Neonatal care SAM exam 3 (Kats copy)

Neonatology

the first 2-4 weeks of a puppy/kitten's life

true or false: the first 2-4 weeks are the most critical

true

true or false: neonatal animals are NOT fully dependent on their mothers for nutrition and care

false

true or false: mothers stimulate urination/ defecation by grooming

true

History of the neonates include:

-number of ill animals

-method they were raised

-normal environment

-behavior

-weight curves

-clinical signs

-medications given

history of the dam include:

-vaccine status

-nutrition

-medications

-problems with pregnancy

equipment for examination:

-pediatric stethoscope (2cm bell)

-digital thermometer (low as 85 degrees F)

-warm, clean surface for examination

true or false: neonates cannot regulate body temperature the first 2 weeks of life

true

Physical exam includes:

-hydration status

-check MM not skin turgor

-urine color

-ventral abdomen skin

-discharge from orifices

-body symmetry

-body conformation

physical exam for integument:

-body hair (should cover all but ventral abdomen)

-muzzle and forelimbs (hairless initially)

-lack of hair or sparse (genetic abnormality, premature birth)

ventral abdomen skin NORMAL

dark pink

ventral abdomen skin CYANOSIS

bluish

ventral abdomen skin SEPSIS

dark red

discharge from orifices

abnormal unless it is urine or feces

body conformation includes:

-head

-neck

-thoracic malformations (pectus excavatum)

-abdomen (body wall defects)

-dorsum

-tail

-stimulates urine and defecation

Palatal defect

this defect will cause nursing milk to go to the nasal cavity

the number one breed that is prone to open fontanel

chihuahua

first week developmental landmarks

-sleep 80% of the time

-nurse every 2-4 hours

-neuromuscular reflexes absent (time specific)

-some motor skills present

-responds to stimuli

-elimination by dam

-sex determination

Motor skills that are present in the first week

-lifts head by 3 days

-crawls by week 1

-suckle (immediate)

-vocalize

Neonates respond to which stimuli

-odor

-touch

-pain

How to do sex determination

anogenital distance; is greater in males than female

second week development landmarks

-begins to crawl

-body temp rises towards adult levels (cannot maintain this well)

-double their body weight

-eyes open

-ear canals open

what age do puppies and kittens open their eyes

kittens- 7-12 days; dogs 10-14 days

what age do puppies and kittens open their ear canals

kittens- 14-16 days; dogs- 6-21 days

neurological exam of pediatric patient

difficult in neonates, nervous system is not fully developed

what reflex is present at birth

suckling

Heart

not completely developed until 7 months of age

immune system

minimal transfer of antibodies in utero colostrum must be consumed in the first 24hrs; mature at 3-4 months

colostrum

extremely important in the transfer of maternal antibodies

liver

be careful in administering drugs here that require hepatic metabolism

kidney

fluid requirements high due to inability to conserve fluid

throid

hyperthyroidism

GI

born sterile

blood samples

-jugular vein

- caution with TV

-cats 60/ml

-dogs 80-90/ml

urine samples include:

-stimulation to urinate

-gently express bladder

-check color to assess hydration

-USG 1.012-1.020 (glycosuria, normal)

-avoid cystocentesis

imaging techniques are

-ultrasound (7.5-MHz transducer, less kilovoltage)

-radiography (focus on one area, reduce kVp by half for an adult)

routine maintenance

healthy neonatal puppies/kittens need almost no care the first weeks of life, healthy mothers take care of everything

New owners must understand that:

-proper essential nutrition

-preventative medications and vaccines are important

-address behavior problems as early as possible

when should owners address behavior problems

As early as possible

Neonatal illnesses that require immediate attention

-hypothermia

-dehydration

-hypoglycemia

-neonatal isoerythrolysis

-malnutrition

normal body temperature management

-neonates depend on proximity to dam to maintain thermal balance during the first two weeks

