Pediatrics, An Issue of Veterinary Clinics of North America: Small Animal Practice, -  Autumn Davidson

Pediatrics, An Issue of Veterinary Clinics of North America: Small Animal Practice, (eBook)

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2014 | 1. Auflage
201 Seiten
Elsevier Health Care - Major Reference Works (Verlag)
978-0-323-28729-6 (ISBN)
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This issue focuses on pediatric disorders in dogs anf cats. Topics will include: clinical pathology of dogs and cats, pediatric neutering, pediatric immunization, nutrition, seizure disorders, canine pediatric dentistry, pediatric feline upper respiratory disease, neonatal fading syndrome, holistic pediatric medicine, management of the cleft palate, and urinary ectopia.

Front Cover 1
Pediatrics 2
copyright 
3 
Contributors 4
Editor 4
Authors 4
Contents 6
Veterinary Clinics Of 


9 
Preface 10
Neonatal Resuscitation 12
Key points 12
Beyond the ABCs 18
When to stop resuscitation 19
Umbilical cord management 19
Husbandry: the first days 20
Warmth 22
Immunity 22
Groceries 24
Further readings 25
Pediatric Clinical Pathology 26
Key points 26
Introduction 26
Hematopoietic system 27
Clinical Implications 27
Urinary system 28
Clinical Implications 31
Hepatobiliary system 33
Clinical Implications 37
Lipids 37
Clinical Implications 38
Minerals 38
Clinical Implications 38
References 39
Pros, Cons, and Techniques of Pediatric Neutering 42
Key points 42
Introduction 42
Anesthesia and surgery 43
Benefits of gonadectomy 44
Societal 44
Behavioral 45
Medical 45
Mammary neoplasia 45
Pyometra 45
Benign prostatic hypertrophy 45
Testicular neoplasia 45
General considerations 46
Detriments of gonadectomy 46
Behavioral 46
Medical 46
Surgical complications 46
Obesity 47
Neoplasia 47
Orthopedic problems 47
General considerations 48
Summary 48
References 49
2013 Update on Current Vaccination Strategies in Puppies and Kittens 56
Key points 56
Basic immunology 57
Developing vaccine guidelines using risk assessment 58
Types of vaccines 59
General recommendations 60
Core canine pediatric vaccines 60
Distemper 60
Canine Adenovirus 66
Canine Parvovirus 66
Rabies 67
Noncore canine pediatric vaccines 67
Leptospirosis 67
Bordetella 68
Parainfluenza 68
Borreliosis 69
Measles 69
Canine Influenza Virus 70
Rattlesnake Vaccine 70
Canine, generally not recommended 70
Canine Corona Virus 70
Canine Adenovirus Type I 71
Core feline pediatric vaccines 71
Feline Panleukopenia Virus 71
Feline Herpesvirus I 71
Feline Calicivirus 72
Rabies 72
Feline Leukemia Virus 73
Noncore feline pediatric vaccines 73
Chlamydiosis 73
Bordetella 74
Feline, generally not recommended 74
Feline Immunodeficiency Virus 74
Feline Infectious Peritonitis 75
Adverse events associated with vaccines 76
Feline Injection-Site Sarcomas 76
Type I Hypersensitivity 79
Type II Hypersensitivity 80
Type III Hypersensitivity 80
Type IV Hypersensitivity 80
Special circumstances 80
Summary 81
References 81
Pediatric Nutrition 86
Key points 86
Introduction 86
Pregnant and lactating bitches 86
Prebiotics 87
Pediatric puppies: weaning to 6 months 88
Supplements that affect the immune system in puppies and kittens 89
Colostrum 89
Probiotics 91
Milk replacers for orphaned puppies and kittens 92
Summary 93
References 93
Pediatric Seizure Disorders in Dogs and Cats 96
Key points 96
Portosystemic shunts 97
Hydrocephalus 99
L-2 hydroxyglutaric aciduria 101
Lissencephaly 102
Granulomatous meningoencephalomyelitis 102
Necrotizing encephalitis 104
Infectious diseases 105
Distemper 107
Neosporosis 108
Toxoplasmosis 108
Cryptococcosis 109
FIP 110
Epilepsy 111
Anticonvulsant choices 111
Phenobarbital 112
Bromide 113
Levetiracetam 113
Zonisamide 113
Gabapentin 114
Pregabalin 114
Felbamate 114
Benzodiazepines 115
Therapeutic monitoring 116
References 117
Canine Pediatric Dentistry 124
Key points 124
Normal deciduous dentition 124
Developmental anomalies in puppies 126
Microglossia and Ankyloglossia 126
Cleft Lip and Cleft Palate 126
Delayed eruption of teeth 128
Persistent deciduous teeth 128
Endodontal disease in deciduous teeth 129
Exodontics of deciduous teeth 129
Normal Occlusion 130
Malocclusions 130
Commonly observed malocclusions 131
Treatment of malocclusions 133
Developmental anomalies in juvenile dogs 135
Dentigerous Cysts 135
Anatomic Anomalies 135
Abnormalities in Number of Teeth 137
X-linked Hypohidrotic Ectodermal Dysplasia 138
Localized Enamel Hypoplasia 138
Generalized Enamel Hypoplasia 138
Intrinsic Tooth Discoloration 139
Oral tumors in juvenile dogs 139
Odontomas 139
Canine Papillomatosis 139
Canine Oral Papillary Squamous Cell Carcinoma 140
References 142
Successful Management Permitting Delayed Operative Revision of Cleft Palate in a Labrador Retriever 146
Key points 146
References 150
Pediatric Feline Upper Respiratory Disease 152
Key points 152
Introduction 152
Feline herpesvirus-1 infection 153
Feline calicivirus infection 154
Chlamydiosis 156
Bordetellosis 156
Mycoplasma infections 157
Streptococcus infections 157
Diagnosis 158
Treatment 159
Prevention 160
References 161
Diagnosis and Management of Urinary Ectopia 164
Key points 164
Supplementary data 173
References 174
Holistic Pediatric Veterinary Medicine 176
Key points 176
Holistic perspective 176
Individual Nature of Health and Disease 176
Progression of Disease 177
Treating Whole Patients 177
Description of common complementary and alternative veterinary medicine modalities 177
Traditional Chinese (Veterinary) Medicine 177
Traditional Chinese (veterinary) medicine terminology 178
Treatment using the traditional Chinese (veterinary) medicine model 178
Homeopathy 178
Law of similars 178
Medicinal (primary) action induces curative (counter) action 178
Medicine selection 179
Homeopathy definitions 179
Chiropractic Therapy 179
Manual Therapy 179
Treatment of diseases in pediatric patients 180
Gastroenteritis 180
Infection-associated gastroenteritis 180
Endoparasite-associated gastroenteritis 180
Helminth Infestations 181
Protozoal Infections 181
Treatment of Gastroenteritis 181
Homeopathics, Herbals and Nutritional Supplements 181
Adjunctive therapy 182
Infection-Associated Respiratory Disease 182
CIRD 182
Treatment of CIRD 182
Herbal supplements 183
Feline upper respiratory infections 183
Treatments for Feline Upper Respiratory Disease 183
Homeopathics, herbals and nutritional supplements 183
Dermatologic Disease 184
Otitis externa 184
Topicals and nutritional supplements 184
Demodicosis 184
Treatment of Demodicosis 184
Topicals and nutritional supplements 185
Flea allergy dermatitis 185
Natural Flea Control 185
Resources for veterinarians 185
References 186
Index 188

