Neonate With Pectus Excavatum

[catwoman707]

Here is a sample pattern I had created in a rush but to show another person how to create, the rectangles are where the sticks go and the cut out center across his back. Ties together in the front.
The important part is fitting him so the sticks on the sides sit right at the widest part
Obviously my crudely made pattern would be for an adult sized cat! lol

 

[bklyn]

I see, so basically cutting out a hole in the back so it's not pulling there on his spine right? Other than that, the sticks (currently thick velcro but will change) do fit on the widest part of the ribs.

 

[catwoman707]

It's not necessary to cut the hole really, the vest can even be the shape of a narrow 8 just as long as those side sticks are straight and putting a small amt of pressure on his side ribs to allow room for him to breathe better, which since he is growing every day will influence his ribs to grow differently and narrower and make room for his heart and lungs.

 

[bklyn]

Okay, should be set with it for tonight and will see how he does. Will update in the morning, thank you again for your help.

 

[catwoman707]

You're welcome, glad to help.

 

[Sarthur2]

Here is a thread from 3 years ago in which Catwoman advised another member on the vest for this condition:

Flat Chested Kitten Syndrome??

 

[bklyn]

Sarthur2 Yes that's what keyed me in to the vest, it's the first I heard of it. So glad I found it through google when looking up about his condition.

I'm going to have to continue to monitor him throughout the day to give a full update. So far so good I think, but it's too soon to say much. He had a good night, ate well, playing well, no screaming fits. Will report back when I feel like I know better what's going on. I'm also likely going to do follow up x-rays at some point soon, not yet though.

 

[catwoman707]

Did he wear the vest during the night?

 

[bklyn]

Trying to get a feel on what's going on with him is really difficult.

So I put the vest on several times yesterday, and every time his eyes would water to the point of sticking shut. I tried adjusting the tightness, shortening the duration he wore it, but still it would be like he went from completely clear eyes to red, watery, URI eyes.

So I cautiously continued with short two minute stints wearing the vest + light massaging, on and off for the evening, which seemed to be okay for him.

Today, his seems to definitely have developed a URI, with watery eyes and now a little bit of sneezing. My guess is it was on the way in, and doing the vest/massages brought it to a head quicker. If I massage him at all today, his eyes water more. So I've been done only light massaging throughout the day.

So that's the bad news. The good news is his appetite is up (He's gained 11 grams already today and had a bowel movement), and his breathing has been more regular. He still has some small episodes, but he was playing like crazy with my cat, rolling around, lunging at him, smacking him, for about 20 minutes straight at three different times today, and never once did his breathing escalate. I don't know why he can do all that and be fine, but then sometimes do nothing and have labored breathing. I do know both peeing/pooping trigger heavy breathing for sure. His appetite is definitely still suppressed by his condition, but it's improved a bit the past two days.

He's definitely been stable today. Tomorrow he goes to the vet, and they're going to observe him for a few hours as well, since they have pretty much only seen him at his best, which makes understanding/helping him a bit harder. They'll bottle feed and take good care of him, and I'll be right around the corner. I also have to be extremely careful that the URI doesn't develop into a bacterial infection or pneumonia.

I will continue to update, but it's definitely hard to really articulate/umderstand what's going on with him. Overall, the URI is concerning, but his behavior/breathing/appetite is better. He continues to sleep on his sides which helps.

 

[Sarthur2]

You might want to ask the vet to put him on clavamox as a preventative measure. The last thing he needs is an infection.

 

[bklyn]

So literally a minute after I posted my vet called and said that she's been speaking with other vets who all agree his symptoms are very severe for both his age and the physical severity of his pectus (which is mild), so they think there's an underlying respiratory issue that is definitely a culprit here. She told me to start him on clavamox (she gave it to me unmixed to hold onto a few days ago when I noticed his eyes were starting to get stuck randomly on and off), and he's going in tomorrow morning for observation. I know nothing about what underlying respiratory issues could exist, how treatable they are, etc, but for now he will be on clavamox. My vet thought that was immediately needed, and I hadn't even told her about the now developed URI yet (of course now I have).

 

[catwoman707]

Usually when kittens are going to start showing a uri is about 3-4 weeks old, when the antibodies are wearing off from mom's milk, so it's right on time.
Yes he has no room for a uri for sure.....
I would still put the vest on him as often as possible today, he's got to get those ribs growing rounder because each day his little self continues to grow.
While his ribs are still pliable and soft.

I suspect it is nothing more than the common uri virus herpesvirus, which is not related to herpes at all, just nicknamed that, it is actually rhinotracheitis. However it will not be helpful when he has breathing episodes.
He will probably be given terramycin ointment for his eyes which clears them up well.
If/when he gets sounding congested in nose or chest, a steamy bathroom for 10-15 mins a few times a day will help tremendously.
Need to get his ribs right though asap.
Also wanted to reply to your comment about sleeping on his sides, this is definitely a big help, him being flat on his chest at his earlier age was only prompting his ribs to continue growing flat, so now the side sleeping is helpful for sure!

 

[Sarthur2]

They can also give him steroids for his breathing.

