Hand-Rearing Kittens

I have realized that many people reading this article will be working in less-than-ideal conditions and will have no access to certain equipment of supplies. I have tried to write in plain English, explaining common veterinary/medical terms as I go.

Reasons for Hand-Rearing Kittens

Newborn kittens are tiny and helpless. They are deaf, blind and totally dependent on their mother for food, warmth and protection. Normally they are cared for by their mother. She is on hand 24/7 to care for them and her milk changes as they grow. When confronted with orphaned kittens first try to find a surrogate feline mother. A local rescue organization or local vets may know of a lactating mother cat that may take the kittens. Only if this is not possible should you attempt to hand-rear kittens.

The task of hand-rearing kittens can be daunting – they need constant care and will put great demands on your time and energy. At first they need to be fed every couple of hours so you will not be getting much sleep.

Do not raise kittens simply because you feel sorry for them. Only attempt to rear them if you plan to keep them, or they have a decent chance of finding homes and they have a good quality of life. Even if they present no actual problems to a hand-rearer, the overpopulation situation or local attitudes to cat care may make it more humane to euthanize abandoned (probably unwanted by mother cat’s owner) kittens. It is far more cruel to hand-rear a kitten and then to abandon it; hand-reared kittens are even less able to adapt to a feral life than are kittens raised by their natural mother.

There are various reasons for hand-rearing kittens either from birth or during development. Sometimes you need to assist a mother in rearing her kittens i.e. supplementary feeding only. Other reasons include:

• abandoned/orphaned kittens
• death, illness or incapacitation of the mother cat
• mother has no milk or proven to be a poor mother
• mother temporarily unable to care for kittens e.g. surgery required, short-term illness, milk not yet dropped (more common if labor is premature)
• mother rejects some or all kittens
• mother has produced more kittens than she can care for unaided
• an owner has insisted on aborting near-term kittens and veterinary staff have given the kittens a chance

Note: Kittens have sometimes been successfully raised by small nursing bitches or a non-nursing bitch has helped with the cleaning, elimination and keeping warm aspects of kitten care. This is the exception not the rule. If you do have such a dog, you will already know her reaction to kittens and the extent to which she helps. Otherwise, do not tempt fate.

When Not to Hand Rear

There are some cases where a kitten or kittens should be euthanized at birth. The following list is not exhaustive. In some cases the decision is difficult. In a few, surgery may be possible (e.g. if it is not a genetic condition and the kitten is important to a breeding program).

• Feline overpopulation means the kitten has little chance of finding a home.
• Gross deformity such as spina bifida or other spinal deformity, multiple missing limbs, fused twins (twin-headed, double bodied etc), anencephaly (lacking large amount of brain), anasarca (effusion of blood serum into tissues) or generalised oedema (waterlogged tissues).
• Cleft palate (incomplete soft and/or hard palate i.e. hole in roof of mouth)
• Hydrocephalus (water on the brain)
• Imperforate anus (no anal opening)
• Major hernia or missing abdominal wall.
• A lesser disability which is not lethal of itself, but will (in your area) prevent a kitten from finding a home. Anopthalmia (eyelessness) is one example.

Some lesser abnormalities (eyes, ears, brain-damage, spinal problems) do not show up until later on. Twisted limbs and joints can usually be rectified with physiotherapy and splinting, or with amputation if only a single limb is affected; the joints are still being formed in the weeks immediately after birth.

Nervous or first time mothers may reject or abandon some or all kittens. In large litters, some kittens may be pushed out, become chilled and be ignored by the mother. Some mothers reject weak kittens which cannot compete against stronger, more active siblings. If a kitten is continually rejected by an experienced mother cat rearing a small litter, the mother may have sensed an abnormality. If you do attempt hand-rearing, be prepared for the worst.

Prioritize

If you are involved in cat rescue and have limited means (financial or facilities) decide on you priorities.

• What are the kittens’ chances of survival e.g. are they sickly, premature, underweight etc?
• Can you find a foster mum i.e. a cat nursing kittens of similar age/size (bearing in mind any risk of cross-infection)?
• Do you have the time to devote to hand-rearing?
• Can you provide warmth, round the clock care, suitable food, aid in urination/defecation?
• What are the chances of finding permanent homes?

If the kittens are poorly, you have little time and the overpopulation state is such that homes are few and far between, your only option may be euthanasia in order to save the lives of kittens and cats which are already independent of such intensive care.

