Veronesi Fusi 2022 Feline Neonatology From Birth To Commencement of Weaning What To Know For Successful Management
Veronesi Fusi 2022 Feline Neonatology From Birth To Commencement of Weaning What To Know For Successful Management
Veronesi Fusi 2022 Feline Neonatology From Birth To Commencement of Weaning What To Know For Successful Management
CLINICAL REVIEW
FELINE NEONATOLOGY
From birth to commencement
of weaning – what to know
for successful management
Maria Cristina Veronesi and Jasmine Fusi
R E V I E W / Feline neonatology
R E V I E W / Feline neonatology
R E V I E W / Feline neonatology
birth. Thus, the clinical assessment of kitten milk intake subsequently. Moreover, thermal
maturity at birth remains a challenge. and nutritional support must be provided,
when necessary.
Viability
in newborn dogs, assessment of viability at Kitten immunity
birth, using the Apgar score,24 has been demon-
strated to be useful in improving neonatal out- The cat’s colostral phase of lactation has been
come. A very recent study has proposed a demonstrated by higher total concentrations of
modified form of Apgar scoring for the assess- immunoglobulin (ig) classes G and A in the
ment of feline neonate vitality (see Addendum, mammary secretions collected on the day of
page 241). By adapting some of the Apgar score parturition when compared with day 7 of lac-
parameters it is possible to check viability. tation.27 The major ig class in both colostrum
Moreover, viability can be also assessed by the Newborn and milk is igG.27 Thus, the susceptibility of
evaluation of reflex scores, as suggested by the newborn kittens to many harmful conditions is
same recent study in kittens. indeed, in that kitten counteracted by the acquisition of passive
study a positive correlation between Apgar immunity from the mother. The endotheliocho-
score and reflex score was found. it is therefore reflexes and rial placenta of the queen largely prevents the
advisable to assess the presence of vital reflexes vocalisations transfer of antibodies from the maternal to the
such as the righting, rooting, sucking and swal- fetal compartment,28 and thus passive transfer
lowing reflexes, which enable the kitten to are less robust of immunity via the placenta is extremely lim-
reach the nipple, attain the correct position for ited. in a study by Crawford et al, all kittens
nursing within a few seconds and nurse effec-
than those were found to be agammaglobulinaemic at
tively. Active movements and vocalisations are of puppies. birth,29 while ig concentrations in queen’s
also indicators of newborn kitten viability. it is colostrum were reported to be 40–50 g/l
the authors’ opinion, however, that in compar- Distinguishing compared with <1 g/l in milk.30 Therefore, the
ison with puppies, newborn kitten reflexes and colostrum is the major source of passive immu-
vocalisations are less robust; therefore, experi-
between nity in kittens, providing immune protection
ence is needed to distinguish between normal viable and throughout the neonatal period, with endoge-
viable and moderately less viable kittens. nous igG production starting between 5 and
moderately 6 weeks of age.28 Absorption of colostral
Birth weight less viable immunoglobulins from the digestive tract and
Birth weight is reported to be associated with subsequent transfer to the bloodstream is
survival.9 in a study by Mugnier et al,25 birth kittens requires recognised to be crucial for the survival of new-
weight less than the first defined quartile for the born kittens.30 Enteric absorption of igG peaks
breed was associated with kitten mortality, not experience. at birth and rapidly decreases in the following
only in the first 2 days, but also thereafter at 2–42 hours, ceasing at about 12–16 h after birth.30
days after birth. in a separate study, average Although there is an old study showing that
birth weight in kittens was reported to be 104 g milk obtained any time during lactation from
(range 65–165 g), and was found to increase with queens could be used as a colostrum replace-
increasing weight and height (at the withers) of ment,31 more recent studies have demonstrat-
the queen.26 Conversely, birth weight was report- ed the different concentrations of ig between
ed to be inversely proportional to the number colostrum and milk.27 Colostrum, produced
of pregnancies and litter size.26 in a study by during the first 2 days after parturition, repre-
Musters et al,2 mean birth weight was 98 g, with sents the main source of immunoglobulins
a range of 35–167 g; mean birth weight was high- and nutrients for the newborn kitten, and also
er in males than females. Birth weight less than contributes to digestive tract maturation.29
45 g was significantly associated with stillbirth.2 Kittens should nurse as soon as possible
The critical threshold for birth weight, after birth, and promptly after resuscitation.
