I need help!!

[Mardelin]

Originally Posted by Woogie Man

It's been a busy week and I know I'm behind on the pics. Will get some ASAP.

I just tried to cover the basics for the OP on getting these babies settled in. I truly hope for the best.

Mary, I know you've mentioned about sub-qing the babies. Should that be done on an as needed basis or should one be pro-active with it and assume they need the extra hydration? I know about the importance of hydration but am unsure on what to advise for the OP.

Jim,

I've used it, after I've determined the hydration is needed, pup is too weak to suckle. I've only have Sub-Q'd on a newborn......and only as recommended by my vet; 48 hours is what is usually recommended. It allowed the pup to gather strength. It worked with one of my preemie pups and it didn't with the pup that was very under developed.....

However, I only recommend it with a vet's instruction. Dextrose is something I keep on hand for whelps.

[yorkielady06]

As a nurse I want to state this not to criticize but from my education and from my 2 veterinarians. Dextrose solution should not be given subcutaneously.
"Fluids
Some of the most commonly used fluids that are administered subcutaneously include saline, Ringer's solution and Plasma-Lyte. Fluids with dextrose should not be administered in this manner.
Dextrose
Dextrose administered subcutaneously is painful and can cause infection and inflammation, or necrosis (deadening of the tissue) at the injection location."

I have many times given subq LR (lactated ringers) to newborn pups, especially to premature ones. I have a home incubator and oxygen concentrator for this and for the newborn that is having difficulty breathing or is raspy after birth with great success. Also, if done properly, tube feeding a newborn pup, sickly pup, or premature pup is the safest way to feed. The key is if done correctly. You should always underfeed a new pup until you know what they can take and so that they do not aspirate. A general rule taught to my by a few vets is 1 cc per ounce yet you should be safe with 1/2 that if using subq LR for the first day or 2. After that the feedings should be by mouth as soon as possible.

I also have a pump to collect colostrum from the bitch that can be made quite simply for anyone that would like to know. It also works great for early mastitis to prevent it from getting worse if you catch it in time to prevent the need for antibiotics which preferred when the bitch is nursing. I learned how to make these from an old mentor when I first started with Cocker Spaniels in the 80's, so I wanted to give her credit (Sylvia)

[Woogie Man]

I don't recall seeing anyone suggest dextrose for sub-qing, but thanks for the clarification. My vet has given me a sodium chloride solution in the past.

Tube feeding is probably the best in this case, but, as you said, must be done correctly. The eyedropper can be used and an inexperienced person may be better able to do that.

[Mardelin]

Originally Posted by Woogie Man

I don't recall seeing anyone suggest dextrose for sub-qing, but thanks for the clarification. My vet has given me a sodium chloride solution in the past.

Tube feeding is probably the best in this case, but, as you said, must be done correctly. The eyedropper can be used and an inexperienced person may be better able to do that.

I suppose every vet would recommend various types of Sub-Q products. I usually contact my vet and he contacts my med provider. Now one time I obtained a solution without my contacting my vet and was able to obtain Seperate containers of Dextrose and Saline Solution.....It required some calculating....and I'm no good at that when I'm under the gun.....so, now I just ask my vet to prescribe the pre-measured solution.....much easier that way.

[yorkielady06]

Originally Posted by Mardelin

To Tube or Not To Tube
The answer to this depends entirely upon whether you want your puppies to live or not.

What! You say, tubing is the ONLY way to save puppies. And besides, it's fast.

Fast, yes, and deadly. It's one of those things that sounds too good (easy) to be true; and if it sounds too good to be true it is; we know that it is in our most private thoughts. Fast and deadly isn't doing your part by the bitch or the puppies. You may be certain that you are getting the tube in the esophagus (which leads to the stomach) and not the trachea (which leads to the lungs). But, this isn't the problem I'm referring to.

Consider this: when we eat, the process of eating stimulates waves of contraction throughout our entire GI tract. You know very well that as puppies nurse they defecate. That reaction is due to these waves of contraction, which are called peristalsis.

