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SA Therio > Canine and Feline Neonatology > Flashcards

Canine and Feline Neonatology Flashcards

1
Q

What are four of the main causes of neonatal death?

A
  • Hypothermia
  • Hypoglycemia
  • Hypoxia
  • Hypovolemia
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2
Q

Neonate age range

A

birth to 2 weeks

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3
Q

Pediatric/infant age range

A

2 weeks to 8 weeks

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4
Q

Juvenile age range

A

8 weeks to 6 months

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5
Q

Adult

A

6 months +

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6
Q

How long is dog pregnancy?

A

9 weeks

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7
Q

Unique characteristics of puppies and kittens when born

A
  • Blind
  • Poikilothermic
  • Limited mobility
  • Entirely dependent on mother for survival
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8
Q

How does blood pressure change from week 1 to week 4 of life?

A
  • Low BP (50) to higher (~150?)
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9
Q

How does heart rate change from week 1 to week 4 of life?

A
  • Decreases (200 to ~100)
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10
Q

Cardiovascular physiology of neonates (skipped in class so maybe don’t emphasize)

A
  • Umbilical circulation occluded
  • Close ductus venosus and ductus arteriosus
  • Circulation redirected to lungs and liver due to changing pressures
  • Increased circulation to kidneys, GIT, muscles
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11
Q

How does anoxia affect the heart rate of puppies?

A
  • Mild hypoxia doesn’t affect

- Anoxia before 4 days of age causes profound bradycardia (45 bpm) and marked hypotension (systolic pressure 23 mmHg)

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12
Q

Heart rate response to vagal inhibition in puppies

A
  • Parasympathetic structure appears mature but heart rate responds poorly to vagal inhibition in puppies under 2 weeks
  • Poor or no response to atropine, so treat bradycardia with oxygen and warming
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13
Q

First respirations in neonates?

A
  • Inhibited in utero
  • Respiration stimulated by hypoxia, hypercapnea, and cooling of the skin at birth
  • Breathing must begin within 8-10 minutes if permanent brain damage and death is to be avoided
  • Genital and umbilical stimulation induces reflex respiration
  • First breath is most difficult
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14
Q

Beginning breaths and pressure

A
  • Viscid fluid in alveoli requires inspired pressure of -30 cm H2O
  • Neonate can exert -60 cm H2O
  • Expiration of first breath requires positive pressure of 40 cm H2O to empty the alveoli
  • Normal breathing is present is present within 40 minutes with pressure 0-15 cm H2O
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15
Q

Steps to take when a neonate is first born?

A
  • Clear airways and use suction if needed
  • Don’t sling newborn around in effort to expel fluids from airway
  • Newborn puppies and kittens can be intubated with tiny Cole tubes, small feeding tubes, and Tom cat catheters
  • Don’t overinflate
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16
Q

What % fluid are newborns?

A
  • 80% at birth
  • Skin is permeable and weight lost during first 24 hours
  • Dehydration can occur quickly
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17
Q

How long must urination be stimulated reflexively?

A
  • 2 weeks
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18
Q

Renal function of neonates

A
  • Functional immaturity for 8 weeks
  • Low GFR, depressed reabsorption
  • Exaggerated salt loss and low concentrating ability
  • Low serum urea nitrogen and creatinine with elevated phosphorus
  • neonatal renal blood flow is correlated with blood pressure and not responsive to RAAS until 6 weeks of age
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19
Q

GI of neonates

A
  • Sterile at birth
  • Neutral pH with increased permeability up to 10 hours after birth
  • Intestinal electrical activity limited before day 40 so contents move mostly due to pressure gradients
  • Stomach and intestinal contraction will sotp if body temp less than 94 degrees F
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20
Q

Why is it so important to warm up neonates before feeding them?

A
  • Stomach and intestinal contraction including sphincter control stops if the body temperature is <94°F
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21
Q

Musculoskeletal movement of puppies and kittens newborn (skipped in class)

A
  • Puppies and kittens move reflexively soon following birth with a nuzzling response
  • Flexor dominance present for first 4 days
  • Extensor reflexes dominate from day 5 to 3 weeks
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22
Q

Neonatal TPR***

A
  • Rectal temperature of newborn is 97°
  • HR >200 BPM
  • RR 15-35 breaths per minute
  • Hypothermia and hypoxia cause bradycardia
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23
Q

What should you check first if a newborn is bradycardic?

A
  • Temperature and oxygen status!
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24
Q

Body weight of puppies and kittens at birth

A
  • Puppies 100-700g

- Kittens 100g

25
Q

Poor prognostic indicator based on kitten weight

A
  • Kittens <90g
26
Q

Normal weight loss in puppies and kittens after they are born

A
  • Should lose weight during first 24 hours
27
Q

Weight gain in puppies and kittens

A
  • After losing weight in first 24 hours, should gain weight at 5-7% each day
  • Puppy weight should double by about 1-2 weeks and kittens double by 2 weeks
28
Q

Signs of a healthy puppy

A
  • Strong and wiggly

- Gentle handling and patience required

29
Q

Signs of a sick puppy

A
  • Cry for prolonged periods (>20 minutes)
  • Weak, limp, cool neonates are in serious conditions
  • Deterioration and death can occur very quickly
30
Q

Factors affecting neonatal survival (skipped in class)

