VCS81210 Pediatrics21.ppt

Canine and Feline Pediatrics Steve Thompson, DVM Dipl ABVP – Canine/Feline Practice Director – Pet Wellness Clinic My VCS 81210 Class Objectives     Outline orphan guidelines you would give to a fostering breeder or pet owner. Initiate critical care management for a sick neonate Identify antibio...

Canine and Feline Pediatrics Steve Thompson, DVM Dipl ABVP – Canine/Feline Practice Director – Pet Wellness Clinic My VCS 81210 Class Objectives     Outline orphan guidelines you would give to a fostering breeder or pet owner. Initiate critical care management for a sick neonate Identify antibiotics that are safe in pediatric patients and those that are used with caution Be able to assess a pediatric patient for common congenital disorders on your physical exam Goals of my lectures… By the time you’re in clinics…     Understand the critical period/socialization period during pediatric development Be comfortable outlining infectious disease control guidelines for kittens and puppies Be comfortable with a practice team approach to pet wellness from pediatrics to geriatrics Have resources for working with breeders and pet owners to identify and treat pediatric problems Special Thanks   Dr. Cheryl Lopate, DVM Dipl ACT Theriogenology Resident   ‘96 - ’98 Diehard OSU Buckeye Management of Dam        Selection of Breeders Nutrition during pregnancy (1.3X) and whelping Sanitation High ambient temp (72oF) Humidity 40-60% Parasite Control Monitor Weight of pups Normal neonatal parameters  Body temp Week 1-2 = 94 – 99oF  Week 2-4 = 99 - 100oF  Week 4+ = 100 - 101oF      PCV initially normal than typically drops by 9 weeks of age before rebound post deworming Dilute Urine S.G. with high metabolic rate Flexor dominance during initial few days Extensor dominance at 3 - 5 weeks Normal neonatal parameters  Eyes open 10-15 days in puppies  7-10 days in kittens   Reflexes   Activated sleep up to 3 weeks of age   Shiver at 1 week, Gag at 10 days “hyperkinesia”, jerking during sleep Defecation and Urination  Stimulation required during initial 14 days Neonatal care and feeding    Hypothermia persists to 4 weeks of age GI tract stasis below 94oF The most important factor affecting survival and growth of the neonate is thermoregulation  The most important factor affecting survival and growth of the neonate is thermoregulation Neonatal care and feeding  Nurse within 12-24 hours for colostrum     Immunoglobulin transfer, nutrients, energy Fluid needs – 100-120 ml/kg/day Monitor body weight daily Begin supplementation at 3 weeks of age Coincides with socialization  Avoid oversupplementation   Can begin weaning at 6 weeks of age  Force weaning at 4 weeks when necessary… Orphan care  Incubator 1st week  2nd week  3rd week  4th week    85-90oF 80oF 75oF 70oF Allow room for pups to move away from heat Clean bedding Orphan care    Feeding formulated diets for species Do not feed if temp below 94oF If body temp is good, minimize frequency   Enlarged abdomen but not distended    q 8 hours is acceptable, q 6 hours in toy breeds Stomach capacity about 5% of body weight Nipple should drip, not flow… Weigh each puppy or kitten daily Orphan care – bottle feeding Weigh  daily Wake before feeding  Sternal recumbancy Burp after feeding  Moist cloth/cotton ball on abdomen/perineum  Foster Homes & Surrogate Moms Neonatal mortality   10-30% mortality, Highest during first two wks Neonatal deaths due to:   Immaturity indicators   Exposure, stillbirths, infections, prematurity, congenital, undetermined Small size ( canine) Histiocytomas (canine) Juvenile Cellulitis, puppy strangles (canine) Hypertrophic OsteoDystrophy (HOD) (canine) Neonatal Isoerythrolysis (feline) Juvenile diarrhea / hematochezia (feline) Extra credit point on examif submitted Journal article is automatic preexam Question on the exam related to one disease that I can’t cover due to time constraints Canine Papilloma virus Focal and Generalized Demodecosis Focal and Generalized Dermatophytosis Otodectes (feline > canine) Impetigo, puppy pyoderma (canine) Ciliary dyskinesia (canine) Questions ?? Practical Pediatrics Pediatric visit/exam  Initial visit has importance to you and pet owner    Awareness of species specific zoonoses Gather individual and environmental history Thorough physical exam  Evaluate for congenital problems Oral cavity Ocular Thorax Abdomen Musculoskeletal Urogenital Congenital Problems  Oral cavity  Cleft palate  Malocclusion Prognathism, Brachygnathism  Retained teeth  Supernumerary or missing teeth  Tonsillitis is common post vaccination and with oral ingestion of novel antigens Aging by dentition      All deciduous teeth erupted by 8 weeks of age 1st permanent incisor erupts 2-5 months (12-16 weeks) 3rd incisor eruption has the tightest range of time at 45 months of age Canine teeth erupt at 4-7 months Kitten growth charts show 1 pound/month to 4 months of age, males bigger than females Base Narrow Canines Congenital Problems    Abdomen Palpate for kidneys, bladder, colon Palpable loops of bowel due to roundworms  Hernias – use abdominal press, elevate front Reducible vs Non-reducible, self repair? -Umbilical – 4% in one survey -Inguinal Genetic vs Maternal trauma? Congenital Problems  Musculoskeletal Polydactyl  Absence/presence of dew claws  Open fontanelles/hydrocephalus  Patellar luxation – 8% incidence in one survey   Hip dysplasia incidence high in many breeds Difficult to evaluate in young dogs  Look for hip laxity at time of neutering  Congenital Problems    Urogenital Dribbing urine? Patent urachus (at umbilicus) Ectopic ureter vs sphinctor incontinence Cryptorchid R > L Feline – descend at birth  Canine – delayed if after 3 months, up to 6 months?   Vulvar or prepuce discharge common Congenital Problems      Thorax Heart Murmurs Point of Maximum Intensity (PMI) Puppy (left basilar murmurs predominate) PDA, SAS, PS, VSD, tetralogy of Fallot, A-V valve dysplasia Kitten (right sternal/apex murmur predominates) VSD, A-V valve dysplasia, AS, PDA BASE P A M APEX Congenital Problems     Ocular Adnexal more than intraocular Entropion, ectropion Distichia, dermoid Nasolocrimal duct atresia (feline esp) Lens Persistent Pupillary membranes, Cataract Fundus Collie eye, coloboma, retinal dysplasia Common PE Findings  Puppy Pyoderma/Impetigo Typically inguinal  Treat topically   Generalized lymphadenomegaly   Common response post vaccination Ear debris/otitis externa Rule out Otodectes ear mites as primary cause  Topical treatment will typically resolve infections  Behavior Development         Ask questions about behavior development Housebreaking and Elimination habits Aggression to other pets, family, strangers Fears – objects, noises Separation Anxiety Destruction Nuisance behaviors Training Can I clarify anything for you?!