OK. So, we have a sluggish or weak puppy. We put it on the bitch and it won't nurse. What to do! TUBE. NO! If the puppy does not have a good sucking reflex, it will not have any peristalsis. This means the milk we force in through the tube will just sit there. When the tube is removed, it forces itself back up the esophagus, into the trachea, and ends up in the lungs. It does not travel down through the stomach into the intestine.

Now, how big is the stomach of a newborn puppy in your breed? 1/2 cc? Less? As much as 1cc? Probably not much more. That stomach is just a slightly wide spot on a narrow tube. So; let's stick 2 1/2 cc into it . Fast and Deadly. The stomach and esophagus will stretch a bit, then return to it's original shape and size after the milk runs into the lungs. Not going to raise many puppies that way.

Well then, what do we do? Easy. We give them sub-cutaneous dextrose and saline. Sugar in salt water. The solution which is used for IV therapy. All puppies need 3 things. Warmth. Water. Sugar. That' all they need right away and for an additional few days if necessary.

So, we take the weak puppy out of the whelping box. We drop a few drops of colostrum onto its tongue several times in the first few hours. Got that immunity taken care of. We keep it in a confined box with a heat source - a heating pad or light bulb, and we give subQ dextrose in saline to supply the sugar and water. We gently stimulate it to urinate and defecate. We've met all the puppies needs.

How much fluid do we give? We give enough to satisfy any current dehydration debt and to provide a cushion for an hour or two in the future. How much is that? It is enough so that when we refill the syringe with dextrose and saline, the last 10 cc injection we gave hasn't already disappeared. And it will disappear, just that fast, if the puppy is already dehydrated.

So first, we need to satisfy the back log, and then we put in some more. We want to raise a good sized lump - say the size of a golf ball on a 12-16 oz puppy. We want that golf ball to stay there a while. If it does, we can safely leave the puppy for a couple of hours. As time goes by, the fluids in this reservoir will be absorbed and the lump will disappear. Also, gravity will take a hand in removing the lump, shifting any spare fluids down around the neck.

We can keep this puppy going in this way for 2 to 4 days easily. There no danger here, if the area is clean when and where we inject, and as long as the needle is parallel to the body - not pointed down at the body. We don't want to pith the puppy (look it up). With the needle parallel to the body, the worst we can do is squirt the wall. The wall can take it. Fluids given intravenously, by contrast, would run the risk of drowning the puppy - excess fluids in the veins will force their way out through the lungs. This result is essentially the same as that of tubing. Not good. SubQ fluids are essentially outside the circulatory system - just in a repository under the skin. If a fluid defecit exists, they can be instantly drawn into the blood stream. Until then, they have no other effect on the body.

While we are satisfying the puppy's needs in this way, we will also repeatedly present a nipple to the puppy, several minutes after we have placed a drop of Karo syrup on its tongue. The Karo give the puppy an energy boost, so that when we place it on the bitch, it will make as strong an attempt to nurse as it can muster. We will also present the puppy with a bottle, as it will be easier for it to get milk from the bottle's nipple than from the bitch, most of the time, during the first couple of days.

One of the greatest deterrents to getting puppies started, after tubing, is the 'Pet Nurser' which is widely available. Few if any breeds will nurse off of this thing - maybe a couple of toy breeds I've never encountered. Rather, puppies from 4.5 oz to 2# and up will readily take a Playtex preemie, or Playtex 0-3 months nipple (slow flow), one which has a flat, button-like shape.

I just read this and reacted to this. I do not want anyone to lose a puppy due to giving dextrose subq....

[Mardelin]

Originally Posted by yorkielady06

I just read this and reacted to this. I do not want anyone to lose a puppy due to giving dextrose subq....

Not argueing with you. However, on a preemie pup with sucess. By the way it was done with my repro vet's instruction.

