The Sickest Kitten of Them ALL

I knew when I saw her that she was a hopeless case.

She had every possible ailment piled on top of her and she was a scrap of a specimen.

Unfortunately, she was being delivered to me from a dear friend with a very fragile spirit. Every fiber of my scientific being told me to speak up, be honest, and count this kitten as another sad statistic to a society that doesn’t take responsibility for a barn cat.

I held that kitten, felt her weightlessness, and looked at my friend tell me for the second time now, to hear the tail end of her story of “how she just couldn’t leave her there by the side of the busy 4 lane highway. She seemed to pop up into thin air, and if she hadn’t I would have missed her. Do you think she will be alright?”

I had to take a long pause before I could answer. The simple efficient answer was “No.” The answer I could live with and the crushing blow I was trying to dart was, “I will do whatever I can to save her.”

I stuck with answer number two. My friend said she would take her as soon as she was well enough to go to her house for foster care.

Kittens are about the most resilient creatures created. I thought she would likely be dead in a day or in foster care in three.

She didn’t weigh a half a pound when she was found. She was a carpet of fleas, and so weak she lay in my hand unable to respond to her natural fear of being with a stranger in a vet hospital.

The next two hours were spent combing off fleas, and killing each life sucking ecto-parasite from her emaciated bony pathetic body. This is a common ailment for a sick kitten. I have seen many many kittens come to me with fleas, but there seems to be some delicate ethereal balance between the host and the parasite. Most healthy outdoor kittens have a few straggling fleas swimming under their coats. But the weakened sickly kittens seem to have a plethora. It appears that the fleas can detect the easy targets and they gang up to deliver their coordinated fatal blow.

If you have a kitten, or find a kitten, please make sure that you de-flea them. A comb, some water, and patience are the safest tools to eradicate them. If you have a severe burden we sometimes use a very tiny amount of a commercially available anti-flea product. (Ask your veterinarian, or call your local rescue for advice with which ones are safe to use). Please, please don’t use anything from an old remedy. I have had clients bring in kittens treated with deadly toxic things, too awful to mention, (stay tuned for future blogs, where I divulge them). But, one last thing, if you get a kitten wet you need to be very very careful to not let them get cold. The big kitten killers are cold, parasites, and lack of nourishment.

The secret to flea removal in kittens is to comb them out with a metal flea comb. The flea comb will separate every hair shaft and remove every flea from the pets’ coat. After the flea is caught in the coat it is wiped on an alcohol soaked paper towel to kill it. The objective is to gently comb the fleas out without getting the kitten wet.

Kittens die from two things first, cold and lack of sustenance, (anemia from being sucked free of your red blood cells by a militia of tiny vampires comes in a close third).

I give a ton of kitten advice every spring: Keep them warm, clean and eating. And remember that peeing and pooping is assisted by their mom, so if you are their foster mom you have to be prepared to stimulate, (if you don’t know what I am talking about ask your vet or rescue). And as always get advice early and often.

Every community has an underground congregation of women (and a few compassionate men, I know this sounds sexist, but check me, I’m spot on), who provide emergency and primary care to throws of abandoned kittens every year. Know them, use them, and help them by keeping your kitten in your home until it is 8 weeks old and ready for its forever home. Also check a fecal, see your vet and always, always be kind to a pet.

Back to my poor pathetic near dead kitten.

She was the worst case I had seen in I think about ever.

Her first day in captivity included de-fleaing, warming, feeding and assessing. She was about 1 month old, but about half the weight she should have been. The fleas were eradicated and she was warmed like a preemie in the NICU ward. All swaddled and bundled and appearing to be a happy patient.

My skepticism in her ability to meet her medical challenges was addressed again by the FeLV/FIV test. She was barely pink, and I was demanding three drops of her short supply blood.

We vets are a hard-line bunch. We tend to try to lighten our load at the starting line by looking for the reasons to give up on our patients. We make our mental list of possible pit-fall problems and proceed through the diagnostic tree to try to reach our conclusive diagnosis. For cats the death sentence is usually wielded by the blue dot determining a felid as either feline leukemia (FeLV) or feline immunodificiency virus (FIV). Those dots mean almost certain death for a feral cat.

