Flat Chested Kitten Syndome
Part Two: Treatment Options

Published April 2006

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In the In the article titled Flat Chested Kitten Syndrome: Part One, we discussed the FCK condition, including its development, causes, identification and prognosis.

In Part Two of the discussion about FCK, we will cover treatment options for flat chested kittens.


FCK is an acronym for Flat Chested Kitten. In FCK, the underside of the ribcage flattens and sometimes caves in. If the ribcage is pulled inwards there is a danger of lung damage and in extreme cases, the kitten will start gasping for breath and will die if not aided.

Treatment Options

While some mildly affected kittens may resolve without any intervention, there are some treatments that you can try to increase your FCK's chance of survival.

  • Treatment options include:
  • Diet
  • Physiotherapy
  • Massage
  • Splinting
  • Surgery

1) Diet Supplements

  • The kitten pictured on the right was a single FCK in a healthy litter, and was losing weight and clearly failing until he was put on supplement feeding with KMR. He is now happy and healthy, though his sternum has not righted itself. He is smaller than his siblings.
  • A kitten may need supplemental feeding with a kitten formula such as KMR or Just Born, to help maintain weight and good condition, as kittens with FCK sometimes have trouble nursing from the mother-cat.
  • Some vets believe that the condition is due to a vitamin deficiency and recommend giving nursing kittens human baby liquid vitamins.

2) Physiotherapy

  • Twice daily physiotherapy to encourage the kitten's chest to grow in a more normal shape may counteract the flattening of the chest.
  • If a kitten has splayed legs and prefers to lie on his back or flat on his stomach, turn him to lie on his side and gently holding him that way for a few minutes, several times a day..
  • When the kitten is old enough, encourage him to walk, as this helps the chest return to a more normal shape.
  • 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. 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.
  • You may strengthen the chest muscles by encouraging the kitten to cry, though without distressing it unduly.
  • Work has been done in the Netherlands involving physiotherapy for 15 minutes every three hours, supported by steroid treatment. This also seems to have a good success rate, and should be investigated further.

Vets in Holland 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 physiotherapy. A success story from Holland using this protocol can be read here: http://www.felinefantasy.nl/ , look at: a cat's tale - Smirnoff's Story.

3) Massage

The kitten's legs are gently flexed and massaged into the normal position. This loosens and lengthens the muscles and tendons in the legs, allowing them to gradually develop into the correct position.

4) Splinting

Splinting of the chest is aimed at preventing the kitten from lying on its flattered chest which contributes to the condition. Splinting is a very effective, low-tech solution to helping a mildly affected kitten overcome the affects of FCK syndrome.

It is very important to be check that as the sides of the ribcage are squeezed, it causes the lower part of the chest to move outward. If the sternum has already begun to collapse inwards, the pressure on the sides may worsen the condition by pushing it in further instead of out.

Example (A) Splinting with a Cardboard Tube

A cardboard tube is cut to size with holes for the front legs added and then fitted on the kitten. Gauze is crisscrossed over the kitten's chest to hold the tube in place then tied behind its back. The tube is curled tightly around the body and tied in place so that it presses on the sides of the ribcage, pushing the flattened portion back outward. As the kitten grows, the fit of the tube needs to be adjusted frequently.

Example (B) Splinting With Two Pieces of Cardboard

Two flat pieces of cardboard tied together at the front of the chest and across the kitten's back may be an improvement over using a round cardboard or plastic tube as it prevents the kitten from sleeping on its chest.

Example (C) Splinting With Vetwrap

Vetwrap is a flexible, stretchy bandage which sticks to itself and eliminates the need for clips or fasteners. It maintains consistent, non-slip support. It can be used to create a splint by cutting two strips and sandwiching a harder material between them to provide a stiffer support. Allow for extra wrap on the end as a fastener.

Precautions When Splinting

There are two warnings to be careful about when 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. Before you try anything check that the sternum will move outwards when the ribcage is compressed by pressing the sides of the chest gently with your fingers. 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.

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.

5) Surgery

Surgical correction for FCK has proven to be successful. The most common surgical method used is to fix the ribs and sternum to an external splint which moves them into the correct position. The earliest a kitten can have this surgery is about 8 weeks old.

Prevention of FCK

Because we don't know exactly what causes FCK, it is difficult to suggest how to prevent it.

Main things to do to prevent the occurrence of FCK may include:

  • Good nutrition during pregnancy and nursing: Plenty of fresh high-quality food must be available to the queen at all times
  • Avoid use of antibiotics or medications during pregnancy or nursing if possible.
  • Avoid queens who do not produce a good milk supply.
  • Supplement kittens quickly if they fail to thrive.
  • Avoid using cats in your breeding program known to have produced FCK kittens.


Unfortunately we really don't know enough either to avoid the condition entirely or to cure it successfully every time. Mild cases can often recover with no help at all, sometimes remaining slightly flat, and sometimes the ribcage goes back to normal. In cases where the kitten begins to have trouble breathing, the kitten often dies.


The organization THINK, Thoracic Investigations in Kittens, was launched formally at the GCCF Supreme Show in the United Kingdom in November 2005. It is a research group founded to raise funds and collect data in order to create an academic research post to investigate thoracic deformities in kittens, particularly FCK.

Its aims include:

  • Identifying specific thoracic deformities
  • Informing the public and vets on identification and treatment
  • Funding multi-disciplinary approaches to researching the problems
  • Identifying causes with an aim to prevention and treatment

Donations towards these research aims are needed and greatly appreciated. For more information, go to http://www.think-project.org.

Note From The Author: This text is placed here to help breeders and owners who may come in contact with this distressing condition. Please note, I am not an expert, nor do I have veterinary training. I have gathered information from breeders who have experience of FCK to pass on to those who suddenly find themselves confronted with it but have no information on how to deal with it, and I would like to acknowledge all their contributions. Even the tiniest additional piece of information helps. This web-page is NOT a criticism of breeders or breeding - no good breeder will knowingly breed kittens who will get FCK.

Related Articles


  • Boudrieau R et al. Pectus excavatum in dogs and cats. Comp Contin Edu Pract Vet 12(3): 341-355, 1990
  • Fossum TW et al. Pectus excavatum in eight dogs and six cats. J Am Anim Hosp Assoc 25:595-605, 1989
  • McAnulty JF, Harvey CE. Repair of pectus excavatum by percutaneous suturing and temporary external coaptation in a kitten. J Am Vet Med Assoc 194(8): 1065-1067, 1989
  • Sturgess CP, Waters L, Gruffydd-Jones TJ et al. Investigation of the association between whole blood and tissue taurine levels and the development of thoracic deformities in neonatal Burmese kittens. Vet Rec 141:566-570, 1997

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