which is useful in identifying kittens at risk of This is particularly important for kittens born
mortality, was defined in seven cat breeds by by caesarean section, as the mother cannot
Mugnier et al,25 and ranged from 77 g in take care of the litter until completely recov-
oriental breeds up to 120 g in the Maine Coon. ered from anaesthesia. in the case of pro-
it is interesting to note that, in Maine Coons, longed maternal recovery time, it advisable to
Socha et al6 reported a mean weight of 119.6 ± place the kittens near to the nipples and stim-
18.4 g in kittens born alive, with birth weight ulate the suckling of colostrum.
increasing in kittens born after prolonged ges- The only exception with respect to colostrum
tational lengths (although within the reported intake relates to the risk of neonatal isoerythrol-
ranges) and decreasing with larger litter sizes. ysis, which is discussed in an accompanying
When a low birth weight kitten is presented, review on fading kitten syndrome in this series.
it should be strictly observed to make sure it Following colostrum intake, the acquisition
will ingest an adequate amount of colostrum of passive immunity by kittens can be assessed
within the first hours of birth,21 and a regular by measuring peak serum igG concentrations
R E V I E W / Feline neonatology
(range 350–6000 mg/dl). A study by Claus and vials for a few months. However, harvested
From a
colleagues reported that this can be performed as colostrum can be contaminated by bacteria
early as day 1 after birth, although quantification clinical harboured on the skin of the nipple, or, in
is better at day 2.27 These investigators collected some cases (ie, E coli contamination), the pro-
0.25 ml of blood from the jugular vein of the kit- standpoint, cess of colostrum thawing can lead to bacterial
tens; however, the present authors consider this maximising membrane rupture and release of endotoxins.
procedure not to be routinely applicable, mainly Therefore, colostrum must be collected asepti-
due to the fragility of the veins in newborns. colostrum cally and always coupled with bacterial cul-
Adequate passive immune transfer can also ture to avoid possible harmful contamination.
be indirectly assessed by measuring alkaline quality could Serum can be administered orally to kittens
phosphatase activity in the blood, with a represent in the first 12–16 h30 and up to 24 h of age, and
threshold of 1500 iU/ml at day 1.29 The ade- subcutaneously or intraperitoneally in older
quacy of passive immunity depends on several a strategy to kittens. Parenteral administration of 150
factors, such as individual maternal ability to ml/kg adult cat serum subcutaneously or
produce colostrum containing different con-
ensure the best intraperitoneally to colostrum-deprived kit-
centrations of specific immunoglobulins, and outcome for tens has been reported to lead to serum igG
the varying efficiency of colostrum uptake levels comparable with those of suckling
within the litter.28 To the authors’ knowledge, newborn kittens.33 However, it should be underlined
however, the kitten threshold for acquired that, although subcutaneous administration is
kittens.
protective passive immunity is currently not performed at different sites of inoculation,
available. Nevertheless, in the study by Claus sometimes severe and potentially disastrous
and colleagues,27 serum igG concentrations subcutaneous necrosis can occur, leading to
of <400 mg/dl were observed in colostrum- kitten death or the need for euthanasia.
deprived kittens and, therefore, this was
suggested as the threshold to detect failure of From birth to the commencement
passive transfer of immunity, as also reported of weaning
in large animal neonates. Furthermore, while
the uptake of maternal passive immunity Weaning in kittens usually begins around
undoubtedly provides strong protection for 4 weeks after birth, and as early as 3 weeks
newborns against possible life-threatening after birth in orphans. Monitoring from birth
infections, it should also be considered a to the beginning of weaning implies regular
‘double-edged sword’. The high concentra- observation of the queen, the whole litter and
tions of maternal antibodies, in fact, prevent each kitten. Kitten monitoring is essential for
the development of the neonatal endogenous the prompt recognition of any abnormality
immune response, with the maternal igG half- in weight gain, age-related development,
life reported to be around 4.4 days in kittens.31 behaviour and body temperature, and to
Colostrum is crucial for neonatal adapta- promptly detect any sign of sickness.
