Guide to Raising UnderageKittensThis guidebook is designed to provide a lot of information on thecare of underage kittens and is applicable to foster parents,rescue groups, and animal sheltering facilities. We have brokenit into small sections for you to read through. There is a largesection on Kitten Nurseries for anyone ready to take that bigleap.

This guidebook is part of a resource library maintained jointly bythe Shelter Medicine Programs at the University ofWisconsin and UC Davis. The latest version of this document andall other shared resources can be found at their respectivewebsites.

This content is licensed under a Attribution-NonCommercial-NoDerivatives 4.0 International

Last updated on Apr 27, 2017

Intake Diversion Programs

During kitten season, many well-meaning members of the public swoop in to “save” litters ofkittens that they see and then bring them to over-crowdedshelters that do not have the capacity to provide 24 hour carebecause they think it is the right thing to do. Prior to kittenseason, let the public know when they should and should notintervene with kittens that they find. You can provideinformation on your website and to the media through a pressrelease. Encourage members of the public to wait and watch formom before picking up any stray kittens. Mom may just be awaybriefly but she will not come back if they stay near the kittensand they should monitor from afar. If mom does not come backor if they know she has been hit by a car, then it is appropriateto intervene. However, they should be prepared to see theirgood deed through and not immediately take them to a shelterthat is not prepared to care for them. Taking in animals that arenot best served by coming into the shelter is a practice thatanimal shelters across the country must get away from. Considermanaged admission of kittens (along with all other animals) andtry to recruit “foster finders.” Try to partner with otherorganizations and rescue groups in your area to create anetwork for underage kittens. For more information, refer toDeveloping Intake and Adoption Decision Making Criteria.

Foster FindersOne pool of future foster parents are the people who findorphaned kittens and bring them to the shelter. By their actions,these people show they care about the lives of these kittens andmay be willing to keep them in their homes but are often unsure

they can provide the necessary care. When a shelter providesthese people (labeled “foster finders”) the means andknowledge to care for kittens through a training program, fostercare programs start growing. The training for potential fostersshould include an easy-to-follow kitten care guide, fostercoordinator contact information, and a kit containing the itemsneeded to set up a little nursery at their home. A kit shouldcontain a kitten nursing kit, syringes for syringe feeding, kittenmilk replacer, canned kitten food, a small litter box, kitten-appropriate litter (no clumping litter), a small double diner dishand a kitten care guide. If finances allow, include a heatingsource like a Snuggle Safe disk and a small kitchen scale fordaily weighing. If you can’t include a heat source or a smallscale, then encourage foster parents to acquire these. Thesefoster finders also need to know what the shelter will provide,such as medical care, food and litter, and that the shelter takesthe kittens when ready for adoption unless the foster parentsfind adopters on their own.

Home Nursery Kit Contents

Nursing kitSyringesKitten Care GuideKitten milk replacerCanned kitten foodSmall litter boxNon-clumping litterSmall double dinerHeat source (e.g. Snuggle Safe disk)Digital kitchen scaleFoster Coordinator Contact Information

Caring for Kittens from Birthto Eight Weeks5 Requirements for Kitten Care:

1. Keep kittens warm.2. Provide kittens with adequate nutrition.3. Keep kittens clean.4. Provide socialization with people and with cagemates.5. Do your best to protect them from infectious disease.

Body WarmthSince kittens under four weeks of age do not have the ability tothermoregulate, we must help them maintain body warmth. Onemethod is to place a warmed Snuggle Safe disk at the opening ofthe cage or crate. This disk then provides the needed warmth for8 hours. Instructions for how long to heat the Snuggle Safe diskdepending on the wattage of the microwave are printed on eachdisk. If you are unsure what wattage the microwave is, heat thedisk for 5 minutes, then check the temperature with your hands.Make sure it does not feel too hot before placing it in the cage orcrate. Cover the heating disk with a soft folded towel or blanketso the kitten cannot directly contact the disk. If no heating disk isavailable, place a heating pad on the low setting under the crateor on the bottom of the cage, then place a soft folded towel orblanket between the kitten and the heating pad. Check the heatsource frequently to ensure it is not too hot or too cold. Makesure some area of the cage does not contain a disk or have aheating pad under it so kittens can move away from the heatsource if too hot. Kittens also like a nice nest in their cage orcrate so bundle them in a nice fleece that they can crawl intoand out of.

We cannot overemphasize the need for a heat source inorphaned kittens. The queen would have provided a nice 100 -103oF (38 – 39oC) environment for them. Continue to provide aheat source for orphaned kittens until four to six weeks of age.Although kittens over four weeks old may start avoiding thewarmed bed, if the room is cool, even older kittens will seek outa warm spot. For this reason, as well as for socialization,consider appropriately pairing new single kittens of the same

age so they can share body heat and be less likely to experiencehypothermia.

Providing a good environment for kittens, means providing awarm, non-drafty room. A good practice is to make sure a towelcovers the entire bottom of the cage and a bed made from asmall litterbox or food carton is available so kittens do not sleepin their litterboxes. A towel covering the crate or front of thecage prevents drafts and keeps kittens under 4 weeks of agenice and warm. Ideally, kitten rooms should be kept around 85oFor 29oC but we recognize that it isn’t always practical. A kittenover 6 weeks of age only needs the availability of a warm, cozyspot.

Kitten FeedingDaily weight gain is an indication that the diet is meeting thekittens’ nutritional needs. Weigh kittens at the same time daily,not only to ensure adequate weight gain but also to calculate theamount they should be eating with each feeding. Kittens shouldgain about ½ ounce (14 grams) per day or 4 ounces (113 grams)per week. Keep in mind that the younger the kittens are, themore accustomed they are to staying latched onto their mom’snipple all the time and nursing small amounts periodically.Frequency is essential for digestion and allows the kitten’sdigestive system to handle small amounts at any one time. Additionally, the act of nursing stimulates digestion. If you noticea kitten not eating enough in one feeding, increase thefrequency of feedings or go back to that kitten after the othersfinish eating to give it another chance to take more food.

Guidelines for bottle feeding kittens:

Kittens must be warm, they cannot digest properly if theirbody temperature is low.Combine 1 part powdered KMR formula to 2 parts water.(NEVER give them cow’s milk and keep them on the sameformula.)Kittens should eat 2 tablespoons or 30 ccs of formula per 4ounces of body weight within a 24 hour period.Feed kittens less than 2 weeks of age at least every 2hours.Kittens 2 to 4 weeks of age should eat every 3-4 hours. Ifthey are sleeping for longer periods during the night, do not

wake them to feed.Feed weak kittens or ones not eating enough morefrequently.Some individual variations in frequency and amounts foreach kitten may occur.

Click here for a video from Maddie's Institute on Orphaned KittenCare and bottle feeding

General Feeding Guidelines

Test the temperature of the formula before feeding, it should bewarm (around 100oF or 38oC), but not hot. Warm the bottle byplacing it in hot water for a few minutes or by putting it in themicrowave until it reaches the correct temperature. If you usethe microwave be sure to mix the formula well before testingbecause hot spots may develop in the heating process.

Always properly position a kitten for feeding. NEVER recline akitten on its back while feeding. This can cause it to aspirate,which means the kitten inhales the formula into their respiratorytract rather than swallowing. Aspiration can lead to a reactivepneumonia and be fatal. Kittens must be leaning forward or flaton their belly while feeding. They are most comfortable whenpositioned as they would be if nursing from their mom. Toachieve this position, place the kitten on its stomach on a towelor cloth so the kitten can cling to the material and kneadinstinctually. If the kitten is acting frantic while nursing, trywrapping the kitten in a towel while feeding it. When bottlefeeding, gently open the kitten’s mouth with the tip of yourfinger and slip in the nipple. Once the kitten learns what iscoming, it will search out the nipple enthusiastically. You will feela vacuum effect when the kitten gets into suckle mode. Watchfor bubbles in the bottle during suckling and ears wiggling.These movements mean the kitten is suckling successfully. Tokeep air from getting into its stomach, hold the bottle at a 45-degree angle, keeping a slight pull on the bottle. Allow kittens tosuck at their own pace. If a kitten refuses to take the nipple orwill not suckle, try rubbing it vigorously on the forehead orstroking its back much as its mom would. Using a toothbrush tostroke the kitten can simulate the feeling that it would get fromthe queen’s tongue. If you still cannot get it to nurse from thebottle, syringe feed the kitten to make sure it gets adequatenutrition. If a kitten requires syringe feeding, have a plan inplace for who foster parents should contact.