If the overpopulation state is such that late abortion of females is necessary, or if physical trauma means a mother must have an emergency caesarian pre-term, agree beforehand what is to happen to the kittens if they are living. Rather than leave viable pre-term/aborted kittens to die, ask your vet to either euthanize them or to provide appropriate emergency care for them until they are passed into your care or, if possible, to their own mother or a feline foster mother. It is better to decide beforehand (or to have a policy) that such kittens cannot be saved than to make rush decisions on an emotional basis.

Premature Kittens

Premature kittens happen when the mother goes into labor early for some reason, including physical trauma (some traumas may necessitate caesarian delivery). Many vets avoid late-pregnancy abortions because the kittens are viable. Females who birth early may fail to nurse the kittens because the hormones triggering maternal behavior are not released; she may even kill the kittens as a result.

Some pedigree breeds kitten two or three days early, without any problems. F1 hybrids of a domestic cat and a larger wild cat (e.g. serval) may be born on time as far as the mother cat is concerned, but at an earlier stage of kitten development because the wild species has a longer pregnancy. This means that the kittens are premature in terms of how well developed they are.

My own experience of premmies is from late-aborted kittens (at the owner’s insistence) which were fostered by a shelter kitty who had given birth the same day. As with other orphan kittens, a foster mother is preferable as fostered kittens can suckle at will and get more maternal attention. Where not possible, a human foster mother is necessary.

The more premature a kitten is, the less likely it is to survive. Survival chances decrease rapidly for kittens more than 5 days premature. Kittens born more than 2 weeks premature are unlikely to survive. They are small, fragile and easily become chilled. Their lungs will be poorly developed and lacking in surfactant (the moisture which lines the airways in the lungs). Their digestive systems will also be immature and unable to cope with full-strength kitten formula.

It is very important that the kittens get queen’s colostrum in the first few hours of life. This provides maternal antibodies giving them passive immunity to a number of diseases. To prevent stressing their systems, their first feed should be glucose solution (they cannot store glucose for long and burn it up at a tremendous rate) and then diluted milk solution. It is best not to feed full strength milk until the kittens reach their due date. This reduces the strain on their immature digestive systems. They will probably not increase greatly in weight until they have passed their due date.

Their sucking reflex may also be poor and they may require tube feeding. Kittens born more than 6 days early should be tube fed. Very premature kittens also require steroids and antibodies (administered by the vet) to help their immature lungs. Premature kittens often resemble mice in that their tails, legs and ears lack fur. Sometimes the body fur may be so fine as to be barely visible.

In general, the first week or so of their lives is spent reaching the full-development stage at which they should have been born. They don’t put on weight at the same rate as a full term kitten because their bodies are expending energy on growing fur (up to 30% of their intake may be devoted to growing and maintaining fur) and "finishing off" immature internal organs.

When the fur has "grown in" they often gain weight rapidly. Because premature kittens must finish off crucial development outside of the womb, weight gain often begins later than in full term kittens e.g. a week later, though they usually catch up after several weeks. A two week premature kitten will be at a similar stage of development to a normal few days old kitten, not at a similar stage to a two week old born at full term. I have found it helpful to think of them as "minus 2 weeks old", "minus one week old" instead of "a week old", "two weeks old" etc as this gives a more realistic idea of how fast they should be growing.

Basic Considerations

When hand-rearing, you must minimize physical stresses on the kitten. Its actual rate of growth will depend not only on food and warmth, but on its state of health and whether it was born full-term or premature. Kittens do not all grow at the same rate – the figures quoted here are averages. Some will grow faster, some will grow slower. As long as the kitten is healthy, do not immediately panic if your kitten is not growing at the expected rate. If you are concerned at lack of growth, seek veterinary advice.

Not all readers will have state-of-the art facilities. Many cat-rescuers have worked wonders using improvised equipment and sheer hard work. The basic needs for hand-rearing are:

• Clean, warm environment
• Suitable feeding regime and feed type
• Assistance in emptying kitten’s bladder and bowels
• Health care

Common pitfalls include:

• Chilling or heat-stroke
• Dehydration
• Starvation
• Diarrhea

Remember that newborn kittens have immature systems which are easily stressed – their livers are poor at detoxifying drugs, their kidneys are inefficient. They cannot store glucose for long and they cannot regulate their body temperatures for the first few weeks. Minimizing stress to their systems is essential.

