FELINE MEDICAL CURIOSITIES: FACIAL DEFORMITIES
Hydrocephaly, Two-Headed/Two-faced Kittens, Cyclops kittens
Copyright 2001 - 2013, Sarah Hartwell

Two-faced kittens

Note: Contrary to suggestions on some bulletin boards, the images here are not photoshop. With the exception of those labelled as artist's impressions these are photos of medical conditions. These pages are intended as a medical reference site. Offsite links to images on these pages is not supported - bandwidth costs money!

HYDROCEPHALY

The peculiar shaped face of this five week old black-and-white kitten is due to hydropcephaly and anophthalmia.

Hydrocephaly means fluid accumulating inside the skull. It causes a distinctive domed appearance. While the kitten is young, the skull grows increasingly domed or bulbous to accommodate the fluid. The tall forehead is characteristic of the condition. Later, the skull cannot stretch and the build-up of fluid causes pressure on the brain, increasing brain damage and eventually death. Nicknamed "the dog-faced kitten", the black-and-white kitten (above) was put to sleep at about 8 weeks old because of increasing fluid pressure and poor prognosis. In hydrocephalic humans, shunts are used to drain the fluid; at present shunts are not available for cats with the condition.

Some case of hydrocephaly do survive. "Moon" (pictured left) was a hydrocephalic kitten with hare lip and cleft palate and is owned by Leila in Sao Paulo, Brazil, who sent these photos. According to Leila, Moon was found abandoned at 4 months old. He has undergone surgery to repair his hare lip and cleft palate and, at the time of writing, was a year old and doing well. I believe this to be hypertelorism (wide face) rather than hydrocephaly as the head is wide, rather than domed.

Helen Simpson (Cambridgeshire, UK) provided these photos and details of her hydrocephalic kitten, Josh. Josh's case was not too severe and he has survived kittenhood and is doing well. When Helen got Josh from a rescue in Kent, he he was due to be put to sleep because of the shape of his head and the organisation he was with said no-one would want him. Luckily someone told Helen about Josh's case. His head is quite domed and to begin with the vets were not sure if he would live because affected kittens rarely survive as their mothers reject them or they have far more severe cases of hydrocephaly. As he's grown older he has "grown into" his head (it is less out of proportion) although it is still very domed. As a small kitten, his head resembled a balloon on his tiny body.

Josh was a strange kitten with "no real sense of reason but bags of personality." To begin he often ran into things and when running, his brakes didn't work. When working out how to do things, for example how to jump on a bed, he squeaks and chatters to himself about it. He was 8-9 months old in April 2007 and has been neutered (using a different anaesthetic from normal due to his condition).

MENINGOENCEPHALOCELE
(Incomplete skull with protrusion of meninges and brain)

Squeak (owned by Tigger Browne) was a rescue kitten with a cranial abnormality. By 4 months her skull did not cover her brain properly and her face is twisted from just above her nose. Leading from the top of her nose is a very big V-type groove which leads to a soft lump on the top of her head. The soft lump on her head is a meningoencephalocele - the protrusion of her brain through the gap in her skull. Usually kittens with meningoencephalocele are stillborn, die very early or are put to sleep, so Squeak may be unique in having survived to 4 months. A skull x-ray would determine how much skull is missing and how much brain is protruding through the gap. In addition, Squeak's gender is ambiguous and s/he has a small umbilical hernia (Squeak will be referred to as "she" for convenience).

Because the brain had developed and was growing abnormally resulted in seizures and abnormal behaviour: panic attacks involving foaming at the mouth and wetting herself and showing signs of terror. Seizures lasted for 2 - 3 minutes after which she became very clingy and loving and tried to clean herself obsessively (she had problems cleaning her head and her rear end). In general, her behaviour was scatty, but not intellectually retarded. She appeared to hallucinate, morseso that cats that normally chase invisible prey. Her movement tended to swing when she walked and she frequently missed her target when jumping or pouncing; her owner believed Squeak may have had some impairment of vision or spatial awareness. The seizures were are likely to get worse, eventually leading to ataxia (lack of co-ordination), possibly blindness and probably increasing paralysis. The brain is also very easily damaged where it protrudes; any trauma could cause swelling. It's not possible to give a prognosis in months or years because Squeak is unusual in surviving this far. In some cats, this is inherited (American Shorthair Craniofacial Defect, Burmese Head Defect), though it can occur at random through mutation or developmental abnormality.

Apart from the seizures and strange behaviour, Squeak weaned quickly and ate and drank normally and was quick to learn to use the litter tray. She was fully housetrained except when having a seizure. She was underweight when adopted, but grew to a healthy 2 kg (4.4 lbs) and was a lively, happy, inquisitive little soul that loved playing with feet or running around like any other kitten causing mayhem wherever she went. Tigger is experienced with epileptic animals and rescue cats and monitored Squeak's condition. It wasn't known whether anti-epileptics would control the seizures. As Squeak (still sexually ambiguous, but possibly developing as a male) grew her fits initially decreased in frequency and intensity. She went through the normal shedding of kitten teeth and the dome-shaped swelling on Squeak's head became less pronounced, especially on the right side, as she grew. She also became able to clean herself. Unfortunately on Saturday 13th December 2008, Squeak became hyperactive and had 3 increasingly violent fits in succession. As her fits were becoming continuous and more distressing due to the pressure on the brain, she was put to sleep aged approximately 5 months old. Squeak appears to be the oldest recorded survivor of meningoencephalocele.

