Neonates Flashcards
Immediate care of the neonate
Airway - remove membranes, dry with towel, aspirate fluid
Breathing - rub chest, positive pressure ventilation
Circulation - external cardiac massage
Dry and warm
Record weight
Record temperature
Check for abnormalities
APGAR
Activity
Pulse
Grimace
Appearance
Respiration
Examination of the bitch post partum
Settles after last pup
Red/green/brown discharge is normal
Haemorrhage abnormal
Check for milk
What are the risks with neonates
Increased susceptibility to disease - immature immune system
Limited body temperature regulation, poor breathing and lack of energy stores leads to poor disease response and high mortality
Key ongoing care aspects for neonates
Ensure colostrum/milk intake
Ensure hydration status
Monitoring environmental temperature and behavior (huddled likely cold)
Regular clinical exams
Things to look out for in sick puppies
Frequent crying
Cold to touch
Failure to gain weight
Inelastic skin
Slack abdomen
Dirty/unkempt coat
Loss of body twitching
Delayed characteristic development
Treatment of minor disease in the puppy
Early recognition crucial
Tube feeding is necessary
Ensure adequate colostrum within 12h
Maintain temperature, hydration, urination
Nursing care
Antimicrobials due to susceptibility for commensal overgrowth
Problems of significant disease in puppies
Escalation of issues - failure to suck = hypoglycemia/dehydration= hypothermia/hypoxia/bacterial overgrowth
4 hourly rectal temp, urine colour, skin elasticity, MM colour, CRT, RR, HR
Treatment of hypothermia
Slow reheating - 1 degree/hour
Maintain higher environmental temperature
Do not feed colder than 34° as gut won’t work
Fluid therapy for puppies
Maintainable 60-100ml/kg/day
Jugular or intraosseous
Predictors of low mortality
Low APGAR score
Dehydration
No increase in BW
Rectal temp under 35
Plasma glucose under 100mg/dL
Umbilical lactate >5mmol/L
IgG <3g/L = 35% mortality
Most life threatening conditions for 2-6 weeks
Dehydration from diarrhoea
Internal and external parasites
Trauma
Most life threatening issues at 6-12 weeks
Infectious disease
Disease associated with inquisitive behavior
Causes of fading puppies
Managemental and maternal causes
Very low birthweight
Congenital defects
Inadequate surfactant
Infection
True fading puppies
Lack of surfactant causes inadequate surfactant and therefore respiration so die day 3-5
Sting tendency for dams to have multiple
Differences between immature and mature lungs
Immature low surfactant
Non conductive of gas exchange
Thick blood gas barrier
Immature epithelial gas exchange
Poorly vascularized
High resistance to blood flow
Mature is opposite
pituitary dwarfism
growth hormone deficiency
inherited - GSD
other pituitary hormones can be affected
stunted growth from ~2 months, delayed dentition, retained puppy coat
shortened lifespan
diagnostics - biochemistry - elevated creatinine, GH deficiency, TSH deficiency, low T4/TSH
GH stim test, genetic testing
treatment - porcine GH (difficult to acquire) Medroxyprogesterone - mammary GH production. supplement thyroxine
congenital hypothyroidism
thyroxine deficiency
primary - dysmorphogenesis (anatomical thyroid abnormality) or dyshormonogenesis (abnormal hormone synthesis)
central - secondary pituitary abnormality
tertiary - hypothalamic abnormality
present with disproportionate dwarfism (wide skull, macroglossia, delayed dentition
diagnosis - hypercholesterolaemia, non-regenerative anaemia, low t4, high TSH,
treatment - levothyroxine supplementation (thyroxine)
EPI
pancreatic - aplasia, hypoplasia or atrophy
dog - pancreatic acinar atrophy
cats - chronic pancreatitis
CS - voluminous fatty diarrhoea (steatorrhoea), flatulence, borborygmi, V+, PD, greasy coat
Dx - biochemistry - increased liver enzymes. folate increased, cobalamin low. Trypsin like immunoreactivity being low is diagnostic (cTLI in dogs, fTLI in cats)
Treatment - pancreatic enzymes supplementation, coalbumin, dietary management (avoid high fat)
lifelong treatment
juvenile DM
insulin deficiency (absolute)
Dx - <6m, uncommon, inherited in keeshunds
presentation - stunted growth, PUPD, poor BCS, cataracts, concurrent EPI possible
diagnosis (as diabetes
treatment - insulin therapy (but challenging)
porto-caval and portosystemic shunts
foetal vascular structure failing to close
presentation - neurological (depression, blindness, ataxia,seizure), GI (hypersalivation, V+/D+)
urinary signs (dysuria, pollakiuria, haematuria, stranguria), stunted growth
Dx - leukycytosis, microcytic anaemia, increased bile acids,alt,alp,hyperammonaemia, low usg, microhepatica, renomegaly
treatment - surgery - closure. medical - lactulose, antibiotics to reduce ammonia from bacteria, protein restriction
vascular ring anomaly - persistent right aortic arch
failure of foetal vascular closure
6 embryonic paired arches around the foregut
arches either persist or involute with maturity
presentation - regurgitation in solid food (struggles to pass through oesophagus with ring restriction)
dx - radiography, barium study, CT angiography
tx - surgical closure
