Sugar Crashes / Hypoglycemia

The following is a combination of well used information. I have added my own comments and recommendations to this page in order to help my 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 missleading. 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. The upsets place and added strain on the energy reserves of the liver and bring 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 (food always available in dish) until they are 5-6 month old. 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 Karo syrup in the puppy quickly! Depending on the size of the pup it can be from 1-3 cc's of Karo syrup. 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 karo sirup on his gums. Karo will not hurt pups so if you think something might be wrong just give them some karo and watch them. Do not use honey more than once or twice! Some dogs, like humans, are allergic to honey and that can complicate matters!

Hypoglycemia is 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!

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 E. Keen