tempt her to eat voluntarily.  If the vet doesn't have these foods, you can use stage one chicken baby food (for humans).  This is not as complete so it should only be used for a few days, until her appetite returns.  

There is an appetite stimulant called mirtazapine.  It's not really known to what extent this passes in the breast milk, so it's best to avoid using this in lactating mothers when possible.  However, it may be a consideration to discuss with the vet if things get desperate.

If the kitty has a stuffy nose, this may be a reason she won't eat.  You can help relieve a stuffy nose by instilling a couple of non-medicated nose drops in each of her nostrils a few times a day.  I like Baby Ayr, but any saline nose drop will work.  This will just help break up mucus and help her sneeze it out.  Once cats can breathe more easily, their food is usually a little more tempting.

Any time a cat comes down with a URI, I strongly recommend adding a lysine supplement to the treatment plan.  Lysine is an amino acid that the immune system requires to build antibodies, and it will help combat any viral aspect of the infection that she's fighting.  This is helpful since most URI's begin as viruses, and bacterial infections invade the body while the immune system is compromised.  Lysine is found in products made especially for cats, such as Viralys and Enisyl-F treats, pastes, powders and gels.  Or, you can use lysine tablets made for people.  If you buy the 1000mg tablets, cut them into quarters.  Then, grind up a quarter and mix it into canned food twice daily (I mix it into baby food and feed it with a syringe twice daily).

As far as removing the babies, I'm always reluctant to do this.  The stress of losing her babies could worsen her condition.  Additionally, the kittens are continuing to receive some antibodies from her breast milk.  I would be concerned about removing them from that source of antibodies, especially knowing that they have just been exposed to an infection.  You may want to supplement them with some formula if they will take it, to reduce the drain on mom's body, but I would avoid removing them from mom unless the vet suggests that it's time to do so for mom's health.

I hope she feels better soon!

Jessica