Behavior and Training, Breeding, Newborn Care Tips, Reproductive Health Advice

Neonatal Puppy Development Webinar

* What are the puppy development stages?

* What are the milestones of a newborn puppy?

* What is normal newborn puppy behavior?

* What is the neonatal stage of a puppy?

In this webinar, Revival’s Director of Veterinary Services, Dr. Marty Greer, discusses neonatal puppy development. Dr. Greer will talk about newborn puppy milestones and what is normal puppy development and what is not. This must-see webinar talks about puppy stages from birth and is ideal for both new and experienced dog breeders as well as anyone who works with pregnant dogs and newborn puppies.

***REGISTER HERE for Part 5 of Dr. Greer’s Newborn Puppy Webinar Series: The Troubled Newborn. This free webinar will be in April 2024.

Normal Neonatal Puppy Development Webinar

How Old is a Neonatal Puppy

Most people consider puppies neonates until they’re about six weeks old. It is at that point when they enter the pediatric period.

Normal vs Abnormal Puppy Behavior

You can’t know abnormal until you know normal. So do you really understand how normal puppies develop and what their development should look like?

If you have a concern, do you know how to verbalize that and explain it to your veterinarian or their veterinary team? Because it can be really hard to just call and say, “I don’t know. It just doesn’t seem right,” whether it’s your pregnant dog or whether it’s your puppies, newborns, or a little bit older. The better you can compare to normal and abnormal and the better you can define this when you call or email your vet clinic and say, I think I need help, the better chances are that they can give you the right information, get you in at the time that they need to get you in and give you the help you need.

What is Normal Newborn Puppy Behavior?

A normal newborn puppy at birth should be alert and able to crawl. Whether it’s born by C-section or whether it’s born by vaginal birth, either way, they should come out of the uterus alert, crying, being able to breathe comfortably and crawling around, kind of looking for where they’re supposed to be. If you have a puppy that’s crying incessantly and it’s not just a little fussy, but it’s really crying, you want to consider it first to be chilled and hungry. So those are the first things that I want you to do, is get the puppy warm if it’s appropriate, warm it up, take its temperature first, slowly warm the puppy. The general rule of thumb is to not warm it more than one degree an hour. If your puppy’s at 92 degrees, you don’t want them at 96 in an hour. You want to bring that up slowly. And then once they’re warm, you want to make sure that they’re fed. Those are the two most common things that we see causing a puppy to be crying and in distress.

What to Look for After Puppies are Born

A normal puppy should be able to right itself, in other words, get its feet underneath its belly, not laying on its side or on its back. It should be able to right itself. It should be able to root, which means if you hold your fingers in a circle, the puppy should seek out a side that it would look for a nipple. That’s a normal rooting reflex puppy should be able to do that at birth. They should be seeking a nipple by turning their head side to side in that little circle. And they should have a withdrawal reflex, meaning that if you pinch their toe or their tails, they should feel it and they should pull back.

Puppy should also be able to suckle as soon as they’re born or shortly thereafter, and that should be present as a reflex until they’re about three weeks old. Those reflexes are things that you can very easily check at home; righting, rooting, withdrawal and suckling should all be present as soon as the puppy is born. Then, tactile, anal and urinary reflexes. As soon as you touch them, they should start to defecate and urinate appropriately.

Until the puppies are four days old, they should have flexor dominance, meaning they should flex their head down and flex their limbs in. And then after day four, they start to extend or they start to get longer, taller when you hold them.

Puppy Nervous System Development

The nervous system in a puppy develops much more slowly than it does in some farm animals, our calves, our baby pigs, our goats, our sheep. They’re born eyes open, ready to run within an hour. And if they don’t, they’re prey, they don’t survive. Just like animals in the wild. If they’re not able to get up and run, there’s a reason for that. Those babies aren’t going to have a good chance of survival. So by comparison, our puppies are pretty slow in developing. They don’t do some of these things until they’re several weeks old.

When Do Puppies Open Their Eyes?

Puppies are born with their eyes closed and they don’t open their eyes until they’re 10 to 14 days old.  There’s a reason that a lot of animals, wild animals and our domestic animals go into labor just before a storm. When there’s a barometric pressure drop, just before the big snowstorm, just before the big rainstorm, just before the hurricane. So tornadoes, whatever kind of weather is coming. A lot of babies are born because the moms go into labor just before that. It’s felt that evolutionarily that if you had your baby during a storm, that, yes, it could get wet and cold. But on the other hand, the animals that are going to look for your babies as prey animals, as dinner, are also going to be hunkered down someplace. So they’re not as likely to get out and about and be looking for your babies.

Now, dogs are different than a lot of the species because they have litters and they have to leave them when they go out to hunt. They can’t take them along for the first several weeks to months, so they have to hide them in a den.

Is it Normal for Newborn Puppies to Twitch When Sleeping?

The answer is yes. Puppies don’t have good neurologic function at this point, and they sleep 90% of the time. When they sleep, it is normal for them to twitch. That twitching motion is absolutely normal. That is not a seizure.

It’s absolutely normal for puppies to dream, sleep and to twitch when they’re sleeping. And it’s absolutely normal for puppies to have the hiccups frequently. Those are not reason for concern. It’s really pretty cute when they do it. So don’t be concerned about either of those.

