A lot of us will recognize the problems concerning extra feeding / bottle feeding with kittens. Others, who so far never were required to do it, might just stumble across this problem before long. Bottle feeding might be required with "orphaned" kittens, kittens born with a caesarian section which can cause the production of milk to fail or obstructs the mother-child relation, underdeveloped nipples which makes it impossible for the mother to feed her kittens, too large litters, acute infection of the womb, problems related to blood type (e.g. a blood type B mother with A type kittens) or for any other reason why a mother cat cannot feed her newborns (sufficiently) herself.

Just imagine. Sterilizing bottles and teats, a strict feeding schedule, all the hassles of clogged up teats, or teats that were accidentally punctured too widely, and not to mention the alarm clock that wakes you up every 2 to 3 hours for feeding. Have you ever considered what could happen if those little kittens or one of them refuse to be bottle fed, or if one had decided to just take his time drinking the necessary amount of milk in order to stay alive and grow. In that case, just forget all about the alarm clock, as by the time you have finished round one, you are 1 ½ hours later and have just enough time left to prepare the next round of food. In short, a murderous schedule, especially as all other regular activities at home just go on. You can imagine a breeder's anguish when after all his effort and care, one of the kittens choke and gets fluid in his lungs and no longer wants to eat, constantly crying his little heart out while having more and more trouble breathing. It will try to leave the nest in his panic and finally dies at the edge of the box or basket.

Taking all this into consideration, one can say that bottle feeding young kittens is a very exhausting and scary job.

Another and safer way of feeding very young kittens is by feeding tube. This method was introduced about 15 years ago in The Netherlands by the American professor Bill Klein at a veterinary conference in Amsterdam. Our vet, present at the conference, became very enthused by this method and set out to learn how to do it. Afterwards he shared his knowledge with dog and cat breeders who visited his surgery with their feeding problems. In short, there are only advantages to using a feeding tube:

- the danger of choking is reduced to almost nothing

- no more messing around with milk that ends everywhere except where it belongs

- hungerstrikers are deprived of their life threatening weapon

- feeding measures and more important feeding schedule can be monitored much more easily.

A schedule between 7 a.m. and 11 p.m. with feeding every two hours and the first and last measuring 4 grams, the others 2 grams, should do nicely, even after reductions for the secretion and the lack of nightly feedings.

In short:

- you can have your much needed night's rest

- one feed a day could be skipped provided the previous and next one are increased in quantity.

- slow eaters can eat as slowly as they wish. In the meantime you are giving them the required nutrition and can return them quickly to the warmth of the nest.

-

Note: should you decide to go and get a feeding tube after reading this article, don't throw away the bottles and teats as yet. Tube feeding is recommended for very young, weak or ill kittens who don't have enough strength to suck up sufficient milk, and who, on vet's orders, need extra food. For older and stronger kittens the normal feeding bottle will suffice.

What is a feeding tube?

Enclosed illustrations already explain most of it. It is a thin (1,5 mm to 2 mm) see-through tube, approx. 50 cm long that is used to transfer the mother's milk surrogate straight into the kitten's stomach.

KMR, other ready made substances or non glogging liquids (also see note 2) are recommended.

For a small amount you can buy a feeding tube at most vet's.

1 - Feeding tube (size 1,5 to 2 mm)

2 - Short strand of colored tape to attach to the tube at about 8 cm from the bottom up.

4 - At both ends an opening of approx. 1,5 mm.

6.A matching pair of plastic syringes with contents of minimum 2 ml. A large size is preferred as it gives you a better grip.

7 - take care the kitten doesn’t wriggle too much in case the tube slides out again.

Using the Feeding Tube.

It is recommended you consult your vet before using the feeding tube. There could be any number of reasons either with the mother or the kittens why they are not gaining weight. In those cases using a feeding tube might worsen the situation and might even threaten the kittens' life.

Should the vet advise you to give extra food, than the feeding tube could be a tremendous help.

This is how you do it:

-spread a big, soft towel on the table.

-put a small receptacle close at hand, but big enough to enable you to suck up the milk easily into the syringe.

-KMR or something like it (see Kitten Glop under catdiet.htm) should be brought up to body temperature and kept like that while feeding.

-Fill one of the syringes

- before filling the syringe with milk, suck up 0,5 ml of air into the syringe, (*

- then add 2 to 4 ml of milk.

-the tape, previously attached to the tube, indicates up to where you should insert the tube. With normal fully grown kittens of about 100 grams, it will be aprrox. 8 to 9 cm.

