RISK FACTORS LINKED TO PUPPIES

- Neonatal Disorders -

Puppies are born blind and deaf, but this delay in development is not only limited to the sensory organs. It also affects thermal regulation, immunity, hydration and metabolism, in addition to which, there is a lack of hepatic and fatty reserves. All these handicaps make the puppy susceptible to numerous disorders of origins as diverse as trauma, infections, dehydration, hypoglycemia or low body temperature. 

A recent study showed that puppy mortality before weaning was 17.4% and fell to 4% after weaning. The highest losses occurred during the first week of life (55.6%). Weaning leads to another peak in mortality, which drops off around the twelfth week. These results indicate that prevention efforts must focus primarily on the first week. 


Hypoxia

Parturition and the puppy's first respiratory movements are undeniably the most critical moments for the newborn. 
Veterinarians now have several tools to prevent neonatal hypoxia on the first day:

  • Estimating lung maturity of puppies by measuring progesterone levels and decreasing maternal pulmonary progesterone levels in the puppies by measuring progesterone, since maternal pulmonary progesterone levels are concomitant with the application of a lipoprotein surfactant, which is indispensable in deploying the pulmonary aveoli. This tool has considerably decreased neonatal mortality caused by premature caesarians, especially in brachycephalic breeds.

  • If necessary, manual assistance during whelping in cases of listless parturition (especially during posterior presentation, which is an additional risk factor for still birth because the expulsion time is increased). Early medical assistance can also be given to reduce the risk of inhaling amniotic fluid, knowing that what stimulates the puppy's first breath does not seem to be separation from the placenta but rather the thoracic depression that follows pelvic compression (increase of the pCO2 in the umbilical vessels);

  • Monitoring anesthesia and palinesthesia during cesarean delivery;

  • Clearing obstructions from the path of the puppy's upper airways by extracting amniotic fluids with a enema;

  • Traditional emergency procedures (heating, rubbing, etc.) and treatments (in particular bulbar respiratory stimulants and oxygen masks) for puppies. 

Hypoglycemia

As with piglets, puppies are not born with the brown adipose tissue that allows for thermogenesis without chills. Their hepatic and muscular glycogen stores are very limited (depleted within a few hours after birth). They are also difficult to mobilize, which traditionally makes the puppy predisposed to classic hypoglycemia during the first fifteen days. Whether a hypoglycemic attack occurs or not (convulsions, followed by listlessness), essentially depends on how quickly the colostrum is ingested and the surrounding temperature. 
Thus, to prevent death from hypoglycemia in the first few hours, the puppies first need to be warmed up and put on the breast soon thereafter (glucose supplied from hydrolysis of the lactose). Finally, if these measures have not been successful, the puppies need to given a shot of isotonic glucose serum. 

Hypothermia

Similar to an air conditioner, the evaporation of the amniotic fluid at birth causes the puppy's body surface to be proportionally cooled. This phenomenon explains why puppies of small breeds are more exposed to hypothermia than dogs of the same age from larger breeds. 
As with glycemia, the puppy's body temperature is closely linked to how soon the first feeding occurs and how much colostrum is ingested.

No prevention tool for hypothermia is ideal:

  • Infrared lamps sometimes cause dehydration in puppies (especially when hygrometry is less than 55%). They can also cause burns on the mother if they are placed too low.

  • Heating pads and ground heaters have the disadvantage of heating the mother just as much as the puppies, which may impede lactation. 
    When extreme temperatures are needed, especially in the case of a CHV infection, incubators require that the puppies be separated from the mother. 

    Therefore, a few precautions are necessary:

  • long before whelping begins, "test" the mother's ability to tolerate high temperatures while pregnant (accelerated breathing is a good indicator that her thermal regulation abilities have been saturated),

  • in the case of hypothermia, do not separate the mother from her entire litter, but place the puppies an incubator on a rotating basis,

  • allow the mother to see her puppy through the incubator glass.

  • warm the puppies gradually in order to prevent cardio-respiratory failure

  • pay close attention to small litters in which it is difficult for puppies to warm themselves by huddling together

  • ensure that the temperature gradient is suitable for both puppies and mother.

Dehydration

The risk factors for dehydration in puppies during the first fifteen days of life depend on the weight/area ratio (which is lower in small breed puppies), how developed retinal filtration is, the surrounding temperature and hygrometry, how smoothly feeding occurs and possibly diarrhea. Diarrhea, however, can all too often go unnoticed because of the mother licking the puppies (often all that is left to see is the "wet bottom"). 
In order to prevent death from dehydration, it must first be diagnosed (skin fold indicators, regularly weighing the puppy for the first few days), the above-mentioned parameters must be fully understood (usefulness of humidifiers) and if necessary, the puppy can be rehydrated orally or parenterally. Conversely, the risks of over-hydration in puppies are considerable if their bodies are unable to regulate renal filtration. 