UNEVEN FACIAL DEVELOPMENT

Sarah Saylor provided these photos of a 5 and a half week old kitten "Batty Cat" with facial deformites. It appears that one side of Batty's face hasn't developed as fully as the other side - giving him a smaller eye and twisting his nose and mouth to one side. As long as he can eat and drink normally and the rest of his body is unaffected by developmental deformities, Batty should have a normal life. The cleft lip is cosmetic and there is no cleft palate; the lip could be repaired surgically if it caused any problems. The twisting of the nose could cause noisy or obstructed breathing, but that could be helped by surgery. One eye is under-developed and appears to have limited sight. As Batty grows, a vet will need to check his jaw alignment (it may grow unevenly) in case there's any twisting or under-development on one side in which case he might need some adult teeth removed to avoid over-crowding. Batty was otherwise in good health and had a good appetite, though it has been a little harder for him to move onto soft food due. He was bottle-fed from birth.

TWO-HEADED/TWO-FACED KITTENS (FACIAL DUPLICATION)

More striking than extra ears are extra faces; often in the form of two heads fused together. This "Janus" condition may be a form of conjoined twin where the fertilised egg does not completely split in half. More recently, it has been attributed to disrupted embryo growth due to a protein called "sonic hedgehog" which causes excessive widening of the face to such an extent that 2 muzzles are formed. While there are lots of photos of afflicted kittens, I have found no x-ray images or photographs of the skulls of two-faced kittens. It would be very interesting to see how the bones have developed and the duplicate features have formed. Although kittens are born with folded ears and usually (but not always) with the eyes shut, most taxidermy of two-faced kittens shows pricked ears and eyes open for artistic effect.

An undated account (possibly between 1900 - 1920) comes from Bromhead, Saskatchewan, Canada. It lived for only a short time and the mother apparently adopted a rabbit after the twin-faced kitten died. A two-headed Red Persian kitten was born in El Paso, Texas, in September 1946. The kitten survived for 5 days, apparently suckling with one head while its mother washed the other. It is likely that the second head was not functional. The mother cat was said to have been inconsolable when her special kitten died. There are undated reports of a two-faced kitten called "Xerox".

Germaine Vandegoor from Belgium found an account of a 2-headed kitten in the magazine "Weekblad van de stad Antwerpen" dated 29 December 1933. I've included the Dutch and French descriptions as well as the English translation "Little cat with two heads. Photo from 1933 - This cat of Janus (double head) is from California. It has a normal body, and miaows for two". Nederlands: Katje met 2 koppen: Foto uit 1933 - Dit Januskatteken (tweekoppig) is van Californische oorsprong: het heeft een normaal lichaam, vreet en miauwt voor twee. Français: Petit chat à 2 têtes: Photo de 1933 - Ce signe félin de Janus (double tête) est d'origine Californienne : il possède un corps normal, bouffe et miaule pour deux.

A two-headed kitten (undated) dubbed Gemini was born to Dan Lizza's cat in Latrobe, Pennsylvania. Gemini had two faces and two muzzles at right angles to each other. The other 3 kittens in the litter were normal.  From all accounts, the owner intended to rear the kitten though there were no further details. In mammals, this sort of deformity almost always results in death because of brain abnormalities. A two-headed, four-eyed kitten was born in July, 1991 in Brighton, Illinois. It lived for just two days. Despite having two mouths, it had only one oesophagus (food-pipe).

 

The most complete report is that of a grey kitten called "Image" (below) born in Bensalem, Bucks County, Pennsylvania in June 2000. Image had two sets of eye, two mouths, two tongues and two noses. It was given a good prognosis for survival as long as owner Sandra Pyatt fed it with two eye droppers since it tried unsuccessfully to nurse from the mother with both mouths. Dr. Anil Rastoggi, of the Croydon Animal Hospital, drove over to the Pyatt home to examined Image and found him to be in generally good health. He believed it could survive because the double features posed no health problems, but admitted he had only ever read about this "genetic mutation". Examination showed that it had only one head and two ears. It had two complete faces, but only one mouth connected to an oesophagus and the rest of the kitten seemed normal. Despite one mouth not being connected, both mouths tried to suckle. Reports suggested that Image mewed from both mouths, but with only one oesophagus, one trachea and one set of lungs this would be impossible. Image died four days later and the owner apparently intended to donate Image's body to the Philadelphia Mutter Museum of Medical Oddities.

There was some doubt in veterinary circles over the authenticity of Image's story since the vet seemed unaware of the lethal brain abnormalities associated with the condition. However, the photos are genuine. In cases of conjoining there is generally a "mirror image" effect and this is sometimes cited as evidence for faked images. In human conjoined twins that have been dissected after death, the internal organs are also mirrored.

In July 1979, a stray cat in Montreal produced a litter of kittens which included a two-headed kitten. The two-headed kitten later died. By coincidence, another two-headed kitten was born in Indianapolis that same month. Named Tom and Jerry by its owner, it later died. Its littermates were normal. Both are more accurately called two-faced kittens. Like Gemini, they had a single skull which split into two muzzles.

On August 22nd 2001, I received an email from Thomas Ross of Livonia, Michigan, USA. Tom's 2 and a half year old cat Carlyle had given birth to 4 kittens on August 19, 2001, her 3rd litter. 3 of the kittens were normal but the 4th (the last born) was a 3.36 oz, 2-faced kitten which Tom and his wife named "Shadow". Shadow had one skull and brain, but 4 eyes, 2 noses, 2 mouths but only 2 ears. When he mewed, both mouths moved but the sound came from one mouth only. In all other respects, the kitten was formed normally. When Tom wrote to me, Shadow was not doing well, having been abandoned by the mother cat. Tom researched the curiosity on the Internet and he and his wife Maralee did what they could for the kitten. However they realised that the kitten's prospects were poor: "Nature was probably taking its course," Ross said, "Maybe the mother realized it wasn't going to live that long." Shadow lived for only 4 days.

