Following birth, if a pup is slow to get going, appears lifeless and if swinging and rubbing briskly with a coarse towel does not work, try a drop of Brandy on the tongue. Or try alternating the puppy in bowls of hot water and cold water. Fill 2 bowls with water--one from the hot tap and one from the cold tap. Immerse the puppy first in one pan and then in the other (to the neck). I have used this method successfully over the years on several occasions, with seemingly dead puppies and it has worked! The idea is to shock the system into taking that first breath. Do it about 10 times. If it works, towel dry the puppy vigorously until he is breathing normally and then put him with the dam. Sometimes there isn't time to fill water dishes and with a lifeless puppy, time is of the essence. In a case such as this, hold the puppy under the water faucet with alternating cold and hot water -- as hot and as cold as is safe. Also try artificial respiration by laying the puppy on his back and blowing gently into his mouth (pull the tongue forward), while alternating with applied pressure on the puppy's chest. Continue rubbing briskly. Don't give up on a lifeless pup if the color is good. It is possible to revive a seemingly dead puppy up to 20 minutes after delivery. Do not waste time on obviously defective pups.

Right after birth, if a pup bleeds excessively from the umbilical cord, swab the cord in iodine and tie it off at the base of the cord with dental floss.

When the bitch is finished whelping, an old piece of advice  is to give her a bowl of heated milk. This should consist of canned (condensed) milk, with equal parts water and two egg yolks. Many bitches won't eat right after whelping, but few will turn down a warm bowl of milk. This gives a warming assurance and is helpful for encouraging milk production.

Encourage puppies to nurse right away. Not only does nursing help stimulate contractions, but the puppies need "colostrum": that first milk produced during the first 24 hours. This early milk, which is different looking than later milk, is loaded with antibodies and special nourishment that will protect the puppies from infection and viruses. It's really imperative that all puppies get colostrum. Pay close attention to the smaller puppies. Through no fault of their own, they may get pushed off the nipples by the bigger puppies.

Congenital defects: Congenital defects can affect just about any area, but the heart, lungs and digestive tract seem to be the most prevalent. Sometimes puppies can be born so premature that organs won’t be fully developed and/or they will be missing hair. Following birth, check each puppy, looking for the obvious signs like cleft palate, and in the rare instance, no anal opening. Some congenital defects are apparent right away, but others may not become apparent until the puppy is much older. Defective puppies should be put down, as trying to save them, will only bring heartache later on.

The most critical period of a dog's life is during the first week. The early care and environment of the newborn puppy are of the utmost importance. Early causes of death can usually be attributed to: difficult whelping, congenital or genetic defects, environmental factors (i.e. too cool or drafty), carelessness of the dam, infection, viruses, toxic milk or insufficient nourishment.

Check weights at birth. Over the years, I have seen tremendous fluctuation in puppy birth weights. While 12 to 16 ounce puppies at birth are the easiest to raise, there is nothing wrong with 6-8 ounce puppies, if they are strong. I have even had healthy and strong 5 ounce puppies. Small does not necessarily mean weak! It doesn’t hurt to monitor weight for the first couple of days. Normally, most pups lose weight the first 24 hours but resume weight gain on the second day. All healthy pups should gain weight on a regular basis. Ideally, the birth weight should be doubled within 7-10 days. If hand-raising a litter, puppies should be weighed daily, not only to assure proper weight gain, but to calculate the correct amount of formula.

Some bulldog bitches are excellent and careful mothers…but keep an eye on restless, nervous or flighty bitches, especially if it's a first time litter. Thankfully, most of the horror stories I have heard about, involve other breeds. It should go without saying that the mother and puppies should be in their own private area, away from other dogs and anything they deem as a threat. Bitches in the wild have been known to eat their young when threatened, so use common sense. NEVER leave the mom alone with her pups. Puppies have died from being smothered easily.

Spotting a sick puppy in the early stages, is very important, since time is critical and can mean the difference between life or death. Classic warning signs of trouble in neonatal puppies are weakness, failure to nurse, insufficient weight gain, temperature drop, dehydration, continuous crying, Diarrhea and/or vomiting and rejection by the dam.

