Infectious Disease in Kittens:
Prevention and CureDr Kerry Rolph BVM&S Cert VC PhD FANZCVS(Feline Chapter) DipECVIM-Ca FRCVS
European Specialist in Small Animal Medicine
RCVS Specialist in Feline Medicine

Kitten Mortality• Higher incidence in pedigrees?
• Birth to 1 year: ~35%
• Range 8-40%; compared to 10-17% in DSH• Stillbirths: ~7%• Pre-weaning: 15-30%• FAB Survey*• Stillbirths: mean 7.2%
• → 8 weeks: mean 9.1%

*Sparkes et al 2006 JFMS

Kitten Mortality• Pre-weaning ‘fading kittens’• Post-weaning• 4 weeks → 6 months

Percentage mortality %• Stillbirths + birth → 4 weeks

141174012345

Age in weeks

678Causes of Fading Kittens• Birth / queen related• Low birth weight• Dystocia• Inappropriate nutrition• Congenital abnormalities• Neonatal isoerythrolysis• Environment• Infection• Multifactorial

Kitten Mortality
Diagnosis or classTotal- non infectious causes69• Pre-weaning
Feline Parvovirus- infectious causes 44• Post-weaning
Inconclusive
Enteritis derived antibody25(MDA)• Role of maternally/ management / pathogens
18• GeneticsPneumonia

Perinatal<1 dayNeonatal
1-14 days

Pre-weaning
15-34 days

Post-weaning
35-112 days

00366234350042103114

Feline Infectious Peritonitis

1700017

Feline Herpes Virus

140941

Feline Calici Virus

70223Heart Failure*140266Septicaemia

100316Congenital**

70322

Traumatic

42011Total

229

42528172

Modified from: Kitten Mortality in the United Kingdom: a retrospective analysis of 274 histopathological examinations (1986 to 2000): Veterinary Record (2002) 151, 497-501.; Cave TA, Thompson H, Reid S.W.J,
Hodgson D.R Addie D.D. * Including 7 cats with congenital cardiac disease, and 7 with idiopathic cardiac disease. ** Excluding 7 cats with congenital cardiac diseaseImmunity• Maternally Derived Antibody• Only 5% MDA is acquired transplacentally• Kittens require Colostrum for the development of a normal
immune system• Kittens’ ability to absorb colostrum starts decrease at 6hrs
old and is no longer possible from 48hrs.

• MDA Levels• Vary markedly between individual kittens• Wane typically around 3-4 weeks but highly variable, forexample FHV 2-10wks, but FCV 10-14 wks.

Assessing Kittens• Assessing kittens for signs of ill
health can be challenging.
• The cardiovascular system, nervoussystem, urinary and GI tracts are notfully mature-”normal parameters”
are altered

Assessing Kittens
Parameter

Normal Values

Birth Weight

Domestic Shorthair/Longhair: 90-110g
Pedigree breeds: 73g (Korat) to 116g or more (Maine Coon)

Rectal Temperature

Newborn: 36-37°C
One month: 38°C

Heart Rate

First 2 weeks: 220-260 bpm

Respiratory Rate

Newborn: 10-18 bpm
One week: 15-35 bpm

Urine

Specific Gravity: <1.020
Urine Output: 2.5ml/100g body weight/day

Water Requirement

13-22ml/100g body weight/day

Stomach Capacity

4-5 ml/100g body weight

Caloric requirement

20 kcal ME/100 g/d

From: Little, S. (2013) “Playing Mum: Successful management of orphaned kittens.” Journal of Feline Medicine and Surgery 15: 201-210

Diagnostics• Blood Sampling:• 4ml/kg/wk (7.5% blood volume)• Consider glucometer etc.

• Sites:• Jugular• Medial Saphenous• 1ml Syringe with 25-, 26-guage needle• Positioning• “Scruff” Reflex• On backDiagnostics• Special Considerations:• Reference Values are for Adults• FIV testing: Antibodies don’t mean the kitten isinfected• Urinalysis: Urine concentrating capacity doesn’tdevelop until 8-10wks of age

From: S. Little: Feline Focus: Feline Pediatrics: How to Treat the Small and the Sick Pediatrics, Compendium, 2011 (Vol 33, Issue 9)

Viral Infections

Viral Infection• 71% deaths are attributable toviral disease• FHV, FCV, FCoV, FPV, FeLV, FIV• FHV most common cause of death
2-14days• FPV and FIP most prevalent in post
weaning period (35-112d)

Treatment• Intravenous Fluid Therapy• Lack of renal concentrating ability• Lack of skin tent until severely dehydrated• Immature sympathetic nervous system• “Maintenance” 80-100ml/kg/day

