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Raising the Tiniest Miracles with Love, Patience and Health
By: Lacie Lee DVM

“Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.
-The Lorax-

So, you’ve had the pleasure of being gifted a tiny kitten to raise. With this comes many responsibilities and milestones that you will have the pleasure of experiencing for the next moments until he or she is ready to find a forever home. Before you take your kitten home, assess its overall health with a veterinarian familiar with pediatric care. Young kittens, especially in the first week of life, often are found cold (hypothermic), weak (hypoglycemic), dehydrated, and sometimes hypoxemic (low oxygen). Young neonates without mom are very prone to infections; inspect your kitten’s overall appearance paying special attention to the umbilicus region or umbilical cord. Look for signs of blood, swelling, discharge or trauma anywhere on your kitten. If you suspect any of these, get them to a veterinarian for critical care. You can begin to warm them yourself while headed to the hospital. Holding them close to your skin while wrapped in a warm blanket or simply drying them with a warm towel if found wet are safe methods of warming them. Heating pads, water bottles, heat lamps and the like can be dangerous to young neonatal skin if not carefully applied. My general rule is, if it is too warm to lay across your arm for at least fifteen seconds, then it is too warm for your kitten’s skin. If you are going to use a heat source, pay close attention and provide a blanket or towel between the kitten and heat, then proceed to your veterinarian for critical care.

*Never force a cold kitten to eat, they do not have a suckle reflex or a good swallow reflex and will aspirate. Your veterinarian will warm them, provide care, then begin to feed via stomach tube until a suckle reflex is present.

Now your new kitten appears healthy and ready to go home! Here are some developmental milestones to help you age your kitten. Consider taking in and caring for another orphan kitten of similar age as developmental alongside littermates is an integral part of your kitten’s wellbeing.

Aging your Kitten

1. Umbilical cord usually falls off around 3 days of age
2. Eyelids open around 10 days of age (range is 2-16 days).
3. Ear canals open 9 days of age (range 6-17 days).
4. Normal vision is around 30 days of age.
5. Crawling begins 7-14 days.
6. Walking begins 14-21 days.
7. Voluntary elimination begins about 3 weeks of age.
8. Baby incisors/canines- 3-4 weeks of age.
9. Baby premolars- 5-6 weeks of age.
10. Ability to shiver- 1 week of age.
11. Homeothermic (Can regulate own body temperature without a heat source)- 4 weeks of age.

Weighing and logging your kittens schedule

Body weight is an important sign of overall health in your kitten. It is also a good indication of how well you are able to meet your kitten’s requirements for growth. You will want to have a gram scale on hand to weigh your kitten twice daily. Kittens should gain 10-15 grams per day. Often the first sign of illness is zero weight gain in a 24-hour period. Newborn kittens will double their birthweight in the first 7-10 days of life. I have a postal gram scale that I use to keep track of a kitten’s weight twice daily. Have a journal to record twice daily weights in grams as well as any other observations you may notice about your kitten’s appearance or behavior. Don’t hesitate to call your veterinarian if something feels off. Use your intuition with these little guys, waiting even a day can be life or death.

Housing and bedding for your kitten

1. Provide a dry, safe enclosure that has a heat source for warmth. An incubator is best.
If not available you may use a small plastic top loader style kennel or enclosure for neonates up to about 3-4 weeks. I like this style carrier as it provides a draft free, safe environment that is easy to clean. Humidity for these little guys should be about 55-65% to keep them from dehydrating and decrease chances of bacterial growth and infection.
2. Feliway plugins in their room have been shown to be calming and
decrease stress. The two most stressful times in these orphan’s lives are week 1 and week 4-5 (weaning).
3. Clean their bedding daily and more often if it is wet or soiled.
4. Wipe the kennel or container clean daily.
5. Provide a heat source that allows the kitten to choose to be on it or away from it. Make sure there is always something like a towel or a blanket between the heat source and the kitten. If I feel this isn’t evenly distributed warmth I will add a small kitten
microwavable bean bag. Be careful not to put this on kitten’s direct skin contact. I put this under a blanket as well.)
6. Always keep them safe from other house pets as they do not have immunity.
7. I move them into a larger box or cage around 4 weeks to begin introducing a litter box.
8. I often begin with kitten attract litter on a small baking tray or a paper plate is fine.
9. Clean the box often!!! Its messy!