Because puppies cannot maintain or regulate body temperature on their own, they are completely dependent upon their environment for the first couple weeks of life. A puppy’s normal temperature at birth is approximately 94 degrees. During the first week, a normal temperature should be between 94 and 98 degrees (it increases gradually every day). By three weeks old, the temperature should be 99 to 100 degrees. After three weeks, it should be approaching the normal body temperature for an adult dog (101.5). Amazingly, I have actually come across emergency-room veterinarians that had no idea that a puppy’s temperature differed from that of the adult dog!

Because of this inability to maintain body temperature, the greatest danger during the first week of life, is chilling. Some books on newborn puppies suggest keeping the environment 90 to 95 degrees, but most breeders will tell you this is way too warm. Keeping the room around 70 to 80 degrees (with no drafts) for the first few days is usually adequate. The puppies, of course, get their best radiant heat from the dam and box temperature of 70 degrees should be more than sufficient! Without the mother, 75-80 degrees should be satisfactory. Make sure the temperature is gauged on the floor of the box. Other sources of warmth can be heating pads or heat lamps. If using a heating pad, monitor the intensity of heat, as pups have been known to cook on pads set on high settings.

Hydration is one of the most important things to monitor in new pups, as it can be one of the first signs of trouble. This can be checked by pinching the skin on the back of the neck or on the top of the back. If hydration is OK, the pinched skin will bounce right back into place. If the pinched skin stays creased, the puppy is dehydrated and needs fluid replacement. Also a dehydrated pup's coat will sometimes have a ruffled or scruffy appearance. Dehydration can either be a result of inadequate nourishment, too much heat or sickness. Accompanied with diarrhea and/or vomiting, it can be dangerous and fatal.

Another classic warning sign of a puppy in trouble is incessant crying. If this is combined with cramping, you better figure out quickly what is causing the problem. If the puppy is bloated and has loose stools, it could be the dam’s milk. If you are lucky, it could just involve a simple correction in the dam’s diet or it could be something more serious, such as mastitis (bacteria-infected milk). Check the mother’s milk and keep an eye out for discolored milk (green or brown) or streaks of blood. If the puppies are sick and you suspect the milk, have a veterinarian do milk cultures.

Be very careful what you feed the nursing mother. It’s important to remember that whatever you feed her will go right through the milk and into the puppies! As an example, a friend of mine experienced disastrous results upon supplementing a nursing mother with honey (upon the advice of a holistic veterinarian). The pups developed a clear hard covering over the anus, resulting in an inability to eliminate. Fortunately, she discovered the problem before losing any puppies. In the case of an extreme emergency when a puppy is really bloated and not nursing, it is possible to remove contents from the stomach. If this is attempted, it should be done very carefully, using a feeding tube and syringe. Unpasterized honey carries bacteria and can infect the mother's milk.

Puppies almost always pile together in relative proximity to one another. Sometimes the dam may reject a puppy - sometimes for a reason (there may be something wrong with the pup) and sometimes she can do it for no reason at all. If a puppy continually gets separated from the others, ending up in a corner by himself, he bears watching. There may be something wrong……

Dip each puppy’s umbilical cord in a bottle of alcohol, several times during the first 24 hours after birth. Not only does this disinfect the cord but helps it dry quicker. Or swab the cord with iodine. The first 24 hours is the most critical for cord infection. Watch out for spongy, soft or discolored cords. These signs usually indicate umbilical infection and can lead to a systemic infection throughout the entire body and lead to the death of the puppy. Treatment calls for an oral antibiotic. This is when a box of Amoxi-drops comes in handy, since things usually go wrong in the middle of the night! Under normal conditions, the cord should be hard and stringy within hours and usually falls off by day two or three.

For the first couple of days after birth, check the bitch’s milk supply to make sure that she has an adequate amount for feeding the litter. If a puppy pulls on the nipple and cries out in frustration, check the milk. This can be done by gently squeezing the breasts below the nipple. Milk should flow freely! Sometimes a bitch will have adequate milk on the day of whelping, but by the second day, it will disappear only to return on the next day. Following C-Sections, the milk can be really slow to come in. If the litter is small in number, be sure to check the breasts by making sure that all are being used and emptied. Beware of breasts that are “hot” to the touch and have a packed “hard” feeling. If milk is not cleaned out regularly, the breast could develop an infection leading to an abscess. Milk will be sticky between the fingers if mastitus is present.

A good formula for either supplementing or handraising a litter:In a pinch I have also used Esbilac with excellent results.

Approximate dosage: Amounts will vary depending on whether the litter is being completely hand-raised or supplemented along with the dam's milk.

