The Case of the Comatose Kitten

History:

This kitten was brought in by a woman who found the kitten by her driveway.  It was not her cat so there wasn't a lot of history.  The things she could tell us is that in the morning she had seen a "dead cat" by her driveway but she was in a hurry to get to work so she told herself she would deal with it when she got home.  When she returned home about 3:30 pm she went to move the cat and it moved!  She put it in a box and brought it in.  By the way, this was October of 2009 and very cold with snow already on the ground!

Thanks to our wonderful clients who donate to Robyn's Fund for Strays we are able to take in and care for some strays that are brought in.  It is up to the discretion of the veterinary team to make the decision as to whether the pet is treatable and do we think we can find the pet a good home.  At this particular time we did have some money available in Robyn's Fund but it was impossible to tell if this kitten would be a good pet - we have no idea if it is nice, feral or aggressive because it is comatose and near death.

If you have worked through the other cases, you know the next step is the physical examination.  This picture isn't the kitten that came in, there's no time for pictures in a life and death situation.  This kitten actually looks good compared to the stray on the exam table that day.  The things that are similar is it was a brown tabby, terribly thin (a body condition score of 2/10 with 5 being "normal").

Physical Examination:

The kitten weighed in at 1.3 pounds he was comatose with miotic pupils (very small pupils) that were non-responsive.  His heart rate was very slow (70) - normal for a kitten is 140-170 when here in the hospital.  His respirations were 2-3/minute.  His temperature would not register on the thermometer.  He had fleas all over him.  His gums were pale.  He had all his baby teeth in but no adult teeth yet.  No broken bones were found.   It doesn't look good for this kitten. 

Problem List and Differential Diagnoses:

Comatose- Low blood sugar, head trauma, infection (rabies), shock, toxin, congenital abnormality, nutritional disorder (he is thin and he is a stray)

Slow heart rate and respiratory rate - impending cardiac arrest, shock, blood loss, toxin - a slow heart rate in a cat is a VERY POOR prognosis

Pale gums - blood loss, toxins, shock

Fleas - fleas are what they are - no real differentials, however, you do have to think about what they cause - they eat blood so they can cause blood loss and anemia and they can transmit diseases (tapeworms, cat scratch fever, tularemia to name a few)

This is the hardest decision ever in veterinary medicine.  Most of the time we are making the decision with an owner and helping them decide what the best thing is for their pet and their situation.  In this case, this kitten would likely take extensive care, deplete our fund for other strays that might be able to be helped and we don't know his personality.  A decision must be made and it must be made quickly as he is running out of time.  Do we help him cross the Rainbow Bridge or do we try to save him?

 A Leap of Faith...