Hypoglycemia, (the medical term for low blood sugar) is a condition resulting in a drastic, sudden drop in the level of blood sugar in puppies.  It is a puppy problem most often seen in toy breed puppies. Hypoglycemia is usually found in tiny yorkies or under weight puppies brought on by poor diet, lack of food consumption, stress, infections or parasites in some form. Hypoglycemia usually occurs in puppies from 2 to 5 months of age but CAN occur in mature toy breeds when they are subjected to STRESS.

A yorkie puppy will appear limp and lifeless. The gums and tongue will lack pink pigment. Often the eyes are unfocused and unresponsive. Temperature will drop below normal, the puppy could be shivering and trembling in the early stages. As condition worsens, puppies either go into a coma or convulsions.

Signs are weakness, confusion, wobbly gait, frothing or drooling, possible seizure. Gums will be tacky and appear pale, a grayish white in color rather than a healthy bright pink. Yorkie puppies can go into shock if not cared for properly and promptly.

Causes

1) Over-handling young puppies, not allowing them enough rest and sleep. 2) Puppy refuses to eat for over a period of 8 hours. 3) Change of home environment and or food. 4) Any related stress due to travel - trips to the vet, groomers (regular outings should be limited until five to six months of age). 5) Exposure to low room temperatures for a period of time. 6) Bacterial Infections, *coccidosis or intestinal parasites *Coccidia is a protozoan infection that many puppies and adult dogs carry that usually remains dormant until stressful situations arise. A puppy or adult under stress may lose their appetite, not ingesting the needed daily nutrition. This weakens the puppy’s natural immune system allowing Coccidia to rapidly multiply in the intestinal track which if left untreated can cause serious illness and trigger hypoglycemia. 7) Poor diet

NOTE: a puppy should sleep 80% of the day without being disturbed, never wake a sleeping puppy, puppies need a regular schedule of rest, meals, play and potty. Never give a baby puppy full run of your home, they will forget where their food and water is located; It is always recommended to confine them in a small area (example; kitchen and family room until they learn their way around memorizing where their food source, water and pee pads are located)

Hypoglycemia is usually first triggered by yorkie puppies not eating or not being offered palatable or high calorie food. Any significant stress, such as change in homes, a routine trip to the vet's, daily outings, absence of a recent meal, lack of rest or improper nutrition can cause the blood sugar to drop to dangerously low levels. Because of their tiny size Yorkshire Terrier puppies cannot ingest enough in one to two feedings a day; yorkie puppies should be fed several times a day a high quality diet.

Low environmental temperatures, infections, parasites, vaccinations, strenuous exercise such as being "played with" by young children who do not allow the puppy adequate rest time, inadequate nutrition increase the risk even further.

Treatment

The level of the blood sugar must be raised at once and the stress condition treated. Nutri-Drops 1/4 cc per lb or Nutrical should be administered immediately (do not repeat Nutri-Drops they are fast acting drops that will last for 12 hours). If your using Nutrical place about 2" on your finger and wipe it on the roof of the mouth or tongue, repeat in 10 min intervals if needed.  In a pinch white Karo syrup or honey, rubbed on the tongue and roof of the mouth several times over a hour will combat the first symptoms once alert and active feed wet food or baby rice cereal mixed with baby food and a bit of karo mixed. Do not combine any of the above! Always make fresh water available.

Warmth is essential, puppies in the progressive stages of hypoglycemia rapidly loses body temperature. A temperature that falls below 96 degrees usual result is coma. The increase in sugar (Nutrical, Nutri-Drops or Karo) and feeding will begin to raise the puppy's temperature, once fed wrap the puppy in a fleece blanket or use a heating pad. Keep the puppy warm and calm until fully recovered.

Feeding recommendations for yorkie puppies at risk for hypoglycemia include: frequent (4-5 times a day) feedings of high-carbohydrate, high-protein and or fatty foods. Feeding soft moist foods may help prevent a hypoglycemia attack due to the high sugar content. As a preventative add 1 tsp. white Karo syrup to warm water, allow this to be their daily drinking water.

Hypoglycemia usually affects tiny pups, under weight puppies, puppies weaned too early or placed before 12 weeks, most outgrow it at 4 - 6 months of age. Puppies with estimated adult weight under 4 lbs are at higher risk of occurrence and may have several episodes throughout their lifetime. Always pay careful attention to the diet of any TINY TOY DOG.

Suggested things to have on hand
We prefer Nurti-Drops (only available online - Nurti-Drops ordering ) over Nutrical (available at Petsmart or Petco)
White Karo Syrup
Chicken or beef puréed baby food
Baby rice cereal
Pedialyte or Rebound - for dehydration
Heating pad