Dogs have problems with a condition similar to FCK, and breeders sometimes call it 'Swimmer Puppy'. It seems to be very similar to kittens (although it may not be the same condition), and a useful website that suggests a way of helping the puppies may offer hope to cat breeders with FCKs. The key seems to be to persuade the kitten to lie on its side rather than on its chest. Please take a look at this link and PLEASE let me know if you try this and it works with your kittens - it could help a lot of kittens to survive.
According to the puppy people, the normal sleeping position for a kitten is on its side, but ones that develop FCK end up sleeping on the chest: this must exacerbate the flatness, as well as keeping the kitten in an unnatural position, which may be bad for lung development. The key to the puppies is to force them to lie on their sides, and the breeders do this by a combination of sitting over the puppies and continually turning them back onto their sides both when resting and when feeding, and also by putting them into a sock stuffed with cotton balls that makes a rounded shape on the underside of the body, thus rolling the puppy onto its side when it is relaxed.
If you are not able to devote this sort of time to your kittens, then please give them to someone who can. It would be terrible to lose one of these brave little lives because your other commitments prevent you from caring for it. Think very carefully about the wisdom of continuing to breed if you cannot take time off to look after kittens if anything goes wrong: breeding is time-consuming and often requires sacrifices, and if your work or life prevents you from being there to support a struggling kitten then breeding may not be the right thing for you.
I am able to report that in late 2004 and early 2005 four breeders with affected kittens had success in taking action on the physical symptom (the flattened ribcage) by 'splinting' the ribcage (and several breeders have since tried it succesfully). The first two did this with a cardboard toilet roll, cut to shape. This was curled tightly around the body and tied in place so that it pressed on the sides of the ribcage, pushing the flattened portion back outward. The curved underside meant that even lying on its front, the kitten was not putting pressure directly on the ribcage, so its sleeping position was not making the condition worse.
One of the breeders who tried this said the tube did not make the kitten roll over onto its side (see below), but although this helps, simply lifting the chest off the floor of the bed will relieve the immediate pressure on the flat surface, allowing it to expand out naturally if it is able to do so. It is clear that pushing the sides of the ribcage in can provide immediate relief to a kitten that is having breathing problems. I think this could be a life-saving solution to the condition. We still don't know what causes FCK (and there IS definitely a genetic component, or we would not be able to predict it happening in certain lines), but if this turns out to be an effective treatment we have won a very large battle. The puppy breeders use a sock, but because kittens are so much smaller and more delicate to handle, I think the toilet roll solution is far better.
There are two warnings to be aware of if splinting:
If the ribcage is beginning to poke inwards, or the sternum (breastbone) is already poking in, pressing on the sides could force the sternum inward rather than outward and kill the kitten - make sure that before you try anything you are CERTAIN that the sternum will move outwards when the ribcage is compressed by pressing it gently with your fingers first. If in doubt, just put the roll on loosely and work on making the kitten lie on its side. This should be sufficient if the key is indeed to prevent the kitten lying on its front. It is always a good idea to consult your vet about anything like this, and he or she should be able to advise you on whether your kitten has an inverted sternum or not if you are unsure. Many vets are skeptical about information found on the internet: if this is the case, please direct them to this page where they can access the veterinary article for themselves, or else print the article off and take it to them.
Second, be patient and gentle - tighten the splint gradually in stages (over hours or days) or you could harm the kitten or break ribs by forcing. One breeder of Maine Coons had a kitten who was struggling with breathing, but as soon as she splinted him he could breathe again. She is not the only breeder who has tried this and been successful. Many thanks to this little fellow's mummy, who kindly took these excellent photographs. He's now doing very well and only wore the splint for a week.
Another breeder was kind enough to send me his thoughts and some photos of what he thought about this solution... 'Your pic of a kitten in a cardboard tube would do nothing to keep kitten on its side or put pressure on his sides instead of front of chest. I did something else. The ridge keeps the kitten sleeping on his side and he can not put pressure on his tummy side'. Although some people seem to have been successful with the tube version, we have no way of knowing if the kitten would have survived anyway or not, so it's a good idea to consider everything that may help. The younger a kitten is, the more likely the splint will succeed, and the quicker it will show results. However you have to be careful if a kitten seems all right and you remove the split, in case the chest flattens again. If caught within a few days of developing, a week in a splint seems to be enough to reverse the damage. Older kittens may need a lot longer. You can take the splint off to check the condition and massage the ribcage, though if it is hard to get it on and off in the right position then you may find it easier not to do that.