Warmth

Kittens cannot control their own body temperature. They cannot shiver. They instinctively form kitten-heaps, snuggling on and under each other (often sliding off the top and burrowing into the bottom of the pile) and their mother keeps them warm by having the snuggle up to her body. Cold kittens cry for attention, but quickly become hypothermic and can no longer cry. A kitten’s temperature will also affect its ability to feed and to digest food.

Cold kittens must be warmed up slowly. Rapid warming can be fatal. In an emergency, newborn kittens have been warmed by holding them in warm water (i.e. up to their necks). Kittens warmed in this way must be dried in a warm environment.

Newborns are wet and chill rapidly as they dry. The ideal solutions are an incubator, heat lamp (infra-red – not placed too close to kittens, not in a small enclosed space and with care not to overheat them) or heated pad. If these are not available, wrap a warm (not boiling) hot water bottle or microwavable pad in a towel and lay the kittens on this. Cover them with a section of blanket or fleece (fleecy side inwards). Fix a thermometer inside the box to check the temperature.

Suggested kitten nests are fleece (e.g. VetBed) which must either be washable or disposable; towels or blankets. These can be placed in a low-sided box (disposable) or crate (washable). Initially, divide the box or crate into compartments because very young kittens have such a strong urge to suckle that they may start to suckle parts of each other’s body, leading to skin lesions which are an infection risk. The kittens remain in separate compartments until they are three weeks old. After three weeks, kittens NEED social contact and they like to huddle together. If the suckling is still excessive and causes skin sores, separation will be necessary for a little longer.

Caution: If using a plant propagators as an emergency incubators, be extremely careful of the temperature; heated plant propagators, or propagators placed on top of a heat pad, may get too hot for kittens as the heat is not easily dissipated.

Expected Temperature of Kittens and Environment

Age of Kitten	Rectal Temp.	Environmental Temp.
Newborn – one week/ten days	95 – 99 F (35.0 – 37.2 C)	85-93 F (29.4 – 34.0 C) Nest box must be large enough for the kittens to move away from the heat source if they become too hot. Where there are a number of kittens they may need less heat because they will form a kitten-heap.
One week/ten days	95 – 99 F (35.0 – 37.2 C)	Gradually reduce temperature to 80 F (26.7 C) by 7-10 days if the kittens are thriving.
Two -three weeks old	97 – 100 F (36.1 – 37.7 C)	80 F (26.7 C) and gradually reducing as kittens grow
Fourth week onwards	100 – 102 F (37.7 – 38.9 C) i.e normal adult temperature.	As above
30 days	100 – 102 F (37.7 – 38.9 C) i.e normal adult temperature.	gradually reduce temperature to 72 F (22.2 C) by the end of the first month.

Note: You need a suitable thermometer and training to measure rectal temperature – ask your vet for advice. Undersized, premature or poorly furred kittens need slightly higher temperatures at each stage.

Preferred Feeding Instructions for Temperature Ranges of Kitten

Body Temperature	Feeding Details
91.4 – 93.2 F (33.0 – 34.0 C)	Nil by mouth!
93.2 – 95 F (34.0 – 35.0 C)	Electrolytes only! Digestion cannot occur below 95 F
95.0 – 95.9 F (35.0 – 35.5 C)	Birth temperature
95.9 – 96.8 F (35.5 – 36.0 C)	2-3 weeks old
100.4 – 101.3 F (38.0 – 38.5 C)	4 wks to adult

Note: A kitten with a body temperature below 94F is clinically hypothermic and likely to die/may already be dying. Its digestive system does not function at this temperature.

Environmental Humidity

Low humidity and poor liquid intake leads to dehydration. Signs of dehydration are poor skin elasticity and sticky mucous membranes (gums). You can determine dehydration by the skin pinch or "tenting" test. Gently pinch the kitten’s skin around the shoulder blade. Pull it out just a little way i.e. "tent" it. When released, it should immediately return to normal. If it remains tented, the kitten is badly dehydrated and probably needs injected fluids. If it returns slowly to normal, the kitten needs rehydration fluids.

Maintaining a humidity of 55% – 65% in the incubator or nest box prevents the kittens’ skin from drying out. Humidifiers can be as simple as a shallow dish of water or wet towel placed on a warm radiator. A steaming kettle (be careful of boiling water) will provide instant humidity in the room, but must be switched off and placed somewhere safe after use.

