Kitten Cuddling 101 by Allison Cowen

The following is a guest post by Allison Cowen, DVM class of 2016 at Cornell University.

When people ask me what I’m doing this summer I tell them I am playing with kittens, professionally. While this is by no means 100% true, it comes closer than most jobs could. Let me explain.

At some point during my second year in veterinary school I approached Drs Berliner and Scarlett with a proposition: “I want to do research at the shelter. Can you help me?” We sat down for several meetings with some of the Maddie’s(R) shelter medicine crew and the brainstorming began. The goal was to find a project that was do-able in several months, would be interesting, but most importantly would be relevant and helpful to shelters.

charlieIt was the second or third meeting when Dr. Berliner said “Wouldn’t it be nice to know how kittens grow in foster care and in shelters?” The answer was unequivocally “yes”, and so the idea was hatched, and we ran with it. I did a comprehensive literature review to see what information was out there regarding growth rates in shelter kittens and foster kittens. Nada. I looked for papers on disease occurrence and mortality in shelter kittens and foster kittens. Nada. In total, I found several papers that looked at these factors but only within environments that differ greatly from the shelter and foster environments, ie catteries, private homes, pathogen-free colonies, feral colonies, or in adult populations. But these are inherently very different situations.

The orphaned malnourished kitten with snot coming out of its ears, eyes, nose and feet that was found in a drainpipe may grow at a very different rate from the purebred Siamese kitten in the cattery being sung to sleep every night. So it would be nice to know, is the universally accepted “1-pound per month” rule for kitten growth even relevant for kittens under these disadvantaged circumstances? What is normal for a hungry worm-filled kitten, and what is worrisome? Our hope for this study is that we will establish a normal rate of growth for kittens in these two very unique situations (shelter and foster care), and be able to use this information when monitoring the health of future kittens. We are also tracking disease occurrence as well as mortality in hopes of being able to draw correlations between some of these variables.

And so my career as a kitten snuggler began.

In actuality though, there is very little snuggling that goes on, as I do not want to become fomite-number-one. My days typically go like this: wake up, tend to whichever foster kittens I have at my home (including weighing them in what I have affectionately dubbed “the kitten cup”), head off to the shelter. I get out my data recording forms (every kitten gets its own form) and the kitten cup and work my way through the shelter kittens following these important steps:

  1. GLOVE UP
  2. Check to make sure I’ve got the ID number written down on the form matches the corresponding kitten (nothing worse than invalid data!)
  3. Pick up the kitten from the cage and try really, really hard not to snuggle it (by far the hardest part of my day)
  4. Place the kitten in the kitten cup, and jot down its weight
  5. Check its face for any ocular or nasal discharge
  6. Put kitten back
  7. Repeat all those steps for any kittens in the same cage
  8. Check its cage for stool quality, and also note how much they’ve eaten
  9. Take off gloves, spray down scale, and maybe even change scrub top if the kitten forced you to snuggle

cutieI do this for every kitten in the shelter every day that looks to be less than or around 8 weeks old. For the foster kittens, these responsibilities fall on the foster providers. Fortunately, Tompkins County SPCA has a really awesome and dedicated pool of foster parents, most of whom are more than happy to help with this and have been amazing about tracking each kitten’s weight, fecal quality, eating habits, and any disease and subsequent treatments. Much my day involves corresponding with the foster care providers, making sure things are going okay, and bringing them anything they may need – new forms, a scale, etc.

As someone who previously thought she was not a “research person” I can 100% tell anyone that whether or not you are a “research person” depends on what you are studying and whether or not you care. This has been an absolutely rewarding summer because I care about the project and am genuinely excited to see what our data holds. And of course a large part of what makes this project SO easy to care about is seeing the kittens day after day and knowing that these will be the beneficiaries of your research. I truly hope this information will be helpful in the future – helpful to shelter staff, to foster parents, to veterinarians, and most importantly to the kittens.

And lastly, a huge thank you to Drs Berliner and Scarlett, the Tompkins County SPCA staff, the dedicated foster parents, Maddie’s Fund, Morris Animal Foundation, and American Humane Association for making my summer wonderful.

Making a difference one conversation at a time

Once again this year’s ASPCA Cornell Maddie’s Shelter Medicine Conference was a wonderful success, offering a variety of helpful topics for all shelter and animal welfare team members. A trending topic, often of great value to anyone invested in animal welfare, was presented this year by Matt Piccone of PAWS of Rochester on, “Engaging your community to increase positive outcomes for dogs.”

