Written for kittens: Medical protocols for foster kitties


Kittens demand their own set of rules. Shelter medicine expert Dr. Amanda Dykstra shares some of the medical protocols she follows to give foster kittens and their families the best chance at success.

Andrii Zastrozhnov/stock.adobe.comKittens aren't small cats. That's why it's incumbent upon any organization with a kitten foster care program to develop medical protocols tailored to caring for these petite patients-starting with the intake exam.

Risky business?

If your organization lacks the human or financial capital needed to provide thorough intake exams, you may want to rethink running a kitten foster care program at all, says Amanda Dykstra, DVM, MPH, DABVP (Shelter Medicine Practice), a Fetch dvm360 conference educator, a former professor of shelter medicine at the University of Tennessee College of Veterinary Medicine and now a medical director for a nonprofit and a shelter consultant. (Read more about what's needed to run a kitten foster program here).

“Exams are important for many reasons-one of which is to identify special needs cases that may need to go to foster homes more equipped to handle their needs,” Dr. Dykstra explains. In other words, intake exams can help identify high-risk kittens and spare inexperienced foster parents from potentially traumatic and overwhelming experiences.

Low birth weight. According to Dr. Dykstra, birth weight is the best indicator of survival. “One study of 477 kittens determined that the survival rate of low-birth-weight kittens was only about 40%, while the survival rate of normal-birth-weight kittens was about 68%,”1 she says. “So low-birth-weight kittens should be considered higher risk and placed in appropriate homes.” A normal birth weight for a kitten is 100 g, give or take 10 g. If a kitten weighs less than 75 g, it's considered “very, very high risk,” says Dr. Dykstra. 

Congenital abnormalities. The presence of congenital abnormalities (e.g. cleft palate, imperforate anus, omphaloceles, gastroschisis, abnormally large fontanels) is another high-risk determinant. “Congenital abnormalities will range from very mild to those that require euthanasia,” says Dr. Dykstra. “Where the line is drawn will depend on the resources available to care for the kittens as well as the availability and experience of the consulting veterinarian.”

Singletons. “Singletons can also be considered ‘special needs' because of the lack of a littermate to provide warmth and socialization,” Dr. Dykstra explains. But they aren't just considered high-risk for reasons of behavior or body temperature. “If the history of the litter is unknown, singletons are also thought to carry some extra risk, because infectious disease may be the underlying reason for arriving at the shelter alone,”2 she says. For example, perhaps the mother had feline panleukopenia when pregnant, died after giving birth and this is the only kitten that survived. 

Lack of colostrum. According to Dr. Dykstra, any kitten that has been separated from its mother too early and doesn't have access to colostrum or a replacement should also be considered high risk.

But wait-there's more!

The goals of the intake exam go beyond determining the kitten's likelihood of survival.

Age. Dr. Dykstra recommends estimating the kitten's age immediately upon intake, which can be done using weight and milestone charts (e.g. those considering umbilical cord loss, open eyes, crawling and other factors).

When and why to retest FeLV-positive kittens

Dr. Dykstra has heard Julie K. Levy, DVM, PhD, DACVIM, DABVP (Shelter Medicine Practice), note a statistic that about half of underage cats that are FeLV positive are negative by 8 weeks old, and experts aren't sure why: “So if you get an underage kitten that tests positive, there's a 50% chance that at 8 weeks it'll be negative. Retest it at 8 weeks to see if it's reverted.”

Infectious diseases. Kittens and queens should be checked for any signs of infectious disease, notes Dr. Dykstra. “Queens need to be tested for feline leukemia virus (FeLV) and feline immunodeficiency virus before being placed in a home, and kittens should be tested for FeLV before going to a foster family, when possible,” she says. “Be sure to confirm positives, and I recommend retesting as well.” (See “When and why to retest FeLV-positive kittens” above.) Dr. Dykstra cautions against pooling samples, calling it “incredibly inaccurate.” And she warns that you can't just test one kitten from a litter: “Some shelters don't test at all, and that's OK. But if you do test, you must test each kitten individually,” she says.