Elimination (Urination & Defecation)

Kittens cannot urinate or defecate unaided during their first two weeks (approx). The mother normally stimulates these function by licking their lower belly/anal region. Where the human foster mother is entirely responsible for the kittens, this must be mimicked using moist cotton wool or moistened tissue. A kitten must past urine and feces at least once per day. Always stimulate a kitten’s elimination functions after waking it up. After each feed is also good time – since you will be cleaning up milk spillages as it is. If they don’t eliminate each time, don’t force the issue – you could abrade their delicate skin. If they become constipated (a few do) see your vet. Very occasionally an enema is required.

At 2 – 3 weeks old, the kittens should start controlling their own functions. Placing them on the litter tray should trigger the reflex to urinate and/or defecate. Leave a small amount of soiled litter in the tray to build up a scent association for the kitten.

Growth Rate

Keep a log of the kittens’ weights. Accurate digital scales are best for weighing, but good kitchen scales will suffice. Weigh them daily (twice daily is even better) at the same time each day until they are fully weaned and are obviously thriving. Full-term kittens should double their birth weight in the first 7-10 days, then continue to gain weight steadily. Premature kittens gain weight more slowly until their bodies reach the stage of development of a full-term kitten. Keep an eye on whether the kittens are gaining/losing weight or there is no change.

Kittens which have suffered a setback e.g. illness may lag one – two weeks behind in growth. Premature kittens may not begin their growth increase until after the day they should have been born. When keeping records, it is easy to become confused if you have a litter of several near-identical kittens – especially when you are doing a 2 a.m. feed and are on auto-pilot. A dab of nail varnish on a claw will help to distinguish between kittens. Either use a different color for each kitten, or paint the claws of a different paw on each kitten. When keeping records, make a note of the kitten’s nail varnish color or pattern (more on record-keeping later).

Signs of Illness

Kittens can deteriorate rapidly so better safe than sorry when it comes to signs that something is "not quite right". If in doubt, seek veterinary assistance. If the mother is present, but you are aiding the rearing process, take her to the vet with the kittens – she might have mastitis or an infection etc. Normal kittens spend 90% of their time eating and sleeping during their first 2 weeks. Signs of problems include:

• Excessive crying
• Failure to suckle
• Failure to thrive or loss of weight and/or condition (may be getting insufficient milk)
• Diarrhea
• Dehydration
• Appearance of vomiting/regurgitation
• Fever
• Bloating

Note: Fading kitten syndrome is a well-known problem and has many causes. This includes blood-type mismatch akin to the human Rhesus factor.

Colostrum

Kittens are sensitive to disease and infection. Kittens which did not get any mother’s milk are at increased risk. In first 1 – 2 days after the birth, a mother cat secrets a special milk called colostrum which contains vital antibodies. These maternal antibodies (including antibodies triggered by vaccination of the mother cat) give the kitten immunity to many kinds of disease and infection. Without colostrum they are more susceptible to disease. Colostrum also contains more protein and less lactose than normal milk and it is rich in vitamins A and D – the first 36 hours are the most crucial hours of a kitten’s life, the rich colostrum also helps it recover from birth trauma.

Kittens absorb colostrum and its maternal antibodies in their small intestine, maximum absorption is within the first 8 hours. At 12 hours old, the kitten loses the ability to absorb antibodies. Some vets can provide artificial colostrum (its effectiveness is debated) or early vaccination with special killed vaccines at 2-3 weeks of age. This varies from country to country.

At first (before the socialization stage), keep the kittens isolated from other kittens. You may have to take the calculated risk of fostering them onto another nursing female. If there is a chance of a surrogate feline mother becoming available, this is usually better for the kittens than hand-rearing by humans. Weigh up the pros and cons of each individual case. Is the potential surrogate mother healthy? Are the other cats and kittens around healthy and vaccinated? Before handling tiny kittens which are being kept isolated, wash your hands thoroughly or wear disposable medical gloves. It is a tough decision, but if the kittens are to grow into normal cats they will need to mix with other cats, people (and possibly other animals) during the sensitive socialization stage (3 to 8 weeks).

Note: Antibiotics are not a substitute for colostrum. The routine "preventative use" of antibiotics is not recommended as it help the development of drug-resistant bacteria and may weaken the immune system (just like muscles, immune systems need a workout).

