Hypoglycemia

Whenever you receive a puppy, the first and foremost most important thing is to ensure that the puppy eats well the first few days you have it. Small breed dogs, especially puppies, are very susceptible to life-threatening issues when missing a meal. Even missing just one meal can allow Hypoglycemia, or low blood sugar, to set in. This usually affects puppies up to 4 months of age. When a puppy has low blood sugar, their body does not produce much energy, leaving them lethargic. This leads to a quickly setting loss of appetite, and before you know it, the puppy refuses to eat at all. 

Hypoglycemia is easily treatable in the early stages, but fatal if allowed to progress.  Many puppies are lost needlessly to hypoglycemia because of ignorance on the part of their owner or a veterinarian.

The first sign of hypoglycemia is the puppy slowing down and then acting lethargic or still.  The puppy will then begin to tremble or shiver. This is a reaction caused as the brain is starved for glucose. The trembling is followed by a blank stare and the puppy lying on their side. The puppy may also experience convulsions. After a time, the puppy will become comatose. Their body will be limp, lifeless and the tongue and gums will be a grayish/blue color. The body temperature will be subnormal. The puppy may even appear to be dead.

If caught in the early stages, treatment is simple. Rub Nutri-cal (Caro Syrup will do if you do not have Nutri-Cal) on the puppy’s gums, under the tongue, and on the roof of the mouth.  (Caution: do not use honey.)  Get a heating pad or heating blanket and slowly warm the puppy to proper body temperature.  If the puppy responds, all is well.  Feed a quality canned food right away (you may want to mix with egg yolk) and then monitor the puppy to be sure that the condition does not recur.  Be sure to eliminate the stress that caused the episode if at all possible. 

If caught in the more advanced stages, treatment is more complicated.  Always assume the puppy is alive.  Rub Nutri-cal (Caro Syrup will do if you do not have Nutri-Cal) on the puppy’s gums, under the tongue, and on the roof of the mouth and carefully insert a small amount in the rectum. (Caution: do not use honey.) Slowly warm the puppy to proper body temperature (101-102F) and keep him warm continuously with light heat. If the puppy still does not respond, call your veterinarian and inform him you have a hypoglycemic puppy.  He will advise you on further instructions.  Request a fecal exam.  Your puppy may have intestinal parasites such as worms, coccidian, or giardia that need to be eliminated immediately.  A bacterial or viral infection may also be present and antibiotic treatment necessary.  If your puppy has been given glucose injections, it is probably a good idea to treat him with antibiotics so that infection does not occur.  Your vet will likely recommend a prescription canned food to give as your puppy recovers.  You must also keep the puppy warm at all times.  As your puppy improves he will begin to eat in his own and then you can gradually phase back in his regular food.

It is important to understand that just because a puppy has an episode of hypoglycemia; it does not mean that the puppy is truly “hypoglycemic.”  True hypoglycemia is a chronic condition caused by overproduction of insulin by the pancreas.  Even though the pancreas may normally function properly, toy puppies can still have an isolated hypoglycemic incident in reaction to stress.  

Hypoglycemic incidents are almost always preceded by a stress of some kind.  Some examples of common stresses include: weaning, teething, vaccinations, a change of environment, shipping, over-handling, cold temperatures, intestinal parasites, infections, anorexia, etc.  Many puppies simply play too hard and stress their system or forget to eat. I have heard of males experiencing hypoglycemia when a female in heat is around.  They become so worked up over the female that they do not eat and their blood sugar drops.

The best way to protect your dog from hypoglycemia is to prevent it in the first place. Here are some things to try:

- Do not disturb your puppy. As much as you may want to play with them as soon as you get them, it is best to let them settle in in a crate with fresh food and water available for the first few hours at least. If you disturb them, you will distract them from eating. Ensure they get plenty of undisturbed crate time where they are able to eat and drink the first few days until they settle in to your household and routine.

- Put a blanket over their crate. When giving your puppy time to eat in their crate, they may be distracted by the household. Placing a blanket over the crate to hide their view will sometimes help settle them. 

- Slowly transition your puppy to their new food. While with me, your puppy will be on Nutrisource brand puppy food. To get them used to a new brand of food, it is best to mix the brands for the first few days so that the puppy receives both. 

- Offer safe raw, wet, or canned food the first few days. This entices them to eat even if they are nervous in their new home. 

If your new puppy is refusing to eat, here are some things you can try:

- Offer a food brand they are familiar with 

- Offer a better quality food brand

- Offer types of canned food

- Offer buttermilk 

- You may mix canned food, dry food, and/or buttermilk to see what they are willing to eat

- Give your puppy probiotics

- Give your puppy sugary and nutritional mixes made for dogs, such as Nutri-Cal or Caro Syrup, to get them feeling good enough to eat 

- Encourage your puppy to eat by rewarding them when they do so

- Do not disturb your puppy when they are eating or drinking

Do not forget to consult your vet if your puppy crashes, skips a meal, or becomes lethargic.