Neonatal care and resuscitation, and post-operative care of dam Flashcards
(30 cards)
Neonatal period - what is it? what happens in this time? (puppies)
= from both until ~3w/o
- pups eyes being to open 10-14d after birth and during the 3rd week the eyes gradually begin to function
- most of the puppy’s life in this 1st stage of growth is spent feeding or sleeping
— this is vital to healthy development, and care should be taken to avoid disturbing the litter or mother
- pups will spend all their time within crawling distance of their whelping pen or mother during this period
- after birth, pups will continue to rely off their mother for the important proteins they need to synthesise
Whelping area for bitches and neonates - what should it be?
- warm and comfortable
- in a quiet area
- lined with a clean and absorbent bedding
- big enough for dog to stretch out and turn around in
- high enough to stop newborn pups escaping, but low enough for the dog to get out
- fitted with railings/barriers on the inside to stop any pups being squashed
Post-delivery physical exam of the pups - points
- mm should be pink & moist
- inspect oral cavity: suckle reflex should be present, no cleft palate
- presence of ears & ears
- ascultate thorax: clear breath sounds and lack of murmur
- palpate abdomen: soft & full
- inspect umbilicus: should be dry, without erythema/infection
- inspect urogenital structures: urethra and anus patent, should pass urine/faeces when stimulated with a warm, wet swab
- limbs: movement and muscle tone, check for deformities
- assess behaviour: squirm/vocalise when picked up, settle with dam, root, suckle, attempt to right selves
- inspect coat: full & clean
Weight gain in pups - milestones
- require daily exam and weighing
- healthy pup should gain 14-28g in 1st 48h
- expect a healthy pup to have doubled weight by 7-10d
Management plan for pups post-whelp
- ensure all get colostrum asap after birth
– colostrum is crucial for pup survival, providing both immunoglobulins and nutrition for the newborn - implement a method of identifying pups so they can be monitored
- individuals losing or not gaining weight should be weighed 2-3x daily
- pups should gain 5-10% of birth weight daily for 1st 3w
- intervene with supplementation/assisted feeding if pups losing weight or not gaining
- clean and warm environment: newborn pups should be kept at around 30C, if this is too warm for the dam, it needs to be at least 26C
- stimulate urination and defecation if this is not carried out by the bitch - use clean cotton wool/swab soaked in warm water
- implement a specific plan for any pups showing any problems e.g. hypothermia, dehydration, constipation
Importance of warmth in pups
- pups lack thermoregulatory mechanisms until 4w/o -> ambient temp must be high enough to maintain body temp (36C)
- hypothermia impacts immunity, suckling and digestion
- exogenous heat should be supplied, ideally via an incubator or heat lamp
- heat pads = burn risk as neonates are incapable of moving away
Fading puppy syndrome
- many pups and kittens (approx 55% of total losses) are lost without an apparent cause
- these losses are often attributed to ‘fading puppy/kitten syndrome’
- true fading puppy syndrome is generally observed 2d after birth onwards, with most pups dying between d3-5
Signs
- 1st signs detected in 1st few hours/days of life
- failure to suckle leading to dehydration
- progressive weight loss
- depression
- persistent crying
- generalised weakness
- hypothermia
What is hypogammaglobulinaemia?
- reduced serum immunoglobulin (antibody) levels
Congenital vs transient hypogammaglobulinaemia
Congenital
- delayed onset immunoglobulin in newborn
- may have delay of several years between clinical presentation and diagnosis
- recurrent resp infections common
Transient
- delayed onset of immunoglobulin production in newborns -> more immediate effect
- prone to resp, GI and skin infections, allergies
Bottle feeding - supplementary feeding
Ideally the bitch’s milk is given as the composition differs to meet the changing needs of the pups, provides adequate nutrition and is easy to digest
- a litter may need handing feeding either partially or fully e.g. loss of the bitch, the clinical condition of the dam, inadequate milk supply or a big litter
- commercial milk replacement products available with detailed feeding guides: prep the feed as per instructions on the packaging
- warm the milk to 36C
- neonates require feeding every 2h
- clean and sterilise equipment and ensure hygienic practice
Bottle feeding - equipment
- sterilised bottle with tear
- avoid using an eye dropper or syringe as may cause milk to enter the lungs -> aspiration/inhalation pneumonia, the pup may also take in air which can lead to colic
- small hole can be made in teat using sterile scissors
- when the bottle is turned downwards the milk should drop out slowly
- fi the hole is too small the pup will find it difficult to feed and too much could cause aspiration pneumonia or ingestion of air in large quantities
- kitchen roll/towel for mopping up during feeding
- cotton wool balls to stimulate toileting
Bottle feeding - feeding procedure
- test temp of milk
- sit down and put towel on knee and sit pup on lap
