Tube Feeding

by Janice Reichle
Originally published in The 1987 CFA Yearbook

Sooner or later, all breeders find themselves faced with the necessity to supplement the feeding of a kitten or litter or perhaps even raise an orphaned litter. When you mention “tube feeding” to those who have not done it before, they are sure they cannot do it. The usual reaction is “Oh, I’d be afraid of getting the tube in the kittens lungs!”.  Actually, it is virtually impossible to the the tube in the lungs through either the oral or nasal route. The trachea (windpipe) is in front of and adjacent to the esophagus (tube to the stomach) and the lrynx (tracheal opening) is a lateral slot whose position insures that the feeding tube cannot enter it.

There is much more risk involved in feeding a kitten with an eye dropper or a bottle of some type. Either of these methods require that a kitten be willing to nurse or able to swallow, and with a sick or ill nourished baby, this is part of the problem.  Using an eye dropper is very slow, tedious, and seldom successful. If the baby will nurse, by the time it takes a few good, healthy “sucks”, the dropper is empty so you have to break the suction it has established and refill the dropper. Long before the kitten has received enough formula to sustain itself, the kitten becomes tired and stops nursing. If the kitten will not or cannot suck, and you try dropping the formula in its mouth, you are  apt to get some in the lungs as the kitten inhales. This can, and usually does, cause a mechanical pneumonia and any pneumonia is almost always fatal to babies.

The use of a bottle can also be a problem. Survival depends upon the kitten being willing and able to suck. Making the right size hole in the nipple is more difficult than it sounds. Too big a hole means the milk pours down the throat too fast, causing choking. Many of us have had this experience with a sputtering, choking kitten with milk pouring out of its nose and mouth. Again, pneumonia can result.

Tube feeding is ideal because (1) you put the food into the stomach with no chance of getting it into the lungs, (2) you know and control exactly how much to give the kitten, and (3) you need not feed nearly as often because you are giving more at one feeding than is possible with the other methods. If you use a bottle or dropper, you will have to feed every hour or two.

The number of situations that can arise to necessitate tube feeding make it worth while to have the equipment on hand. Some of these things will be in the delivery kit. For instance, I keep old, soft face cloths for drying or massaging kittens after delivery. You can wrap a tiny kitten in one or lay them on the counter while you are working on the baby. The other item from the delivery kit is a postage scale, one that weighs only up to one pound so that it is marked in increments of quarter ounces. If you weigh your kittens at birth and at the same time daily thereafter, you will know what their average weight gain should be. With my silvers, I know they gain approximately a half ounce daily after the first 24 hours for the first few weeks. If I have a kitten that does not show any gain in 24 hours, I begin to supplement. Frequently, that little “boost” is all they need.

In addition to your scale and washcloths, you will need a tube, syringe and formula. I use either a 10 c.c. or 20 c.c Luer Lock glass syringe with a Luer Lock connector. The connector locks into the syringe and the other end of the connector is graduated in diameter but is “threaded” to hold the tube securely. Some tubes have Luer Lock ends. A #5 feeding tube is very fine, simple to insert and a good size for kittens under three ounces. In fact, until you feel comfortable feeding, this size tube and a 3 c.c. syringe would probably be easier to handle. When feeding a larger kitten, you will need a #8 feeding tube.

A formula can be simple or complicated. I have heard of some odd combinations over the years but I have raised kittens, raccoons, squirrels and guinea pigs solely on Borden’s Esbilac, available from pet shops and animal supply dealers. I used it long before Borden’s KMR was developed and I continued to use it because it is available in powdered form, vastly cheaper than the cans of liquid. KMR is now available in powder as well as liquid and dissolves more readily than Esbilac. Directions for mixing are on the container. There are other good commercial pet milk-substitutes that can be used but these are what I have had experience in using.

If the kittens you are feeding are new-born and either orphaned or getting no milk from their mother then for the first few days it is best to feed, through the day, every three hours. (You can get a little more sleep at night!) By the time they are three days old you can feed them at four hour intervals. While they are under eight ounces in weight they should get 1 c.c. of formula per ounce of body weight at each feeding. That is why an accurate postage scale is a necessity. When their weight is eight ounces, give them approximately one and one half c.c. of formula per ounce of body weight. When they weigh 12 ounces, you can put them on a five hour schedule. By now, when you feed them, you should be able to judge when they have had enough by the nice, plump feel of the mid-section. You can gradually increase the amount so that if you are still tubing when they weigh two pounds, (which is unlikely with cats), you will be giving almost two c.c.’s of formula for each ounce of body weight at each feeding but you need only feed every six hours. It is important not to under feed; some people give less “to be on the safe side”. That is not the safe side. It will only result in a under-nourished kitten which you will eventually lose. If you over-feed, some of the milk will come up but will not cause the choking problem caused by forced liquids i.e. dropper/bottle fed. If the kitten seems uncomfortably full, you can always pull back on the plunger a bit and remove some liquid but this shouldn’t be necessary if you measure accurately.

Now to the actual feeding. Assemble your equipment: syringe, tube, formula, scale, record book and pen, permanent magic marker, face cloths and an extra box with a towel covered heating pad set on low. Put a kitten on a cloth and place the tube against the kitten and measure from the tip of the nose to the last rib. Mark the tube with magic marker at that spot. Weigh and identify the kitten and write down its weight. Withdraw the correct amount into the syringe from the container of formula and attach the tube. Very carefully press the plunger until a drop of formula shows. Dip the tube into the container of formula. This will act as a lubricant and the taste will also encourage the kitten to swallow the tube. Working on a surface at a convenient height, take the kitten in your left hand approximating nursing position. GENTLY press against the chin/lower jaw with the tip of your right index finger to open mouth slightly. Tip the head back and begin to insert tube. Until you have practiced a bit, it will be somewhat awkward with the syringe attached. Thread the tub they are much easier to feed. This will become especially important if you are feeding kittens with teeth. As they struggle to evade feeding, you will not only get scratched, but also bitten. The ungrateful little mites will also bite through feeding tubes so that you spray formula in every direction when you press the plunger. Keep a supply o cats may not object to the nasal tube as much as the oral tube but I have not tried it.

It has been said that more cats with respiratory infections die of starvation than of the infection. They will not eat what they can not smell and vigorously fight force-feeding, even when they are in a weakened condition. They can, then, be saved by tube feeding so learning this simple procedure is well worth the effort.