tion, not only as a source of immunity, but
for the maturation of several organs; it is also Weight gain
an important energy source.31 The quantity of The gold standard for kitten monitoring is
colostrum needed to cover energy require- regular weight measurement with an accurate
ments should be at least 16 ml for a 100 g body 1 g scale and meticulous record-keeping. This,
weight kitten/day, based on the reported in turn, entails regular handling, allowing
requirement of 20–22 kcal/100 g/day.32 Healthy kittens evaluation of behaviour, reactivity (reaction
From a clinical standpoint, maximising should to external stimuli) and vigour, as well an
colostrum quality could represent a strategy approximation of body temperature. Weight
to ensure the best outcome for newborn kit- be weighed gain is assured by regular and adequate milk
tens. This can be achieved through careful uptake. inadequate intake can be due to kitten
attention to the management of breeding daily until weakness, illness, competition from siblings
queens, including nutrition and hygiene. An 2 weeks of age or various maternal-related factors (see
increase in antibodies specifically directed below). Healthy kittens should be weighed
against pathogens affecting newborns, such as and then twice daily until 2 weeks of age and then twice a
FCV and FHV-1,30 may be achieved through week until fully weaned. Sick kittens will
vaccination performed as close as possible a week until require more frequent weighing, depending
to the beginning of heat in queens scheduled fully weaned. on the severity of the illness.
for mating.30 When kittens do not ingest A loss of <10% birth weight is not unusual in
colostrum and passive immune transfer is Sick kittens the first 24 h of life. However, in the authors’
known to have failed, it is possible to provide experience, with healthy, viable kittens where
a defence through the administration of stored
should be queens exhibit normal prompt lactation and
colostrum or serum obtained from an adult weighed more provide maternal care, this loss does not occur,
cat. Breeders can store colostrum obtained and weight gain will have already started
from queens by freezing it in small volume frequently. by day 1. Weight gain is an important and
R E V I E W / Feline neonatology
accurate indicator for assessing the newborns’ In kittens, Although these maternal actions are innate,
health. in kittens, a weight gain of 50–100 g some queens do not show a normal pattern
per week is expected,15 with differences main- a weight gain of maternal behaviour and care for their
ly related to breed. Weight gain should be newborns, especially young primiparous
steady and progressive; any loss or stasis of 50–100 g queens or those experiencing stress. There-
needs strict observation, and treatment as per week is fore, the authors would always advise discreet
appropriate. When weight gain is lower than (no disturbance) surveillance to allow prompt
expected, supplemental feeding must be pro- expected. intervention and assistance to the newborns,
vided, and the kitten observed scrupulously so when necessary. Moreover, when a caesarean
as to promptly detect any possible underlying section is performed, maternal instincts may
disease. For orphan management, a high qual- be disrupted in the first 24 h after surgery.
ity commercial milk replacer formula is the
best option (see later). if the diet is not correct- Maternal factors
ly balanced, multivitamin, energy or taurine it is important to note that besides genetic
supplementation may sometimes be needed. predisposition, age and parity of the queen,
there are other maternal factors that can cause
Monitoring of development kitten loss, including nutritional or metabolic
The handling of kittens for daily weight mea- abnormalities such as diabetes mellitus,
surement allows evaluation of flexor tone hypothyroidism, hypocalcaemia and preg-
(Figure 2) initially, and then also extensor tone, nancy toxaemia. Kitten death at birth can also
both of which are good indicators of normal be related to poor maternal care and savaging
kitten development. Absence of flexor tone behaviours.8,9 Kittens that have experienced
could indicate severe defects and often carries intrapartum trauma usually show extensive
a poor prognosis. Multiple factors could be regional haemorrhage and/or oedema; with
associated with delayed development of the inappropriate maternal care, amputation, skin
kitten; among them are slow growth rate, lesions and/or skeletal fractures have also
inadequate colostrum intake and/or problems been observed (Figure 3).14
at birth (ie, hypoxia) or thereafter. The conse- A queen responsible for infanticide in a litter
quence is lack of preparation for weaning at Figure 2 Flexor tone in a suggests an increased risk of infanticide
21–28 days; slow growth rate is also a risk 2-day-old Devon Rex kitten in future litters.14 Causes of infanticide are
factor for post-weaning wasting.34 multiple and include genetic predisposition,
extremes of maternal age, low viability of the
Maternal role newborn and environmental causes (in partic-
ular, interference from intra- or interspecific
Maternal dependence individuals).38 Strict surveillance of maternal
Newborn kittens depend on the mother not only behaviour around parturition and during the
for nutrition, but also for the maintenance of first 48 h after birth is crucial, especially in
correct body temperature, for grooming, protec- primiparous queens, to promptly identify
tion and stimulation of urination/defecation.37 abnormalities and to save kittens.21 The
Therefore, appropriate maternal behaviour and authors advise that each case of infanticide
care at birth (and subsequently) is necessary for should be fully investigated to clarify, and
kitten survival. At birth, under normal condi- where possible address, the underlying cause.