When Should Puppies Start Walking?

Puppies should be able to walk by day 21, and neonates should be able to start to stand by ten days if you’re a kitten and by 14 days if you’re a puppy. Smaller puppies tend to stand up a little faster than those bigger, heavier puppies. They don’t run until they’re two or three or four weeks old. They just don’t.

What are the Reflexes of a Newborn Puppy?

Puppy reflexes, in some ways because they’re a delayed development, are lacking. Puppies cannot shiver until they’re about three weeks old, so our puppies need auxiliary heat. Having them at just 70 degrees or 68 degrees in our homes is not warm enough for puppies. They need to be kept warmer. They lose a lot of body heat when they’re first born, they’re wet and the water evaporates quickly, they chill. So it’s important that we know that they can’t shiver. We can’t expect them to keep themselves warm. So we have to heat them. We have to give them additional heat. I prefer the heat from underneath, not the heat from above. I don’t like heat lamps. I do like the heating nests, like the whelping nests that heat from underneath.

Puppies do not gag. So if you’re trying to feed with an eyedropper or a syringe without the appropriate kind of nipple on it, where they have to suckle on it, they may not be able to gag and so they may aspirate fluid. And they cannot urinate and defecate without stimulation for the first 10 to 14 days. All those things need to be taken into account when you’re taking care of your babies.

What Should I Watch for in a Newborn Puppy?

The three things you should really be monitoring the closest at home are going to be the puppies body temperature, their urine color and their body weight. So these are pretty simple to do. But a lot of people are reluctant to do some of these things. To take a puppy’s temperature, you take a rectal thermometer, you put Vaseline on it, you slide it into the puppy’s rectum, and you hold it in the rectum until the beep goes off and tells you that the thermometer is done reading. Any size puppy can accommodate a thermometer. Get one of the fast digital thermometers that go into the rectum, because shake-them-down kinds are pretty long until they actually get to a temperature that you can read. So, take a temperature with a digital thermometer. It’s very quick. It’s very easy. It’s not difficult to do. Lubricate it well and put it in. You want to make sure that the puppy’s rectal temperature is at least 96 degrees before you initiate feeding. It’s very important that you’re temping these puppies if you’re supplemental feeding.

How Do You Stimulate a Newborn Puppy to Pee?

Number two is to check the puppy’s hydration. And this is a not a sophisticated system, it requires a cotton ball. Just hold the puppy over a waste basket because the puppy is going to urinate more than what one cotton ball will hold. By simply stimulating the puppy to urinate and defecate by rubbing the cotton ball on the genital area, you can check the color of the urine, and the urine should be a very, very pale yellow on the cotton ball.

How Can I Weigh My Newborn Puppy at Home?

Weighing a newborn puppy is also relatively simple. I like the puppy scales that will do both digital in grams and in ounces. Just put the puppy on the platform. I like the scales that toggle back and forth. Ounces are what most people think of here in the United States. You think it ounces, you think your puppy is 14 ounces. It’s almost a pound when it’s born and that’s easy to calculate. The advantage to grams is that smaller incremental changes will be noted earlier if you’re measuring in grams rather than ounces. With ounces, there are only 16 divisions in a pound. But with grams there are 454 in a pound. So you can see much smaller changes either on the way up or on the way down. So if you have a puppy that you’re not sure is adequately nursing and you’re thinking maybe I should supplement, or maybe the puppy is not gaining as well as it should be, measure in grams, and keep a record of it. And it’s very simple to just keep a notebook with the column for the temperature, a column for the weight, a column for the urine color, and then track at least twice a day what your puppies’ weights are, what their temperatures are, what their urine color is. And you’ll pick up really early changes in things that are happening that you won’t pick up by just observing the puppies, by peering over the whelping box side.

Make sure that you’re doing those three parameters. They are very easy to check. They’re simple. Doesn’t take expensive equipment. Thermometers and a scale are tools that will be life-saving for your puppies. So make sure that you’re getting enough supplementation in these guys. If they’re dehydrated, if they’re not gaining weight the way they should be, then start your bottle feeding or tube feeding. Active learning starts at three weeks of age for puppies, and their social period starts at around four weeks and typically ends by about eight. So you have a very small window of time to get these puppies adequately socialized.

Should I Bottle Feed My Puppies?

If the puppies are not gaining weight and their urine is dark, bottle or tube feed. If they’re doubling their birth weight in the first 7 to 10 days, their urine is pale, they’re gaining, they’re happy, they’re healthy, they’re doing well, I don’t intervene. But you can always stick a bottle in their mouth and see. If they’re hungry, they’ll probably take it. And if they’re not hungry, they probably won’t. What many people are concerned about is that if I supplement feed that, I’m then going to suppress the puppies’ likelihood to go over and want to nurse. And the answer I have for you is do you go to Thanksgiving dinner? When you finished dinner at Thanksgiving, do you push back from the table and then come back for a piece of pie because you’re full? You’re going to eat anyway. So you’re not going suppress the puppies’ likelihood to want to nurse because nursing is not just a functional behavior of getting calories, it’s also a social behavior. So I don’t think you’re going to suppress the puppy’s willingness to nurse. I watch weight, I watch urine color, and I make the decision based on that.

