Do newborn puppies need anything? The answer is, Yes. Newborn puppies are the most fragile dogs we have. As newborns, they don’t have the resources to adapt to internal and external environmental changes the world throws at them. Small changes in temperature, humidity, oxygen, and food intake can destabilize their ability to maintain their internal bodily functions. When we provide them the support they need, they can not only survive but thrive.

Revival Animal Health’s Director of Veterinary Services, Dr. Marty Greer and Ken Sunden, CEO of Puppywarmer will discuss how to keep newborn puppies warm, how do you help a weak newborn puppy, the 4 H’s of neonatal puppy care, how the 4 H’s are intertwined and how the Puppywarmer system can significantly change your success rate in raising puppies.

*During this webinar, Dr. Greer mentions a handout. Scroll down below Shop This Webinar to find the handout she is referencing.

What Newborn Puppy Supplies Do I Need? Shop This Webinar!

Some of the newborn puppy supplies Dr. Greer mentions in this webinar include:

Puppywarmer Incubator

Puppywarmer Oxygen Concentrator

Breeder’s Edge Foster Care Canine Milk Replacer

Breeder’s Edge ID Me Collars

Delee Mucus Trap

Bulb Syringe

Breeder’s Edge Repeat Whelping Pads

Breeder’s Edge Nurture Mate

Breeder’s Edge Oxy Momma

Miracle Nipple

Feeding Tube

Pet Heat Mat

ThunderEase Calming Diffuser Kit

Doc Roy’s Forti Cal

Breeder’s Edge Puppy Lyte

Doc Roy’s GI Synbiotics

Royal Canin Starter Mousse

Fenbendazole

Cephalexin

Clavamox

Albon

Digital Scale

Digital Thermometer

Stethoscope

Gloves

Canine Reproduction and Neonatology (book)

Handout

What to Look for After Puppies are Born?

Hypoxia is low oxygen, hypothermia is low body temperature, dehydration is of course the loss of fluid, and hypoglycemia, is low glucose or low sugar. These are the four Hs that we really want to focus on and how those all are important to our newborn puppies.

If our puppies get chilled, then they become dehydrated. When they’re dehydrated, their glucose drops and if their glucose drops and they’re more vulnerable to bacterial infections. It’s all a cycle of all these things interplaying. If they’re not getting enough oxygen, they’re going to get chilled. It’s really important that we don’t look at one category of puppy support, but we look at all four of these in a really critical interaction between them.

Newborn Puppy Breathing Problems

Hypoxia is the very first thing that we have to do, to get our puppies to start to breathe as soon as they’re born. We can measure APGARs and how we can affect our puppy survivals based on that.

We need to make sure that the puppies have a clear airway as soon as they’re born, whether they’re born by C-section or vaginal birth. We need to be there to help the airways clear. We need to make sure that they’re getting enough oxygen. And if room air oxygen isn’t sufficient, oxygen concentrators take room air, which is 20% oxygen and turn it into 95% oxygen.

The most important thing that happens with our puppies as soon as they enter the world is they have to take their very first breath and become self-sufficient. Until that moment, their mom has done everything for them, especially supplying them oxygen. Of course, she’s kept them warm and hydrated and all the other things, but they don’t have to take any breaths until the very first time that they breathe. This is the biggest physiological change that takes place as soon as they take their first breath. As soon as that happens, their circulation changes. Instead of the blood just being circulated through the body, the heart has to change. There’s a PDA that has to close and it starts to shunt oxygen and blood through the lungs. So it’s a huge physiological change with that very first breath. Remember, when you blow up a balloon for the very first time, the first time you inflate the balloon is the very hardest time because you’ve had to stretch it out. And it’s sort of the same thing with the puppy’s lungs. The very first time that they take a breath, they have to stretch out the alveoli, circulate all of the surfactant, which is that chemical in their alveoli, the little sacs in the lungs, so that it coats the entire alveoli of the inside of the lung and it allows oxygen to start entering and leaving the puppy’s lungs, air coming in and out, and then oxygen to be delivered into the bloodstream, which then changes physiologically the whole puppy.

The first time you blow up a balloon is the hardest. And the very first thing that these puppies have to do to make sure that they survive on their own is within seconds of the time that they’re born, they have to take their first breath and take it very effectively.

As soon as the puppies are born, their oxygen level drops from what they had in their circulation. It starts to go down and that trend of downward dropping of the oxygen will stimulate their brain to say, okay, the carbon dioxide levels are building up, the oxygen levels are dropping, we need to start breathing. And that’s the stimulus that it takes.

