Low Blood Sugar Can Kill a Puppy

“Puppy Passed Out, Shaking, Won’t Get Up!”

A 12-week-old female Maltese puppy curled up in an unnatural position in the middle of a dirty pink kitchen towel.  Slimey drool and corn syrup stuck all over her chin and her whiskers.  Her little eyes shut tightly, she barely breathed.  Then her paw twitched spastically.

(There is no picture of this because Yours Truli, VirtuaVet, was running down the hospital hallway to the treatment room, “Get the Dextrose solution and the I.V., STAT!”  No time for pictures when a little life is on the line.)

Shasta needed sugar desperately to keep her brain functioning.  The body itself can run on replacement molecules, for example: ketones.  The brain, however, needs glucose, a particular kind of sugar easily obtainable from food.  If the brain does not receive the glucose it needs, the symptoms of low blood sugar rear up.

After 15 minutes, her eyes open, breathing smooths, seizures subside, and a puppy might look like Shasta did:

Shasta after some Dextrose

Symptoms of Low Blood Sugar in a Puppy (or Rabbit, or Kitten, or…)

• Weakness
• Confusion
• Incoordination
• Falling Over
• Tremors, Spastic Movements, Falling Over
• Twitches, Seizures
• Coma
• Death

Dog Breeds Likely to Become Hypoglycemic

• Yorkshire Terrier
• Chihuahua
• Maltese
• Toy Poodle
• Shih Tzu
• Miniature Pinscher
• Toy Terrier
• Papillon
• Japanese Chin
• Pomeranian
• any tiny breed destined for 10 pounds or less full grown…

Low Blood Sugar Treatment

Your puppy will perk right up with glucose in its system.

Sources of Sugar for your Puppy in an Emergency:

• NutriCal
• Karo syrup (corn syrup)
• Molasses
• Maple syrup (pancake syrup, too)
• Barley Malt
• Brown Rice Syrup

If your puppy gets to the veterinarian before you know what’s going on, the veterinarian will give dextrose, a clean, safe, medical form of sugar that is given by mouth or intravenously.  The body converts dextrose to glucose almost instantly.

But that’s not all!

Your veterinarian can measure blood glucose levels to confirm the diagnosis.  There are a few other conditions that cause passed-out, weak puppies.  Dehydration, hepatic encephalopathy, renal dysplasia…to name a few.

VirtuaVet Pet Peeve

The hand-held glucometers that measure the blood glucose really quickly on a tiny drop of blood are accurate to about 60 mg/dL glucose in the blood.  Below about 60 (it varies from device to device), the measurement is inaccurate.  It is low, for sure.  Too low, and confirms the diagnosis.  But when a nurse or a doctor says, “The sugar was 7!”  or  “The sugar was 20” or whatever ridiculously low number, technically, they cannot confirm that exact number from the hand-held machine reading.

Below 60, the measurement could be 1, or it could be 59.  The hand-held machines are not accurate below 60!  The diagnosis is correct.  Your puppy is hypoglycemic.  VirtuaVet’s Pet Peeve is this: the panic, and the awesome story where everybody justifies US$1,500 worth of ICU care because “the sugar was 5!” is sheer human emotion.  Let’s just be clear about the accuracy of what we are saying, that’s all.

Shasta slept a lot the first day!

After your puppy perks up, the little tyke looks like everything’s all better.  Do not be fooled.  Do you think you could go from a coma, or seizures, when you weigh 2 pounds, you have almost no body fat, and you probably have, or had intestinal parasites within the past week, and you will just bounce back to normal with no problems?

Without hospitalization, most hypoglycemic puppies will relapse in the first 24 hours. Now you’re in a bind.  If you have a tiny puppy, you probably spent every penny you had on the tyke.  Now you are facing intravenous fluids with a slow IV dextrose drip, maybe heat and oxygen therapy, and tons of specialized nursing care.

Your hypoglycemia puppy may have complicating infections, like pneumonia, kennel cough, coccidia, hookworms, or other illnesses. If you have the financial ability, let the veterinarian hospitalize your puppy, if your vet recommends that course of action.

If you do not have the money (it can be US$500-$1500, depending on the city, sickness, etc), your puppy may still pull through.  Do not give up on the puppy.  You just inherited a ton of work, that’s all.

Your veterinarian can give subcutaneous fluids (“clisis” for you old nurses out there!), deworm your puppy, and give you oral dosing syringes made especially for administering liquid food to sick animals.

Keep reading to learn how to care for a tiny, potentially hypoglycemic puppy.

Inexperience: The Easiest Way New Puppy Parents Are Fooled by Low Blood Sugar

“But she was eating just fine.”