In the meantime, I agree wholeheartedly with Catwoman that the kitten needs to wear the vest daily as often as possible to facilitate his rib cage growing properly.

 

[bklyn]

The day I brought him to the vet I mentioned that I thought I could hear congestion at times in his breathing. She listened to his lungs for a while and his breathing sounded normal. I also mentioned the eyes shutting, and she gave me clavamox to have on hand in case it developed further. I started him on terramycin this morning. Ever since I learned it wasn't prescription (which I thought it was for over a year), I always have it on hand. I think it's very possible that the URI triggered his decline, as prior he was eating normally, pooping regularly every day, and was breathing normally, maybe a bit heavy once a day, but definitely no crying or screaming. Hopefully my vet will be able to learn more from observing him tomorrow, now that she's specifically looking at that as well.

Between his chest shape, his age, and the fact that he's a Persian and has a flat face, the URI was inevitable, and I have to be really careful to avoid pneumonia. I have a humidifier by him (just water, no scent or anything), am keeping him warm, and his eyes clear with compresses and terramycin. I'll bring him by the shower tonight before bed for a while too. I will definitely continue to work on his ribs, I think that's why he's feeling better today. He's up on his feet a ton now, and loves walking around. Typically at this age the bottle babies I've had in the past are still pretty wobbly, but he's been so completely steady for a while, he never gets knocked over and now is already lunging at my fingers and moving really quick. He hasn't been breathing heavy even when playing a lot either. He's really just so adorable.

 

[corvidae]

I had never heard of this condition before clicking on this thread but I just wanted to express gratitude to B bklyn and all the folks replying and giving advice for caring so much about this little buddy! He's absolutely adorable and I'm rooting for him.

 

[catwoman707]

How's it going today?
Herpesvirus rarely turns in to pneumonia btw, calici virus which is the 2nd most common uri on the other hand, does like to become pneumonia in the littles, but with the eyes involved I do suspect it's herpe vs calici, thankfully.

 

[bklyn]

Sorry for the delayed update, we had a pretty bad storm by us today and were without power most of the day.

I agree it seems like herpesvirus. He spent most of the day at the vet being observed. It seems like the URI had been brewing and leading to a lot of his distress this past week, because as he's now on clavamox and it's passing, his breathing is mostly normal and his appetite is returning. This is the second day straight that he has not had any of his restless/screaming heavy breathing fits. He's not 100%, but he's been trending in an increasingly positive direction. Now my focus is on getting more weight on him, as it's been slower than it should be, but is also trending more positively every day.

My vet wants me to continue with the physical therapy to reshape his chest, which is good. She spoke to another specialist who was willing to do the surgical splint now (where they put a stitch around each rib and then attach it to a cast), but now that his symptoms are less severe (he still has a couple of bouts of slightly heavy breathing throughout the day), the splint feels too extreme, and she believes that we can reshape with compressions and/or the vest as well. She did an x-ray while he was there as a courtesy, and it seems like maybe the inversion has gotten a little bit better, but it's hard to tell because he angles very slightly from one x-ray to the other. For sure it hasn't gotten worse.

I have a busy weekend, but am going to focus on his physical therapy, and will report back with updates, which I'm hoping at this point will continue to be positive. He's up on his feet and playing a ton now. I really thought I was going to lose him at one point (actually several points), so the fact that he's stable now is really overwhelmingly great. My vet has also been extremely amazing in helping him get to this point, and has definitely fallen in love with him, so he's got a great team behind him.

 

[catwoman707]

Excellent!
main focus is continue molding those ribs so they will start growing correctly without prompting them.
The weight will come soon after
I agree, splint is drastic and unnecessary at this point since you have been shaping his ribs, coaxing them. If we can get the vest worn for a few consecutive days with breaks here and there or during the night only, he would likely be done with all of this madness (as far as he is concerned!
Maybe a couple days during the following week to remind them to grow right. But that's how fast it works.

 

[bklyn]

His appetites returned and he's gained almost 40 grams total over the last two days, which is definitely a lot for him! I'm continuing with the compressions and his breathing's been completely normal, no heavy bouts whatsoever. He's tolerating the vest less since he's so active now, but I have him on a schedule for his "physical therapy" and it's been working. I will plan to do a follow up in about a week or so, but he's quickly become a normal little guy! I will update here and there, but my guess/hope is that there won't be much to report on, at least until after his follow-up.

I appreciate all the support and especially catwoman707 's help, I really didn't think he was going to make it, let alone have such a full turnaround. I'm hopeful with help he'll outgrow his inversion, and no surgery will be necessary. Now it's time to catch up on some work, the past two weeks have been non-stop vet appointments/doting on him/worrying!

 

[catwoman707]

This is such a great update, and it warms my heart to know I was able to be of some help in getting this cutie pie turned around.
I see no reason why it shouldn't continue to improve, his ribs just needed/need some coaxing to grow properly.
Just continue with his therapy and remember that the sooner/younger when it's done, the softer and more easy it is to convince his bones to grow right
I was pretty worried there in the beginning before the vest, etc.
Love to hear he is turned around so well.