On June 11th, we experienced one of our most challenging births yet. One where we knew the babies would die if we missed a step, weren't fast enough, or made a mistake.
Watch Pomelo's last time giving birth, and learn about the Neonatal Isoerythrolysis that would have killed all of her kittens within the first week:
24 agonizing hours of bottle feedings and supervised weansie visits later, we have six beautiful kittens who are moments away from nursing from their mama for the first time.
It has been heartbreaking to have to take Pom's babies away from her from the moment they were born, especially knowing she has given birth over and over again, only to watch her babies die within the first week. This will be her first litter where she gets to raise her kittens. And thankfully, she will never be pregnant again.
All six kittens have had their first round of serum transfusions, which will give them some of the antibodies they missed out on by being unable to nurse in the first 24 hours. They will have a second round later. We were not able to get enough of the right kind of blood to do a third transfusion, but we are hoping that will be offset by the kittens being able to get some maternal antibodies once they start nursing. We're SO grateful to the wonderful humans/cats who stepped forward to donate blood to help give these babies the best possible chance.
Pom gave birth to seven beautiful kittens, but her 6th was sadly stillborn. We tried very hard to revive him, but he had already crossed the Bridge and we're sure he was welcomed by so many of his older brothers and sisters, as well as one very special Grandpa cat. ❤
Here's more information on why Pomelo's birth was so challenging:
Feral mama-to-be Pomelo's kittens are at risk of a fatal blood type mismatch called Neonatal Isoerythrolysis. It is likely she has given birth many times, and every time, has had to watch most or all of her babies die.
We have promised her we will do everything we can to save these babies, and then she will be spayed and never have to go through this again. ❤️
Thankfully, we do have a way to eliminate the risk of Neonatal Isoerythrolysis... but it's going to be very difficult:
We will need to blood type each kitten as it is born, ideally using blood from the umbilical cord. This means we will need to remove kittens from mom as soon as their placentas come out, open the sac and get the kitten breathing, tie off the cord, take the blood, run the test, and while the test is running, get the kitten dry, check for cleft palate, check gender, listen to heart and lungs, and get a weight.
If the kitten has type B blood, it can return to mom and start nursing safely.
If the kitten has type A blood and is allowed to nurse in the first 24 hours after birth, the anti-A antibodies from Pomelo's colostrum will be absorbed directly into the kitten's bloodstream and attack the kitten's red blood cells, causing hemolysis. To save the lives of these kittens, we need to prevent them from nursing for the first 24 hours after they are born. We will keep type A kittens in our incubator and feed them formula every two hours for the first 24 hours.
After 12-18 hours, the kittens' guts will close so they are able to digest the anti-A antibodies instead of absorbing them into their bloodstreams. This means it will be safe for non-B kittens to return to mom and nurse as usual after 24 hours.
Because Pomelo is feral and lived outside, the odds of her having mated with male cats who have type A blood are high (it is estimated that 94%+ of cats in our area are type A). Because A is completely dominant over B, 100% of the kittens produced by a type B mom and a type A dad will be type A. There is a rare chance the dad could be type AB, in which case 50% of the kittens would be expected to be type A. Type B blood is only thought to occur in up to 6% of cats, and if mom and dad are both type B, kittens will be type B.
Just to be transparent about the reality of the situation we're facing, we are anticipating a number of potential complications:
1. Failure of passive transfer. This occurs when a kitten doesn't get colostrum from the mom. Colostrum is what provides antibodies for the first 6 weeks of life, which help protect kittens from infection. To address this, we have been working on getting Type A cat blood donated and made into serum which can be injected subcutaneously into the kittens to provide some of the antibodies they should have gotten from mom. Each kitten requires 15ml of serum, which is injected in 5ml doses every 8 hours for 24 hours. It is possible to purchase canine neonatal serum from bigger blood banks, but it is not possible to purchase feline serum so we have been collecting as much as we can on our own, with the help of the awesome team at Mountain View Veterinary Hospital. ❤
2. Stress for mom. Pomelo is a very fearful feral cat. Taking her babies as they are born will be stressful for her, and we will hate every minute of it. There is a risk her stress will impact her labor and her ability to care for her kittens. We will do everything possible to keep her stress level as low as possible, but it is not possible to eliminate stress in this situation.
3. We are expecting a big litter. It is going to be a long, exhausting, extra stressful labor for Pomelo. We have started monitoring 24/7 because we must be in the room and ready when the first kitten arrives, no matter what time of day or night.
4. It is important for kittens to nurse during and right after labor, because they stimulate hormones that promote contractions and boost milk production. We are hoping to have at least some type B kittens to help with this, but we have to be ready in case we don't. There's nothing we can do about it for the first 24 hours if all kittens are type A, but once the 24 hours is up, we will do everything possible to get kittens nursing and back on track.
5. We did discuss with our vet team whether doing a c-section at the onset of labor could give us a better outcome, but ultimately, given the large number of kittens, amount of anesthesia and time for surgery, and intensive recovery for mom, we decided it is better to stick to our usual protocol of reserving c-sections as the method of last resort. The odds of this many kittens all surviving a c-section are low, even with the fastest and most skilled of veterinary teams.