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Neonates Flashcards

1
Q

what type of placentation do bovine have? small ruminants?

A

cotyledonary, epitheliochorial (synepitheliochorial)

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2
Q

are Ig’s transferred across the placenta?

A

no

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3
Q

what are some of the stressful things that occur from a fetus/neonate point of view?

A 
decreased O2
physical - squeezed thru the birth canal
temperature - cold outside!!
sounds
light
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4
Q

How do neonates adapt to stress/new life on earth?

A

epinephrine and cortisol increase

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5
Q

How do you explain neonates that “were doing really well” for the first little while, and then “all of a sudden crashed”?

A

the increases in cortisol and epinephrine can mask problems that the animal was having while in-utero

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6
Q

which body systems of the neonate need to change and begin functioning right away after birth?

A

cardiovascular, respiratory (immediately), acid-base balance, energy metabolism, temperature regulation

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7
Q

describe the changes that occur in the circulatory system of the neonate

A

Separation of the umbilicus -> anoxia -> (also compression of the chest helps to expel fluids out of the lungs) reflex gasping -> lungs are aerated -> surfactant keeps them open (surface tension)
Pulmonary vascular resistance is DECREASED -> allows for increased alveolar ventilation -> more blood flow to lungs

Increased venous return to LA (from lungs) -> increased pressure in LA -> reversal of the R-L shunt of the FO, FO closes

chemoreceptors on aorta sense increased O2, stimulate closure of the DA

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8
Q

what are the three physiologic things that help initiate respiration in the neonate? (besides physical compression)

A

Loss of immersion reflex (the immersion reflex inhibits breathing in the womb)

Breathing centers are stimulated by cold, light, touch, limb movement.

O2, CO2, pH receptors maximally stimulated.

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9
Q

a fetus may be [HYPER/HYPO] active if it becomes hypoxic inutero

A

hyper!

obviously hypo if deadmeat

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10
Q

what are some ways you can stimulate breathing?

A

remove fetal membranes
clear fluids from resp tract
stimulate those breathing centers!! (massage, move legs, poke their nasal philtrum)
if necessary, ventilator
Keep them in sternal recumbency and bring back legs forward underneath them

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11
Q

hypothermic neonates are failing to adapt. what are the sequelae of decreased body temp?

A

hypothermia -> CNS depression -> do not nurse -> hypoglycemia

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12
Q

heat production due to brown fat metabolism is maximized at ___ after birth

A

3 hr

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13
Q

factors affecting thermo regulation

A

Enviromental: temperature, moisture, wind
Individaul differences:
body mass: surface area ratio
brown fat (determined by nutrition of the dam during pregnancy)
Critical temperature for calves = 55F. If ambient temp is <55, calf will need to increase dietary intake in order to maintain body temp
Maternal behaviors
Energy/activity of the calf

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14
Q

What are the ways a calf can produce heat?

A

Brown fat metabolism

Shivering - requires metabolism of glucose and liver glycogen stores (from colostrum, milk, liver)

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15
Q

When are a neonate’s brown fat stores typically depleted?

A

within 1-5 days. depends on the amount they had to start with, which depends on the dam’s nutrition during pregnancy

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16
Q

when are a neonate’s liver glycogen stores typically depleted (if not replenished by nursing)?

A

4-6 hours

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17
Q

when you suspect hypothermia, what are three things you should check for?

A

Low body temp
Absent-decreased suckle reflex
No shivering

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18
Q

general causes of hypothermia

A

cold, wet, windy environment; lack of energy (not nursing); disease

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19
Q

treatment for hypothermia

A

Dry them off!
put them in a warm air (calf dryer etc.), hot water bath, warm oral fluids, blanket, straw, warm dry bedding in barn, etc.

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20
Q

which body systems are slower to develop/adapt to extra-uterine life?

A

GIT, renal, nervous, musculoskeletal, immune

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21
Q

Small intestine is able to absorb ____ for the first 24 hrs of life

A

large particles including proteins, bacteria, maternal cells.

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22
Q

What effect does sickness, stress, or debilitation have on the metabolism of neonates and what does it mean for treatment?

A

higher metabolic demands, need to provide extra nutrition!

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23
Q

T/F: kidneys are functionally mature at birth

A

true!