Why is the Puppy’s Temperature Important When Feeding?

A puppy below 96 degrees Fahrenheit rectally will not have normal GI motility. The gut will have what’s called ileus. It’ll just sit there and be static. When that happens, then the milk foams up in the stomach and then the puppy starts to aspirate and gag on the milk and end up with aspiration pneumonia. Having a chilled puppy that you’re feeding is dangerous.

When feeding my favorite puppy milk replacers are Breeder’s Edge Foster Care and Esbilac goat’s milk based product. I never use a homemade formula. They’re not going to have the amino acids and the fatty acids. I don’t use goat’s milk, the fat and the protein contents aren’t correct. You want to use a commercially available canine milk replacer.

What Color Should a Newborn Puppies Tongue Be?

The oral cavity of the puppy should be a pink color, a nice bright pink. It should be moist. If it’s dry or if the puppy’s tongue doesn’t seem the right color, then you may have a puppy that’s not getting enough oxygen or not hydrated enough. And remember, hydration. You can’t pull up the skin on the back of a puppy’s neck and check hydration like you can in an adult dog. Puppies don’t have the amount of body fat that adult dogs have. So you need to look at urine color. You need to look at the oral cavity and see if they’re adequately being hydrated. The puppies’ mouths should be a little bit redder when the puppies either crying or nursing because of blood flow.

If you see sores in the mouth and if you’re looking at the mouth, you’ll see them. You may have those either because there is a bacterial infection or a viral infection like herpes. So if you have a sick puppy, be sure that you check the oral cavity for wetness, for the color and for any signs of sores.

Cleft Palate in a Puppy

Now, unfortunately, cleft palates are one of the most common defects that we see. Oftentimes, puppies with cleft palates have additional defects, so sometimes trying to save them can be more than frustrating. It can be just downright heartbreaking. So it’s not for everybody to save them. If they do have a cleft, they’re going to need to have a surgical procedure done. I’ve had people say full cleft. I’ve never seen a partial cleft. It’s really if there’s a cleft, it’s going to be a cleft. It’s pretty obvious. If you’re not sure, either get a flashlight or if you’re at the vet clinic, get an otoscope, the thing you look in ears with and get a good look because in dimly light rooms you can sometimes miss these. Oftentimes we’ll have a puppy that comes out with a defect on its leg or it’s really small. Something else looks like it’s wrong with it. And those are puppies that have clefts. Before you really beat yourself up about losing a puppy or about a puppy, that just doesn’t seem to be thriving, check with a flashlight, see if there’s a cleft.

The first thing I tell people when they’re having a puppy not thriving is to look for a cleft. Typically, the dental departments at the universities and dental specialists are now putting acrylic plates in the roof of the mouth to cover that defect instead of trying to suture it closed. It is a fairly expensive surgery, and for some people that’s appropriate. For other people, or if the puppy has additional defects, sometimes just letting the puppy go is the best option.

I do recommend folic acid to help prevent cleft palate. Prenatal supplements for dogs such as Breeder’s Edge Oxy Mate has folic acid in it.

Cleft Lip in Puppies

Cleft lips, on the other hand, are also fairly common, but they’re pretty easy to fix surgically. Usually one surgical repair will take care of it, so they are not difficult to fix. And if the puppy doesn’t have an associated other defect, they can go on to live pretty close to normal lives.

If there’s a cleft lip puppy in the litter, it is possible that that will happen again. The litter mate may carry the genetics for it, so you probably want to think hard about it. Now, the rule of thumb that I have been taught by a geneticist at UPenn, (because I had one litter of my own that had three out of eight puppies with clefts) was that with so many puppies in the litter, it probably wasn’t genetic. It was probably due to some environmental influence. So I don’t throw them all out. But you want to be very thoughtful about whether that dog that should be in a breeding program or not, because it may be genetic, it may not be when it’s that percentage. If it’s one puppy, it’s probably genetic and you probably should think really hard about whether that’s a breeding that you want to repeat.

Puppy Teething

Very important that we’re aware of when our dogs are teething. It is normal for puppies to teethe. Sometimes you’ll find blood on things if they’re chewing on fabric or toys or some of those things, you’ll see that there’s blood. But that’s normal. They should start teething when they’re about four months old. The toy puppies tend to be a little bit more delayed than the other breeds of dogs. So the little tiny dogs may start at five or five and a half months, but the average dog is going to teething around four months of age.

What are the Stages of Puppy Teeth?

It is normal for puppies to lose their all their baby teeth starting in the middle of the top with the maxillary teeth. And then it marches along so that they start at four months by 5 to 5.5 months, the canines, the big fang teeth have been replaced by adults and then they go on to finish up by getting all their pre-molars and molars in complete replacement should take place by six months of age. If the puppy has a retained tooth instead of having that tooth fall out when the adult tooth comes in, sometimes we have to have those teeth extracted. It’s not uncommon for that, especially in the toy breeds. So don’t be surprised if that’s the case. If the dog is put under anesthesia for a spay or neuter, then that’s a great time to remove those additional teeth.

