Rescue organizations: Caring for sick neonates
Caring for sick neonatal puppies and kittens
The Pet Doctor www.thepetdoctorinc.com
Rescue Shelter Training 2011
Birth weight is the most important predictor of survival. Those neonates that are 25% of the litter average weight are at particularly high risk for hypoglycemia, hypothermia, hypoxia, bacterial septicemia and pneumonia. Daily monitoring weight gain is a good indicator of health status.
Puppies should double their weight in 10 days. They should gain 5-10% increase in body weight each day. Kittens should also double their weight in 10 days. Normal kittens gain 10-15 grams each day. Kittens should weigh 1 pound per month of age for the first 4 months. Formula fed neonates grow at significantly slower rate despite the identical caloric intake.
Signs of healthy newborn puppies and kittens include adequate weight gain, strong wake and sleep patterns, firm muscle tone and strength, and not crying. Puppies cry when hungry, neglected (separated or culled), in pain, and especially when cold. If they continue crying, there may be another problem
Thermoregulation is a concern in the neonate. Chilling is always a major threat to the survival of newborn puppies and kittens. The shivering reflex and peripheral vasoconstriction response are not fully developed until at least 1 week. Their relatively large surface area, plus the lack of insulating fat, promotes rapid heat loss. They must use the warmth of the dam and litter and environment to maintain an adequate body temperature. Mothers who refuse to care for their babies places these individuals at high risk for hypothermia. Hypothermia is a common cause of death in the newborn. If body temperature reaches below 94° F the suckling reflex becomes weak and ineffectual. The intestines become hypomotile and the heart rate increases.
Environmental temperature can be critical as a healthy newborn can only maintain a body temperature that is about 10 degrees higher than that of the surrounding environment.
Hypothermic patients should be re-warmed slowly (1-2 hours) to a temperature of 98°-99°F. Warming increases the respiratory and heart rates; increases effectual nursing and swallowing reflex; increases visceral movements; and mobilizes energy. Do not feed cold neonates prior to rewarming. Focal heat sources such as circulating hot water blankets, warmed rice bags and hot water bottles insulated with towels may also be used. Whenever a focal heat source is used, a temperature gradient should be created to allow the neonate to either move to or away from the heat source. Heat lamps and electric heating pads are not recommended because of increased the risks of burns and overheating. Remember to turn the patient every 20 minutes or so to prevent burns.
Dehydration is always a concern with a sick puppy or kitten. It is no surprise they are extremely susceptible to dehydration. They are >70% water with a large surface area and an inability to concentrate their urine. Hydration status can not be accurately assessed with skin turgor. Dehydration must be determined by dryness of the mucus membranes and eyes, plus the urine specific gravity. Accurate body weight and urine specific gravity can be used to monitor the rehydration efforts.
Re-hydration fluids may be administered to the neonate by tubing, subcutaneous fluids, intravenous fluids, interosseous fluids, or rectally depending on the severity of the problem and resources available. Fluids should be warmed to 95°F-98.6°F. Oral fluids and nutrition are contraindicated in hypothermic neonates because of gastrointestinal hypomotility. We can teach you how to tube feed neonates, come in for a class before you need it!
Hypoglycemia is one of the most common and serious problems seen in the neonates. A normal blood glucose for a puppy or kitten is 90-140 mg%. A fasting puppy can maintain an adequate blood glucose for 24 hours. After that period a dangerous drop occurs.
Hypoglycemia is often secondary to another disease process (sepsis). Preventative treatment of hypoglycemia is recommended for all sick neonates.
Clinical signs of hypoglycemia include visual problems, incoordination, muscle tremors, seizures, lethargy, depression, collapse, coma, death. These symptoms can also be associated with numerous other common neonatal illnesses. The diagnosis of hypoglycemia is based on the clinical signs, low blood glucose, and response to dextrose therapy. Therapy options include 10% Dextrose dosed at 1-2 ml/kg given slowly intravenously or 1-2 ml/kg 10% dextrose given orally with tubing. Karo syrup can be given if the neonate is swallowing normally. Do not every give fluids with Dextrose in a subcutaneous injection. It will cause sloughing of skin in the area.
Once the hypothermia, hypoxia, hypoglycemia and dehydration have been addressed, and then consider nutritional supplementation. Tube feeding with a commercial milk replacement formula initially diluted is the next step in patient care of the sick neonate.
Life threatening sepsis occurs when a bacterial infection overcomes a neonates defense mechanisms.
Staphylococcus, Streptococcus, E coli, Klebsiella, Enterobacter, Clostridium, and Salmonella are commonly isolated from septic neonates. This can come from the gastrointestinal tract, respiratory tract infection, urinary tract, skin and the umbilical cord. The risk of infection is incr eased due to inadequate colostrum, hypothermia, hypoglycemia, poor nutrition, viral infection, endoparasitism, plus metritis and mastitis in the bitch or queen.
Typically neonates with sepsis show the following- prolonged crying, restlessness, weakness, hypothermia, shock, cyanosis. Laboratory findings are show an initial increase in white blood cell count, then as the system becomes overwhelmed, the septic puppy or kitten will show a low white blood cell count.
A septic neonate should be managed as an emergency. Any hypothermia, hypoxia, hypoglycemia, shock, and dehydration need to be addressed. Antibiotics should be given and cultures are recommended prior to starting treatment with antibiotics.
Puppies and kittens that slowly waste away and die during the neonatal period often referred to as a “fading puppy” or “fading kitten” syndrome. The pups and kittens are born apparently healthy, but nursing slowly ceases, they fail to gain weight, become weak, thin, and eventually die, for no apparently obviously reason. The syndrome represents a myriad of causative agents. Rule outs should include congenital anomalies, nutritional deficiencies in the mother, traumatic birth injury, maternal neglect, and neonatal isoerythrolysis. There are also infectious agents that can be the cause.
In a litter with one or several losses, necropsy diagnosis may yield information that will be beneficial to the rest of the litter and future litters. The neonate should be kept refrigerated (never frozen) until a trained pathologist performs necropsy. If the necropsy is performed at the clinic, the procedure should include a thorough examination for congenital anatomic defects.
