With the arrival of each and every spring, the staff of shelters across the county know they will soon face the overwhelming influx of underage, often orphaned, kittens. In the past, euthanasia of these kittens often seemed the only viable and humane choice even at facilities with a robust foster program. It takes resources and time to raise kittens to adoption age, two items in short supply at our largely underfunded, understaffed shelters. But as more shelters increase their life saving ability, creative programs aimed at increasing live release rates are emerging. One such new and innovative program is the development of kitten nurseries. A kitten nursery saves lives, but it takes planning, funding, good protocols, and a network of dedicated staff and volunteers to succeed.5
Creating a successful kitten nursery takes commitment and resources from the shelter, local affiliates and the community. Protocols governing the care of the kittens, the cleanliness of the nursery, and methods of controlling infectious diseases are other critical elements.
Before moving forward with establishing a nursery program, many questions must be examined and answered. Shelter and other organization leaders associated with animal care must decide how great the need for a nursery is and how well it will serve the community. For communities where large numbers of kittens are euthanized annually and the sheltering agencies are looking for solutions, a kitten nursery may be the right solution.
The availability of physical space is one of the first requirements to determine. A separate building is ideal. The primary reason in keeping the facility separate is to control the spread of infectious diseases within such a vulnerable population. A secondary reason is the ability to allow volunteer staff to enter and leave the nursery without having access to the main shelter building. If a separate location is not an option, the ability to isolate the nursery from the main shelter is necessary. The chosen location and size will also affect the number of kittens housed, staff required, daily routines and medical protocols.
Staffing the nursery will, most likely, involve a combination of permanent and part-time personnel, seasonal help, and volunteers. At least one permanent, full time staff member should be assigned to the nursery. Will there be funding for additional staff or additional hours for part-time personnel during kitten season? This type of program generally relies heavily upon volunteer participation. Are reliable volunteers available? If relying heavily on volunteers, it is essential that at least one staff member is present at all times to ensure facility consistency, adherence to procedures, and to relay important information.
Few shelters have the resources to run an around-the-clock kitten nursery, therefore do not underestimate how essential a strong foster care program is. Are enough foster homes available to care for the orphaned, unweaned kittens and kittens not thriving in the nursery?
What community partnerships will enhance and increase resources? Look to local rescue groups and city or county organizations. Community partnerships can help in establishing the nursery and may provide joint staff and volunteers, an increased pool of fosters and adopters, assistance and participation with funding, and larger adoption events.
How will the nursery be funded? Are grants available? The initial cost of setting up the nursery may be significant. Fundraising efforts, such as a “kitten shower” can help offset those expenses and spread the word about the nursery.
Nursery design must protect the kittens against the spread of infectious disease, provide for their physical needs, and allow them proper social development. Some nurseries may keep kittens from birth to eight weeks of age; others only kittens four weeks and above. Foster care is used for nurseries without the capability to house unweaned, orphaned kittens as well as kittens not thriving at the nursery.
To help with management of the nursery, each room should be color coded and fully equipped. For example, one room may be identified as the blue room, one the green room and so on. Each of the rooms as well as the non-housing areas, such as the work spaces, laundry space, and storage space, should be color coordinated. Color code any items that can be moved with spray paint or duct tape, such as the signs on the doors, food containers, litter container, watering can, trash can, laundry basket, broom and dustpan, mop, disinfectant spray bottles, and so on. Color coordinating is a way to help control the spread of infectious disease by giving staff and volunteers a visual way to make sure that everything that belongs in a room stays in that room. This is especially important for cleaning items such as brooms, mops, dustpans and spray bottles or anything that could serve as fomites from one room to another. Color coordinating is also useful for items belonging in areas that do not house kittens. This will identify them as “clean” areas. Staff and volunteers will need training on why everything staying within the assigned room is so important. They must understand this method reduces the spread of diseases and also ensures efficient daily operation since no one must go looking for a misplaced essential item. If an item does get carried into another room, staff will be able to quickly see it does not belong.
