Tube feeding is the ideal route for ill or orphaned neonates. Weak neonates are unable to suckle effectively from an appropriately
sized nipple hole. Enlarging the hole to allow easy passage of the formula risks aspiration pneumonia. Tube feeding results
in quick, safe administration of appropriate nutrition. Use the largest French red-rubber feeding tube that can be easily
passed into the affected neonate's esophagus. Measure from the tip of the neonate's nose to its last rib with the head in
an extended position, and mark this length on the tube. This is where the tube must reach to be securely in the stomach.
Table 1. Feeding Protocol for Neonatal Puppies*
The appropriate amount of warmed formula for a neonate's age and species is noted in Table 1 and Table 2.1 These guidelines should be adjusted to attain appropriate daily weight gains. In general, feed 22 to 26 kcal/100 g/day.9 While some advocate feeding intervals greater than every two hours, I have found greatly improved survival rates when feedings
are maintained at two-hour intervals.
Table 2. Feeding Protocol for Neonatal Kittens*
If a conspecific foster dam is not available, use formula appropriate for the species. While homemade formula may be useful
in an emergency, commercial formula is recommended because it is similar to dam's milk (Table 3).10 If returning to the dam is not possible, cross fostering to an appropriate dam is ideal. Many puppies and kittens fed commercial
formula exclusively may develop diarrhea or constipation. Administering a probiotic supplement, containing normal beneficial
bacteria, is common in neonates. The goal of probiotic administration is to support and provide normal intestinal flora, but
no data exist on efficacy in neonatal puppies and kittens. The manufacturer should provide a product evaluation for content
of live organisms. If probiotics are given, daily administration is most likely required.
Table 3. Components of Milk*
Tube feed neonates until it is no longer possible to do so. Once neonates are too vigorous for tube feeding, bottle-feeding
can commence. Using bottles and nipples for premature infants is often more successful than pet nursing bottles, except for
very tiny neonates.
Kittens at risk for neonatal alloimmune hemolytic anemia can be removed from their dam before nursing and allowed to suckle
a lactating type A queen. Queens produce antibodies in their milk throughout lactation, so passive antibody transfer will
occur. Kittens can continue to be fostered on the type A queen or returned to their dam after 24 to 48 hours.11 For kittens and puppies that do not receive colostrum, passive antibodies can be provided by using serum from healthy, well-vaccinated
donors.11,12 In pups, 16 ml pooled serum can be given subcutaneously, either slowly or in multiple doses over 24 hours.12 To collect serum, obtain blood in a sterile manner from healthy, well-vaccinated donors free of communicable diseases. Once
the blood has clotted and been centrifuged, remove the serum and administer it in a sterile manner. In kittens, appropriately
typed serum given subcutaneously at a dosage of 150 ml/kg divided into three doses and given over a 24-hour period provides
passive antibody concentrations until at least 6 weeks of age that are similar to antibody concentrations of kittens that