Kitten Regurgitating, Sneezing Food

oleander

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2 weeks ago I was driving down the road on a terribly rainy morning and a small black kitten was staggering across in front of me. I stopped and grabbed her and took her to work with me. She was freezing, soaking wet, gums were white, emaciated- skin and bones. I got her heated up, her blood sugar up, and eventually eating. She had horrific coccidia and really bad conjunctivitis as well as URI. She responded well to treatment for coccidia and was put on Clavamox for her URI and Tarramycin eye ointment which was changed a few days later to Erythromycin as there had been no improvement. That cleared her eyes up quickly.


The diarrhea stopped within 4 or 5 days and her URI improved greatly. About the time the coccida cleared up, she stopped showing any interest in canned food and instead wanted kitten formula or weaning formula, which she ate well. The uri continued to improve but she was so very congested. Chlorpheniramine was added which seemed to help.

Oh, I should add that she weighed 15oz but was approximately 7 weeks old when found. That means she is about 9 weeks old now.

Canned food and baby food were added to her weaning formula to get her back to a more solid diet, Which has worked fine. She won't drink water though. She will sometimes eat some canned food as long as it is gravy based and not a pate.

In the last few days she has started regurgitating her food shortly after eating. It's like after she eats the congestion gets worse and she will regurgitate a little bit of the food, and then have a sneezing fit where mucus mixed with whatever she just ate comes out of her nose. It's the oddest thing. She is not aspirating and her lungs are clear. Last week she was up to 1lb 5oz prior to this new issue. She was 1lb 3oz this morning.

In general, she seems to be much improved. She is more alert, her eyes are clear, she is active. She loves attention and enjoys her gruel food mixture. Today she ate some dry food happily but then sneezed mucus with bits of dry food a bit later. She is keeping enough food down as her gums are nice and pink, she is not dehydrated, however she isn't gaining like she should and the whole situation is concerning. Her antibiotic was changed today by the vet to doxycycline to see if that would help with the congestion, since the clavamox hadn't helped.

She has been checked for a cleft palate and I have also looked a few times and I cant see anything. Also since this issue just came about in the last few days, that seems unlikely. I know megaesophagus could account for the regurgitation but that wouldn't normally cause the sneezing of food and mucus, and again, the issue just presented in the last few days.

I've fostered neonates and kittens for years, hundreds have come through my house... but I've never seen anything like this.

I'm wondering if anyone has seen anything similar before putting this little kitten through tons of tests. I'd love to have a direction to go in or some ideas. I haven't had blood work done as she is so small and I'm not sure they can really get enough blood from her.
 

silkenpaw

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You took my thunder away :). I was going to ask about cleft palate. I’ll still ask, though I know about this in humans, not cats. Has anyone felt around for a submucous cleft? That’s where there’s a defect in the muscle layer but it’s covered by mucous membrane, so you can’t see it but may be able to feel it. Don’t know whether that’s a possibility in cats.

Thank you so much for taking care of this kitten. You are the best. Hugs to you and her. :)
 

Mamanyt1953

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One of the quickest ways to get a fair idea that this may be megaesophogus is to feed her in an upright position, on her haunches. Hold her there for several minutes after she finishes. If there is no regurgitation, it is probably megaesophogus. Probably.

And if it is, she can still have a happy, almost normal life. You'll want a Bailey chair for her. This company makes them for dogs, but I've seen people use them for cats, as well, with excellent results!

Bailey Chairs for dogs, canine megaesophagus, megaesop

Thank you so much for caring for this little one. If not for you, she would not have survived, and would have died alone, hungry, wet, cold and afraid. You are one of my heroes.
 
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oleander

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So a lot has happened in the last few days!
She was at the emergency vet Thursday night, xrays were taken but they were not conclusive. The regurgitation was getting worse and she was losing weight.
Friday we were back at the emergency vet. She was so freaking hungry, she was jumping on my dinner plate, eating my food and then regurgitating it immediately, then jumping back in to eat. Friday night they did Barium xrays which required her eating the a/d mixed with barium about 6 time before they could get the xrays before it came back up! The xrays showed pretty severe megaesophagus. The vet said to tube feed her for the next 3 days to see if it improved (since it had not been that way since day 1, we were hoping it was caused by something and would get better.) They tube fed her some a/d and showed me how to do it... I have tube fed neonates but never a 10 week old kitten. She was not amused, but she had a full belly and looked satisfied instead of starved for the first time in a while!

