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Ensuring the Health of Newborn Puppies: Managing the 4Hs

Newborn puppies are particularly vulnerable to illness and death in the early stages of life. Four critical factors, referred to as the 4Hs—Hypothermia, Hypoglycemia, Hydration, and Hypoxia—are essential to monitor and manage to ensure the survival and well-being of the pups.

Hypothermia in Newborn Puppies

Hypothermia, or low body temperature, significantly increases the risk of death in newborn puppies. Puppies cannot regulate their body temperature effectively until they are about three weeks old. To prevent hypothermia:

  • Room temperature: Maintain at 75°F.

  • Surface temperature: Maintain between 90°F to 95°F.

  • Rectal temperature: Should be 94°F to 96°F for the first 24 hours and 96°F to 98°F for the first week.

Use a rectal thermometer and weather station to monitor temperature and humidity. Avoid feeding until the puppy has maintained an appropriate rectal temperature for one hour. Instead of heat lamps, which can cause dehydration, use an incubator to provide precise warming for hypothermic pups.

Hypoglycemia in Puppies

Hypoglycemia, or low blood sugar, occurs when puppies do not receive adequate nutrition or expend too many calories staying warm and moving. Puppies with glucose levels below 90 mg/dl are at higher risk of death. To manage hypoglycemia:

  • Use a glucometer to check glucose levels.

  • Increase calorie intake through tube or bottle feeding.

  • Administer glucose orally or by IV if needed.

Ensure glucose levels are 90 mg/dl or higher within the first 24 to 48 hours of life.

Hydration for Puppies

Proper hydration is crucial for newborn puppies. Dehydration, typically resulting from inadequate milk intake, can be assessed by monitoring urine color. Manage hydration by:

  • Encouraging nursing.

  • Providing bottle or tube feeding.

  • Administering fluids subcutaneously if necessary.

Electrolytes can help rehydrate puppies, especially those experiencing vomiting or diarrhea.

Hypoxia in Newborn Puppies

Hypoxia, or low blood oxygen, can be managed by using an oxygen chamber. Increasing the oxygen concentration in the pup’s environment enhances survival chances. Options include:

  • Oxygen tank: Provides 100% oxygen.

  • Oxygen concentrator: Provides 95% oxygen.

  • Room air: Contains 20% oxygen.

Hypoxic puppies, identified by blue or gray gums and difficulty breathing, benefit from increased oxygen until they can breathe adequately on their own.

Additional Tools and Tips

  • Pulse oximeters: Measure oxygen levels in the blood through a clip on the toes or lip, useful for assessing both newborn and adult dogs during respiratory distress or anesthesia.

  • Sanitation: Ensure hands are washed before handling puppies, and all feeding equipment is thoroughly cleaned and sanitized.

  • Feeding Practices: Avoid overfeeding to prevent diarrhea and sudden death. Monitor the puppies’ stomach distension and adjust feeding volumes as necessary.

  • Temperature of Milk Replacer: Warm the formula to 100°F and always check the temperature on your wrist before feeding to avoid burns.

Contact Information

For additional guidance on caring for newborn puppies, visit

By carefully monitoring and managing these critical health parameters, you can significantly improve the chances of survival and health for your newborn puppies.

Newborn Puppies
Newborn Puppies


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