Dr. Dykstra says that a Wood's lamp exam should also be performed before placing kittens in a home,3 and it's important to use the real thing (i.e. blacklight bulbs won't do). “Small, sickly kittens are especially prone to ringworm, and you don't want to spread the fungal infection to the foster kitten's unsuspecting family,” she explains.

Parasites. To avoid sending a foster kitten home with unwanted passengers, give all kittens over 2 weeks old a broad-spectrum dewormer and repeat every two weeks until the patient is 2 months of age, says Dr. Dykstra. At that point, if the kitten remains in foster care, it will need to be dewormed once a month.2

Depending on the parasites common in your part of the country, Dr. Dykstra says you may want to administer ponazuril, an anticoccidial medication,4 or praziquantel, which treats tapeworm infections. “I always tell people that if you have a kitten that's not doing well and you can't find an explanation, give it some praziquantel and see what happens,” she says. “Sometimes it'll just get better.”  

You should also check kittens and queens for ectoparasites, says Dr. Dykstra. “In very young kittens, the safest way to manage flea infestations is to bathe and manually remove them, although fipronil spray (Frontline Spray, Boehringer Ingelheim) is labeled for use in kittens as young as 2 days old in some countries,” she notes. 

Write down the right way

Once you develop protocols, write them down and keep them in a place where everyone has access to them. This is especially important if you use contract veterinarians. “Your staff should know exactly what to do when you're not around to ensure treatment is consistent,” says Dr. Dykstra.

Something else you should write down: a manual for your foster parents. Read more here.

Vaccinations. Dr. Dykstra says you should vaccinate foster kittens as you would any shelter kitten. Administer the modified-live virus feline viral rhinotracheitis, calicivirus and panleukopenia vaccine at 4 weeks and then every 2 weeks until the kitten is 16 to 20 weeks old.5 “I see a lot of vets stopping after three vaccines, but kittens can have maternally derived antibodies much, much later than that,” she explains. Dr. Dykstra also recommends vaccinating queens that are going into foster care for rabies, even if they're still nursing.

More foster kitten facts

Get tips from Dr. Dykstra on:

> creating your own kitten foster manual

> figuring out what basic resources a kitten foster program needs.

Beyond the intake

Dr. Dykstra stresses the importance of good pain management for these vulnerable patients. “Kittens experience pain, and it needs to be managed,” she says. “Hyperesthesia is a real thing. If they have an acute, terribly painful experience as an infant, they'll likely have a lower pain tolerance for the rest of their lives.”6

Again, it's important to remember that neonates aren't small cats. “Kittens respond to disease in a limited number of ways, so treatment is often symptomatic until the underlying cause can be identified,” Dr. Dykstra explains. “But we've learned that this symptomatic therapy saves lives-even if we don't have any idea what's wrong with them.”7


1. Lawler DF, Monti K. Morbidity and mortality in neonatal kittens. Am J Vet Res 1984;45(7):1455-1459.

2. Smith-Blackmore M, Newbury S. Foster Care. In: Miller L, Zawistowski S, eds. Shelter Medicine for Veterinarians and Staff. 2nd ed. Ames, Iowa: Wiley-Blackwell, 2013;495-513.

3. Davidson AP. Neonatal resuscitation: improving the outcome. Vet Clin North Am Small Anim Pract 2014;44(2):191-204.

4. The UC Davis Koret Shelter Medicine Program. Use of Ponazuril for Treatment of Coccidia in Kittens and Puppies. Available at: https://www.sheltermedicine.com/library/resources/?r=use-of-ponazuril-for-treatment-of-coccidia-in-kittens-and-puppies. Accessed May 6, 2016.

5. Scherk M, Ford R, Gaskell R, et al. 2013 AAFP Feline Vaccination Advisory Panel Report. J Feline Med Surg 2013;15(9):785-808.

6. Mathews KA. Pain management for the pregnant, lactating and neonatal to pediatric cat and dog. Vet Clin North Am Small Anim Pract 2008;38(6):1291-1308, vi-vii.

7. Meade C. Fading syndrome in kittens. In Practice 2014;36(6):266-276.

Sarah Mouton Dowdy, a former associate content specialist for dvm360.com, is a freelance writer and editor in Kansas City, Missouri.

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