Initially treating fading puppies and kittens - Veterinary Medicine
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Initially treating fading puppies and kittens
Providing adequate warmth, hydration, and nutrition are the priorities in treating puppies and kittens with this fading syndrome. Additional initial therapy is indicated when the cause of the illness is evident.


Finally, drug metabolism is altered in neonates because of reduced glomerular filtration rate and tubular secretion in the kidneys.19 Hepatic metabolism is also immature.19

These alterations in drug absorption, distribution, and metabolism in neonates provide us with challenges in administering drugs. Few studies give us absolute answers, so we must make our best choices based on understanding the pharmacology of the particular drug.

Antimicrobial and antiviral treatment

Table 4. Antibiotic Use in Neonates*
Since most ill neonates will not have a definitive diagnosis at the onset of treatment, antibiotics are often administered in case bacterial infection is present. Common antibiotics used in neonates are shown in Table 4. In general, beta-lactam antibiotics are considered safe and are typically used as initial empirical therapy. While concern exists about the use of fluoroquinolones in immature patients because of the risk of cartilage damage, they have been used successfully in neonates under the age of 4 weeks with no apparent ill effects.4,19 In resistant infections, the benefits of use may outweigh the risk. One study showed that in kittens 2 to 8 weeks of age, subcutaneous and intravenous administration of enrofloxacin achieved therapeutic ranges when given at 5 mg/kg, but oral dosing did not.20

In puppies with canine herpesvirus infection, treatment with acyclovir (10 mg/kg orally every six hours for five days) can be successful.5

Antiparasitic treatment

Empirically treat all neonates with pyrantel pamoate for prepatent roundworm and hookworm infestations. While treatment is routinely started at 2 weeks of age and continued every two weeks until post-weaning, it can be safely given to ill neonates at any age at a dosage of 5 to 10 mg/kg orally.7 Preventing larval migration from the dam to offspring can be achieved with fenbendazole at a dosage of 50 mg/kg given orally daily from Day 40 of gestation to 14 days postpartum.7

Giardiasis in the neonate can be treated with fenbendazole as well at the same dosage for seven days. Coccidiosis can be treated with sulfadimethoxine at 30 mg/kg/day for 20 days in puppies and kittens weighing at least 2.2 lb (1 kg).7 Tritrichomonas foetus infection causes chronic large bowel diarrhea in kittens. It has been successfully treated in 10-week-old kittens with ronidazole (30 to 50 mg/kg b.i.d. for two weeks).21


Certain defects, such as cleft palates and patent ductus arteriosis, are amenable to surgical correction. With cleft palates, the neonate must be carefully tube fed until surgery can be successfully completed, typically 6 to 12 weeks of age depending on breed and size. Patent ductus arteriosis is best corrected as soon as the pup is large enough for the surgeon to operate—this may be 6 to 9 weeks of age. Atresia ani, while technically correctable with surgery, carries a high risk of permanent fecal incontinence, so most neonates with this problem are euthanized.

In swimmer neonates, the typical dorsoventral flattening and inability to walk are responsive to physical therapy. Rule out pectus excavatum because of its poor prognosis. Once you identify dorsoventral flattening in a puppy or kitten, change the neonate's bedding to egg-crate foam or heavy artificial sheepskin to provide good footing. Loose tape hobbling of the affected limbs will reduce the permanent dorsoventral flattening.22 Be sure not to compromise blood flow to the limbs when applying hobbles, and check them frequently as the neonate grows. In addition, make a channel from towel-covered concrete blocks just wide enough for the neonate to walk through. Three times a day, pass the neonate through this channel five to 10 times. This protocol is almost always successful in achieving normal locomotion, although the thorax may always be somewhat flattened.


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