12 April 2017

Birthing Emergencies

Summarized from "Emergency Interception During Parturition in the Dog and Cat," Frances O. Smith, Vet Clin Small Anim 42(2012): 489-499

There are 3 stages of birthing:
Stage 1: uterine contractions and cervical dilation -- usually 6-12 hrs, but maybe up to 36 hrs.  Queen is restless, may pant, refuses food, nests
Stage 2: fetal expulsion -- usually 4 to 16 hrs, with occasionally upto 42 hrs.
Stage 3: placental expulsion -- usually each placenta is passed within 15 minutes of the fetus

Dystocia (difficult birth) occurs 3.3% to 5.8% in feline births.  Clinical signs include:
-- pregnant queen >71 days after breeding
-- straining for 1 hr continuously before delivering
-- green or black vaginal discharge before delivery
-- resting over 3 hrs between births
-- delivery of stillborn
-- protrusion of fetal membranes for over 15 minutes without delivery of fetus
-- vaginal hemorrhage
-- weak or distressed queen

Causes of dystocia can be divided between problems with the queen and problems with the fetuses.  67.1% are of maternal origin and 29.7% are of fetal origin.  [and no the numbers don't add up, but I didn't write the article!]

Fetal causes:
-- malpresentation (the most common fetal problem) -- 70% of kittens are born head first, and while butt-first is not abnormal in cats, it does increase the risk of death.
-- fetal abnormalities
-- fetal death
-- fetal oversize
-- anasarcous fetuses (fluid filled fetuses)

Maternal causes:
-- uterine inertia (the most common maternal problem) -- Primary inertia, the queen has little to no contractions and does not reach Stage 2.  Partial primary, the queen reaches Stage 2 but the contractions are too weak to expel a fetus.  Secondary inertia arises from anatomic problems.  The uterus may become exhausted in the case of obstructed birth canal.
-- pelvic fracture
-- uterine torsion -- Abdomen is very painful with a racing heart beat.
-- vaginal abnormalities such as bands
-- malnutrition
-- parasites

Medical management
If the queen has not been in labor too long, the cervix is dilated, fetal size is appropriate, and the fetal heart rate is normal, then the use of drugs may help.  Drugs should NOT be used in cases of obstruction or when more than 1 fetus remains in utero due to uterine fatigue. 
-- oxytocin increases the frequency and quality of contractions.  Doses range from 2 to 4 U IM, with a recommended dose of 0.5 to 2 U.  The author spcifies an initial dose of 0.1 U/kg, with a repeat dose after 30 minutes, and no further use after that.  (Oxytocin will cause placental separation and lead to fetal distress.)
-- calcium increases the contractions but "in the queen, calcium use is controversial, due to the very strong uterine contractions seen when it is administered".  [I'm planning on looking into this frther.]

Mechanical management
In the case of malpositioning, it is possible to use sterile lubricant and fingers to rotate and extract the fetus.  Otherwise an episiotomy is possible, but with the complication of scarring and increased risks for future pregnancies.

Surgical management
60-80% of all dystocias result in surgery.  Fetal heartrates below 150 beats/min require immediate surgery, and 150-170 should be monitored closely as surgery is prepared for.  The author does not recommend an ovariohysterectomy at the time of a ceasarean, unless the uterus is damaged, due to risk of hemorrhage and loss of fluids. [skipped all the discussion of anesthetics and surgery as this is not a DIY project, hopefully]

The accompanying flowchart shows neonatal resuscitation.  While it is for neonates after a ceasarean, much of it does apply to normally born kittens too.

11 April 2017

Feline Gestation

Summarized from "Current Advances in Gestation and Parturition in Cats and Dogs", Catherine G. Lamm, Chelsea L. Makloski, Vet. Clinics Sm Animal 42(2012) 445-456

In cats, the normal gestation range is given as 52-74 days, depending on the breed.  As cats are induced ovulators, the luteinizing hormone only surges 24-40 hrs after copulation.  If the copulation is not observed, it is difficult to determine when ovulation occurs.

After 5 days (post breeding) the fertilized ovum enters the uterus with the outer layer (zona pelucida) being shed 10-12 days after breeding.  Implantation occurs at 12-13 days.  Heart beats can be detected at 16 to 25 days.