- if the bitch hasn’t recently toileted the pup, rub warm cotton wool on abdomen and genital region to encourage ruination, once empty the pup is more likely to want to feed
- use thumb and forefinger to gently squeeze the corners of the pups mouth open
- place teat in and ensure the pups tongue is under the teat
- the pup should then suck the teat
- if the pup is feeding well, give 1/2 the feed and then encourage urination again before finishing feed
Tube feeding
- suitable if the pt has no suck reflex but must be conscious
- risk of aspiration pneumonia
Transition to weaning
= transition from mothers milk to pup food
- usually occurs from 4-8w
- complete age-appropriate puppy food should always be used and advised
– supplements are not needed if a complete food is used
– overuse of supplements can lead to abnormalities
How to
- introduce gradually, giving small amounts little and often (small stomach size)
- use shallow dish
- soft, moist puppy food or dry food soaked in warm water and left to cool to body temp
- frequency of meals decreased, and size of meal increased over time
- if soaking dry food, slowly reduce quantity of water added
Weaning - suggested guide
Week 1
- milk feed every 2h
Week 2
- milk feed every 3h
Week 3
- milk feed every 3h
Week 4
- milk feed every 4-6h, offer a saucer of water and softened puppy food for lapping
Week 5
- wet puppy food, fresh water to drink
- milk down to lap and top up bottle feeds if necessary
Week 6
- fully weaned off milk
- feed a complete puppy food and water
What does dystocia result from
- maternal factors (uterine inertia, pelvic canal anomalies), foetal factors (oversize, malposition, anomalies), or a combination of both
What is the most common cause of dystocia clinically
- uterine inertia developing after the delivery of 1 or more neonates (secondary inertia)
Identifying dystocia (CS)
- infrequent, weak uterine contractions for the stage of labour
- stage I labour is not initiated at full term
- stage I labour is >24h without progression to stage II
- stage II labour doesn’t produce a vaginal delivery within 1-2h
- foetal or maternal stress is excessive
- moribund or stillborn neonates are seen
- stage II labour doesn’t result in the completion of deliveries in a timely manner (within 4-12h)
Management plan for the bitch post-whelp
Clinical assessment
- nose to tail
- check vulval discharge daily
– reddy/brown is normal, can last several weeks post whelping
– black discharge with a strong smell can indicate infection
- hygiene: wash back end to prevent matting from puppy urine/faeces
- check mammary glands 2x daily for adequate milk supply and signs of mastitis (heat, redness, inflammation)
- check c-section wound daily for inflammation, redness, discharge, breakdown
Environment
- provide clean, dry bedding
– promotes good hygiene/prevents cross-contamination
Husbandry
- clean/fresh water
- frequent small meals, highly digestible, high energy
— this may need offering to her if she is reluctant to leave whelping area
- correct diet crucial to avoid eclampsia (periparturient hypocalcaemia) -> calcium levels crucial
- regular toilet breaks
– good chance to check her over at this point
Behaviour
- common behavioural signs associated with milk production including panting and digging
- monitor interaction with pups, is she allowing feeding?
Management plan for the bitch post-whelp - EMERGENCIES
Retained placenta/pups
- v+, decreased appetite, fever, lethargy , discoloured (green) vaginal discharge
Eclampsia
- restless, panting, seizures, tenancy, ataxia, unconsciousness
Care for the bitch - nutrition continued
- vital from pre-mating through pregnancy and parturition to avoid deficiencies and malnourishment
- malnourishment may present with low BCS and muscle mass post whelp, with inadequate reserves to support lactation
- poor nutrition = poor colostrum and high frequency of fading puppy syndrome
- give palatable, high calorie food -> puppy food
- bring food and water to her
- reduced appetite can be normal therefore high calorie food is key
- most commercial adult dog foods don’t contain sufficient nutrient density
– protein and calcium levels often too low
Nutritional plan for nursing bitch - daily meals
Wk 1
- 150%* split across 1x meal
Wk2
- 200%* more split across 2x meals
Wk3
- 300%* more split across 3x meals
Wk 4
- 300%* more split across 4x meals
- = of her normal daily food amount
Reasons for perinatal loss in dogs and cats
Environment
- incorrect temp
- husbandry issues: dirty environment
- cross-contamination from bitch to pups e.g. E.coli or campylobacter
Maternal
- failure of maternal duties due to behaviour or illness
- bacterial infection acquired in utero
- heavy roundworm burden
- milk supply issue e.g. blood loss or mastitis
Puppy
- defects such as cleft palate (unable to feed adequately)
- metabolic problems
- heart/organ defects
- immaturity: lack of lung surfactant, immature digestive, liver and kidney systems causing breathing and feeding difficulties
What is the most common cause of neonatal loss? What are the causes of this?
Asphyxia or reduced oxygenation
- reduced blood flow to the uterus during contraction
- the umbilicus is stretched or occluded
- the placenta separates from surrounding tissue prior to, or during delivery