Specific shelter and community environments often determine how a nursery should be arranged to provide the best kitten care. For example, are highly contagious infectious diseases, particularly panleukopenia, extremely common in the area or are they a rare occurrence? Do a lot of kittens come in with confirmed dermatophytosis? In shelters where panleukopenia and dermatophytosis are common, including procedures to minimize the spread of infectious diseases should be a primary factor in nursery design. Where infectious diseases are common, grouping kittens as cohorts based on intake may be the best arrangement because housing kittens in a single room for their entire time at the nursery minimizes the potential for a panleukopenia outbreak even if a case or two occurs within the room. This method keeps the infectious disease confined to one room/intake week group. Procedures must then include plans for treating mild illnesses such as diarrhea, upper respiratory infection, and conjunctivitis in the room without pulling the kittens out. In addition, grouping kittens by intake week provides the means to control the number of intakes each week based on space availability, thus keeping staff and volunteers from becoming overwhelmed.
For shelters in communities where infectious diseases like panleukopenia and dermatophytosis are a rare occurrence, nursery design may be based on age. The dominating factor governing the arrangement of these rooms can be meeting the physical and social needs of the different age groups, such as nursing moms with litters, orphaned, unweaned kittens from 0 – 4 weeks of age, and the 4 – 8 week old kittens just transitioning to solid foods who need more play and socialization time.
Shelters considering a neonatal nursery must take into account the expense of a 24 hour, seven-days-a-week operation. Orphaned, unweaned kittens are a fragile population requiring round the clock care, frequent rechecks, more supervision, and are more susceptible to illness. Caring for them requires a staff of employees and volunteers assigned to strictly work with this age group and who are trained in the care of neonates.
Juvenile animals are the most vulnerable to infectious disease because of their immature immune systems and maternal antibody interference. No matter how many vaccinations a kitten receives, it is still not necessarily protected from disease until around 16 to 20 weeks of age, so vaccine boosters must be continued until that time.
Medical protocols should be developed by or with the help of an experienced shelter veterinarian. Protocols may vary based on the geographical location of the shelter, infectious diseases prevalent in that area, and the ability of the shelter to isolate and treat highly contagious diseases like panleukopenia and dermatophytosis. It is imperative that any kittens with either of these conditions be immediately removed. For shelters with an isolation room and the capability to provide adequate medical treatment, the kittens must be immediately moved to the isolation area. For shelters without the capabilities to isolate and treat animals infected with panleukopenia or dermatophytosis, euthanasia of affected kittens is likely the only option. There are many other common illnesses and conditions seen in kittens which will need to be addressed and have a protocol in place that outlines clinical signs, diagnosis, isolation, treatment, and resolution. For more information on protocol development, refer to Developing infectious disease policies and protocols in an animal shelter.
Intake protocols should be defined for your facility with the help of an experienced shelter veterinarian. All kittens under four weeks or age should receive routine deworming with the antiparastic pyrantel pamoate and the antiprotozoal ponazuril upon intake. If fleas are present, kittens need a quick bath with warm soapy water, taking care to prevent hypothermia. For more information, refer to Steps to Bathe an Underage Kitten in Chapter 2. Fleas should then be manually removed.2 Intake staff can be trained to estimate the age of incoming kittens based on the general guideline that they gain an average of 4 ounces (113 grams) each week. All kittens four weeks of age or older and weighting at least 1 pound (454 grams) should receive routine deworming with pyrantel pamoate and ponazuril, and an initial vaccination with a modified live vaccine containing Feline panleukopenia virus (FPV), Feline Herpesvirus-1 (FHV-1), and Feline Calicivirus (FCV).3 They can also receive a routine flea preventative like selamectin dosed for weight.2 Some shelters may consider giving nitenpyram if fleas are visible and the kitten meets minimum weigh requirements. Praziquantel may also be administered assuming the kitten has tapeworms. Shelters should screen for feline retroviruses before pairing unrelated kittens and ideally before placement in adoption, although this is not an absolute for individually housed kittens or individually housed litters of kittens.4
All cats/kittens entering the shelter should have a picture taken on intake and individual identification made. This is essential for accuracy of medical records. For litters of underage kittens too small for ID bands or microchips, consider an alternate way of identifying them with something like writing a number inside their pinna with a permanent marker or using different colored dots.5 Each should be assigned an individual animal ID number just like any other animal entering the shelter on intake. Cage cards help track the individual identification numbers and will be important for maintaining accurate medical records and tracking daily weight.