When supplementing the dam's milk, smaller quantities 2 to 3 times a day should be sufficient (depending on how big the litter is and amount of milk that the dam has). For instance a 10 ounce puppy can be given 3-5 cc's, 3 times a day.

If totally hand-raising a litter, (with no maternal milk), quantities should be larger and more frequent. The younger and smaller puppy will need more frequent feedings and smaller amounts. For a puppy under 7 ounces: 2-4 cc of formula, every 2 to 3 hours for the first couple of days. Larger puppies can be fed greater amounts. Over 7 ounces, 1 cc per ounce of weight, every 4 hours. It is very important to not overfeed. If the puppy is overfed and vomits or has formula come out of its nose, it runs the risk of inhaling the formula which can result in inhalant pneumonia. Tube feeding (see below) is the safest and quickest method for puppy feeding.  They can be used in a pinch if nothing else is available, but they need to be used carefully and not if you intend to hand-raise an entire litter. Care also needs to be taken with bottle-feeding. Not only does it take a great deal of time, but the nipple flow can be difficult to regulate. Plus, it has a tendency of allowing air in the stomach. Some breeders prefer to bottle feed because it satisfies the newborns need for suckling. If you bottle-feed, you will need to burp the puppy by firmly rubbing their back and sides (up and down) or by gently but firmly patting the back or sides. However, that said, even puppies that are tube fed or ones that nurse naturally may sometimes need to be burped!

Whatever type of equipment is used, it should be washed thoroughly following each use.

Regarding tube feeding: Tube feeding is the safest and easiest way to supplement or hand raise a litter. Contrary to popular myth, it is extremely difficult to get a tube into the lungs. If a tube were to get into the lung, the puppy would immediately go into coughing spasms. You do have to watch a tube doubling back, which is why I hate the small flimsy tubes (such as #8) and you also have to make sure the tube is inserted far enough into the stomach (measure the tube before inserting and make sure it reaches behind the last rib of the puppy). Also of great importance – be careful how quickly you press the plunger of the syringe. It should be pressed slowly and once all the formula is expelled, the tube should be removed quickly. These areas present the greatest risks and usually are the reasons for puppy death during tube feeding!

Milk bubbling from the nose means the puppy is being over fed. When milk bubbles come from the nose, you run the risk of overfeeding the puppy and of causing inhalation pneumonia. The amount of formula tubed, especially to small pups, should be carefully regulated (small amounts more often). It is far safer to underfeed than overfeed!

Never under any conditions, feed milk to a chilled puppy. Chilled puppies should never be fed since the entire intestinal tract literally shuts down. Think about it - even in humans when the body temperature falls below normal, all body functions begin to slow or shut down. Food that was previously fed, just sits there. Consequently, by feeding a chilled puppy you are adding additional formula to an already full stomach. Feeding a chilled puppy is the quickest way to kill it! Pups should be warmed to normal temperature before feeding. Sometimes a puppy won’t appear chilled because the body feels warm from external heat sources (such as heat lamp or heating pad). The best and surest way to check whether a puppy is chilled or not is to feel the tongue. If the pup’s tongue has a chilled/cold feeling, do not feed milk.

The first thing to do is warm the chilled puppy very slowly (heating pads and ovens aren’t good choices!). If a puppy becomes dehydrated along with the chilling (a typical combination), the quickest and most effective method to rehydrate is to give fluids under the skin (by using a needle and syringe with a solution of lactated ringers). The best way to learn how to do this is to have your veterinarian show you the first couple of times. If you are uncertain about giving fluids under the skin, you can administer the water solution orally. However, you must be very careful inserting the feeding tube. A chilled puppy makes it that much harder to pass the tube and sometimes the tube will double back on itself. The preferred method is to give fluids subcutaneously. Remember that dehydration can result as a secondary symptom. So you may correct the hydration problem only to have it reoccur, if you don’t figure out and cure the primary problem.

