Dehydration or fluid loss is a frequent problem in puppies younger than six weeks. Immature skin and kidneys, and high metabolic rate result in increased water loss. Dehydration can be mild with no clinical signs, or it can be life-threatening, causing shock, circulatory shutdown, and death.
Fluid therapy (under the direction of a veterinarian) can help ill puppies by replacing lost fluids. The degree of dehydration can be estimated by taking a history from the owner, performing a physical exam, and by the results of a few simple blood and urine tests. The veterinarian will evaluate the moistness of mucous membranes, and check the urine. Normal urine color of newborn pups and is clear and
colorless. Any yellow-gold tint to the urine may indicate dehydration.
The veterinarian will attempt to replace losses with a fluid that is similar in volume and electrolyte composition to that which has been lost from the body. Fluids should be warmed to body temperature to prevent dangerously low body temperature. Keeping young pups warm is crucial. Fluid replacement can be accomplished in several different ways. The routes of administration include the intravenous (in the vein), the subcutaneous (under the skin), the
interosseous (into the bone), the intraperitoneal (into the abdomen), and the oral routes.
Intravenous administration is preferred in critically ill puppies that have had severe fluid loss and need rapid replacement of fluids. The intravenous route requires close monitoring during fluid administration to avoid overhydration and other complications such as infection and blood clots. The veins available for intravenous use in puppies are generally the jugular (in the neck) and in larger puppies, the cephalic veins (in the upper forelimbs). Sometimes, the veins of puppies are so small that it is impossible to insert a needle into a vein. In this case, the
interosseous route can save lives. For subcutaneous administration of fluid, overload is unlikely because the fluid is not going directly into the blood vessels, and therefore fluid is absorbed much more slowly. The subcutaneous route is inadequate for puppies and kittens with severe fluid loss, dehydration, and shock. The subcutaneous route is helpful in maintaining fluid volume after critically ill animals are stabilized. Intraperitoneal fluids are administered by inserting a needle directly through the abdomen into the abdominal space. This route allows for rapid absorption of large volumes of fluids. Giving fluids by mouth is the ultimate goal, but should not be used if the puppy is nauseated or vomiting. Once stabilized with no vomiting, oral fluids are encouraged.
Home nursing with subcutaneous fluids
Sometimes, the veterinarian will provide instructions for administration at home. It is important that the fluids are warmed, handled carefully to prevent contamination, and that the needle is handled with care to avoid human injury. The clinic will normally take the refuse back for proper disposal. Instructions should be followed closely; overdosing and underdosing can occur if the task is distributed in the household; only one person should act as care giver, and there should be a checkbox on a calendar to track treatments.
Johnny D. Hoskins, DVM, PhD, Diplomate, ACVIM