Important Tips to Caring for an Orphaned or Sick Puppy

An orphan is a newborn puppy without a female parent or dam. The maternal instinct is one of the strongest in nature, but pups can become orphaned as the result of a variety of circumstances, such as death or illness of the dam, or the inability of the dam to produce sufficient amounts of good quality milk. A canine mother may abandon her litter as part of the natural selection process of weeding out sickly puppies, or due to a lack of bonding with her litter. In any of these cases, the pups will need someone to take over their care if they are to have a chance of survival.

The Normal Puppy

Newborn puppies should be sleek and round with good muscle tone and pink mucous membranes. The primary activities of puppies are suckling and sleeping. Birth weights range from 100 to 750 g depending upon breed and body weight should double in first 8 to 10 days. Heart rates are 230 to 240 beats/minute for the first 2 weeks. Normal respiratory rates are 15 to 35 breaths/minute. Normal rectal temperature at birth is 96 to 97 degrees F, which gradually increases to 100 degrees F by four weeks of age.

Common Problems with Orphaned Puppies 

The most common causes of sickness, and sometimes death, for neonatal puppies are hypoglycemia, dehydration and hypothermia. Call your veterinarian if your pup does not double its weight in 8 to 10 days or frequently cries for more than 20 minutes. These are both abnormal and usually indicate a problem of hunger, cold, maternal neglect or illness.

What to Watch For

Signs of problems with orphaned puppies may include: 

Persistent crying

Failure to gain weight

Decreased activity

Decreased muscle tone

Diagnosis of Orphaned Puppy Problems

To be certain the puppy is in good health, your veterinarian may recommend the following diagnostic tests:

Complete medical history and thorough physical examination, weight and vital signs (temperature, pulse and respiratory rate)

Blood glucose tests

Further blood work on neonates is often not done initially because response to immediate treatment is usually positive.

Treatment and Care of Orphaned Puppy Problems

Treatments will depend on the findings of the diagnostic exam. These treatments revive most neonates within a few hours, but if the puppy is not revived, then additional diagnostics may be performed. Your veterinarian may perform the following:

Slowly raise the puppy’s body temperature to normal if the puppy is hypothermic.

Administer dextrose (sugar solution) if the puppy is hypoglycemic.

Administer fluids subcutaneously (under the skin) to correct dehydration.

To provide nutrition, tube-feed the puppy a warmed milk replacement formula.

Home Care of Orphaned Puppies

Maintain a log (record) identifying each puppy’s weight, appetite, amount of formula fed and urination and defecation frequency. It is important to identify each puppy if there is more than one because they can be difficult to differentiate.

Tips for Feeding Orphaned Puppies

Puppies may be fed by bottle or stomach tube. The stomach tube is faster and especially handy with large litters. Many people, however, prefer to bottle-feed. Feeding with an eyedropper should be discouraged due to poor accuracy, tendency to give food too rapidly (increasing risk of aspiration) and the rigid nature of an eyedropper, which can cause soft tissue injury to the oral cavity. A bottle might be best.Newborn puppies should be fed 4 times daily by tube feeding or 5 to 6 times daily by bottle-feeding 4 times daily by tube feeding or 5 to 6 times daily by bottle-feeding. At 2 weeks of age, four feedings per day are usually sufficient. It is preferred to feed small amounts at frequent intervals rather than large quantities infrequently to prevent diarrhea and lower the risk of aspiration. Overfeeding can be worse than slightly underfeeding.
The recommended daily feeding amount is based upon weight and age (most milk replacers contain 1 kcal/ml). This amount of milk should be divided into at least 4 feedings per day:

Week 1: 13 to 15 ml per 100 g body weight
Week 2: 15 to 18 ml per 100 g body weight
Week 3: 20 ml per 100 g body weight
Week 4: 20 ml per 100 g body weight and also eating mostly solid food

Recommended milk products:

Milk from another nursing bitch (foster mother if possible)

Esbilac Powder or Liquid (Pet-Ag, Inc)

Canine Milk Substitute (Waltham)

Unilact Liquid or Powder (Upjohn Company)

Bitch’s Milk Replacer (Iams)

The puppy should be burped after a meal to relieve swallowed air. Hold the puppy in the palm and gently rock back and forth or massage the abdomen until an air bubble comes up.