Kitten Hygiene

1. Clean your kitten daily with a soft moist warm washcloth. Make sure they are dry after.
2. Until your kitten is 3 weeks and reveals its ability to urinate and defecate on its own you will need to stimulate at each feeding. Use a soft tissue with a bit of mineral oil on it or a cotton ball works well too. Gently rub the perineal area (where the genitals are) from front to back with the cotton ball. Kitten urine should be very dilute (not a dark yellow color, more like water). Stool should be yellow-ish and consistency depends a lot on formula choice. Sometimes it takes a bit longer to stimulate a bowel movement. Keep using fresh cotton balls. A kitten will urinate at each feeding. Depending on formula used it may not defecate at each feeding.
3. Keep your kittens bottom clean and dry, you may use a bit of desitin, Boudreaux’s butt paste, vitamin e oil, or aquaphor if the genital area is inflamed from loose stool or urine. KEEP THIS AREA AS CLEAN AS POSSIBLE!
4. If your kitten has fleas you can do a warm dawn bath and remove fleas manually with a flea comb, or frontline spray on a cotton ball to rub on them is approved for use in these young kittens. Please make sure they are dry following applications of either. Do flea treat them however, fleas can be dangerous to them and their delicate cardiovascular system.
5. Clean the kitten’s eyes daily with a warm tissue or cotton ball to stimulate healthy tear flow and prevent accumulation of eye discharge and thus infection. It is normal to have clear to mucous accumulation at corners of their eyes daily. Just keep them clean. If you notice green discharge or ocular swelling, please see your veterinarian for treatment ASAP!
Pay close attention to the eyes even before they open. If you notice swelling under the lids please don’t wait as this is often a sign of infection that needs immediate treatment.
6. Pay attention to the umbilicus and genital areas (especially the male’s penis) daily for signs of infection or littermates nursing on one another if multiple kittens. This behavior can be dangerous and even life threatening especially to the male kittens. If you notice this nursing behavior you will need to separate the littermates throughout the day. They can be reunited at intervals as long as the behaviors don’t start again. Make sure they are well fed as sometimes this is a sign of hunger. I also will provide a stuffed animal between kittens and this sometimes will dissipate the nursing behavior.
7. If you notice any skin lesions or hair loss patterns please see your veterinarian for an exam.
8. Deworming should occur with kitten safe dewormers at approximately weeks 2, 4 and 6. Your veterinarian will be a good source for this.

Feeding your Kitten

The stomach capacity of a kitten is usually 4-5 mls per 100 grams or 3.5 ounces of body weight. This doesn’t seem like much but its plenty for these young kittens. There are many formulas, nursers and ways to feed your orphan kitten. I will share mine below. These are general and I do vary formula options and intervals from kitten to kitten. My preferred method is the miracle nipple (see below) on a syringe. These have pre-slit holes in the nipple. It is so important that the size of the hole on the nipple not be too large, yet not too small to allow frustration. Rule of thumb- when held upside down milk SHOULD NOT flow freely, yet with a gentle squeeze a drop should be released. As the kitten ages and the amount per feeding increases I will transition the miracle nipple to a normal kitten Pet Ag small pet bottle.