We justify the sentence as a way of eradicating the disease from the population. Medicine in its truest form is statistics and prognostic indicators for favorable outcomes, but it is usually determined on the idea that we serve the populations better good, not on the heart-strings of the meekest long shot at survival. We are trained to serve the health of the population even though we are called to medicine by the yearning to serve those with the poorest odds.

With a favorable disease free FeLV/FIV test behind her we took another step down the triage tree. Mental checklist went as follows; warm, check. FeLV/FIV free, check. Flea free, check. That left only the anemia to resolve.

OK, here’s where I get obstinate  If you aren’t going to a vet that places femoral catheters you are losing kittens. It is a scary thing to do the first time and a breeze of life saving breathe every time there after. I place them in seconds and I place them with EVERY SINGLE KITTEN that I think is sick.

It has single-handily saved more kittens then I can remember counting. It is the easiest, quickest, and most effective way to provide life support. Whether that be via delivery of itra-osseous fluids or blood. In most kittens cases it ends up being blood, but in all cases it is life-saving emergency fluids.

Within an hour you can transform a lifeless on the verge if death kitten into a playing, purring, animated spark. It will melt your heart, and make you feel like a god.

I was certain she wouldn’t make it through her first day. She had anemia, pneumonia, and was emaciated. I didn’t give her a name, and I didn’t call my friend to commiserate about my premonition.

I had told her that the first 24 to 48 hours were critical, and that if she made it to hour 49 she was probably out of the woods. It was a commonly used medical adage, but I was wrong about that too.

It took one day for me to see even a tinge of color in her gums, but she remained a weak, motionless mass for days.

Her coat went from flea dirt peppered to wet greasy and sickly. Her eyes swelled shut and her head was eternally cocked back nose to the sky to allow her heavy dense lungs to attempt to pull air through her crusted cloaked nostrils. She never lay down, but instead remained sitting up, head back clinging to life by a tiny thread.

I carried her with me everywhere I went. Closed in a tiny cat carrier, a postcard sized litter box, thimble sized food bowl and tea cup bed enclosed in a plastic box with a handle for portability.

I spoke to my friend every day, usually three or four times a day, always saying the same thing. “She is very, very sick, I keep expecting her to get better, but she instead trades one disease or affliction for another. I still don’t think she is going to make it.”

And everyday she would say the same thing, ‘’Well as soon as you think she is well enough I will take care of her, but I’m so thankful that you have her now.”

Every night I carried her little carrier up to the bedside table so I could hear her breathe, and monitor her cage. I woke up every hour or two to listen to her strained struggling wheezing. I cleaned her face and nose at every wake up and at every visit. She became my portable defibrillator, my oxygen tank, my blood pressure monitor, and my pacemaker. I was never away from her. She knew me by my touch, and would flop into my hand as soon as I opened her cage door. She couldn’t see me, or smell me, but I was her lifeline and her care taker and she was fully imprinted on me.

For a few days she ate, but after the profuse green snot erupted from her nose, and eyes she gave up on eating.

A cat is strongly motivated to eat by their sense of smell. If they can’t smell food they are usually not going to eat. Figuring out how to motivate a stuffed up, congested, snot-ridden kitten how to smell, let alone be interested in the food you put in front of her is quite a feat. I always recommend offering a small assortment of anything that smells appetizing if you are a kitten. I suggest trying lots of varieties of canned foods, baby food (meat), and ask your vet about the prescription high-calorie food. For kittens under 2 pounds, (kittens weigh one pound per month of age up to about 6 months old), offer some kitten formula, or mix kitten formula with some canned kitten food.

That little tiny speck of feline spent 4 months tempting her own mortality. For every shuffle forward she shuffled another back. I know without a shadow of doubt that if she had landed in anyone else’s hands, or not jumped at the exact second that she did that she would not be here with me today.

I willed her to live as much as she fiercely fought to grow. There were months of nights that I awoke to peer into her cage to see if her tiny chest still heaved under the brute force of her pneumonia. She needed two surgeries to un-glue her scarred eyes, and to this day, two years later I have to supplement her almost monthly for short periods with an antibiotic. There are still days where her stuffed up nose requires a tissue, and I never let her out of my sight.