Transportation

You may be asked to collect orphaned or abandoned kittens from the finder. Use a closed sided carrier which has been sterilized and is lined with blanket or fleece. A warm pad may be placed under the fleece. If it is necessary for the kittens to spend more than a couple of hours in transit, you must stop to feed them and empty their bowels and bladder. Take a flask of warmed formula and necessary equipment (and some baby wipes!) with you.

Some kittens will arrive in less than ideal containers ranging from open boxes to garden buckets. They may need to be warmed up and/or treated for hypoglycemia or hypothermia. Check for any skin damage which might lead to infection. Also keep a close eye on them for signs of infection.

Hygiene

When hand-rearing or providing supplementary care, disinfect your hands before and after handling kittens to prevent cross-infection with other litters. Also clean or replace the box or crate used as a nest. Cardboard boxes should be considered disposable, plastic crates should be used in rotation so that you always have a disinfected one ready while the other one is in soak or drying.

Avoid pine disinfectants (strong fumes) and any disinfectants which go cloudy when mixed with water. These are toxic to cats and more so to kittens due to their poor liver function. Your veterinarian can provide advice or sell you a suitable veterinary disinfectant. A weak solution of a sodium hypochlorite bleach may also be used. In a situation where a safe disinfectant is impossible to obtain, freshly made salt water (boiled and allowed to cool) may prove effective.

Feeding

A mother cat produces very rich milk to enable kittens to grow rapidly. By comparison, cows’ milk contains less protein and fat and more sugar (lactose). A mother cat’s milk changes over time to match the kittens’ changing needs and growth rate. If the kittens’ mother is feeding them but not producing enough milk (or has a large litter), you must supplement this with kitten formula milk. For orphaned/abandoned kittens or kittens where the mother cannot feed them, you must provide all of their food. By far the best solution is a feline foster mother with same age kittens (if her kittens are a different age, her milk may not be suitable).

There are a number of commercial kitten milk replacement (formula milks e.g. "Cimicat" in the UK) available from vets. Never feed kittens with cows milk – it will cause diarrhea which can be life threatening. Do not use the "cat milks" from supermarkets, these are not kitten milk substitutes! Make the formula food up in strict accordance with manufacturer’s instructions unless instructed otherwise by your vet. You will need a reduced volume if you are providing supplementary feeding only. You may need to strain the feed through a sterile cloth or plastic tea-strainer (small gauge plastic sieve) to remove any undissolved lumps.

If the instructions state "amount per 24 hours", divide this into a number of feeds. Approx 2ml every 2 hours to begin with (= 25 ml per 24 hour period). Two hourly is required to prevent hypoglycemia (low blood sugar), a potentially fatal condition. The amount can be increased and the frequency decreased after 14 days. Do not overfeed – overfeed prevents proper digestion of food. At 2 – 3 weeks feed the kittens every 4 – 5 hours; at 4 weeks old it is every 6 – 8 hours. These are guidelines only and depend on the kitten’s size, growth rate and state of health. It is, however, crucial to feed the very young kittens 2 hourly.

Warm the milk to 35 – 37.8 C (95-100 F). This is approximately the temperature of your forearm. If you use a microwave to warm the milk (not recommended it can easily burn small quantities), it must be left to stand until it has reached the correct temperature. After use, sterilize all utensils used for feeding kittens. Water is needed to replace fluid lost in urine, feces and breathing. Proteins are required for growth and maintenance of body tissues; kittens need more proteins than do adults because of their growth rate. Carbohydrates provide energy and may be converted to fat for storage. Fats are a source of energy. Some fats are essential for cell function. Vitamins and minerals are necessary for normal functioning of the body. If you can get it, commercial kitten food (liquid or solid) is carefully balanced.

If commercial kitten formula is not available, a suitable feed mixture for healthy kittens is 1.6 ml evaporated milk, 1.6 ml cooled boiled water, 1 level teaspoon glucose, 1 small egg yolk (no white at all). One recommended by a veterinarian is 3 oz condensed milk, 3 oz water, 3 oz plain full fat yogurt, 3 large or 4 small egg yolks (no whites). An alternative is kitten glop. These are not suitable for sick kittens. If a newborn cannot cope with milk, give a rehydration mixture to begin with. This should stabilize its condition. If it is healthy, introduce milk (mixed 50/50 with rehydration mixture) within 12 – 24 hours of birth. Gradually increase the proportion of milk until the kitten is on 100% milk made up according to manufacturer instructions.