Pregnancy diagnosis can be made by palpation for the gestational sacs 21-25 days post breeding.  After 35 days, however, the sacs flatten and palpation becomes more difficult.

Ultrasound is the most sensitive and reliable method of pregnancy detection.  With skilled technicians, fetal structures can be detected 11-17 days post breeding.  It is less reliable to determine the number of fetuses.  Heart rates can be monitored from day 25 onwards, and should be greater than 193 beats/min.  Fetal movement can be observed at 28 days.  After 40 days, the gestational age can be estimated using the foloowing two formulas:

Age = (25 x head diameter cms) + 3
Age = (11 x body diameter cms) +21

Mineralization occurs at 38-40 days.  Xrays can then be used to determine the number of fetuses.  Once mineralization begins, age of the fetuses can be estimated as seen in the table.

Use of hormones to determine pregnancy is dependent on the hormone.  Progesterone is not reliable.  Relaxin is specific to pregnancy as early as about 25 days.  Prolactin is not reliable as it will spike in pseudopregnant animals.

Unlike in dogs, queens need a slow increase in calories beginning at 14 days.

Queens may have normocytic, normochromic anemia as well as mild neutrophilia.  Other changes in bloodwork include decrease in proteins, increase in lactate dehydrogenase, increase in cholesterol, and decrease in creatinine. 

For high risk pregnancies, monitoring of progesterone levels should be used.  If a decrease in progesterone level is seen, females can enter pre-term labor, which may be stopped with exogenous progesterone or terbutaline.

Termination of pregnancies can be done either by spaying or, if fertility needs to be maintained, by using a variety of compounds such as estradiol cypionate.

19 June 2016

Homemade Kitten Formula

Orphan kittens ideally should be placed with a nursing queen to get cat milk.  This is not often possible, so caregivers must find a substitute. 

The simplest is fresh, raw goat milk, or even a commercial version.

If this is not available, then either commercial kitten milk (such as KMR) or a homemade version needs to be used.

Under no circumstances should only cow's milk be fed - it lacks important nutrients for kitten growth and there are reports of severe diarrhea when fed exclusively.

The Recipe:
Ingredients for 1-¼ cups kitten formula:

1 cup of goat milk (if unavailable, whole milk can be used but is not preferred)
1 large egg
2 teaspoons of powdered protein
1 teaspoon of nutritional yeast
110 mg of powdered calcium
1-day dose of vitamins formulated for adult cats

You'll also need a mixing bowl, a hand mixer, a saucepan, and a small nursing bottle.
Beat the egg, and thoroughly stir in the remaining ingredients. Warm the formula in a small nursing bottle by placing it into a cup or bowl of hot water. Test the formula on the underside of your wrist to check the temperature. If the formula is too hot, wait until the formula cools down. If the formula is too cold, continue soaking the bottle in hot water. Always be sure to test the formula again before giving it to the kitten.
Never re-use formula that you have warmed. Discard it and use fresh formula for each feed.

There is concern among some kitten fosterers about the use of any cow's milk with kittens.  There concern centers on the lactose content of the cow's milk.  Here are the lactose levels in various milks:

cat milk  4% (constant from birth to weaning)
cow milk  4.5-4.9%  (various authors report different figures)
goat milk  4.1% (or 10% less than cow milk, so 4.1-4.4%)

Feline nutritional experts also agree -- young kittens can digest lactose (obvious from it being in mother's milk), but as they mature to adults, some cats lose this ability and become lactose intolerant.

Lastly, almost all commercial kitten formulas, except where clearly labelled as derived from goat milk, are all make using cow milk in various forms -- casein, powdered milk, whey, etc.

