Care of the canine and feline neonate: part 1 (Proceedings)

Puppies and kittens are generally considered to be neonates from birth to two weeks of age although some references consider the neonate period to extend to four weeks of age. Neonates pose special problems in husbandry and health care due to their small size and developing organ systems. The overall mortality rate reported for puppies and kittens in the first few weeks of life is 30%. Recognizing the disorders associated with neonates and becoming familiar with their specific needs can significantly improve the neonate's chances for survival.

In humans the positive effect that quality prenatal care and support of the nursing mother has on the newborn's health has been recognized for many years. These factors are no less important in the dog and cat in producing healthy offspring. If possible, the veterinarian should be involved early in the breeding process, helping the pet owner develop and carry out a health maintenance plan for the bitch or queen and the stud dog or tom.

A health maintenance plan for the bitch and stud dog prior to breeding should ideally include the following:

     • Annual health check-up by a veterinarian, including a complete physical exam and minimum lab data base

     • Consider OFA and CERF certification prior to breeding, if indicated

     • Nutrition

     • Good quality, complete, and balanced commercially available diet appropriate for the current life stage

     • Maintain reasonable weight

     • Vaccinations

     • Core vaccines should be administered at intervals recommended by the veterinarian to maintain protection and satisfy legal requirements

     • DA2PPL- distemper, adenovirus 2, parainfluenza, parvovirus, ± Leptospira

     • Rabies

     • Vaccines should be given to the bitch and stud dog at least two weeks prior to breeding

     • Non-core vaccines may be given as the situation requires.

     • Bitch and stud dog should have Brucella negative status and be screened for other infectious disease as recommended by the veterinarian

     • Parasite control

     • Fecal samples should be checked annually for parasites and deworming carried out as

     • indicated

     • External parasite (fleas, ticks, mites) control should be practiced routinely in a manner

     • appropriatefor anticipated breeding circumstances

     • Perform heartworm testing and prevention as advised by theveterinarian

     • Runs or other housing areas should be properly maintained and disinfected

     • Appropriate drainage

     • Concrete surface ideal for runs

     • Feces should be removed on a regular basis

     • Disinfectants cannot work appropriately if feces, urine, or plant material

     • are not removed from the surface of the area to be disinfected.

     • Food should be properly maintained in an uncluttered rodent and insect-free environment.

     • Detailed health maintenance records should be kept.

A health maintenance plan for the queen and tom prior to breeding should ideally include the following:

     • Annual health check-up by a veterinarian, including a complete physical exam and a minimum lab data base.

     • Nutrition

     • Good quality, complete, and balanced commercially available diet appropriate for the current life stage

     • Maintain reasonable weight

     • Vaccinations

     • Core vaccines should be administered at intervals recommended by the veterinarian to maintain protection and satisfy legal requirements

     • FVR-CP- feline viral rhinotracheitis, calicivirus, and panleukopenia

     • Rabies

     • Vaccines should be given to the queen and tom at least two weeks prior to breeding

     • Non-core vaccines may be given as the situation requires.

     • Queen and tom should be FeLV and FIV negative and screened for other infectious diseases as recommended by the veterinarian

     • Parasite control

     • Fecal samples should be checked annually for parasites and deworming carried out as

     • indicated

     • b. External parasite (fleas, ticks, mites) control should be practiced routinely in a

     • manner appropriate for anticipated breeding circumstances

     • c. Perform heartworm testing and prevention as advised by the veterinarian

     • Housing areas should be properly maintained and disinfected

     • Disinfectants cannot work appropriately if feces, urine, or plant material are not removed from the surface of the area to be disinfected

     • Litter pans should be emptied, washed and disinfected regularly

     • Food should be properly maintained in an uncluttered rodent and insect-free environment.

     • Detailed health maintenance records should be kept.

Many of the same concerns addressed prior to breeding must be addressed after the bitch or queen has been bred. However, the recommendations will differ due to the demands of pregnancy and lactation. Diets designed for health maintenance or specific therapeutic purposes are often not suitable to sustain the pregnant or nursing bitch or queen. Suitable diets should be labeled as nutritionally complete and balanced for gestation and lactation. Such diets have increased digestible calories and highly digestible proteins. Changes in diet should be made gradually to avoid gastrointestinal distress. Food intake will increase during pregnancy and lactation. The bitch generally experiences an increase in food consumption about 10% above regular maintenance levels during the first two weeks of pregnancy, an increase of approximately 40% above maintenance during weeks 4 – 7, and an increase about 200 – 400% above maintenance during peak lactation (usually 20 –30 days after whelping). A similar pattern of increase in food intake is usually observed in the queen. However, the queen will also typically experience transient episodes of appetite loss at various times during her pregnancy, including a decline in appetite about 24 – 48 hours prior to the delivery of kittens. During peak times of consumption it is appropriate to feed the queen free choice or to feed smaller multiple feedings throughout the day. Water consumption is also important for both the dog and cat during pregnancy and lactation and should be encouraged by making available cool, fresh water at all times. An appropriate ration does not usually require the addition of dietary supplements, and the pet owner should be discouraged from giving such supplements unless specifically instructed to do so by the consulting veterinarian.