On a neonatal puppy, the very young ones, the lower jaw sticks out further. That’s normal. That’s the way the puppy can really get a good hold of the nipple and nurse. If the puppy has a short lower jaw, be looking for a cleft palate or some other defect because something is wrong. But their lower jaw should jut out a little bit when they’re newborns. And then as they grow the upper jaw catches up and it grows into a position so that the adult incisor teeth on the left hand side of this picture come in in front of the lower incisors. And then the lower canine two should come in in front of the upper. So that’s what a normal bite should look. And then if you look at the side bite you can see that the molars and the pre-molars alternate like a like a saw blade. So they don’t line up on top of each other. They line up adjacent to each other.

If we have a puppy with a short lower jaw that’s called or base narrow, in other words, the narrow the lower jaw is too narrow, then instead of the canine tooth being in front as it should be, you can see that the canine tooth falls behind and oftentimes is too narrow, and then it punctures these holes into the roof of the mouth. So these puncture wounds are from the lower canine teeth hitting the upper palate. This can be very uncomfortable for the dog. So sometimes these teeth needing to be bonded so that they’re blunted or they can be extracted depending on the age of the dog and what the veterinary dentist determines should be done.

So be aware that based narrow is a genetic deformity that we see commonly in dogs. I’ve had clients with this happen in and sometimes in an entire litter, and if they breed away from it, then they will stop having puppies with that kind of a defect. It isn’t life threatening, but it is expensive to fix and you don’t want people that are buying your puppies to have to have expensive dental care as soon as they get a new dog.

Are Probiotics Good for Puppies?

The GI tract, the intestinal tract should be born sterile. So when the puppy first has a stool, if you tried to culture it, nothing should grow. But very quickly it colonizes with bacteria from the environment, from the dam. So it’s not uncommon for them to have bacteria entering the GI tract as they are nursing. Using a probiotic when they’re really young can be preventive. It can also be done if the puppy is on antibiotics. Now, we don’t routinely put puppies on antibiotics, but if your puppy is put on an antibiotic by your veterinarian, then you should also include a probiotic to make sure that the right bacteria are present in the GI tract to prevent diarrhea. Puppy probiotics are also important to use if mom is on antibiotics for mastitis.

Breeders Edge® Nurture Flora is a probiotic labeled for puppies from birth to three months of age. It comes in a tube like some of our other products, and it’s pretty sticky. So it’s hard to get into a feeding tube with formula, but it’s pretty easy to just dab on the tongue or the roof of the mouth, and then the puppy will swallow it. It’s kind of like a molasses paste.

Puppy First Poop

The stool, they should be passing meconium, which is the first fetal stool that should be passed in the first 48 hours. It’s not unusual to see that if a puppy is born with meconium in their fetal membranes, there are times that your veterinarian may want to put them on an antibiotic to prevent them from developing aspiration pneumonia.

A normal neonatal stool should be pasty yellow and seedy. It should have little seed-looking things in it. That’s absolutely normal. Oftentimes you never see it because the dam is cleaning up after the puppies. But if you see that yellow seedy-looking stool, that’s normal stool. Do not get excited. That is not diarrhea. By the time the puppies are ready to wean, their stools are starting to become formed enough that you can pick them up.

Initially, puppies cannot urinate, defecate on their own, so their mothers have to stimulate them for the first 18 to 21 days. If you have a dam that cannot do so because she’s sick or because there’s something else going on, then make sure that you’re stimulating it each feeding so the puppies don’t have any back up, any constipation. If you see yellow or yellow watery stools or green watery stools, that may mean that the puppy’s getting too much to eat, so you may have to back off a little bit. If the stools are foamy and bright yellow, it may be canine herpes. If they’re blood tinged, the puppy may have either a bacterial infection or coccidia. They can get coccidia really young. I’ve had them in my own dogs as early as 14 days of age.

If the dam had coccidia and she brought it in on her pants or on her feet, then those puppies crawl through that loose stool and they end up ingesting it so they can end up with coccidia, giardia, some of these things really young. So a stool sample. To do an ELISA test and floatation is a good idea if you’re having puppy problems with diarrhea. Don’t just willy nilly start putting dogs on antibiotics.

Newborn Puppies with Diarrhea

If you have a puppy with diarrhea, Breeder’s Edge® Puppy Lyte™ is a great product. You can tube feed it, you can bottle feed it. It’s a chicken-soup-based product and it has the electrolytes in it that will help support that puppy. Sometimes cutting the milk by 50% with Puppy Lyte™ for a feeding or two will cut down on the amount of calories that the puppies are taking in while keeping them hydrated So you can cut down on diarrhea without using any drugs.

I also use a lot of baby rice cereal that comes as flakes. The Gerber stage 2 chicken baby food is just straight chicken and water. And yogurt. Those are really nice. You can mix those three together, the baby rice cereal, the chicken baby food and some yogurt. You can mix those together into a paste that you can syringe into the puppies. And that rice cereal and chicken is highly digestible and it can really cut down on diarrhea.

 You do not routinely want to use antibiotics on puppies with diarrhea, and metronidazole should not be used on very young puppies. It will cross the blood brain barrier until they’re about six weeks old and they can end up with neurologic disease problems such as seizures. So do not be putting metronidazole into our newborn puppies.