1. Upon arrival, assess the kitten and do your best to determine when its last meal may have been. If the kitten is warm and is rooting around and has a suckle reflex you can begin to feed. I always start with dextrose and water or very dilute formula (at least by 50%) for the first one or two feedings. This will begin to get intestines moving again as they will slow to stasis if kitten has not eaten in several hours or was found hypothermic (cold). Don’t ever force a kitten to eat by squeezing a bottle or pressing the plunger on a syringe. A healthy kitten with a good suckle reflex will be able to do this on their own. I begin with syringes attached to a miracle nipple for small animals. (I will share photos at the end of all my supplies). In kittens less than a week old I use a 3ml syringe. I replace them often as when you clean them the plunger will get harder for the kitten to move with a suckle reflex. BE PATIENT. It sometimes takes these guys a while to get this. They are just as confused as you are and miss mom. To get them going I will squeeze a tiny drop out of nipple onto their tongue. Often times once they taste the formula they will begin to nurse.
2. Choose a commercially available kitten milk replacer. Follow directions on the bottle or container closely. Clean bottle, nipple and syringes after each feeding to keep bacteria down. Remember many of these kittens do not have a great immunity from their mother. Store formula between feeding in the refrigerator or cooler. Don’t make your own formula. These kittens need so many proteins and micronutrients it is almost impossible to simulate homemade.
3. Sometimes powdered formulas will cause constipation and premade liquid formulations will cause diarrhea. You may need to alternate or add a bit extra water to the powder forms to aid with stool passage and dilute the premade liquid form with water to decrease the richness of the formula creating diarrhea. Sometimes I will dilute my premade liquid preparations as much as 50% until the stool forms. If even this does not form the stool I will switch to a powered formulation. It is not uncommon to do this and often it changes kitten to kitten.
4. When the kitten is full it will push out the bottle, syringe, or nipple and may form bubbles around the mouth. Don’t force them to eat. Let a healthy kitten guide you. They do often know what’s best for them. When properly fed, and stimulated to urinate and defecate they will usually have full round bellies and fall asleep. Sometimes they will purr. The purr is the universal communication between mom and babies for a while. The mom doesn’t normally meow at her kittens, she will reserve this for her humans to signal a need that is not getting met.
5. If your kitten is stressed by absence of the queen or hunger or any other reason it will crawl around its box crying or move side to side in a searching motion. This is your signal to act. Perhaps it’s cold, needs a snuggle, or more food, to urinate or defecate or something that requires veterinary attention. Otherwise it will love to be snuggled in blankets in its nesting box until next feeding.
6. I always take a moment to love on my kittens at each feeding and get them accustomed to human touch as soothing loving and protecting. This doesn’t take long but should be done often throughout the day. Allow others to hold your kitten just remind them to wash their hands prior!
7. Feeding intervals?? Here are my guidelines-
1 week or less- every 2-3 hours max. Mostly every 2 hours. EVEN THROUGHOUT NIGHT! 2-3 weeks- every 3 hours, closer to 3 weeks I begin to go 4 hour intervals at night 3-4 weeks 4-6 hour intervals depending on kitten’s size and amount consumed at each meal.
8. Intervals may need to be adjusted from kitten to kitten. If you are feeding too often they may not drink as much and may get diarrhea. Try increasing feeding interval to see if this improves stool. I don’t stretch then past 3 hours in that first week of life. They usually prefer small amounts often.
9. Don’t hesitate to reach out to your veterinarian, and ask if you are unsure about anything your kitten is doing or how it is eating.
10. Keep all bottles etc. properly cleaned. In that first week of life I will sterilize mine daily in a pot of boiling water for a few minutes.
11. Refrigerate between feedings any leftover formula. Heat to room temperature before feeding. Don’t feed cold formula as it will drop their body temperature and often they will not nurse as good if it’s cold. I use a cup of warm water to heat my syringes or bottle.
12. Most orphan kittens are ready to begin weaning once they have teeth or around 4 weeks of age.