tions and with typical maternal behaviour, the if proved to be individually predisposed to
queen is responsible for opening the fetal mem- infanticide, the queen should be removed from
branes, severing (biting) the umbilical cord and breeding. it has been reported anecdotally that
licking the newborns; the purpose of licking,
aside from being important in stimulating respi-
ration, is to remove fetal fluids and allow the kit-
ten to dry. Licking the anal region and external
genitalia is also crucial for the excretory func-
tions of the kittens, as mentioned above.
Antiparasitic prophylaxis
Prophylaxis against the main inter- to treat flea infestations was report-
nal parasites can be initiated from ed in kittens from 2 days of age.36
2 weeks of age and relies mainly In the present authors’ experience,
on the use of pyrantel pamoate.35 In the best option is to use it indirectly
rescue shelter kittens, coccidiosis, by spraying it on a cotton ball,
as well as fleas, can sometimes lead which is then rubbed on the body of
to severe debilitation, requiring spe- the kitten, avoiding the eyes, mouth,
cific treatment. Use of fipronil spray nose and anogenital area.35 Figure 3 Trauma and haemorrhage due to infanticide
in a newborn Norwegian Forest Cat kitten
R E V I E W / Feline neonatology
using a different tom cat at the subsequent Some Table 2 Milestones in kitten
mating might help to reduce infanticide.
development from birth to
Maternal illness, trauma, inadequate nutri- queens do commencement of weaning15–17
tion, stress or toxin ingestion, and administra-
tion of certain drugs, can all cause stillbirth14 or not show a Parameters Age (days)
have consequences for the health and survival normal pattern Umbilical stump falls off 3
of the newborn kittens. Appropriate manage- Eyelids opening 8–10
ment of pregnant queens and focused clinical of maternal External ear canals opening 6–14
monitoring is important for the early detection
of these conditions, reducing the impact both
behaviour and Crawling 7–14
Walking 14–21
on the mother and the litter. There is a report care for their Normal posture 28
in the literature describing the long haircoat of
the queen as a possible life-threatening factor newborns, Deciduous teeth eruption 14–28
for neonates, leading to the recommendation Flexor tone 0 to 3–4
especially
of regular grooming of pregnant long-haired Extensor tone 4 to 21–35
queens close to parturition.18 young Voluntary urination and defecation 21–28
R E V I E W / Feline neonatology
support, a clean towel should always be used The daily and/or developmental abnormalities (eg,
to cover the source of warmth so there is no secondary hyperparathyroidism).44
direct contact with the kittens to avoid any risk requirement The daily caloric requirement of a newborn
of skin burns. An infrared heat lamp can also kitten is 20–26 kcal/100 g body weight, and most
be used, provided it is positioned at a reason- of a newborn commercial milk replacer formulae deliver about
able distance (at least 60 cm41) from the kittens, kitten for 1.0 kcal/ml.43 Therefore, the daily requirement
which must be closely monitored to avoid skin for commercial milk is about 20–26 ml/100 g
burns and dehydration. commercial body weight.43 However, the frequency of feed-
Whichever method is used, the authors sug- ing and the amount of milk per feed depends on
gest restricting these sources of warmth to one
milk is about the age of the kitten and on stomach capacity.41
side of the box only. Although considered neu- 20–26 ml/100 g during the first 2 weeks, kittens must be fed
rologically immature in terms of their ability to every 2 h. Thereafter, the interval between feeds
move closer to or away from a heat source,42 body weight. can be extended to 3–4 h. Although stomach
in a practical setting it is not uncommon to see capacity has been reported to be 4 ml/100 g body
litters migrating away from the heating device weight,43 in the authors’ experience it is always
in the case of excessive warmth, and vice versa. better to feed smaller amounts (never reaching
indeed, other authors have described healthy maximum stomach capacity), but more frequent-
kittens as being able to escape from an excessive ly (ie, 2 ml per feed a total of 12 times/day for a
heat source, but this is something that must not kitten of 100 g body weight). This is very impor-
be assumed, as it also relates to the viability of tant so as to avoid regurgitation, milk inhalation,
the newborns.41 For all of these reasons, it is nasal discharge, abdominal distension and diar-
dangerous not to provide a means of ‘escaping’ rhoea. orphans with an active sucking reflex can
excessive warmth.36 Finally, where available, be bottle-fed. For sick orphans or kittens with a
paediatric incubators can be used to create opti- weak or absent sucking reflex, milk must be
mal conditions for the kittens. However, even delivered via an orogastric tube.