But sometimes these things don’t happen in the right sequence, and the puppies can start breathing prematurely. We had a puppy born in our practice that was still vaginal, and I could hear the puppy crying. We know that these puppies are already starting to get stimulation to breathe, even sometimes before they’re born. If they inhale too early and they take in a lungful of fluid, that’s not good for them.

On the other hand, if they don’t have the stimulus to start breathing as soon as they’re born and they are without oxygen for too long, then we end up with damage to their brains. And of course, then we don’t have puppy survival. So it’s really important that all happens in this momentary and precise sequence of events.

It’s almost mind boggling to me every time a puppy takes its first breath or a kitten or a baby or whoever, that the physiology actually works. There’s so many things that can go wrong. It’s amazing that it goes right as much of the time as it does. Remember to have your suction devices ready, whether it’s your bulb syringe or your Delee mucus trap. We get these puppies out, get the fluid cleared out of their airways and get them started to breathe as soon as we can with the right stimulus, at the right time and without fluid down in their lungs.

Now, if we’ve suctioned them and they’re still not doing a great job of breathing, my staff’s new favorite product, instead of caffeine tablets, has become 5-hour Energy, which has caffeine. It’s got a little bit of energy in it and it will help these puppies by just putting a couple of drops on their tongue to get them started to breathe. Get this product at any truck stop or Walmart. This is a good product to have sitting around in your whelping kit so that you have it available when you need it.

As soon as we get them started breathing, we’re going to talk about the oxygen concentrator and the importance of an oxygen-rich environment. It’s important that we support them with additional oxygen if we have puppies that aren’t that nice, bright pink color, and are not getting enough oxygen and room air. And this is one of the things that Ken is going to talk about here in a few minutes. These are his products that he’s developed for us.

Why is My Newborn Puppy So Cold?

The second thing we have to really be attentive to is hypothermia, or low body temperature. During the process of drying off the puppies, whether we do it with a towel or whether Mom does it with her tongue, we need to make sure that they’re dried off effectively and that we prevent them from chilling. But if they do become chilled, then we need to support that chilled puppy. It’s important that we warm them, but we need to warm them appropriately, not too quickly and not too harshly, so that they are coming up to a normal body temperature and we have good support for them.

A surface temperature where I keep my puppies (and what I recommend for puppies during their first week) should be about 90 degrees at the surface with room temperature being about 95. The important thing is that if you’re not certain, if you don’t have temperature evaluation, you’re not going to know. So you need thermometers. You need a thermometer at the surface where the puppies are kept and a room thermometer. Monitoring their rectal temperature is very simply done with a rectal thermometer and a jar of Vaseline. And even a regular rectal thermometer that’s made for humans is small enough to fit in the tiniest two ounce puppy. So please don’t hesitate to take puppies’ temperature and to get an assessment of where you’re going with that.

We know that the body temperature is going to drop somewhat after birth simply because they’re not inside Mom. They’re not going to be at that 101 to 102 degree temperature that her core temperature has been keeping them at. So we do expect a small drop, but with support, we should only see a small drop. In inadequate levels of support, we’re going to see too much of a drop and we’re going to see these puppies start to chill. I don’t want to warm them too quickly or too harshly. We want to gently warm them to an appropriate level. Get your thermometers out, know what your room temperature is, what your environmental temperature is, and know what your puppies’ rectal temperatures are. Those are very simple parameters to measure and they’re really critical in keeping puppies safe and warm.

What to Do if Newborn Puppy is Dehydrated?

The third thing I want you to remember is about fluid loss. Really today is all about trends. It’s about, where do they start off before they were born? What happens as soon as they’re born with those trends? You’re going to see some downward trends with all of these things, whether it’s temperature, glucose, hydration or oxygen, they’re all going to trend somewhat downward. What we need to do is stabilize that puppy so that it has a smaller drop as possible with all of those parameters. Anything that we do with the puppy that causes too significant or too rapid of a decline of oxygen, temperature, fluid or glucose, we’re going to start losing puppies. And it’s pretty obvious once you have gotten into trouble that you’re there.