The issue of parasite control continues to be important throughout pregnancy and lactation. The pregnant bitch may infect puppies with round worms and hookworms through placental transmission or through the milk after whelping. Although deworming the bitch prior to breeding followed by deworming the neonates will usually control roundworms and hookworms adequately, internal parasite control can also be addressed by administering fenbendazole (Panacur® - 50 mg/kg /day) by mouth daily to the bitch starting at day 45 of gestation and continuing until the puppies are 4 weeks of age. Transmission of roundworms via lactation also occurs in kittens. Roundworms and hookworms can cause severe illness and death in both puppies and kittens prior to shedding parasitic ova. Pyrantel pamoate can be safely given to neonates for hookworm and roundworm infection starting at two weeks of age. Ideally administration of pyrantel should be continued every two weeks until weaning. Fecal examination should still be carried out to check for the presence of other parasites.

External parasite control must also be performed using methods acceptable for the pregnant or lactating bitch or queen as well as the neonate. In some cases manual removal is adequate. A flea comb will facilitate removal of fleas, eggs, and associated debris. Frontline® spray can be used on both the bitch or queen and the neonate for fleas and ticks. Pyrethrin powder may also be used topically, making certain to brush off and wipe up any excess powder. When applying topical products to the lactating bitch or queen, the mammary area should be avoided. Pyrethrin powder can also be sprinkled underneath mechanically cleaned bedding. A pest strip, hung in the housing area out-of-reach of the bitch or queen and neonates can also be helpful in controlling external parasites, especially fleas. Most mites can be treated with ivermectin (Do not use in herding breeds of dogs.) at a dose of 0.3 - 0.6 mg/kg PO or SQ daily (demodicosis) to weekly or every 2 weeks (Cheyletiella, Sarcoptes, Notoedres). Lime sulfur shampoo and dip is safe for use in both puppies and kittens weekly and will successfully treat Cheyletiella, Sarcopte, and Notoedres). Milbemycin oxime given orally (1 – 2 mg/kg) daily (Demodex) or twice at a 14-day interval (Cheyletiella, Sarcoptes) can also be used, but should be used with caution in herding breeds of dogs. Selamectin (Revolution( ) is effective for control of mites such as Sarcoptes, Notoedres, and Cheyletiella and many other parasites. It is safe for use in the pregnant or lactating bitch or queen, but is not labeled for use in puppies or kittens under 6 weeks of age. With the possible exception of Demodex the environment should be thoroughly cleaned and treated with pyrethrin powder or spray when mite infestation occurs.

Minimizing infectious disease transmission in general can be facilitated by isolating the bitch or queen during the last three weeks of gestation and continuing to isolate the bitch or queen with the neonates for the first three weeks postpartum. Following appropriate sanitation and disinfectant procedures is also essential in limiting spread of disease. In situations where a cattery or kennel operation is involved handling pregnant cats or dogs and bitches or queens with neonates prior to handling other animals in the operation will decrease the likelihood of disease transmission to these vulnerable individuals.

Providing as much of a stress-free environment as possible for pregnant queens and bitches is advisable since both the mother and neonate may be more susceptible to health problems as a result of stress. It is believed that stressful events during pregnancy can cause some developing neonates to undergo changes in the hypothalamic-pituitary-adrenal axis which result in the affected newborn being less well equipped to handle stress and illness.

Dystocia can be a complicating factor in achieving the desired result of both a healthy neonate and mother. It is important to identify situations complicating the birth process relatively early in the course of their development. The decision to intervene with surgery should be made in a timely manner since medical management has been reported to have a successful outcome in only 20 – 40% of dystocia cases.

The causes of dystocia are divided into those of maternal origin and those arising from fetal factors. Dystocia of maternal origin is subdivided into physiologic and morphologic causes. The most common physiologic cause is uterine inertia. Dystocia of morphologic origin is related to anatomic features of the mother which result in obstruction of the birth canal. Fetal factors resulting in dystocia include malpresentation, incompatible anatomic features, and fetal death. Some of these predisposing factors can be potentially identified by signalment, reproductive history, physical examination findings, and diagnostic imaging. Perinatal monitoring devices (e.g., WhelpWise), which track uterine contractions and fetal heart rates, may also provide valuable information indicating the need for medical or surgical intervention.

