HYPOGLYCEMIA  (or low blood sugar) CAN BE DEADLY if left untreated. Tiny dogs are notoriously vulnerable to the condition (especially when young puppies go to their new homes) because they do not have an adequate supply of internal fat to maintain a constant **blood sugar level. Hypoglycemic episodes can happen at any time, to any pup, but they tend to happen most frequently in times of stress, illness, infection, or the most common, simply going too long without eating. Sometimes new owners may take for granted that a puppy has eaten, or has eaten enough, or they may forget to monitor a pup's food intake. It is IMPERATIVE that puppies eat regularly and that food is offered food at least 4-5 times a day, until a pattern and routine is established. A puppy does not need to eat a LOT at each feeding, but it NEEDS to eat; depending on the size of the puppy, a few teaspoons should satisfy a puppy, but he/she MUST eat.  Make sure your new puppy has food available at all times, or is offered food several times (at least 4-5 times) throughout the day for the first few weeks. Always keep Karo syrup or NutraCal on hand in case of an emergency. Plain white sugar dissolved in warm tap water (highly concentrated) will work as well to quickly boost the low blood sugar. Honey may also work, but you're after the high calorie and sugar content for immediate care.

Some signs to look for if you think you may be witnessing a hypoglycemic episode, or "sugar crash", are vomiting, lethargy, weakness and unresponsiveness. One of the first signs that your pup may be hungry and heading towards a sugar crash may be the presence of white and/or yellow foamy vomit (commonly referred to as 'hunger pukes'). This will usually occur in small quantities and may happen just once or twice or become more frequent to many times. If this happens,  you should immediately attempt to feed the puppy, as the puppy is HUNGRY and instinctively trying to regurgitate a previous meal for sustenance. For small puppies, this is your FIRST warning to take IMMEDIATE action. You must either get food into the puppy ASAP and/or supply the puppy with a calorie rich substitute, including NutraCal, STAT, DYNE or any other product advertised as a high calorie nutritional supplement. At the very least, use sugar water honey or Karo Syrup. Additional signs your puppy may be experiencing a hypoglycemic episode may include staggering, lazy eyes (meaning more of the whites of the eyes are visible than normal and the eyes are slow to follow or focus and you may witness squinting or partially opened eyes), unsteadiness, weakness, bobbing head, lethargy, awkward whining. If left untreated, this condition will lead to unresponsiveness and seizures and DEATH. THIS IS AN EMERGENCY AND YOU MUST ACT QUICKLY! You MUST get sugar into the pup's mouth. Simply cover a fingertip in Karo syrup or NutraCal and get it into the dog's mouth, rubbing into gums. You may need to pry the mouth open if he will not lap it up on his own (this is very common). Once he starts to respond, he should start to lap some water on his own and come around fairly quickly, depending how low the sugar/glucose level was. It may take several hours for the puppy to return to normal, but he/she should rebound to responsive relatively quickly. Continue to administer small amounts of Karo, sugar water, etc. until the puppy seems to be alert and aware and has returned to a normal activity level. It may be necessary to continue administering small amounts of sugar product until the sugar level stabilizes in the puppy. (**A glucose monitor can be used to evaluate levels if you have access to one.) When the pup comes around and is receptive to your actions, make sure the pup starts eating adequately!   If the pup continues to refuse food or won't eat on his or her own and is remaining lethargic and weak for several hours...YOU MUST SEEK VETERINARY CARE. This is YOUR responsibility and is of NO fault of the breeder. If your puppy winds up being admitted to a veterinary hospital due to this issue, you must be aware that it is incredibly common for secondary infections and issues to develop as a result of the sugar crash, due to the severe reduction and suppression of your pup's normal metabolic activities. Your pup may experience abnormal blood cell counts (anemia), increased viral and bacterial loads and even possible respiratory infections and liver issues. BE AWARE these are INCREDIBLY common side effects resulting from a sugar crash. They did not CAUSE the sugar crash, but are the direct results of one. The breeder is in NO way responsible for the crash nor any issues arising from one. This is the OWNER'S responsibility to identify and remedy. If an owner allows the pup to throw up for several hours and does not intercede, the outcome will be grave.

Once the pup has rebounded, you can offer plain yogurt, egg yolks, meat, baby foods, raw or boiled chicken or beef, bits of raw liver...anything to stimulate his an appetite. I find most puppies, after having a severe sugar crash, are highly motivated by raw chicken, beef, liver...something that triggers the back of the brain (instinctively) to eat as it would in nature. Do not just feed sizable quantiles of all meat though, this will cause diarrhea and soft poops. The pup will also need fiber. I find using a mallet of some time to break up small pieces of raw chicken cartilage and bones work GREAT! Not sure what or how to do it, CALL ME! 

**Normal blood glucose levels in healthy dogs are 80-120 milligrams per decilitre (mg/dl).  

The breeder is in NO WAY responsible for ANY issues or veterinary expenses resulting from hypoglycemia after pick up/delivery.