Lack of Care at Birth

Without dwelling on the well-known principles of intensive care (assisting with delivery, rupturing the amniotic sac, stimulating the first breath, etc), it is important to emphasize the usefulness of regular antisepsis of the umbilical cord until healing is complete. Remember that the both mother's mouth (especially from licking the puppies lochia and the perianal region) and the litter are the main risk factors in terms of umbilical cord contamination. 

Other Causes of Neonatal Mortality

The are many diverse causes of neonatal mortality in puppies. However, the following should be mentioned:

  • Hemorrhagic syndrome, when it is linked to the fact that the mother's food is not properly preserved, can be effectively prevented through prolonged doses of vitamin K1 given to the mother and the puppies.

  • Hemolytic syndrome, which, if it occurs too frequently in a genetic line, would justify blood typing the parents before they are mated or at least, before any blood transfusion is performed on the mother.

  • "Swimmer Puppy" Syndrome (hind legs in a "frog" position), which in less severe cases, leaves room for hope for accelerated recovery through sensory stimulation of the front footpads (with a toothbrush, for example). Chances are also good that the hindquarters will temporarily solidify by using elastoplast "handcuffs" and of course, by placing the puppy on a rougher surface. Vitamin E-based treatments and selenium have not produced results that are significantly different from the spontaneous recovery that is sometimes observed.

  • Iatrogenic neonatal mortality (that is caused or at least precipitated when medical treatment is given without choosing the medication and dosage based on the fact that sensitivity and pharmacokinteics are different in puppies than in adults). However, veterinarians are now sufficiently aware of the main contraindications and the recommended dosages that they can refer to them before making any treatment decision that affects the mother or the puppies

  • Puppy Diarrhea is all too often systematically medicated, whereas in most cases, all that needs be done is to adapt the quantity, quality or frequency of food intake (whether it be the mother's milk, substitute milk or weaning food). This should be done in order to adapt to the slow maturation of the puppy's enzymatic digestive tools (lactase and amylase, in particular).

  • Viral Infections are prevented, whenever possible, by passive immunization (colostrum, seropathy) or active immunization (vaccination).

Bacterial Infections

Many bacteria that cause neonatal septicemia or diarrhea in puppies are also found in clinically healthy animals. Therefore, whether puppies develop symptoms or not will generally depend on the number of bacteria involved. It also depends on the animal's immune system, which in turn depends on the immune status of the mother, as well as the amount of colostrum absorbed, the age of the puppy, the amount of microbes in the surrounding environment, stress and many other individual factors. 

Thus it is clearly difficult to blame any one type of bacteria simply because it was found to be present during a bacteriological examination of the stool. 

That being the case, the most common pathogenic bacteria in puppies are:

  • the germs responsible for mastitis in the mother ("toxic milk syndrome") that can cause particularly severe gastroentritis in puppies. This can then lead to rapid dehydration and cause the anus to turn blue and to protrude in what is referred to a "cauliflower" shape. Withdrawing the puppies and feeding them artificially will protect the litter from the risks of embolization of intestinal germs (septicemia).

  • The presence of cutaneous abscesses (staphylococcic) in the mother can also cause neonatal septicemia in puppies. Septicemia can also be the result of umbilical infections, especially when the mother is suffering from a prognathism, because this malocclusion makes it difficult for her to cut the umbilical cords;

  • Escherichia transmitted by feces, milk or the mother's coat. 



From Aniwa.com

Infections reported to cause late-gestational abortion,
stillbirth or neonatal mortality in dogs

VIRAL
  - Canine herpesvirus
- Canine minute virus (parvovirus type-1)
- Canine parvovirus type 2 (CPV-2)
- Canine distemper virus
BACTERIAL
  Campylobacter spp.
Escherichia coli
- Beta-hemolytic Streptococci
- Mycoplasma
- Ureaplasma
Brucella canis
PROTOZOAL
  Toxoplasma gondii
Neospora caninum

NOTES

Cleft Lip/Cleft Palate

Cleft lip (hare lip) results from failure of fusion of the two sides of the lip during embryonic development. It is not cosmetically appealing to owners, but does not usually cause a problem. It can be surgically corrected. 

Cleft palate is a more serious condition involving a failure of fusion of the two sides of the palate. This can involve the soft palate only or the hard and soft palate. This defect can be inherited genetically or can be due to an event occurring during embryonic development. 

Cleft palates are usually discovered when young animals are presented to the vet because of nasal discharge, coughing, and not keeping up with littermates in terms of weight gain. Surgical correction is done once animals are old/big enough to undergo anaesthesia. Without repair, most or these animals will die of pneumonia. 

Puppies and kittens should be examined with in the first few days after birth for cleft palates. If one is discovered, the pet should be examined by a vet, and not allowed to nurse from the mother, but rather tube fed until reaching a size/age at which they can undergo anaesthesia. 

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