Treatment• Intravenous Fluid Therapy• Lack of renal concentrating ability• Lack of skin tent until severely dehydrated• Immature sympathetic nervous system• “Maintenance” 80-100ml/kg/day

Treatment• Nutrition• Quickly develop hypoglycaemia• DO NOT feed when hypothermic/
hypovolaemic (gag reflex not present until
10d pp)• IV dextrose• Stomach tube (Pre-weaning) 5% to 10%
dextrose orally at 0.25 to 0.50 mL/100 g• Syringe feeding: 4–5 ml/100 g body weight• Oesophagostomy tube: first 4 weeks of life isapproximately 24 kcal ME/100 g body weight

Treatment• Nutrition• Quickly develop hypoglycaemia• DO NOT feed when hypothermic/
hypovolaemic (gag reflex not present until
10d pp)• IV dextrose• Stomach tube (Pre-weaning) 5% to 10%
dextrose orally at 0.25 to 0.50 mL/100 g• Syringe feeding: 4–5 ml/100 g body weight• Oesophagostomy tube: first 4 weeks of life isapproximately 24 kcal ME/100 g body weight

Image From: S. Little: Feline Focus: Feline Pediatrics: How to Treat the Small and the Sick Pediatrics, Compendium, 2011 (Vol 33, Issue 9)

Treatment• Anti-Viral Medications• FHV: Famciclovir (40-90mg/kg PO q8hr)• ? Interferon• Nucleoside Analog GC or GSMedications

Antibiotics• Secondary Bacterial Infections• Broad Spectrum coverBacterial Infections

Bacterial Infections• Common infections from• Queen’s birth canal (betahaemolytic Streptococcus sp.
[Strep. G infection])• Gastrointestinal tract (E. coli,
Salmonella sp., Campylobacter sp.,many normal enteric bacteria)• Respiratory tract (Bordetella sp.,
Pasturella sp., Mycoplasma sp.).

Bacterial Infections• Common infections from• Queen’s birth canal (betahaemolytic Streptococcus sp.
[Strep. G infection])• Gastrointestinal tract (E. coli,
Salmonella sp., Campylobacter sp.,many normal enteric bacteria)• Respiratory tract (Bordetella sp.,
Pasturella sp., Mycoplasma sp.).

Umbilical Cord Image From: S. Little: Feline Focus: Feline Pediatrics: How to Treat the Small and the Sick Pediatrics, Compendium, 2011 (Vol 33, Issue 9)Bacterial Infections• Risk septicaemia and death• Kittens have an increased risk of sepsis, especially if there has
been inadequate colostrum intake, or failure of passive transferof MDA.
• Neonates develop hypoglycaemia and hypothermia, both ofwhich predispose to the onset of intestinal ileus.
• If ileus develops there is significant risk that bacteria will translocate fromthe GI tract and enter the blood stream. Clinical signs can occur very
rapidly or the disease may run a more protracted course. Severe cases
will present with bradycardia, dyspnoea, dehydration, weakness, crying,seizures, coma or death

Treatment• Maintain normovolaemia• Treat hypothermia once normovolaemic• Treat hypoglycaemia once normothermic• Antibiotics• Antibiotics would ideally be selected according to culture and sensitivity testing.
• Often it isn’t possible to wait for laboratory results as neonates candecompensate rapidly.
• The penicillins are often the first choice, as they are generally less toxic thanmost other antibiotics.

Parasitic Infections

Parasitic Infections• A severe flea, tick or hookworm
infestation can result in significant
anaemia.
• Gut parasites, such as Giardia,
Tritrichomonas foetus, Isospora or
Cryptosporidia may cause diarrhoea anda failure to thrive.
• Toxoplasma infection may result inabortion, stillbirths and fading kittens.

Treatment of Parasitic Infections• Toxocara• Pyrentel pamoate or fenbendazole from 2-3wks• Giardia• Fenbendazole or metronidazole (care)• T foetus• Ronidazole (not licensed)• Coccidial• Toltrazuril or TMPS (care)• Toxoplasma• Clindamycin or azithromycin• External Parasites• Fipronil (2d)Treatment of Parasitic Infections• Toxocara• Pyrentel pamoate or fenbendazole from 2-3wks• Giardia• Fenbendazole or metronidazole (care)• T foetus• Ronidazole (not licensed)• Coccidial• Toltrazuril or TMPS (care)• Toxoplasma• Clindamycin or azithromycin• External Parasites• Fipronil (2d)Any Questions?