Shadow's story was reported in Tom's local Observer newspaper. Photos copyright 2001, Tom Ross

Dr Ben Yamini of Michigan State University's Animal Health Diagnostic Lab (ADHL) said the congenital malformation likely occurred early in the embryonic process. Without examining Shadow he could only guess at a cause, but some viruses or exposure to certain toxic substances (known as teratogens, meaning "monster causing") can cause birth abnormalities. In 25 years, Dr Yamini had encountered other unusual cases such as two-headed calves, but had never seen this particular defect in a cat. Ross contacted a Philadelphia Physicians College staff member, who may be interested in examining Shadow's remains which were being kept in the family's freezer. Ross wanted a hospital to use Shadow's remains for research. For the record, Shadow was not the first unusual cat in the Ross household - they once took in a kitten which had an extra paw on one leg. (Information and photographs of Shadow courtesy of Tom Ross.)

These photos and accompanying information have kindly been provided by Jean Jahoda, a breeder of Persians. In this case, the angle between the two muzzles is relatively small and there is a single central eye; there appears to be a hare lip (and possibly cleft palate) on each of the two muzzles. Jean described the sound of the two muzzles crying at birth as especially bizarre. (Description & photos copyright Jean Jahoda)

Jean writes "On July 28th, 2003 the following kitten was born alive. It died within minutes of its birth. This kitten shared a placenta with another perfectly normal kitten. By shared we mean that each kitten's umbilical cord was attached to the same placenta. The normal kitten is a male. This kitten was a female. As can be seen, the kitten has two ears, two noses, two mouths and three eyes. The center eye was open at birth. The other two eyes, as normal, were closed. The kitten was alive and crying. Immediately after the umbilical cord was removed it died. Look at the mouths and you will see full teeth on the bottom of each mouth. Kittens don't normally get their teeth in until 3-4 weeks of age."

On 8th March 2005, a two-faced kitten was born in Lake City, Florida, USA to a cat owned by Teresa Morrison. "Deuce" had two muzzles (two mouths and two noses) and four eyes. Unlike many of the two-faced kittens reported here, Deuce was able to nurse from its mother using one mouth. The other mouth did not appear to function. The veterinarian had not seen any similar cases first hand, but believed that if the kitten did not have brain abnormalities and managed to survive the first 48 hours, the prognosis was said be good. Deuce died two days after his birth. His owners were apparently forced to put Deuce to sleep when the kitten developed pneumonia and was not strong enough to survive. The pneumonia may have been caused by inhalation of milk into the lungs as one muzzle fed while the other breathed. To date, no kittens with this abnormality have survived beyond a few days and the only two-faced mammal known to have survived into adulthood was Ditto the pig.

On Sunday 12th June 2005, a two-faced kitten was born in Roseberg, Oregon, USA to a cat owned by Glide resident Lee Bluetear who had been breeding 4 lb miniature cats. Gemini was born to a miniature mother and normal size father. "Gemini" had two mouths, two tongues, two noses and four eyes, but a single windpipe and oesophagus. Bluetear could not be sure if the kitten would survive, but believed that if she did she would be perfectly normal apart from having 2 faces. Veterinarian Alan Ross examined the kitten when it was 2 days old and gave it a 10 percent chance of survival. He and his 2 colleagues had never seen a two-faced kitten before. Gemini was said to be getting stronger and suckling well, but if she did survive she would need surgery to remove extra tissue between her two mouths. Not unexpectedly, Gemini died aged 4 days, having become very lethargic on the Thursday and not wanting to eat. The exact cause of death was not known. Bluetear was considering giving Gemini's body for academic or scientific study.

A two-faced tabby kitten was born in Grove City, Ohio, USA on 12th July, 2006 to a cat owned by the Roberts family. Called Tiger, the other 2 kittens in the litter are normal. Though born in the morning, the kitten did not start nursing until the afternoon and is unlikely to survive for long. It has two muzzles, 2 mouths that mew in unison and 4 eyes. On Saturday July 16th, the kitten apparently vanished from its Grove City home. It had been bottle-fed, due to being unable to suckle from the mother, and had last been seen just after Friday midnight. When checked at 4 a.m. it was not in the bed with the mother (a newborn kitten should have been fed every 2 hours, 4 hours between feeds is too long). There was no sign of the kitten and the family believed it was stolen as one of their doors was unlocked, however their dog did not raise the alarm. The most likely explanation is that the malformed kitten was dying and the mother ate it - this is a normal, natural thing for a mother cat to do.

A similar kitten was born at Ste-Genevieve-de-Batiscan, near Trois-Rivieres, Quebec, Canada on 14th July, 2006. It had a single head with 4 eyes, 2 noses and 2 mouths but one head. Dubbed "Two Face," it appeared to be healthy, but died 3 days later. The mother was owned by France Trudel and the kitten's deformity was noticed by her daughter Valerie Bastarache. Veterinarian Isabelle said the malformation was probably due to a problem with cellular division in the foetal stage. Although she hadn't examined the kitten, she said that internal organs, including the brain were probably also malformed.

A 2-faced cat in Millbury was 6 years old in 2006. Named "Frank and Louie" (so that each face had a name), the owner's details were withheld due to the excessive publicity surrounding recent 2-faced kittens. This cat is the exception. He has 2 mouths, 2 noses and 2 functioning eyes plus a 3rd central eye that doesn't function. Only the mouth on the cat’s right side (Frank’s side) is connected to the oesophagus (food pipe), so that side does the eating. From either side the cat appears normal, but head on the 2 faces are apparent. He has a sweet personality and was adopted by the owner from a vet clinic at 1 day old when taken for euthanasia. He came from a breeder who did not want her line associated with congenital defects. His adopter tube fed the kitten every 2 hours - running a tube down the throat and straight into the stomach so there was no danger of choking. Although most such kittens die within a few days due to internal problems, Frank and Louie survived. He is healthy and plays with other cats and the owner's dog and likes walking on a leash. All the teeth in the non-eating mouth have had to be removed. Because the eyes are placed almost on the sides of the head rather than at the front, he has limited binocular forward vision, but has learnt to compensate for this.