these instruments require continual monitoring Milk replacers are available in liquid or
to verify the correct ambient conditions.42 powdered form, the latter needing correct
dilution as detailed by the manufacturer.35
Feeding Errors in dilution can lead to diarrhoea or
of all the issues surrounding hand-rearing of constipation. Although many authors advise
kittens, feeding is the foremost. in the authors’ preparing and refrigerating enough milk for
experience, many kittens sadly die because 24–48 h,15,32,36 the present authors recommend
of incorrect feeding by caregivers. Kittens preparing only the amount needed for each
must not be fed when their body temperature feed to avoid contamination and possible
is below 35.5°C and, where warming of It is always fermentation. Before feeding, the milk must
chilled kittens is necessary, this must be be warmed up (eg, using a water bath) to
achieved gradually (the authors suggest no better to 35–38°C. All equipment (Figure 4) must be
more than 1°C in 1 h).21,36,40,42,43 often there is cleaned and sterilised at every feeding;16 the
feed small
a mismatch between the amount and frequen- present authors suggest the use of sterilising
cy of feeding and the physiological stage of amounts solutions for baby bottles for this purpose.
newborn development. orphans must be monitored for weight gain
Commercial milk replacers are largely (never reaching even more strictly than kittens being nursed
better quality than homemade formulae maximum by their mothers. Weight gain in orphaned
(which should be limited to emergency situa- kittens fed with commercial formula milk is
tions36), ensuring that kittens’ specific nutri- stomach slower than in kittens fed with queen’s milk.16
tional requirements are met. Cow’s milk or
milk from other animal species must not be capacity), Suckling
fed.41 The wrong choice of milk can lead to but more Suckling is important not only for feeding;
acute diarrhoea and regurgitation, gastro- the behaviour also satisfies an innate kitten
intestinal meteorism, abdominal colic and frequently. desire. Early weaned and orphan kittens can
starvation and, in the long run, metabolic develop cross-sucking behaviour.45 This refers
to non-nutritive sucking of the littermates
(mostly external genitalia and umbilical
Essentials for orphan management
stumps), a behaviour that can inflict severe
< Appropriate environmental (urine and faeces) injuries. Where this happens, kittens must be
temperature, humidity and < Daily weight measurement separated. if cross-sucking recurs when kit-
ventilation < Strict hygiene (environment and tens are reintroduced, they must be separated
< Warm, soft, clean kitten box instruments) again and kept alone. While there is much still
< Adequate feeding instruments < Age-dependent sensorial and to be learnt about this phenomenon, a recent
(Figure 4) social stimulation
study45 documented an increased risk of
< Correct (age-dependent) feeding < In the case of illness, disease-
cross-sucking development in orphan, bottle-
< Regular stimulation of excretion specific approach
fed and younger kittens, as well as in those
R E V I E W / Feline neonatology
R E V I E W / Feline neonatology
Informed consent
KEY POINTS
This work did not involve the use of animals (includ-
< Kittens are highly vulnerable at birth and until weaning. ing cadavers) and therefore informed consent was
not required. For any animals or people individually
< An understanding of basic neonatal physiology is needed
identifiable within this publication, informed con-
for the correct management of kittens at birth and up to the
sent (verbal or written) for their use in the publica-
beginning of weaning.
tion was obtained from the people involved.