Glucose solution is absorbed rapidly through the mouth tissues and can be a life saver for kittens without a suck reflex. Keep the kitten warm and use your little finger to stroke a drop of glucose onto the roof of the mouth and the front of the tongue. Continue this for up to 10 minutes, allowing the kitten to rest for 20 minutes between glucose feeds. Like any emergency treatment, it is not guaranteed, but sometimes it saves life. Do not feed glucose solution alone for more than 8 hours unless under veterinary guidance. The "traditional" drop of brandy is not recommended.

Probiotic or bio-yogurt can be used to replace the beneficial gut bacteria after a course of antibiotics. Vitamin drops should only be used on veterinary advice or if the milk formula does not contain added vitamins. Most milk formulae already contain adequate vitamins.

Bottle Feeding
Baby bottles can be bought which are specially designed for kittens. The size of the hole in the teat (nipple) is important. Fill the bottle and tip it upside down – if it drips or dribbles freely, the hole is too large and there is a risk of drowning the kitten. Alternatively, if you have to squeeze the bottle hard, the teat is too small and the kitten will not get enough food (or may give up trying). It should drip when gently squeezed. As the kitten grows it will need a larger hole in the teat to deliver milk faster. Keep the bottle at a 45? angle. That helps keep the teat full of milk and not air. A feeding kitten should lie comfortably on its stomach or side. Gently lift its head towards the bottle. The hole must be correctly sized to regulate milk flow. Over time, the teat will become worn and the hole enlarges; worn teats must be changed for new ones. Kittens may become fixated upon one particular teat (a scent association) and may be reluctant to feed from a replacement teat.

Eye Dropper Feeding
Dropper feeding is similar to spoon feeding. Gently drip or dribble the milk into the kitten’s mouth. Quicker and cleaner than a spoon or syringe method and usually safer. Dropper feeding requires practice to get good control of the dropper. Practice using water into a cup, not on a kitten.

Fingertip/Soaked Napkin
Improvised methods for an emergency where you do not even have a spoon. Soak the corner of a clean cloth napkin in milk and used this to drip milk into the kitten’s mouth. This is a non-sterile method and is very slow. I have used this with a sickly 4 week old kitten using goats milk (in an emergency "in the field").

Spoon Feeding
Most people have access to a spoon. Gently pour each spoonful into the kitten’s mouth. Do not elevate the kitten’s head or milk may enter the windpipe. It is slow, messy and requires practice. New-born kittens have a poor gag reflex and milk can end up in their lungs causing drowning or aspiration pneumonia.

Syringe Feeding
An emergency method, but with practice and a good syringe this can be manageable. I have used this method safely when giving supplementary feeding to kittens over 3 weeks old. If the plunger sticks and then suddenly gives way, a large volume of milk can end up in the kitten’s mouth and lungs, causing drowning or aspiration pneumonia.

Tube Feeding
The cleanest and most efficient method. Requires specialist equipment, training and technical skill. Useful if a kitten’s "suck reflex" is poor or the kitten cannot suckle properly (e.g. cleft palate where surgical correction will be performed later). Stomach tubes must be soft, flexible, blunt-ended and no more than 2-3 mm diameter. Suitable tubes are: premature human baby feeding tube or soft urinary catheter of the right diameter. Syringes should be 2 ml for small kittens, 5 ml for larger ones.

Measure the tube to the correct length (from the kitten’s nose to just behind the point of the elbow), and mark the tube at this point. This measurement will change as the kitten grows! Lubricate the exterior (e.g. with KY jelly) before insertion. Open the kitten’s mouth by pressing gently at the corners.

Keeping the head flexed downwards, slide the tube along the roof of the mouth, over the back of the tongue and down the back of the kitten’s throat into the esophagus. Pass the tube down until the mark on the tube is level with the nose. The other end of the tube will then be in the stomach. If any resistance is felt, withdraw the tube gently – it may have entered the lungs! If you have a stethoscope, listen to the kitten’s chest – wheezing or bubbling sounds means the tube has entered the lungs.

A syringe containing pre-warmed milk can then be attached, and the milk can be delivered slowly to the stomach. Make sure that the syringe does not contain any air. Wait a few seconds before removing the tube.

The kittens have no control over how much they are fed and can easily be overfed or underfed. Kittens with a strong suck reflex are deprived of something to suckle. They may suck on each other and cause skin damage. Accidentally putting the tube into the lungs – this will cause drowning or aspiration pneumonia. If the kitten’s head is kept flexed forward, it is quite difficult to miss the esophagus or put the tube into the airway by mistake. Many kittens meow throughout the whole procedure – if they stop mewing the tube may be in the airway. This technique requires at least some training from veterinary staff.

