Care of the Neonate

Question 1

Detail the pediatric period classifications? (length)

Answer 1

Pediatric period = 0-12 weeks
- Neonatal= 0-2 weeks
- Infant/ paedeiatric= 2-6 wks
- Juveniles 6-12 wks

Question 2

What are the most common causes of paediatric mortality?

Answer 2

• hypothermia
• hypoglycaemia
• hypoxia
• dehydration

Question 3

what are the main differences in neonatal and adult physiology?

Answer 3

• Thermoregulation
• Cardioresp
  -Neurologic
  -Gastrointestinal
  -Immunology
  -Nutrition

Question 4

What is the neonatal triad?

Answer 4

HYPOthermia, HYPOXIA, HYPOglycaemia

Question 5

What should the bitch/queen do at birth?

Answer 5

• Clear membranes
• Lick to clear airway and dry coat
• Bite off umbilicus
• Nudge newborns to feed

Question 6

When should colostrum be consumed?

Answer 6

Within first 8 hrs (then barrier closes)

Question 7

HOw would u go abot assessing a neonate?

Answer 7

• 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

Question 8

Describe scoring on APGAR

Answer 8

10-14= healthy
5-9= probs stressed
0-4= severely stressed

Question 9

Neonatal resusc steps?

Answer 9

A- Airway (clear it)
B - Breathing (stimulate with vigorous rubbing, gentle pressure & supply oxygen)
C - Circulation (Cardiac massage, fluids )
D - Dry & warm

Question 10

Causes of congenital abnormalities?

Answer 10

• Genetics
• Inbreeding or breed related
• Maternal age
• Illness of dam during pregnancy
• Drugs or toxins during pregnancy
• Intrauterine infection
• Poor maternal nutrition

Question 11

What are some common congenital abnormalities?

Answer 11

• Cleft palate, cleft lip
• Hydrocephalus
• Cranial cleft
• Absence / abnormalities of limbs
• Umbilical or other hernias
• Atresia ani
• Gastrostochitis
• Limb and tail abnormalities

Question 12

What are INVISIBLE abnormalities to be aware of?

Answer 12

• Hydrocephalus
• Cerebellar hypoplasia
• Chiari-like malformations
• Syringomyelia
• Cariac abnormalities
• PSS
• Urogenital abn (PKD, ectopic ureters…)

Question 13

Signs of illness in neonates?

Answer 13

• Smaller than rest of litter
• Don’t gain weight
• Not active
• Not sucking reflex
• Isolated by bitch
• Crying >15mins

Question 14

Describe what is meant by Fading puppy/kitten syndrome

Answer 14

• born healthy but start dying within 2 weeks
• Prolonged crying, restlessness, hypothermia, shock
• Petechial hemorrhages
• Sloughing of distal extremities

Question 15

What can cause fading puppy/ kitten syndrome?

Answer 15

• Husbandry and mothering
• Congenital defects
• Infectious diseases
• Parasites - worms

Question 16

What SHOULD u use for AM therapy in little ones?

Answer 16

• IV
• Amox 10-20mg/kg
• Amox/ Clavulanic acid 12-25mg/kg
• Cephalexin 10-30 mg/kg

Question 17

What SHOULD NOT be used in little ones?

Answer 17

• AminoGs
• Chloramphenicol
• Quinolones

Question 18

Detail Omphalitis

Answer 18

Umbilical cord infection/ abscessation

Rx: drain abscess, antibiotics

Question 19

Detail Ophtalmia neonatorum

Answer 19

• Purulent conjunctivitis
• Pus behind closed eyes
• Open eyes carefully in flash
• AB ointment

Question 20

Describe neonatal isoerythrolysis in cats

Answer 20

• 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

Question 21

do we see neonatal isoerythrolysis in dogs?

Answer 21

not unless previous transfusion

Question 22

What can cause neonatal septicaemia?

Answer 22

• Pups exposed to chilling
• Colostrum deprivation
• Omphalitis
• Infection from dam or environment

Question 23

what signs of neonatal septicaemia?

Answer 23

Cyanosis, toxic MMs and skin discolouration and respiratory distress

Question 24

What to do for neonatal septicaemia

Answer 24

Culture peritoneal fluid
Treat litter mates early

Question 25

Why are little ones at higher risk of hypothermia ?

Answer 25

shivering and peripheral vasoconstriction only develops after 1 week - cannot control body temp for 2- wks

Large SA no fat

Question 26

How to reheat for hypothermia ?

Answer 26

• 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

Question 27

Describe hypoxia in neonates

Answer 27

• Happens with sepsis & penumonia
• Arterial blood gas analysis impossible
• Pulse oximeter >90%
• 50% oxygen max

Question 28

What maintenance rq of fluids in puppies?

Answer 28

80-100ml/kg/d

Question 29

What is the ideal glucose range?

Answer 29

5-9mmol/L

Question 30

What can lead to hypoG?

Answer 30

Starvation, sepsis

(inc demand for glucose due to low fat reserves, low hepatic and muscle glycogen reserves)

Question 31

When does gag relfex develop?

Answer 31

10 days

Question 32

Describe nutrition in neonate

Answer 32

• Colostrum NB first 3 days of life
• Energy need 20-25kcal/100g/d
• Commercial milk formula
• Stomach capacity 4ml/kg

Question 33

How should we feed neonates?

Answer 33

• 4 meals per day at least
• Burp and elimination after fee
• SKip meal if D+
  Older pup NE or NG tubes

Question 34

How do we encourage elimination?

Answer 34

• 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

Question 35

What should urine USG be in neonate?

Answer 35

1.007-1.017 (proteinuria and glucosuria normal in neonate)

Question 36

Haematocrit at birth?

Answer 36

up to 60%

Question 37

TSP in neonate?

Answer 37

35-52g/L

Question 38

Temp at birth? after 1 wk?

Answer 38

36°C at birth, 37-38°C after 1 week

Question 39

Weight should …… by 10-12 days

Answer 39

double

Question 40

Eyes open at ….. days

Answer 40

10-14 days

Question 41

can walk from ….

Answer 41

3 weeks

Question 42

Solid food when?

Answer 42

3 weeks