Saturday morning she was not doing great. Lethargic and just not herself at all. I had to go into work for a few hours so I took her with me. She was too weak for me to tube feed- and I could tell that she had developed pneumonia, likely from aspirating over the last few days. I was suctioning out what she was getting up and keeping her hydrated with sub q fluids.

We went to the emergency vet around 1pm and the prognosis wasn't positive, but they got her warmed up (temp was 97.6 I believe) and got her stabilized. I went home to take a nap and eat since I had maybe 4 hours sleep in the prior few days. When I called in the evening to check on her, they were excited and surprised that she was doing really well and her lungs had cleared significantly!
I went and hung out with her for a few hours.

This morning I had a tire blow out so had to spend a few hours waiting to get that replaced. I called to check on her and all they would tell me was that I needed to come down there and talk to the vet. I was not happy. I called back an hour or two later and got a better person who put a friend of mine on the phone who works there. She was fine, but that particular vet (multiple vets rotate there) wanted to talk to me about putting her to sleep "because the long term prognosis isn't great" -- um, no. She is fighting hard to get through this and I'm going to give her every chance I can.

So I went to see her around 3 today and she was much more perky and feisty. They had a hell of a time tube feeding her. The stuff coming up from her lung is no longer thick mucus and her breathing sounds really good. She is also able to regulate her body temp much better now. I'm going back tonight to talk to a different vet about several possible options for a feeding tube due to how stressful it is to tube feed her the way we are doing it now. If we can alleviate some of the stress then she can be fed more often and we can get her weight up and get her past the pneumonia so we can see if her megaesophagus is operable- or if it will improve on it's own.

xray1.jpe

xray2.jpe


Ember2.jpg

Ember1.jpg
 

silkenpaw

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Yay, so glad you have a diagnosis! That’s more than halfway there! And I’m glad she’s getting better from the pneumonia.

She’s precious! I love the little white locket. A feeding tube would improve her life so much! I’ve had several cats with them and it really made a difference in all of them.

Thank you again for taking care of her!
 

Mamanyt1953

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This is a kitten with determination and a will to fight! I'm just so glad that the right person with an equal will to fight for her has her! And do look into a Bailey Chair for her. I've heard some good things about them concerning cats.
 
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oleander

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Sunday evening Ember was doing SUPER good! She had her feeding tube put in about 6am Monday morning and I picked her up a few hours later.

The feeding tube scares the heck out of me but I'm learning! We have been to the emergency vet the last 2 nights since she got it put in due to my own over cautious fears and paranoia, lol! 6 days in a row at the emergency vet- the staff is joking I should get a part time job there.

I've had a few issues with the tube clogging so now I am blending the a/d and water in my vitamix blender to make it super pureed so it cannot clog at all. I'm also adding some Nutri-cal that I soak and mix first so it isn't a sticky gel. Trying to get the most into every drop I get into her!

Tonight we went in to have her checked over and have her bandage changed. She is doing really good. She hasn't gained any weight yet, but part of that is due to the tube clogging and me not getting enough in her the last 2 days. They flushed it out tonight and gave me a better syringe to use. She is currently at 1.005 lbs. She was the same Sunday night, Monday night she had dropped ever so slightly to 1.003 lbs. So maintaining is better than losing, but I'm hoping tomorrow she will show a gain!

She has not had any food by mouth since Friday and my gosh she wants to eat SO bad. She tries to eat the cap to her feeding tube, my fingers, plastic, paper, etc. I can't eat around her because she dives into it (so far nachos from Taco Bell and a bag of Lay's potato chips, lol!)

I'm hoping tomorrow night will be our first night NOT at the emergency vet! She seems to be adjusting to the tube. She purrs and makes a lot of biscuits!

Ember3.jpe

Ember4.jpe
 

silkenpaw

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Check out this site: kittykollar.com/. In addition to having awesome collars for esophagostomy tubes, they have a page with useful tips about dealing with the tube. I used to always puree the food in a blender so it would go down easier, just shaking it doesn't cut it, I think.

Don't sweat the difference between 1.005 and 1.003 lbs. That's less than a decent poop or pee. Look at the trend over several days. If it helps you, put it on a graph.

I'm so glad she's doing well. Bless you for taking care of her!
 
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