-the "normal" temp is initially lower

-shivering and vasoconstrictive mechanisms begin 6-8days

- at 6 weeks body temp is similar to adults

hypothermia characteristics

-gut motility slows with decreasing body temperature

-risk of aspiration/ pneumonia, bloating

-inhibits cellular immune functions

true or false: body temperature for hypothermia depends on age

true

body temp for hypothermia for BIRTH

body temp for hypothermia for 1-3 days of age

body temp for hypothermia for 1 week of age

clinical signs of hypothermia when temp is >88f

-restlessness

-crying

-red MM

-skin is cool to touch

-respiratory rate is >40 breaths/min

-heart rate >200bpm

clinical signs of hypothermia when temp is 78-85 degrees F

-lethargy

-uncoordinated, unresponsive

-respiratory rate is 20-25 breaths/min

-heart rate

clinical signs of hypothermia when temp is

-appears dead

-treat if able to arouse

treatment of hypothermia

-slowly reheat patient 2-degrees F/hr, monitor heat shock is possible if too rapid

-incubator/veterinary oxygen cage

-warm IV fluids, not >2 degrees F above body temp

dehydration

-any disease process or imbalance of fluids will lead to this

-high fluid requirements

-total volume is low

-less able to conserve fluids

true or false: all fluids should be warmed to 98-99 degrees F before being administered

true

what are the common routes to treat dehydration

-IO (intraocular)

-PO (by mouth)

hypoglycemia characterisics

-great risk

-neonate is born with few glycogen stores

-poor gluconeogenesis in liver

-failure to suckle after 24-36hrs cause this

-most common cause of seizures

dextrose supplementation for hypoglycemia

5-10% by IV, 15% PO

neonatal isoerythrolysis

occurs with type B mothers giving birth to type, high levels of naturally occurring antibodies against type A RBC's

neonatal isoerythrolysis clinical signs

-jaundice/death within the first 2 days of life

-tail tip necrosis

-test at birth

Why do you remove kittens from the queen in the first 24hrs during neonatal isoerythrolysis

the antibodies in the queen, that the kitten cannot consume are in the colostrum in the first 24 hours; tube feed

malnutrition

-maintain good hydration

-if needed supplement feeding with SQ fluids

-milk replacers that are species appropriate

-tube feed

tube feeding watch for

-technique

-overfeeding

-underfeeding

-monitoring weight

what is the landmark for tube feeding

last rib (palpable)

watch out for when tube feeding

-aspiration in the lungs

-regurgitation

-coughing

-air in the syringe

fading kitten/ puppy syndrome clinical signs

-failure to gain weight

-anorexia

-lethargy

-emaciation

-birth defects

-stillbirth/ weak at birth

-death

fading kitten/ puppy syndrome causes

-poor management

-malnutrition

-inappropriate environmental conditions

-congenital/ genetic defects

-infection

orphan care; materials needed:

-warm cleaning bedding

-milk bottles, nipples

-feeding tubes

-syringes

-gram scale

-cotton balls

-heat source

-hand sanitizers/ fur clippers

why should we weigh orphans

to assess hydration and dehydration status

Ambient temperature for the first week for orphans

84-90 degrees F

Ambient temperature for the second week for orphans

79-84 degrees F

Ambient temperature for the third week for orphans

73.4- 79 degrees F

orphan care

-maintain clean, dry housing

-proper nutrition and supplementation

-stimulate urination and defecation after each feeding

true or false: neonates should take up to their daily requirements in 4-5meals/ day during the first few weeks of life

true

during the first week of life how much will kittens ingest in body weight of milk

10-15% then will increase to 20-25% the next few weeks

puppies get their energy from what the first few weeks

fat, watch milk replacer contents

kitten get their energy from what the first few weeks

protein, watch milk replacer contents

if only 3 feedings per day can be provided then what do you can do to meet the requirements

use milk replacers with energy intake consideration and provide extra fluids SQ

Feeding neonatal's risks

-overfeeding (diarrhea)

-underfeeding (dehydration, lack of weight gain)

-bottle feeding (nipple size)

selection of milk replacers

- Evaluate commercial milk replacers available.

- Energy density

- Homemade diets

- Use only proven recipes.

Medications in the Neonatal Puppy/Kitten

- Due to difference in size, medications are not metabolized at the same rate as adults.

- Care must be taken when choosing and administering medications.

-liver, kidney, BBB are not fully developed