Intake staff should be trained to do a basic physical examination to identify any medical concerns. This is important for identifying common illnesses like URI and conjunctivitis and for identifying any animals needing immediate veterinary attention. All cats and kittens should also receive a routine Wood’s Lamp Screening as part of their intake exam so that any ringworm suspects can be immediately identified.6
Click here for a video from Maddie's Institute demonstrating a physical exam on an orphan kitten.
Upon admission, all kittens between four and 20 weeks of age should receive a vaccination with a modified live product containing FPV, FHV-1, and FCV and then boosters every two to three weeks until 16-20 weeks of age while in the sheltering environment.3 A modified live vaccine is preferable in the animal shelter facility because the potential onset of immunity is much faster than with a killed product.
Cats should be vaccinated low in their right forelimb following AAFP vaccination site recommendations. All cats over 20 weeks of age should receive a vaccination with a product containing FPV, FHV-1, and FCV on admission and then one booster in two to three weeks.3 For most shelters, the benefit of vaccinating the pregnant or nursing queen outweighs the risks of not vaccinating her.7 While there is a possibility the kittens may develop cerebellar hypoplasia due to vaccination of the queen, natural infection with panleukopenia will often prove fatal to both the queen and her kittens. Vaccinating a nursing queen does not provide any protection to the kittens. They only receive maternal antibodies from the colostrum they receive in the first one to three days of life.
Kittens in foster care should be scheduled to receive their first vaccine at four weeks of age if weighing at least 1 pound (454 grams). Vaccinations can be harmful to kittens under four weeks of age and may cause cerebellar hypoplasia.
Pyrantel pamoate should be repeated with each booster vaccine until kittens reach 16 weeks of age; then monthly until six months of age. Selamectin can be given routinely each month. All cats and kittens over 12 weeks of age may receive a rabies vaccination during a veterinary examination.3
A robust foster program is essential to a kitten nursery. Foster homes provide kitten care for shelters without 24-hour nurseries and for kittens not thriving in the nursery setting. An extensive foster program is also an invaluable source of temporary homes for kittens when no space is available at the nursery. Foster parents can also be an extension of the adoption program by supporting community adoption events and even finding homes for the kittens they foster.
Setting up a nursery will be easier for shelters with a well-established foster program. These shelters can rely on foster parents who will retrieve orphaned, unweaned kittens on the same day they arrive. Foster parents great at bottle feeding can “trade-in” a litter transitioned to solid food for a new litter of unweaned, orphaned neonates instead of fostering the older babies until ready for adoption.
Enlisting new foster parents is an on-going endeavor for all shelter nursery programs. Social media, the shelter’s website, and word of mouth are all traditional ways to recruit foster parents, and a “kitten shower” is another recruitment tool. Fosters also need to know what the shelter will provide, such as medical care, food and litter, and that the shelter takes the kittens when ready for adoption unless the foster parents find adopters on their own.
Another way foster homes help in the height of kitten season is by keeping foster kittens until shelter space opens for them. Foster parents will also often volunteer to bring the kittens living in their homes to offsite adoption centers on weekends or bring them to shelter-hosted adoption events.
By far, the biggest risk to underage kittens is exposure to infectious diseases, therefore every action within the nursery from feeding the kittens to cleaning the cages to nursery staff and volunteers entering and exiting the rooms must be performed to keep potential pathogens out or at least confined to one area. Even within the nursery, strict adherence to procedures preventing cross contamination cannot be overstressed.
One of the items highly recommended for each room is a bound or electronic copy of all protocols. Those protocols should include detailed step-by-step instructions on cleaning everything within the room, such as cages, toys, bedding, bowls, and litter boxes. Not only should the order of completing the task be included so should the finer details, such as how to change bedding or measure out the proper amount of food. Between the written protocols and the nursery staff/volunteer training, ensure each person working within the nursery understands not only the practices but also why adherence to them is so imperative.
The best practice for gowns and other protective garments is to assign one gown or smock to each cage. Staff or volunteers must wear the assigned gowns when cleaning, feeding, and socializing the kittens in that cage. These gowns should be stored above or below the associated cage. Another option is using disposable gowns. However, this method is often too costly for a shelter budget. Whichever procedure is used, staff and volunteers must understand the significance of wearing and, when necessary, changing the protective garments, and never, ever wearing them outside of the particular nursery room. They must also understand the need to change gloves between cages. These practices may be impractical for some nurseries, but allowing any contact between items in individual rooms opens the pathway for the spread of infectious disease.
