FADING PUPPY SYNDROME 

 


The first few weeks of a puppy’s life are crucial. Puppies are fragile and they rely completely on their mother for nutrition as well as social requirements. Puppies that do not survive the first few weeks are afflicted with “fading puppy syndrome” and are called “faders.” About 20 to 40 percent of all puppies born do not survive past 12 weeks of age. 

Causes of puppy death in the first 12 weeks of life are generally linked to problems developed while in the uterus, problems associated with the birth process or problems around the time of weaning. 

Uterine Development Problems
Birth defects, which include both genetic as well as drug or environmental causes, account for a large number of fading puppies. The easiest birth defect to detect is malformation of the head, limbs, genital or anal area as well as a cleft palate. After birth, thorough examination of the puppy, including examination of the roof of the mouth, can help pick up on any potentially fatal birth defects. Pregnant dogs that are fed a low quality diet have a higher incidence of fading puppies. The puppies are often born weak, diseased and underweight. In very large litters, some puppies suffer from uterine malnutrition due to competition between other developing feti.

Birth Process Problems
The delivery process can be quite traumatic for both the bitch and the puppies. Extended labour and difficulty passing the puppy can result in potentially fatal traumatic injuries. Cannibalism at the time of delivery can also occur, leading to puppy death. Neglect of the newborn either due to a nervous, highung new mother or due to illness usually results in early puppy death.

Weaning Problems
Problems during nursing and weaning that can cause puppy death include various bacterial and viral infectious diseases, as well as parasites. Parvovirus and herpes virus are primary culprits in puppy death between the ages of 2 to 12 weeks. Staphylococcus and streptococcus bacterial infections also play a significant role in the early demise of some puppies.


Diagnosing Fading Puppy Syndrome
Puppies that do not survive beyond 12 weeks of age are generally diagnosed with fading puppy syndrome. These puppies can slowly deteriorate, stop nursing, and become profoundly weak and thin. The exact cause of the fading puppy is usually not determined. If more than 20 percent of the litter is affected, submitting a recently expired puppy for post mortem examination to determine the cause of death may be helpful in preventing additional puppy losses.

Treatment
Finding the cause of the fading puppy syndrome helps to determine if any treatment is possible. Birth defects and severe traumas are difficult to treat with a good outcome. Bacterial and viral infections can be treated, and with aggressive care, some of these puppies can survive. Expect your veterinarian to recommend hospitalisation, injectable fluid support, antibiotics and assisted feedings. If the puppy does not survive, post mortem examination in order to help the remaining litter is recommended.

Home Care
Early detection of fading puppy syndrome is essential. Thorough exam at the time of birth to detect any developmental defects is important. Daily weights are also crucial in monitoring the puppy’s development. Make sure the bitch is fed a high quality pregnancy diet and then a high quality nursing diet. Monitor the puppies closely for signs of trauma, cannibalism, weakness or neglect. Prompt veterinary attention for those suspect puppies is necessary.

Preventative Care
Certain numbers of puppy losses are unavoidable. Feeding the bitch a high quality pregnancy diet and keeping her quite and calm can help. Detecting early signs of fading puppy syndrome with prompt veterinary care can help reduce the number of puppy deaths. 



By PetPlace Veterinarians


NEONATAL MORTALITY

AND FADING PUPPY SYNDROME 

What are neonatal mortality and fading puppy syndrome? 
Neonatal mortality is the death of a puppy or kitten from the time of birth until it is 2 weeks of age. Fading puppy or kitten syndrome is the failure of the newborn to grow and thrive; the newborn is a "poor doer." Fading puppy or kitten syndrome may lead to neonatal mortality. 