To encourage suckling, stroke the kitten’s throat gently. Stroking the mouth on either side of the nose can encourage suckling in very tiny kittens. At the other extreme, greedy kittens should be given half of a feed at a time. After feeding, gently tilt its head up and use your other hand to rub its back towards the tail – kitten-burping to get rid of swallowed air.

Keep a record of the time each feed is given, the type and amount given, whether or not the kitten urinates and/or defecates (and whether these are normal). Also weigh the kitten twice daily and record this. You can decrease the frequency of weighing as the kitten grows.

Weaning

Weaning begins at 3-4 weeks of age. Start by teaching the kittens to lap their milk from a saucer. They can be encouraged by dabbing a drop of the milk onto their noses or encouraging them to lick a drop of milk from your finger. When they are lapping consistently, mash a small amount of kitten food into the milk to make a thin paste. As they progress from lapping to "shoveling" and then to eating normally, the amount of kitten food can be increased so that they progress from the paste to solid food. During this time a kitten’s digestive system is adapting to cope with solid, meat-based food instead of milk. They can later progress gradually to dry food if that is your preferred food.

The kitten food used must be balanced, palatable and easily digested. Kittens need plenty of protein for rapid growth and high activity levels. Never use poor quality food just to save money – this could cause digestive upsets and stunt growth. Whether you use a commercial diet or a home formulated diet, it must be fully balanced. A vegetarian diet is not suitable – it lacks vital nutrients. Kittens need variety as long as this is not causing diarrhea – feeding a variety of food prevents fussiness in adulthood. To avoid digestive upsets, only add a maximum of one new type of food in any 48 hour period.

Kitten glop can be adapted for weaning kittens. Mix in liquid cat food (e.g. Liquivite), pureed cat food, meat gravy or pureed baby food. If using pureed baby food, avoid any which contain onion or onion powder. Onion products cause Heinz body anemia in cats; this is especially dangerous in kittens due to their low blood volume.

Avoid stressing the digestive system (e.g. over-feeding, hard-to-digest food, irregular meals) as this can cause diarrhea. Less commonly, a kitten may be allergic to certain foods or ingredients. Kittens have small stomachs and need several small meals at regular intervals throughout the day. Kittens can eat two-three times as much as an adult! A well-fed kitten is active, healthy, grows well and has good bowel motions. Over-feeding causes obesity, lethargy and orthopedic problems due to too much stress on bones and joints.

Weaning hand-reared kittens is a messy business. Be prepared for them to paddle in their food, shovel it around and get it all over themselves. Clean up the kittens before the food becomes encrusted in their fur or around their eyes and noses.

Note: Dried food can cause constipation if the kittens are not used to drinking additional water. Do not introduce them to dry food too early. Only use kitten or cat formula foods. That designed for dogs or humans lacks vital nutrients and may contain things toxic to cats.

Rate of Growth and Development

Note: premature kittens or kittens which have suffered a setback (infection etc) may be two – three weeks behind in their development.

Birth – fourteen days: neonatal period
Body systems are at an early stage of development and unable to cope with stress. The most critical period is the first 36 hours. Neonates are born scraggy, but normally fill out within 24 hours and double their birth weight in 1-2 weeks. 90% of the time is spent sleeping or suckling. They should be relaxed and sometimes twitch in their sleep. When awake, they search vigorously for a teat (they can smell the teat). Eyes and ears are closed. They initially move with a swimming motion and start learning to walk once their eyes open.

Kittens cry if they feel pain, are too hot, too cold or are hungry. Crying kittens should be attended to promptly. Continuous crying causes exhaustion which is fatal. They cannot control their own body temperature and are dependent on the environmental temperature. Hypothermia (chilling) is a common cause of death. Hyperthermia (heat-stroke) is also he fatal. They like to nestle up to something soft and form may kitten heaps with siblings – this helps to conserve heat.

Newborns have a good sense of taste and should have a strong suck reflex. The suck reflex is actually developed before the kitten is born – premature kittens are often able to suckle. A young kitten has a tiny stomach which can only hold a small quantity of food. It needs frequent, regular, small feeds and cannot survive for long without adequate fluids.