We want to give you the tools to keep you from developing those issues and to keep those puppies in a nice, stable environment. Puppies are born well hydrated. They’ve had blood flow through the placenta. They’re not dehydrated. If you check their urine color the first time, it’s going to be a little bit dark. But very quickly, they’re going to come up to speed, but they’re all going to be well hydrated because they’ve been hanging out in this beautiful, wonderful amniotic fluid that keeps them warm and hydrated and protected. So fluid intake has to happen fairly shortly after they’re born because they’re going to start secreting fluid through their kidneys, out into the urine. If we don’t hydrate the puppies, we’re going to see them develop dehydration, which is then going to turn into that cycle where we see a body temperature drop and a glucose drop and oxygenation drop and then everything just gets bad very quickly.

Fluid intake needs to start with colostrum. Puppies should nurse as soon as they’re born, as soon as possible after birth so that they get appropriate amounts of colostrum. Remember, puppies are born without much immunity, so most of their immunity comes through colostrum, the first milk from mom, then it continues through mom’s milk. If the puppies aren’t adequately nursing, we can supplement them with formula. We need to give them fluids by tube feeding or injection if our formula isn’t getting in, in adequate amounts, and then plasma. These are all things that we can do to support the puppy’s hydration status.

With energy loss, the same thing happens. They’re going to be born with a normal blood glucose of somewhere around 90. It’s going to be 80 to 120 in a normal puppy. But again, if we don’t start to see fluid intake or energy intake, we’re going to lose those puppies. They’re going to drop their blood glucose and they don’t have the glycogen stores in their liver that adult dogs do. Fasting, going a few hours between meals, is not okay for puppies. Adult dogs can go hours between meals. But without the amount of energy that they’re supposed to get in the colostrum or the milk of the mother as they’re nursing, or by supplementing with formula, food or other products, we’re going to see problems with their puppies dropping their glucose.

I do use Karo syrup and sweetened condensed milk. I think it’s really convenient that they developed this for us. Now we can keep this bottle in our refrigerator and have access to a little bit of glucose when we need it for puppies. I want you to remember that glucose should stay fairly steady. We don’t want our puppies getting Karo syrup and having their glucose shoot up and then their insulin starts to come in and then it drops and plummets, then we give them more Karo or more sweetened condensed milk. Then we have this up and down, up and down, up and down, zigzag effect. We want these puppies to stabilize so it’s okay to give Karo syrup or sweetened condensed milk a time or two, but we can’t rely on that too heavily, or we’re going to have our puppies just all over the board. We really need to stabilize that, making sure that they’re getting appropriate amounts of formula. The commercially available formulas like Breeder’s Edge Foster Care™ are superior to any of the homemade diets or the homemade formulas that are found online. If you need those at 2:00 in the morning, they’ll get you until morning. But you really need to have Foster Care™ or one of the products that are commercially available to have a more complex carbohydrate, so that our puppies aren’t zigzagging around with their blood glucose all over and it’s staying more steady. Remember, we don’t want our puppies to lose more than 4% of their body weight in the first 24 hours. We used to say 10%, but that’s no longer what we really think is appropriate. We need to make sure that we’re stabilizing them with no more than a 4% body weight loss. They should double their birth weight within 7 to 10 days of birth. Bottle feeding is fine. If you have puppies with strong suckling reflexes, you can use the Nuby nurser. We can use Miracle Nipples. We’ve got good products on the market. But if the pups are not strong enough, I want you to be comfortable in tube feeding a puppy.

A specific pet test device is made to measure blood glucose on adult dogs and adult cats, and this easily can be used on puppies as well. It comes with a lancet, which is a little blade that you can use to stick the footpad of the puppy, and little test strips so that you can very easily check your puppy’s glucose levels. So it should be 90 or above. If it’s below that, either the puppy’s getting inadequate amounts of glucose or it’s septic, which means it has a bacterial infection that’s overwhelming its system. And at that point we’re going to see a fourfold increased risk of death. It’s really important that we know what our glucoses are and that we’re managing those well.

I’m a big fan of tube feeding, and bottle feeding is necessary. No one starves to death under my roof. There are plenty of reasons that we lose puppies, but starvation should not be one of them.

I do keep together all my whelping supplies. So these are some things that you want to keep together.

A whelping kit is our list of supplies and equipment that we want to have. Some of these are pretty simple and inexpensive things to have at home. And then we want to make sure that we have our drugs and medical supplies as well, so that we have the supplies that we need. We used to be able to run out and pick up a bottle and some supplies in the middle of the night. But where you are, where I am, those aren’t available anymore. So we need to make sure that we have our supplies and all of our equipment stocked well in advance and not at the last minute scrambling to get our items together.