What causes neonatal mortality and fading puppy syndrome? 
The causes of neonatal mortality and fading puppy or kitten syndrome are divided into two main categories, non-infectious causes and infectious causes. They include:

Non-infectious causes: 

  • Mother dog (bitch) or mother cat (queen) associated problems, such as difficult birth, prolonged labour, trauma, inadequate nutrition, nursing (lactation) disorders, excessive or lack of attention to the litter, or cannibalism

  • Environmental problems, such as extremes of temperature or humidity, poor sanitation, overcrowding, or stress 

  • Nutritional problems in puppies or kittens, such as inadequate or ineffective nursing, low blood sugar (hypoglycaemia), or poor digestion due to low body temperature (hypothermia) 

  • Birth defects 

  • Breakdown of red blood cells in newborn (neonatal isoerythrolysis) 

  • Trauma to the puppy or kitten

Infectious causes: 

  • Viral infections, such as adenovirus, distemper virus, and herpes virus in dogs and calicivirus, feline leukaemia virus (FeLV), herpes virus, and panleukopenia virus in cats 

  • Bacterial infections 

  • Neonatal sepsis, caused by Escherichia coli (E. coli), Streptococcus, or Staphylococcus

  • Respiratory infections, such as Bordetella bronchiseptica (kennel cough) or Pasteurella 

  • Gastrointestinal infections, such as E. coli, Salmonella, or Campylobacter

  • Brucella canis infection (dogs) 

  • Parasite infestation, such as roundworms, hookworms, coccidia, or Giardia 

How are neonatal mortality and fading puppy syndrome diagnosed? 
Neonatal mortality and fading puppy or kitten syndrome are diagnosed by medical history and physical examination. It usually is not possible to obtain blood from a fading puppy or kitten for testing. An examination of the newborn, as soon after death as possible, is extremely important to determine the cause of death. The examination of the newborn's body is a "necropsy" or post-mortem examination. Special consideration is given to evaluating the stomach contents, thymus, urinary bladder contents, and lungs. Any anatomic malformations are identified. Multiple tissue specimens should be submitted to a laboratory for virus isolation, bacterial culture, and microscopic examination. 

How are neonatal mortality and fading puppy syndrome treated? 
The treatment for neonatal mortality and fading puppy or kitten syndrome is directed at the underlying problems. Some puppies and kittens will not survive, no matter how well they are treated. When problems arise with neonatal mortality and fading puppy or kitten syndrome, it is important to identify the cause and to try to eliminate it, thereby protecting the remaining puppies or kittens in the litter. Underlying deficiencies in care, management, and breeding should be corrected as soon as possible. Surviving newborns should be warmed slowly to a temperature of 97°F to 98°F, 36.1°C to 36.6°C over several hours, if necessary. An environmental temperature of 85°F to 95°F, 29.4 °C to 35.0 °C with relative humidity of 55% to 66% should be provided. Oxygen supplementation (30% to 40%) may be necessary. A neonate with a body temperature of less than 94°F, 34.4°C should not be fed until warmed; then it should be encouraged to nurse. Other treatment includes administration of fluids, antibiotics, and vitamin K. In some cases, the pet guardian will need to act as the "foster parent" by keeping the newborn warm, providing formula (milk replacer) with a nursing bottle, and stimulating urination and defecation. The veterinarian will demonstrate care of the newborn and will recommend a formula designed for puppies or kittens. 

What is the prognosis for neonatal mortality and fading puppy syndrome? 
The prognosis (outcome) for litters with neonatal mortality depends on the cause of death. Other puppies or kittens in the litter may be affected and measures need to be taken to try to save the remaining newborns. Whether or not the remaining newborns will be saved depends on the underlying cause and the rapidity with which veterinary attention is sought. The prognosis for puppies or kittens suffering from fading syndrome is guarded to poor. If the body temperature can be maintained, appropriate fluids can be administered, and the nursing and care by the bitch, queen, or pet guardian are adequate, the newborn may be saved. 

 

FADING PUPPY SYNDROME

Quite a few times I have heard “….. she had X puppies, but one (or two) died a few days later”. Has this happened to you? Have you asked yourself why? One of the most common causes of neonatal death is fading puppy syndrome (FPS). This is the name used for a condition found in previously normal puppy which, a few days after birth (5 to 14), stops nursing, gets gradually weaker and literally fades away until it dies.