If for any reason the above practices cannot be followed, the constant potential for exposure is always present so additional procedures designed to minimize the risk are necessary. If one gown per cage is not possible such as in a room with no way to store the gowns, an alternative practice allowing the use of one gown per person within a single room requires these additional steps:
Within the nursery, one of the most important allies in fighting potential pathogens is a good disinfectant. Any disinfectant considered for use should be researched for required concentration, contact time, and efficacy against different pathogens, as well as staff and animal safety concerns. The respiratory tracts of all cats but particularly kittens are sensitive and easily irritated so the disinfectant must be both powerful against the pathogens targeted and yet gentle enough to not make kittens more susceptible to upper respiratory infections. Accel, an accelerated hydrogen peroxide, is one possible choice for a kitten nursery disinfectant. Not only is Accel effective at the correct concentration against calicivirus and panleukopenia with a 5 minute contact time but it is also effective against dermatophytosis with a 10 minute contact time.5,8
All cages undergo deep cleaning after the cage is vacated, before it can be used again. A deep cleaning is also recommended anytime a cage is heavily soiled. Deep cleaning involves emptying the cage and cleaning every part of it with a disinfectant. If kittens are still residing in the cage and you have double sided housing, the kittens can be shut on one side while the other side is cleaned. If you only have single sided housing consider having feral cat dens or carriers in each cage that the kittens can be shut in and removed during deep cleaning. Nursery staff and volunteers cleaning the cage must know how to remove all items properly to prevent the potential spread of diseases. All organic debris (scattered litter, food or clumps of feces) must be removed before disinfecting begins. The debris should be carefully removed, taking care not to scatter it onto the floor or cage below. Once the cage is free of loose debris, all surfaces of the cage, including the doors and ceiling, must be cleaned before disinfecting to remove any caked-on debris. Nursery protocols should include descriptions of what to discard, what to clean or launder, and how to safely do so. Disinfecting the cage involves spraying the disinfectant inside of the cage, covering all surfaces, including the ceiling. A controlled spray is necessary so no misting or splattering into neighboring cages occurs. One way to avoid inadvertently spraying the nearby cages is to liberally spray a clean rag and wipe down the edges and doors of the cage. Spray the cage again using the disinfectant and wipe down all surfaces of the cage, including the doors with a clean rag. Allow this second application to sit for the product’s recommended contact time before wiping dry with another clean rag. If using Accel, no rinse is needed. Place a fresh litter box with litter, empty food/water bowl and towel or blanket inside the cage. The cage is ready to use again. For more information, refer to Sanitation in Animal Shelters.
Spot cleaning of cages must be done daily. Spot cleaning involves light tasks such as freshening the litter box, wiping up spilled food and water, removing any feces, and so on. As with any other task that involves interacting with the kittens or the cage, the staff member or volunteer must wear a gown and new pair of gloves. Kittens need not be removed from a double-sided cage if the kittens can be kept in the side not being cleaned, or if it is not double-sided, if the kittens can be shut inside a feral cat den. Kittens may need to be moved temporarily to a clean cat carrier if the cage is not double-sided or does not have a feral cat den. Cleaning tasks should follow the nursery’s protocols. At a minimum, bowls should be cleaned if required, food and water refreshed, litter boxes scooped or emptied, and the bedding straightened or replaced if soiled. If bedding or other items are removed, nursery staff should know never to handle items such as bedding or newspapers in a way that might spread fur, litter, or other organic debris outside of the cage or the trash bin. This is another precaution to prevent the spread of potential pathogens. All bedding, toys, and newspapers may remain in place during spot cleaning if not needing cleaned or replaced. For more information, refer to Sanitation in Animal Shelters and Spot Cleaning Cat Cages.
The same sort of care taken with cleaning the cages must also be applied to general nursery cleaning. Nursery staff and volunteers must use only the room’s color-coded cleaning items and supplies. All countertops in the room must be cleaned, then sprayed with disinfectant. Swept floors need to be mopped with disinfectant properly diluted for the task per the manufacturer’s recommendations. Heavily soiled spots (encrusted dirt, food, litter, etc.) need to be scrubbed.