What is the Best Environment for Newborn Puppies

We’re going to talk about the ten things you need to know about your neonates’ environment. An incubator is simply an enclosed apparatus or enclosure that is providing a controlled environment for the care and protection of premature or small-for-gestational-age puppies. We can add to that gasping puppies and all puppies when they go through their first couple of feedings. An oxygen concentrator is a device that processes room air and utilizes filters or what’s called a molecular sieve to strip out nitrogen out of the air and delivers air that contains substantially higher oxygen content, so you never run out of oxygen.

So what does a puppy need? The average newborn puppy regulates its temperature to about 11 degrees above the ambient. If you look at what the environment is for them, an 88 to 90 degree target temperature with a little bit warmer and a little bit cooler parts of the environment is ideal and then 40 to 60% humidity range. The humidity is pretty forgiving. But if it’s too low, you run the risk of dehydrating a puppy and if it’s too high, you run the risk of some lung issues.

We’re finding all puppies benefit from an oxygen rich environment directly after birth; they seem to feed better coming out of a C-section or feed better coming out of a natural birth. The challenge really is to only give your puppies good choices.

Here are ten things you should know about your neonates’ micro environment:

1. Preventative measures early are more effective than heroics late. If we do things right, there are less stories about a puppy that has faded and what had to be done to save it, and there are more stories about how this litter (where you had a wide range of weight or you had some other conditions) got stronger sooner than you expected them to. You need to plan for probable outcomes, and then each puppy you save could fund your next purchase for a probable outcome. But if you have larger litters, you’re going to have small-for-gestational-age puppies. If you’ve had premature puppies in the past, you’re probably going to have them again. Gasping puppies, if you have a low number of puppies about to be born, there’s a good chance the first puppy is going to be born a gasping puppy. There can be plans, C-sections or emergency C-sections. And planners save puppies.
2. Get them breathing right, then warm, dry and fed. If you’re normally putting them right on a nipple and feeding them, get them dry, get to the right internal temperature, get some oxygen enrichment, they will feed better. Puppies process food and colostrum best when their internal temperature is above 95 degrees and ideally closer to 100, not 100, but closer to 100. Puppies lose body temperature through evaporation, so getting them dry before feeding allows them to hold their temperature better. And if you’re wondering what that feels like, hide all the towels, take a shower and come out into the bathroom and you’ll feel evaporative heat loss. Elevated oxygen encourages stronger feeding.
3. The first day is critical. The first couple moments are really critical in terms of the first breath. But the first day is really where they start to build their immune system. They process food and colostrum, and you really want to maintain the body to body weight as best as you can. So the ability to process colostrum well is essential to the development of a strong immune system. Hypoxic and gasping puppies have a shorter window to process colostrum and less oxygen is applied immediately. There’s no time to phone a friend and figure out who has an oxygen concentrator; you need it at that moment. Getting a puppy to the right internal body temperature before and after feeding is essential for efficient processing of colostrum and nutrition.
4. This whole concept of a normal birth weight and they’re regulating their temperature by the ambient–not all puppies are the same. The puppies that were larger needed a lower temperature than the ones that were smaller and had less body fat. The larger, higher body fat puppies may be regulating to 13 degrees above their environment, and the premature small-for-gestational-age might be regulating eight or nine degrees above ambient. As puppies age and as their eyes open, that’s generally a clue that they are either currently regulating their own body temperature or they’re about to be able to regulate their own body temperature.
5. Puppies seek out warmer and cooler parts of their environment with their noses, so they act as quasi-cold-blooded creatures. They’re fine-tuning their body temperature by finding the slightly warmer and slightly cooler parts of their environment. The trick is to only give the puppy easily accessible good choices. We discovered this a bit because we tried to build an even better incubator than the ones with glass and we use special materials and I probably got it within plus or minus one degree Fahrenheit and puppies hated it. Minutes-old puppies were trying to scale the walls, trying to get out because they couldn’t find the slightly warmer and the slightly cooler parts of their environment as they’re innately able to do so. A consistent environment with a slight thermal gradient enables the puppy to self-regulate its temperature by finding the warmer or the slightly cooler spots. If the temperature is too uniform, the puppy has difficulty settling down.
6. Give and grip. Well, this isn’t necessarily to save a puppy but to give a puppy a better life throughout its entire life. Hip dysplasia has both a genetic and early environmental component to it. Puppies who spend the first weeks of their life on a slick or hard surface are more likely to develop hip dysplasia. If you think that they could slide or splay out a bit, there are studies that have shown that puppies that have been on the slicker surfaces or harder surfaces have a higher propensity to have hip dysplasia, whether they’re predestined to have it or if the if they are not genetically really determined that that’s a likely thing. So it increases the likelihood of hip dysplasia. Puppies raised on a surface that has give and  grip to it, so if you push down, it has some give. And if you can feel like you can stick your fingers into it or they can stick their paws into it a bit, that gives them a surface that they can push off of and not splay out.
7. Your room is part of the system. An incubator can augment and certainly improve an environment. But if you have a dry room, the room is going to draw the moisture out. If you improve the humidity of your room, it helps all the puppies, whether they’re in the incubator or not. And then the second part, specifically with our system and with most incubators, if you keep a room at 85 degrees and you have the incubator in there, most of the incubators are designed that they have some level of heat loss to the room. In having that heat loss to the room, it requires the heater to run a little bit more. If you have a room too warm, especially with our system, you’ll have less benefit of the radiant heat because the heater has to work less hard in order to keep at the right temperature.
8. You can save puppies that you don’t expect to save. Get the environmental conditions right and the puppies will respond well. In the puppy warmer system for us, that means 90 to 92 degrees until all puppies are warmed dry and fed, 88 degrees as a rule for puppies that are normal birth weight, and 90 degrees for dry, small-for-gestational-age or preemie puppies. Other systems will vary. We know well what we can do with our system.
9. The puppies tell the story. What you want to see is a puppy laying out longer than you’ve seen them before. They’re maximizing the heat that they can receive from the warm floor and from the infrared. If they’re curled up in a “C,” they’re too cool. If they’re in a puppy pile, they’re too cold. Even if it’s really, really cute, YOU take a photo of it. If they start to sleep on their sides or they turn their belly to the sky, that’s an extremely comfy puppy. In our system, moving back and forth from the center to the edge shows that they’re utilizing the thermal gradient to fine-tune and regulate their body temperature. This helps the puppy be stronger sooner. This is an example of what we love to see, puppies laying out long on their sides, on their backs and there’s a number of puppies that are really, really cute when they’re on their back. Frenchies are my personal favorite as puppies that are laying on their back.
10. Why is the correct temperature essential to neonatal health? Essentially, a healthy neonatal puppy can regulate its temperature to 11 degrees above Fahrenheit and the internal body temperature below 95 F negatively affects the ability to process colostrum, which is essential to a strong immune system.