Different aetiologies have been attributed to FPS but by now it has been proved that both infectious and non-infectious components act in combination. Usually the affected puppies didn’t suck enough Colostrum and therefore are immune-deficient and susceptible to infections. On the other hand, since the adequate intake of colostrum contributes to the postnatal blood volume, a deficiency in this sense may result in circulatory insufficiency and cardio-pulmonar failure. These pups are also more prone to hypothermia and this, in its turn, makes them more susceptible to infection by pathogen germs. Another factor contributing to their weakening is the quick (in more or less 24 hours) consumption of the glycogen (energy) reserves when the puppy doesn’t feed adequately. Is there any possibility of treatment? Yes there is, but don’t you think it’s better being forewarned?

To prevent FPS from happening we have to detect the pup which isn’t feeding enough colostrum while the mucous membrane of the bowel is still permeable for antibodies, and this lasts only 24 - 36 hours. Looking at the pups while they suck is not enough, appearances may be misleading. An adequately feeding puppy has to increase its birth weight 10% after 24 hours of life, or at least maintain it. If, on the contrary, it loses weight, this is because it didn’t feed enough colostrum and it risks suffering FPS. Puppies are weighed for the first time as soon as they are born, after drying them and before putting them to suck. If instead of waiting 24 hours to weigh them, it is done when they are 12 hours old, there are more chances to detect in time the one who is lagging behind and give him the opportunity to feed more while his siblings sleep. As regards weight loss there is one exception, pups born after 58 or 59 day long pregnancy do lose weight in the first days (Never found the explanation for this in the literature) but in this case, it’s the whole litter not just one of them.

If in spite of this there is a puppy which after 24 hours has lost weight, this is the one at risk and it is necessary to monitor it more frequently to be able to detect the first signs of FPS. It stops feeding, may start to cry, later it is weak and loses body temperature, feeling cold when touched, and limp when it is picked up. Treatment has to start at the first noticeable sign. It is my rule to indicate treatment only in professional publications, but in this case I will make an exception as FPS is an emergency condition which can begin at any time of the day or night, and because, unfortunately, not all my colleagues (not least in my country) are proficient in neonatology.

In FPS the most important thing is, bearing in mind the triad, dehydration, hypoglycaemia and hypothermia, and the treatment has to be directed to correct these three factors. If the pup has cooled down (the dam rejects it when it’s rectal temperature drops under 34°C (93°F) it is important to warm it slowly and the most natural way, and that is by contact. Never try to warm it too quickly (to put it in the oven is no good) - because this raises the need of oxygen of the tissues. But this need is not covered due to the slow cardiac and respiratory rate of the hypothermic pup, which dies because of oxygen deficiency and haemorrhage. It’s better to use the old, classic, hot water bottle or pocket of our clothes where it gets our warmth and the movements of our body act as a soft massage.

To treat dehydration and hypoglycaemia Ringer Lactate Solution and 5% Dextrose Solution are needed. In our country they are not available at every pharmacy, it’s easier to find them at those that are near to hospitals or clinics. An equal parts mixture of both solutions is administered by injection at the rate of 3cc for every 100 grams bodyweight. For example, a puppy weighing 400 grams needs 12cc obtained when mixing 6cc Ringer Lactate with 6cc of 5% Dextrose. This is repeated every 2-3 hours until the pup is able to nurse by itself. Never try to bottle feed milk substitutes to a hypothermic pup. It won’t be able to digest it as below 34°C of body temperature there is visceral paralysis.

In these sick puppies it is wise to administer vitamin K which is needed for coagulation (in FPS death ensues with haemorrhage, sometimes only internal, other also from mouth and nose). Normally the intestinal flora produces this vitamin, but puppies of this age have not yet completed the colonisation of their bowel by these beneficial bacteria. In our country it is sold under the name of Konakion, in boxes with three 1cc ampoules, each one containing 10 mg of vitamin K. The dose for a Cocker pup is 0.05 mg, impossible to measure with one of the more common syringes. Therefore a 1cc tuberculin/insulin syringe is used; this is graduated in 1/100ths. 1/10cc (that is 1 mg of vitamin K) is filled in the syringe and then it is completed to 1 cc with Ringer Lactate Solution. 9/10th of this mixture is discarded and half of the rest is administered by subcutaneous injection. Eventually it can be repeated 12 hours later.