If feeding multiple kittens, it will be easier to get them all fed therequired amount if you feed each one multiple times during thesession. To accomplish this, feed the first kitten until it stopsnursing, then feed the second, and so on. After each has had oneturn at the bottle, go back to the first and repeat the process.Usually after two or three nursing turns, a kitten has had enoughfor one feeding. When a kitten has had enough formula, it willusually get some bubbles around its mouth and its abdomen willbe very rounded, almost pear-shaped.

Kittens that seem too weak to nurse may be hypothermic orhave an underlying medical issue. A kitten refusing to nursebeyond the first few "getting the hang of it" times may indicateillness and it needs to be examined by a veterinarian. Have aplan in place to for who foster parents should contact.

After each feeding session, give each kitten a full-body onceover with a barely damp, warm washcloth. Use short strokes likeits mom would use. This activity keeps the kitten’s fur clean,teaches it how to groom and gives it needed socialization. Makesure the kitten is completely dry before placing it back in itscage.

Kittens naturally suckle on each other and on fingers, even aftereating. Kittens suckling on each other excessively may be a signthat the frequency of feedings need increased. If littermatesuckling becomes problematic, especially around the genitalarea, separate the kittens. Check each kitten’s genitals toensure sucking activity is not causing problems (redness,irritation, penis hanging out, etc.). Suckling on genitals can leadto the urethra swelling shut and having to be surgicallyreopened. If any of this occurs, have a plan in place for whofoster parents should contact.

Weaning

A kitten is ready for the weaning process when it bites the nippleoften and forcefully, and is able to lick formula from fingers.Continue bottle feeding through the weaning process to ensurekittens get adequate nutrition and are not overly stressed. Thefirst step of the weaning process is to get the kitten to lap upformula from your finger and then a spoon. Once it masters thisskill, put formula in a flat dish. Introduce the kitten to solid foodby mixing warm canned kitten food and prepared kitten formulainto a thin gruel. Gradually reduce the amount of formula mixed

with canned food until the kitten is eating just the food.

Place the food in a shallow dish. Some kittens begin lapping rightaway; others prefer to lick the gruel from your fingers. Allowthem to do so and slowly lower your finger to the dish. Thekittens may bite the edge of the dish or walk in the food.Sometimes it takes two or more meals before they catch on. If akitten does not seem interested in the gruel, try gently openingthe kitten’s mouth and rubbing a little of the food on its tongueor teeth. Be patient, the weaning process takes time. As thekittens catch on, thicken the gruel. When kittens are eatingthicker gruel, they should always have fresh water available in alow spill-resistant bowl.

Kittens often walk through their food. Make sure the kittens areclean and DRY before putting them in their cages. Most weaningkittens are messy eaters so you may not be able to leave gruelor water in their cages at first. Wet kittens can rapidly lose bodytemperature.

Click here for a video from Maddie's Institute on weaningorphaned kittens onto solid foods.

Stimulation for Urination and Defecation

Mother cats groom their kittens to stimulate urination anddefecation on a regular basis. If you are acting as their fosterparent, you get this important duty. Very young orphan kittenswill not be able to urinate and defecate without your help, so thisis a crucial part of neonatal kitten care. Before and after eachfeeding, gently rub the kitten on its lower abdomen, as well asthe genitals and rectum with a cotton ball/pad dipped in warmwater or a fragrance free baby wipe. Make sure to rub onlyenough to get the kitten to eliminate because overstimulationwill irritate the area. Keep an eye out for chafing and lingeringdirt and do not let the kitten get chilled. Kittens should (andalmost always will) urinate during each stimulation. They shoulddefecate at least once daily.

General guidelines are:

Kittens need to be stimulated until about 3 weeks of age.Kittens should be stimulated before and after each feeding.Kitten should urinate every time and defecate at least oncedaily.

When kittens get to be 3 – 4 weeks old, they no longer need helpeliminating body wastes. Place a litter box in the crate or cageand fill with non-clumping litter or shredded newspaper.Clumping litter can create litter clumps in their stomachs andrespiratory passages and should not be used with young kittens.

At the same time as introducing a litterbox, you may need tostart providing some dry kitten food so the kittens can chew onthe food and not the litter. When teaching a kitten to use alitterbox, placing their feces in the box so they smell it in thereoften helps. If you have a kitten that defecates on its towelinstead of in the box, move the feces to the box instead ofcompletely cleaning it out of the cage.

Click here for a video from Maddie's Institute on how to stimulatea kitten to urinate and defecate.

Kitten Weight Gain andDevelopmental MilestonesKittens should gain about ½ ounce (14 grams) every dayor 4 ounces (113 grams) per week. Weigh them at the sametime every day with a kitchen or small postal scale. Lack ofweight gain in a 24 hour period is cause for concern. Beginsyringe feeding the kitten and have a plan in place for whofoster parents should contact. To syringe feed the kitten, mix upthe KMR as usual and then draw it up in a syringe. Put a nippleon the end of the syringe and place the kitten in the properfeeding position. Try to get the kitten nursing by slowly pushingKMR out of the syringe and through the nipple into its mouth.Make sure it swallows the formula before you push more into itsmouth.

Kitten Developmental Milestones

Age

Weight

Milestones

Birth

3–3.7 ounces

90–100 grams

Eyes and ears are closed.

Sleep 90% of the time.

Minimal handling.

2 – 3 days

Umbilical cord falls off.

4 days

Begins to purr.

10 – 14 days

8 ounces

227 grams

Eyes and ears should be open.

Healthy kittens will be round and warm with pink skin and willrarely cry.

2 – 3 weeks

12 ounces

340 grams

Deciduous incisors erupt, can begin to eliminate without help.

Will start crawling, standing, and playing with littermates.

Begin regular handling.

Ready for deworming.

4 weeks

1 pound

454 grams

Deciduous canines erupt, beginning to walk but do not havegreat balance, will start to groom themselves, able tothermoregulate.

Continue daily handling.

Ready for their 1st vaccine.

Ready for gruel and may be ready for introduction of dry kittenfood.

6 weeks

1.5 pounds

680 grams

Deciduous premolars erupt.

Running, playing, using the litterbox, grooming themselves.

Should be eating dry kitten food, supplemented with canned.

Ready for surgery and adoption (if you are able to place them atthis age).

8 weeks

2 pounds

907 grams

Ready for surgery and adoption (if you are unable to place themat 6 to 7 weeks of age).

0 - 1 Week of Age

Feeding: If the kittens are orphaned, they need to be bottlefedevery 2 hours. If the queen is with the kittens, they should nursevigorously and compete for nipples. Newborns can nurse up to45 minutes at a time. Be sure to watch kittens nursing at leastonce a day, if the queen will permit it. Check to make sure thateach kitten is settled and nursing. A great deal of activity andcrying could indicate a problem with milk flow, quality oravailability. When the queen reenters the box, there should be

some fussing for only a few minutes before everyone has settleddown to serious nursing.

Environment: The temperature of the nest box should be niceand warm: 85-90oF. Hypothermia is the number one danger tonewborn kittens.

Development: At one week of age, the kittens should weigharound 4 ounces and should be handled minimally. Kittens willsleep 90% of the time and eat the other 10%.

1 - 2 Weeks of Age

Feeding: Continue bottle feeding orphans every 2 - 3 hoursuntil kittens are full but not bloated.

Environment: Floor temperature of the nest box should be niceand warm: 80-85oF.

Development: Kittens at 2 weeks of age will weigh around 8ounces. Ear canals open between 5 and 8 days. Eyes will openbetween 8 and 14 days. They open gradually, usually starting toopen from the nose outward. All kittens are born with blue eyes,and initially no pupils can be distinguished from the irises - theeyes will appear solid dark blue.

Healthy kittens will be round and warm, with pink skin. If youpinch them gently, their skin should spring back. When you picka kitten up, it should wiggle energetically and when you put itdown near the mom it should crawl back to her. Healthy kittensseldom cry.

To determine the sex of the kittens, hold a kitten on its back inyour hand. In females, the vulva is a vertical slit above the anus;they are very close together. In males, the penile opening isabove the anus, but they are separated by a raised scrotal sacand thus seem far apart. It is easiest to see the differencesbetween the sexes if you examine all the kittens and comparethe differences.

2 - 3 Weeks of Age

Feeding: Continue bottle feeding orphans every 2 - 3 hoursuntil kittens are full but not bloated.

Environment: Floor temperature of the nest box should be nice

and warm: 75-80oF.