A
  • Unhealthy mother, stressful delivery
  • Drugs used during delivery
  • Congenital abnormality
  • Poor nutrition
  • Infectious disease
  • Environment (temperature, ventilation, sanitation, housing)
31
Q

Mortality rate depending on time spent in Stage II labor

A
  • <5 hours - 5.8% mortality

5-24 hrs - 13%

> 24 hours - 90% mortality!!**

32
Q

Things needed for preparation of action after birth

A
  • Trained personnel
  • Suction
  • Dried towels
  • Oxygen and intubation
  • Hemostat, suture, disinfectant, scissors
  • Warm, soft, absorbent post delivery box
33
Q

APGAR score

A
  • Activity
  • Pulse
  • Grimace
  • Appearance
  • Respiration
  • Higher numbers are better
  • Measure at 1, 2, and 60 min post partum
34
Q

Activity score

A
  • Flaccid (0)
  • Some flexion (1)
  • Active motion (2)
35
Q

Pulse score

A
  • 0 <180
  • 1 180-220
  • 2 >220
36
Q

Grimace score

A 
0 = absent 
1 = grimace 
2 = vigorous
37
Q

Appearance

A 
0 = cyanotic 
1 = pale 
2 = pink
38
Q

Respiration score

A

0 = no crying, <6 bpm

1 = mild crying, 6-15 bpm

2 = crying >15 bpm

39
Q

Excellent condition score

A
  • Routine care

- 7-10 points

40
Q

Moderately depressed APGAR

A
  • 4-6

- Rub thorax, ventilate, O2

41
Q

Severely depressed APGAR

A
  • 0-3

- As above (rub thorax, ventilate, O2) plus IO epinephrine

42
Q

Maternal causes of neonatal death

A
  • maternal neglect
  • Immaturity/anxiety/cannibalism
  • Mastitis
  • Metritis
  • Sub involution of placental sites
43
Q

Preweaning mortality %

A
  • Preweaning mortality is 10-20% with most deaths in the first week of life
44
Q

The four hypos again

A
  • Hypothermia
  • Hypovolemia
  • Hypoglycemia
  • Hypoxia
45
Q

Treatment for hypothermia

A
  • Rewarm
  • Place in incubator (warmth, oxygen, and humidity)
  • recirculating water heating pads, suspended light
  • Do not use electric heating pads, hot water bottles, or rice bags directly on puppies
  • Rewarm over 1-3 hours
46
Q

Goal temperature for rewarming a neonate

A
  • 98°F

- Mimicking febrile response

47
Q

Hypovolemia treatment - when to give oral fluids?

A
  • ONLY IF TEMPERATURE ABOVE 94°

- If it’s below, you will kill them as gastric and intestinal motility is diminished and aspiration pneumonia may occur

48
Q

Rate and dose of fluids for neonatal hypovolemia

A
  • Administer 1mL LRS +2.5 mL 10% dextrose per 30 g body weight IV or IO
  • Repeat once every 15 minutes until rehydrated and urine production begins
49
Q

Parenteral routes for neonatal fluids

A
  • IV (jugular vein)
  • IO (proximal tibia, greater trochanter of femur, or proximal humerus) - WATCH OUT FOR THE SCIATIC NERVE
  • Use spinal needle or 22g hypodermic needle
50
Q

Hypoglycemia treatment

A
  • Administer 0.25 mL 10% dextrose per 30 g body weight by stomach tube if body temperature above 94°F
  • Warmed orphan formula may be administered as supplement if puppy or kitten warm and strong
51
Q

Hypoxia in neonates

A
  • Sepsis, pneumonia, hypothermia
  • Incubate at 40% oxygen
  • Do not give for prolonged periods at high levels due to potential for development of vitreal fibroplasia
52
Q

Drug options for neonates

A
  • blood transfusion if anemic
  • Serum if FPT or suggestion of it
  • Clavamox or cephalosporins generally safe
  • Amikacin if aminoglycoside is needed but watch hydration status due to nephrotoxicity potential
  • Vitamin K1 in puppies for hypoprothrombinemia
  • L-thyroxine is last ditch
53
Q

Milk composition of the bitch

A
  • Mostly fat (65%), then 23% protein and 12% lactose (sugars)

By calories

  • varies by species
54
Q

Hand raising puppies and kittens

A
  • Feed via bottle or with feeding tube
  • Feed 105-120 kcal/lb body weight
  • Kittens 100-175 kcal/lb bwt daily

Feed every 2-4 hours for first three days then every 4-6 hours after

  • Don’t wake them up if they appear full
55
Q

Tube feeding puppies

A
  • Tip of nose to last rib
  • Should pass easily
  • 8 or 10 Fr so it’s less likely to go into the airway
  • want them to swallow
  • make sure you prefill the tube
56
Q

Clinical lab testing of puppies

A
  • Hematocrit and TP (often won’t be normal)
  • CBC
  • Glucose
  • BUN
  • ALP
  • GGT (should increase with colostrum)
57
Q

Post-mortem examination (skipped)

A
  • May be only means to establish cause of death
58
Q

What do a full gall bladder and empty stomach suggest in a newborn?

A
  • Failure to receive colostrum
  • Even with diagnostic lab submission about 50% of cases not determined
  • Submit entire puppy or kitten

SA Therio (10 decks)

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