Weaning- see additional hand out

1. Weaning will begin around 4 weeks of age. This process requires patience, diligence, calmness and cleanliness.
2. Its messy there is just no way around this!
3. There are many ways to wean kittens, not one is best and ultimately the kitten will guide you in terms of its readiness and willingness. Just BE PATIENT with yourself and the kitten.
4. Here are a few steps of this process I use:
1. When the kitten has teeth, and is beginning to use its mouth more in a biting manner versus a suckling manner this is my sign it’s time to wean.
2. I prefer a shallow wide mouth dish so multiple kittens can join in if possible. It really only takes one kitten to “Get It” and the rest will slowly follow.
3. I begin by leaving a dish with just water and a dish that I freshen each feeding with whatever formula is in the bottle.
4. I will not offer the bottle at the feeding time, I will instead sit on the floor with a towel on my lap and slowly introduce each kitten muzzle to the milk saucer with gentle muzzle into dish nudging. They will come up shaking and licking their face. This will allow a taste and then some will begin to taste the liquid. Others require more time.
5. I also will always offer some tiny kitten kibble pre-moistened with water from about 4.5-5 weeks on.
6. If they figure out how to drink out of a dish I will gradually introduce some kitten mousse type food in the milk to gradually thicken as days go forward. The goal is to lessen the milk to canned food ratio over time.
7. I ALWAYS offer the bottle after their exploration into self- eating to let them know there is always a reward and it decreases frustration and stress.
8. Eventually over time they will get this and they will gradually drink less and less of the bottle.
9. Before you know it, you will no longer offer a bottle.
10. Some kittens will be stubborn and test you, don’t let this bother you they WILL WEAN. Be patient and keep repeating the process. ALWAYS end on a positive note and snuggle. This teaches human to cat interaction is love!
11. There is no one way or right way this is simply one of the ways that works many times for me.
12. Sometimes a gentle yet firm nudge is needed and you may have to withhold the bottle for some kittens approaching the six-week mark. You can still end on a positive note with gentle pets and a cuddle.
13. Make sure you have a feliway plug in in their room during this process if possible!

Socialization- See the Socialization Guide

Orphan kittens can have the reputation of being some of the most difficult cats as they mature into adulthood. There are many reasons for this, some genetic, some in utero, but some of these behavior patterns may be associated with improper socialization and development that occurs at key points during the kitten’s growth that we, as fosters, may fail to realize and provide. The most crucial socialization period in the life of a cat is age 2 weeks-9 weeks as a kitten. The people, animals, sights, sounds, smells, and environment a kitten is exposed to during this crucial period will mold their adult personalities. Orphan kitten raising is not only a huge commitment from the care and feeding standpoint, but from the socialization and behavior development standpoint it could mean a long life of happiness. Wash your hands, have others wash their hands, handle them often, pass them to friends, let them mingle with other healthy kittens, let them meet your kids, your dogs (if safe), your cats, (if safe), car rides, outside sounds, washing machine sounds, hair dryer sounds, the list goes on and on. Your kitten will learn during this period what it will be most receptive to, what is safe, and what should be avoided. Understanding normal kitten development allows the fosters to provide the right environment for a healthy kitten to develop into a healthy adult. This will provide a more socially developed cat for his forever family with less mis-matched homes, surrenders to shelters and inter home behavioral issues. If possible, avoid “singleton” kittens. Even with the most perfect foster program these kittens will often have significant behavioral development stunting. If you commit to an orphan, consider committing to two! You should be able to locate another during kitten season!

1. Paternal factors- Paternal genetic factors have the strongest influence on the development of a kitten’s personality. If the sire was bold and friendly, the kittens will have this tendency, if the sire was shy to humans, thus will the kittens have this tendency. It will then be the fosters job to expose the kitten to many humans with a gentle, quiet touch to increase their chances of good human socialization.
2. Sensitive periods in a kitten’s quick developments:

1. Neonatal (0-7 days)- totally dependent on mom (you), need food and warmth, cleanliness, tactile stimulation (touch specially to urinate and defecate). Kittens have a tremendous olfactory (smell) sense. This is how they find the mothers teats to nurse and by day 4 will find their favorite teat.
If your young neonate has nasal congestion it will likely have a difficult time eating or suckling and should be seen by a veterinarian. They will also as early as 2 days show avoidance of offensive odors. This is key to one of the reasons odors will set some cats off in a direction of aggressive behavior. Kittens have a strong suckle reflex when touched near the mouth at this age and if touched on the face it will turn towards the side it was touched. You can gently touch a newly awakened kittens mouth to stimulate the suckle reflex for feeding time.
2. Transitional (7-14 days)- Kittens will begin to raise their bodies off the ground and move with a slow paddling gait. The eyes and ears will begin to open. Hearing is present at day 5 but now the kitten will begin to orient towards sound.

