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Why Show and Hobby Breeders Should NOT ever leave their bitch to whelp alone
Reason why human canine midwifes must be there 
There are numerous causes for neonatal mortality, most of which can be prevented. These have been divided into the following general categories: peripartum hypoxia; growth retardation (intrauterine and postnatal); maternal aggression, neglect or rejection; nutritional deprivation resulting in hypoglycaemia or dehydration; hypothermia; and pathogens (bacterial, viral and parasitic). Of course, in many instances, overlap exists between these categories. Neonatal losses within the first few months of life are a common yet unavoidable problem in canine reproduction. The overall expected mortality rate in young dogs should be less than 12-15% of full-term births by the age of weaning. However, this could range from 5-35% depending upon factors that predispose to neonatal losses. Of those deaths, approximately 50% are lost within the first seven days. Puppies are born much less mature than newborns of many other domestic species and thus are more dependent on care during the few weeks of life. It is important to understand the unique physiology of the canine neonate so that the main non-infectious and infectious causes of mortality can be anticipated and prevented. Fading puppy syndrome is a term that is used far too frequently to account of ignorance of normal neonatal needs and poor management. It is normal for neonates to lose a little bit of weight (mostly water) in the first 24 hours. Neonates that lose more than 10% of the birth weight in the first day have a poor prognosis. After that, puppies should gain 5% to 15% of their birth weight daily, doubling their birth weight by 10 days of age. This equates to 1 to 3 grams per day per pound of anticipated adult body weight. Neonatal body weight should be monitored daily to ensure normal weight gain.
Although historically a common method for removing amniotic fluid from the respiratory tract of neonatal dogs and cats, the swinging of new-borns is no longer advocated because of potential cerebral haemorrhage from concussion. Spontaneous breathing and vocalizing within one minute following delivery is highly correlated with neonatal survival. Vigorous rubbing with gentle intermittent stretching stimulates breathing and clears airways of fluid. A tactile respiratory reflex can be stimulated in the genital and umbilical regions for the first 3 days of life. In addition, in the mildly depressed neonate, vigorous tactile stimulation of the lumbar area by rubbing the fur backwards will help to elicit crying and further clear airways. The most critical period in neonates is the first three weeks because this is when neurologic and behavioural maturation is completed. After three weeks, the eyelids and ear canals are open, thermoregulation is established and the puppy is capable of eating solid food. The following definitions have been suggested for neonatal puppies: perinatal period (less than one day), neonatal period (one to 21 days), maturation period (21-28 days) and preweaning period (28-42 days). In the normal neonatal puppy, the rooting and suckling reflexes disappear between 25 to 28 days. However, these reflexes may persist longer in orphans. The oral cavity should be free of congenital defects (e.g. cleft palate). The hydration status should be assessed by checking moisture of the mucous membranes because skin turgor of neonates is not as developed as in adults. If dehydrated, skin on the ventral abdomen and muzzle may appear a deeper red colour. The skull should be examined for the presence of open fontanelles. A cranial nerve examination can be conducted in puppies after 3 weeks of age. Although the palpebral and corneal reflexes are present at birth, they are more easily visualized after the eyelids open. Puppies’ eyes open at 9 to 16 days. The menace response in puppies may not appear until the after 3 weeks because the retina is not fully developed before this time. Visual depth perception develops by approximately 28 days. Ear canals open in puppies between 10 and 14 days of age, but sound orientation does not occur until approximately 21 days It is abnormal for a healthy neonate to cry for longer than 20 minutes. Continuous crying usually indicates a cold or hungry puppy, but it may be a clinical sign of other painful or infectious processes. On thoracic auscultation, the lungs should be clear and free of fluid. In a healthy puppy, breathing is regular and unlaboured. The normal respiratory rate in neonatal puppies is 25 to 35 breaths per minute for the first two weeks of life, which decreases to normal adult rates between 3 to 4 weeks of age Initial respiratory rate of newborn puppies is 10 to 18 breaths per min and they lack the typical pause between breaths that is normal in adult animals. Heart rate is higher in neonates (>200 beats per minute) whereas blood pressure is lower (60±5 mmHg). The neonatal heart rhythm should be a regular sinus rhythm that is not associated with breathing patterns because vagal reflexes do not develop until approximately 8 weeks of age. Normal rectal temperature in the canine neonate is 35.0 to 37-2C (95 to 99F), which increases to 36.1 to 37.8C (97 to 100F) by 14 days. Poikilothermy gives way to autonomic thermoregulation by 28 days. Sick puppies lack normal bowel sounds on abdominal auscultation. The umbilicus should be dry and without any surrounding redness. Discoloration on the umbilicus or the ventral abdominal skin is indicative of sepsis Colour of the urine should be checked as a relative assessment of hydration status. Low specific gravity and glucosuria are common normal findings in neonates. Orphans will need manual stimulation of the orifices with cotton or a soft cloth to elicit this reflex by owner the first 2 weeks until voluntary control of these functions is developed. If the perineum is not stimulated, the bladder will continue to fill, causing abdominal distension. The anogenital reflex persists until 3 to 5 weeks of age, at which time postural control develops, which enables the puppy or kitten to assume a proper stance for urination. If the mother's milk is slow to come in, supplemental feedings are necessary for neonates that are not gaining weight or for orphaned puppies. A neonates caloric requirement approximates 230 to 260 kcal/kg body weight. daily (given over multiple feedings). Most commercial milk replacers deliver approximately 1.0 kcal/mL. The total daily feeding should be divided into at least eight feedings per day (approximately every 2 to 3 hours) during the two weeks of life to reduce the risk of stomach overdistension, abdominal discomfort, diarrhoea and aspiration. Smaller and toy breeds require more frequent feedings to prevent hypoglycaemia. The frequency of feedings can slowly be decreased as the amount being fed increases. Powdered formula lasts longer, since the unused powder can be frozen for 6 months. Once powdered formula has been reconstituted, contents should be used within 48 hours, provided the unused portion is refrigerated in a glass container. Liquid milk replacer should be used within 48 hours once the can is opened, provided the unused portion is refrigerated. If commercial milk replacer is temporarily unavailable, an emergency formula may be used. The emergency formula consists of 1 cup (250 mL) of whole cow's milk, 3 egg yolks, 1 Tbsp (15 mL) corn oil, 1 drop high-quality oral multiple vitamin solution and a small pinch of salt. This emergency formula is strictly for emergencies and should be replaced with a commercial milk formula as soon as possible. Puppies that are fed milk replacers should not be expected to maintain growth rates in parallel to those fed with dam’s milk and will take longer to double their birth weight. After each meal, neonates need to be stimulated to urinate and defecate by rubbing the perineal and preputial areas with a cotton ball that has been soaked in warm water. Gastrointestinal motility is reduced in neonates less than 30 days old. The formula should be warmed to body temperature to enhance gastrointestinal motility and prevent hypothermia. In addition, it is strongly advised to ensure proper body temperature, as hypothermia can also cause delayed gastric emptying.