Now, if you have puppies with really, really nasty diarrhea, you can sometimes give plasma. Now, plasma we typically don’t think is absorbed after the first 12 to 24 hours after birth. So from a perspective of giving the puppy immunity in their system, they’re not going to absorb it. They’re going to digest it as a protein. But there are studies done in calves (and we get back to the bovine industry because there’s a lot more studies on calves than there are in puppies) that show that you can get local immunity by giving that plasma through a feeding tube. I had a client that called and asked if they could give it through a bottle. And I’m like, I don’t think they’ll take it, but feeding tubes are how we usually give our plasma.

Now, if you have puppies that are really gassy that also have diarrhea, you can buy infant drops. These are simethicone drops. That and a probiotic should get your puppies back on track.

Constipated Newborn Puppies

If you have the opposite problem, if you have constipation, either Karo syrup or Eagle Brand sweetened condensed milk, which at some stores comes in a bag so it’s easy to reseal. That glucose content is high enough in the in a formula that it will help loosen up their stools. So taking their temperature with a well lubricated thermometer and giving an enema with Ivory soap can help with constipation.

Some signs to know if a puppy is constipated include a puppy that’s straining to defecate. If you’re not sure, just stimulate the rectum. And typically a puppy will pass some stool and problem solved if they’re if they’re having normal stools and they’re passing when you stimulate them or the female licks them, you should be good. It’s not common, but you know, usually know, they don’t eat well. They just feel they look kind of distended and kind of bloated. And then they’re just they’re just not quite right.

Constipation isn’t common. It’s much more common to see diarrhea, but sometimes you need to do this. Use a red rubber feeding tube attached to a syringe. It’s got soapy water with Ivory soap in the water and you can simply slide the tube in and give a little enema. It’s pretty simple. Just lubricate the tube, side it in and then gently put in some of the warm water with Ivory soap in it. Please, please, please use Ivory soap. Do not use Fleet enemas. There’s a lot of phosphorous in those, and puppies can absorb too much phosphorus into their intestinal tract. Additionally, if you have a puppy that you’re not sure if it’s passing a stool, make sure that you’ve put in a thermometer with lubricant on it like Vaseline and making sure that the puppy actually has an open rectum. Again, this is not a common defect, but it is a defect we see a couple of times a year where the puppy is born without a rectum or without a Patent rectum. So be aware that that could be the case.

Metabolic Blood Testing Puppies

Puppies can be blood tested and I think it’s important that your vet has access to this. The equipment that we have now requires tiny, tiny samples of blood. So it’s not difficult to get a couple of drops of blood from the footpad of a puppy using a lancet or with a jugular stick. And the equipment that we have at our veterinary hospital is used just a couple of drops of blood so we can get a CBC and a chemistry panel on these little kids if we need to.

If I had a puppy that was sick, that wasn’t doing well I recommend doing liver, glucose and kidney testing. Now bile acids are routinely done on Irish wolfhounds before they typically go to their new homes. So if you have an Irish wolfhound or a line of dogs that might have a problem with liver shunts, then it would be routine. It is not routine. It is mostly if you have a puppy that’s not doing well, that you would have those blood tests done.

It’s important that you know that liver function tests are always low on our young puppies because they don’t have fully developed liver enzymes. If they have an elevated bile acid, that would suggest a liver shunt. Again, that’s a common defect, but relatively uncommon even at that. But that’s a simple test to run, even on a really young puppy. I’ve seen puppies as early as two weeks of age that we were able to diagnose with a shunt, with a blood test. If you’re putting your puppy on antibiotics, your vet is putting them on an antibiotic or other drugs, you need to be careful how you select the drugs and how you dose the drugs, because drugs metabolized through the liver or excreted to the liver are not going to be excreted as well. So they can build up to toxic levels in the body fairly quickly. So important to calculate those doses carefully. And then the ALP is always high in neonates because they have a lot of bone growth. That is not a liver specific enzyme. It is an enzyme that goes up with liver disease, but it can go up with arthritis, it can go up with pancreatitis, it can go up with bone growth. So an ALP elevation should not be a reason for concern. But an ALT, which is another liver enzyme, should be normal.

Kidney and Urine Testing

Kidney tests are a little high. Usually at the beginning it’s easy to collect urine and the urine should be very pale and very dilute. If you’re checking with a specific gravity, then it should be 1.006 to 1.07. That will help us with hydration. But you can check based on urine color at home, on a cotton bowl or a wet rubs or a dry tissue.

It’s not uncommon to see a little protein and a little glucose in the urine until the puppies are six weeks old because their kidneys aren’t fully developed yet. Now, there’s a test frequently done on the IDEX panels called an SDMA. It’s a really nice test for determining if there is early sign of kidney failure. However, until the dogs are mature, until their kidney function is matured around 6 to 12 months of age, it’s not reliable.