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24
Q

T/F: dilute urine indicates poor renal function in the neoneate

A

False! Milk has a lot of water -> dilute urine!

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25
The nervous system of neonates is prone to ___ and ___
trauma and asphyxia
26
How can trauma to the musculoskeletal system lead to other problems?
Rib trauma --> tracheal/esophageal problems | legs --> unable to nurse --> hypoglycemia, hypothermia, etc -> anaerobic metabolism --> acidosis
27
clinical findings of dystocia
``` meconium staining poor thermoregulation crazy blood glucose nervous system issues hypoxia - dummy facial edema (will lead to difficulty nursing) ```
28
dystocia calves are potentially more prone to disease later in life due to___
metabolic and organ system derangements
29
T/F: you should worry about little things like decreased vigor, other subtle non-specific things happening with a neonate?
true! subtle things like lack of vigor, slow to rise and nurse (within 2 hr), disinterest in dam, decreased suckle, lack of curiosity can be early signs of more severe impending disease
30
the chances of having successful treatment/management of disease are best if ___
they are initiated early and aggressively! do not advise "wait and see" approach
31
definition of successful passive transfer of immunity
TIMELY ingestion and absorption of an adequate MASS of IgG (and other factors) by the neonate
32
failure of PT is indicated if serum IgG concentration___ (bovineSR and camelid)
<1000 mg/dL at 48 hr old | <800 mg/dL @ 36-48 hr (camelid)
33
Why is PTI important?
Calves with FPT have increased risk of death within first 3 mos. of life (increased risk of septicemia, diarrhea, enteritis, omphalitis, resp dz...). Also experience decreased weight gain, milk production, and decreased survival past 1st lactation.
34
what are the mechanisms of protection that colostral Ig's offer? (3)
Lactogenic - bind and neutralize pathogens in the gut Systemic - absorbed into circulation -> neutralize antigens in the blood Enteric - IgG that was absorbed is secreted back into the gut -> neutralize antigens
35
how do Ig's get from the maternal serum into colostrum?
4-6 weeks pre-partum, IgG, M, A, binds to receptors on Basement Membrane of mammary glands -> transport vesicles -> apical membrane -> secreted into milk
36
how do Ig's get from calf gut to ECF?
non-selective, non-receptor mediated transport across gut wall
37
What are 3 major factors associated with successful passive transfer
1. FORMATION of colostrum with adequate IgG concentration by the Dam 2. ingestion of an adequate MASS of IgG by the neonate 3. TIMELY absorption of Ig's by the neonate
38
beef cows produce colostrum with higher or lower concentration of Ig's than dairy cows?
higher. shitty beef colostrum is usually higher quality than the best dairy colostrum.
39
What is the goal for adequate mass of IgG1 ingestion by the neonate?
150-200 grams
40
some factors that might lead to FPT
``` poor mothering teat conformation (large, small, tight, long, short) hard milkers weak, ill, stressed neonate dummy/hypoxic twins/triplets/quads ```
41
goal is to have neonate ingest a sufficient amount colostrum by ___ hrs
6
42
gut closure occurs in a ___ fashion, and is considered 100% closed to absorption of IgGs by ___
linear | closed by 24 hr
43
Calf serum protein concentration of ___g/dL is consistent with adequate passive transfer
5.2
44
calf serum protein pre-suckle is typically ___ g/dL
4.5
45
the most practical way to determine if a neonate has adequately absorbed IgGs is ?
measure serum solids concentration with Brix Refractometer
46
T/F: you can judge the quality of colostrum based on appearance
NOPE
47
Colostrum best practices - dairy
1. MILK cows asap after calving 2. MEASURE colostrum quality 3. FEED 150 g IgG1 / 7.5% body weight within 4 hr of life 4. FEED again, within 12 hrs of life 5. PASTEURIZE (if Map, salmonella, Myco, or BLV is prevalent in the herd) 6. avoid pooling colostrum, or pool colostrum of similar quality (so you can control the amount of IgG that each calf gets) 7. MONITOR calves for FPT/spt