-insert the empty syringe - piston completely depressed - in the other end of the tube.

-now remove the kitten from the nest and best just lay it on his belly on the towel. You should be able to insert the tube now, gently and evenly. Most times this will go without a problem, although the kitten might struggle. Don't panic if it does not work the first time and don't try to force it down. Just stay calm and try again.

It might help to lift the right / left front leg of the kitten with the thumb of the hand in which you are holding the kitten. Almost as a reflex, the kitten will swallow, taking the tube down.

(* try it first with 0,5 ml of air. Best is to try it out first in the wash basin or so. Fill the syringe as indicated, insert the syringe in the top of the tube and empty the syringe. When the syringe is empty, except for the 0,5 ml of air, there should still be some milk left in the tube. By injecting the air into the tube, the remainder of the milk flows out of the tube.

- Should the tube be empty before, than 0,5 ml of air is too much and in that case you would inject air into the kitten's stomach.

- Should there still be milk left in the tube, than 0,5 ml of air is too little.

Precautions

Do not try to insert the tube in one go. But first insert approx 5 -6 cm and than try to very gentle create a vacuum. If you have got a vacuum or feel pressure, you know you indeed have inserted the tube in the gullet. The gullet is flexible like a balloon and will be sucked against the opening of the tube. Than depress the piston of the syringe slightly to relieve the vacuum. (*

* Best is to try it out with an empty, fully depressed syringe which you close off with your thumb when trying to fill the syringe with air, you will the skin of your thumb being sucked against the opening.

- you can find a cat's stomach behind the lungs, halfway down the trunk

- Trachea / Windpipe: is firm (not flexible) has rings of cartilage

- The Gullet is soft and flexible like a balloon.

Should you on the contrary feel no pressure when trying to create a vacuum, than you have inserted the tube into the windpipe as the rings of cartilage prevent the wall of the windpipe being sucked in. In that case gently remove the tube and reinsert. The chances of this happening are minimal, as even for expert vets it is very difficult to insert a tube into the windpipe even when it is needed.

Feeding

After relieving the pressure of the vacuum, you can insert the tube further down, up to the marking. Remove the empty syringe and replace with a filled one. Empty the syringe gently and evenly in to the tube, as described above. After the syringe is empty, slowly remove the tube for the first 2 to 3 cm, For the last 6 cm remove the tube while gently sucking up air, and that just in case a drop of milk is left dangling at the end of the tube and gets accidentally into the windpipe when removing the tube. By sucking in some air you prevent any milk left in the syringe to get into the windpipe where windpipe and gullet meet each other at the back of the throat.

Note: it is advisable to rinse the tube and syringe with boiled water after every use or even boil them.

And that is all there is to it. The kitten is fed with the right amount of food ( 2 to 4 grams). It all sounds very complicated, but all is quite simple in practice. After the first few times, it will take you only a minute to feed a kitten

Hold the kitten steady in one hand to prevent the feeding tube form moving too much, change the syringes with the other hand.

Afterword

How does the kitten feel about all this?

That is a different questions, but he won't enjoy it, that is for sure. But sometimes there just is no other option and it feels save that while being fed he can scream all he wants without the chance of choking.

Not enjoyable is the right word as it definitely does not hurt.

On top of that, several of the kitten's senses and functions are not as yet fully developed, e.g. they are still blind and can not walk. This appeased to e.g. a baby giraffe who stands up on his own four feet almost right after birth, and that is a necessity as he needs to be able to accompany his mother on her journey.

At the Diergaarde Blijdorp zoo they once experimented with tube feeding a baby giraffe (using a garden hose as a tube) and as the giraffe was completely with it, it was a nightmare for the animal.

Don't let people upset you with their hear-say stories, or people who say you mistreat animals or people who say that kittens fed by tube became people haters. All nonsense! Most kittens are just happy to have their little tummies filled and will start purring as soon as they are able to.

Yes even with the feeding tube down their throats.

A lady vet living in North Holland (somewhere near the Afsluitdijk) will most probably react with" .. Curse, curse, that I should learn all this in a cat magazine." At least, that was how she reacted after reading the article on blood types.

Let it be a comfort to her and maybe even your vet, there are a lot of vets who don't know how to handle tube feeding. Years ago, our own kittens were guinea pigs, when we got a new vet who wanted to learn how to do it. Although she learned, she still sometimes refers some of her problem cases to us.