A smaller puppy has a higher ratio of skin to body mass, which essentially means there’s more opportunity for heat loss than there is for heat retention. That puppy has difficulty regulating its body temperature even 11 degrees above ambient. If you can get the conditions right for that puppy, it can process food better, it can process colostrum better, and you greatly improve its chances of survival.

Not all heat sources are created equal.

What Is the Ideal Humidity and Temperature of the Room where Puppywarmer Incubator and Oxygen Concentrator are Located?

In terms of humidity of your room, if you can get it above 40%, that’s going to benefit the puppies and I think, in terms of the ideal temperature, what we tell people for our system, the ideal temperature is generally around 72. If it’s a little bit higher or a little bit lower, that’s okay. If your room temperature is much higher than that, somewhat paradoxically, you need to raise the temperature a degree or two so that the radiant heat works a little bit harder to keep the incubator at a set temperature. There’s a lot of benefit associated with the radiant heat and heating a puppy more deeply than just the environment would do. There is a device associated with the oxygen concentrator that delivers humidified air along with the oxygen. So by adding distilled water to the chamber of the oxygen concentrator that delivers the appropriate level of humidity into the environment where the puppies are receiving oxygen.

How Long Do Puppies Need to be in an Incubator?

If you think there’s a group of puppies that are going to do well, no matter what, those can be warm, dry, fed, warm, dry, fed, warm, dry, fed and out. Then there’s another group of puppies that you think, I just want to watch them a little bit. In that case, you could watch them, make sure that they’re breathing right, make sure that they’re feeding right. And that could be in additional hours to days, depending upon the conditions of the puppies.

There’s a third or fourth category of I think these ones need the most help. In the case of a small-for-gestational-age puppy, what you’re looking for is you probably want them in a day or two longer than they have a strong sucking reflex. Once they start to have a strong sucking reflex, they can generally start to be in a less precise environment.