In September 2011, Frank and Louie gained a place in the Guinness Book of Records as the longest surviving cat with the "janus" condition.

Another surviving 2-faced kitten was reported in November 2007. Lil'Bit is a 7 month kitten from Arizona and was one of a litter of 5 kittens. He could not suckle and was hand-reared. Originally, the 2 eyes in the centre appeared separate, but as Lil Bit grew they apparently converged into a single eye sockets. His noses and mouths are separate; it is not reported if both muzzles are capable of feeding and breathing. It was suggested Lil'Bit had 2 fused brains, or at least separate control of each faces, because the faces sleep, wake and blink independently of each other. One face appears to be less well-developed than the other. When he caught a cold, only one nose ran (which suggests the non-runny nose and mouth aren't fully functional otherwise the cold virus would have spread via a shared trachea and oesophagous).

A two-faced kitten was born in Amarillo in February 2008 to a 3-year old Persian-mix female owned by Renee Cook. Nicknamed "Double Trouble" by the media, it had 2 mouths, 2 noses and 4 eyes. The other 6 kittens in the litter were normal. The 2-faced kitten was rejected by the mother and found slightly apart from its littermates. When found, it was cold and sluggish, but once warmed up it had a strong heartbeat and began to move. Cook went to the Northwest Texas Hospital and obtained some formula from their paediatric ICU and a syringe (human formula is far too weak for kittens - she should have procured kitten milk replacement). The kitten was unable to latch on or suckle, but could swallow and be syringe fed. According to vet Dr David Hodges, its chances were slim and depended on how the lungs, two tracheas, oesophagus and mouths were connected. Its lower jaws appeared to be under-developed so if it survived it would be unable to chew. (News reports erroneously called the mother a "Persian and Calico mix" - calico is a colour, not a breed).

Another two-faced kitten was born at the start of August 2008 to a shop cat at Woodville Auto Finance in Northwood (outside Toledo), Wood County, ohio. The grey-tabby-and-white kitten had four eyes and two noses, but only one functioning mouth (on the kitten's right side). On the kitten's left side, the face was less well developed with a hole beneath the nose. The mother cat had been hanging around the shop for several years. She appeared not to mind the abnormality, nursing and caring for the kitten until its death on 6th August. Video footage shows the kitten to be alert and active indicating it was able to suckle. It may have died due to inhaling milk while suckling. In November 2008, a 2-faced grey-and-white male kitten with a cleft palate in one face was born in Perth, Western Australia. Both mouths can miaow in unison (both are connected to the trachea). The mother had been taken to the Swan Veterinary Clinic in Perth due to complications during the birth. The litter of three kittens were delivered by vets George Huber and Louisa Burgess. The 2 littermates had no deformities. The clinic has seen cats with 2 tails and with extra legs, but had not previously seen a 2 faced kitten. Initially it was doing well, suckling with one mouth only due to the cleft palate in the other, but it died at 3 days old; asphyxiating after getting fluid in his lungs. There were concerns about neurological problems due to unusual behaviour such as excessive head shaking. The owner had considered naming it Mr Men or Quasi Modo if it survived.

A two-faced kitten was born in Charleston, West Virginia, USA in June 2010. The mother cat refused to suckle it and the unidentified owner took the deformed kitten to North Gateway Animal Hospital where it was examined by vet Dr Erica Drake. The kitten has 2 muzzles and 4 eyes and its mouths act independently of each other which could mean 2 oesophaguses leading to its single stomach (this could be bad news - if one muzzle breathes while the other is suckling it could lead to inhalation pneumonia caused by milk entering the lungs). No X-rays have been taken so far to see exactly what is going on inside which means though the kitten seemed otherwise healthy, it wasn't possible to give an accurate prognosis.

Nathan Roberts provided this photo of a diprosopus kitten, called Prof Harvey Whiskers. This kitten was born in West Virginia, and lived for four days before finally passing away. The birth was the product of the mother cat, and one of her sons from a previous litter, though it is unclear if the inbreeding contributed to the cranial defect. Nathan collects animal specimens with severe teratological defects and is interested in purchasing and preserving other specimens.

Another two-faced kitten (now increasingly being termed Janus cats by the media) was reported in February 2012, but survived only a short time. It was born in Port Charlotte, Fla, USA and named Harvey Dent after the "Two-Face" character in the Batman series. The kitten had four eyes, two noses and two mouths. All of the duplicated external features appeared to function and the mouths worked simultaneously, both when eating and mewing (it is not known if both had a functioning oesophagus/trachea). Although the kitten's owners Nash Hand and his wife Amanda Forsythe hoped it would survive, some critics referred to it as an abomination and called for it to be put down. Harvey Dent survived only two days.

A 2-faced kitten was born in Missouri on May 9th 2012, but did not survive long after birth (Jean/Jstieh).

A two-faced (janus) kitten was born in Amity, Yamhill County, Oregon on Tuesday 12th June 2013. "Duecy" was examined by a vet and appeared to be in good health despite the deformity, however she was rejected by the mother cat and owner Stephanie Durkee attempted to hand-rear her. The kitten died two days later from complications associated with its deformity.

Such mutations are not actually becoming more common. They remain rare, but are better reported due to the speed and inexpensiveness of the internet, email and digital photography. Owners now have a ready market for photos and videos of such mutations. In the past, the animals or their remains were sold to exhibitors of curiosities and were seen by relatively few people. In modern times, news and images of mutant animals can spread worldwide in less than 24 hours.