Tjerk Huisman © 1998

                   CARING FOR THE ORPHAN KITTEN
    (roughly as it will appear in The Whole Cat Catalog, ed. Lynne Motley)
 
 A general note about taking in strangers.  Always, always isolate a
 rescued cat or kitten from your pets for at least ten days and until it
 has been examined by your veterinarian and tested for lethal disease; even
 
 a tiny kitten can pack a killer virus or parasite.  Make the kitten
 comfortable in a room that is frequently visited by you and is separate
 from your other pets, and wash your hands with an antibacterial soap
 between visits to the new animal and your household.  Consult with your
 veterinarian, so that you are able to weigh the risks against the many
 blessings of taking in an orphan kitten.
 
 The following, numbered sequence could be applied generally to an
 orphaned kitten of any age but is particularly important for the frail
 newborn.  Less detailed instructions for older kittens follow.  Good luck
 to foster mothers everywhere.
 
 1.  Determine the Kitten's Condition
 
 If the kitten is lethargic or cool to the touch, you may have a
 life-threatening emergency (such as exposure or distemper).  Get the
 kitten on a heating pad or other primary heat source (see item 2) and get
 it to a veterinarian right away or consult an emergency veterinary
 clinic.  Do NOT feed a chilled newborn -- you will kill it.  Instead,
 administer slightly warmed Pedialyte (an infant rehydrating fluid,
 available in any grocery or pharmacy), using an animal nurser, syringe,
 or dropper.  Feed the kitten only when it is warmed and indicates it is
 hungry.
 
 If the kitten seems over-warm, it may be feverish or suffering from heat
 stroke.  Try wiping it down with a cool, damp cloth to lower the body
 temperature, then administer Pedialyte.  Get the kitten to a veterinarian
 as soon as possible or consult an emergency veterinary clinic.
 
 If the kitten is active and screaming lustily for its mother, go quickly
 to item 2; you will find that a heating pad will help calm the kitten
 while you prepare its first meal.
 
 2.  Make the Kitten Warm and Comfortable
 
 A newborn kitten is not capable of generating or maintaining body warmth
 and must depend on its mother (and now you) to sustain warmth and life.
 Keeping a newborn orphan warm (even on a warm day) is a priority, more
 important initially than feeding.  Bundling up the kitten will do no
 good; it has no body heat of its own to retain.  And putting the kitten
 near a space heater or other heating element is neither sufficient for
 the long-term nor safe.  Wrap a heating pad, set at low, in a towel or
 flannel and place it in a box, leaving room for the kitten to crawl off
 the pad as needed.  (Emergency, short-term measures:  If you don't have a
 heating pad, put the kitten on a wrapped hot water bottle or snugged
 against a tightly sealed and well stablilized jar of warm water.  Or put
 the kitten next to your body -- next to the skin if possible.  Then go
 out and borrow or buy that heating pad.)
 
 Empty the Bladder.  Newborns cannot evacuate their bowel or bladder
 unassisted.  The kitten you have found may be in excruciating pain or in
 danger of going toxic from having to retain its own body waste.  You
 should help the kitten at least empty its bladder before proceeding with
 feeding or even the trip to the veterinarian.  With the kitten on a towel
 in your lap, rub the kitten all over with a rough, dry washcloth.  (At
 that
 
 point, the kitten may roll over or otherwise present its bottom to you.)
 With a generous handful of soft tissue (also to be kept handy at all
 times) gently stroke the kitten's behind, keeping the tissue in contact.
 The kitten will oblige by urinating a rather amazing amount.  Simply
 rotate the tissue until kitten stops urinating or the tissue is soaked,
 whichever comes first.  (Did I mention to keep a waste bag handy for this
 procedure?)
 
 Another method to stimulate evacuation is to use a tissue or wash cloth
 moistened with warm water instead of a dry cloth or to apply a moistened
 Q-tip (hold the kitten over a sink or a folded towel if you use the latter
 method).
 
 The Den
 
 Newborns should be shielded from direct light and contained in their den
 until they are at least three weeks old.  Remember to try to provide the
 kitten an area in the den where it can crawl off the heating pad if it
 gets overheated.  A small airline-style carrier doubles very well as a
 den and a taxi, though the kitten will soon outgrow it.  A pair of large
 nested boxes is a good den, as long as the kitten cannot crawl out.  If
 you are fostering a single kitten, provide a surrogate sibling in the
 form of a small stuffed toy or bundled sock.
 
