FIE is one of the diseases that, in Ireland most cats are vaccinated for as a standard, and with good reason – it is well known for sudden and often unexplained death in kittens. While fostering in the autumn of 2008, we learned the meaning of this several times, but most sharply with Hershey. This gorgeous kitten was in perfect health one minute, dead the next. We also saw the extreme variation in the severity of the virus – this again was most apparent within a single family, the Coalshed Crew.
One of the things that scared the be jaysus out of us when we first searched for FIE on line was the amount of sites that stated categorically 90% mortality rates in infected kittens. THATS A HUGE NUMBER! We found this discouraging to say the least. Did this mean we were destined to loose almost all our kittens? A single website found during our search gave us a glimmer of hope – while not sounding much different from the others, it suggested lower mortality rates, provided adequate care was given.
As mentioned previously, our mortality rate was only 29% compared to the 90% most sites state. We’re terrified that the 90% mortality stat will lead vets and individuals to give up on their FIE kittens. We had plenty of time to care for these kittens (not the case in many shelters) and we strongly believe that palliative care, time consuming though it is, can give hope for kittens struck down with FIE.
All of the vets that saw the kittens in the beginning failed to see the potential for FIE in the symptoms. Admittedly, none of the kittens displayed typical symptoms, and some of them displayed symptoms that were so broad you could include half the medical dictionary. In the end it took sitting down and racking our brains, to finally realise we could have an FIE outbreak. At this stage the disease had moved from the Leaded family, through the Stones and on to the Candies and Spices. By the time FIE was first mentioned we had already lost both Nutmac and Mica, and both Sherbert Dip and the Stick began to show symptoms.
The one piece of advice we can give as a result of this is to weigh your kittens once or twice daily until they’re old enough to be vaccinated. Any weight loss, or lack of weigh gain, can then be spotted immediately and acted upon. It’s very easy to miss weight loss in kittens otherwise and it’s one of the best ways to spot FIE onset (or any other problem for that matter).
After much surfing and book scouring, it turned out we had followed the correct path of action by offering the sick kittens palliative and supportive care. FIE is a virus and, as such, there is no cure. Supportive care aims to keep the patient alive long enough for the immune system to respond and for the animal to recover. FIE has been compared to Parvo virus in the dog, though the viruses are unrelated, and Parvo has a hospital stay of seven to ten days. FIE is described as being ‘more fatal’ than Parvo in the dog, but basic treatment remains the same.
Originally we tried putting the kittens on a plain diet of chicken and baby rice. FIE strips the lining of the intestine which often causes repeated bouts of vomiting, so the idea of the plain diet was to reduce the likelihood of the food irritating the gut and causing vomiting. However, after further exploration it turned out the baby rice was too complex a carbohydrate for the little ones to easily breakdown and they refused to eat full stop, so the chicken was wasted. We also tried Cimicat (the cat milk substitute), Complan and eventually found that Hills Science Plan a/d diet mixed with baby porridge worked quite well. The porridge was easier for them to digest and the a/d is for animals recovering from trauma, surgery or illness – it has a higher level of protein, which is used by the body for growth and repair of damaged tissues. We mixed these together to the correct consistency to syringe feed the kittens. We also supplemented them by offering either Complan or Cimicat by syringe.
So a feeding regime of every two hours was established. It started by giving approx ten mls every two hours and gauging the reaction of the kitten with regards as to how to proceed. If the food stayed down the next feed would continue as the previous. If the kitten was sick then the amount was reduced to five mls and we started again.
The veterinary advice we were given was again supportive. The kittens were given antibiotics to cover them for secondary bacterial infections such as pneumonia. They were also prescribed an antacid (Gaviscon) to try and line the stomach, and severe vomiters were prescribed Maxolon to try and prevent vomiting.
Dehydration is another huge problem associated with FIE, and one of the symptoms is described as ‘the cat will sit with its head over the water bowl, unable to drink’ (see Paraffin’s picture on the previous page). Our guys were given fluids under the skin by vet staff and, if they would drink at all, their water was supplemented with small animal lectade to try and keep them hydrated. Along with the subcut fluids the vets administered duphlyte. This contains amino acids and electrolytes as well as B vitamins, which are vital to the breakdown of protein and indeed the manufacture of red blood cells. The FIE virus is also known for destroying the red blood cells and the electrolytes give the animal some form of energy.
All of this sounds fine until you actually try to force feed sick kittens that don’t want anyone to disturb them. Some of them were very good and took their handling pretty much in their stride, others refused to be fed and would struggle continuously throughout. This made the nursing harder, as we often questioned was it fair to make them eat? But if they didn’t eat they died, and kittens don’t understand basic biology – if the force feeding could ensure that they would survive the infection and lead a perfectly good life afterwards, was it not worth the struggle? I think Paraffin would agree – without force feeding she would have died, no question.
A couple of ways we managed the struggling was to scruff the kitten and hold them so their head tilted backwards slightly. The mix of food could then be syringed in to the side of their mouth SLOWLY and would run back down their throat – the kitten would be obliged to swallow. Another method was to wrap the kitten completely in a towel so all their legs were taken out of the equation entirely and only their mouth was there to be dealt with.
FIE is highly infectious! This is why it’s the bane of animal shelters, catteries and multi-cat households. It occurs most commonly by direct contact with infected cats or their excretions. During the early stages of the infection, virus is shed in faeces, urine, saliva, and vomitus. In addition, fleas may transmit FIE from infected to susceptible cats during the acute stage of the disease. The virus may also be spread by contact with contaminated objects, such as food bowls, litter pans, bedding, and cages, or by persons (on hands or clothing, for example).
It’s important to know that FIE can be transferred distances on your clothes, or anything you carry from the infected site – Jenni took FIE from my house to hers just by moving between the two places. The virus is incredibly difficult to kill and can stay in the atmosphere for months to years. Even smothering everything in bleach can’t guarantee you’ll kill the virus in the atmosphere. I won’t be taking anything unvaccinated into my house for at least another year because of the danger. It’s not worth risking a cat’s life.
The good news is that the standard feline vaccination protocol includes a vaccination against FIE. And the FIE vaccination is long lasting – perhaps even for life. Cats can be vaccinated from eight to ten weeks of age. Please vaccinate your cats!!!!
We don’t know why some kittens are more affected than others. In one family alone, the Coal Shed Crew, we had the whole range, from Hershey being perfectly healthy one minute and dead an hour later, to Caramello who’s symptoms were nothing more than poor appetite for a few days, with the other three kittens on a sliding scale in between. If the kittens’ mum is immune, her milk can contribute to the kittens immunity for the first few weeks of life. Beyond that we’re at a bit of a loss and can’t find any information.
However, we have found one significant correlation (without doing a scientific study I hasten to add): of the kittens old enough to be vaccinated, those exposed to the virus and then given their first vaccination were the most severely affected. Of the Candies and Spices, only Liquorice Stick was not vaccinated and she and Riko were the only survivors. All the vaccinated kittens were seriously ill and Riko was lucky to survive at all. FIE had not been diagnosed at the time (and it was these guys’ illnesses that finally got the vets to recognise it) and they were only in the house three days before being vaccinated, showing perfect health. But they must have had the FIE in their system and our experience suggests that something about the vaccination allowed the FIE to kick in with a vengeance. This was highlighted for us recently when Temperance was vaccinated (despite the fact that she seemed to be showing signs of FIE, which was utterly utterly wrong of the vet) – three days later she was dead, despite palliative care, the most severe case we’ve come across.
If anyone has any information on FIE and vaccinations please do let me know!