Although "two-faced" or "two-headed" kittens survive only a few days, a two-snouted pig called "Ditto" (2 snouts, 2 mouths, 3 eyes) survived to maturity. Several genetic disorders cause extremely wide-set eyes (hypertelorism). One such disorder is due to mutations in a gene that normally limits the activity of a protein called sonic hedgehog. A lack of sonic hedgehog causes cleft lip. Hypertelorism syndrome causes very broad noses, noses with two tips, or even two noses. Once the face of the embryo widens beyond a certain point, whole structures (e.g. nose, mouth) are duplicated. Ditto, a Duroc pig born in Iowa, had two snouts, two tongues, two oesophagi and three eyes. It may have started out as two twin embryos that fused, but because the duplication was confined to the face and forebrain it is most likely that it grew from a single embryo with a very wide head. Ditto died in 1998 and his head is preserved in a jar at the University of California, San Francisco. Ditto died of pneumonia, apparently caused by inhaling food into one snout while the other snout was eating. Two-faced individuals caused by sonic hedgehog aside, statistically, conjoined twins are more often female than male. This is because a female embryo is more likely to split into twins than a male embryo. Sometimes the split is incomplete, leading to conjoined individuals.


Taxidermy exhibit of a two faced kitten (one head, two faces due to the "sonic hedgehog" protein).


Taxidermy exhibit of a two headed kitten (one body, two complete heads - if genuine, this is conjoined twinning).

FACIAL DUPLICATION X-RAY IMAGES

The images from veterinary nurse Erin Peters (Animal Emergency of McHenry County Crystal Lake, IL,USA) show the skull structure of a two-faced kitten. Erin dealt with a semi-feral cat that was trapped due to having a stuck kitten after delivering 2 stillborn kittens. The 3rd kitten had facial duplication and was photographed and radiographed by Erin to help other veterinary staff visiting this page.



X-ray images (radiographs) of the same kitten.

MISCELLANEOUS CRANIAL AND CRANIOFACIAL DEFECTS

Cranial refers to head and skull defects that affect the braincase. Craniofacial defects affect the head and face: the soft tissues and the bones forming the front of the skull i.e. the face and jaws. These abnormalities are often related to other conditions such as dwarfism, hydrocephaly or metabolic disease. These include extreme over-bite/under-bite, hare lip (cleft lip) and cleft palate.

Craniofacial anomalies are an intrinsic part of some breeds such as the modern ultra-typed Persian and the now-extinct Peke-Face Red Persian (extreme brachycephaly) and the extremely elongated head of the modern Siamese. The Peke-Face Persian is different from the modern "piggy" Persian and the last known true Peke-face Persians was registered in 2002, and only about 100 such cats were ever registered. Their skull structure differed greatly from the standard Persian: a very round head with a very strong chin and very wide-set eyes. The muzzle was wrinkled and the nose pushed inward and indented between the eyes, plus there there was an additional horizontal break located between the usual nose break and the top dome of the head. This second break created half-moon boning above the eyes (brow ridge and double dome) and an additional horizontal indentation (dimple) in the center of the forehead. These features were part of the breed standard and caused a lot of problems. Kittens tended to have heads too large for them to be born without a caesarian section. Their palates could be too high so that they couldn't suckle. Their tear ducts were malformed and did not drain (a problem seen in extreme Persians today). In the wild, the kittens and their mother would not have survived, so this was a deferred lethal mutation. Probably multiple genes were involved rather than a single gene, and these genes were combined together because of inbreeding.

Inbreeding is a problem in cats with small gene pools. Yoda, below, has thickened facial skin giving a puffy appearance. The thickened facial skin does not have working hair follicles, so Yoda lacks fur on his face and lacks whiskers.

A dwarf cat named Tardar Sauce (born April 4, 2012), Tabatha Bundesen, became an internet meme in the guise of “Grumpy” because her condition gives her a flat face, protruding eyes, an under-bite and a grumpy facial expression. Tardar Sauce (a colourpoint with white) and her brother (black-and-white bicolour), also a dwarf, called Pokey were born to normal parents. As well as their distinctive faces, they are undersized and have limb deformities associated with feline dwarfism.

Tabby and white Lil Bub (2013), owned by owner Michael Bridavsky, has a serious and rare bone condition that cause her paws to be deformed and her tongue permanently protruding due to a very short loweer jaw. Lil Bub's face has a distinct "stop" (change of angle) between the wide set eyes, an extremely under-developed mandible (lower jaw) and she lacks teeth. She is also a polydactyl, have six toes on her paws.

THE AMERICAN BURMESE & AMERICAL SHORTHAIR CRANIOFACIAL DEFECTS

Some American lines of Burmese cats are genetically prone to head abnormalities due to breeding for a domed skull (European Burmese are more oriental in shape and apparently free of this defect). As seen above, the upper part of the muzzle and roof of mouth are duplicated and the area above the muzzle is incomplete. There is only one lower jaw and tongue. The ears and eyes are malformed. The skull doesn't close completely, leaving a protruding area of brain covered only with skin and not protected by bone. It is necessary to humanely destroy any kittens that don't die at birth. Because such deformities invariably involve brain damage, it is merciful that the kitten died within moments of birth.

Some American lines of Burmese cats are genetically prone to head abnormalities due to breeding for a domed skull. European Burmese are more oriental in shape and apparently free of this defect. As the photos show, the upper part of the muzzle and roof of mouth are duplicated and the area above the muzzle is incomplete. There is only one lower jaw and tongue. The ears and eyes are malformed. The skull doesn't close completely, leaving a protruding area of brain covered only with skin and not protected by bone. It is necessary to humanely destroy any kittens that don't die at birth.

