Neonatology

What are neonatal deaths caused by?

• poor husbandry practices

• suboptimal management

• poor monitoring

In utero vs at birth

Utero → lungs fluid filled, right side of the heart to the lungs, causes blood to shunt from the R side of the heart to the L. ductus arteriosus → blood goes from pulmonary artery to aorta. foramen ovale → blood goes from right atrium to left atrium

At birth → lungs fill with air, right side of the heart = low pressure system, no longer shunting from R - L, L side pressure is greater, ductus arteriosus closed, foramen ovale closes

What happens in neonates right before birth?

adrenal glands produce cortisol → cortisol released into the blood → goes to the lungs → stimulates type 2 pneumocytes to secrete surfactant → surfactant keeps alveoli open to facilitate breathing and reduce surface tension

Why is fetal hypoxia common?

newborns → dyspnea = reflex contraction of the chest with negative pressure/suction into the lungs → inability to inflate lungs → umbilical cord is cut → hypoxia → inc vascular resistance

Why are puppies more at risk of death at birth?

Not fully developed at birth. Have poor myocardial contractility and do not compensate well for hemorrhage, hyperthermia, acid/base imbalances. Not good blood pressure control

• inc oxygen tension → ductus arteriosus narrows & pulmonary vessels dilate.

• inc left sided pressure → closure of formen ovale

Why are puppies sensitive to temperature?

• cannot shiver

• cannot vasoconstrict

• inc surface area

• little body fat

• poor blood flow

• high water composition

• unable to pant

Why are puppies more susceptible to bacterial infections?

they have a high stomach pH. they are born with sterile GI and get their microflora from mom, environment & diet

When is colostrum given to puppies?

available 2-3 days after birth, gut permeable closes 8 hrs after birth and none after 24 hrs

60-75% is IgG

What can we use to replace colostrum?

• fresh/frozen plasma

• pooled serum from healthy adults

• can be given as 3 boluses or all at once

Normal puppy weights

normal weight loss in 24hrs (C-section)

• gain 5-10% of body weight daily

• should double their weight within 7-10 days of age

When do puppies have normal glomerular filtration rate?

6 weeks of age

Why are puppies prone to hypoglycemia?

• born with limited glycogen stores

• poor gluconeogenesis capability

• inc demand for glucose, inc loss of glucose, dec ability to make glucose

APGAR scoring

Appearance, pulse, grimace, activity, respiration

score of 0-2

• HR

• spontaneous breathing

• response to an irritating stimulus

• muscle tone

• color of mm

score 10 → viable

score 6 or lower → mortality & need supportive care

• rooting

• righting reflex

• suckle reflex

What causes dehydration?

• not nursing

• GI disturbances

skin tent and mm not reliable

look at urine color → very dilute, dark or brown is dehydrated

give fluid oral, sq, IV, or IO

What causes hypoglycemia?

diarrhea, vomiting, infection, dec intake

• clinical sign: weakness, anorexia, tremors, crying, coma, seizures

Why do puppies get hypothermia? treatment?

cannot shiver or generate heat

• should not be less than 35 C

• when cold do not feed the puppy because their gut is slowed down → ileus

• give fluids & warm them up very slow 1 C/hr

What causes sepsis?

wounds, tail docking, ear crops, umbilicus, respiratory infections, in utero

• clinical signs: hypovolemia, vocalizing, reluctant to nurse, dec urine, inc lactate, cold, loss of hair

• dx: culture

• tx: warm fluids, plasma, antibiotics

Causes of fading puppy syndrome

infectious, sepsis, environment, genetics

• sick at birth, weak, small, unable to nurse, dehydration, hypothermia, hypoglycemia, death

• some can be appear healthy at birth but get sick in first weeks of life

What causes canine herpes virus?

in the environment → necrotizing disease in neonates

• pups under 3 weeks

• clinical signs: acute, stop nursing, vocalize continuously, death in 1-3 days

• PM: petechial + ecchymotic hemorrhage on major organs

• hard to diagnose and treat

What causes neonatal isoerythrolysis?

hemolytic disease of newborn kittens → type A blood have a dam with type B blood

• anti-A antibodies attack own type A blood

• clinical signs: anemia, icterus, tail tip necrosis, weakness, tachypnea, tachycardia, hemoglobinuria, sudden death

• remove kitten from dam and if severe transfuse

• avoid mating type B queens to type A toms

What are some congenital disorders?

• excessive vit A → midline defects

• lack of vit D → tooth & bone abnormalities

• feline parvo → cerebellar hypoplasia

• corticosteroids → cleft palate when given at certain stage of gestation

• hare lip, umbilical hernia, anal atresia, skull disorders

How often do neonates need to be fed?

• 1 ml of milk/oz of body weight

• 6-8x daily or once every 2 hrs

• food should be 38 C

• 4 tsp/lb

• royal canin protech for the first week or 2 then switch to less expensive