Hypoglycaemia management with a hypercaloric supplementation in neonatal puppies delivered by caesarean section

Abstract

There is a high perinatal mortality rate in dogs, estimated at 20%, and one of the leading causes of this rate is hypoglycaemia. Therefore, we aimed to evaluate the efficacy of a hypercaloric supplement containing vitamins and amino acids in newborn puppies presenting hypoglycaemia at birth. Ninety‐nine pups were divided into four groups: normoglycaemic caesarean section (NORMOCS), hypoglycaemic caesarean section supplemented with the hypercaloric (SUPLCS), hypoglycaemic caesarean section supplemented with glucose (GLICCS) and eutocic delivery (EUT). We evaluated the following parameters glycaemia, Apgar score, neurological reflexes and rectal temperature of neonates at the following moments 5 min (M5), 30 min (M30) and 60 min (M60) after birth. Brachycephalic dogs were 73.3% (22/30) of caesarean sections (c‐sections). The puppy's average glycaemia represented about 90% of the maternal glycaemia, while 15.1% (14/99) of the neonates had hypoglycaemia (<90 mg/dL) at M0 and 46.5% (44/99) at M60. Only four neonates had glycaemia below 40 mg/dL at M30 but without showing any clinical signs. The puppy's fasting while waiting for the intraoperative period and the dam's anaesthetic recovery was considered risk factors for hypoglycaemia. There was no difference in mean blood glucose levels or vitality parameters among puppies from the SUPLCS and GLICCS. In conclusion, the hypercaloric supplement can be used as a replacement for glucose in hypoglycaemic puppies and it can also bring nutritional benefits for the puppy. The prepartum glycaemia of the dam is an important parameter to be measured, and the appropriate management of it reduces the chances of the puppies being born with hypoglycaemia.

Neonatal hypoglycemia in dogs—pathophysiology, risk factors, diagnosis and treatment

“…In humans, newborn glycemic levels correspond to approximately 60–70% of maternal levels ( 15 , 18 , 27 , 28 ). In newborn dogs, however, glycemic levels at birth correspond to approximately 90% of maternal levels ( 29 ). This highlights the importance of assessing maternal blood glucose at the time of delivery and replacing it, if necessary.…”

“…Hypoglycemia is the most common metabolic alteration in newborn patients. In veterinary medicine, the puppies most likely to manifest hypoglycemia are neonates who have gone through stressful events such as hypoxia at birth, neonates born from hypoglycemic mothers, sick, orphaned, premature and low birth weight neonates ( 5 , 29 , 41 ). Table 1 shows the main risk factors for the development of neonatal hypoglycemia.…”

“…A study has shown that about 15% of dogs can be born hypoglycemic and about 66% of dogs born by cesarean section can develop hypoglycemia in the first hour of birth, due to prolonged fasting while waiting for maternal anesthetic recovery ( 29 ). Also, about 74% of newborn dogs that are brought in for veterinary care due to some alteration or condition are diagnosed with hypoglycemia ( 42 ).…”

“…In cesarean sections, some factors can lead to neonatal hypoglycemia. One of the reasons is related to the prolonged time of preoperative maternal fasting, since maternal blood glucose correlates with fetal blood glucose ( 27 , 29–31 , 43 , 45 , 46 ). Another factor occurs due to the surgical procedure and anesthetic recovery of the parturient, newborns may go through a period of prolonged food deprivation, which leads to a gradual drop in the patients’ blood glucose ( 27–29 , 32 , 47 ).…”

“…However, some hypoglycemic animals may be asymptomatic. A study demonstrated that hypoglycemic puppies (<90 mg/dL to 60 mg/dL) did not show relevant clinical signs ( 29 ). The observation of clinical signs such as a decrease in the Apgar score or neonatal reflexes, seizures and coma, is usually associated with very low glucose concentrations: <40 mg/dL, considered severe hypoglycemia ( 32 ).…”