06 February 2016

Thoughts on Syringe-Feeding a Cat

Since I seem to have better than average experience with this, a vet invited me to share some tips and tricks with her and others. I have been thinking about and actually spent part of day observing at a local vet clinic to really see what the differences were. I think there are 5 critical differences.
1. Time. I usually am force feeding only one cat at a time and don't have to rush off and do other things. I will take anywhere from 10 minutes to 30 minutes to get the food into the cat. I only put a small amount in and I let the cat swallow and relax before the next mouthful.
2. Location. I force feed the cat in my lap or between my legs while sitting on the floor. I have the cat surrounded with my legs and arms, with my torso draped over the cat. I believe this makes the cat feel safer. Rarely do I have to 'towel' a cat to force feed it -- even with new arrivals.
3. Tools. I use a feeding syringe from FourPaws. It holds a nice amount and the tip can be cut off so that the food comes out quickly. I have tried regular syringes and I didn't like it. If the syringe is re-used, the plunger sticks. The tip is usually too small unless one uses the 50ml size and then it's too big to easily handle.
4. Food. I always feed the food at or slightly warmer than room temperature. (And apologies, Dr. Muns for this next part.) I know Science Diet A/D is considered a great force feeding food, but many cats do not like it. I may use it, but I mix it with other ingredients, such as goat milk, to make a mix that is more appealing to cats. The food also needs to be of the right consistency -- not runny, not thick, but something like cold gravy.
5. Position of head. I try to keep the head level and squirt small amounts of the food ( like .5ml) in the middle of the upper palate. This works better than what owners are told to do -- squirt it between cheek and teeth. I know vets and vet techs are afraid owners will choke the cat with the food, but if it's the proper consistency (not a liquid) and if it's small amounts, I've never had any problem.

18 January 2016

10 Books Cat Breeders Should Own

Here's a list of 10 books that cat breeders should have in their libraries.  The books range from genetics to care of kitten.  I wish to thank several of my breeder friends for make suggestions and comments on these books.

  1. The Cat Breeder's Handbook  -- This is a collection of articles by various experts on everything from selecting cats for a breeding program to showing cats at a cat show.  There is a good article on cattery design.
  2. Feline Husbandry -- One of the classics for cat breeders, which is still useful.  It covers diseases in a multicat environment, caring for kittens and mothers, and nutrition among other topics.  The book is fairly expensive as it is out of print, but it is available for free online through the UC Davis website.
  3. Practical Guide to Cat Breeding (Royal Canin) -- I have not personally seen this book but it was highly recommended.  From the description, it sounds good as it has sections on genetics, reproduction problems, pediatrics, and even legal matters.  The down side of this book is the price -- it is out of print and routinely sells for over $100.
  4. Robinson's Genetics for Cat Breeders and Veterinarians -- This is THE book on cat genetics and how breeders need to consider relatedness among cats.
  5. Notes on Feline Internal Medicine -- This is a technical veterinary book, but one of the best books for clearly diagnosing internal problems, explaining bloodwork, and giving medication suggestions.
  6. Veterinary Notes for Cat Owners, Cat Owner's Home Veterinary Handbook, or Cornell Book of Cats -- PICK 2 -- These are more user-friendly books that the above book.  They provide the reader with more background information on disease processes without the technical terminology and the medication suggestions.  Each book explains topics in slightly different ways, hence the suggestion for 2 books.
  7. Infectious Disease Management in Animal Shelters -- This book is invaluable to understand and help prevent diseases from spreading in a closed environment, such as a cattery.  While it is for animal shelters, and thus includes dogs, it is very applicable to catteries.
  8. Plumb's Veterinary Drug Handbook -- This standard reference on veterinary drugs is invaluable for understanding the biochemisty of drugs as well as for dosages.  Sadly, the book is expensive and some newer drugs are omitted until the newest edition is published.
  9. The Pill Book Guide to Medication for Your Dog and Cat -- This is a more user-friendly drug book which covers the most commonly prescribed drugs, discusses the pros and cons of using human medications, and provides a simple first-aid guide.
  10. Raising Cats Naturally: How to care for your cat the way nature intended -- For breeders interested in feeding raw food, this is THE book to have.  Not only does it provide clear recipes, it provides the rational behind the ingredients with references to literature.

17 January 2016

10 Cat Books the Average Owner Should Own

Here is a list I compiled awhile ago of 10 books that are both readable for the average cat owner and very useful.  (Links are to the book page on LibraryThing.com)

