Problems of the newborn Flashcards
Why is the neonate different to the adult and what do these factors result in?
Poor breathing
Limited ability to regulate body temperature
Poor regulation of fluid balance
Limited energy store
Immune system is immature
=>
Increased susceptibility to disease
Poor response to disease (rapid hypothermia, rapid fluid loss, energy depletion and poor immunological response)
Potential for high mortality rate
What are the 2 sources of maternally derived antibodies?
Some antibodies cross the placenta
Some antibodies are present in colostrum (the first milk)
Why is colostrum important in dogs?
In the pup most there is limited trans-placental maternally derived antibodies (MDA)
Most MDA is from colostrum
Colostrum intake must occur within a few hours of birth:
- 60% absorption before 4 h
- 5% after 12h
What are the 2 causes of failure of passive transfer?
Poor quality colostrum
Poor intake by neonate (time or quantity) due to underlying neonatal disease
What causes poor quality colostrum?
Early lactation and colostral loss
Primiparous animals (first birth)
Poor udder development
Mastitis
Lack of appropriate maternal antibodies
What are the consequences of failure of passive transfer?
GI disease
Respiratory disease
Joint sepsis
Umbilical abscess
Fading puppy syndrome
Increased mortality
Poor weight gain
Increased antibiotic usage
Increased cost
Poor welfare
Increased likelihood of infection => sepsis => septic shock => death
What is the treatment for failure of passive transfer?
Donor colostrum
Hyperimmune plasma
What are the key aspects of ongoing care for neonates?
Ensuring colostrum and milk intake
Ensuring hydration status
Monitoring environmental temperature and pup behaviour
Regular clinical examination
What is a common failure of immunity in neonates?
Transient hypogammaglobulinaemia (low levels of immunoglobulins)
Give examples of diseases which cause congenital hypogammaglobulinaemia
SCID (severe combined immune deficiency)
Agammaglobulinaemia
Selective IgM deficiency
Fell Pony Immune Deficiency Syndrome
Immunoglobulin deficiency and CID (combined immunodeficiency disease) in dogs
When does hypogammaglobulinaemia usually manifest in neonates?
After maternal immunity has waned
What is required in active monitoring of neonates?
APGAR:
Activity - muscle tone/movement
Pulse - HR
Grimace - response to stimulation
Appearance - membrane colour
Respiration - Rep rate
Scored 0-2
Scores added - <6 is a predictor of poor survival
What are the signs of a sick pup?
Frequent crying or failure to gain weight early indicator
Feels cold to touch
Skin inelastic
Thin, bony appearance
Slack abdomen (empty stomach)
Dirty unkempt coat
Persistent crying
Loss of body twitching
Delayed development of neonatal characteristics
What are the clinical signs of equine neonatal sepsis?
What are the signs of a foal born premature or dysmature
<320d gestation
Low birth weight
Silky hair coat
Domed forehead
Floppy ears
Flexor laxity/hypotonia
Weak suck reflex
Poor thermoregulation
Entropion
Poor glucose regulation
Immature renal function
What is the difference between premature and dysmature?
born premature - early
dysmature - on time but underdeveloped because of placental disease
What are the causes of puppy mortality before day 3 after birth?
28% pups are sick at birth
- Managemental and maternal causes (16%)
- Very low birthweight (7%)
- Congenital defects (5%)
What is the most common cause of puppy mortality between days 3 and 5?
55% of puppy deaths are due to inadequate surfactant in the lungs
What is the most common cause of puppy mortality after day 6?
15% appear normal at birth but succumb to infection
Describe the treatment of a sick pup with ‘minor’ disease
Any pup with even “minor” signs (lethargy, slow to feed, lack of weight gain, coloured urine [dehydration]) must have early supplemental feeding as these “minor” signs are important predictors for the demise of the pup
A source of frozen-thawed or replacement colostrum should be given before day 3
If necessary use tube feeding
Maintain body temperature
Environmental temperature should also be monitored
Adequate hydration should be ensured (urine examination, weight gain, skin elasticity)
Regular perineal stimulation to ensure urine and faecal voiding
Antimicrobial preparations should be considered as the neonate is susceptible to commensal overgrowth
What should be included in a clinical exam of a puppy with significant disease?
every 4 hours:
- rectal temp
- urine colour and skin elasticity (hydration)
- mucous membrane colour and CRT
- resp and heart rate
Describe the treatment of puppies with hypothermia
Slow re-heating (1C per hour)
Maintain environmental temperature 29-32C (slightly higher than normal) using Pads/lamps/bottles
Do not feed pup if colder than 34C
Add dextrose to fluids (as increased calorific demand)
What is the purpose of oxygen administration in sick puppies
useful for concomitant upper respiratory tract problems
can help overcome hypoxia
artificial ventilation may be useful to reverse acidosis and encourage lung surfactant production
How can oxygen be administered to sick puppies?
incubator
homemade oxygen tent
tracheal catheter