They cannot pass urine or feces unaided. The first bowel motion is the tar-like meconium and has accumulated in the bowel before birth. It is sterile because the kitten’s gut has not yet been colonized by bacteria. Early feces is derived from milk and is dark yellow which gradually changes to a yellow-brown as the kitten grows.

Fourteen – twenty-one days: transitional stage.
The kittens become less focused on the mother and more aware of their environment. They grow rapidly, sleep less and begin to explore their surroundings. They can react to discomfort by moving away from it. Although able to control body temperature, their small size means hypothermia and hyperthermia can still occur. Their eyes are open but weak and can be damaged by bright light. They are beginning to focus and will watch moving objects. Their ears should be open and they will react to sound.

They are still reliant on milk as their main food, but may show an interest in cat food. By about 3 weeks old, a kitten can empty its bladder and bowels unaided and should instinctively use a litter tray. By three weeks, a kitten should be active and strong enough to romp and climb. Kittens which cannot support their own weight may have a skeletal abnormality e.g. flat-chest, limb abnormalities.

Twenty-one days to twelve weeks: socialization stage.
Kittens are active and by four or five weeks of age they should be playing with littermates. If they have no littermates, the surrogate mother must provide play. It is preferable that they interact with other kittens or cats in order to learn proper cat behavior. The kittens become increasingly independent and must begin to interact with people, other cats and with normal household items. They learn to purr and to meow. Between six and ten weeks there is a fearful period, this is also the optimum time for learning and traumatic experiences should be avoided. Kittens brought up "underfoot" are more confident.

Also at this age, congenital defects (if present) might come to light. They have increasing control of body temperature and eyesight is improving and will continue to improve for several months. Hearing is acute by three or four weeks and kittens learn to determine what sounds mean. At three to four weeks they should squat when eliminating. At about the same time their first teeth are erupting.

Twelve weeks to six months: juvenile stage
The kittens are young adults and normally reach sexual maturity at 5 – 6 months OR when they attain their final adult weight.

Record Keeping

Whether you use a notepad or a spreadsheet, record-keeping is essential. Unless you keep records, you will not know if a kitten is progressing, stable or deteriorating. Good records mean you can seek veterinary help more promptly. The first thing to do is to check the kitten’s general state to determine its chances of survival or whether it needs intensive nursing or immediate veterinary attention.

If possible record the date of birth and whether it was full-term, premature or overdue. If not full-term, note how many days it was premature/overdue. This is not possible with "found" kittens so make a best guess based on the kitten’s current size, weight and condition. All later weights will be compared to this initial weight to determine how well it is growing. Note whether it is behaving normally for its age, or whether it is precocious or slow. Is it restless, limp or normal? Does it cry more than it should? Is there any vomiting or diarrhea?

Check the rectal temperature, weight and whether the kitten is at all dehydrated. If you have, and can use, a stethoscope check the heart rate – it is normally 200 beats per minute. You can also heck this by placing your little finger behind the kitten’s left elbow.

Either place the kitten to your ear or use a stethoscope to determine if the kitten is breathing normally or is it wheezing or rattling. Check that the fontanelle is closed by using your little finger to stroke from the between the eyes towards the back of the head. If you can feel a soft patch or opening, the bones have not fused; if it does not fuse within the first week or the skull is deformed (hydrocephalus) seek veterinary advice.

Is the head a normal size and shape; are the ears and eyes normal for the kitten’s age? Is there any sign of discharge from eyes or nose? Are the gums and tongue healthy pink, pale (indicating anemia e.g. due to flea infestation or kitten/mother blood group mismatch) or bluish (indicating oxygen starvation). Deep red indicates an infection. Dark blue indicates heart and lungs are failing – by this time there will be brain damage and death is almost certain. The mouth should be moist and warm with no obvious holes in the roof of the mouth (cleft palate) and the kitten should suck on your finger.

Look for obvious defects or deformities such as flat chest, hump-back, spina bifida, umbilical hernia or twisted limbs. Also check that muscle tone is good. Poor muscle tone indicates illness. Check for any infection at the navel and whether the kitten’s belly is abnormally distended (recently fed kittens generally have pot bellies for a short while). Check that the kitten urinates and defecates when stimulated and that urine and feces are normal. If no feces is passed, check for imperforate anus.

Full term kittens should have a full coat of hair (possibly sparse on the paws). Premature kittens usually lack hair on the lower legs and tail; some may appear almost hairless . Kittens with less fur will need plenty of warmth as they lack their own insulation.