Dirty carriers, transport cages, and feral cat dens should be cleaned and dried outside the nursery, then sprayed with a disinfectant solution mixed per manufacturer’s recommendations and allowed to sit for the required contact time. The items do not need to be rinsed if Accel is being used and must be allowed to dry.
Dirty laundry (bedding, rags, gowns, etc.) should be kept in laundry baskets or containers and never piled on the floor. Laundry baskets should have a fresh trash bag placed in them daily so the laundry can be taken to the laundry room without removing the basket from the room. This method helps prevent any cross contamination. Heavily soiled items or items that contacted panleukopenia or dermatophytes must be thrown away immediately. Towels, sheets, blankets, pillow cases, washable pet beds and pillows are to be washed with HOT water. Overloading a washing machine results in a “less than clean” condition. Persons handling dirty laundry need to wear protective gowns to keep from contaminating personal clothing. When handling clean laundry, nursery workers must make sure they are not wearing a contaminated gown to keep from contaminating the laundry.
Using disposable litter pans eliminates washing litter pans in the same area, and often at the same time, as the bowls, dishes and toys. Having a dishwasher in each of the nursery rooms to wash the dishes would be ideal but not practical for many facilities. For manual washing, hot soapy water should be used for washing bowls, dishes and plastic toys. After they are cleaned, the items should be soaked in a disinfectant solution for the recommended concentration and contact time, then rinsed with fresh water. The easiest way to ensure compliance with this three-step cleaning process of all dishes is to set up a cleaning area with three utility sinks in a row. Let items air dry before returning them to the cages.
Bottle feeding equipment must be cleaned after each feeding. Each bottle and nipple must be washed with soapy water until all residues are gone. Disinfect the feeding equipment in the strength recommended by the product manufacturer (For example, if using Accel, the solution would be 1:64 or two ounces per gallon of water) for the recommended contact time, then rinsed with fresh water. If available, a dishwasher is the best way to disinfectant the feeding equipment. Allow all bottles and nipples to dry before the next use. For more information, refer to Sanitation in Animal Shelters.
It is important to have a plan in place so nursery staff and volunteers know who to contact and when for a medical concern with kittens in the nursery. You want to ensure that kittens receive immediate attention when needed but that the nursery staff and volunteers do not contact medical staff constantly. One way to manage this is through a list of medical warning signs so that they know what they should do. In the example below, a system with a list of red flag and yellow flag signs was established.5
Red Flags – if any of the following occur, alert the medical staff member on call immediately.
Yellow Flags – if any of the following occur, monitor the kitten, alert the nursery staff member, and fill out a veterinary exam request form. These forms are checked at least once daily.
Many kittens will be admitted into the facility in poor body condition, heavily parasitized, and suffering from mild illnesses.1 While we cannot cover everything in depth here, it is important to mention that there should be nursery protocols in place for diagnosis, treatment, and prevention of the common illnesses seen in the local kitten population. Conditions to cover include things like flea infestation, flea anemia, ear mites, intestinal parasites, coccidiosis, upper respiratory infections (including feline herpesvirus and calicivirus), conjunctivitis, diarrhea, dermatophytosis, and panleukopenia
The number of dermatophytosis cases vary, often by season. An increase in the prevalence of the disease usually coincides with “kitten season” and for some regions, it is a constant challenge. Regardless of the geographical location of a kitten nursery, underage kittens often come in with ringworm. Intake staff must be trained on what the next steps will be for any cats or kittens with a positive Wood’s Lamp exam at intake or with suspicious alopecia.
Any staff handling ringworm suspects should wear a gown and gloves, plus take precautions to avoid contamination of surfaces like an examination table. To avoid contamination of work surfaces, disposable drapes are a great option, followed by disinfection with a product effective against dermatophyte spores. Confirmation of a diagnosis of ringworm requires a visual examination, Wood’s Lamp examination, direct microscopic examination of glowing hairs, and a fungal culture.7
All shelters in general, but particularly those with a kitten nursery, should develop formal, written protocols dealing with any ringworm positive cats in their care. These protocols must address diagnosis, isolation, treatment, cleaning protocols, and clearing the cats or kittens for adoption. For more information, refer to the Ringworm Guidebook.