To sum up: If 24 hours after birth a puppy has lost weight he may be prone to FPS. Be prepared providing the kennel’s medicine chest with vitamin K, one sachet each of Ringer Lactate Solution and 5% Dextrose Solution, a 10cc syringe, and a tuberculin/insulin syringe, plus a few 25 x 8 or 25 x 9 hypodermic needles. Vitamin K has an expiry date, not so the solutions. Once the sachet has been pierced (not in the middle but at one of the extremes) the small hole is covered with medical adhesive tape. This way it can be stored in the refrigerator (pierced side up) for approximately one month. But if before that time when slightly shaken the liquid looks cloudy like cigarette smoke, it has to be discarded. Before re-using the solutions they have to be warmed, putting the sachets in a container of hot water, changing this until the solutions feel warm, like a feeding bottle for a baby. The vitamin K ampoule once opened can be stored with a cotton wool plug, at room temperature during 48 hours. After that it has to be discarded. I do not know if in your country these solutions and the vitamin K are sold over the counter. If you cannot get them at your pharmacy, do consult your vet. Show him this article, I’m sure he will help.



Written by Dr Milada Ivacic V.M.
A recently retired professor of Veterinary Science specialising in Neonathology in Brazil.

 COMPANION ANIMALS DIOGNOSTICS

FADING PUPPIES

There are many causes of fading puppies. On this page I try to explain the commonest causes of puppy death, diagnosis, and treatment or prevention. 

For diagnosis in an outbreak of fading puppies, send a whole pup to Companion Animal Diagnostics for post mortem. Open the abdomen and take 3 x 1cm lengths of duodenum, jejunum and ileum into 10% formol saline. Recent research has shown that sending the whole carcase is more likely to result in a specific diagnosis than just selecting some organs.

Canine adenovirus   Canine distemper   Ectoparasites   Canine herpesvirus
Neospora caninum   Canine parvovirus   Toxoplasma gondii

Canine adenovirus (ICH - Infectious canine hepatitis, Rubarth's disease)
Less common cause of puppy death than parvovirus.

Signs: from 3 weeks of age onwards - sudden death, vomiting, abdominal pain. Post mortem shows haemorrhages in superficial lymph nodes, serosae, liver enlarged and dark, possible ascites.
Virus shedding: in urine, faeces or saliva (shedding in urine can persist up to 9 months). 

Transmission: direct or indirect contact with virus in urine, faeces, saliva. Virus can persist in the environment up to 10 days and is resistant to formalin and some other disinfectants.

Prevention: vaccinate bitch before mating, modified live vaccines can give lifelong protection from a single dose. Half life of CAV maternally derived antibody (MDA) is 8.6 days. Disinfect premises using steam, or aldehydes, phenols or hypochlorites.

Canine distemper
Rarely a cause of pup mortality before 12 weeks of age.

Signs: mucopurulent oculonasal discharge, depression, anorexia, cough, pyrexia, CNS signs, "hard pads".

Virus shedding: in respiratory secretions, urine.

Transmission: direct, by aerosol. Not indirect, poor virus persistence in the environment.

Prevention: vaccinate bitch before mating. Susceptible to most disinfectants.

Canine herpesvirus (CHV)

Signs: in adult dogs, only upper respiratory or genital tract signs, but can cause stillbirth, abortion and puppy mortality. Puppies typically have a nasal discharge, sneezing, moaning, anorexia and uncoordinated movements. On post mortem, pups have areas of focal necrosis on liver, spleen, lungs and kidneys.

Transmission: pups become infected oronasally during whelping or in first days of life from their bitch or littermates

Prevention: Keep newborn pups warm. Bitches which have already lost pups to CHV are unlikely to lose subsequent litters, even though infection is lifelong. A vaccine is available made by Merial. In a field trial, vaccinated pups from vaccinated bitches tend to have better survival odds

Ectoparasites 
Heavy flea or louse infestation can cause such severe anaemia in neonates as to be fatal.

Prevention: treat bitch before mating and treat other dogs and/or cats in household, and the household itself. Fipronil (Frontline) can be used in puppies over 2 days old.

