New born kitten with torn ambilical cord

Question
My moms cat just had 5 kittens at 4 pm today, its her first litter and as the mother was removing the cord she created a flesh wound where the kittens intestines are pushing out ward but not coming out. the kitten is the size of about half your palm and the wound is the size of a thumbnail bed. We have no money to take it to the vet, I am going to get some sailene to wash the wound and gauze to wrap his tummy. The wound is starting to heal a bit around the edges but is dirty with hair and stuff. They were born inside so I don't think there is a maggot risk but I need to know if I am taking the right actions. i beleive the gauze will push the stomach back in where it is pushing out.
Please respond as soon as possible!

Thanks

Answer
Jessica,

I really don't have much experience with newborn kittens, so you may want to ask someone else.  However, I will speak purely from a medical point of view based on my medical background.

Anytime you have an abdominal wound where intestines are pushing out, it is considered a "dirty" wound.  The reason is because intestines are a dirty organ--they contain stool, which isn't clean.  So, when they start protruding outward, and if the skin should start to break, you've got a potential disaster on your hands.  That will most likely (actually 99%) get infected, and it will be a tough infection to treat, because stool typically has lots of different bacteria in and on it, but the most common is E. coli, which can be difficult to treat in cats--especially in a newborn kitten whose immune system is immature.  The fact that you mentioned there is hair and "stuff" around it concerns me because that already tells me bacteria have gotten into that wound.  Even if the skin isn't broken, all it takes is micro-punctures which are great portals for bacteria to enter.  These micro-punctures can be microscopic in size, not visible to the human eye, but tons of bacteria can enter.  This is likely happening with your kitten.  Therefore, it is extremely important for this kitten to see a vet!  Any type of skin break in the abdominal area is begging for a severe, nasty infection, and in such a young, young animal that's only a few hrs old, it becomes even more critical.  

If the intestines should start to actually break the skin where you can visibly see it, or they start "popping" through in any other way (dehiscence), you need to take a STERILE 4x4 gauze (several put together) soak it with NSS (normal sterile saline) and wrap it around the intestines that are protruding.  Then, gently place some dry 4x4's on top of that.  At that point, you NEED to get the kitten to a vet, because at that point, it becomes a medical emergency.  But the reason for keeping the wet 4x4's around the intestines is because any internal organ needs to be kept moist--all organs are moist-at least to some degree-and if they are allowed to dry out, they will become necrotic (dead) and the necrotic pieces will have to be cut off because they no longer have blood supply.  

So, that is why it's so important to get this kitten to a vet.  A vet should evaluate the degree to which the intestines are poking through the skin, evaluate if there are micro-punctures, and absolutley place that kitten on antibx.  You have to remember that a newborn kitten doesn't have any immunity yet, and as it drinks the mother's colostrum, it will gain some active immunity, but not enough to fight off a severe infection.  And until that kitten gets its first set of immunizations at 8 wks or so, it's not protected from much of anything (even after it's first vaccines, it's not protected, which is why a series of vaccines are recommended for kittens).  

I hope you can get this kitten to a vet, as this is truly one situation, based on what you've described, that warrants it immediately.  That thin skin or membrane covering the intestines, while skin, is very thin right now.  Anything can cause that skin to be broken, such as the kitten stumbling or falling into/onto something, the mother's teeth or claws, another kittens teeth or claws, etc. Also, even if this kitten sails through this with no sequlae, there's also the risk down the road of a hernia.

I just posted to someone before answering your question, about the organizations and societies that are available to provide financial assistance, as I needed help too.  If you google "veterinary financial assistance" or something similar (play with the terms), a whole lot will come up.  I had a $3500 bill, and was awarded $2500 from one organization, and $400 from another.  It was a godsend, and I so appreciated that money given to me so that I could get my cat the treatment she needed desperately at the time (she had CRF and I'd just been laid off from my job).  There are organizations out there that can and will help you---you just have to look for them because they don't advertise.  Also, see if your vet will work out a payment plan for you, because I have a feeling this kitten is not going to be a cheap kitten!  

In the meantime, watch for s/s of infection, such as lethargy, not eating/latching on to mom, slow respiratory rate, slow heart rate, either real hot, or real cool/cold, redness around the area you're talking about, drainage around that area, swelling, "screaming" from the kitten when you touch it around there, etc.  If you notice any of these, those are all s/s of infection and you need to act on them quickly to save the kitten's life.

Keep me posted.

Savannah