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Theriogenology > Neonatology > Flashcards

Neonatology Flashcards

1
Q

when do most neonatal deaths occur

A

in the first week of life

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2
Q

what are most neonatal deaths caused by

A

◦ Poor husbandry practices
◦ Suboptimal management
◦ Poor mothering

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3
Q

are most neonatal deaths preventable

A

YES

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4
Q

pups lungs in utero vs at birth

A

in utero = fluid filled
at birth = inflate with air

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5
Q

pups hearts in utero vs at birth

A

in utero = Right side of the heart (to the lungs) = essentially high pressure system. Causes blood to shunt from R side of the heart to the L

at birth = Right side of the heart = low pressure system. No longer any shunting from R to L = pressure on L side is actually greater than the R side
(Ductus arteriosus and Foramen ovale closes)

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6
Q

function of ductus arteriosis and foramen ovale

A

◦ Ductus arteriosus = blood goes from pulmonary artery to aorta
◦ Foramen ovale = blood goes from right atrium to left atrium

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7
Q

what is the most common prenatal condition

A

◦ Most common prenatal condition = fetal hypoxia (maternal stress, compromise,
dystocia, etc.)

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8
Q

where do neonates get oxygen from in utero

A

placenta

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9
Q

what happens just before birth with the adrenal glands

A

◦ Just before birth: adrenal glands = cortisol = stimulates production of surfactant

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10
Q

what happens when the umbilical cord is cut

A

◦ When umbilical cord blood supply is cut = hypoxia + inc in vascular resistance = dyspnea = reflex contraction of the chest

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11
Q

what can in newborns related to the respiratory system

A

◦ In newborns = inability to inflate lungs = hypoxia

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12
Q

what cant neonates compensate well for and why

A

Neonates cannot compensate well for:
◦ Hemorrhage
◦ Hyperthermia
◦ Acid/base imbalances

This is due to poor myocardial contractility

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13
Q

why do neonates not have good BP control

A

Have incomplete autonomic innervation of heart and vasculature = not good blood pressure control

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14
Q

what happens at birth related to CV system

A

◦ inc oxygen tension = ductus arteriosus narrows & pulmonary vessels dilate
◦ inc left-sided pressure = closure of foramen ovale

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15
Q

why are neonates more sensitive to temperture fluctuations (7)

A

◦ They cannot shiver
◦ They cannot vasoconstrict
◦ They have inc surface area:body mass ratio
◦ Have little body fat
◦ Have poor blood flow to extremities
◦ Have high water composition
◦ Are unable to pant

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16
Q

what is the result of the high stomach pH in neonates

A

more susceptible to bacterial infections

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17
Q

when does gut permeability start to decrease

A

Gut permeability starts to dec 8hrs after birth; virtually none by 24hrs

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18
Q

colostrum vs transition milk timepoints

A

Is the 1st mammary secretion produced after delivery = transition to milk at day 2-3 post partum

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19
Q

what % of Abs are passed through placenta in dogs and cats

A

<5% of antibodies are passed through placenta in dogs; 25% in kittens
-> Almost have no immunoglobulins @ birth

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20
Q

what is the highest % of Ig in colostrum

A

60-75% IgG

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21
Q

Risk of neonatal mortality depends on 2 factors:

A

◦ Quality of the transfer of passive immunity
◦ Growth of the puppy between birth & 2 days of age

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22
Q

rules for colostrum replacement

A

Administer plasma or serum from vaccinated adult
◦ Oral if <12hrs old
◦ Subcutaneously if >12hrs old – achieve higher levels when given SQ

If you can, its good to get pooled serum from multiple vaccinated adults of same household
◦ Not ideal to use the dam

Can give as 3 boluses (birth, 12 & 24hrs) or all at once

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23
Q

when to use colostrum replacement

A

in cases of failure of passive transfer

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24
Q

what does weight loss after first 24hr of life indicate

A

indication that something might be wrong; can precede clinical signs by 16hrs

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25
Q

how often should pups be weighed

A

◦ Should weigh pups at least 1x/day à ideally 2x/day – encourage owners to make a chart/graph