Similar defects appeared in the American Shorthair breed since the 1970s/1980s and may also affect the American Wirehair. The incidence of cleft palate in Persian cats (also noted for their wide set eyes, short muzzle and domed head) may be related. Again, they appear to be related to breeding cats for domed heads. The most minor forms of the defect were overlooked as "merely cosmetic" by breeders as the cats generally had superior conformation (wide spaced large eyes, short broad muzzle, concave profile, large boning) and were successful on the showbench. Show success made these desirable breeding animals and caused the spread of the defective gene. The "cosmetic" effects were actually indicators of the more serious defects that would show up when carriers were bred to each other. About 90% of cats with only 1 copy of the mutant gene had a "dot" (longitudinal depression) on their nose that was evident from birth. Others had dermoids (abnormally located patches of skin) and a few had more serious defects such as harelip, severe cleft palate, duplicated canine teeth, duplication of tongue tissue, crooked jaw, coloboma (fissure of the eye) through to lethal athymia (missing or non-functional thymus gland) or seizures (indicating brain abnormalities).

The dermoids were usually pieces of whisker pad, complete with small whiskers, growing in abnormal places on the face e.g. on the side of the nose, below the eye or even on the eye itself. Small dermoids were hard to spot e.g. a whiskery "mole" under a nostril. Breeders often snipped off tiny dermoids, believing them to be cosmetic and not realising they were symptoms of the head defect gene. The nose was often skewed and the jaw crooked, showing that the head had not formed symmetrically. Coloboma (fissure of the eye socket) is caused by the eyelid plate not developing properly; it looked as though the rim of the eye socket (brow) is crooked. These supposedly cosmetic traits were clear indicators that the cat carried the head defect trait.

When a cat with a "dot" on the nose was bred to unaffected cats, about 50% of the offspring inherited the "dot" and about 5% of the offspring inherited lethal defects. The 50% affected offspring also inherited one or more of the defects such as dermoids or harelip . This suggested the gene was an autosomal (not sex-linked) dominant. When 2 cats with dots on the nose were bred together, many more offspring inherited 2 copies of the gene, resulting in gross and lethal head deformities.

(a) "dot" on midline of nose
(b) distortion of brow-line (upper part of eye socket)

(c) cheek-pad tissue growing on side of nose, distorting nose shape
Images copyright Carol W Johnson, DVM,PhD,DACVP

Kittens that inherited 2 copies of the gene were often born alive, but severe head defects meant they survived only a short time. The brain might be covered by skin but the bony skullcap was missing. The skin might cover a fluid filled chamber (hydrocephaly). The brain was grossly abnormal with little or no normal brain tissue; it ranged from holoprosencephaly (malformed forebrain) to anencephaly (no forebrain). Holoprosencephaly is a failure of the forebrain to divide into hemispheres or lobes and is accompanied by under-development of facial features such as the nose, lips, palate and teeth. In milder cases holoprosencephaly causes wide spaced eyes, harelips and cleft palate, but in severe cases it causes cyclopia (the eyes fuse into a single deformed central eye, often with a proboscis above it). Other affected kittens had small rudimentary eyes located on the sides of the head rather than on the face. Some had severe cleft palate, extreme harelip on both sides of the mouth, brachygnathia (short or receding jaw, flat face) and protruding tongue.

Because cats with minor defects such as the nose dot were often superior in other ways, breeders were unknowingly selectively breeding the cranial defect into the breed. The desire to "ultra-type" cats meant that breeders working with extreme types were more likely to breed affected cats together and encounter the head defect than breeders working with the more moderate or traditional types. Some of the affected cats had won high accolades on the showbench and were desirable breeding stock. The gross deformities would only show up a few generations later when cats with the mutation were bred to each other and kittens with lethal head defects were born.

Like the twin-faced kittens, the cranial defect is associated with the sonic hedgehog gene (Shh) which controls facial symmetry. There are 3 known hedgehog proteins: sonic hedgehog (shh), desert hedgehog (dhh) and indian hedgehog (ihh). Sonic hedgehog is the most common and best documented of these. The sonic hedgehog protein is made in the notochord of developing embryos. Different levels of the protein cause different types of cells to be formed in the developing embryo. It is involved in separating the single eye field into two bilateral fields, hence a mutation of sonic hedgehog can cause cyclopia. Too much sonic hedgehog causes duplication of structures. It also affects limb development and orientation, neural tube (brain/spinal cord) development and seems to affect the growth of hair, feathers or scales. The many effects of sonic hedgehog demonstrate that when selectively breeding for one trait, there is a danger that the gene controlling the desired trait also controls undesirable traits.

According to Carol Johnson (correspondence Oct 2006), the defect has not yet been definitively linked to sonic hedgehog. There is no mutation of the shh gene itself and it is speculated that the cranio-facial abnormalities may be due to a mutation in a downstream gene.

CYCLOPIA

Cyclopia or synophthalmia (known medically as holoprosencephaly (HPE)) is a gross lethal deformity of the skull. The eyes are fused into a single enlarged eye that is placed below the nose (the nose may or may not form, if it forms it resembles a proboscis). Much of the face may be missing, such that the eye and proboscis (if present) are placed near the crown of the skull. Cyclopia results from a failure of the embryo's forebrain to divide into 2 hemispheres. It can result from defective genes or from certain toxins. These seem to interrupt development by interfering with a protein called Sonic hedgehog (Shh). Severe cases of cyclopia result in stillbirth or in death within a few hours of birth. Severely affected kittens will show primitive reflex actions (crying, swallowing etc), but have no higher brain functions.