< At birth, suitable maternal care and/or assistance improves
neonatal outcome. References
< Normal birth weight is a strong predictor of kitten survival.
1 Sparkes AH, Rogers K, Henle WE, et al. A question-
< Colostrum intake, as soon as possible and no later than after naire-based study of gestation, parturition and
12 h of life, is needed for passive immune transfer.
neonatal mortality in pedigree breeding cats in the
< Steady and progressive weight gain is related to normal neonatal UK. J Feline Med Surg 2006; 8: 145–157.
development. 2 Musters J, de Gier J, Kooistra HS, et al.
Questionnaire based survey of parturition in the
< Maternal instinct and appropriate behaviour is critical for kitten
queen. Theriogenology 2011; 75: 1596–1601.
survival and normal growth.
3 Fournier A, Masson M, Corbière F, et al. Epidem-
< The success of orphan management depends more on a skilled iological analysis of reproductive performances
dedicated person than the availability of a fully equipped facility. and kitten mortality rates in 5,303 purebred queens
< Hand-rearing of orphans involves not only correct of 45 different breeds and 28,065 kittens in France.
feeding, but also warming, protection, voiding, Reprod Domest Anim 2017; 52 Suppl 2: 153–157.
grooming and socialisation. 4 Ström Holst B and Frössling J. The Swedish breed-
ing cat: population description, infectious dis-
eases and reproductive performance evaluated by
a questionnaire. J Feline Med Surg 2009; 11: 793–802.
5 Romagnoli S, Bensaia C, Ferré-dolcet L, et al.
handling is needed to allow for an appropriate Fertility parameters and reproductive manage-
degree of behavioural and social maturation. ment of Norwegian Forest Cats, Maine Coon,
Persian and Bengal cats raised in Italy: a ques-
Addendum tionnaire-based study. J Feline Med Surg 2019; 21:
1188–1197.
At the time of going to press, a paper was 6 Socha P, Lengling R, Bonecka J, et al. Obstetric
accepted for publication in JFMS that discusses and newborn parameters in the Maine Coon cats.
routine assessment of newborn kitten vitality. Pol J Vet Sci 2019; 22: 439–443.
Readers are referred to Hibaru et al’s study,51 7 Bailin HG, Thomas L and Levy NA. Retrospective
which demonstrates significantly lower Apgar evaluation of feline dystocia: clinicopathologic
scores and reflex scores (ie, low vitality) in 13 findings and neonatal outcomes in 35 cases
neonates delivered by caesarean section com- (2009–2020). J Feline Med Surg. Epub ahead of print
pared with 19 neonates delivered by natural 14 June 2021. doi: 10.1177/1098612X211024154.
birth. The paper proposes the use of a modified 8 Root Kustritz MV. Clinical canine and feline repro-
feline Apgar score that allows the provision of duction: evidence-based answers. Hoboken, NJ:
immediate assistance at birth, increasing the Wiley-Blackwell, 2010.
chance of survival for these patients. 9 Lawler dF and Monti KL. Morbidity and mortality
in neonatal kittens. Am J Vet Res 1984; 45: 1455–1459.
Conflict of interest 10 Cave TA, Thompson H, Reid SW, et al. Kitten mor-
tality in the United Kingdom: a retrospective
The authors declared no potential conflicts of inter- analysis of 274 histopathological examinations
est with respect to the research, authorship, and/or (1986 to 2000). Vet Rec 2002; 151: 497–501.
publication of this article. 11 Willoughby K. Paediatrics and inherited diseases.
in: Chandler EA, Gaskell CJ and Gaskell RM
Funding (eds). Feline medicine and therapeutics. 3rd ed.
oxford: Blackwell Publishing, 2004, pp 355–377.
The authors received no financial support for the 12 Veronesi MC. Patologie neonatali. in: Veronesi
research, authorship, and/or publication of this article. MC, Castagnetti C and Taverne MAM (eds).
Neonatologia veterinaria. Napoli, italy: EdiSES,
Ethical approval 2013, pp 93–144.