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26
Q

normal weight gain in puppies

A

◦ Normal for weight to decrease in 1st 24hrs (if c- section, less so if natural whelping)
◦ Should then gain 5-10% of their body weight daily
◦ Should double their weight within 7-10 days of age

27
Q

what aspects of normal neonatal physiology predispose them to hypoglycemia

A

◦ Are born with limited glycogen stores
◦ Have poor gluconeogenesis capability
◦ Glucose – neonates have an: (Increased demand for it, Increased loss of it, And a decreased ability to synthesize it)

28
Q

what aspects of neonatal physiology are important when it comes to drug selection

A

-Decreased renal clearance; Do not have normal glomerular filtration rate until 6 weeks of age
-Decreased hepatic metabolism

29
Q

aspects of PE (12)

A

◦ APGAR scoring
◦ Body temperature
◦ Hydration status
◦ Behavior/mentation
◦ Sensory Organs
◦ Neurologic System
◦ Respiratory System
◦ Cardiovascular System
◦ GI/Abdomen
◦ Dermatology
◦ Musculoskeletal System
◦ Reproductive Tract

30
Q

what does APGAR scoring consist of?

what does a score close to 10 vs under 6 tell us

A

-Consists of assigning a score (0-2) in each category:
◦ Heart Rate
◦ Spontaneous breathing
◦ Response to an irritating stimulus
◦ Muscle tone
◦ Color of mucous membranes

-Scores close to 10 = associated with neonatal viability

-Scores 6 or lower = associated with neonatal mortality & should receive supportive care

31
Q

what three extra parameters can be added to APGAR scoring to assess fetal viability

A

◦ Rooting behavior
◦ Righting reflex
◦ Suckle reflex

32
Q

common causes of dehydration (2)

A

◦ Inadequate feeding
◦ GI disturbances (diarrhea, vomiting, anorexia)

33
Q

what can dehydration lead to

A

Can lead to hypovolemia quickly = lack of compensatory mechanisms

34
Q

how to assess dehydration in neonates

A

◦ Skin tent is not reliable
◦ Mucous membranes – should be deep pink, can be misleading if just nursed
◦ Urine color = should be dilute yellow if well hydrated

35
Q

how can you do fluid administration in neonates

A

◦ Oral (if GI is working) ok
◦ Subcutaneous
◦ IV or IO (intraosseous)

36
Q

causes of hypoglycemia

A

◦ Diarrhea
◦ Vomiting
◦ Infection
◦ Decreased intake

37
Q

clinical signs of hypoglycemia

A

◦ Weakness, anorexia, tremors, crying, coma, seizures

38
Q

what cant puppies do related to temperature

A

Puppies cannot shiver or generate heat by moving

39
Q

how to avoid hypothermia in puppies (4)

A

-Should not be less than 35C = should not be warmed up more than 1C/hr

-Should be kept warm in environment (heat lamps, warm towels)

-Temperature should be taken regularly

-Can give warm fluids as tx

40
Q

should you feed a cold puppy, why or why not

A

NEVER!

bc hypothermia slows gut down = ileus = previously ingested food ferments = gas = bloat

41
Q

when can sepsis occur

A

◦ 2nd to wounds (tail docking, ear crops, umbilicus)
◦ Respiratory or GI infections
◦ In utero acquired infection (less common

42
Q

clinical signs of sepsis

A

◦ Can be subtle
◦ Hypovolemia
◦ Vocalizing
◦ Reluctance to nurse
◦ Decreased urine output
◦ Increased lactate
◦ Cold extremities
◦ Loss of hair or sloughing of extremities (tail tip, ear tips)