Water is the most common essential nutrient most animals are deficient in. Neonates are especially susceptible to dehydration as a result of the physiologic immaturity of their kidneys. Although their bodies are more than 80% water, their ability to conserve water (concentrate urine) is significantly diminished since kidneys do not fully mature until 6 to 8 weeks of age. Because of the immaturity of the autonomic nervous system, canine neonates have an impaired ability to change systemic vascular resistance and cardiac contractility in response to dehydration. Water deficits are most frequently caused by prematurity; vomiting, diarrhoea or pneumonia; excessive ambient temperature; and reduced intake secondary to inadequate suckling or poor lactation. The daily water requirement for neonates is 130 to 220 mL/kg of body weight per day. Oral rehydration is preferred if gastrointestinal function is normal and the neonate is not hypothermic. Hypothermia suppresses appetite (resulting in failure to suckle), possibly as an adaptive response to reduce risk for aspiration. Hypothermia also causes intestinal ileus at temperatures below 34.4C (94F). Decreased intestinal motility can cause fermentation of milk in the stomach, resulting in bloat and severe abdominal pain. Hypothermic neonates should be slowly warmed over 30 minutes to 2 hours and not faster than 1ºC (2F) per hour. Rapid warming increases metabolic demand, with risk of exceeding the delivery capacity of circulatory and pulmonary function; this can cause loss of cardiovascular integrity, secondary hypoxia, cerebral changes, and sepsis. If the body temperature is raised more than 2C (4F) per hour, life threatening organ failure (specifically the heart and kidneys) can result. Neonates should be rotated often to ensure even warming, and rectal temperatures should be checked frequently. To prevent hypothermia, environmental temperatures need to be increased because higher temperatures will help neonates maintain their core temperature. If neonatal anaesthesia or surgery is necessary, appropriate steps should be taken to prevent hypothermia by limiting heat loss, such as clipping only a minimal amount of hair and avoiding alcohol-containing antiseptics. Side effects associated with hypothermia include cardiovascular alterations (bradycardia, hypotension, decreased cardiac output, arrhythmias), prolonged recovery times and drug metabolism, as well as increased infection rate and decreased wound healing.
The most commonly reported bacterial causes of neonatal sepsis include: Escherichia coli, and other gram-negative enteric organisms (e.g. Enterobacter sp), Campylobacter sp., Clostridium perfringens C. perfringens type A, -haemolytic Streptococcus sp. (e.g. S.canis), Staphylococcus sp. (S.aureus, S.intermedius), and Salmonella. Unfortunately, post-mortem cultures are how most neonatal bacterial infections are diagnosed. Aspiration of meconium, milk or other substances can result in pneumonia and systemic bacterial infection. Aspiration pneumonia may occur following bottle-feeding or with misplacement of a gastric feeding tube. Around the time of weaning and the transition to solid food, aspiration pneumonia can also occur secondary to oesophageal or pharyngeal dysfunction, congenital megaoesophagus, persistent right aortic arch, or cricopharyngeal achalasia. The clinical signs of aspiration pneumonia are essentially the same as infectious pneumonia (e.g., increased respiratory rate, fever, and a productive cough). Respiratory sounds may be harsh. Crackles may be auscultated over the affected regions of the thorax. Wheezing is less common but may be heard if there is significant bronchial involvement. Radiographic signs of aspiration pneumonia are variable and may not be present until 12 to 24 hours after aspiration. Bacterial pneumonia typically shows a cranioventral distribution of interstitial to alveolar patterns, viral pneumonias tend to show a more diffuse, interstitial pattern. Right cranial and medial lung lobes are most commonly affected in animals who aspirate while in sternal recumbency. Other lobes may be affected depending on positioning at the time of aspiration. A high percentage of neonatal puppy mortalities have combinations of pulmonary congestion, oedema, haemorrhage, and atalectasis.
more neonates die from improper husbandry and inadequate nutrition than infectious disease. Hypoglycaemia, dehydration, hypoxemia and hypothermia are the main mechanisms for neonatal losses. Birth weight is the single most important predictor of neonate survival. The neonate’s body weight should be monitored twice daily for the first two weeks and any loss or failure to gain should be investigated. Therapeutic goals of preventing neonatal mortality include supportive care and identification and eradication of the cause when known. In many cases, a number of simple actions can significantly reduce neonatal mortality

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