 3.  Prepare the Feeding
 
 The Formula.  There are several good milk replacers on the market,
 available in liquid or powder form (my personal favorite is called Just
 Born).  The ready-mix liquid is more convenient.  Be sure the product is
 engineered for kittens and that it is fresh (some have a short
 shelf-life).  Milk replacers can be found in any pet supplies store, most
 veterinary clinics, and even in some variety stores.  In an emergency or
 for the short-term, you can make up your own formula from tinned or
 powdered goat's milk (see below).  If the kitten seems weak or ill and you
 
 cannot get to a veterinarian right away, you should administer slightly
 warmed Pedialyte before offering the milk replacer.
 
 Mona's Homemade Goats Milk Formula.  Mona Myers, a certified bird
 rehabilitator in Seattle who has in the past rescue orhphan kittens,
 swears by this formula and prefers it to the ready-made products.  You
 might try her recipe if the kitten is not responding well to the
 commercial product.
 
 Use tinned or powdered goats milk.  (Either should be kept in the fridge
 when opened)  For a newborn or a kitten suffering from exposure,
 substitute Pedialtye for water to reconstitute the powdered goats milk.
 (Stick with the Pedialyte formula for the first week or so with a weak
 newborn, then switch to boiled water as the base.)  Warm a measured
 amount of the liquid slightly and pour into a bowl.  Using a flour
 sifter, sift the goats milk powder into the liquid, blending with a wire
 whisk.  To every 8 oz of goats milk, whether tinner or reconstituted, add
 1/3 dropper Avitron and 1/3 dropper Avimin (available in pet supply
 stores).  Finally, add 1/4 tsp acidophilus culture and 1/4 tablet
 (crushed) papaya enzyme (these last ingredients are found in health food
 stores; acidophilus culture must be refrigerated).
 
 This formula is best after being refrigerated for at least an hour, but
 it can be warmed (in hot water or microwaved a few seconds in a dish, not
 in the nurser) and served immediately.
 
 The Nurser
 
 While you are purchasing the milk replacer, find a good nurser.  Most of
 these look like a baby bottle in miniature; I prefer the model with a
 pointy nipple.  Pierce the nipple with a large-gauge needle (heated with a
 match) or ask the veterinarian to prepare the nurser for you.  The nipple
 is constructed of tough stuff and is difficult to pierce; whatever you do
 do NOT cut the nipple with a knife or scissors, however tempted you may be
 -- you may kill the kitten if you make the hole too large and flood its
 lungs.
 
 Other possible nursers are a 6-cc syringe or the king of squeeze bottle
 used to dispense droplet medication (ask your veterinarian or pharmacist).
 
 These do present some risk, as the formula must be forced into the
 kitten's mouth, again increasing the risk of flooding the lungs.  Last
 choice is a dropper, the slowest of the slow, but better than nothing
 until you go out and buy a nurser.
 
 The Feeding
 
 Heat the formula (in hot water) until it is comfortably warm.  Test a
 stream on the inside of your wrist, first shaking the bottle to even out
 the temperature.  Within easy reach, set a rough washcloth, paper towel,
 and a box of tissue.  Also keep a cup of hot water nearby (but not where
 it could tip onto the kitten) to warm the nurser as needed.  Then lay an
 old towel, the fluffier the better, across your lap.  Hold the kitten
 belly-down, steadying and guiding the head to the nipple with the same
 hand that is holding the bottle.  (This is just my technique; you may find
 another that works best for you.) Try to center the nipple in the kitten's
 mouth, over the tongue, and apply just enough pressure on the nurser to
 bead out a bit of formula on the nipple.  If this is not enough to induce
 the kitten to begin suckling, squeeze a tiny bit into its mouth and wait
 for it to swallow before (gently!) squeezing again.  This can be even
 trickier than it sounds, particularly if the kitten is desperately hungry.
 Convincing a frenzied kitten to slow down and suckle is no easy task.
 Another kitten may be put off by the strangeness of the offering and so
 will resist feeding or may be too weak to take the nipple immediately.  Be
 patient and calm and persistent, applying careful pressure on the nurser
 to keep the formula coming at a natural rate without squirting it down the
 kitten's throat.  Watch the ears:  If they start to bob, the kitten is
 getting just the right amount of formula.  If formula bubbles out the
 nostrils, pull back immediately -- you are drowning the kitten.
 