  1. Veterinary Notes for Cat Owners or Cat Owner's Home Veterinary Handbook -- These books are well written so the layperson can understand a variety of diseases and conditions in cats.  The photos are particularly helpful at times.
  2. Raising Cats Naturally: How to care for your cat the way nature intended -- This is the 'bible' for feeding raw.  Not only does it give 2 options for preparing the food (with and without a grinder), but it explains the rational behind the diet's ingredients with references.
  3. The new natural cat : a complete guide for finicky owners -- Excellent book on general cat care, using a variety of alternative treatments.
  4. Dr. Pitcairn's Complete Guide to Natural Health for Dogs & Cats -- This was the book that started my interest in both alternative veterinary medicine for cats and in raw food.  While his recipes rely too much on grain in my opinion, his sections on vaccines and then the catalog of diseases and treatments are very good.
  5. Cat Wrangling Made Easy: Maintaining Peace and Sanity in Your Multicat Home -- Excellent book by someone who has lived in a multicat home on how to manage things.  Some of the tips and suggestions are brilliant!
  6. Cat Vs. Cat: Keeping Peace When You Have More Than One Cat -- Another book on cat behavior and interaction by a top behaviorist.  Her method of introducing new cats has become the standard method and actually does work!
  7. Getting in TTouch with your Cat -- This book explains a wonderful massage-type treatment for cats.  It is simple to learn and helps many cats to relax.
  8. Cats Naturally: Natural Rearing For Healthier Domestic Cats -- While this is an older book, it is well worth buying it as it is the best guide out there for using herbs with cats.
  9. The Nature of Animal Healing : The Definitive Holistic Medicine Guide to Caring for Your Dog and Cat -- A newer and very useful book on holistic medicine for dogs and cats.  Some of the suggestions, such as the Chinese medicine ones, are rarely seen in even other holistic vet books.
  10. Starting from scratch : how to correct behavior problems in your adult cat -- Another behavior book, but this one is specifically on how to correct already established bad behaviors.  I like this one since using drugs is the absolute last resort.

16 January 2016

Treating Feline Urinary Problems: Cranberries

If you go to any alternative medicine site and look for natural treatments for bladder infections, cranberry in its many forms is touted as a cure or prevention.  But does it work?  And more importantly for me, does it work for a cat?

Cranberry seems to work because a proanthocyanidins (an antioxidant) prevents the E. Coli from attaching to the cell walls in the bladder.  In vitro studies have confirmed that proanthocyanins do cause deformation of the E. coli cells and thus suggests prevents them from adhering to the bladder walls.  The adhesion in one study was reduced by 75%

There are no studies in cats.

There is a study in beagles showing that the metabolites of the cranberry do appear to make it to the bladder and do reduce the adhesion of the E. coli.  The researchers administered 1 Crananidin tablet per day and the dose peaked at 7 days after which it remained steady.

There are human studies that show no significant improvement with the use of cranberries.  Several of the studies do comment that perhaps the potency of the cranberry used in the study was not sufficient.

So what does this all mean?  It does seem that cranberry can prevent UTIs in cell cultures, but there is no evidence that it does in cats.

There are however many anecdotal accounts by cat owners that cranberry pills, cranberry powder, and even cranberry juice has helped cats.  I know from personal expereience, I have used cranberry powder with cats exhibiting UTI symptoms and the symptoms disappeared in 2-3 days.  Was it coincidence?  Maybe, maybe not.  I do know that 1/2 a cranberry extract pill is a much larger dose for a cat than 1 pill 2x a day is for a person.  So maybe, the proanthocyanins did reach a therapeutic level in my cats.

There are also a couple of concerns about using cranberries with cats.  One is cranberries contain salicylic acid (aspirin).  Now, before people panic, cranberry juice contains 7mg/L of juice.  Presumably poders and extracts would contain more.  But.... for cats, the toxic level for aspirin begins at about 50mg/kg of body weight.  So an 11 lb cat (5 kgs) would need 250mg to reach a minimum toxic level, of about 37 quarts (35L) of juice.

The other concern is the presence of oxalates.  Oxalates have been tied to the formation of oxalate kidney stones in humans, but cats rarely develop kidney stones -- they are more likely to have bladder stones, so I am unclear if this is even a concern.  In any case, cranberries contain 5-7 mg of oxalates per 3.5oz of food.  This is the same level for pumpkin, which is wildly used for cats and regarded as beneficial.

Bottomline, if I have another cat with UTI symptoms, I will use it again.  If and when the researchers ever do a sound study on felines and show it does not work, then I may rethink my position.

Summary of scientific studies from "Complementary and Integrative Therapies" by Donna Raditic, in Vet. Clinics of N. Am.: Small Animal Practice,  July 2015