 

In January 2006, another cyclops kitten photo did the rounds of the internet (the white kitten, above right). Cy, short for Cyclopes, was a Ragdoll kitten born 28th December 2005 with only one eye and no muzzle. The owner, Traci Allen, raises Ragdolls in Redmond, Oregon. The litter contained only 2 kittens, this one and a normal sibling. Cy, photographed by the owner as a newborn (the fur appears slick from amniotic fluid rather than fluffy and dry), died after living for one day, was one of two in the litter. Many blogs and boards have claimed the photos to be fake, but have no knowledge of cranial defects to support their opinion. It is not a fake (after death, Cy was verified as real by veterinarian Karen Laidley, who examined the body). Although kittens do not open their eyes for 2 weeks, Cy has no eyelids and cannot close the eye (compare this with the black kitten where the eye protrudes from the skull). The eye is still moist, either from amniotic fluid or possibly from being moistened by the breeder (even normal kittens are sometimes born with open eyes). The bottow rim of the eye is incompletely fused. Although the head appears to be normal size, the eye is disproportionately large and occupies most of the central facial area - this is due to the abnormal growth of the facial structures associated with cyclopia. The internal structure of the eye is also defective: it lacks the pigmented iris that is blue in normal kittens; it has no blood vessels and no tapetum (the reflective layer that causes red-eye/green-eye in flash photography). The malformed brain means the eye is blind. The head is an abnormal shape with no muzzle and with the mouth presenting as a slit below the eyes.

During its short life, the kitten was syringe-fed and made comfortable by the owner. The malformation of the brain means the kitten would not have suffered during its short life. It would have been rejected or killed by its mother. Following its death, the kitten's body was deep frozen in case it could be examined for research. The owner has been contacted by Ripley's Believe It Or Not and by the curators of the "Lost World" museum of oddities due to open near Syracuse, New York in 2006. Both want to display Cy. A Harvard University professor has requested a sample of Cy's DNA to study. In spite of the great interest in Cy and debate over the authenticity of the photos, news agencies declined to publish follow-up stories considering it to no longer be newsworthy.

Dr Keith Johnson of the Mountain View Veterinary Clinic delivered a cyclops kitten in the 1970s. He has kept the kitten's remains in a jar and shows it to those who ask to see it. Johnson noted that cyclopia is an extremely rare condition and he would be surprised if many more such kittens have been born. Most affected foetuses are aborted, or in the case of cats, reabsorbed, and do not reach full-term. Johnson noted that his one-eyed kitten was the result of inbreeding.

The three photos above are a cyclops kitten born to a Bengal breeder in November 2013. The kitten lived for 3.5 hours. The single eye appears to have 2 irides and pupils. Photos reproduced by kind permission of ClonzBorneo Cattery.

This was not the first Bengal born with cyclopia. In October 2012, a video and photos of a cyclopic Bengal called Cleyed went viral. Cleyed was born by emergency caesarian when his mother had difficulties delivering a litter. He was the second kitten delivered and died a short time afterwards. Although this death was attributed to suffocation, cyclopia caused brain abnormalities and is a lethal defect.

SEVERE HOLOPROSENCEPHALY

Some very extreme cases of holoprosencephaly/cyclopia have been described in cats. In these cases, the mouth and nose do not form and the only facial feature present is a large, centrally positioned eye. A veterinarian present at one such birth noted that the kitten was struggling for breath (a reflex action). Examination showed no mouth or nostrils present, resulting in suffocation once the kitten was no longer sustained by its umbilical cord. In the holoprosencephaly case below, the eye was also absent.



Tina Pollard's 3/4 Persian Milo produced this kitten in June 2007 along with a normal littermate. It lived for about 20 minutes. It looks like severe holoprosencephaly, essentially cyclopia but without the eye. Tina lives in rural New South Wales, Australia and unfortunately was unable to preserve the kitten or donate it to an anatomy museum. The vet was unable to offer a full explanation of the deformity and disposed of the body without further investigation.

If you compare the photos to those of the cyclopic kitten, you will see what appears to be the rim of an eyelid and ear flaps either side. No other facial structures, such as mouth or nostrils, are visible. There appears to be no cerebrum (forebrain) so the kitten was never conscious and did not suffer. Parts of the hindbrain would have allowed some reflex actions.

There are numerous cyclopic human infants preserved in medical museums. Cyclopia has been described in sheep, cattle and goats. Cyclopic infants, regardless of species, have a single monstrous eye in the middle of the forehead, underneath what remains of the nasal cavity. Those few that reach full term survive no more than a few days. The most usual cause is a mutation in the Sonic hedgehog gene and the degree of cyclopia depends on how badly the gene is damaged. Sonic hedgehog codes for a morphogen protein that instructs cells where they are, where to migrate to and what to become. When this protein malfunctions, the body’s geometry is disrupted to a greater or lesser degree. Before the eyes form, part of the forebrain (cerebrum) is dedicated to the brain wiring related to the eyes. Sonic hedgehog normally divides this region (optic field) into two smaller areas, one on either side i.e. one for each eye. If the gene malfunctions, only one optic field forms and there is either a single fused eye or two eyeballs in a single eye socket. The internal organs may also be affected depending on how badly the gene is damaged. If Sonic hedgehog is completely disabled, the embryo does not develop paws or a face, it just has an eyeless, earless, mouthless trunk in place of the head.

CONJOINED KITTENS

For othe types of conjoining see Conjoined Kittens

ANENCEPHALY (ABSENCE OF FOREBRAIN)

The following information and accompanying images have been provided by Joen Seddon In December 2004 for the benefit of other breeders encountering gross deformities in kittens. Joen's tortoiseshell queen produced a litter of 4 kitten following a difficult labour. The first kitten arrived after approximately 3-4 hours after bearing down. The queen had lost a great deal of fluid (more than usual) before the first kitten arrived. The kitten was born tail first with the sac already broken. On first sight, the kitten was found to have extremely bulging eyes and no eyelids. Closer inspection indicated that there may have been eyelids (or skin) present, but they were completely transparent and the eye ball was completely visible. The pupils were large. The tongue was enlarged and everything from the bridge of the nose upwards appeared to be collapsed or absent. The kitten lacked a forehead and fontanel. The ears were approximately at nose level and facing outward rather than upward. On the top of the head was a small opening revealing a membrane. The kitten appeared very strong, but showed no interest in feeding.