Development: If there is a queen, she will begin to spend largerperiods of time out of the nest, though she will not go far from it.Kittens will weigh around 10 - 12 ounces. Their ears will becomeerect. Kittens begin to crawl around day 18 and can stand byday 21. Kittens will begin to play with each other, biting ears,tails, and paws, even before their teeth have come in. Kittenslearn to sit and touch objects with their paws.

Kittens begin their socialization phase - they will be stronglyinfluenced by the behavior of their mother for the next sixweeks. To further socialize kittens, increase the amount ofhandling, and get them accustomed to human contact. It isimportant not to expose them to anything frightening; childrenmay seem intimidating and should be supervised closely whilevisiting to ensure gentle handling.

3 - 4 Weeks of Age

Feeding: Continue bottle feeding orphaned kittens every 3 – 4hours and begin the weaning process. At this stage kittens maystart lapping from a bowl.

Environment: Floor temperature of the nest box should be 70 –75oF from this point onward.

Development: Kittens will weigh around 13 to 16 ounces. Adulteye color will begin to appear, but may not reach final shade foranother 9 to 12 weeks. Kittens begin to see well and their eyesbegin to look and function like adult cats' eyes. Kittens will startcleaning themselves, though their mother will continue to domost of the serious cleaning.

4 - 5 Weeks of Age

Feeding: They can usually drink and eat gruel from a shallowdish by 4 weeks. Weaning should be done gradually and bottlefeeding should be continued every 4 hours while they arelearning to eat solid foods. Introduce dry food and water.

Development: Begin litter training at four weeks. Use a low boxwith one inch of non-clumping litter or shredded newspaper. Donot expose the kittens to the clumping variety of litter, as it isharmful if ingested. After each feeding, place the kitten in the

box, take his paw, and gently scratch the litter. Be patient! Thekitten may not remember to do this every time, or may forgetwhere to find the litter box, but will learn quickly. Be sure to givethe kittens lots of praise when they first start using their boxes.Most will use it from the start, but like other babies, might makean occasional mistake. It is a good idea to confine the kittens toa relatively small space, because the larger the area the kittenshave to play in, the more likely they will forget where the litterbox is. Keep the litter box clean and away from their food.

5 - 6 Weeks of Age

Feeding: Feed gruel 4 times a day and thicken the gruelgradually. Dry food and water should be available at all times. Ifyou are fostering a litter with their mother, continue weaning.Some kittens will not like canned food. For reluctant eaters, trymixing any meat-flavored human baby food with a little water.The meat flavor is often more appealing to the picky eaters. Besure the brand you get does not contain onion powder as thisingredient can be hazardous to kittens.

Development: At about five weeks, kittens can start to roamaround the room, under supervision. They will weigh 1 poundand the testicles of male kittens will become visible. Thestrongest, most curious kitten will figure out how to get out ofthe nest. The others will quickly follow.

Play with your kittens daily! It is a good idea to wear longsleeves and pants, as they can play roughly and their claws aresharp. If you sit on the floor they will play "King of the Mountain,"using your knees and shoulders as vantage points. This game islots of fun and good exercise for them. Some kittens may befearful at first; do not force yourself upon them. You can getthem used to your presence by sitting in the middle of the roommaking phone calls; this way they hear your voice but do not feelthreatened. Make them an important part of your householdactivities; accustom them to the sounds of the TV, vacuumcleaner, and other household sounds.

6 - 7 Weeks of Age

Feeding: Kittens should be eating canned and dry food well.Feed the kittens at least three meals daily. If one kitten appearsfood-possessive, use a second dish and leave plenty of food outso that everyone is eating. Bear in mind that a kitten at this age

has a stomach roughly the size of an acorn, so, although theymay not eat much at a single sitting, they like to eat at frequentintervals throughout the day.

Development: By this time, you have "mini-cats." They willwash themselves, use scratching posts, play games with eachother, their toys, and you, and many will come when you callthem. Be sure to reintroduce them to their litter box after meals,during play sessions, and after naps. These are the usual timesthat kittens need to use the litter box.

Adoption: It is safe for healthy, robust 6 week old kittens to bespayed/neutered and made available for adoption if you are ableto place them at that age in your community. Check your stateand local animal ordinances to find out if this is possible for yourfacility.

7 - 8 Weeks of Age

Feeding: Offer wet food 2-3 times a day (each kitten will beeating a little over one can of food per day). Leave down a bowlof dry kibble and water for them to eat and drink at will. If youhave a litter with a mom cat, she should only be allowing briefnursing sessions, if any.

Development: By the end of the 8th week, kittens should weigh2 pounds each and are now miniature cats.

Adoption: It is time for their spay/neuter surgery and adoption!

Socialization and BathingBeginning around 3 weeks of age, kittens need exercise topromote muscular and circulatory development and to learnsocial skills. They will begin to play with their littermates andlearning from their mom if they are not orphaned. It is good tobegin regular daily handling of kittens to get them used tocontact with people. Play is the best method to help themphysically and socially develop.

If kittens are orphaned and do not have a mom to regularlygroom then, it is important to teach them to groom and keepthem clean. After each feeding session, give kittens a full-bodyonce over with a barely damp washcloth. Use short strokes like aqueen would use. Kittens often get dirty between cleanings and

it is okay to wash a kitten with warm water under a sink faucetbut focus only on the areas needing cleaned. A simple "buttbath" will usually do the trick. After bathing, wrap the kitten intowels/blankets and a heating pad set on low. Your body heat isnot sufficient to warm up a cold kitten. Make sure you do notleave a kitten until it is completely dry.

Socialization

It’s a hard job, but someone has to play with kittens toensure they are well socialized and people friendly byadoption time.Kittens will naturally socialize with their mom andlittermates if they have them. Socialization is anotherreason to pair single, same-age kittens on intake.The key socialization period in kittens is 4 to 12 weeks ofage.Kittens start to play and explore at about 4 weeks of age.1 Make sure they have toys and stimulation in their cage.Pipe cleaners, cardboard rolls from toilet paper and papertowels are great play items in addition to traditional kittentoys.In a foster home, the foster parent should spend some timeeach day sitting in the foster room with the kittens andhaving play time. In a kitten nursery, make sure the kittensget some hands on in-cage socialization time with nurserycaregivers.Introducing new fosters to the foster parents’ resident petsduring the first two weeks is not recommended. Let thekittens get acquainted with their new home before exposingthem to other animals. After this time, introducing fosterkittens to adult cats and dogs in the home can be great forthe socialization of the kittens but should definitely be donewith care and only under supervision.

Steps to Bathe an Underage Kitten

1. Get a small sink or a basin ready with some warm water. Ifthe kitten is really dirty, a small amount of Dawn or babyshampoo can be used in the water. Make the water a nicewarm temperature like you were taking a bath.

2. To keep the kitten from getting chilled, have towels readyto immediately dry it off. If possible, warm the towels in thedryer beforehand.

3. You may want to wear long sleeves and gloves. Kittens may

panic and start to scratch. Gently hold the kitten by thescruff and support its body with your other hand. This mayhelp calm and control the kitten.

4. Give the kitten a quick but thorough bath to get any foodand feces off them. If only its butt is dirty, then onlyimmerse the butt, not the whole kitten.

5. Rinse the kitten off with warm water and immediately wrapit in a towel.

6. Rub vigorously to get the kitten dry. If the first towelbecomes wet, switch to a clean, dry towel.

7. Keep the kitten with you and do not put it back untilcompletely dry. If needed, wrap a heating pad around theoutside of the towel while the kitten is drying.

Click here for a video from Maddie's Institute on bathingorphaned kittens.

Care of the QueenIf you are fostering a pregnant queen during her final week ofpregnancy, it is important to remember she may not have a bigappetite because the kittens are crowding her internal organs.Feed her several small meals daily, rather than one or two largermeals. Leave dry kitten food and water out at all times. It isvirtually impossible to overfeed a nursing or pregnant queen.Food requirements increase up to three times the normalamount.

Prepare a kittening box. Place it in a dry, warm, relatively darkand out-of-the-way place, and put the queen in it. If she doesn'twant to stay in it, don't insist, but you can encourage her bypetting her and giving her little food treats. If your nursery roomis not that warm, you can keep the box warmer by wrapping aheating pad in a towel, setting it on "low," and placing it underHALF of the box so that the queen and kittens can removethemselves from the heat source if they choose. One word ofwarning: you might consider wrapping duct tape or a cordprotector around the cord, as the kittens tend to chew on it!Alternatively, consider using a Snuggle Safe Disk which does notrequire a cord. Until the queen delivers, fill her litter box withshredded newspaper instead of cat litter. Many cats will delivertheir kittens in the litter box. Newspaper provides a muchcleaner environment for the cat and kittens than litter. After thekittens are born, you can switch to your normal non-clumping

litter.

