Practical relevance: Orphaned kittens are common and veterinary team members should be prepared to assist owners in providing appropriate care. If a foster queen is not available, the physiologic needs normally provided by the queen, such as warmth, nutrition, elimination, sanitation and social stimulation, must be replaced. Specialized knowledge of physiology and nutritional requirements is necessary for successful management in this age group.
Clinical challenges: The condition of neonatal kittens can deteriorate rapidly and orphans may have an even higher risk of illness than kittens cared for by a healthy queen. Thus an increased level of veterinary care and monitoring is required. Rapid recognition and correction of problems can only be accomplished through detailed observation and knowledge of developmental milestones. Survival may be dependent on treatment that compensates for the failure of passive transfer of immunity.
Audience: This review is addressed at veterinarians and all veterinary team members, as well as care-givers such as rescuers and shelter workers.
Evidence base: The guidance contained in this article is based on a combination of published literature, the author's personal experience and the experience of colleagues.