Normal neonatal kitten ___________________________________ - PDF document

Critical Care of the Neonatal Kitten March 13, 2014 ___________________________________ ___________________________________ ___________________________________ ___________________________________ Caring for the Neonatal Kitten ___________________________________ ___________________________________ Elizabeth Thomovsky, DVM, MS, DACVECC ___________________________________ Purdue University College of Veterinary Medicine March 13, 2014 ___________________________________ ___________________________________ ___________________________________ Objectives ___________________________________ ___________________________________ • Brief review of the “normal” neonatal kitten • Brief review of common disease in neonates ___________________________________ • Care for the sick neonate ___________________________________ – Thermoregulation – Fluid support/catheterization ___________________________________ – Medication administration – Feeding ___________________________________ – Blood transfusion ___________________________________ • Serial monitoring ___________________________________ ___________________________________ Normal neonatal kitten ___________________________________ ___________________________________ • Birth – 2 weeks = neonatal period ___________________________________ • 2-4 weeks = transition period • >4 weeks = socialization/juvenile period ___________________________________ • Birth weight: 100 g +/- 10g ___________________________________ – Best predictor of survival ___________________________________ – Underweight if endocrinopathy, poor maternal nutrition, uterine crowding, congenital anomalies ___________________________________ – Double weight in 10d (10-15g/day) if nursing ___________________________________

Critical Care of the Neonatal Kitten March 13, 2014 ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Normal neonate - thermoregulation ___________________________________ ___________________________________ 96-98°F week 1 99°F week 2 ___________________________________ 100.5°F week 3+ ___________________________________ • Unable to shiver ___________________________________ • Impaired peripheral vasoconstriction • Large body surface non-cornified skin ___________________________________ • Lack insulating fat ___________________________________ • Maintain 12°F greater than environment ___________________________________ ___________________________________ Normal neonate - fluid balance ___________________________________ ___________________________________ • 75% water with large body surface area non- cornified skin ___________________________________ • Nephrogenesis first 3 weeks life To the ___________________________________ bathroom – Unable to concentrate urine again! – Highly susceptible to dehydration ___________________________________ – Water turnover 2-3x of an adult ___________________________________ – High normal BUN × 7d – spG 1.006-1.017 ___________________________________ – Mild glucosuria/proteinuria × 6 weeks ___________________________________

Critical Care of the Neonatal Kitten March 13, 2014 ___________________________________ Normal neonate - development ___________________________________ ___________________________________ • Decreased cytochrome P450 enzymes (liver) first 4 weeks ___________________________________ – Abnormal bile acids – ALP elevation ___________________________________ – Normal ALT ___________________________________ • GI tract sterile at birth – Colonized by bacterium from mother (E. coli, Proteus, ___________________________________ Enterococcus, Lactobacillus, Clostridium, Bacterioides) – Stool yellowish-tan, soft ___________________________________ • Maternal immunity from colostrum within first 24 hours ___________________________________ ___________________________________ Normal neonate - vitals ___________________________________ • Umbilicus fallen off by 3d post-birth ___________________________________ • RR= 30 by 3 hrs post-birth • Mucous membranes ___________________________________ – Dark pink/red for one week ___________________________________ – Later pale pink (along with extremities) • Heart rate/cardiac output/central venous pressure ___________________________________ higher than adults – HR>250 bpm until at least 4 weeks age ___________________________________ (No PNS tone) – No sinus arrhythmias ___________________________________ – Heart murmurs innocent until 12 weeks age • Blood pressure/stroke volume lower than adults ___________________________________ ___________________________________ Normal neonate - diagnostics ___________________________________ ___________________________________ • Blood sampling ___________________________________ – Jugular venipuncture (hemolysis) – No alcohol (cooling) ___________________________________ – 100 gm kitten blood volume= 6mL! ___________________________________ – Hematoma formation • Significant loss blood ___________________________________ • Obstruction airway ___________________________________ – Less than 10% blood volume/24 hrs • 68-75ml/kg= blood volume ___________________________________ www.floppycat.com

Critical Care of the Neonatal Kitten March 13, 2014 ___________________________________ Normal neonate - diagnostics ___________________________________ ___________________________________ • CBC – High red cell mass (MCV) and PCV (42%) at birth ___________________________________ – PCV decrease to 24% by 8 wks (dilution by increased ECF) • Serum chemistry ___________________________________ – BUN high × 7d  then normal – Creatinine lower than adults – ALP elevated, ALT normal range ___________________________________ – Phosphorus elevated – Normal electrolytes ___________________________________ • Urinalysis – Low spG × 3 weeks ___________________________________ – Proteinuria × 6 weeks – Glucosuria × 6 weeks ___________________________________ ___________________________________ Normal neonate - diagnostics ___________________________________ ___________________________________ • Radiographs hard to interpret ___________________________________ – Size patient – Lack abdominal fat ___________________________________ – Poor mineralization bones ___________________________________ – Reduce KVP by 50% and detailed film/screens ___________________________________ • ECG ___________________________________ – Lead II diagnose arrhythmias ___________________________________ ___________________________________ Common illness of neonatal kitten ___________________________________ ___________________________________ • Parasitism ___________________________________ – Fecal-oral parasites (environment) – Transplacental transmission ___________________________________ – Cause ___________________________________ • Dehydration • Anemia ___________________________________ • Diarrhea • Impaction ___________________________________ • Neurologic disease (aberrant migration) www.vcahospitals.com ___________________________________

Critical Care of the Neonatal Kitten March 13, 2014 ___________________________________ Common illness ___________________________________ ___________________________________ • Septicemia – Bacteria enter from GI tract, respiratory tract, urinary ___________________________________ tract, skin, umbilical cord – Predisposed by: ___________________________________ • Inadequate colostrum • Hypothermia ___________________________________ • Hypoglycemia • Poor nutrition ___________________________________ • Viral infection ___________________________________ • Endoparasitism • Mastitis/metritus in dam www.tabbysplace.org ___________________________________ ___________________________________ Common illness ___________________________________ ___________________________________ • Clinical signs septicemia – Prolonged crying ___________________________________ – Restlessness ___________________________________ – Weakness ___________________________________ – Cyanosis or mucous membrane hyperemia – Discoloration/sloughing extremities ___________________________________ ___________________________________ ___________________________________ www.pet-informed-veterinary-advice-online.com ___________________________________ Common illness ___________________________________ ___________________________________ • Fading kitten syndrome – Fail to gain weight, weak, die ___________________________________ – No apparent reason ___________________________________ – Look for underlying infection, congenital ___________________________________ abnormalities, etc. ___________________________________ ___________________________________ ___________________________________