The Birth of Kittens, or KitteningThe majority of cats give birth with no problem or need foroutside help. Before delivery, the queen may become irritableand restless. She will search for a place to have her kittens. Puther in the designated kittening box. She may choose not to havethem there, so it helps to keep the box in a room with as fewnooks and hiding places as possible. If she has her kittensoutside of the kittening box, let her. When she is completelydone with the delivery, move them all into the box. If the cat hashad her kittens outside the box, don't worry about the "mess" -when she is finished she will normally clean up and leave verylittle evidence of the birth.

Some cats may want you to stay with them, and will try to followyou if you leave. You will probably have to spend some time withthis kind of cat soothing her. Often after the birth of the firstcouple of kittens, she will be very busy and not so dependent onyour presence. Other queens will try to get away from you andhide. Give her the space she needs, but keep checking in on herregularly. It is quite possible that you will miss the birth processentirely. You might wake up one morning or come home fromwork to find the new family born, dry, and nursing.

Stages of Feline LaborThe first stage may take 12 hours, during which the queen maypurr and breathe rhythmically. She may become very active, tryto dig at the floor, appear to be straining to use her litter box,and cry loudly.

In the second stage, the water breaks, and straw colored fluid ispassed. A kitten will be delivered a few minutes later. The queenwill lick the kitten clean and bite through the umbilical cord. Sheis bonding with her kittens through this process, and learning torecognize them as her own. Do not disturb her. It may look as ifher treatment is too rough, but she is actually stimulatingbreathing and blood circulation. Kittens should begin nursingbetween subsequent births.

In the final stage, the placenta follows a few minutes afterdelivery of a kitten. The mother will probably eat some or all ofthe placentas. Kittens are born anywhere from 15 to 30 minutes

apart, so most deliveries take 2 to 6 hours. The average litter is4 to 5 kittens. Larger litters of 6, 7, or more are unusual.

If a kitten is not born within 2 hours and the mother appears tobe continually straining or in distress, call a veterinarianimmediately. She may need a Caesarean or a drug calledoxytocin to stimulate contractions. If the mother is content andhappy, she is probably finished, though there have been cases inwhich a cat resumed delivery sometime later.

Nursing QueensIf you are lucky enough to have a mom taking care of herkittens, your job is much easier. You need to make sure thatmom is getting plenty of food because nursing a litter of kittensrequires a lot of calories. The queen should be eating dry kittenfood supplemented with canned food and she can eat as muchas she wants. You also need to monitor her mammary glands asmastitis (or inflammation of the mammary glands) is a commonproblem. Her mammary glands should not be overly swollen orhard, should not look red or inflamed, should not be painful tothe touch, and you should be able to express milk out of them.One way to monitor the queen’s lactation is by monitoring thekittens. They should not be overly vocal, should sleep most ofthe time, and should have a nice, round belly. There should be aplan for who foster parents should contact if they have anyconcerns with the queen or kittens they are fostering.

Considerations for MixingCats and KittensShelter staff and foster parents are tasked with caring for andadopting out animals who are healthy and well-socialized petsfor their future adoptive homes. We want growing animals to beable to experience the world and we want adult animals to beable to express their normal behaviors and have interactionsthat would enrich their lives. It is important to balance thesemental/emotional needs with medical health needs, includingpreventing the spread of infectious disease. Kittens, inparticular, are highly susceptible to infectious disease andspecial consideration must be given to when it is or is notreasonable to mix them together; in addition, there are someimportant details to keep in mind when mixing unrelated cats of

any age.

Limitations on capacity - staff, time, and/or number of fosterhomes or amount of cage space - can pose challenges toproviding the care necessary to move animals efficiently andsafely to the point of adoption. These challenges may lead someshelters to make a choice to mix unrelated cats or kittenstogether just in order to find more “space.” However, thatchoice often leads to more challenges rather than fewer if thechoices of which cats to mix are not balanced against the abilityto screen for and recognize signs of infectious disease.

All Cats and KittensDoes the shelter have adequate screening andmonitoring practices in place to identify animals withsigns of infectious disease?

Cats showing signs of infectious disease should not beco-mingled or housed in groups. Signs to watch forinclude:

Sneezing, nasal discharge, squinting/swollen eyes, oculardischargeVomiting, diarrhea, poor appetiteItchy skin (pruritis), visible external parasites, suspiciousareas of hair loss, Wood’s positive skin lesionsUnexplained weight loss, history of littermate with suddendeath

Screening for these signs must begin at intake and monitoringshould continue daily for the duration of the animal’s time in theshelter.

Infectious disease may be brewing in apparently healthycats. The time between being infected with a pathogen andshowing signs of illness is called the incubation period. Duringthe incubation period an animal may be contagious to otheranimals but appear healthy. The incubation period forpanleukopenia is well established, typically 5-7 days but can goup to 14 days. A cat is unlikely to be incubating panleukopenia ifthey appear healthy for 7 days, and the chances are slim if nosigns have been seen for the past 14 days. For this reason, catswho have at least 7 days (and ideally 14 days) of a well-documented, healthy medical history in the shelter make better

choices than cats with an unclear history.

Additionally, the incubation period for ringworm is 2-4 weeks. Ifcats are being screened for suspicious lesions (as well as othersigns of infectious disease) at intake, receiving a wood’s lampexamination at intake, and are checked again prior to beingmixed, this will help to limit the spread of ringworm betweencats in your shelter.

Does the shelter routinely vaccinate all cats and kittensat time of intake (or as soon as they reach 4 weeks ofage) and every 2 weeks thereafter?

Vaccination is a key component of preventing disease outbreaks.The panleukopenia component of the FVRCP vaccine inparticular offers robust protection from disease, but it does takeat least 5 days for the vaccine to provide full immunity.Furthermore, the presence of maternal antibodies may prevent avaccine from successfully immunizing a kitten, so it is importantthat they get re-vaccinated every 2 weeks while they are in thecare of the shelter or until they reach the age of 20 weeks.

Kittens < 20 weeks oldThe benefits may be worth the risks for mixing unrelated kittenstogether when combining pairs of single orphaned kittens whorisk missing out on critical opportunities for socialization withother cats. In other cases, the risks of combining kittensprobably outweigh the benefits. While shelters may choose tomix kittens together for other reasons, this often posessignificant risk for welfare and health for other individuals andpossibly for the population as well.

There are several factors that should be weighed beforemixing animals from different sources together in anysituation:

Do not mix sick kittens with other (healthy or sick)kittens. Much like children in daycare, if one kitten is sick,chances are all of them are going to get sick. But in kittens thestakes are higher, because the illness could be life threatening.Kitten’s immune systems are developing from the day they areborn but it takes time to develop a robust immune system.Furthermore, because kittens may have received antibodies

from their mother soon after birth (that are important but caninterfere with immunization), they may not be immunized by thevaccines they receive until the levels of maternal antibodies fallbelow a certain threshold. Because we can never be certainwhen that threshold is, kittens must be vaccinated every 2 – 3weeks until 20 weeks of age when all maternal antibodies areknown to have subsided. Also, even though 2 unrelated kittensmay have signs of upper respiratory disease, you cannot becertain the disease is being caused by the same pathogen somixing them together may result in complicating their upperrespiratory infections.

Considerations when using surrogate queens:

Putting orphan kittens with an unknown history with a queenwith older kittens may be a very risky choice for all of thekittens. Even if apparently healthy, the new kittens may beincubating disease that could affect the queen or other kittensshe is nursing. Older kittens often also outcompete orphans forthe milk they need to grow and thrive.

Queens provide more than just food and a warm snuggly pillowto their kittens. Kittens receive colostrum from their mothers intheir first nursing sessions after birth. Colostrum serves to offersome immune protection from infectious disease until kittensdevelop an immune system of their own. Unfortunately, kittensare only able to absorb colostrum for the first 24 hours of theirlife, and queens only produce it soon after queening. Kittens whomiss out on receiving colostrum are at high risk for disease andfading kitten syndrome. The colostrum-deprived orphans have apoor prognosis, and if/when they become ill they may put thequeen’s original kittens at risk.

NOTE: Kittens do not receive any immune benefits throughnursing after the first 24 hours of life. Vaccinating a queenprovides no immunity to her nursing kittens. Kittens who are 4weeks or older should each receive their own vaccinations (orstart once they reach 4 weeks of age), repeating as describedabove.In addition, overloading a queen with more than her litter or withsequential litters may cause health and welfare risks for thequeen. The nutritional needs of nursing queens are high, andcaring for orphan kittens will take a toll on her physical healthunless nutritional needs are maintained. Furthermore, it is

important to maintain consideration for the behavioral needs ofthe queen over time.