 Do not overfeed, especially at the first meal.  A series of small meals
 is better than one large one.  And don't get crazy, trying to follow the
 complicated instructions on the formula container.  Feed the kitten until
 it settles down and its tummy is full but not distended, then gently
 remove the nipple and rub the kitten gently but briskly all over with
 that rough dry washcloth.  (Remember, you are a momcat now; your baby
 needs the stimulation provided by that tough-love tongue all mother cats
 have.)  If the kitten doesn't immediately begin to complain and nuzzle for
 more milk, it is fed.  Continue rubbing or patting until you get a burp.
 If you don't get a burp right away, try putting the kitten over your
 shoulder like any other baby and patting it gently on the back.  Then
 return it to the heating pad for about 15 minutes before going to the
 next step.  (Or to the next kitten, if you are caring for a litter.)
 
 Frequency of feedings.  Feed a newborn every four hours or on demand.  Do
 not overfeed.
 
 A note on tube-feeding.  The feeding process can be greatly speeded up by
 feeding per catheter directly to the stomach.  Consult with your
 veterinarian and insist on a training session before attempting to
 tube-feed.  I do not recommend tube-feeding on a daily basis; kittens need
 nurturing, physical contact in order to thrive almost as much as they need
 nourishment.
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Subject: Tube Feeding Instructions
 
 Finally I have a chance to enter this!  I will capitalize
 the parts that I think are most important.  If any of you
 Doctors have any comments, feel free.  All I can say is
 that it has worked for me and for Rene' Beek of Poonanilam
 who gave these to me.
 
 How to tube feed a baby:
 
 1.  Put the kitten on a cloth and place the feeding tube
 against the kittens side and measure from the tip of the
 nose to the last rib.  This is where the stomach is.
 
 2.  Mark the tube with an indelible marker at that spot.
 
 3.  Weigh and identify the kitten, write down its weight.
 
 4. Withdraw the correct amount of formula into the syringe
 from the container of formula and attach the tube.  The formula
 should be at room temperature.
 
 5.  VERY CAREFULLY PRESS THE PLUNGER UNTIL A DROP OF FORMULA
 SHOWS AT THE END OF THE TUBE. (tube is NOT in kitten yet)
 
 6.  Dib the tube into the container of formula.  This will act
 as a lubricant and the taste will also encourage the kitten to
 swallow the tube.  You may also use a little K-Y jelly. ( I have
 not)
 
 7.  Working on a surface of convenient height, take the kitten
 in your left hand approximating a nursing position.
 
 8.  GENTLY press against the chin/lower jaw with the tip of
 your right index finger to gently open the mouth slightly.
 
 9.  Tip the head back and begin to insert the tube.  Thread the
 tube down the throat UNTIL YOU REACH THE SPOT MARKED ON THE TUBE.
 
 10.  Slide your hand a bit intil you are holding the not only
 the kittens head in your palm but also holding the tube
 between your thumb and forefinger so it does not slide out.
 THIS IS VERY IMPORTANT!
 
 11.  With an even pressure, press the plunger all the way. Not too
 fast.  DO NOT REMOVE THE TUBE AT THE SAME TIME YOU ARE PRESSING
 THE PLUNGER.
 
 12.  To prevent the kitten from wiggling and the tube sliding out,
 you must hold both firmly.  WHILE THE PLUNGER IS IN ALL THE WAY,
 CAREFULLY REMOVE THE TUBE.
 
 13.  The only possible trouble you could have is IF you withdraw
 the tube while pressing the plunger or IF the tube has not
 been inserted to the point of your mark.
 
 ** If the tube doesn't want to go as far as your mark, remove
 it slowly and try again!
 
(Note:  My vet once showed me that she starts out with a saline
solution instead to make sure the tube is in the right 'hole'
and then puts on the syringe with the formula in - obviously just
a little bit.

Average size of kitten at birth:  3 - 3 1/2 ounces.
(1 ounce = 28.4 grams)
 
 AGE     WEIGHT    # FEEDINGS PER DAY   TOT. DLY. REQ.   AMOUNT PER FEEDING
 
 1 WEEK  4 OZ.     6 FEEDINGS/DAY        32 CC.          5.33 CC
 2 WEEKS 7 OZ.     4 FEEDINGS/DAY        56 CC.          14 CC
 3 WEEKS 10 OZ.    3 FEEDINGS/DAY        80 CC.          26.67 CC
 4 WEEKS 1 POUND   3 FEEDINGS/DAY        104 CC.         34.67 CC
 
 (These are approximate but will give you a god idea.  For smaller
 breeds of cats, you may not be able to give the suggested amount
 per feeding and increase the number of feedings to balance out.)
 
  
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