OBJECTIVE:To present evidence- and consensus-based guidelines for resuscitation of newborn puppies and kittens. DESIGN:Prioritized clinical questions pertaining to newborn resuscitation and in the Population-Intervention-Comparator-Outcome (PICO) format were used to inform systematic literature searches by information specialists, to extract research findings from relevant publications and synthesize them into evidence, to assess this evidence for quality, and, finally, to develop draft treatment recommendations. These steps were followed by a consensus process and a community commenting period prior to finalization of the project. These RECOVER Newborn Resuscitation Guidelines are a concise summary of the newborn resuscitation process to provide clear and actionable clinical instructions to veterinary professionals. SETTING:Transdisciplinary, international collaboration in university, specialty, and emergency practice. RESULTS:A total of 28 PICO questions pertaining to resuscitation of puppies and kittens at birth were addressed in this project. This resulted in 59 treatment recommendations that delineate an iterative approach to newborn resuscitation starting with airway clearance, tactile stimulation, and temperature control, as well as positive pressure ventilation, and instruct on more advanced measures such as CPR. An algorithm displays the flow of assessments and actions over the course of the resuscitation process. CONCLUSIONS:These RECOVER Newborn Resuscitation Guidelines present a concise and comprehensive framework for resuscitation of puppies and kittens at birth. These works serve to support veterinary professionals and breeders, educational systems, and research initiatives in conducting, implementing, and advancing newborn resuscitation in puppies and kittens.

OBJECTIVE:To systematically review the evidence on, to devise clinical recommendations for, and to identify critical knowledge gaps in resuscitation of newborn puppies and kittens. DESIGN:Standardized, systematic evaluation of literature pertinent to newborn resuscitation following Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Prioritized questions were reviewed by Evidence Evaluators, and findings were reconciled by Domain Chairs and Reassessment Campaign on Veterinary Resuscitation (RECOVER) Co-Chairs to arrive at treatment recommendations commensurate with the quality of evidence, risk-benefit relationship, and clinical feasibility. This process was implemented using an evidence profile worksheet for each question that included an introduction, consensus on science, treatment recommendations, justification for these recommendations, and important knowledge gaps. Treatment recommendations underwent a modified Delphi consensus process and were then distributed to veterinary professionals for comment for 2 weeks prior to finalization. SETTING:Transdisciplinary, international collaboration in university, specialty, and emergency veterinary practice. RESULTS:Twenty-eight questions pertaining to temperature management, respiratory and metabolic support, and CPR were addressed. Of the 59 treatment recommendations formulated, 21 concerned medications, 20 addressed respiratory measures, 20 provided guidance on CPR, and 3 related to temperature management. Taken together, the recommendations emphasize the importance of early administration of bag-mask ventilation in nonvigorous, severely bradycardic newborn puppies and kittens. Most recommendations are either expert opinion (n = 28) or based on very low quality of evidence (n = 26). CONCLUSIONS:Significant uncertainty remains regarding most resuscitative interventions in newborn puppies and kittens at birth. However, through a comprehensive evaluation of the evidence and a consensus process that included considerations of feasibility, the resulting treatment recommendations lay the foundation for clear, actionable guidance in small animal newborn resuscitation. In addition, a list of prioritized knowledge gaps was identified to guide collaborative clinical research to overcome the significant lack of veterinary scientific data at present.

Cesarean section (CS) is performed primarily to improve newborn survival. There are situations in which CS is indicated to preserve maternal health or future fertility but in most cases, the choice of CS is all about saving pups! Canine CS is well covered in the literature, comparing anesthesia techniques and methods for improved newborn recovery. In this edition, pertinent literature is reviewed, with an added focus on refined techniques from the authors' experience of more than 1300 successful CS cases over several decades. Although management of the emergency CS (Em-CS) is important for all small animal veterinarians, the authors additionally encourage an acceptance of the elective CS as a planned event.

Canine Cesarean Section (CS) is primarily performed to increase survival of newborns and less commonly to save the life or reproductive future of the dam. Conducting proper ovulation timing to accurately predict the due date will allow a planned, elective CS as an excellent alternative to a high-risk natural whelping, and possible dystocia, for certain breeds and situations. Techniques for ovulation timing, anesthesia, and surgery tips are provided.

Veterinary care of breeding dogs begins before a breeding takes place, during prebreeding consultations, through matings, gestation, and delivery of newborns.

FOP is a rare genetic condition, described mainly in man and cats, characterized by progressive, painful debilitation and shortened lifespan. A 10-month-old neutered male Savannah cat was referred for progressive gait abnormalities and multifocal firm masses within the soft-tissues that were unresponsive to previous treatment. Diagnosis of FOP was based on histopathological evaluation of intralesional biopsies, which revealed osteo-cartilaginous metaplasia and fibrocellular proliferation with intralesional chondrogenesis and endochondral ossification. The cat was managed with 5 mg/kg BID enrofloxacin and hydrotherapy for 3 years until acute death. During that three-year period, the cat displayed consistent improvement in endurance, quality of life, and range of motion. Postmortem histopathology further confirmed the diagnosis of FOP via identification of intramuscular and intra-fascial ossification with lymphoplasmacytic infiltration, degeneration, and regeneration of adjacent myocytes. To the authors’ knowledge, this is the first report of long-term enrofloxacin treatment and hydrotherapy for the management of FOP in a cat, leading to improved mobility and survival time, and the first report of FOP in an exotic breed cat.