Founder and director of PAWS of Rochester, Matt Piccone

Founder and director of PAWS of Rochester, Matt Piccone

Matt began his presentation by telling his own personal story of why he founded PAWS of Rochester. Before establishing and directing PAWS, Matt worked for the security department of a national cable TV company. His position required him to search for illegal cable TV hookups to houses within the less affluent areas of Rochester, NY. Matt’s work necessitated entering the yards of hundreds of houses each day, where he immediately became exposed to dogs living in very concerning conditions.

Quickly realizing the need for both animal welfare education and veterinary access to these communities, Matt self-admittedly became consumed with finding a solution. He ultimately left his job with the cable TV company in order to dedicate his career to serving the animals and people living in the under-privileged areas of Rochester. Matt partnered with a dedicated local animal control officer, and the two began going door to door within the community offering animal welfare education and assistance with the care of their dogs.

Matt reported that through trial and error, he learned how important it is not to be judgmental of the people who own the animals in the targeted communities. By engaging these owners in benign conversations about their dogs, Matt learned time after time how much they loved their dogs, and strived to provide the best care possible. He cautioned the audience members that because these community members typically experience “empty promises” it may take an extended period of time to earn their trust, which is crucial for succeeding your organization’s mission.

Matt explained that it is this very reason that he is sure to always follow through with his commitment to the owners and their dogs. For example, PAWS of Rochester transports animals to veterinary clinics, donates dog houses, and repairs fences for owners who agree to have their dogs spayed or neutered. Committing to these services not only establishes a foundation for an impactful relationship, but also directly improves the lives of the dogs in these communities. Matt is now a trusted member of many of the at-risk Rochester neighborhoods, which in turn, makes his efforts even more successful.

Dog house and straw donated by PAWS of Rochester

Dog house and straw donated by PAWS of Rochester

Before ending the session, Matt advised that establishing a non-profit animal welfare organization is not an easy feat. It takes trial and error, and there will likely be set backs. But, Matt has kept on open mind towards the community members he is aiming to help and his mission remains close to his heart. He whole-heartedly encouraged the audience members to do the same. Gauging by the audience’s questions and comments, I can see that Matt Piccone was an inspiration to this year’s conference goers.

A lucky dog who has been helped by PAWS of Rochester

A lucky dog who has been helped by PAWS of Rochester

For more information about PAWS of Rochester visit: pawsofrochester.org

For additional information on establishing an open-minded, effective organizational culture visit this blog post by ASPCApro highlighting Amy Mills of Emancipet: http://www.aspcapro.org/love-me-love-my-owner

Revisiting feline infectious peritonitis

imageOn July 18-20th, the annual ASPCA Cornell Maddie’s Shelter Medicine Conference took place in Ithaca, NY. There were many engaging speakers from different aspects of shelter care. One of the speakers was Dr. Elizabeth Berliner, who is the Janet L. Swanson Director of Shelter Medicine at the Maddie’s Shelter Medicine Program at Cornell University. Dr. Berliner gave the last lecture of the conference, and overview and advances in the identification and development of feline infectious peritonitis (FIP).

Corona virus is very common among our small animals. Corona can be transmitted fecal to oral, through the saliva, as well as across the placenta. The virus primarily affects the lining of the GI tract, causing self-limiting diarrhea. However, there is potential for the virus to mutate into a highly pathogenic variant. The mutation allows the virus to enter into macrophages, a type of white blood cell, which will have effects on the host based on the severity of the virus and the host’s immune system. Some cats potentially clear the virus, others experience inflammation of blood vessels which leads to fluid build up in the abdomen or chest.

Clinical signs of FIP can include lethargy, anorexia, icterus/jaundice, and a waxing and waning fever. Abdominal masses may be palpated as a result of granuloma formation. Remember to look at the eyes! Blood in the eyes, color changes, inflammation and retinal changes may be some of the earliest signs observed. Neurologic abnormalities may also be observed, but keep in mind major differentials such as lymphoma, heart failure, liver disease, and bacterial peritonitis/pleuritis.

FIP is a disease of younger cats, generally from 6 months to 2 years. Currently, we believe that there is good evidence that the disease has a genetic component, since multiple kittens from one litter can all develop the disease. The cats with a litter mate that has developed FIP are 2-10 times more likely to develop the disease themselves, likely through a combination of genetics and exposure. Non related kittens have no increased risk of FIP development than any other kitten. Unfortunately there is no treatment or effective vaccine for the disease. Anti-inflammatory suppression of the immune system may serve to make the cat more comfortable, but does not alter the disease progression.

Interestingly enough, ferrets develop a remarkably similar corona virus mutant with many of the same clinical signs and clinical pathology abnormalities observed.

For more information, visit http://www.dr-addie.com

ASPCA/Cornell/Maddie’s 2014 Recap: Foreign Bodies in Shelter Dogs

Picture1This article contains a brief synopsis of information presented at the 2014 ASPCA Cornell Maddie’s Shelter Medicine Conference. This presentation was given this past July by Tiva Hoshizaki, BVSc, the Janet L. Swanson resident in shelter medicine at Cornell University, to the shelter staff and volunteer track.