For all of the time it took to get her to the point of adolescence and adulthood she is my shadow. She needed me and now I need her. When I come home each day I call her name and she runs to me. The time it took to nurse her back to health bonded us and that bond reminds me every day that love can sometimes cure all.

If you ever find yourself in a position to adopt a kitten, and if you see a tearing, snotty, feeble little thing I have to warn you there is some chance that they may stay a little runny for the foreseeable future, but then again you just might get a soul that reminds you how precious and miraculous life is.

I named her Wren, because I was so afraid my little bird might never sing.

Curing Beau's Anxiety

The other day I introduced you to Beau. He had lost his lifelong beagle companion and it sent him into an anxiety-ridden tailspin that led to destroying drapes, crying and whining incessantly. His fears were becoming more diverse, more frequent, and intensifying. He is the poster child for "separation anxiety" as we call it in veterinary medicine. I had met Beau not too long after his best friend had passed away and talked to his family about how to most adequately address Beau's stress and condition.

Beau's fight with the drapes. AKA "I want out!"

The family knew very early on after the death of their beagle that they needed to find another friend for Beau. They had jobs and lives outside of their love for Beau. He was a mess on his own and they couldn't fill the gap that their beagle had.

I saw Beau's family about a week and a half ago on my Sunday walk-in hours. Their chart was in the exam room box and I saw that they had a new pet. I was so excited to see their new addition and to hear about Beau's response to having a new friend that I forgot to actually read the chart's entry for "reason for visit."

When I walked in the room I saw looks of concern and a small Beagle recumbent on the exam table. Within a second my excitement dropped to despair.

The beagle on the table was small, about 12 pounds, and she was laying on her sternum with her head extended, nose pointed straight ahead, and breathing as if every tiny inhalation might be her last.

We didn't need words. We all knew she was terribly ill.

I then turned to read the chart. "New pet, sick."

Why hadn't I suppressed my excitement long enough  read the file? Why had I burst into the room excited when the room contained despair?

They introduced Brea to me and told me that they had just picked her up yesterday from the SPCA. (I quickly did the math in my head. They had only had her 20 hours).

They were told when they adopted her that she had kennel cough but was being treated for it. They then produced her antibiotic, doxycycline. They also told me that she had been given up, and then adopted, and then surrendered again.

When you see lots and lots of animals you get a good 6th sense about them. I could tell that there wasn't a mean aggressive tendency in this small scared and pitiful pup. She is a beagle. And although they are vocal and sometimes their nose forces them unconsciously to wander off for that elusive smelly bunny, they are sweet affectionate dogs. They told me that the second family had brought her back because she ran off and wouldn't come to them when they called. (Do people think that this is abnormal? Especially for a beagle? They are powerless to the nose-brain force that drives them to investigate the scent of any animal that has passed by). All pets need to be trained, and all new pets need to be intensively supervised and also trained. Poor Brea, she was a little beagle in a world that couldn't understand or appreciate her. That was until Beau's parents found her.

They explained that they loved beagle's and knew that another beagle would be perfect for Beau. They were so happy to find her, loved her instantly, and didn't care that she was a little sick, but on the mend.

I looked at Brea, gave her an exam and then notified them that she was "Very, very sick." I suspected that her kennel cough had turned into pneumonia and I was not sure she would live." How else could I tell them? She was less than a day theirs and I wasn't very hopeful that she would live past today.

This is what a dog that can't breathe looks like. Head extended, open mouth, reluctant to move.
Brea is in our oxygen cage. The sides are covered in yellow snot becasue she is so congested.
Pink tape covers her i.v. catheter.

Yellow crusted nose.

They said that they loved her already and they wanted to give her a chance. I told them they could call the SPCA tomorrow and see if maybe they would help with her treatment plan.They explained that they had signed paperwork that clearly stated that any medical conditions were their responsibility and that there was a medical facility they could send her to. But they felt confident that she wouldn't get immediate medical intervention and that the SPCA may elect to put her down. They didn't want to wait for her care and they didn't want to give her up.

