Neonate Flashcards
Critically ill neonate fluid therapy
Neonate anaesthesia
The sick neonate diagnostics– urinalysis
Initial challenges
-
birth
Treating the clearly sick neonate
•
Isotonic crystalloids
How do we reduce losses in neonates?
•
Normal body condition, adequate nutrition
•
Nutritionally complete and balanced diet
•
Bitches should gain 36% BW in pregnancy
•
Increased food requirements last 1/3 gestation (60%
more by whelping)
•
Almost impossible to overfeed in lactation
The normal neonate
-
growth
The normal neonate parameters
HR Wk 1 = 200-220 bpm (<150 = Oxygen)
– HR- physiological v. pathological
* Respiratory rate = 15 bpm (Day 1) –> 20-30 bpm
* Rectal temp 35-36C (wk 1)–> 37-38.2C (wk 2)
CRT 1-1.5 sec, MM pink–> sl. hyperaemic first few days
Dry umbilical cord in 24 hours (lost by day 3-4)
Resuscitation
Feline Neonatal isoerythrolysis
Artificial rearing feeding
Artificial rearing
Signs of illness neonate
Causes of hypoglycaemia
Stages of parturition?
General considerations neonates
Artificial rearing nutrition
ideally want the neonates to feed from dam/queen
Temperature critical! Warm first if necessary!
Diagnosis and treatment of feline neonatal isoerythrolysis
Treating the clearly sick neonate
- FLUID THERAPY
Maintenance fluid requirements are
180 ml/kg/d
•
Oral fluid/electrolytes rarely adequate
•
IV access
best (
jugular)
- STERILE TECHNIQUE
•
Intraosseous next best
•
Risk sepsis, bone damage
•
Intraperitoneal last
•
Slow absorption
•
risk sepsis
Cats
-
neonatal isoerythrolysis
Two different categories of the fading puppy
- Puppies that die after 7 days of birth (~50%)
- tend to have a known cause for death
– poor husbandry
– illness of the dam–> mastitis, metritis, etc.
– congenital defects
– poor mothering
– trauma
– immune insufficiency
–infection (20%)– viral, bacterial, parasitic
Neonate? Pediatric?
Husbandry of neonates
Take home messages neonates
Date of parturition and reasons for variation?
Treating the mildly sick neonate
‘Fading’ puppies and kittens cycle
Hypovolaemia and dehydration in neonates
Assessing hydration: paediatric gram scale, Hct (PCV) and TS (caution), skin turgor and lactate unreliable
* Treatment for hypovolemia and dehydration
- moderate dehydration- IVFT crystalloid bolus @ 30- 40 ml/kg or 20-30 ml/kg (kitten)
- maintenance = 80-100 ml/kg/day
- correct dehydration over 24 hours
- ongoing losses
‘Fading’ puppies and kittens
The sick neonate diagnostics– biochemistry
Resuscitation neonate
Assessing the sick neonate
-
EXAM
Colostrum– exam
Hypoglycaemia signs? Tx?
Assessing lab results
-
biochemistry
Stillbirths and neonatal deaths
Initial challenges
-
immunity
COMMENSAL FLORA of the bitch or queen can rapidly colonise
and invade a debilitated neonate, causing
sepsis
and rapid
death
Treating the clearly sick neonate AMs, monitor, bloods
The normal neonate
•
Eyelids separate at 10
-14 days (except some cat breeds)
•
Corneas cloudy, vision develops within 4 weeks
•
External ear canals patent at 14
-16d
•
Testicles descend soon after birth in kittens, can take 4
-6
weeks in puppies.
•
Must be stimulated in the perineal region to induce urination
or defaecation
Normal neonate- sensory
Initial challenges
-
fluid balance
hypoxia– in utero and post parturition?
Weight of neonate
Husbandry neonates
Adequate warmth and nutrition in
the first 3 weeks reduces mortality
Perinatal mortality
neonate parameters
Critically ill neonate oxygen therapy
Initial challenges
-
energy intake
Other causes of failure to grow and thrive
General pharmacologic considerations neonates
Initial challenges
-
in utero
Critically ill neonate AMs and monitoring?
When to intervene
- Obstruction
- Not entered labor and progesterone < 2 ng/mL
- Systemically ill
- Fetal HR < 160-180
- Suspicion of uterine rupture or torsion
‘Fading’ puppies and kittens known causes
Assessing the sick neonate
-
HISTORY
Orogastric tube feeding if sick or large litters (faster)
Maternal factors for healthy birth
General pharmacologic considerations specific drugs
The sick neonate- diagnostics– haematology
Specific infectious agents neonates
Normal neonate- neuro
Assessing lab results neonates
-
haematology
specific infectious agents neonates
Signs of hypoxia in neonate? Treatment?