Foreign bodies can gastrointestinal obstructions, which can be life-threatning in dogs and cats. Any item has the potential to be a foreign body. Most commonly we will see dogs eating toys, balls, fabric, rocks or plastics. Foreign bodies cause vomiting, inappetence, lethargy and even diarrhea. Many dogs in shelters develop vomiting and or diarrhea, mostly due to stress, viruses or dietary indiscretion. Dogs which have persistent or severe signs should be seen by a veterinarian for work up including x-rays and or ultrasound.

Surgery to remove a foreign body can be expensive, over $1500 in many cases! If your shelter can afford to take out a foreign body, then be sure to ask the following questions before you commit:

  1. How bad is it? The sicker the dog is, the longer the foreign body has been there, and the type of foreign body will all impact the prognosis. In uncomplicated cases 95% of dogs survive and do fine. In dogs with severe illness, such as septic peritonitis only survive about 50% of the time.
  2. How adoptable is this dog after surgery? Some dogs are already beginning to deteriorate in the shelter. Are there concurrent medical or behavioral issues which may make this dog unadoptable in the future?
  3. Will your shelter be able to manage this dog in the future? Dogs who get foreign bodies are more likely to get them again in the future. That means this dog needs supervised time with toys, special toys, special bedding, and a special adopter to take them home. Will you be able to monitor and prevent a future surgery?

Picture12There are a variety of factors that inhibit ingestion of a foreign body such as the item itself, the dog, and the environment. The item itself is not always a dangerous object, although can pose life threatening consequences if not addressed in a timely fashion. Some dogs are classic offenders like the inquisitive puppy who just loves to eat rocks while out for a stroll, or the larger breed who unknowingly gnaws off and swallows a piece of your child’s Tonka truck. These dogs can make even low-risk toys into a foreign body. Conversely, some dogs go their whole lives playing with high-risk items and never require surgery. Most importantly, is the setting and environment of the shelter. Dogs are in high stress situations, with often minimal exercise and enrichment. While a certain dog may do well with toys at home in a supervised setting, a dog in a shelter setting may relieve its anxiety by shredding and eating its blanket! When making decisions about risk, remember to consider all three factors: DOG, TOY and ENVIRONMENT!

A brief word about toys and their relative risks. The highest risk toys are those which are cheap plastics and fabrics. They are easy to destroy and often have appealing squeakers which are the perfect size to become lodged. Avoid the bargain bin at pet stores, as these cheap toys aren’t worth the time and effort. Moderate risk items include rawhides, dental chews, balls, rope toys and tough fabric toys. The slightly edible toys are great fun, but can be swallowed if they are the wrong size for the dog, or if they are broken into smaller pieces. While edible bones and chews are good for dogs in a home, use them with care in the shelter! The lowest risk toys include the hard plastics and rubbers, or super tough fabrics. These toys include treat dispensing cubes, Kongs, “dental” toys, and other items designed for “tough” chewers.

Once again a reminder: Any item can become a foreign body. Any dog or cat can develop a foreign body. There are no hard and fast rules–you must judge based on that individual animal’s risk with that item and its environment!

Picture13The prevention of foreign bodies require communication between staff, daily monitoring of animals and their items (remove broken items!), awareness, and teamwork. Here are some other suggestions which you could implement in your shelter:

  • Do daily rounds!
  • Make foreign body prevention part of volunteer orientation and staff CE
  • Ensure there is a question on your owner surrender form about foreign bodies, and a complete medical and behavior history
  • Provide adoption counseling for potential adopters with a history of FB ingestion
  • Use a shoe rack with labeled slots for each toy, so that at the end of each day, all toys are put away and accounted for
  • Include appropriate toys and treats on the animal’s cage card
  • Use homemade shelter enrichment items which are completely digestible such as kibble, broth ice blocks, or treats in paper bags or egg cartons. Avoid making fabric or plastic bottle toys!

Do you have any other ideas of how you can prevent foreign bodies in shelter dogs? Please post below with your ideas!

Kitten season is here – Presurgical pediatric examination

Examining kittens

The high time is upon us and it is time to go back to the basics! The importance of the physical examination of our pediatric patients (especially prior to surgery) cannot be overstated. It tells us not only the age, gender, and health status of our patients, but also alerts us to many potential surgical complications, and conditions that need to be addressed during surgery. Pediatric spay/neuter is routinely performed on patients that are between 7 and 16 weeks of age. However, patients of this age may also be presented for other surgeries as well, such as enucleation or limb amputation.