Feedback from breeders is essential to learn more about FCK and different ideas and experience can refine our ideas and solutions. I am very grateful to Barbara, a Burmese breeder in Germany, who read this information and made a website with very clear and informative pictures showing her kitten and his progress with the splint. She and her vet also thought that the join in the tube should be below the ribcage rather than above the back, to encourage the kitten to lie on its side and her results are really encouraging. Her website is here: http://www.burmesen.com/chester2.htm. Sadly, Chester died after initially improving dramatically, but it is clear that the splinting did relieve his problems while he was alive.
More information from someone who read this page: 'We have an FCK and we printed the information you gave on the internet and brought it to our vet so she could see about the brace. We made a brace/splint only we made it differently. Ours doesn't go over the front legs. To make this brace use a soft curved piece of plastic about 1 1/2 inches wide and about 3-3 1/2 inches long depending on the size of your kitten. We got our plastic from an 8.75 oz Sunny-Delight bottle. Then took the plastic and covered it with horse wrap, so the plastic would not iritate the kitten. Envelop the 6'' horse wrap around the plastic piece leaving enough of the horse wrap extended to go around twice. Wrap it snuggly yet comfortably around the kitten's chest under the front legs. You should change the horse wrap every 2-3 days, for it loses its stickiness. (it sticks to itself not the kitty) Our baby is doing quite well.'
If splinting turns out to be a viable and practical solution, it could save a lot of lives, but bear in mind that sometimes the FCK seems to be caused by poor lung or heart development, not the other way around, so even if the ribcage is rounded out again it may not solve the underlying problem, and the kitten may still die. However this is much more hopeful than any of the other things that have been suggested in the past, giving instant relief to a kitten having difficulty breathing. We do know that sometimes the internal damage is caused by the FCK and not the reverse, so please let me know if you are trying splinting, and please do let me know the outcome. The cases I have been told about so far are of single FCK kittens in a litter; it would be very useful to know of a case where this is tried with a whole litter that has gone flat, as the condition tends to be more serious in these cases, and the incidence of survival is lower.
Vets in Holland seem to have more experience of FCK than those in the UK, including it in their training, and have taken a more pro-active attitude to treatment: they recommend physiotherapy and massage on the thorax every three hours for 24 hours a day or more often if you can do it. This is combined with treatment using anabolic steroids (Bolbane) pioneered by a practice in Zeist which they believe speeds up the changes initiated by the physio. Unfortunately for English speakers the site is only in Dutch, but since the Dutch usually speak very good English, your vet may be able to contact this practice for more information (the vet is called Nico Dijkshoorn). A success story from Holland using this protocol can be read here: www.felinefantasy.nl, look at: a cat's tale > Smirnoff's Story.
Some vets also recommend making a flat-chested kitten move more by pulling it away from the mother so that it has to work to get to the milk, and also encouraging it to cry, though without distressing it unduly. The thinking behind this is that it will strengthen the muscles used in breathing and this may encourage the ribcage into the correct shape. I have no idea whether this works or not, but I suspect the extra energy the kitten is forced to expend is not helpful if it is already losing weight because it is not feeding well.
Finally on splinting: some kittens are extremely distressed by splinting, and the distress it causes would be counter-productive in attempting alleviate symptoms. One breeder reported that her kitten was gasping for breath after screaming because it did not like the splint. You need to gauge how the kitten is reacting to make sure that the pressure you are providing is not too great, and also that having a splint on is not going to upset the kitten so much that it expends too much energy fighting or crying, and that it stops feeding because it feels it cannot move. If you cannot splint because it distresses the kitten too much, then use massage and GENTLE pressure on the ribcage to keep encouraging it to a normal shape. Do this as often as you can. DON'T do it while the kitten is suckling, or it may stop suckling because it associates feeding with something nasty happening to it.