Failure to thrive and fading puppies Flashcards
what needs to be done with regards to the immediate care of a neonate?
what body weight should a puppy gain each day?
what is the respiration rate of a puppy?
what temp should a puppy be?
Always check
Airway ….and if necessary
- Remove membranes, dry with towel, aspirate fluid
Breathing ….and if necessary
- Rub chest, apply positive pressure ventilation
Circulation ….and if necessary
- External cardiac massage
If necessary clamp and cut umbilicus (at 3cm)
Dry the pup and place in a warm nest
Encourage the pup to suck
Then:
Record birth weight
Should gain 5-10% bodyweight per day; failure to do so may indicate disease
Monitor respiration (15–40 breaths/m)
Record temperature – often considered unnecessary but really helpful (34C)
Check for congenital abnormalities, such as cleft palate or harelip
why is the neonate different ot the adult?
what do these factors result in?
Why is the neonate different to the adult?
* Poor breathing
* Limited ability to regulate body temperature
* Poor regulation of fluid balance
* Limited energy store
* Immune system is immature
All of these factors result in:
* Increased susceptibility to disease
* Poor response to disease (rapid hypothermia, rapid fluid loss, energy depletion and poor immunological response)
* Potential for high mortality rate
*
what are the key aspects of ongoign care of puppies?
how can you check these?
- Ensuring colostrum and milk intake
- Essential to have adequate intake within the first 48 hours
- Neonates should suck every 2-4 hours
- Ensuring hydration status
- evaluate urine colour - colourless
- Monitoring environmental temperature and pup behaviour
- 28-30C for 1st week
- 26 C for next 3-4 weeks
- huddles/spread out
- Regular clinical examination
- Frequent crying or failure to gain weight early indicator
- Feels cold to touch
- thin
- dirty/unkempt coat
when should puppies stand and walk?
when do the eyes open?
when can they defecate and urinate voluntarily?
- Strength gradually increases and standing seen from day 10; most pups walk at 3 weeks
- Eyes open 10–14 days after birth. Cornea may appear slightly cloudy at first
- Voluntary defecation/urination after week 2 or 3
what is the treatment of puppies with minor signs of disease?
- Any neonate with minor signs of disease (lethargy, slow to feed, lack of weight gain) should have early supplemental feeding
- If concern over intake of colostrum, a source of frozen-thawed or replacement colostrum should be given before day 3
- If necessary use tube feeding
- Maintain body temperature, which should be recorded every few hours
- Environmental temperature should also be monitored using a thermometer placed adjacent to the neonates
- Adequate hydration
- General nursing care is important and should include regular perineal stimulation to ensure urine and faecal voiding
- Antimicrobial preparations may be considered
- Not because there is a primary bacterial infection
- But, the neonate is susceptible to commensal overgrowth
- Oral clavulanic acid-potentiated amoxycillin at 12.5 to 25 mg/kg twice daily
how much colostrum is absorbed in puppies before 4h and after 12hs?
60% absorption before 4 h and 5% after 12h
what is the treatment of a puppy with significant disease?
Absence of feeding, dehydration or other clinical signs necessitate immediate aggressive treatment:
* Reverse hypothermia (1C per hour), do not feed pup if colder than 34C, add dextrose to fluids (as increased calorific demand)
* Reverse hypoxia
* Treat / prevent dehydration - IV or Intraosseous
* Prevent commensal organism overgrowth
what are the predictors of mortalitiy in puppies?
- Low APGAR score (less than 6)
- HR, RR, Response, Mobility, Mmemb colour
- Dehydration (urine is coloured)
- No increase (worse = decrease ) in bw
- Rectal temperature less than 35C
- Plasma glucose less than 100 mg/dL
- [Worse is low glucose and low temp = 67% mortality]
- Umbilical lactate concentration above 5 mmol/L
- IgG less than 3g/L = 35% mortality
what ar the most life threatening problems of puppies 2 weeks to 6 weeks of age?
what other conditions may become apparent in this period?
what are the best predictors fo wellness?
Most life threatening problems
* Dehydration from diarrhoea
* Internal and external parasites
* Traumatic insults
Other conditions may become apparent in this period
* Congenital defects such as megaoesophagus as change from liquid to solid food
* Juvenile hypoglycaemia (immature hepatic enzymes – failure to adapt to fasting between meals [ie seen after weaning]) in some breeds
* Fatty liver syndrome in some breeds may be evident as failure to thrive
Best predictors of wellness
* Continued growth
* Normal behavioural development (walking, exploration, interaction)
* Normal rectal temperature
what are the most life threatening problems of puppies 6 -12 weeks?
Maternal antibody starts to be lost during this period so increased susceptibility to infectious disease
Most life threatening problems
* Infectious disease
* Disease associated with inquisitive behaviour (foreign bodies, biting electric cables)
what are the causes of failure to thrive in puppies 6-12 weeks of age?
what are the common presenting signs?
Many cases of failure to thrive :
* Poor nutrition
* Poor energy absorption (e.g. GI disease [always consider parasitism])
* Poor energy conversion (e.g. porto-systemic shunt)
* Within, or after, this period metabolic disease may become apparent
* Hypoglycaemia (substrate-limited hypoglycaemia
Common presenting signs
* Failure to gain weight
* Neurological signs
* For fitting always consider hypoglycaemia first
* Porto-systemic shunt
* Hydrocephalus
what metabolic diseases can become apparent in puppies 6-12 weeks of age?
- Pituitary dwarfism
- Features and problems of chondrodysplastic breeds become apparent
- Congenital hypothyroidism
- Juvenile diabetes insipidus
- Juvenile diabetes mellitus
- Juvenile onset hyperadrenocorticism
- Juvenile hyperparathyroidism
what are the cause of fading puppies?
28% are actually sick at birth
* Managemental and maternal causes (16%)
* Very low birthweight (7%)
* Congenital defects (5%)
* Often fade and die before day 3
55% appear normal at birth but may have inadequate surfactant
* Fade and die between days 3 and 5
15% appear normal at birth but succumb to infection
* Often fade and die after 6 days
what are the lungs of immature puppies like?
Low surfactant levels
Not conducive to gas exchange
Thick blood gas barrier
Low compliance
Immature epithelial cells
Small area for gas exchange
Poorly vascularized
High resistance to blood flow
what is the role of surfactant and fading puppies?
Role of lung surfactant
-> Poor respiratory function
-> Respiratory distress
-> Inability to suck (as cannot breath)
-> Fatal cycle of hypoxia, dehydration, low blood sugars, hypothermia and death