Imagine the worst case scenario when making a choice tomix kittens and weigh that against your goals forsocialization and/or foster home placement. If you decideto mix 2 unrelated litters of kittens, imagine theconsequences if a serious disease were to spread to allindividuals:

What if you placed 1 orphan baby with a nursing queen and her4 kittens? If either group is harboring disease, all 5 of thesekittens (and possibly the queen) are now at risk. The benefits ofputting the orphaned kitten in this group to save his life mayultimately jeopardize 5 other lives.

What if you placed 2 single orphaned kittens together? In thisscenario, even if the worst happens, only these 2 kittens are putat risk for disease. As singletons, these kittens have a relativelyhigh risk of developing behavioral problems that can reducetheir adoptability. The choice to combine them carries somedisease risks, but also offers real socialization benefits. The risksof 2 kittens remaining alone versus living together does notmultiply the risk additional animals.

Kitten NurseriesWith the arrival of each and every spring, the staff of sheltersacross the county know they will soon face the overwhelminginflux of underage, often orphaned, kittens. In the past,euthanasia of these kittens often seemed the only viable andhumane choice even at facilities with a robust foster program. Ittakes resources and time to raise kittens to adoption age, twoitems in short supply at our largely underfunded, understaffedshelters. But as more shelters increase their life saving ability,creative programs aimed at increasing live release rates areemerging. One such new and innovative program is thedevelopment of kitten nurseries. A kitten nursery saves lives,but it takes planning, funding, good protocols, and a network ofdedicated staff and volunteers to succeed.5

Creating a successful kitten nursery takes commitment andresources from the shelter, local affiliates and the community.Protocols governing the care of the kittens, the cleanliness of the

nursery, and methods of controlling infectious diseases are othercritical elements.

Developing a kitten nursery requires: 5

PlanningSetting up the NurseryCreating an Extensive Foster Care ProgramControlling the Spread of Infectious DiseaseCaring for Kittens from Birth to Eight Weeks Medical Care and Protocol DevelopmentTraining Staff and VolunteersSupersizing the Adoption Program

PlanningBefore moving forward with establishing a nursery program,many questions must be examined and answered. Shelter andother organization leaders associated with animal care mustdecide how great the need for a nursery is and how well it willserve the community. For communities where large numbers ofkittens are euthanized annually and the sheltering agencies arelooking for solutions, a kitten nursery may be the right solution.

The availability of physical space is one of the first requirementsto determine. A separate building is ideal. The primary reason inkeeping the facility separate is to control the spread of infectiousdiseases within such a vulnerable population. A secondaryreason is the ability to allow volunteer staff to enter and leavethe nursery without having access to the main shelter building. Ifa separate location is not an option, the ability to isolate thenursery from the main shelter is necessary. The chosen locationand size will also affect the number of kittens housed, staffrequired, daily routines and medical protocols.

Staffing the nursery will, most likely, involve a combination ofpermanent and part-time personnel, seasonal help, andvolunteers. At least one permanent, full time staff membershould be assigned to the nursery. Will there be funding foradditional staff or additional hours for part-time personnel duringkitten season? This type of program generally relies heavilyupon volunteer participation. Are reliable volunteers available? Ifrelying heavily on volunteers, it is essential that at least onestaff member is present at all times to ensure facility

consistency, adherence to procedures, and to relay importantinformation.

Few shelters have the resources to run an around-the-clockkitten nursery, therefore do not underestimate how essential astrong foster care program is. Are enough foster homesavailable to care for the orphaned, unweaned kittens and kittensnot thriving in the nursery?

What community partnerships will enhance and increaseresources? Look to local rescue groups and city or countyorganizations. Community partnerships can help in establishingthe nursery and may provide joint staff and volunteers, anincreased pool of fosters and adopters, assistance andparticipation with funding, and larger adoption events.

How will the nursery be funded? Are grants available? The initialcost of setting up the nursery may be significant. Fundraisingefforts, such as a “kitten shower” can help offset those expensesand spread the word about the nursery.

Setting up the NurseryNursery design must protect the kittens against the spread ofinfectious disease, provide for their physical needs, and allowthem proper social development. Some nurseries may keepkittens from birth to eight weeks of age; others only kittens fourweeks and above. Foster care is used for nurseries without thecapability to house unweaned, orphaned kittens as well askittens not thriving at the nursery.

To help with management of the nursery, each room should becolor coded and fully equipped. For example, one room may beidentified as the blue room, one the green room and so on. Eachof the rooms as well as the non-housing areas, such as the workspaces, laundry space, and storage space, should be colorcoordinated. Color code any items that can be moved with spraypaint or duct tape, such as the signs on the doors, foodcontainers, litter container, watering can, trash can, laundrybasket, broom and dustpan, mop, disinfectant spray bottles, andso on. Color coordinating is a way to help control the spread ofinfectious disease by giving staff and volunteers a visual way tomake sure that everything that belongs in a room stays in thatroom. This is especially important for cleaning items such asbrooms, mops, dustpans and spray bottles or anything that could

serve as fomites from one room to another. Color coordinating isalso useful for items belonging in areas that do not housekittens. This will identify them as “clean” areas. Staff andvolunteers will need training on why everything staying withinthe assigned room is so important. They must understand thismethod reduces the spread of diseases and also ensuresefficient daily operation since no one must go looking for amisplaced essential item. If an item does get carried intoanother room, staff will be able to quickly see it does not belong.

Specific shelter and community environments often determinehow a nursery should be arranged to provide the best kittencare. For example, are highly contagious infectious diseases,particularly panleukopenia, extremely common in the area or arethey a rare occurrence? Do a lot of kittens come in withconfirmed dermatophytosis? In shelters where panleukopeniaand dermatophytosis are common, including procedures tominimize the spread of infectious diseases should be a primaryfactor in nursery design. Where infectious diseases are common,grouping kittens as cohorts based on intake may be the bestarrangement because housing kittens in a single room for theirentire time at the nursery minimizes the potential for apanleukopenia outbreak even if a case or two occurs within theroom. This method keeps the infectious disease confined to oneroom/intake week group. Procedures must then include plans fortreating mild illnesses such as diarrhea, upper respiratoryinfection, and conjunctivitis in the room without pulling thekittens out. In addition, grouping kittens by intake week providesthe means to control the number of intakes each week based onspace availability, thus keeping staff and volunteers frombecoming overwhelmed.

For shelters in communities where infectious diseases likepanleukopenia and dermatophytosis are a rare occurrence,nursery design may be based on age. The dominating factorgoverning the arrangement of these rooms can be meeting thephysical and social needs of the different age groups, such asnursing moms with litters, orphaned, unweaned kittens from 0 –4 weeks of age, and the 4 – 8 week old kittens just transitioningto solid foods who need more play and socialization time.

Shelters considering a neonatal nursery must take into accountthe expense of a 24 hour, seven-days-a-week operation.Orphaned, unweaned kittens are a fragile population requiringround the clock care, frequent rechecks, more supervision, andare more susceptible to illness. Caring for them requires a staff

of employees and volunteers assigned to strictly work with thisage group and who are trained in the care of neonates.

Medical Protocols

Juvenile animals are the most vulnerable to infectious diseasebecause of their immature immune systems and maternalantibody interference. No matter how many vaccinations a kittenreceives, it is still not necessarily protected from disease untilaround 16 to 20 weeks of age, so vaccine boosters must becontinued until that time.

Medical protocols should be developed by or with the help of anexperienced shelter veterinarian. Protocols may vary based onthe geographical location of the shelter, infectious diseasesprevalent in that area, and the ability of the shelter to isolateand treat highly contagious diseases like panleukopenia anddermatophytosis. It is imperative that any kittens with either ofthese conditions be immediately removed. For shelters with anisolation room and the capability to provide adequate medicaltreatment, the kittens must be immediately moved to theisolation area. For shelters without the capabilities to isolate andtreat animals infected with panleukopenia or dermatophytosis,euthanasia of affected kittens is likely the only option. There aremany other common illnesses and conditions seen in kittenswhich will need to be addressed and have a protocol in placethat outlines clinical signs, diagnosis, isolation, treatment, andresolution. For more information on protocol development, referto Developing infectious disease policies and protocols in ananimal shelter.