If you have a dog that goes in for a spay and it comes back with an elevated SDMA, don’t get excited. Just ask your vet to call IDEX and talk to them about what those results mean. Now, glucose is really easy to run. You can run them at home if you need to. You can run them at the vet clinic. There is a device called a PetTest. It’s made for dogs. It’s the same kind of glucometer that they use for people with diabetes. The glucose should be over 90 and so if you have a weak puppy or a puppy that’s having seizures, it’s relatively easy to collect the blood. You need a lancet, which is how you poke the puppy’s foot. You need a test strip and you need the equipment to do this. So it’s three pieces. And again, this is something that you can pretty easily do with a glucometer at home if you have a diabetic family member. This puppy came into our practice. It’s normal, but we just hope the bottom of the foot get one little drop of blood, put it on the test strip, and in 30 seconds, less than 30 seconds, we have a result. If you have puppies, especially the toy breeds that tend to get low glucose hypoglycemia, this is a test that you can run very easily at home.

When Do Puppy Testicals Drop?

We should see testicles descended by the time the puppy is at birth, but you usually cannot find them until they’re between four and seven weeks of age. You should feel two. If you only feel the right one, it’s unlikely that the other one is going to come down because it has a shorter distance to go. So the left one should always be down. But for the right, if you’re only feeling one. Balanoposthitis mastitis is really common and really normal. That’s that little yellow, gooey green sticky stuff at the tip of the pre puce where the puppy’s penis comes out. Do not get excited about that. Do not put the puppy on antibiotics. Clean it up, but do not start antibiotics for this.

Urinary obstructions can occur in male puppies. They are pretty rare, but they can occur. So if you see a puppy that’s straining and you’re not sure if it’s defecating or urinating, you may have to go to the vet and have it checked. But if you use your cotton ball trick and the puppy can urinate, then you don’t have a urinary obstruction. Just be aware that those can happen pretty young and they’re pretty devastating to the puppies.

On the girls side, it’s normal to have a nice, normal vulva. Oftentimes before a heat cycle we’ll see what’s a recessed or an inverted vulva. Very common, not anything to be excited about, but a heat cycle will typically create the hormonal changes that it takes to make that a more normal shape and normal exposure to the vulva. This is why we do not recommend spaying female puppies, especially if they have an inverted vulva until they’ve had their first cycle. Unfortunately, there are veterinarians who are really happy to spay very young and then go to surgery and fix this recessed vulva. Now you’ve paid for two, maybe three surgeries to get this fixed. So it’s really important that you include in your contracts with people that are buying your puppies, that if they have a recessed or inverted vulva, that you give them the opportunity to have a heat cycle before they’re spayed.

There’s also an uncommon condition called Os clitoris. It’s the comparable female version of an Os penis. Now all male puppies should have a bone in their penis. That’s absolutely normal. It’s called an Os penis. If it’s in the female, it’s called an Os clitoris. That is not a normal structure. These, again, are not common, but they happen. So it’s something to be aware of. And if it does occur, you probably don’t want to repeat that breeding.

How Do You Take Care of a Puppy’s Umbilical Cord?

Remember that umbilical cords are normal, but when they are born, you should be cutting and tying the cord if the female hasn’t taken care of that for you, and then dipping the cord at birth, at 2 hours, 8 hours, and then twice a day until the cord falls off. I recommend Breeder’s Edge Clean Cut™ Iodine. It is meant to be used for one litter and then the bottle discarded. It is not meant to be used on multiple litters. It’s a small volume. And this kind of gelatinous material in here does a really nice job of staying on the cord. Additionally, when you go into the vet or when you’re checking your puppy, you should be checking for umbilical hernias, which are the ones at the bellybutton and inguinal hernias, which are the ones in the groin region. Those you can see on all breeds of puppies. It’s not specific to your breed. For dipping the cord, When I say dip the cord, I really do mean dip the cord. I really do mean dip the cord in the bottle. And then tip the puppy over and make sure that you’ve completely covered the cord in this Betadine. That will help the cord to dry up and fall off before it becomes infected. I personally lost a puppy to that. Don’t let that happen to you.

The only the only way to avoid umbilical hernias is to not breed them. I don’t care what anybody says. They want to tell you that it’s not a genetic concern. It’s genetic. There are some breeds that it’s just so common and we almost expect to see it. Bernese Mountain Dogs are certainly one of them is really common. All you can do is try to avoid breeding parents that both have it. But unfortunately it’s pretty common and it’s not a fatal disease. It does not lead to omphacele or gastroschesis in its worst form. Those are completely separate defects.

Now we can sometimes see open abdominal walls. There are two versions of it. There’s an omphacele and a gastroschesis. One is on the midline, one is off the midline. One has an intact intestinal tract, one does not. So sometimes you can put these puppies back together, especially if they’re born by C-section at the vet clinic, or you recognize it fast before the females bites that off. If you find this happening, then you want to get to your vet as soon as possible and see if they can help you with a surgical correction of that. But don’t let the females lick at this if you’re seeing that that was not caused by the females. This was a birth defect. We do see these in humans as well. So it is not caused by licking at the cord or pulling too hard. This is a genetic defect.