Chapter Sixteen POCUS: Pediatrics Autumn P. Davidson, Autumn P. DavidsonSearch for more papers by this authorTomas W. Baker, Tomas W. BakerSearch for more papers by this author Autumn P. Davidson, Autumn P. DavidsonSearch for more papers by this authorTomas W. Baker, Tomas W. BakerSearch for more papers by this author Book Editor(s):Gregory R. Lisciandro, Gregory R. Lisciandro Co-owner Hill Country Veterinary Specialists CEO, FASTVet.com President International Veterinary Point-of-care Society (IVPOCUS), Spicewood, Texas, USASearch for more papers by this author First published: 08 January 2021 https://doi.org/10.1002/9781119461005.ch16 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onFacebookTwitterLinked InRedditWechat Summary Cageside point-of-care ultrasound (POCUS) pediatrics and its abdominal ultrasound provide valuable clinical information about the peritoneal cavity, great vessels, abdominal viscera, and lymph nodes and can usually be obtained without sedation or anesthesia unless the patient is markedly painful. This chapter discusses the uses and limitations of POCUS pediatrics. It provides information on common pediatric abdominal disorders, including gastrointestinal disease, peritonitis/peritoneal effusion, bowel perforation, gastroenterocolitis, intussusception, enteric thrombosis, and congenital herniation. Portosystemic shunts are congenital malformations of the hepatic portal venous drainage system and can have either a familial, that is, genetic, or random occurrence. A ureterocele is an uncommon congenital dilation of the ureter near the bladder, appearing as a cystic structure within the bladder lumen or wall. Cystic calculi, visualized as discrete hyperechoic focal echogenicities in the dependent portion of the bladder, occur most commonly in pediatric patients with urinary tract infection and portosystemic shunts. Point-of-Care Ultrasound Techniques for the Small Animal Practitioner, Second Edition RelatedInformation

Canine coccidioidomycosis, a systemic fungal infection endemic to arid and semiarid regions of North, Central, and South America, is commonly diagnosed in dogs living in or traveling through lower Sonoran life zones in the states of California and Arizona. Canine and human cases have geographic overlap. Similarities between clinical coccidioidomycosis in dogs and humans include asymptomatic infection, primary respiratory disease and disseminated disease. Differences include a high rate of dissemination in dogs, differences in predilection of dissemination sites, and a granulomatous or diffuse meningoencephalopathic form in the canine central nervous system (CNS) without the obstructive component seen in humans. Dogs presenting with CNS coccidioidomycosis most commonly experience seizures. Prior disease history and serology are unreliable indicators of CNS coccidioidomycosis. Magnetic resonance imaging (MRI) is advantageous for diagnosis of CNS coccidioidomycosis in dogs. Long-term administration of antifungal medication is promoted for treatment of both primary and disseminated coccidioidomycosis in dogs. Supportive treatment addressing pain, fever, inappetance, coughing, and other clinical signs improves patient care. Glucocorticoids and or anticonvulsants are also recommended for canine disseminated CNS disease. Protracted treatment times, lack of owner compliance, failure of the disease to respond to the first antifungal drug selected, and high cost are challenges of successfully treating dogs.

Neonatal dogs and cats are defined here as those less than 4 weeks of age, prior to weaning. Neonatal patients are most commonly presented to the emergency veterinarian due to failure to thrive or to an acute onset of signs of illness. Clinical signs are most commonly due to previous dystocia, congenital anomalies, infectious disease, and trauma. Diagnostics and therapeutics are limited in neonates due to their small size, fragility, and, commonly, the client's financial limitations.

A formerly fertile 5-year-old 45-kg Labrador retriever was evaluated for azoospermia noted during routine semen collection for an artificial insemination. Over the past 3 years, the dog had sired 4 litters of anticipated size for the breed out of 5 breedings, the most recent a litter of 10 conceived and whelped 2 months previously. Physical examination findings were normal with the exception of bilaterally small and soft testes. An open excisional wedge biopsy of the right testis was performed under general anesthesia. Histopathology findings supported an immunologic, autoimmune pathogenesis that had resulted in infertility over the previous 4 months.

A 2-year-old intact male South African Boerboel presented for semen cryopreservation and was discovered to be azoospermic. The dog had excellent libido and had sired litters within 6 months, so a further investigation of why his collection lacked sperm was warranted. On further examination of his scrotal contents, his right epididymis had an enlarged area with a hard texture. Ultrasonography revealed that the enlarged area of the right epididymis was fluid filled. A sample of the fluid was aspirated for aerobic culture. No bacteria showed growth. Although the culture was negative, it was suspected that this dog had an epididymitis or epididymal abscess, and treatment with enrofloxacin at 10mg/kg orally was initiated for 4 weeks. The abnormal texture and fluid-filled cavity in the right epididymis persisted, despite antibiotic therapy. Cytology of a repeat aspiration of the fluid-filled area after antibiotic therapy revealed a mixture of red blood cells and sperm. Owing to the potential for blood-testis barrier disruption, a unilateral orchiectomy of the right testicle was performed, as an attempt to protect future sperm production of the remaining testicle. A spermatocele was confirmed on histopathology. After another month, an excellent-quality semen sample was collected, with 90% progressive motility, good concentration, and few morphologic abnormalities. A subsequent collection was acquired and was successfully cryopreserved for future breeding. In dogs with spermatoceles, semen quality can be preserved with aggressive treatment to remove the affected testicle. The disruption of the blood-testis barrier in spermatoceles may result in antisperm antibody production and eventual infertility; however, cryopreservation can result in long-term options for owners seeking to continue using an animal in their breeding program.