Doc Truli hears this every day.  There are a few reasons a puppy that appears to be eating still gets hypoglycemia – low blood sugar. Most of these reasons have to do with husbandry, or the way you care for the new puppy.  A very few of the reasons have to do with healthcare and disease of the puppy.  This is why most pet stores and less-then-reputable breeders will not honor a health guarantee if the illness is hypoglycemia–Hypoglycemia is almost always preventable in a healthy puppy.

So, the easiest way you are fooled and let your new puppy get hypoglycemia is inexperience. You either never cared for a small breed puppy before, or your previous dog was “always healthy,” and you never really had to pay attention, because your perfect dog was an “easy keeper” and never seemed to need special care or attention to detail.

Most small breed puppies need special attention

Here’s what you do to keep these puppies eating, and keep their blood sugar steady:

• Put one person in charge of the puppy. Everybody an help out.  But make sure one person keeps the weight and food chart in one place, like pinned to the kitchen fridge or counter.
• Get a gram scale.  Weigh the puppy every day.  Puppies gain weight every day, or else they are in BIG TROUBLE (Go to the vet’s).  Write down the weight and check the trend each day.
• Get a high quality puppy food.  Canned food is palatable.  The tastier, easier to eat food makes the puppy get more calories and nutrition than only dry food.
• A 2 pound puppy should eat 1 Tablespoon (15 mL) food every 4 hours, approximately.  If you are not sure if the puppy is eating enough, then weigh the puppy each day.  If puppy will not finish the Tablespoon, then try a teaspoon every 2 hours.  Really work at it!  Set the alarm and get up, you human, you!
• Measure how much you give puppy.  Measure how much is left when puppy is done eating.  Feel if puppy’s belly feels big and full all day long.  Good human!
• Puppies might be weaned at 4-6 weeks old.  But possibly, of your puppy is 6 weeks or under, he or she still needs some mother’s milk.  Feed Puppy Milk Replacer, or mix Puppy milk replacer into the canned food to be sure your puppy eats what he or she wants.
• If your puppy is older than 6 weeks, he or she should be able to eat puppy food.  If the puppy cannot, something is terribly wrong.  Probably intestinal worms or a genetic defect.  Go to the vet’s!

Do Not Make These Top Common Mistakes When Feeding a Tiny Puppy

To Kill a Puppy:

• Put the kids in charge of the feeding.  By “kids,” let me be clear: any female under the age of 18, and any male under the age of 35.  I’m not kidding.  This is based on years of experience!  (I don’t care if “the puppy was a present for Fiona,” who’s 12.  Fiona will feel terrible when her puppy dies because she tried her best, but she’s a kid, and you made her in charge of something you should have been helping her with.)
• Do not weigh the puppy daily.
• Weigh the puppy, but do not write it down, and forget the number every day.  Then tell your veterinarian you “forgot.”  (Be sure to also tell the vet you lost your job because of the economy and could they please do your thinking for you for no charge?)
• Say “the puppy ate an hour ago,” but when Doc Truli–looking at a seizing, passed out puppy asks, “how much did the puppy eat?” look blank and have no idea how to estimate how much food the puppy eats.  That’s super helpful.
• Again–be sure you act helpless, do not take responsibility, feel overwhelmed by the idea that your emotional purchase/adoption is taking too much work, freeze up and refuse to accept responsibility.  Cry at the vet’s office as you sign over a US$2,000 puppy because you thought it would just be a great present for the kids because daddy was out of country on assignment and they were lonely, and the sleazy pet shop won’t even take the puppy back for free.

With Love and Home Nursing Care, Puppies Pull Through Hypoglycemia!

Maltese puppy tries her paw at accounting on the adding machine. Should we hire her?

Shasta’s original family had purchased two tiny puppies, and with 3 kids, and dad away on work, it was too much for mom.

Shasta needed treatment for tracheobronchitis (kennel cough), coccidia, and hookworm intestinal infections.

Shasta’s new mom fed her every 2 hours for the first 48 hours, bringing her to work and feeding her 1 teaspoon of Puppy Canned food (and some puppy cookies) every few hours.  Whenever it was feeding time, and Shasta was asleep, her new mom let her sleep a little while, but watched.  When Shasta woke up, she got taken out to the bathroom, and then fed.

The first 24 hours, she gained 50 grams (up to 340).  Another 30 grams (370) the second day, and counting!

P.S. August 11, 2010: Shasta weighs 810 grams today!  She’s doing great.  Mom stopped setting the alarm after 4 nights.  In a another week or so, she’s going to have to eat from a dish like her housemates.  But for now, its hand feeding until we’re certain she’s not going to relapse.