Butt Troubles: Marlin's Story

Tiny Marlin: the heart of a lion, the butt of a mouse. (Photo courtesy of Photographers for Animals.)

Tiny Marlin: the heart of a lion, the butt of a mouse. (Photo courtesy of Photographers for Animals.)

When I started sharing Marlin's story on my Instagram, I had no idea how much everyone would love the hashtag #ButtTroubles! Perhaps it's because it's a funny sounding term, or maybe it's just that it's nice to give some comedic relief to an uncomfortable topic -- but Marlin really seemed to become an icon for kittens everywhere with medical issues involving their butts. While it's a cute hashtag, I wanted to create a blog detailing his condition, to explain the rather serious implications of his butt troubles and to share how his life was saved.

Marlin's brothers weighed around 3 pounds, but he was only 1.5. Stunted growth is a common side effect of his condition.

Marlin's brothers weighed around 3 pounds, but he was only 1.5. Stunted growth is a common side effect of his condition.

Marlin came to me with a batch of three feral littermates -- but something was different about him. He was literally half the size of his brothers, and almost immediately I noticed that something about his butt looked odd. (Yes, I know, it's a fun skill to be so familiar with staring at kitten buttholes that you can tell when one looks different. Try not to be jealous.) He went to the vet, who gave him an enema, and sent him on his way. But in spite of the enema, his little butt was just not performing. 

Oh dear. That is not a normal butt.

Oh dear. That is not a normal butt.

A few days into having him, I became scared for his life. It's somewhat normal to see kittens with constipation, which you can treat at home either with dietary changes (like switching to diluted wet food or diluted formula, or supplementing with pumpkin puree or mineral oil) or with laxatives like Miralax. But in spite of all my efforts, and daily enemas, he was backed up so substantially that I feared he would prolapse, or worse -- die. This is all to say: he literally could not poop. At all.

Marlin's butt was distended, looking almost like he had been impaled by a golf ball. He strained, and screamed the saddest little screams in the world. The pain of not being able to poop was unbearable to witness, and it became clear that his life was in danger.

Fortunately, I was able to take Marlin to a specialist who really knows their stuff when it comes to kitten butts. NOVA Cat Clinic in Arlington, VA is one of the only clinics I've ever found that really understands the unique needs of kittens, and after a quick x-ray, they immediately identified the problem: Marlin has a congenital defect known as atresia ani. Atresia ani is a congenital anomaly in which the lower gastrointestinal tract is malformed, essentially making it impossible for the kitten to pass stool. Marlin's condition also causes him to be abnormally small -- which explains his stunted growth. Without treatment, Marlin would have no chance of survival.

Many a sleepless night of helping Marlin poop. If you want to become an enema queen, just find yourself a kitten with #ButtTroubles and you'll be well on your way.

Many a sleepless night of helping Marlin poop. If you want to become an enema queen, just find yourself a kitten with #ButtTroubles and you'll be well on your way.

Here's the best way I've found to describe Marlin's condition: it's like he was given the wrong butt at the butt factory. They were supposed to give him a kitten butt, but instead, they gave him a mouse butt. So now poor Marlin has to try to live as a kitten, and eat as a kitten, but he has to try to poop out of a mouse butt. It just doesn't work. What he needs is to trade in his mouse butt for a kitten butt so that he can have a normal, functional butt situation. But how do you get the right sized butt for a kitten born with the wrong one? Can you just trade it in?

This is really fascinating, because not a lot of veterinarians are doing anything to help kittens like this. Most kittens with atresia ani would simply die without ever being diagnosed, and those who are diagnosed would generally be recommended for euthanasia. However, Kitten Lady don't play like that. Kitten Lady is all about taking chances and saving lives. 

Marlin receives an innovative, life-saving treatment for atresia ani.

Marlin receives an innovative, life-saving treatment for atresia ani.

Here's what we did: once a week, for three weeks in a row, Marlin's vet performed a procedure to expand Marlin's rectum. First, Marlin was put under anesthesia, with his vitals being monitored. Next, a balloon was inserted into Marlin's rectum, and very slowly inflated with a syringe to expand it to a normal size. The vet then held the balloon steady for 5 minutes, deflated it for one minute, and then inflated it again. After three five-minute inflations, the balloon was removed and the procedure was complete. Marlin was then treated with steroids to slow the healing process, encouraging the rectum to stay stretched enough to pass stool.

Marlin receives a balloon dilation to correct his congenital defect.

Marlin receives a balloon dilation to correct his congenital defect.

Simultaneously, we treated him with stool softeners (Miralax) and other drugs to help him maintain muscle tone. The idea has been to keep his stool soft enough to easily pass through his system without causing him to back up, and to slowly stretch the rectum to allow him to eliminate on his own. After the first procedure, he was able to poop for the first time -- but then relapsed within 3 days. After the second procedure, he did better -- but relapsed within 7 days. And after the third procedure, his body seemed to truly take to it. He has been able to pass stool ever since. It's a process, but it works.

Marlin's LVT, Ellen Carozza, gives a kiss of encouragement after an x-ray showing promising progress.

Marlin's LVT, Ellen Carozza, gives a kiss of encouragement after an x-ray showing promising progress.

I've never seen a kitten so happy, and so proud to poop. Once he started being able to pass stool without help, Marlin became a totally different kitten -- he began to purr incessantly, to eat voraciously, and to learn how to play! Marlin could finally discover what it is to be a kitten. 

Marlin's treatment isn't necessarily complete -- he may need a more intensive surgery to release the stricture and permanently fix his rectum (reconstructive butthole surgery, anyone?) He is, however, 100% stable thanks to the efforts put forth to save him. 

Marlin snuggles up, feeling better by the day.

Marlin snuggles up, feeling better by the day.

The moral of Marlin's story can't be understated: every day, kittens are needlessly dying because we do not know how to care for them. The veterinary community does not prioritize neonatal health because there is no one pushing them to care; it's too easy for people to say a kitten is in hopeless condition and euthanize them. Kittens die and we call it "fading kitten syndrome," but this is a non-diagnosis that would be more appropriately named "we don't know enough syndrome." The thing is, unless someone steps up and tries to know enough, we will always have kittens dying of mystery illnesses. We have to care enough to learn, to try, and to teach each other what we know so that kittens can be saved next time.

This is the goal of Kitten Lady: to not only rescue kittens, but to let their stories inspire a new approach to kitten care for fosterers, animal shelters, and veterinarians. I'd like to challenge the veterinary community to go a step beyond saying "he can't be saved," to be willing to discover what is truly impacting kitten health, and to try aggressive and innovative treatments to save lives. 

Marlin is just one tiny, half-sized kitten with a funny mouse butt, but his life has value, and he deserves a chance to be loved. As Marlin transitions into his new forever home, let's allow his story to inspire all of us to try a little harder, to share our successes with one another, and to value every individual life. Every kitten matters, and every kitten saved can teach us how to save others. 

Marlin is small, but mighty -- and his story can save others just like him.

Marlin is small, but mighty -- and his story can save others just like him.

If you're inspired by the work I'm doing, please take a moment to make a quick, tax-deductible donation. A monthly contribution of just $10 or $20 can go a long way towards supporting Kitten Lady's advocacy efforts. With your support, we can change the world for kittens like Marlin.

Special thanks to Ellen Carozza, LVT and Dr. Erica Barron at NOVA Cat Clinic for providing expert care. May you go down in the Kitten Butt Hall of Fame!

For the little ones,

Hannah Shaw, Kitten Lady