43
Q

diagnosis of sepsis

A

◦ Culture of organisms from blood or affected tissues

44
Q

treatment of sepsis

A

◦ Warm fluids
◦ Fresh or fresh frozen plasma from well vaccinated adult
◦ Broad spectrum antibiotics

45
Q

signs of response to therapy in sepsis cases

A

◦ Less pale MM
◦ Stronger pulse
◦ Warmer extremities
◦ Lower lactate levels

46
Q

3 potential causes of fading puppy syndrome

A

◦ Infectious agents = sepsis = most common
◦ Environment
◦ Genetics

47
Q

2 manifestations of fading puppy syndrome

A

◦ Sick at birth, born weak & small or with birth defects = unable to nurse = dehydration, hypothermia, hypoglycemia = death within 1st few days of life (Caused by perinatal bacterial infections & respiratory distress_

◦ Neonates initially appear healthy but become weak in 1st few weeks of life = become depressed, anorexic = enter fatal cycle of dehydration & hypothermia

48
Q

diagnosis of fading puppy syndrome

A

◦ Can be difficult
◦ Based on history & physical exam findings
◦ Culture & sensitivity of tissues
◦ If neonate can’t be saved à post mortem exam is recommended

49
Q

clinical signs of canine herpesvirus

A

◦ Acute
◦ Stop nursing
◦ Vocalize continuously
◦ Death in 1-3 days

50
Q

diagnosis and prevention of CHV

A

Hard to diagnose & treat
Prevention = keep warm neonatal environmen

51
Q

who is most likely to be affected by CHV

A

Pups under 3 weeks of age = most likely to be affected (Typical to have the quickest growing pup affected)

52
Q

what does CHV cause in neonates

A

Causes necrotizing disease in neonates

53
Q

type A vs B blood type cats and their antibodies

A

-Type A cats have weak anti-B antibodies
-Type B cats have strong anti-A antibodies

54
Q

how does neonatal isoerythrolysis occur

A

◦ Occurs when kittens with type A blood have a dam who’s type B blood
◦ Queen has strong anti-A antibodies in her colostrum
◦ Kittens ingest these anti-A antibodies
◦ Attacks their own type A blood

55
Q

clinical signs of neonatal isoerythrolysis

A

◦ Anemia, icterus
◦ Tail tip necrosis
◦ Weakness
◦ Tachypnea
◦ Tachycardia
◦ Hemoglobinuria
◦ Sudden death
◦ Mortality rate is high even with prompt intervention

56
Q

prevention of neonatal isoerythrolysis

A
  • Avoid mating type B queens to type A toms
  • All breeding cats should be blood typed and bred to their own blood type
  • Blood type kitten before allowing it to nurse
57
Q

what to do after kittens born to mismatched blood type mom

A

Kitten should be removed from the dam and transfused if necessary
◦ Can use washed type B blood or cross-match blood

58
Q

congenitive disorders; excess vitamin A

A

midline defects

59
Q

congenitive disorders; lack of vitamin D

A

tooth and bone abnormalities

60
Q

congenitive disorders; feline parvovirus

A

cerebellar hyperplasia

61
Q

congenitive disorders; corticosteroids

A

cleft palate when given at a certain stage of gestation

62
Q

what other congenitive disorders to look out for

A

◦ Hare lip, umbilical hernia, anal atresia, skull disorders (open fontanel)

63
Q

different nutrition for neonates is important if:

A

Important if:
◦ There’s a need to supplement (large litter)
◦ Have to wean early (maternal illness)
◦ In orphaned or neonates that needs additional support (runt of the litter, not gaining well)

◦ Can do bottle feeding, sponge feeding or tube feeding

◦ Commercial milk replacer is recommended over home-made

64
Q

how often should neonates be fed

A

◦ Newborns need to be fed 6-8x daily (once every 2hrs)
◦ Once they are a couple weeks old = can increase intervals
◦ Food should be warmed to 38.6C
◦ Average stomach capacity = 4tsp per lb

Theriogenology (37 decks)

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