The puppy should be stimulated to urinate and defecate after feeding. Simulating the licking mother by rubbing the urogenital area with a moist warm cloth or cotton ball can do this. Puppies should be able to relieve themselves after three weeks of age.

By three weeks of age, introduce solid foods mixed with water or the same milk replacer used to feed previously. Pan-feed a thin gruel made by blending an approved puppy food with the milk formula (e.g. 1 part dry food with 3 parts formula or 2 parts canned food with 1 part formula). Gradually thicken the gruel using less liquid until about six weeks of age. At this time, the pups should be offered an approved puppy food 4 times daily. Fresh clean water should always be available and replenished daily.

Supplies to Have On Hand for Orphaned Pups

Thermometer

Puppy nursers or tube

Feeding kits

Gram scale for weighing puppies

Soft blankets and heating pads

Common Causes of Illness in Newborn Puppies

The most common causes of sickness, and sometimes death, for neonatal puppies are hypothermia, dehydration, and hypoglycemia.

Hypothermia. Neonates cannot control their body temperature well during the first 4 weeks of life and are dependent upon staying close to the dam, huddling with littermates or an environmental heat for warmth. Immediate environmental temperature of orphans should be 84 to 90 degrees F during the first week and 79 to 84 degrees F during the second week. Immediate environmental temperature of litters should be 75 to 81 degrees F during the first week. Their shivering reflex does not develop until 6 to 8 days old. Therefore, orphaned neonates are highly susceptible to hypothermia, and with a fall in body temperature and decreased ability to suckle or cry, circulatory failure and death may result.

Dehydration. Body water content of neonates is 8 percent at birth and their water requirement is 60 to 100 ml (cc) per pound of body weight per day. If the pup has not nursed or received a milk substitute within hours of birth, dehydration becomes apparent within 12 to 18 hours. Again, circulatory failure and death may result from dehydration.

Hypoglycemia. Neonates should receive colostrum from the dam within 12 to 16 hours of birth. Commercial milk replacers with a similar composition to bitch’s milk and those that have been tested in puppies should be fed to orphaned puppies. Most milk replacers contain 1 kcal/ml (cc) and most neonates require 24 kcal/100 g of body weight per day.

Other possible illnesses in orphan puppies can include: pneumonia, early placental insufficiency, induced hypothermia, infectious diseases, drug toxicity, congenital abnormalities, abnormally low birth weights, traumatic insults during or after the birth process, parasites, placental infections, neonatal isoerythrolysis and undetermined causes.

Instructions for Feeding Orphaned Puppies

The two most common methods for feeding sick or orphaned puppies are bottle feeding and tube feeding. Below is information and instructions on how to bottle feed or tube feed a puppy. 

Bottle Feeding Puppies

Puppies may be fed by bottle or stomach tube, but not with an eyedropper. Many people prefer to bottle feed puppies with a vigorous suckle reflex because they will suck until they are satiated and reject the bottle when full. Bottle-fed puppies require an appropriately-sized bottle and nipple, so avoid sizes that could be swallowed. Nipple bottles made for feeding orphans (or infant preemies) work well.

Ensure the nipple hole is properly sized to allow proper flow. A hole too large can cause gagging, drooling of milk from the corners of the mouth, and an increased risk of aspiration (inhalation). A hole too small requires extra time and energy to consume a meal, which may cause fatigue. When bottle is inverted, milk should ooze. The nipple hole can be enlarged with a hot razor blade by making a horizontal slit, allowing the neonate to suckle easily.

The bottle should be inverted, a drop of milk squeezed onto the nipple and then the bottle should be gently placed in the mouth. Puppies should be held horizontally with the head in a natural position. The milk should be sucked and not squeezed out of the bottle into the mouth. Great caution should be taken because if done in haste this may cause aspiration, pneumonia and death.

Tube Feeding Puppies 

Tube feeding is faster and especially handy with large litters. Tube feeding is useful in puppies less than 10 days of age, those that are weak or those with poor suckle reflexes. The tube feeding procedure uses a soft, rubber, feeding tube. Use a # 5 French feeding tube for puppies weighing less than 300 grams or a # 8 to 10 French feeding tube for puppies greater than 300 grams. An equivalent-sized soft rubber urethral catheter can also be used.