Pediatric Clinical Pathology


Benita von Dehn, DVM,     Idexx Laboratories Inc, 1 IDEXX Drive, Westbrook, Maine; Department of Small Animal Medicine, Pet Care Veterinary Hospital, East Campus, 2425 Mendocino Avenue, Santa Rosa, CA 95403, USA. Email: docbenita@aol.com

This article provides clinically relevant and applicable information about normal biochemical values in puppies and kittens younger than 6 months, and is intended to provide practical guidelines for the interpretation of serum biochemical results in these young animals. At present there are no published sets of normal hematologic reference ranges for mixed-breed puppies and kittens younger than 6 months. Reference-value sets for closed research colonies composed of a few selected breeds are available, which help to provide insight into trends in normal hematologic and biochemical values for puppies and kittens.

Keywords

Neonatal clinical pathology

Pediatric hematology

Urinary system

Hepatobiliary system

Key points


• Because of variations in enzymology and functional capacity of neonatal organ systems, care must be taken when interpreting any changes in clinical chemistry values when using standard adult reference ranges.

• Although published reference ranges are provided, based on the available research in current literature it is recommended that these ranges are used only as guidelines, owing to the lack of standardization of reference intervals among reference laboratories.

• This article is not intended to provide a fully comprehensive review of all hematologic and biochemical changes that occur from birth to 6 months of age, but to help provide a practical guideline for interpretation and useful diagnostic information in determining the state of health or cause of illness in a young dog or cat.

Introduction


Neonates possess a decreased functional capacity of many organ systems and variations in enzyme levels, which improve in accordance with appropriate growth. Because of these physiologic developmental changes, care must be taken when interpreting any changes in clinical chemistry values when using standard adult reference ranges.

This article is intended to provide pertinent and applicable information about normal biochemical values in puppies and kittens younger than 6 months. The article is not intended to be a comprehensive review of small animal biochemistry and physiology, but rather aims to help provide practical guidelines for interpretation of serum biochemical results in puppies and kittens younger than 6 months.

At present there are no published sets of normal hematologic reference ranges for mixed-breed puppies and kittens younger than 6 months. Reference-value sets for closed research colonies composed of a few selected breeds are available, which help provide insight into trends in normal hematologic and biochemical values for puppies and kittens.