[Mardelin]

Originally Posted by yorkielady06

I just read this and reacted to this. I do not want anyone to lose a puppy due to giving dextrose subq....

Now the information that you're referring too is information from a vet.....

By the way, I was a nurse in a previous life.

[gardenyorkies]

Originally Posted by yorkielady06

As a nurse I want to state this not to criticize but from my education and from my 2 veterinarians. Dextrose solution should not be given subcutaneously.
"Fluids
Some of the most commonly used fluids that are administered subcutaneously include saline, Ringer's solution and Plasma-Lyte. Fluids with dextrose should not be administered in this manner.
Dextrose
Dextrose administered subcutaneously is painful and can cause infection and inflammation, or necrosis (deadening of the tissue) at the injection location."

I have many times given subq LR (lactated ringers) to newborn pups, especially to premature ones. I have a home incubator and oxygen concentrator for this and for the newborn that is having difficulty breathing or is raspy after birth with great success. Also, if done properly, tube feeding a newborn pup, sickly pup, or premature pup is the safest way to feed. The key is if done correctly. You should always underfeed a new pup until you know what they can take and so that they do not aspirate. A general rule taught to my by a few vets is 1 cc per ounce yet you should be safe with 1/2 that if using subq LR for the first day or 2. After that the feedings should be by mouth as soon as possible.

I also have a pump to collect colostrum from the bitch that can be made quite simply for anyone that would like to know. It also works great for early mastitis to prevent it from getting worse if you catch it in time to prevent the need for antibiotics which preferred when the bitch is nursing. I learned how to make these from an old mentor when I first started with Cocker Spaniels in the 80's, so I wanted to give her credit (Sylvia)

[maggiesmom_2007]

Just wanting to clarify something here. I found this on the lowchen's website alot of us use and Now I am confused. So what is right?

http://showdogsupersite.com/kenlclub...et/fading.html

What a fading puppy needs is fairly simple - first determine if something else, such as an E. coli infection, needs addressing - this particular information is best obtained by culturing the bitch before breeding. Then, provide the heat, calories and fluids to support the puppy for first 2 to 4 days of its life.

Remove the fading puppy from the whelping box and put it into a small box with a heating pad. Provide different amounts of padding over the heating pad at different parts of the box so the puppy may find the amount of heat most comfortable for it. Partially cover the box with a towel. We must do this because the bitch will allow the puppy to get chilled when it is not as vigorous as the rest of the litter.

To provide the water and sugar needed, we inject sub-cutaneous fluids under the skin on the top of the neck of the puppy. You should do this every 2 hours while the puppy is in the box. You must go over this with your veterinarian so that you can be instructed on how to do this safely. However, that being said, this is the most totally effective thing you can do for this puppy and you will save nearly all of your fading puppies with this technique. The fluid is dextrose in saline. This means that in addition to preventing dehydration, it will provide energy - the dextrose part is sugar. With this method, you can satisfy any fluid requirements in a dehydrated puppy and you can leave a repository of fluid for the puppy to draw on for the next two hours. A few other things such as stimulation to urinate and defecate, and you've got it managed. After about 48 hours in the box, nearly all the puppies you undertake this with will be strong enough to rejoin the litter full time.

[JeanieK]

Do we know anything more on these babies.

[Mardelin]

Originally Posted by maggiesmom_2007

Just wanting to clarify something here. I found this on the lowchen's website alot of us use and Now I am confused. So what is right?

http://showdogsupersite.com/kenlclub...et/fading.html

What a fading puppy needs is fairly simple - first determine if something else, such as an E. coli infection, needs addressing - this particular information is best obtained by culturing the bitch before breeding. Then, provide the heat, calories and fluids to support the puppy for first 2 to 4 days of its life.

Remove the fading puppy from the whelping box and put it into a small box with a heating pad. Provide different amounts of padding over the heating pad at different parts of the box so the puppy may find the amount of heat most comfortable for it. Partially cover the box with a towel. We must do this because the bitch will allow the puppy to get chilled when it is not as vigorous as the rest of the litter.