We took a chest x-ray and ran some blood work. I reported back to them that the x-ray and the blood work didn't appear to look as badly as she clinically did. I discussed options for them. She could go to the ER until we opened again on Monday at 8 am. I told them that the "average ER overnight stay is about $500-$700." I also explained that they could take her home and monitor her very closely and go to the ER if she worsened. Because her blood work and x-ray weren't as severe as I had thought they decided to go home and bring her back first thing the next morning.

Brea's first three days in the quarantine area of our hospital were "touch-and-go."

Quiet, recumbent, and depressed. In quarantine.
A/d slurry (a high calorie prescription food) in with her, just in case she feels well enough to eat.
Because she hadn't eaten in so long with had to add potassium to her fluids.

She went to the ER every night at 8 pm for overnight oxygen cage therapy and came to us everyday for nebulization, i.v. fluids and antibiotics and prayer.

She had severe yellow thick mucous from her eyes, her nose and her throat. She was as sick as sick can be without dying. We all tried to convince each other each day that she had some slight glimmer of improvement. We were saying things back and forth to each other like, "she will get worse before she gets better," which is a difficult piece of advice to swallow when you look as sick as she did.
At day three her x-rays and blood work looked as bad as she did.

At day 4 we had a tiny interest in food. This was a HUGE milestone!

At day 6 we had a bark! A beagle eats and barks! She was finally classified as "recovering."

At day 8 her blood work worsened. Her white blood cell count had continued to climb every time we checked it. On  days 2 through 8 we had her on 3 different very strong antibiotics. On paper we were losing the war. In person we were beginning to see a real live beagle.

As the staff fretted about her stats I reminded everyone that "the pet tells you the most important information. The pet trumps any number." That first exam she was telling us that she was very sick, and now she was telling us that she felt better. We will treat her until both pet and blood work agree that we can stop.

At day 10 Brea remains with us for the day while her new family is at work. She has yet to meet Beau. It will have to wait until she isn't blowing disease droplets at every sneeze. But she is a bright, happy, wagging, nose to the ground, inquisitive girl who I think will be a perfect buddy for Beau.

Out for a walk in the sunshine! This is how you know a beagle feels better.
They are sniffing, digging, and watching other dogs.
And there is that "happy beagle wag!"

Her new family knows that they single handedly saved her life.

Please rescue, and please be patient if you do. These guys often come from broken homes, and many of them have been shuffled around. They in many cases also haven't been "trained." I know many people are hesitant to adopt because they are afraid of inheriting a pet with problems. I hear many people say to me "I think that Fluffy is this way because she was abused." I know a great number of pets who were adopted at 8 weeks old with behavioral issues that were never abused. Your pet Lives in the now and almost every single behavioral problem can be resolved with patience, kindness, determination and assistance from professionals. Please don't give up your pet without asking for help from your vet, your local rescue organizations, and behavioral advisers. Pets are a life-long responsibility.

It has been two weeks of hospitalization for Brea. I am soo happy to report that she is thriving and happy. I will post pictures of her and Beau soon. She is still being kept away from him for a few more days, while the antibiotics kill the last few bugs of her infection.

Update:
On September 13, 2012 Brea passed away due to a severe infection in her spinal cord. Her parents loved her immensely, fought countless battles with and for her, and in the end, although her time with them was very short, she found a place to call her own and a family that loved her every second of her time with them. We all should be so lucky.

Brea and Beau's family came into the clinic a few months later. At that time we were looking for a home for Pheobe. She was an overweight, under exercised mixed breed dog. She had been scheduled to be euthanized because her mom was entering long term hospice care. Her mom didn't believe that there was a possibility that Pheobe could find another home at her advanced age of 8. I spent 20 minutes pleading with her to let us find her a home. I had to say things that I was dumbfounded to answer. Like promising her "that we wouldn't experiment on her." Or, "that we wouldn't let her suffer in a tiny cage and never be able to go outside or see daylight." I was so disheartened that people could do such things, or even imagine doing such things.

Pheobe in the few months that we had her, blossomed into a happy, playful girl. Phoebe got a second chance at life because Brea's parents understood how important it was for Beau to have a buddy.