Page 1143 - Problem-Based Feline Medicine

54 – THE FADING KITTEN 1135

Treatment Prevention

Remove kittens from queen during first day of life to Avoid incompatible breedings (type A stud, type B
prevent further colostrum ingestion. queen).
If a transfusion is required in the first days of life, Breeders may choose to eliminate type B cats from the
administer washed type B red blood cells (available breeding pool entirely.
from the queen) to the kitten.
If incompatible breeding is unavoidable, prevent nurs-
● 3–5 ml donor blood is collected in CPD-A (citrate-
ing on maternal queen for the first 2 days of life.
phosphate-dextrose-adenine). A heparinized syringe
Foster the litter on a type A queen or bottle feed during
can be used to collect donor blood in emergencies
this time. Administer serum from type A donor for
if CPD-A is not available.
passive immunity in place of colostrum. Kittens can
● The blood is centrifuged for 10 minutes at 1500
be returned to queen on day 3 because antibody absorp-
rpm. The plasma (containing anti-A alloantibodies)
tion is complete by that time.
is discarded. The red blood cells are reconstituted
with saline (volume equal to discarded plasma), Rapid in-clinic blood typing of kittens by card test
recentrifuged, and the saline discarded. A second can be used to identify and segregate kittens at risk for
saline wash is performed, and then the saline is dis- neonatal isoerythrolysis.
carded. A volume equal to half of the discarded
plasma is added, yielding washed packed red blood NURSING FAILURE** AND MATERNAL
cells ready for transfusion. NEGLECT*
● Administer the packed red blood cells IV, IO
or IP.
Classical signs
– Avoid volume overload when using IV or IO
routes. ● Ineffective nursing efforts.
– Approximately 70% of RBCs administered IP ● Crying.
reach the circulation by 72 h. ● Loss of suckling reflex.
● Weight loss.
If transfusions are required after 2 weeks of age, red
● Weakness.
blood cells of the kitten’s own type A can be trans- ● Usually present in first week of life.
fused. However, a major cross match (donor cells +
recipient plasma) should be performed to assure the
period of incompatibility has passed).
Pathogenesis
Routine supportive care is essential during the hemolytic
Inadequate milk supply.
phase of neonatal isoerythrolysis.
● Absent or inadequate milk production may be caused
by premature delivery, delayed milk letdown, or
maternal illness or malnutrition. Primiparous queens
Prognosis are more likely to have poor milk production.
● Mastitis may result in milk that is toxic or con-
Acute death without prodromal signs occurs in some
tains microbial pathogens. Uncomfortable queens
severe cases.
may reject nursing attempts.
Early recognition and treatment is expected to save ● Large litters may overwhelm the queen’s ability
many kittens with neonatal isoerythrolysis. to produce enough milk. Less-vigorous kittens
may not compete well for access to nipples.
Some mildly affected kittens have only laboratory evi-
● Poor maternal behavior may result from difficult
dence of disease without clinical signs.
delivery that causes illness or exhaustion in the
Kittens that survive the acute crisis generally recover to queen. Some queens simply fail to bond to their kit-
full health. tens and make no attempt to care for them.