Any animal shelter taking in cats and kittens dreads the appearance of a panleukopenia positive cat. Panleukopenia can be absolutely devastating in a kitten nursery. The nursery population is vulnerable and a large number of kittens are housed within the facility. Strict isolation of the kittens in the nursery and sound protocols help minimize the spread of panleukopenia, but even these steps will not completely stop isolated cases from occurring in newly admitted kittens exposed prior to admission and asymptomatic on intake.
Panleukopenia diagnosis can be made on a snap ELISA test for canine parvovirus and suspected with an extremely low white blood cell count diagnosed on CBC.9 Since sudden death can occur in kittens that appeared healthy the day before, any kitten found dead in its cage should be tested for panleukopenia.1 Sound medical, vaccination, isolation, and cleaning protocols help minimize the potential for spread of the disease by any kitten shedding the virus. A written protocol for panleukopenia must be developed and staff and volunteers must understand the importance of adhering to the protocols and understand how devastating the spread of this virus would be. At a minimum, the panleukopenia protocol addresses diagnosis, isolation, treatment, cleaning protocols, and the decision to euthanize. Any panleukopenia positive kittens, as well as their cagemates, must be removed from the nursery and placed into a strict isolation area for treatment. The potentially exposed kittens in the room must be quarantined for 14 days. For more information, refer to the Panleukopenia Guidebook.
Nursery staff and volunteers need to observe kitten health on a daily basis. This task should include monitoring of appetite, urination, defecation, any concerning signs, and updating weight. Tracking the kittens’ health and progress is most easily accomplished with individual monitoring sheets, which are kept in a room binder. Keeping the sheet on the cage may seem more practical, but with the messiness and playfulness of kittens, the binder is usually the safer option for the paperwork.
Each room should post a schedule for daily veterinary rechecks and the handling of any emergencies that arise. The staff and volunteers can be trained to prioritize any health concerns with a method like the red and yellow flags outlined.
Abandoned kittens are often underweight, heavily parasitized and suffering from an untreated illness when admitted to an animal shelter, which makes the care of them in the nursery even more challenging.5 Only good protocols and practices strictly followed by everyone entering the nursery will afford these kittens the opportunity to flourish and survive. Therefore, all persons involved with the nursery will need some level of training.
Good training involves a variety of teaching techniques – short seminars, guided tours, hands-on practice, and shadowing.5 It is likely that a majority of the nursery staff will be volunteers. These persons may have little knowledge or understanding of caring for these vulnerable kittens. Training should cover both the “what” of the practices and protocols plus the “why.” Both staff and volunteers need to know “why” adhering to each and every practice is critical to the health of the kittens. Learning the protocols and basic steps in caring for the kittens is good seminar material.
Depending upon staff/volunteers’ nursery roles, hands-on training might include learning to draw blood, do fecal floats, calculate meds, give meds, and make entries into shelter software.1 In one form or another, training must cover every step and procedure for caring, cleaning, playing, and feeding from intake to adoption release. No matter how good and engaging the training is, people will not recall everything covered. If relying heavily on volunteers, at least one to two staff members should be on each shift to supervise, ensure consistency, and relay important information. A good handbook is also an essential, so all nursery staff and volunteers should receive, or have access to, a nursery handbook.5
All of these kittens that have gone through the nursery and foster programs will need homes because ultimately that is what all of this is about! Shelters with nurseries will need some creativity to supersize their adoption programs. There are several things that can help. Move kittens into adoption as soon as possible because they are most desirable to adopters at the six to eight week age range. Market the nursery and adoption program by letting adopters know that the kittens are “graduates” of the nursery program. Have adoption specials and make them fun like “Free Feline Fridays” and “Two Purr One.” Consider using adoption space at local pet stores if available. Do not underestimate the power of the internet and social media. Increase adoptions by using good photos, bios, videos, and marketing on your website and your social media outlets.
Build a media partnership. Many local television stations run animal shelter adoption segments during news programs. Be available to television, radio, and newspaper media for interviews. Often television and radio stations will run community service notices (such as an adoption event) and newspapers usually print press releases free of charge.
Expand on your community partnerships. Large weekend events with coalition partners draw in many more potential adopters. This approach eliminates competition between agencies – advantageous because it strengthens community relationships, pools marketing funds, and allows more ways to “spread the word.”