Intake Protocols

Intake protocols should be defined for your facility with the helpof an experienced shelter veterinarian. All kittens under fourweeks or age should receive routine deworming with theantiparastic pyrantel pamoate and the antiprotozoal ponazurilupon intake. If fleas are present, kittens need a quick bath withwarm soapy water, taking care to prevent hypothermia. Formore information, refer to Steps to Bathe an Underage Kitten inChapter 2. Fleas should then be manually removed.2 Intake staffcan be trained to estimate the age of incoming kittens based onthe general guideline that they gain an average of 4 ounces(113 grams) each week. All kittens four weeks of age or olderand weighting at least 1 pound (454 grams) should receive

routine deworming with pyrantel pamoate and ponazuril, and aninitial vaccination with a modified live vaccine containing Felinepanleukopenia virus (FPV), Feline Herpesvirus-1 (FHV-1), andFeline Calicivirus (FCV).3 They can also receive a routine fleapreventative like selamectin dosed for weight.2 Some sheltersmay consider giving nitenpyram if fleas are visible and the kittenmeets minimum weigh requirements. Praziquantel may also beadministered assuming the kitten has tapeworms. Sheltersshould screen for feline retroviruses before pairing unrelatedkittens and ideally before placement in adoption, although this isnot an absolute for individually housed kittens or individuallyhoused litters of kittens.4

All cats/kittens entering the shelter should have a picture takenon intake and individual identification made. This is essential foraccuracy of medical records. For litters of underage kittens toosmall for ID bands or microchips, consider an alternate way ofidentifying them with something like writing a number insidetheir pinna with a permanent marker or using different coloreddots.5 Each should be assigned an individual animal ID numberjust like any other animal entering the shelter on intake. Cagecards help track the individual identification numbers and will beimportant for maintaining accurate medical records and trackingdaily weight.

Intake staff should be trained to do a basic physical examinationto identify any medical concerns. This is important for identifyingcommon illnesses like URI and conjunctivitis and for identifyingany animals needing immediate veterinary attention. All catsand kittens should also receive a routine Wood’s LampScreening as part of their intake exam so that any ringwormsuspects can be immediately identified.6

Click here for a video from Maddie's Institute demonstrating aphysical exam on an orphan kitten.

Vaccination Protocols

Upon admission, all kittens between four and 20 weeks of ageshould receive a vaccination with a modified live productcontaining FPV, FHV-1, and FCV and then boosters every two tothree weeks until 16-20 weeks of age while in the shelteringenvironment.3 A modified live vaccine is preferable in theanimal shelter facility because the potential onset of immunity is

much faster than with a killed product.

Cats should be vaccinated low in their right forelimb followingAAFP vaccination site recommendations. All cats over 20 weeksof age should receive a vaccination with a product containingFPV, FHV-1, and FCV on admission and then one booster in twoto three weeks.3 For most shelters, the benefit of vaccinating thepregnant or nursing queen outweighs the risks of not vaccinatingher.7 While there is a possibility the kittens may developcerebellar hypoplasia due to vaccination of the queen, naturalinfection with panleukopenia will often prove fatal to both thequeen and her kittens. Vaccinating a nursing queen does notprovide any protection to the kittens. They only receive maternalantibodies from the colostrum they receive in the first one tothree days of life.

Kittens in foster care should be scheduled to receive their firstvaccine at four weeks of age if weighing at least 1 pound (454grams). Vaccinations can be harmful to kittens under four weeksof age and may cause cerebellar hypoplasia.

Pyrantel pamoate should be repeated with each booster vaccineuntil kittens reach 16 weeks of age; then monthly until sixmonths of age. Selamectin can be given routinely each month.All cats and kittens over 12 weeks of age may receive a rabiesvaccination during a veterinary examination.3

Creating an Extensive Foster CareProgramA robust foster program is essential to a kitten nursery. Fosterhomes provide kitten care for shelters without 24-hour nurseriesand for kittens not thriving in the nursery setting. An extensivefoster program is also an invaluable source of temporary homesfor kittens when no space is available at the nursery. Fosterparents can also be an extension of the adoption program bysupporting community adoption events and even finding homesfor the kittens they foster.

Setting up a nursery will be easier for shelters with a well-established foster program. These shelters can rely on fosterparents who will retrieve orphaned, unweaned kittens on thesame day they arrive. Foster parents great at bottle feeding can“trade-in” a litter transitioned to solid food for a new litter of

unweaned, orphaned neonates instead of fostering the olderbabies until ready for adoption.

Enlisting new foster parents is an on-going endeavor for allshelter nursery programs. Social media, the shelter’s website,and word of mouth are all traditional ways to recruit fosterparents, and a “kitten shower” is another recruitment tool.Fosters also need to know what the shelter will provide, such asmedical care, food and litter, and that the shelter takes thekittens when ready for adoption unless the foster parents findadopters on their own.

Another way foster homes help in the height of kitten season isby keeping foster kittens until shelter space opens for them.Foster parents will also often volunteer to bring the kittens livingin their homes to offsite adoption centers on weekends or bringthem to shelter-hosted adoption events.

Controlling the Spread of InfectiousDiseaseBy far, the biggest risk to underage kittens is exposure toinfectious diseases, therefore every action within the nurseryfrom feeding the kittens to cleaning the cages to nursery staffand volunteers entering and exiting the rooms must beperformed to keep potential pathogens out or at least confinedto one area. Even within the nursery, strict adherence toprocedures preventing cross contamination cannot beoverstressed.

One of the items highly recommended for each room is a boundor electronic copy of all protocols. Those protocols should includedetailed step-by-step instructions on cleaning everything withinthe room, such as cages, toys, bedding, bowls, and litter boxes.Not only should the order of completing the task be included soshould the finer details, such as how to change bedding ormeasure out the proper amount of food. Between the writtenprotocols and the nursery staff/volunteer training, ensure eachperson working within the nursery understands not only thepractices but also why adherence to them is so imperative.

Sample Outline of a Kitten’s Planned Movementthrough a Kitten Nursery

Intake is performed in animal admissions. Refer to theIntake Protocol for more information. All cats and kittenswill have a wood’s lamp examination performed during theintake exam. The medical department will be alerted if anyanimals are ringworm suspects before they are transportedto the nursery.All underage kittens will be transported to the kittennursery. Volunteers at the nursery may be needed fortransport throughout the day to ensure the kittens are fedwithin 2 hours of intake.Each of the housing rooms is used for one week of intakes.No kittens will be moved into another room. The kittensremain with their intake group for at least 14 days after thelast kitten has entered the room.For the first 14 days of their stay, new intakes arequarantined in their room and monitored closely for anysigns of illness. They may not be moved anywhereelse unless sent to foster care. Unfortunately,panleukopenia is common in the area and we must controlthe spread as much as possible.Any kittens that break with URI or conjunctivitis will betreated in their cage. Their cage will be cleaned/handledlast in that room. Please refer to the Cleaning Protocol formore information.A care card will be maintained for each kitten. Volunteerswill record their weights daily.Once kittens have been through the 14 day quarantineperiod, it is time for some serious play and socialization.Although kittens may still break with URI or conjunctivitis,these are treatable in the nursery.Once a kitten is past the quarantine period and is 8 weeksof age, place a GO card on its cage to alert the medicaldepartment that it is ready to graduate from the nursery.Kittens at the nursery are eligible for foster care at anytime. The focus in the foster department will be to moveunweaned, bottle-fed kittens into foster care. Once theyoungest kittens are in foster care, those eating mush willgo to the remaining available foster homes. If you areinterested in fostering at any point in time, please contactthe foster coordinator.

PPE (Personal Protective Equipment) Practicesfor Staff and Volunteers

The best practice for gowns and other protective garments is to

assign one gown or smock to each cage. Staff or volunteersmust wear the assigned gowns when cleaning, feeding, andsocializing the kittens in that cage. These gowns should bestored above or below the associated cage. Another option isusing disposable gowns. However, this method is often toocostly for a shelter budget. Whichever procedure is used, staffand volunteers must understand the significance of wearing and,when necessary, changing the protective garments, and never,ever wearing them outside of the particular nursery room. Theymust also understand the need to change gloves between cages.These practices may be impractical for some nurseries, butallowing any contact between items in individual rooms opensthe pathway for the spread of infectious disease.

If for any reason the above practices cannot be followed, theconstant potential for exposure is always present so additionalprocedures designed to minimize the risk are necessary. If onegown per cage is not possible such as in a room with no way tostore the gowns, an alternative practice allowing the use of onegown per person within a single room requires these additionalsteps:

1. Protective garments, such as gowns, are worn only within asingle room. These garments are washed or disposed ofdaily.

2. New gloves are worn when cleaning and feeding kittens indifferent cages. Gloves are changed between cages as wellas when handling the common supplies in the room.

