By: Carol Keen
The following is a combination of well used information. I have added my own comments and recommendations to this page in order to help puppy owners understand this issue more clearly.
Toy breed dogs are susceptible to stress, which can cause a condition of low blood sugar, called hypoglycemia. Puppies under 10 weeks of age are more prone to get hypoglycemia. In small breed puppies from post-weaning to 4 months of age, the most common form of hypoglycemia is called Transient Juvenile Hypoglycemia: "Transient" because the symptoms can be reversed by eating; "Juvenile" because it is seen in young individuals. Sugar crashes can also occur in any dog that says small. They are often called "teacups", even though this term is misleading. For example a Pom growing up to be 2-3 pound is much more prone to sugar crashes than a Pom who is growing up to be 5 pounds or more. This fact holds true for other toy breed dogs as well.
Glucose is the "simple" sugar that the body uses for "fuel" to run its various functions. Table sugar, or sucrose, is made up of two simple sugars, glucose and fructose, and can be broken down rapidly after eating. All sugars are carbohydrates. Grains are also carbohydrates but are considered "complex" carbohydrates because they have many more components and take longer to be broken down. The body uses glucose as its primary energy source. All the parts of the body except the brain can, if needed, use alternate energy sources--fatty acids, for example, which the body accesses by breaking down fat stores.
The brain, however, is completely dependent upon glucose to function. If the glucose in the blood is lower than normal, the brain function is the first to show signs. In dogs, these signs may be seen as weakness, behavior changes, confusion, wobbly gait, or even seizures. In fact, in young dogs that have had what may appear to be an epileptic seizure, low blood sugar is generally ruled out before a diagnosis of epilepsy is made. Why are small breeds different? Puppies of very small size and toy breeds of dogs have characteristics that make them more prone to the development of Transient Juvenile Hypoglycemia, which is brought on by fasting.
Pups of any breed are more likely to develop hypoglycemia than adults are, because their skeletal muscle mass and liver size are smaller and brain size, larger, in proportion to the rest of their body. Therefore, there is less glucose being put out into the blood and more being used by the brain, which is dependent upon adequate glucose in order to function. In small and toy breeds, this discrepancy is more pronounced. Even a brief period of fasting in a toy breed puppy can trigger a hypoglycemic "attack."
The first signs are those of listlessness and depression. They are followed by muscular weakness, tremors, (especially in the facial muscles) and later convulsions, coma and death. The entire sequence is not always seen. The dog may simply appear to be depressed or he may be weak, wobbly and jerky or may be found in a coma.
Sugar crashes can occur without warning when a puppy is placed in a new home, or while being shipped. It can happen after a puppy misses a meal, chills, becomes exhausted after too much playing, or has a digestive upset. It can also occur as a reaction to vaccines. The upsets places an added strain on the energy reserves of the liver and brings on the symptoms. Again, an attack may appear as the pup just being tired, or very sleepy. They can have weakness, confusion, wobbly gait, or seizures. If your puppy is lethargic, listless, or not interested in eating, stress and low blood sugar may be the cause. Eating food that is readily digested and metabolized will reverse minor signs, but intravenous glucose administration is required for severe cases. Puppies with Transient Juvenile Hypoglycemia have normal liver size and function, but inadequate glucose precursors or glucose in its stored form. Therefore, any significant stress, such as a routine trip to the vet’s, which occurs in the absence of a recent meal, can cause the blood sugar to drop to dangerously low levels.
Low environmental temperatures, infections, vaccinations, strenuous exercise, worming, and inadequate nutrition increase the risk even further. Feeding recommendations for puppies at risk for hypoglycemia include frequent (4 - 5 times a day) feedings of high-carbohydrate, high-protein and /or high-fat foods. Normal feeding schedules will be 3-4 times per day. Our puppies are free fed, meaning that food always available. Make sure that water is available at all times! Stress and hypoglycemia can cause dehydration and can lead to death.
Treatment is directed in restoring blood levels of glucose. Begin at once! If you aren't sure call your breeder, and or your vet! Prolong or repeated attacks can cause permanent damage to the brain. If the puppy is awake, give the puppy karo syrup or honey by the mouth is the fastest way to bring them back at the time. It is not the only thing you need to do!
If your puppy shows signs of stress, you can use a quick remedy for this: If he/she will drink the fluids on his own, allow him to do so, but you want to get honey in the puppy quickly! Depending on the size of the pup it can be from 1-3 cc's of honey. The puppy will begin to improve within 30 minutes or less. If the puppy is unconscious, it will need to be raced to the vet immediately to be given Dextrose intravenously. It may be necessary to treat for swelling of the brain. If puppy won't drink on his/her own rub a little bit of honey on their gums.
The harder part is that after a sugar crash, regardless of the cause, puppies are then prone to not wanting to eat for up to two weeks or so. They can easily eat one meal, and refuse to eat later. It is almost like they blame the food for them having felt bad in the first place. If you are dealing with this you will be force feeding your puppy for a week or more. You probably will need the help of your breeder, and possibly your vet if you are in need of a person who can show you how to syringe feed if it is necessary. Baby food is also very helpful once you have the main crash stopped, and gel based probiotics are very important! If this happens on my watch, then that baby will not be leaving me until he or she is 120% at themselves. I will not risk you having to deal with this if I can prevent it or deal with it instead of you. Fortunately, it is rare for my babies to go through this. The stress of weaning and relocation is their most vulnerable time. The tiny Poms are the ones who are most at risk over all.
Once a sugar crash has started, and you start treating them, the glucose readings can be off when they are tested. A sugar crash also opens up the gut so that the bacteria and things that are suppose to be inside the gut get out into the blood stream. This drop in their immunity opens them up to catch any and everything they have been exposed to, including virus from their immunization shots.
PREVENT!!! The goal is to just stop sugar crashes before they ever start! The product I know require for all my babies is known to reduce and even eliminate sugar crashes by boosting the immune system to the point that crashes are completely avoided. Please read this page on NuVet Immune Boost information. This is a priority product!
Hypoglycemia is normally totally preventable, but if no action is taken and/or the signs are not noticed, Hypoglycemia can be deadly. Hypoglycemia is not covered in any of my contracts, or health guarantee. Why? Because it is preventable and easily treated if you have the knowledge and you act! If a pup ever has a reaction after a vaccine, then they will need Benadryl with every shot thereafter to avoid reactions.
Be *SURE* that your puppy eats and drinks regularly. Do not ever just assume that he or she ate! You must know it for a *fact*! Again, I am going to stress that if you think your puppy has or is having a sugar crash then call me!!! There is *no reason whatsoever* to put your puppy or you through this when help is a phone call away! Many times much heartache can be avoided by just listening and trusting the person you trusted enough to obtain living creature from. If you have questions do not hesitate to contact me!
Here is to happy, healthy, safe puppies! Carol :)