13 Evermann JF and Kennedy MA. Viral infections.
This work did not involve the use of animals and in: Peterson ME and Kutzler MA (eds). Small ani-
therefore ethical approval was not specifically mal pediatrics: the first 12 months of life. St Louis,
required for publication in JFMS. Mo: Saunders, 2011, pp 119–129.
R E V I E W / Feline neonatology
14 Lamm CG and Njaa BL. Clinical approach to abortion, stillbirth, to correct failure of passive transfer in kittens. J Am Vet Med
and neonatal death in dogs and cats. Vet Clin North Am Small Assoc 2001; 219: 1401–1405.
Anim Pract 2012; 42: 501–513. 34 Lawler dF. The role of perinatal care in development. Semin Vet
15 Little S. Feline pediatrics: how to treat the small and the sick. Med Surg 1995; 10: 59–67.
Comp Contin Educ Pract 2011; 33: E3. 35 Veronesi MC. Gestione del neonato patologico. in: Veronesi MC,
16 Zambelli d. Feline neonatal physiology, behavior, and socializa- Castagnetti C and Taverne MAM (eds). Neonatologia veterinaria.
tion. in: Lopate C (ed). Management of pregnant and neonatal Napoli, italy: EdiSES, 2013, pp 145–161.
dogs, cats, and exotic pets. New York: John Wiley & Sons, 2012, 36 Little S. Playing mum: successful management of orphaned
pp 145–158. kittens. J Feline Med Surg 2013; 15: 201–210.
17 Veronesi MC. Esame clinico del neonato. in: Veronesi MC, 37 Casal M. Management and critical care of the neonate. in:
Castagnetti C and Taverne MAM (eds). Neonatologia veterinaria. England G and Heimendahl VA (eds). Manual of small animal
Napoli, italy: EdiSES, 2013, pp 63–92. reproduction and neonatology. 2nd ed. Cheltenham: British Small
18 Azari o and Akhtardanesh B. A clinical report of entangled Animal Veterinary Association, 2010, pp 135–146.
neonates’ umbilical cord with queen’s fur in Persian cat. Asian 38 Root Kustritz MV. Reproductive behavior of small animals.
Pac J Trop Biomed 2011; 1: 502–504. Theriogenology 2005; 64: 734–746.
19 davidson A. Problems during and after parturition. in: England 39 Marti JA and Fernandez S. Clinical approach to mammary
G and Heimendahl VA (eds). Manual of small animal reproduc- gland disease. in: England G and Heimendahl VA (eds). Manual
tion and neonatology. 2nd ed. Cheltenham: British Small Animal of small animal reproduction and neonatology. 2nd ed.
Veterinary Association, 2010, pp 127–142. Cheltenham: British Small Animal Veterinary Association, 2010,
20 Bonte T, del Carro A, Paquette J, et al. Foetal pulmonary maturity pp 155–165.
in dogs: estimated from bubble tests in amniotic fluid obtained 40 Münnich A and Küchenmeister U. Causes, diagnosis and thera-
via amniocentesis. Reprod Domest Anim 2017; 52: 1025–1029. py of common diseases in neonatal puppies in the first days of
21 Veronesi MC. Assistenza neonatale al parto. in: Veronesi MC, life: cornerstones of practical approach. Reprod Domest Anim
Castagnetti C and Taverne MAM (eds). Neonatologia veterinaria. 2014; 49 Suppl 2: 64–74.
Napoli, italy: EdiSES, 2013, pp 31–48. 41 Veronesi MC. Gestione dell’orfano. in: Veronesi MC, Castagnetti
22 Traas AM. Resuscitation of canine and feline neonates. C and Taverne MAM (eds). Neonatologia veterinaria. Napoli,
Theriogenology 2008; 70: 343–348. italy: EdiSES, 2013, pp 49–61.
23 davidson AP. Approaches to reducing neonatal mortality in 42 Fitzgerald KT and Newquist KL. Husbandry of the neonate. in:
dogs. in: Concannon PW, England G, Verstegen J, et al (eds). Peterson ME and Kutzler MA, (eds). Small animal pediatrics: the
Recent advances in small animal reproduction. ithaca, NY: first 12 months of life. St Louis, Mo: Saunders, Elsevier, pp 44–52.
international Veterinary information Service, A1226.0303. 43 Lawler dF. Neonatal and pediatric care of the puppy and kitten.