Puppy stools are normally fairly soft, but formed and usually are yellow/brown in color. I have seen green puppy stools and stools that have an appearance of bunches of tiny seeds. If all else seems normal, these phenomena seem to be harmless and short-lived. Watery diarrhea, however, can present a serious problem if left unchecked. There can be many causes such as, the dam’s diet or infection. Diarrhea in combination with vomiting usually means infection. Check the dam’s milk and discharge from the vulva. If either appears abnormal, consult a veterinarian. If her milk has clear streaks and/or blood or appears yellow/green, pull the puppies until the situation is diagnosed and corrected. And keep in mind that in the beginning stages, bacteria infected milk can look completely normal. It doesn’t hurt to monitor the mother’s temperature for a couple of days following whelping. And keep an eye on anything over 103 degrees since it could indicate an infection in the uterus or in the milk glands. When in doubt, call the vet!

Rarely does a puppy ever become constipated, but if one does, this can be easily corrected by using children's Castoria or by giving an enema. An enema can be given, using a #8 feeding tube, attached to a syringe, filled with approximately 2-5 cc's of warm water (the amount depends on the size of the puppy). Put a dab of Vaseline on the end of the tube and insert it into the rectum, maybe an inch (again, how far in, depends on the size of the puppy). Gently push the plunger until the liquid is entirely gone from the syringe. Within a few minutes, you will get results. Constipation rarely occurs in puppies that are nursing, but it can be a frequent problem in hand-raised litters, especially if the water amount in the formula is not sufficient. If constipation continues to be a problem in the hand-raised litter, a tablespoon of Karo syrup can be added to the formula.

For the sake of the dam, clip the puppies' front toenails weekly, with small scissors, being careful not to cut into the quick.

Eclampsia: Fortunately this is not a common occurrence, but it can and does happen. It is caused by a lowering of calcium levels in the bitch’s system due to the puppies draining her calcium supplies. Classic signs in the bitch are: restlessness and anxiety, high temperature, rapid respiration, spasms and/or seizures (or falling down). A bitch in this state needs immediate treatment, and it is imperative that she be taken immediately to a veterinarian as she needs calcium intravenously. The puppies should be removed until the bitch’s calcium levels are normal, as nursing and milk production only exacerbate the problem. By the way, there is a school of thought that feels this condition is a result of excessive calcium supplementation during pregnancy. So proceed cautiously with all dietary supplements.

Low Blood Sugar: There is a low blood sugar phenomenon that sometimes can occur the first few days of a puppy’s life. Everything will go along fine and all of a sudden, a puppy will stiffen like a board. Usually the tongue will stick out between the lips. This is generally the result of low blood sugar, especially if more than one puppy is doing this. A veterinarian can do a blood test to determine if this is the problem. The simple solution is to start supplementing the puppy with a formula that has Karo syrup in it. Or the puppy can be tube fed a sugar/water solution. Or a dextrose solution can be given under the skin. Sometimes this phenomenon goes hand in hand with dehydration. This stiffening is basically a seizure and it has nothing to do with epilepsy. It is totally dietary and usually means either the dam does not have adequate milk or the puppies are not getting enough to eat. It can happen to the largest puppies or the smallest. If left untreated, it will most assuredly lead to the death of the puppy. Following a day or two of supplementing, usually the problem corrects itself (if the dam has sufficient milk!). We have used Fading puppy drops from www.naturalrearing.com

If eyes are still closed and look swollen with pus coming out of the corners, the eyes should be gently cleaned with a boric acid solution, while trying to gently express the pus through the corners. Then carefully insert a small amount of antibiotic eye ointment into the inside corner. Usually, one or two treatments takes care of the problem. Once you notice this sort of problem occurring, monitor the litter carefully because if this is ignored, it can result in serious damage to the eyes or in the worst case scenario, the loss of one or both eyes. Normally this problem occurs prior to the eyes opening. A general rule is that eyes open around 12-14 days.

When hand-raising a litter, in order to prevent the dry flakes that can sometimes result (because nothing takes the place of the mother's continual licking and cleaning), wash the pups face and entire body with a rough washcloth several times a day. Also, a mild baby shampoo can be used in the water solution. Daily grooming is important for the neonatal puppy. Think about how the dam spends all her time washing and cleaning every puppy several times a day. If the pups become odorous, they can be washed in warm water and towel dried. They usually dry right away.

For the first week or so, puppies rely completely on maternal stimulation for elimination. If the mother cannot or will not take care of the pup’s elimination, the owner has to step in. Using a cotton ball moist with warm water, rub the abdominal and anal area with sweeping motions. Urine should come out easily every single time. Not so easy (and a big source of frustration when hand-raising pups!) is defecation. They may not eliminate every single time but should produce a stool every third time or so.