If you have a particular highly vulnerable puppy, don’t put the puppy in the incubator by itself. I personally think that a puppy left alone doesn’t feel movement, doesn’t feel activity, feels like it’s been abandoned. And I think those puppies have a tendency to give up. It’s also a lot harder to determine if the environment is appropriate as a puppy too hot to cold, whatever, because if there are really sick puppy, they aren’t going to cry, They’re not going to complain, they’re not going to move around like a normal puppy. So I tend to take a more normal puppy and rotate. It’s not always the same puppy if you have more than two in the litter. I tend to rotate puppies through so that they may be in the incubator with the sick when the sick one may be in their 90% of the time. Then you rotate other puppies through, unless you’re afraid of course, the big puppy being just too big to use it as the canary in the mine shaft. You know, the barometer for what the environment is, and to make sure that that little puppy doesn’t feel deserted, abandoned, and just say, “You know what? Everybody else has gone. I’m giving up.” And then they just fade off. So I think having that as a balance really is useful.

How Long Can a Newborn Puppy Go Without Breathing After Birth?

I like to see puppies breathing in the first minute or two after birth. Typically at C-section, and we do about 200 C-sections in our practice a year, so that averages one every other day, the puppy will take its first breaths as I’m getting the sac off of the puppy and handing it to my technicians. By the time they’re out to the resuscitation station, which is about a 20 foot walk, we make sure that they’re breathing as soon as we possibly can. And if they’re not, then we’re suctioning, we’re doing other resuscitation, we’re using the acupuncture point g b 26 with the hypodermic needle. We’re using our five-hour energy or caffeine. I don’t use Dopram until the puppies are at least 10 minutes old. And remember, Dopram has some downsides to it as well. So don’t reach for Dopram as your very first thing. Make sure you’ve cleared the airway. Make sure you use your acupuncture point, sure you’ve done all your other steps. And then if at that point you’re at the veterinary clinic and you have someone that can put an endotracheal tube into the puppy, great.

I think just the one thing that we’ve seen in a couple cases is you might be able to extend that puppy’s life and discover that there’s a more serious issue, that there could be a cardiopulmonary issue. Most of the puppies that if you clean them out or suction them out appropriately and you apply oxygen, you can see them start to pink up in 45 to, 90 seconds. You know, it may take a little bit longer, but if one is gasping for days or anything like that, there can be a deeper issue. The overwhelming number of gasping puppies, you see a very strong improvement in the condition of the puppy in minutes. What we suggest is you keep them in the incubator hours longer than you think they’re acting normal just so that you can get as much oxygen into their bodies appropriately as you can, because that improves their ability to process colostrum. A hypoxic puppy without oxygen, they have a narrower window to process colostrum effectively where if you apply oxygen right away, it expands that window of processing colostrum.

How Do I Know if My Puppy is Gasping for Air?

It’s that gaping movement of the mouth and that is the first born and have that nice smooth regular appearing respiratory rate and of course some of them are more grayish or bluish. I think it’s mostly a matter of just really observing how your puppies normally look when they’re born and learning the patterns of what looks normal and what doesn’t look normal to you, and then being able to address it with the appropriate supplies and equipment.

If a Puppy is In An Incubator, What are Your Suggestions When It’s Time to Nurse?

I like to see puppies nursing as my first way to feed puppies. Nursing is always superior to bottle feeding or tube feeding. If the puppies can breathe adequately, then they should be nursing and you can return them back to the incubator as soon as they’re done. Puppies that are gasping to breathe cannot hold on to a nipple and effectively nurse. They’re working too hard to breathe and they don’t have any leftover energy or the ability to close their mouth long enough to nurse. Make sure that every puppy that’s born is checked for a cleft palate. A lot of puppies are born with cleft palates. We see those frequently in our practice. And the first thing that my technicians do is get the puppy in the towel at C section. The second thing, on their way to the resuscitation station, is that they check for a cleft. Does that mean we’re going to give up on all those puppies? No, but it does mean that we need to make sure that we know that those puppies that have a cleft palate or some other defect. Check the abdominal wall to make sure that they don’t have intestines exposed. You to start looking over the puppies very, very specifically and very carefully at the very beginning to see if you have any other abnormalities that may reflect a birth defect. That changes how you manage that puppy.

If a puppy’s in the right environment, if it’s at the right internal temperature and it’s in an oxygen rich environment, it’s a very effective communicator that it wants to feed. There’s really no question that it wants to feed.

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