Obligatory Disclaimer: I am not a vet. This is not veterinarian advice. This post is simply a summarization of my experience and expert advice I have received.
I’ve been asked before what I do to treat feline paneukopenia. And I’m going to go over in detail what I do and why. I would like to state that I shouldn’t be given credit for most of this information. It came from the shelter I worked at, particularly from Dr. Hillary Herendeen, Clinical Assistant Professor of Shelter Medicine at Midwestern University. Here is a copy of the protocol guidelines she developed.
Symptomatic vs. Directly Exposed vs. Indirectly Exposed
When a kitten tests positive for panleukopenia, you not only have to deal with that kitten, but any kittens and unvaccinated cats it may have had contact with over the past few days. In a foster situation, you have to consider all unvaccinated cats/kittens in your house. (Vaccinated, healthy adults are not at risk for panleukopenia.) And these kittens generally fall into three categories: kittens who are symptomatic, kittens who had direct contact with a panleuk positive kitten, and kittens who may have had indirect (or secondary) contact with a positive kitten.
Let me give you an example from my past. I had a kitten who developed panleukopenia. The kittens who were being housed with him were directly exposed, but not symptomatic. All other kittens in my house were considered indirectly exposed. (Even though I keep litters separate in different areas, panleuk can be spread fomites. For more information, see Cleaning After Paneukopenia.) Each group is treated a little differently. All three groups are considered “exposed” and quarantined for 14 days.
So let’s talk about what is done and why:
FVRCP Vaccines (All)
Any kitten that is 4 weeks old (or 1 pound) is given the FVRCP vaccine immediately. The vaccine can start producing antibodies for panleukopenia within three hours, so the sooner it is given the better. Ensuring every kitten that can be vaccinated has been vaccinated. The 1 pound weight is used when the exact age is unknown. If one kitten in a litter is 1 pound, all kittens in the litter can be vaccinated.
Kittens who have been vaccinated should receive a booster every 2 weeks. While you may have concerns about vaccinating kittens this young, remember you are doing this to prevent death. Vaccinated kittens are more likely to develop a mild case of panleukopenia. Vaccinate all kittens who have even the slightest chance of getting panleukopenia.
Case in point is a kitten I called Valkerie. At the time, I was housing her with two other litters. All had been quarantined for 14 days prior to putting them together, but one of the other kittens developed panleukopenia. (As far as we can determine, I may have carried it home as I was volunteering in surgery at a shelter.) At that time, she had direct contact with the kitten and had not been vaccinated. We immediately vaccinated her. She developed symptoms about a week later, but they were mild. She never got too sick and made a full recovery.
Deworming (All)
Aggressively deworming kittens is critical as an parasite will weaken their immune system. Typically, I will give them a dose of dewormer at the same time as they get vaccinated. However, according to Merck Manual, “Intestinal parasitism commonly complicates feline panleukopenia, especially in shelter environments, so use of anthelmintics (eg, fenbendazole, 50 mg/kg, PO, once daily for 5 days) is an important consideration and can be started once vomiting is controlled.”
Antibiotics (Symptomatic and Direct Contact)
Convenia has always been the antibiotic of choice for me when dealing with panleukopenia. Typically, we give it to every kitten with direct exposure regardless of symptoms. For me, this usually involves all kittens in the litter. But we won’t do it on kittens with possible secondary exposure, such as kittens in the same house but in a different room.
I like Convenia because it doesn’t usually cause the digestive issues that are common with amoxicillin and similar antibiotics. That makes it easier to monitor how things are developing. So if a kitten has diarrhea, I know its likely due to panleuk and not because of the antibiotics.
Cerenia (Symptomatic)
Kittens who are vomiting or anorexic (not eating) should be given Cerenia. As I’m not a vet, I don’t know much more about it except that is when it is needed and that is why it is given.
Sub-Q Fluids (Symptomatic)
Subcutaneous fluids are critical and need to be given in large quantities around the clock. Typically, I give about 3% (30mL per pound) given in doses every 6 to 8 hours. The fluids will not only help with dehydration, but also helps keep the fever down. (Keep this in mind whenever taking a kittens temperature.)
Metronidazole (Symptomatic)
Kittens with diarrhea, especially bloody diarrhea, are started on metronidazole. As I’m not a vet, I won’t say much more about this.
Fortiflora (All)
For panleuk, fortiflora is my go-to probiotic because I’ve been told it has an appetite increaser.
Vitamin B Complex or B-12 (Symptomatic)
Merck Manual recommends “B vitamins should be added to [sub-q fluids].” I typically give Vitamin B Complex injections. I know some recommend just Vitamin B12 as often as every other day, because it can help stimulate the appetite. But I have never tried it.
Vitamin B12 injections (0.05 to 0.1 ml for kitten and up to 0.25 ml for adult) every day or every other day is extremely helpful and important. Vitamin B12 is more comfortable, but diluted Vitamin B-complex (which is painful on injection) can be used if you give slowly in IV fluid line port or inject into the fluid bubble under the skin of the cat after fluids are administered SC.
Dextrose and Feeding
Some suggest reducing food during panleukopenia is a good idea. As I’m usually dealing with kittens under 2 pounds, I’ve never done this. Most kittens with panleuk become anorexic, so you aren’t able to get much food in them. However, it is not uncommon for panleuk positive kittens to develop hypoglycemia, so it is important that you get some food in them. (Source)
I do recommend feeding bland or consistent diet. I believe kitten canned food to be more consistent in ingredients than canned Fancy Feast. Or you may try ground chicken and pumpkin (but only for 2-3 days max as it is nutrient-deficient for kittens).
Pedialyte
Unflavored Pedialyte is used to help combat dehydration in kittens. It can be added to the food or water. (Up to 50% of the water typically.)