The tube should be pre-measured from the tip of the mouth to the last rib. Re-measuring is essential for as the neonates grow as the distance will increase. The puppy should be positioned horizontally with head in a normal position. The tube can be moistened with water for lubrication, inserted into the mouth and gently pushed into the stomach. The tube should go easily to the mark. If the tube does not go easily, it may be in the trachea and the tube should be removed and reinserted.

Attach the tube to a syringe preloaded with milk formula. Ensure that there are no air bubbles in the syringe. The meal should be given slowly over 2 minutes. If you notice any resistance to feeding, the stomach may be full. Stop feeding and wait until the next feeding to give additional formula.

Regurgitation is infrequent, but if it occurs, stop feeding and wait until the next feeding to give additional formula.

Newborn puppies should be fed 4 times daily by tube feeding or 5 to 6 times daily by bottle-feeding. At two weeks of age, 4 feedings per day are usually sufficient. It is best to feed small amounts at frequent intervals, rather than large quantities infrequently, to prevent diarrhea and lower the risk of aspiration. Overfeeding can be worse than slightly underfeeding.

Follow all manufacturers directions on formula preparations. Refrigerate milk formula between meals but warm to approximately 100 degrees F before feeding. Prepare only a 48-hour supply of formula at a time.

Cold milk, rapid feeding and overfeeding cause regurgitation, bloating, diarrhea and/or aspiration. Formula, both liquid and powdered forms, should contain 12-15% total solids (12 to 15 g/100 ml water). Greater total solid values cause diarrhea and bloating whereas lower values may lead to volume overload before the animal’s nutritional requirements are met.

Milk replacers consist of water, sugar, fat, proteins, minerals and vitamins. The composition of dam’s milk differs with species and even the stage of lactation. However, the composition of puppy milk replacers is the average nutrient profile based on available research. Avoid feeding cow’s or goat’s milk to puppies because the lower protein and higher lactose content make them poor substitutes. If feeding problems occur, reduce volume and/or total solids in the milk replacer, then re-feed at required rate after problems have been resolved.

See your veterinarian for additional information and recommendations.

In-depth Care for Orphaned Puppies – Diagnostic Tests

Veterinary care should include diagnostic tests to help determine the health of the puppy and guide subsequent recommendations. Diagnostic tests may include:

Physical exam. A thorough physical examination of the puppy, and dam if possible, in the presentation of any “fading puppy.” The exam should rule out a cleft palate, cranial deformities, cardiac abnormalities and illnesses. The dam should be examined for adequate (quantity and quality) milk production and infections.

Blood tests. Blood work on neonates is often not done initially because response to immediate treatment is usually positive and it can be difficult obtaining a sufficient amount of blood from a sick neonate. However, if a small amount of blood can be obtained, serum glucose, total protein and blood urea levels can be assessed.

Additional diagnostic tests may be recommended on an individual basis:

A complete blood cell count to evaluate red and white blood cell numbers (to look for signs of infection, anemia and dehydration)

Serum protein levels to provide information concerning the presence or absence of infection, anemia and dehydration

Radiographs to evaluate internal organ or skeletal abnormalities

Serum profile to evaluate internal organ function (liver, kidney, heart)

Treatment and Care In-depth for Orphaned Pups

Body temperature. Raise the body temperature slowly to normal if the puppy is hypothermic. Incubators, hot water bottles and heat lamps can be used to maintain an immediate environmental temperature of 84 to 90 degrees F. Rectal temperature should be taken to monitor body temperature and avoid overheating. Maintaining the humidity around 50% will minimize water loss and dehydration.

Fluid therapy. Administer fluids subcutaneously (under the skin) to correct dehydration. Often it is difficult to catheterize a vein in a dehydrated neonate, so a physiologic replacement fluid can be first given subcutaneously to re-hydrate the puppy. Giving 2-5% of body weight (2 to 5 ml (cc) fluid/100 g BW) may be sufficient to revive the puppy. If not, this dose can be repeated.

Nutrition. To provide nutrition, feed the puppy a warmed milk replacement formula. Feeding puppies raises body temperature and provides fluid and energy substrates for normal metabolism. A cold, comatose puppy should not be tube-fed until corrections of a low body temperature and dehydration have been resolved. Milk will remain in the stomach of cold, comatose puppies. Proper gastrointestinal function requires near-normal body temperature and fluid balance.

These treatments revive most neonates within a few hours. If the puppy is not revived, then additional diagnostics may be performed to determine if the puppy has congenital abnormalities, infections or other illnesses.