To provide the water and sugar needed, we inject sub-cutaneous fluids under the skin on the top of the neck of the puppy. You should do this every 2 hours while the puppy is in the box. You must go over this with your veterinarian so that you can be instructed on how to do this safely. However, that being said, this is the most totally effective thing you can do for this puppy and you will save nearly all of your fading puppies with this technique. The fluid is dextrose in saline. This means that in addition to preventing dehydration, it will provide energy - the dextrose part is sugar. With this method, you can satisfy any fluid requirements in a dehydrated puppy and you can leave a repository of fluid for the puppy to draw on for the next two hours. A few other things such as stimulation to urinate and defecate, and you've got it managed. After about 48 hours in the box, nearly all the puppies you undertake this with will be strong enough to rejoin the litter full time.

It is the method that was provided to me by my vet, as well as other vets have informed me of. The one I posted was from another vet, but the explanation was so thorough and offering various methods and the pros and cons of each method. It's what I've used with sucess.

[babbsiam44]

Is everything OK with the Mom and pups? Been following and I pray for the best.

[gardenyorkies]

Taken from: Subcutaneous Fluids in Dogs

Injectable fluids come in various forms, but only a few should be used for subcutaneous administration. Lactated ringers, 0.9% saline, Ringer's, Normosol-R, and Plasmalyte are most commonly used. Fluids containing dextrose or sugar solutions should be avoided. These can result in infection at the site of injection or severe skin irritation resulting in possible necrosis (dead tissue)

This was the information given to me by several vets...To avoid these side effects it is safer to give the Dextrose to them orally and administer fluids using Lactated Ringers...


I sure hope we hear an update soon!

[Woogie Man]

I don't want to detract from the thread, but the sub-q talk is very interesting. I have previously sub-q'ed pups, but only with a sodium chloride solution. This talk about dextrose added is something I've read before though it never registered as I read it when just doing some random research. I suppose in my mind I only thought of the one type of solution for sub-q as that is what my vet gave me.

So, on this thread, we have differing opinions posted, all from veterinary sources. The obvious question is, "what to believe"? I tend to lean with Mary's opinion as she has used it with success.

One of the most difficult things to manage with preemie or weak, tiny pups is proper feeding. If the dextrose added to the solution works, it seems like a magic bullet for those cases where it could be applied. I know I will be having a discussion with my vet about this.

I'm not trying to stir the pot, but feel that if a dextrose/saline solution is safe, many pups could be saved that otherwise might not be. It could be a valuable tool to use in getting pups over that hump.

Like I said, I've read of this before but it never registered. It's kind of like an 'aha moment' for me. I've learned something from this and will research it further.

[Mardelin]

Originally Posted by Woogie Man

I don't want to detract from the thread, but the sub-q talk is very interesting. I have previously sub-q'ed pups, but only with a sodium chloride solution. This talk about dextrose added is something I've read before though it never registered as I read it when just doing some random research. I suppose in my mind I only thought of the one type of solution for sub-q as that is what my vet gave me.

So, on this thread, we have differing opinions posted, all from veterinary sources. The obvious question is, "what to believe"? I tend to lean with Mary's opinion as she has used it with success.

One of the most difficult things to manage with preemie or weak, tiny pups is proper feeding. If the dextrose added to the solution works, it seems like a magic bullet for those cases where it could be applied. I know I will be having a discussion with my vet about this.

I'm not trying to stir the pot, but feel that if a dextrose/saline solution is safe, many pups could be saved that otherwise might not be. It could be a valuable tool to use in getting pups over that hump.

Like I said, I've read of this before but it never registered. It's kind of like an 'aha moment' for me. I've learned something from this and will research it further.

Good idea. I'm one that believes in consulting with one's vet...nothing should be used just willy nilly. And as I said, I've had input from several vets. My vet in Dallas who sits on the Board of Vets and who I consider one of the best. And of course my repro vet here in California.