Neonates

Question 1

Immediate care of the neonate

Answer 1

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

Question 2

APGAR

Answer 2

Activity
Pulse
Grimace
Appearance
Respiration

Question 3

Examination of the bitch post partum

Answer 3

Settles after last pup
Red/green/brown discharge is normal
Haemorrhage abnormal
Check for milk

Question 4

What are the risks with neonates

Answer 4

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

Question 5

Key ongoing care aspects for neonates

Answer 5

Ensure colostrum/milk intake
Ensure hydration status
Monitoring environmental temperature and behavior (huddled likely cold)
Regular clinical exams

Question 6

Things to look out for in sick puppies

Answer 6

Frequent crying
Cold to touch
Failure to gain weight
Inelastic skin
Slack abdomen
Dirty/unkempt coat
Loss of body twitching
Delayed characteristic development

Question 7

Treatment of minor disease in the puppy

Answer 7

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

Question 8

Problems of significant disease in puppies

Answer 8

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

Question 9

Treatment of hypothermia

Answer 9

Slow reheating - 1 degree/hour
Maintain higher environmental temperature
Do not feed colder than 34° as gut won’t work

Question 10

Fluid therapy for puppies

Answer 10

Maintainable 60-100ml/kg/day
Jugular or intraosseous

Question 11

Predictors of low mortality

Answer 11

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

Question 12

Most life threatening conditions for 2-6 weeks

Answer 12

Dehydration from diarrhoea
Internal and external parasites
Trauma

Question 13

Most life threatening issues at 6-12 weeks

Answer 13

Infectious disease
Disease associated with inquisitive behavior

Question 14

Causes of fading puppies

Answer 14

Managemental and maternal causes
Very low birthweight
Congenital defects
Inadequate surfactant
Infection

Question 15

True fading puppies

Answer 15

Lack of surfactant causes inadequate surfactant and therefore respiration so die day 3-5
Sting tendency for dams to have multiple

Question 16

Differences between immature and mature lungs

Answer 16

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

Question 17

pituitary dwarfism

Answer 17

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

Question 18

congenital hypothyroidism

Answer 18

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)

Question 19

EPI

Answer 19

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

Question 20

juvenile DM

Answer 20

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)

Question 21

porto-caval and portosystemic shunts

Answer 21

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

Question 22

vascular ring anomaly - persistent right aortic arch

Answer 22

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