24 Veronesi MC. Assessment of canine neonatal viability – the Theriogenology 2008; 70: 384–392.
Apgar score. Reprod Domest Anim 2016; 51 Suppl 1: 46–50. 44 Prendergast H. Clinical approach to pediatric nutritional
25 Mugnier A, Mila H, Guiraud F, et al. Birth weight as a risk conditions. in: Peterson ME and Kutzler MA (eds). Small animal
factor for neonatal mortality: breed-specific approach to identi- pediatrics: the first 12 months of life. St Louis, Mo: Saunders,
fy at-risk puppies. Prev Vet Med 2019; 171: 104746. doi: 10.1016/ Elsevier, pp 483–491.
j.prevetmed.2019.104746 45 delgado MM, Walcher i and Buffington CAT. A survey-based
26 Gatel L, Rosset E, Chalvet-Monfray K, et al. Relationships assessment of risk factors for cross-sucking behaviors in neona-
between fetal biometry, maternal factors and birth weight of tal kittens, Felis catus. Appl Anim Behav Sci 2020; 230. doi:
purebred domestic cat kittens. Theriogenology 2011; 76: 10.1016/j.applanim.2020.105069.
1716–1722. 46 Ghosh A, Borst L, Stauffer SH, et al. Mortality in kittens is asso-
27 Claus MA, Levy JK, Macdonald K, et al. Immunoglobulin con- ciated with a shift in ileum mucosa-associated enterococci from
centrations in feline colostrum and milk, and the requirement Enterococcus hirae to biofilm-forming Enterococcus faecalis and
of colostrum for passive transfer of immunity to neonatal adherent Escherichia coli. J Clin Microbiol 2013; 51: 3567–3578.
kittens. J Feline Med Surg 2006; 8: 184–191. 47 Peterson ME. The digestive system. in: Peterson ME and Kutzler
28 day MJ. Immune system development in the dog and cat. MA (eds). Small animal pediatrics: the first 12 months of life.
J Comp Pathol 2007; 137: S10–S15. St Louis, Mo: Saunders, Elsevier, pp 351–367.
29 Crawford PC, Levy JK and Werner LL. Evaluation of surrogate 48 Pignataro G, di Prinzio R, Crisi PE, et al. Comparison of the ther-
markers for passive transfer of immunity in kittens. apeutic effect of treatment with antibiotics or nutraceuticals on
J Am Vet Med Assoc 2006; 228: 1038–1041. clinical activity and the fecal microbiome of dogs with acute
30 Chastant-Maillard S, Guillemot C, Feugier A, et al. Reproductive diarrhea. Animals (Basel) 2021; 11: 1484. doi: 10.3390/ani11061484.
performance and pre-weaning mortality: preliminary analysis 49 Karsh EB and Turner dC. The human–cat relationship. in: Turner
of 27,221 purebred female dogs and 204,537 puppies in France. dC and Bateson P (eds). The domestic cat. The biology of its
Reprod Domest Anim 2017; 52 Suppl 2: 158–162. behavior. Cambridge: Cambridge University Press, 1988.
31 Casal ML, Jezyk PF and Giger U. Transfer of colostral antibodies 50 Radosta L. Feline behavioral development. in: Peterson ME and
from queens to their kittens. Am J Vet Res 1996; 57: 1653–1658. Kutzler MA (eds). Small animal pediatrics: the first 12 months of
32 Prendergast H. Nutritional requirements and feeding of grow- life. St Louis, Mo: Saunders, Elsevier, pp 88–96.
ing puppies and kittens. in: Peterson ME and Kutzler MA (eds). 51 Hibaru VY, Pereira KHNP, Fuchs KdM, et al. Topics in the
Small animal pediatrics: the first 12 months of life. St Louis, Mo: routine assessment of newborn kitten vitality: Apgar score,
Saunders, Elsevier, pp 58–66. reflexes and complementary assessments. J Feline Med Surg.
33 Levy JK, Crawford PC, Collante WR, et al. Use of adult cat serum in Press 2022. doi: 10.1177/1098612X221081404.