48
what is the most practical way to measure colostrum concentration/quality?
Brix refractometer
49
Colostrum best practices - beef
1. avoid heavy dietary intake by dam pre-calving (leads to decrased colostrum volume and increased viscosity) 2. minimize disruption of calving; but intervene if dystocia or hypoxic calf. Tough to balance not intervening too early/too late. 3. monitor calf and make sure they suckle by 6 hr 4. if dam not allowing to suckle, may need ot intervene to restrain or milk her. Bottle feeding calf is best, but tubing may be necessary
50
Colostrum Supplements vs. replacers | Which has the higher amount of Ig's?
Replacers (~ 100 g IgG + adequate nutrients per dose) | Supplements (~ 25-60 g IgG + inadequate nutrients per dose)
51
what are the 4 pathophys mechanisms of diarrhea?
osmotic, secretory, malabsorptive, inflammatory
52
Etiologic Agents in Calf Diarrhea | name the agent and the at-risk age group associated with it
``` E. coli - 0-5 days old Clostridial - 5-10 days most common (can extend to 4 wk) Rotavirus - 5-14 days Corona - 1-4 weeks Cryptosporidium - 5-35 days Salmonella typhi - 2-6 weeks Coccidia - 2.5-4 week/ weaning ```
53
What are the types of E. coli that cause diarrhea in calves?
ETEC (enterotoxigenic) EHEC (enterhemorrhagic) EPEC (enteropathogenic/Attaching and Effacing AEEC) IEC (invasive)
54
what are the virulence factors of E. Coli
Fimbrial antigens K99, F41, others. Allow for attachment --> colonize and multiply STa -> inc secretion of bicarb and Cl- + decreased Na reabsorption -> secretory diarrhea
55
Salmonella dublin infects ___ ages. invasive/ non? what are the clinical manifestations? important concepts?
All ages Invasive meningitis/arthritis/physitis, resp dz, gangrenous distal limbs chronic carriers
56
what is/are the diarrhea mechanism(s) of salmonella
inflammation (invasive! -> hemorrhage, fibrin), maldigestion, PLE
57
clinically, is it important to distinguish between Rota/Corona/Toro viruses?
no. Dx based on the Hx, signalment, clinical signs.
58
rotavirus - signalment affected - incubation period - pathophys - Tx - prevention
calves < 3 wk [many around 6 days] incubation 24 hr infects enterocytes at the villous tips -> maldigestion/absorption NSP4 enterotoxin -> decreased digestion of CHOs, inhibition of Na-glucose transporters -> decreased water aborption supportive care - fluids and electrolytes MANAGEMENT is ket to prevention - proper hygeine of housing, colostrum ingestion, vaccinate cows
59
coronavirus - signalment - incubation period - pathophys - tx - prevention
``` calves < 3 wks, usu. 7-10 d incubation 48 hr infects enterocytes of the villi AND the crypts. -> lots of tissue damage -> malabsorption/digestion supportive care (fluids, elecs) MANAGEMENT ```
60
torovirus - signalment - incubation period - pathophys - tx - prevention
calves <30d necrosis of villous tips and crypts similar to corona
61
cryptosporidium - signalment - incubation period - pathophys - tx - prevention
DAIRY CALVES 5-15 days old severe villous atrophy -> malabsorption incubation 3-5 days, start shedding after 3 days, CS and shedding for 4-17 days Abs in colostrum helps decrease dz severity but does NOT prevent infection
62
clostridium diarrhea | - signalment
calves < 2 weeks (up to 3 mos) type C most common Older calves - d/t high grain diet, change in diet
63
coccidiosis - signalment - incubation period - pathophys - tx - prevention
calves >17-21 days old MANAGEMENT!!!!!!!!! blood-tinged diarrhea ill thrift, poor doers
64
4 principles of prevention of "undifferentiated diarrhea" in calves
1. clean environment - control the level of infection 2. increase calf non-specific immunity - watch for mis-mothering - bonding, - assist with calving if needed - give colostrum if not suckling in 2 hr 3. increase calf specific immunity (colostrum) - vaccinate dam 4. reduce stress - weather - crowding - environment - handling
65
what are the causes of death in neonates with diarrhea?
Fluid, electrolyte, and A-B abnormalities!!! | also bacteremia, septicemia, toxemia, energy deficits
66
Clinical signs of dehydration in the neonate
skin tenting, ,sunken eyes, tacky mm, dry eyes