Flat Chest Puppies

There are multiple kinds of puppy flat chests that we identify in dogs, not very well identified, but we do know that there are multiple kinds. In these cases where you have a singleton puppy that’s very large or a puppy or two that’s really large or a puppy with pepitas excavated, which is what that chest wall defect is called when their chest doesn’t have a normal shape to it and it’s caved in on the sternum and the underside, using a toy like this little octopus guy can be super helpful. He’s got these fun little legs. You can put these guys right in the incubator with your puppies. You can also use egg crate mattresses in the bottom of your whelping box, but sometimes those are harder to keep clean. This octopus just goes in the wash and then you’ve always got a clean octopus for this little puppy to lay on. I don’t know why these legs on the octopus work so well. They’re really meant to be a dog chew toy. They’re not meant to prevent flat chests, but I learned this from a client, and they work beautifully.

Raising a Singleton Puppy

Singleton puppies tend to be spoiled puppies. They’re spoiled by you because it’s the only puppy you have in the litter. They’re spoiled by their mother because they have nothing to do other than dote on this one puppy. Some of these puppies grow up a little different than their they would be if they were raised with a litter. They don’t have the feel of touch and they don’t have the feel of frustration. I learned this again from my own personal firsthand experience, and I had a behaviorist that worked with us on a puppy of ours that was aggressive, not just biting, but aggressively aggressive at the time he was about eight weeks old, because he was a singleton and I didn’t raise him correctly. So what you need to know is they should feel a touch. So you should take a stuffed animal like your little octopus several times a day and push him off the nipple so he’s frustrated and so he feels the touch of someone else against him so that they have that feel of frustration, that feel of competition. It’s really important to do that. I can oftentimes tell if we have a singleton puppy in the exam room when they come in and they’re eight or ten week visit because they do act different. So be sure that you’re doing those things with your singleton puppies. A lot of you have singletons if you have toy breeds, so just be aware that you can prevent some of those behavioral issues if you’re on top of it when they’re very young, like starting at a day of age.

The other thing I do with my singletons is I will take a sock, an old sock and stuff it with either beans, rice and probably two of them, one on each side, because when puppies are nursing and they have a whole row of little puppies and they’re nursing on their mom, they have other puppies against which to lean when they’re nursing. If they’re singleton, they spend their entire amount of energy just holding on to the nipples so that they don’t roll side to side. So having those little stuffed bean or rice socks can be helpful. You can warm those in the microwave so you’re not putting some cold surface against the puppy. Then it helps to support them so that they’re really able to focus their concentration and their effort and their calorie use on getting calories by nursing and not by keeping themselves from rolling side to side. So it’s really helpful. The Snuggle Puppy, which is kind of fun because it has this heat pack in it that you can microwave and then it’s got the little simulated heartbeat. So you can put this in the whelping box with your singleton and it feels like it’s got somebody else in the box with it. Singletons, I think sometimes feel like they’re just abandoned and they kind of give up, so we got to work extra hard on these little singleton guys to keep them going.

Puppy Heart Murmur

I think it’s really important that a veterinarian listens to the heart of these puppies before they leave your kennel or your home. It’s important that you’re not selling a puppy with a murmur. Listening to the heart can be a little bit of a challenge if you’re not a professional in the medical field. So you’ll want to be able to distinguish between a soft, quiet murmur that’s probably not serious. It’s innocent, it’s functional, it’s physiologic, and it’ll go away by 12 weeks versus a serious heart murmur. You don’t want to sell a puppy with a serious heart murmur because that puppy may end up needing some significant medical interventions. Then you’ve got somebody that’s either going to come back to you for money or you’ve broken their heart. And nobody wants to have that as their reputation out in the field selling puppies.

Why do our puppies have heart murmurs when they’re young that they outgrow? Number one is they’re always anemic. So oftentimes there’s more turbulence in the blood. And that’s what we hear with a murmur is turbulence. Sometimes they’re stressed. It can be associated with fever. It can be  associated with an infection. And puppies always have low proteins as well. So they just don’t have the same amount of viscosity or thickness to the blood. So when they’re very young, you will sometimes hear murmurs. Sometimes if the vet holds the puppy right against the stethoscope, instead of standing the puppy on the table and putting the stethoscope across their chest, they’ll pick up a heart murmur because they’ve changed the shape of the rib cage and caused a murmur. More common in kittens, but it can happen in puppies as well. So if they hear a loud murmur, make sure that you have that checked out.

At What Age Do Puppies Open Their Eyes?

Puppies should have two eyes. The eyelids should open between ten and 14 days. The cornea should be cloudy in the first 24 hours after opening, and in the first three weeks they don’t see very well. In the first two weeks, they still have reflex. They can still see light through their eyelids. But for the first week, they’re not going to see very well. That’s normal. If you have puppies with a swelling of the eyelids before the eyelids open, this is a true emergency. The veterinary ophthalmologists a make me talk about this because it’s super important that you get these eyelids open.

They should be treated with both an oral antibiotic like Clavamox, and a topical antibiotic. And it can be almost any topical antibiotic as long as it’s one without a steroid in it. The character of this discharge is pretty disgusting and it is important that you get the eyelids open. If you have a vet that’s willing to do this, great. If you have a vet that can’t or it’s a weekend, use a hemostat, not a pair of scissors just to perfectly clear. You want to put a warm compress on and then use some gauze, perhaps a hemostat. And then with a little bit of gentle pressure, you can get the eyelid to open. Now, if you read the literature, it says this happens in unclean conditions. In my experience, it’s typically been a very, very, very clean household with, a very, very, very fastidious owner. But it just happened that there were bacteria in the environment from something like metritis or mastitis that the females had, so you should not feel bad about it. It happens. It’s not because your kennel is dirty, but you should get these eyelids open. If you don’t, these puppies end up with vision loss. I’ve seen blind puppies. I’ve seen some very beautiful blind puppies. So do not let that happen to you. If you see swelling, even if it’s one eyelid stuck, open them all. You will not cause vision damage by opening them early. You will save vision on your puppies.

