Page 1142 - Problem-Based Feline Medicine

1134 PART 14 QUEEN AND KITTEN WITH PROBLEMS

Continuous infusion of 5–10% dextrose or repeated pass these antibodies to the newborn kittens in the
bolus q 2–6 h may be required to maintain eug- colostrum.
lycemia until the underlying cause can be eliminated.
When type A kittens (blood type inherited from type A
Hypothermia must be corrected before feeding is stud) absorb the anti-A antibodies from the type B
attempted. queen, the kittens’ own red blood cells are lysed
(neonatal isoerythrolysis), leading to acute anemia,
Frequent small meals of high-protein diet supple-
hemoglobinuria and organ failure.
mented with dextrose are given until euglycemia is
maintained. Because most mixed breed cats are type A, neonatal
● Nasogastric or orogastric tube feeding may be isoerythrolysis is uncommon.
required for neonatal or weak kittens with hypo- ● In the US, more than 95% of mixed breed cats are
glycemia. type A, < 5% are B, and AB is very rare.
● In other continents, B is more common in domestic
shorthair cats. For example, in Australia 73% are
Prognosis
type A, 26% are type B and AB < 1%.
If the underlying condition can be corrected, prognosis
Some breeds have up to 50% type B cats and are at
for full recovery is excellent.
high risk for neonatal isoerythrolysis. The breeds
In some cases, neurologic damage such as blindness with the highest percentage of type B cats are Devon
from hypoglyemia may be irreversible. Rex, British shorthair, Cornish Rex, exotic shorthair,
Sphinx, Scottish fold, Somali, Persian, Japanese bob-
Prevention tail, Birman and Abyssinian.
Good husbandry should assure against most causes of
hypoglycemia. Clinical signs
● Neonates should be kept warm and be evaluated for
Kittens are born healthy and nurse vigorously.
nursing effectiveness.
● Older kittens should receive adequate high-quality Dark red-brown urine (hemoglobinuria) appears
nutrition and be free of parasites and gastrointesti- soon after colostrum is ingested.
nal diseases.
A fading syndrome develops in first few days of life.
Kittens should be evaluated daily for adequate food Death may also occur acutely without any prodromal
intake, weight gain and body composition. signs.
Tail tip necrosis may occur in milder cases.
NEONATAL ISOERYTHROLYSIS (NI)**

Classical signs Diagnosis

● Hemoglobinuria. The clinical history suggests kittens were healthy until
● Anemia. colostrum was ingested.
● Acute death on first day of life or gradual
Urinalysis and PCV reveal hemoglobinuria and
decline over several days.
hemolytic anemia.
Blood typing confirms incompatible parental blood
Pathogenesis
types (type A stud, type B queen).
At this time, the blood group system in cats is known
to include: type A, type B and type AB, but additional
Differential diagnosis
blood groups may emerge as more cats studied.
Type B cats produce natural anti-A antibodies, even Hemoglobinuria differentiates neonatal isoerythroly-
prior to first transfusion or pregnancy. Type B queens sis from other causes of early fading kitten syndrome.