Hematopoietic system


Normal physiologic changes reflected in the complete blood count results include a decline in hematocrit in the first several weeks of life. The hematocrit of the neonate may be high at birth, but declines dramatically by 3 days of age, and continues to decrease to adult normal range by 2 to 6 months of age.14 The decreased production and shortened life span of the red blood cells (RBCs) can result in increased polychromasia, nucleated RBCs, Howell-Jolly bodies, and Heinz bodies (kittens only).5,6 The neonate RBC exhibits macrocytosis, with mean corpuscular volume decreasing to that of adults by 4 weeks of age as fetal RBCs are replaced by adult RBCs.7 Gradual progressive climb in hematologic parameters can be detected by 2 months of age, with adult reference ranges for RBC, hemoglobin, and hematocrit usually reached by 6 months. The guidelines for evaluating a regenerative response in adult animals is likely sufficient for puppies and kittens older than 4 months (Tables 1 and 2). A greater regenerative response should be observed in animals younger than 4 months.2

Table 1

Hematologic values for growing, healthy beagle dogs

Values in parentheses are mean values.

Abbreviations: MCH, mean corpuscular hemoglobin; MCHC, mean corpuscular hemoglobin concentration; MCV, mean corpuscular volume; nRBC/100 WBC, number of nucleated red blood cells per 100 white blood cells; PCV, packed cell volume; RBC, red blood cells; total WBC, total white blood cell count.

aNormal ranges and/or mean values from Earl FL, Melveger BA, Wilson RL. The hemogram and bone marrow profile of normal neonatal and weanling beagle dogs. Lab Anim Sci 1973;23:690–5.

bMean values from Anderson AC, Gee W. Normal blood values in the beagle. Vet Med 1958;53:135–8, 156.

Table 2

Regenerative response in puppies and kittens

aThese values represent the minimum absolute numbers of reticulocytes required for an interpretation of a regenerative response. If the packed cell volume (PCV) is lower, the absolute number of reticulocytes should increase proportionately.

White blood cell (WBC) differential analysis for puppies and kittens younger than 6 months remains within the reference interval for adult animals. For puppies, the WBC count as well as neutrophil and lymphocyte counts are relatively high at birth, decline during the first month of life, increase by the second month, and then slowly decline. For kittens, WBC as well as neutrophil and lymphocyte counts at birth are well within the adult reference range, but increase to above the adult reference range for kittens at 3 to 4 months of age, then values return to within normal adult reference ranges by about 5 to 6 months of age.1,2 This leukocytosis, usually comprising neutrophilia and lymphocytosis, may be a physiologic response resulting from excitement and immune stimulation (Tables 1 and 3).

Table 3

Hematologic values for growing, healthy cats

Values in parentheses are mean values.

aNormal ranges ± one standard deviation from Meyers-Wallen VN, Haskins ME, Patterson DF. Hematologic values in healthy neonatal, weanling, and juvenile kittens. Am J Vet Res 1984;45:1322–7.

bNormal ranges from Anderson L, Wilson R, Hay D. Haematological values in normal cats from 4 weeks to 1 year of age. Res Vet Sci 1971;12:579–83.

Clinical Implications


Determining the cause of an anemia in a puppy or kitten is important, and may be vital in determining a diagnosis and subsequent treatment plan. Classifying the anemia into a pathophysiologic category of regenerative, iron-deficiency, or nonregenerative based on changes in the erythrogram may be useful. Elevated reticulocytes are the preferred method for evaluation of the regenerative response in puppies and kittens. Animals younger than 4 months should have a greater reticulocyte response than that considered to be regenerative in adult dogs and cats.2 Once the anemia has been determined to be regenerative, the total plasma or serum protein concentration can be assessed to help determine if the cause of the anemia is hemolysis or hemorrhage. The total plasma protein concentration is usually low with hemorrhage. The common causes of blood-loss anemia in puppies and kittens include inherited or acquired coagulopathies, excessive hemorrhage after trauma or surgeries, and hematophagous parasitism. The hallmark of chronic blood loss and, ultimately, iron-deficiency anemia are microcytic hypochromic RBCs (low mean corpuscular volume and low mean corpuscular hemoglobin concentration).

By contrast, regenerative hemolytic anemias tend to demonstrate normal or increased serum (or plasma) total protein. Common causes of hemolytic anemias in puppies and kittens include immune-mediated hemolytic anemia, most often attributable to neonatal isoerythrolysis, oxidative injury, and Heinz body formation (ie, a variety of foods such as onions, garlic powder, certain drugs, and plant substances); microangiopathy (ie, feline infectious peritonitis); and hemoparasites (ie, hemotropic Mycoplasma, Babesia, cytauxzoonosis).

Nonregenerative anemias are uncommon in puppies and kittens, and are usually associated with underlying illnesses such as renal failure, endocrinopathies, and inflammatory, viral, or neoplastic diseases. A nonregenerative anemia may or may not be seen before 6 months of age with some chronic congenital disorders.

Urinary system


Blood urea nitrogen (BUN) and creatinine are the most commonly assessed indices of glomerular filtration. Significant variability in the rate of maturation of intrinsic renal mechanisms regulating glomerular filtration rate (GFR), renal blood flow (RBF), and distal delivery of water and solute are observed in puppies and between species. GFR increases 7-fold...

Erscheint lt. Verlag 9.3.2014
Sprache englisch
Themenwelt Medizin / Pharmazie
Veterinärmedizin Kleintier
ISBN-10 0-323-28729-8 / 0323287298
ISBN-13 978-0-323-28729-6 / 9780323287296
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