67
clinical signs of decreased perfusion
tachycardia, prolonged CRT, weak pulses, mucous membrane pallor, hypothermia
68
dehydration involved the ____ space, while decreased perfusion involves the ___ space
dehydration - extravascular space | decreased perfusion - intravascular space
69
by the time you have noticed decreased perfusion in a calf with diarrhea, the calf has significant
fluid deficits!
70
what are the 7 questions to ask yourself when making the decision to treat with fluids?
``` is ti indicated? what will the cost be? route? volume? rate? type? duration? ```
71
what are some good adjunct laboratory values to your PE that would be helpful in deciding about fluid therapy?
PCV, TP, Na, Osmolarity | wahtever you can get based on availability, time they take to get results, and cost
72
what is required in order for oral fluids to be absorbed?
gut must be functional! aka must be PERFUSED, so calves in hypovolemic shock -> blood shunted away from GIT -> need IV fluids if just diarrhea and dehydration, oral fluids may work fine. depends on the disease
73
Oral fluids should contain ___ mEq/L Na ___ mmol/L glucose (why?) should also contain ___ and ___
75-145 Na <200 glucose important for Na/glucose transporter! Calf is likely off feed, hypoglycemic. need to make sure the Na can actually get absorbed, plus give them energy K, Cl
74
Homemade oral fluids recipe
``` 1 tsp light salt 2 tsp NaHCO3 (baking soda) 1 3/4 packet of fruit pectin 1 can beef consomme 2 qt H2O ```
75
calf has cold limbs and difficulty ambulating. which fluid route should you choose?
IV!
76
formula for calculating fluid deficit
BW (kg) x % dehydrated = deficit (L)
77
estimated maintenance volumes
1 gal/100 lb BW per day | 1 mL/lb/hr (= 60 ml/kg per day or 40 ml/lb per day)
78
Rules of thumb for correcting fluid deficits?
In general: 1/2 the deficit corrected IV in the first hour, then the other 1/2 over 4-6 hr In calves with diarrhea, can correct the entire deficit in 2-4 hours. In other species, may require 24 hr to correct the entire deficit
79
you start worrying about overhydration in calves when you reach ___X maintenance
4
80
What are consequences of excessive flow rates?
pulmonary & cerebral edema | ascites, chemosis (conjunctival edema), diarrhea.
81
``` For a 10 drop/mL IV set 1 drop/sec = ___ mL/hr For a 15 drop/mL set 1 drop/sec = ___ mL/hr For a 60 drop/mL set 1 drop/sec = ___ mL/hr ```
360 240 60
82
Normal plasma osmolarity = ___ mOsm/L
~300
83
Rule of Thumb: "It's hard to screw things up with a ____ fluid" give examples of these fluids
polyionic | LRS, Normosol, Plasmalyte...
84
Rule of Thumb: "You might screw things up with a ___ fluid: give examples of these fluids
non-polyionic fluid Saline Dextrose
85
Saline will cause ____ in diarrheic calves. Why?
acidosis becuase too much Cl-
86
Dextrose should not be used to correct fluid deficits in diarrheic calves because it will lead to ___.
osmotic diuresis, worsening dehydration!
87
___ is a common molecular compound that is deficient in diarrheic calves
BICARB (HCO3)
88
What is the bicarb deficit formula?
HCO3 def (mEq/L) = BW (kg) x *[base excess/deficit] x (0.6) * base excess/deficit will be from your blood gas analysis. * instead of BE/BD, can use [Normal HCO3 - Existing HCO3] The constant at the end - range from 0.3 (adults) to 0.6 (babies) if you don't have a calculator use 0.5
89
to make an isotonic bicarb buffer solution, add ___ grams of baking soda (1.3% NaHCO3) per L sterile water
13 g
90
If you don't have access to blood gas analysis, how can you estimate Base deficit?
``` behavior and appearance! calf up & nursing: BD 0-5 mmol/L calf up, diarrhea, mild illness: BD 5-10 mmol/L recumbent, dumpy: BD 10-15 mmol/L lateral recumbency, weak: BD 10-20 ```
91
Duration | What is the goal of fluid therapy with diarrheic neonates
get them up and nursing
92
When should fluid therapy be discontinued?
Hydration accomplished Animal can maintain fluid balance on it's own. After hours-days After switching from IV to Oral When you see a clinical response/improvement

Ag Med (8 decks)

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