Neospora caninum

Signs: neonatal death in puppies. Hind limb paresis developing in puppies at 3-8 weeks of age, granulomatous polymyositis at post mortem.

Transmission to pup: transplacental

Prevention: in dogs, successive litters can be infected, so it might be a good idea not to breed with an animal which had already had an affected litter. If one pup is affected, treat the remaining littermates with Trimethoprim-sulphonamide to try to prevent clinical signs.

Canine parvovirus (CPV)

A typical presentation of CPV infection is sudden death, usually of pups, but occasionally of adults. Parvovirus deaths typically occur in an environment with a large throughput of young animals, especially unvaccinated animals, therefore rescue kennels and pet shops are where parvovirus is most often encountered. Puppy deaths can occur at any age, depending on when maternally derived antibody (MDA) wanes. As MDA wanes and before the animal makes antibodies of its own, a window of susceptibility occurs during which parvovirus, if present, can infect the young animal. There ensues a race between the virus and the pup's immune system. A typical scenario is when one pup is sold and becomes acutely ill or dies, while its littermates remain perfectly healthy. The reason for the disparity in clinical signs amongst littermates which must have equally been infected is that the sold animal is stressed by being moved, so that its immune system becomes compromised, and secondly that it may experience a change of food or a new concurrent enteric infection causing more rapid turnover of enterocysts which allows greater replication of CPV. 

Signs: sudden death, collapse, vomiting, dehydration, massive neutropenia as neutrophils flood into the gut, other white blood cell numbers may be normal. Any age from a few days onwards. 

Virus shedding: in faeces, often only shed for up to 48 hours, though 6 weeks has been documented. 

Transmission: indirect - persists in the environment for a year. 

Prevention: once parvovirus has occurred in a premises, the virus will be present for at least a year. Disinfection with sodium hypochlorite, formalin, parvocide, etc. can reduce virus dose but will not eliminate virus from soft furnishings. Since bleach and formalin are inactivated by organic material thorough cleaning is vital for the success of disinfection. It is important to realise that infection is maintained in premises by subclinical infection of susceptible animals which become infected, produce huge amounts of virus and recover, thus part of parvovirus prevention is to stop breeding for a year. No susceptible animals should be introduced for at least a year, any new animals should have had a full course of vaccination before being introduced.

To establish whether a kennel has parvovirus, test some of the breeding animals for antibodies, their titres will be much higher if they have been naturally exposed compared to post-vaccinal levels (such tests can be carried out by Companion Animal Diagnostics, University of Glasgow Veterinary School). Pups are protected by maternally derived antibody, the time that antibody will wane can be calculated by taking the mother's antibody titre and halving it every 10 days of the offspring's life. Thus if a bitch had an antibody titre of 1024, at 10 days old the pup's titre would be roughly 512, at 20 days 256, at 30 days 128, and so on (providing the pup had suckled colostrum adequately). In this example the pup's titre would be 32 at 50 days and so the pup should be re-homed to a parvovirus free environment at that stage and vaccinated. The occurrence of MDA interfering with vaccination has long been recognised in dogs, e.g. Rottweilers, and modern vaccines often attempt to overcome that problem.

Further vaccination of adult breeding stock is often pointless, since many will have a very high naturally acquired immunity, but it may be useful to screen all the breeding stock for antibodies and boost any which do have a lower antibody titre using a live vaccine (inactivated if the animal is pregnant). 

Toxoplasma gondii
Uncommon cause of neonatal mortality in puppies. 

Signs in puppies: diarrhoea, respiratory distress, ataxia.

Oocyst shedding: from cats only, lasts two weeks. Oocysts must sporulate before becoming infective, therefore are not infectious until 48 hours post shedding.

Transmission to pups: transplacental or via suckling.

Prevention: do not feed raw or undercooked meat to pregnant seronegative dogs and cats. May choose to breed with only seropositive animals which have already been exposed and are therefore immune. 


Companion Animal Diagnostics
Veterinary Diagnostic Services 
University of Glasgow Veterinary School, 
Bearsden Road, Glasgow, G61 1QH 
Tel: 0141 330 5777 Fax: 0141 330 5748 
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