3. Socialization period (14 days to 7 weeks)-Kittens begin to explore their environment and learn its surroundings what it likes and dislikes. Visual orienting and following develop in week 3, but avoiding an obstacle develops week 4-5. Brief episodes of running may begin to occur at 5 weeks. Kittens use all patterns of gait by 6-7 weeks of age and develop ability to land on their feet between 3-6 weeks of age. By weeks they should begin to move away from their nesting box and begin social relationships with other animals and people in the environment. Social play with mom and siblings begins at 4 weeks, (this will be directed towards the fosters hands and movements without siblings therefore begin wand play). Social play peaks at 6-7 weeks and is high until about 16 weeks of age. Weaning begins around 4 weeks and is complete by week 6-7. Suckling may continue for several more weeks and this is okay too. Prey play begins at 4 weeks. This is important for the development of a satisfied cat (direct descendent of the North African wild cat –Felis silvestris). You must begin to teach your kitten about prey drive and proper development beginning around 4 weeks. I usually have a feather wand and allow the kitten to follow (stalk), reach for it (pounce), bite (kill), and then it’s usually over. A happy satisfied cat will then lie down to groom and rest. This form of normal play will prevent aggression towards other sibling cats, humans, and household items in its future home. PREY PLAY IS A CAT MUST for lifetime happiness. Kittens weaned early do show higher rates of play especially prey play. By 5-6 weeks old your kitten should be readily in a litterbox scratching and covering it up. Fearful reactions to stimuli may begin around 6 weeks.

4. Juvenile (7 weeks to 6-12 months) -These kittens are preparing to disperse from their home range. They are readily playing around 7-8 weeks of age and social play peaks between 4-16 weeks of age. Social play takes on predation aspects around 12 weeks, object play may be social or solitary.
5. Social maturity (development of adult social behavior and interactions with other cats) is reached fully between 36 and 48 months of age. This includes defense of territory.

3. Socialization is not the same as domestication- It is however, strongly tied to the neurologic and physical development of the kitten. This process continues throughout life and how they socialize as kittens –especially weeks 2-7- will influence how they socialize to new individuals as adults. Hand raised kittens develop social interactions with other cats much more slowly, but be patient it can be done! Recent studies show that orphan kittens are no more likely to display human and other animal fear aggression when raised in a home with other cats and a wand type toy to stimulate play and chase.
4. Kittens held and stroked daily from birth to weeks of life opened their eyes earlier and began to explore earlier.
5. They also approached strange toys and people more frequently and were slower to learn avoidance.
6. So, with sufficient human handling and care, the presence of another cat during kitten social development, and the use of wand type play toys, (to show kitten a hand of the owner is not a proper toy), problems may be minimized or prevented!

Congratulations on your willingness to take on one of the most enriching and rewarding experiences in our love and care for the animal kingdom. If you can remember the most important of all things is to LOVE your kitten you are on your way to successfully accomplishing all the rest. Don’t hesitate to reach out to your veterinarian or other kitten expert with any and all questions.
The cat and kitten are very energy sensitive beings. It is as if they can sense our nerves and anxieties as well as our emotional energies. I find it is very valuable, productive and rewarding to center myself before handling my kittens. They will nurse better, feel and receive a loving vibration, and learn human interactions are stable. After all, how many times has your frustrations revealed themselves in a fight amongst your cats, a struggle to get an orphan to nurse well, or even the thought of medicating your personal cat sends him into hiding. Perhaps that is this sixth energetic form of communication that makes bonding with a cat so rewarding and interesting. Be patient, not all kittens follow a protocol, that’s okay. Ask for help and REMEMBER TO BREATHE!