A physical exam should be conducted systematically, in a routine manner, in order to prevent omission of any of its parts and missing anything important. Equipment should minimally include a stethoscope, scale and recording material, and may also include a thermometer, otoscope or penlight. Ideally kittens should be housed with litter-mates (even in the perioperative period) to minimize stress, facilitate appropriate behavioral development and reduce chance for spread of infectious diseases to other kittens. Each kitten should be clearly identified; this can be with a collar, tag, or gender and adequate description.

The first part of a physical examination is the exam at a distance. Careful attention should be given to mentation, energy level, gait and breathing pattern. Is the kitten interested in its surroundings? Is it friendly or withdrawn? Valuable information can often be gained by observing kittens before handling them.

Ideally the examination room would be free from barking dogs and other loud noises. The kitten should be allowed to approach the examiner rather than being immediately retrieved from the cage upon opening. Remember that kittens are impressionable and that gentle, low-stress handling will positively affect their future behavior. Every kitten should be weighed with a baby scale or gram scale in order to accurately dose analgesic and anesthetic agents and to be sure their weight reflects their known or estimated age. As a general rule of thumb, kittens gain about a pound every 4 weeks. Therefore, an 8-week old kitten should weigh about 2 pounds, and a 12-week old kitten should weigh about 3 pounds and be cutting its first adult incisors.

One approach to an examination is from the head to the tail. For our purposes we will divide the examination into four parts: the head and neck, forequarters and thorax, abdomen and hindquarters.

Wear gloves and minimize cuddling of kittens!

Wear gloves and minimize cuddling of kittens!

For the head and neck be sure to carefully examine the eyes, nose and mouth as well as the skin around those areas. Look for accumulation of dried secretions in the eyelid margins and corners of the eyes. Note the color of the whites of the eyes (sclera) and pink insides of the eyelids (conjunctiva). Observe the clarity of the cornea (the clear part of the eye) and check for inflammation (redness or swelling) of the conjunctiva. Look for abnormalities such as elevation of the third eyelid or discrepancies in pupil size. Press gently on the nares and look for secretions. Check the ears for debris as well as the skin around the ears for scratches and hair loss. Open the mouth gently by grasping behind the upper canine teeth and pressing down on the lower incisors. Inspect for ulcers, mucus membrane color and for abnormalities of the tongue or soft palate. Examine the teeth for discoloration (indicating a dead tooth) or fractures. Check the capillary refill time. Palpate the neck, particularly the left side of the neck, for swelling or other evidence of esophageal disease.  Palpate the mandibular lymph nodes for any abnormalities.

Examine the forequarters and thorax next. The prescapular lymph nodes should be very small or indiscernible. The forelimbs should be palpated joint by joint from the toes to the shoulder. Palpate the long bones for any pain or deformities. Note any additional toes and toenails. Palpate the ribs and spine. Listen carefully to the heart and lungs (ideally with a pediatric stethoscope). The lungs should be ausculted on both the right and left side and in all 4 lung quadrants (dividing into cranial and caudal as well as dorsal and ventral parts) for abnormal sounds or quiet zones. Carefully auscultate the heart on both the left and right sides of the chest. Keep in mind that inadvertent pressure placed on the chest while ausculting can cause an inducible murmur (through deforming the cardiac wall) in cats and kittens. Murmurs can be innocent or congenital. Innocent murmurs do not usually persist past 16-weeks of age. Palpate the femoral pulse while listening to the heart to be sure that it is strong and synchronous.

For the abdomen observe the skin and musculature. Look for evidence of parasites and umbilical herniation. Palpate the spine and abdomen gently for signs of discomfort, masses or other abnormalities. Finally, examine the hind limbs in the same manner as the forelimbs, from toes to hips. Check the perineum and anus for any evidence of fecal staining, inflammation or other abnormalities. Check the gender, and if male palpate for both testicles. A pre-operative temperature may or may not be useful. Kittens usually descend their testicles by 4 to 8 weeks of age. If both testicles are not descended by 16 weeks of age, cryptorchidism should be suspected.

A thorough physical exam just prior to surgery is an invaluable tool in finding common abnormalities seen in kittens including brewing or resolving upper respiratory infections, diarrhea, ear mites and other parasites as well as less common abnormalities such as heart murmurs, cryptorchidism, umbilical hernias and more. A gentle, systematic approach, in a quiet room just before surgery can not only help evaluate anesthetic safety but also save many potential complications including the need to re-anesthetize the patient in the future to correct things that were missed such as fractured deciduous teeth or umbilical hernias.

Adapted from Veterinary Pediatrics, Dogs and Cats from Birth to Six Months by Johnny D. Hoskins, 3rd edition, by Dr. Kara Breeding, Maddie’s(R) Shelter Medicine Intern at Cornell University.