After the remaining kittens were born, Joen removed the deformed kitten (and was surprised that it was still alive) to see if it had any instinct for food in spite of apparent lack of the forebrain. It had a good deal of strength, but lacked the co-ordination to initiate feeding, however it took kitten formula from a small dropper. Though it became excited at being dropper fed, it showed no sucking ability. When placed directly at the mother's nipple, it showed interest in feeding, but could not grasp the nipple and was only able to lick at it with its enlarged tongue. The inside of the mouth was badly deformed. The rest of the body appeared entirely normal and the weight was 200 grammes. At 9 hours, it was active and looked "like a bat". Joen decided to let nature take its course. The kitten survived only 20 hours. After 12 hours it began crying loudly, probably due to inability to feed (because it lacked a forebrain, it lacked the ability to feel pain; the crying was a reflex and did not indicate suffering (this has been studied in human cases of anencephaly)).

The mother cat did not treat the deformed kitten any differently from the three normal siblings. The surviving kittens are described as "normal, hefty and spunky" and also 200 grammes (approx). Oddly, the anencephalic ("lacking forebrain") kitten was also spunky, though the absence of the cerebrum meant the kitten lacked consciousness (feeding reflexes and breathing are due to the more primitive parts of the brain). Joen's photos were taken shortly after the kitten died and there are signs of dehydration. The eyes were even more pronounced in the hours after birth.

The mother had difficulty birthing the deformed kitten, but the remaining 3 kittens were birthed more easily. The mother had previously only been bred 3 times (all planned) with the same male and had produced a single kitten on each of the previous occasions. The latest 4 kittens had been conceived while her previous singleton kitten was only 3 1/2 weeks old and had been sired by a stray tom when the female escaped from the house. It was not realised that the queen was pregnant for a month. The cause of anencephaly is unknown, but human cases are linked to the mother's diet and vitamins, particularly to folic acid deficiency. Gross neural tube deformities due to genetic causes have been reported in the Manx breed, but the kittens are usually reabsorbed early in gestation or arrive as partially reabsorbed ("mummified") kittens. It is therefore possible that the previous singleton litters were due to defective embryos being reabsorbed and that the female carries a defective gene.

The image above was provided by Rochelle Prestwidge in October 2006. Rochelle's cat gave birth to 5 kittens of which 2 were abandoned by the mother. The second-born kitten (male) had anencephaly. Comparing the male to his sister (both were stillborn or died soon after birth), his head is flat from above the eyes straight across with a bulging red membranous section in the middle. Although closed, his eyes are noticeably larger and his lower jaw protrudes slightly. In comparison, the normal kitten's head is domed above the eyes.

Anencephaly is a neural tube defect that occurs when the cephalic (head) end of the neural tube fails to close early in gestation, resulting in the absence of a major portion of the brain, skull, and scalp. Affected individuals are born without a forebrain i.e. the largest part of the brain comprising mainly of the cerebrum which is responsible for thinking and coordination. Lack of cerebrum explains the kittens inability to co-ordinate and suckle. The remaining brain tissue is often exposed (not covered by bone or skin) and matches Joen's description of a visible membrane. The braincase does not form properly and this distorts other features, in this case the lidless prominent eyes and the placement of the ears. According to human medicine, anencephalic newborns are usually blind, deaf, unconscious and unable to feel pain. Some individuals have a rudimentary brainstem, but the lack of a functioning cerebrum makes consciousness impossible. Reflex actions such as breathing and responses to sound or touch may occur. In humans, the condition is found more often in females than in males. Affected individuals are usually stillborn, those that survive birth die within hours or, at most, a few days.

Another photo of a neural tube defect from "mamadkitty". Her cat, Paris had a litter of 3 kittens. The first Kitten was stillborn and appears to have anencephaly. The other 2 kittens, a male and a female, were normal. The photo was taken straight after birth and there has been no shrinkage of tissues.

This stillborn kitten was born 5 days premature and delivered placenta first. The hairlessness, bloating and the darkening under the skin indicates it had died some days earlier; this may have triggered the premature delivery of the litter. It appers to have died, or stopped developing physically, at a stage before the genitalia had differentiated into male or female.

MORE ANOMALIES

If you have come to this page directly from a search engine, please check out FELINE MEDICAL CURIOSITIES for the full index of topics including

  • What Causes Medical Curiosities?
  • Extra or Deformed Toes, Paws and Limbs, Split Foot, Twisted Limbs, Mummification of Limbs, Accidental Part-Amputation of Limbs, Curly Tails
  • Conjoined Kittens
  • Anomalies of the Fur and Skin: Green Kitten, Hairlessness, Curly Fur, All Black Siamese (Porphyria?), Pink Cats
  • Facial Deformities: Hydrocephaly, Cleft Palate, Anomalies of the Eyes and Ears, Two-Headed/Two-faced Kittens
  • Anomalies of Size: Dwarf Cats, Giant Cats, Fat Cats
  • Miscellaneous Anomalies: The Dancing Cats of Japan

BOOKS ABOUT ANOMALIES

If you are interested in medical curiosities, books worth reading are "Mutants: on the Form, Varieties and Errors of the Human Body" by Armand Marie Leroi and "Anomalies and Curiosities of Medicine Vols 1 and 2" by George M. Gould & Walter L. Pyle. The Gould & Pyle books were published in 1896 and are in the public domain. You can download text-only versions of Gould & Pyle from several websites so don't waste money on text-only versions of the book; but if you want the versions with photos, consider the Kessinger editions. The Leroi book explains why and how some deformities and anomalies happen - the mechanism is the same in cats as it is in humans.

MESSYBEAST CATS : CURIOUS CATS AND MEDICAL ANOMALIES

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