Stress & Low Blood Sugar:   Toy-breed dogs can be susceptible to stress, which can cause a condition of low blood sugar, called 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.  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 who have had what may appear to be an epileptic seizure, low blood sugar is generally ruled out before a diagnosis of epilepsy is made.

How 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, 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." As discussed, one of these attacks may appear as 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, that 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.  Make sure water is available at all times.

Stress and hypoglycemia can cause dehydration and can lead to death.  If your puppy shows signs of stress, you can use a quick remedy for this:  Pedialyte (or generic electrolyte replacement formula) can be purchased at WalMart and is an effective quick remedy for stress & hypoglycemia.  Gatorade or similar electrolyte sports drinks can also be utilized.  Even a quick remedy of plain sugar water can be used, if you donít have anything else available.   If he will drink the fluids on his own, allow him to do so!     Improper administration of fluids by syringe or any other means can result in choking or aspiration and can lead to aspiration pneumonia.