3. Kitten cleaning and feeding progresses from an order of thehealthiest kittens to kittens with mild illnesses. Kittens are“color coded” by a green, yellow or red tag on cages. Theseidentification markers convey the health status of thecage’s inhabitants as: a) kittens in cages tagged GREENwere healthy on intake; b) kittens in cages tagged YELLOWneed to be monitored for illness, perhaps because someonenoticed loose stool, sneezing or ocular discharge; and c)cages tagged RED house kittens currently undergoingtreatment for an illness. Color coding is simple but anymethod works that easily informs staff and volunteers ofthe health status of the kittens within a cage. The bestapproach uses a visual signal, such as a laminated carecard, clip, or clothespin.

4. Upon entering one of the rooms, the staff member orvolunteer puts on a fresh gown and gloves and walks theroom, visually checking all the kittens. If any signs indicate

a green-tagged kitten may be getting a URI or if diarrhea ispresent in the cage, the staff or volunteer member places ayellow tag on the cage and completes a request for aveterinary exam.

5. After the visual inspection is completed, cages should becleaned in an order of green to yellow to red. This orderminimizes the opportunity for infectious diseases to spreadand allows for the treatment of any mild illnesses such asURI and conjunctivitis without needing to move kittens fromtheir original cage.

6. The practice of allowing a single gown per person per roomonly works if the staff member or volunteer moves fromgreen to red cages. However, gloves must be changedbetween cages and handling common supplies. If at anypoint, a yellow or red tagged kitten is handled and theperson needs to return to kittens coded “green,” the staffmember or volunteer must change to a clean gown. Whenfinished in the room, the gown should be disposed of ifdisposable or placed in the laundry basket if non-disposable.

Cleaning and Disinfecting

Within the nursery, one of the most important allies in fightingpotential pathogens is a good disinfectant. Any disinfectantconsidered for use should be researched for requiredconcentration, contact time, and efficacy against differentpathogens, as well as staff and animal safety concerns. Therespiratory tracts of all cats but particularly kittens are sensitiveand easily irritated so the disinfectant must be both powerfulagainst the pathogens targeted and yet gentle enough to notmake kittens more susceptible to upper respiratory infections.Accel, an accelerated hydrogen peroxide, is one possible choicefor a kitten nursery disinfectant. Not only is Accel effective at thecorrect concentration against calicivirus and panleukopenia witha 5 minute contact time but it is also effective againstdermatophytosis with a 10 minute contact time.5,8

Deep Cleaning

All cages undergo deep cleaning after the cage is vacated,before it can be used again. A deep cleaning is alsorecommended anytime a cage is heavily soiled. Deep cleaninginvolves emptying the cage and cleaning every part of it with adisinfectant. If kittens are still residing in the cage and you have

double sided housing, the kittens can be shut on one side whilethe other side is cleaned. If you only have single sided housingconsider having feral cat dens or carriers in each cage that thekittens can be shut in and removed during deep cleaning.Nursery staff and volunteers cleaning the cage must know howto remove all items properly to prevent the potential spread ofdiseases. All organic debris (scattered litter, food or clumps offeces) must be removed before disinfecting begins. The debrisshould be carefully removed, taking care not to scatter it ontothe floor or cage below. Once the cage is free of loose debris, allsurfaces of the cage, including the doors and ceiling, must becleaned before disinfecting to remove any caked-on debris.Nursery protocols should include descriptions of what to discard,what to clean or launder, and how to safely do so. Disinfectingthe cage involves spraying the disinfectant inside of the cage,covering all surfaces, including the ceiling. A controlled spray isnecessary so no misting or splattering into neighboring cagesoccurs. One way to avoid inadvertently spraying the nearbycages is to liberally spray a clean rag and wipe down the edgesand doors of the cage. Spray the cage again using thedisinfectant and wipe down all surfaces of the cage, includingthe doors with a clean rag. Allow this second application to sit forthe product’s recommended contact time before wiping dry withanother clean rag. If using Accel, no rinse is needed. Place afresh litter box with litter, empty food/water bowl and towel orblanket inside the cage. The cage is ready to use again. Formore information, refer to Sanitation in Animal Shelters.

Spot Cleaning

Spot cleaning of cages must be done daily. Spot cleaninginvolves light tasks such as freshening the litter box, wiping upspilled food and water, removing any feces, and so on. As withany other task that involves interacting with the kittens or thecage, the staff member or volunteer must wear a gown and newpair of gloves. Kittens need not be removed from a double-sidedcage if the kittens can be kept in the side not being cleaned, or ifit is not double-sided, if the kittens can be shut inside a feral catden. Kittens may need to be moved temporarily to a clean catcarrier if the cage is not double-sided or does not have a feralcat den. Cleaning tasks should follow the nursery’s protocols. Ata minimum, bowls should be cleaned if required, food and waterrefreshed, litter boxes scooped or emptied, and the beddingstraightened or replaced if soiled. If bedding or other items areremoved, nursery staff should know never to handle items such

as bedding or newspapers in a way that might spread fur, litter,or other organic debris outside of the cage or the trash bin. Thisis another precaution to prevent the spread of potentialpathogens. All bedding, toys, and newspapers may remain inplace during spot cleaning if not needing cleaned or replaced. For more information, refer to Sanitation in Animal Shelters andSpot Cleaning Cat Cages.

General Cleaning

The same sort of care taken with cleaning the cages must alsobe applied to general nursery cleaning. Nursery staff andvolunteers must use only the room’s color-coded cleaning itemsand supplies. All countertops in the room must be cleaned, thensprayed with disinfectant. Swept floors need to be mopped withdisinfectant properly diluted for the task per the manufacturer’srecommendations. Heavily soiled spots (encrusted dirt, food,litter, etc.) need to be scrubbed.

Dirty carriers, transport cages, and feral cat dens should becleaned and dried outside the nursery, then sprayed with adisinfectant solution mixed per manufacturer’srecommendations and allowed to sit for the required contacttime. The items do not need to be rinsed if Accel is being usedand must be allowed to dry.

Dirty laundry (bedding, rags, gowns, etc.) should be kept inlaundry baskets or containers and never piled on the floor.Laundry baskets should have a fresh trash bag placed in themdaily so the laundry can be taken to the laundry room withoutremoving the basket from the room. This method helps preventany cross contamination. Heavily soiled items or items thatcontacted panleukopenia or dermatophytes must be thrownaway immediately. Towels, sheets, blankets, pillow cases,washable pet beds and pillows are to be washed with HOT water.Overloading a washing machine results in a “less than clean”condition. Persons handling dirty laundry need to wearprotective gowns to keep from contaminating personal clothing.When handling clean laundry, nursery workers must make surethey are not wearing a contaminated gown to keep fromcontaminating the laundry.

Using disposable litter pans eliminates washing litter pans in thesame area, and often at the same time, as the bowls, dishes andtoys. Having a dishwasher in each of the nursery rooms to wash

the dishes would be ideal but not practical for many facilities.For manual washing, hot soapy water should be used forwashing bowls, dishes and plastic toys. After they are cleaned,the items should be soaked in a disinfectant solution for therecommended concentration and contact time, then rinsed withfresh water. The easiest way to ensure compliance with thisthree-step cleaning process of all dishes is to set up a cleaningarea with three utility sinks in a row. Let items air dry beforereturning them to the cages.

Bottle feeding equipment must be cleaned after each feeding.Each bottle and nipple must be washed with soapy water until allresidues are gone. Disinfect the feeding equipment in thestrength recommended by the product manufacturer (Forexample, if using Accel, the solution would be 1:64 or twoounces per gallon of water) for the recommended contact time,then rinsed with fresh water. If available, a dishwasher is thebest way to disinfectant the feeding equipment. Allow all bottlesand nipples to dry before the next use. For more information,refer to Sanitation in Animal Shelters.

Medical Flag System

It is important to have a plan in place so nursery staff andvolunteers know who to contact and when for a medical concernwith kittens in the nursery. You want to ensure that kittensreceive immediate attention when needed but that the nurserystaff and volunteers do not contact medical staff constantly. Oneway to manage this is through a list of medical warning signs sothat they know what they should do. In the example below, asystem with a list of red flag and yellow flag signs wasestablished.5

Red Flags – if any of the following occur, alert themedical staff member on call immediately.

Kitten did not eat during last meal.Kitten lost weight.Kitten has liquid diarrhea.Kitten is dehydrated.Kitten is listless.Kitten vomited repeatedly.Kitten is bleeding.Kitten has neurologic signs.Kitten found deceased in cage.