How Long Does it Take for Newborn Puppies to Open Their Ears?

Puppies should have two ears. I know that seems obvious, but we’ve had multiple dogs come in that only have one ear canal. They may have both flaps, but they may not have a canal. So look and make sure that they have two ear canals. A puppy’s ears open at 10 to 14 days.

How Do You Test a Puppy’s Hearing?

There is a puppy hearing test that can be done called a BAER test. It stands for brain auditory. Essentially they put little electrodes in the puppy’s scalp and you can tell after six weeks of age. You can’t do it before six weeks because they can be born with hearing and lose it if they have the genetics to do that. And it is complicated. It’s frequently associated with a white coat, which is why I check my farm dogs. But we know Dalmatians, English setters, bulldogs, a lot of the white coat dogs and cats can have deafness. So there’s a hearing test that can be done. There’s usually several veterinarians in every state that do it. So if you have a white breed, you may want to find a veterinarian that can do this. Clapping your hands or dropping your keys behind the puppy is not a hearing test.

Puppies Legs

Puppies should have four normal limbs. I have seen a number of puppies born that are born with their feet rotated almost to the point that their footpads are pointing the wrong direction. But within two or three days, their legs are rotated back and the feet are going in the right direction. Do not euthanize these puppies. Do not get excited about it. Just realize that this is not uncommon. A lot of people do some massage and some physical therapy, kind of flexing and extending the legs. I’ve been told by the bulldog people that puppies born with this kind of a rear have the best rear. That’s a matter of personal preference. But do not give up on these guys because they frequently self-correct.

Syringe Feeding Puppy

It’s very important that you have the ability to syringe or tube feed a puppy. Don’t forget that you can syringe feed a puppy, I like using the Miracle Nipple. So if the puppy’s temperature is 96º or above and the puppy is not getting enough nursing at the nipple for whatever reason, whether mom can’t do it or whatever happens, make sure that you’re feeding these guys. Syringe and tube feeding is a very important tool if you have puppies that are not gaining the way that they should be.

ENS Puppy

What is ENS? ENS is the “super dog” program. It was popularized by Carmen Battaglia. It does create stronger cardiovascular performance, stronger heartbeats, stronger adrenal glands, more tolerance to stress and greater resistance to disease. What is it? Well, it’s a series of five exercises, some people have thrown in a sixth one where they let them have a variety of different smells just for variety. So it takes 30 seconds or less a day per puppy. You do it once a day from day three, to day 16 after birth. Step one is holding the head directly above their hips. So you count to five-1001, 1002, 1003, 1004, 1005. Step two is to hold the puppy head down, not swing it, but just to steadily move it, head down, hold it for 5 seconds. The next step is to hold the puppy on the back for 5 seconds. The step after that is to put the puppy on a cold, wet towel. Then tactile stimulation on the bottom of the foot with a Q-Tip. So it’s five steps. It’s very simple to do. Simple, easy to do. I’ve had lots of kids that are really great at doing this for their family’s breeding program, and I will tell you, it makes a huge difference in this puppy’s ability to tolerate things as they grow up. The veterinary visits, their socialization, their social skills are much better. It’s super easy and the people that start doing this absolutely, positively swear by it.

Should I Remove My Puppies Dew Claws?

Yes, you need to get a puppy’s dew claws clipped most of the time. There’s a lot of people who are not removing the claws surgically anymore. Some of the breeds that we’re doing tails on, they’re still doing some or not. My corgis, we still take them off. My farm dogs, we don’t. There’s a lot of variation out there. Some people take them off at 3 to 5 days of age, other people leave them on. But if they are left on, you must keep them trimmed so that they don’t end up growing and causing problems into the footpad.

Canine Herpes in Puppies

Does a puppy get canine herpes if the mom has an outbreak? The answer is probably yes, the puppy will get it. It can be so severe that the puppy dies in utero. Canine herpes can be something that’s contagious to the puppies up to three weeks of age. So herpes is typically thought of as an upper respiratory disease in the adult dog that does not cause serious disease. But in the puppy, either prior to birth or shortly after birth, can be a fatal disease. So there’s really not a good treatment for it. Treatment essentially is keeping the puppies ultra-warm at 98 to 100 degrees rectal, and administering plasma with the hopes of overcoming the herpes virus. It’s a tough disease.

Written by: Marty Greer, DVM

Director of Veterinary Services

Marty Greer, Doctor of Veterinary Medicine, has 40+ years’ experience in veterinary medicine, with special interests in canine reproduction and pediatrics. She received her Doctor of Veterinary Medicine from Iowa State University in 1981. She’s served as Revival’s Director of Veterinary Services since 2019. In 2023, Dr. Greer was named the Westminster Kennel Club Veterinarian of the Year.

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