Indications of dystocia are included in the following list:

     1. Visible definitive cause

     2. Prolonged gestation

     3. Temperature drop in the bitch or queen and subsequent return to normal without labor

     4. Lack of delivery of fetus within 2 hours of observing green vaginal discharge or fetal fluids

     5. Failure to deliver fetus after 30 minutes of strong, persistent contractions

     6. Failure to deliver fetus after 4 hours of weak, infrequent contractions

     7. Four hours pass without signs of labor or delivery of a fetus

     8. Bitch or queen displays signs of systemic illness or severe pain

     9. Perinatal monitoring system indicates presence of potential problems.

Immediately after delivery, care of the neonate starts with management of the umbilical cord, checking for life-threatening conditions, and providing resuscitation, if needed:

     1. The umbilical cord should be clamped and ligated 1 – 2 cm from the umbilicus

     2. The newborn should be rubbed with a soft, clean towel, removing the amniotic sac and fluids

     3. The nostrils and back of the throat of each neonate should be cleared of secretions by wiping with fingers ± swabs or by using suction. A bulb syringe may be used for suction, but care should be taken to avoid aggressive suctioning since it can induce a vagal response or a laryngospasm.

     4. It is not recommended to "swing" the newborn to loosen secretions because it may cause brain hemorrhage.

     5. Observe the neonates for movement, breathing (15 –35 breaths/minute), color of mucous membranes, and crying

          a. If the neonate has a gray or bluish tinge to the mucous membranes and/or respirations appear depressed, hold the mouth closed and breathe into the nose or open the mouth and blow into the back of the throat to inflate the chest. Repeat as needed if the neonate does not breathe onits own or the mucous membranes remain blue or gray. If intubation or a snug-fitting mask is available, use positive pressure ventilation (40 – 60 breaths/minute), keeping the head and neck extended. If the chest is not expanding, check the seal on the face mask or the endotracheal tube placement, resuction the airway, and open the mouth slightly, and then continue ventilation.

          b. If no heartbeat is detected with warming and/or ventilation, cardiac massage should be begun (100 – 120 compressions/min) and epinephrine administered (0.1 mg/kg) intratracheally, intraosseously, or IV. Vasopressin may also be given (0.8 U/kg IV) through the endotracheal tube or intraosseously. Cardiac compressions in the neonate are carried out by placing the fingers behind the elbows on the sides of the chest and compressing the chest gently five times with the fingers followed by administering one to two breaths and then repeating as necessary.

     6. If the bitch or queen received an opioid during the birth process, consider administering naloxone to the neonate (0.1 mg/kg).

     7. Glucose may need to be administered as the main energy substrate of the neonate.      8. The use of doxapram for respiratory stimulation in neonates is controversial since it may decrease cerebral blood flow.

The mother should be allowed to interact freely with the neonates unless she has a history of neglecting or injuring her offspring. Each newborn should be gently rubbed with a towel to facilitate drying and stimulate activity. Puppies or kittens keeping themselves isolated from the rest of the litter and the mother and/or crying most of the time may be weak or ill. Each newborn should be weighed and the birth weight recorded. The neonates should be observed to make certain that all are nursing. Check non-nursing neonates for a suckle response since a poor suckle response is indicative of a weak puppy or kitten which needs to be supplemented with milk replacer and may need further examination by a veterinarian. Tube feeding is the best way to supplement neonates with a poor suckle response. Encourage neonates that are not nursing vigorously to nurse by giving them unobstructed access to teats and placing the teat in the neonate's mouth, if necessary. Newborn puppies and kittens that do not receive colostrum within the first 12 - 24 hours of life will not receive protective antibodies from the mother. Neonatal puppies and kittens that receive little or no colostrum should be given antibodies subcutaneously through a pooled serum source from healthy, well-vaccinated adults. The recommended dose is 16 ml/puppy of pooled dog serum or 15 ml/kitten of pooled cat serum given in divided doses over a 24-hour period.

Recommended Reading:

     1. Davidson, AP (ed). Pediatrics edition of Vet Clin North Am Small Anim Pract 2006;36:3.

     2. McMichael, M. Pediatric emergencies in Vet Clin North Am Small Anim Pract 2005; 35:2: pp 421 – 434.

     3. Freshman, Joni. Symposium on fading puppy and kitten syndrome. Veterinary Medicine November 2005.

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