Care of the Neonate Flashcards
Detail the pediatric period classifications? (length)
Pediatric period = 0-12 weeks
- Neonatal= 0-2 weeks
- Infant/ paedeiatric= 2-6 wks
- Juveniles 6-12 wks
What are the most common causes of paediatric mortality?
- hypothermia
- hypoglycaemia
- hypoxia
- dehydration
what are the main differences in neonatal and adult physiology?
- Thermoregulation
- Cardioresp
-Neurologic
-Gastrointestinal
-Immunology
-Nutrition
What is the neonatal triad?
HYPOthermia, HYPOXIA, HYPOglycaemia
What should the bitch/queen do at birth?
- Clear membranes
- Lick to clear airway and dry coat
- Bite off umbilicus
- Nudge newborns to feed
When should colostrum be consumed?
Within first 8 hrs (then barrier closes)
HOw would u go abot assessing a neonate?
- CE ->
head, eye e&ar mouth palate ;
Abdomen anus umbilicus
Neuro exam (reflex, sucking, alertness)
Rectal temp (birth 36°C, 37-38° week after)
HR 200-220
Resp 15-35bpm
Describe scoring on APGAR
10-14= healthy
5-9= probs stressed
0-4= severely stressed
Neonatal resusc steps?
A- Airway (clear it)
B - Breathing (stimulate with vigorous rubbing, gentle pressure & supply oxygen)
C - Circulation (Cardiac massage, fluids )
D - Dry & warm
Causes of congenital abnormalities?
- Genetics
- Inbreeding or breed related
- Maternal age
- Illness of dam during pregnancy
- Drugs or toxins during pregnancy
- Intrauterine infection
- Poor maternal nutrition
What are some common congenital abnormalities?
- Cleft palate, cleft lip
- Hydrocephalus
- Cranial cleft
- Absence / abnormalities of limbs
- Umbilical or other hernias
- Atresia ani
- Gastrostochitis
- Limb and tail abnormalities
What are INVISIBLE abnormalities to be aware of?
- Hydrocephalus
- Cerebellar hypoplasia
- Chiari-like malformations
- Syringomyelia
- Cariac abnormalities
- PSS
- Urogenital abn (PKD, ectopic ureters…)
Signs of illness in neonates?
- Smaller than rest of litter
- Don’t gain weight
- Not active
- Not sucking reflex
- Isolated by bitch
- Crying >15mins
Describe what is meant by Fading puppy/kitten syndrome
- born healthy but start dying within 2 weeks
- Prolonged crying, restlessness, hypothermia, shock
- Petechial hemorrhages
- Sloughing of distal extremities
What can cause fading puppy/ kitten syndrome?
- Husbandry and mothering
- Congenital defects
- Infectious diseases
- Parasites - worms
What SHOULD u use for AM therapy in little ones?
- IV
- Amox 10-20mg/kg
- Amox/ Clavulanic acid 12-25mg/kg
- Cephalexin 10-30 mg/kg
What SHOULD NOT be used in little ones?
- AminoGs
- Chloramphenicol
- Quinolones
Detail Omphalitis
Umbilical cord infection/ abscessation
Rx: drain abscess, antibiotics
Detail Ophtalmia neonatorum
- Purulent conjunctivitis
- Pus behind closed eyes
- Open eyes carefully in flash
- AB ointment
Describe neonatal isoerythrolysis in cats
- Type B mated with type A tom - kittens A or AB
- Kittens ingest anti-A antibodies in milk
-Sudden death with icterus, anaemia and hemoglobinuria
do we see neonatal isoerythrolysis in dogs?
not unless previous transfusion
What can cause neonatal septicaemia?
- Pups exposed to chilling
- Colostrum deprivation
- Omphalitis
- Infection from dam or environment
what signs of neonatal septicaemia?
Cyanosis, toxic MMs and skin discolouration and respiratory distress
What to do for neonatal septicaemia
Culture peritoneal fluid
Treat litter mates early
Why are little ones at higher risk of hypothermia ?
shivering and peripheral vasoconstriction only develops after 1 week - cannot control body temp for 2- wks
Large SA no fat
How to reheat for hypothermia ?
- Rewarm slowly over 1-2 h to avoid inc metabolic
- Focal source of heat but able to move away
- Turn regularly
- Keep at:
29-31°C week 1
26-28°C wk 2
23-25°C > wk 3
Describe hypoxia in neonates
- Happens with sepsis & penumonia
- Arterial blood gas analysis impossible
- Pulse oximeter >90%
- 50% oxygen max
What maintenance rq of fluids in puppies?
80-100ml/kg/d
What is the ideal glucose range?
5-9mmol/L
What can lead to hypoG?
Starvation, sepsis
(inc demand for glucose due to low fat reserves, low hepatic and muscle glycogen reserves)
When does gag relfex develop?
10 days
Describe nutrition in neonate
- Colostrum NB first 3 days of life
- Energy need 20-25kcal/100g/d
- Commercial milk formula
- Stomach capacity 4ml/kg
How should we feed neonates?
- 4 meals per day at least
- Burp and elimination after fee
- SKip meal if D+
Older pup NE or NG tubes
How do we encourage elimination?
- Burp by rubbing on sides of chest and abdo to avoid bloat
- Stimulate defecation and urination by gently rubbing perineum and prepuce area
- cLean well
What should urine USG be in neonate?
1.007-1.017 (proteinuria and glucosuria normal in neonate)
Haematocrit at birth?
up to 60%
TSP in neonate?
35-52g/L
Temp at birth? after 1 wk?
36°C at birth, 37-38°C after 1 week
Weight should …… by 10-12 days
double
Eyes open at ….. days
10-14 days
can walk from ….
3 weeks
Solid food when?
3 weeks