Yellow Flags – if any of the following occur, monitor thekitten, alert the nursery staff member, and fill out aveterinary exam request form. These forms are checkedat least once daily.

Kitten has sneezing, wheezing, nasal discharge and/orcoughing.Kitten has ocular discharge.Kitten has mild lethargy or depression.Kitten did not gain weight.Kitten has loose stool.Kitten has occasional vomiting.Kitten has decreased appetite.Kitten has difficulty urinating or defecating.Kitten is limping.Kitten has behavior not normal for the kitten.Kitten has an area of hair loss.

Common Illnesses seen in a Kitten Nursery

Many kittens will be admitted into the facility in poor bodycondition, heavily parasitized, and suffering from mildillnesses.1 While we cannot cover everything in depth here, it isimportant to mention that there should be nursery protocols inplace for diagnosis, treatment, and prevention of the commonillnesses seen in the local kitten population. Conditions to coverinclude things like flea infestation, flea anemia, ear mites,intestinal parasites, coccidiosis, upper respiratory infections(including feline herpesvirus and calicivirus), conjunctivitis,diarrhea, dermatophytosis, and panleukopenia

Dermatophytosis

The number of dermatophytosis cases vary, often by season. Anincrease in the prevalence of the disease usually coincides with“kitten season” and for some regions, it is a constant challenge.Regardless of the geographical location of a kitten nursery,underage kittens often come in with ringworm. Intake staff mustbe trained on what the next steps will be for any cats or kittenswith a positive Wood’s Lamp exam at intake or with suspiciousalopecia.

Any staff handling ringworm suspects should wear a gown andgloves, plus take precautions to avoid contamination of surfaceslike an examination table. To avoid contamination of work

surfaces, disposable drapes are a great option, followed bydisinfection with a product effective against dermatophytespores. Confirmation of a diagnosis of ringworm requires a visualexamination, Wood’s Lamp examination, direct microscopicexamination of glowing hairs, and a fungal culture.7

All shelters in general, but particularly those with a kittennursery, should develop formal, written protocols dealing withany ringworm positive cats in their care. These protocols mustaddress diagnosis, isolation, treatment, cleaning protocols, andclearing the cats or kittens for adoption. For more information,refer to the Ringworm Guidebook.

Panleukopenia

Any animal shelter taking in cats and kittens dreads theappearance of a panleukopenia positive cat. Panleukopenia canbe absolutely devastating in a kitten nursery. The nurserypopulation is vulnerable and a large number of kittens arehoused within the facility. Strict isolation of the kittens in thenursery and sound protocols help minimize the spread ofpanleukopenia, but even these steps will not completely stopisolated cases from occurring in newly admitted kittens exposedprior to admission and asymptomatic on intake.

Panleukopenia diagnosis can be made on a snap ELISA test forcanine parvovirus and suspected with an extremely low whiteblood cell count diagnosed on CBC.9 Since sudden death canoccur in kittens that appeared healthy the day before, any kittenfound dead in its cage should be tested for panleukopenia.1Sound medical, vaccination, isolation, and cleaning protocolshelp minimize the potential for spread of the disease by anykitten shedding the virus. A written protocol for panleukopeniamust be developed and staff and volunteers must understandthe importance of adhering to the protocols and understand howdevastating the spread of this virus would be. At a minimum, thepanleukopenia protocol addresses diagnosis, isolation,treatment, cleaning protocols, and the decision to euthanize.Any panleukopenia positive kittens, as well as their cagemates,must be removed from the nursery and placed into a strictisolation area for treatment. The potentially exposed kittens inthe room must be quarantined for 14 days. For moreinformation, refer to the Panleukopenia Guidebook.

Daily Monitoring

Nursery staff and volunteers need to observe kitten health on adaily basis. This task should include monitoring of appetite,urination, defecation, any concerning signs, and updatingweight. Tracking the kittens’ health and progress is most easilyaccomplished with individual monitoring sheets, which are keptin a room binder. Keeping the sheet on the cage may seemmore practical, but with the messiness and playfulness ofkittens, the binder is usually the safer option for the paperwork.

Each room should post a schedule for daily veterinary rechecksand the handling of any emergencies that arise. The staff andvolunteers can be trained to prioritize any health concerns with amethod like the red and yellow flags outlined.

Training Staff and VolunteersAbandoned kittens are often underweight, heavily parasitizedand suffering from an untreated illness when admitted to ananimal shelter, which makes the care of them in the nurseryeven more challenging.5 Only good protocols and practicesstrictly followed by everyone entering the nursery will affordthese kittens the opportunity to flourish and survive. Therefore,all persons involved with the nursery will need some level oftraining.

Good training involves a variety of teaching techniques – shortseminars, guided tours, hands-on practice, and shadowing.5 It islikely that a majority of the nursery staff will be volunteers.These persons may have little knowledge or understanding ofcaring for these vulnerable kittens. Training should cover boththe “what” of the practices and protocols plus the “why.” Bothstaff and volunteers need to know “why” adhering to each andevery practice is critical to the health of the kittens. Learning theprotocols and basic steps in caring for the kittens is goodseminar material.

Depending upon staff/volunteers’ nursery roles, hands-ontraining might include learning to draw blood, do fecal floats,calculate meds, give meds, and make entries into sheltersoftware.1 In one form or another, training must cover everystep and procedure for caring, cleaning, playing, and feedingfrom intake to adoption release. No matter how good and

engaging the training is, people will not recall everythingcovered. If relying heavily on volunteers, at least one to two staffmembers should be on each shift to supervise, ensureconsistency, and relay important information. A good handbookis also an essential, so all nursery staff and volunteers shouldreceive, or have access to, a nursery handbook.5

Supersizing the Adoption ProgramAll of these kittens that have gone through the nursery andfoster programs will need homes because ultimately that is whatall of this is about! Shelters with nurseries will need somecreativity to supersize their adoption programs. There areseveral things that can help. Move kittens into adoption as soonas possible because they are most desirable to adopters at thesix to eight week age range. Market the nursery and adoptionprogram by letting adopters know that the kittens are“graduates” of the nursery program. Have adoption specials andmake them fun like “Free Feline Fridays” and “Two Purr One.”Consider using adoption space at local pet stores if available. Donot underestimate the power of the internet and social media.Increase adoptions by using good photos, bios, videos, andmarketing on your website and your social media outlets.

Build a media partnership. Many local television stations runanimal shelter adoption segments during news programs. Beavailable to television, radio, and newspaper media forinterviews. Often television and radio stations will runcommunity service notices (such as an adoption event) andnewspapers usually print press releases free of charge.

Expand on your community partnerships. Large weekend eventswith coalition partners draw in many more potential adopters.This approach eliminates competition between agencies –advantageous because it strengthens community relationships,pools marketing funds, and allows more ways to “spread theword.”

References1. Radosta, L. in Small Animal Pediatrics: The First 12 Months

of Life (eds. Peterson, M. & Kutzler, M.) 88–96 (ElsevierSaunders, 2010).

2. Moriello, K., Newbury, S. & Diesel, A. in Infectious DiseaseManagement in Animal Shelters (eds. Miller, L. & Hurley, K.F.) 275–298 (Wiley-Blackwell, 2009).

3. Scherk, M. A. et al. 2013 AAFP Feline Vaccination AdvisoryPanel Report. J. Feline Med. Surg. 15, 785–808 (2013).

4. Levy, J. et al. 2008 American Association of FelinePractitioners’ feline retrovirus management guidelines. J.Feline Med. Surg. 10, 300–316 (2008).

5. Broadhurst, J. in August’s Consultations in Feline InternalMedicine, Volume 7, 1e (ed. Little, S. E.) 706–717(Saunders, 2015).

6. Moriello, K., Newbury, S. & Diesel, A. in Infectious DiseaseManagement in Animal Shelters (eds. Miller, L. & Hurley, K.F.) 243–273 (Wiley-Blackwell, 2009).

7. Newbury, S. et al. Guidelines for standards of care in animalshelters. (Association of Shelter Veterinarians Corning, NY,USA, 2010) athttp://www.sheltervet.org/assets/docs/shelter-standards-oct2011-wforward.pdf

8. Moriello, K. A. & Hondzo, H. Efficacy of disinfectantscontaining accelerated hydrogen peroxide against conidialarthrospores and isolated infective spores of Microsporumcanis and Trichophyton sp. Vet. Dermatol. 25, 191–194,e48 (2014).

9. Tuzio, H. in Infectious Disease Management in AnimalShelters (eds. Miller, L. & Hurley, K. F.) 183–196 (Wiley-Blackwell, 2009).