Bleeding At or Soon After Birth (also known as “PUPPY HAEMORRAGIC SYNDROME”)

Right at the onset, allow me to explain that this condition in newborn puppies is quite distinct and different from the Canine Parvo Virus disease, and from an Acute Hemorrhagic Diarrhea Syndrome, and from Hemorrhagic Gastroenteritis in puppies and young and adult dogs – issues that we will address in later columns.
Please note that the simplest way and easiest to understand definition of “syndrome” is the following explanation: “a group of symptoms or signs that are typical of a specific disease, disturbance or condition appearing in animals (and plants)”.
In today’s column, we shall be dealing with puppies who begin to discharge blood from one or many orifices soon after birth (within 3-4 days). Also, the caregiver has to understand that almost all newborn pups are born with the tendency to bleed easily.
In Puppy Hemorrhagic Syndrome (PHS) the primary cause of the bleeding is the absence of a clotting factor in the blood of the newborn. Without this chemical (a protein) any minor hit or bruise, sustained by the pup, can result in incessant bleeding. Such injuries can be contracted even when the mother dog is in the process of delivering her pups; or shortly afterwards – as she is trying to remove the protective tissues (which surround the pups while they are in her womb) from the newborn pup. This bleeding can be seen at any of the pup’s openings (navel area, vagina, penis, anus, nostrils, mouth, etc.).
Q: Can we save the pup’s life?
A: The answer, guardedly, is YES. Success is dependent on how quickly the caregiver can get professional veterinary care. Further, let it be clear that all newborn animals are fragile and vulnerable. Also, it must be understood that if one pup exhibits the deficiency of the chemical needed to stop the bleeding, then it must be taken for granted that all the other siblings in the litter would carry this blood clotting deficiency and should be treated simultaneously, even if they do not exhibit symptoms.
The treatment, without going into the chemistry associated with this problem, is an injection of vitamin K.
Allow me, further, to advise that any dog breeding establishment, from which this ailment has emerged, would serve itself well to ensure that their reproducing dams receive doses of Vitamin K during pregnancy – especially during the last weeks of gestation.

There is a condition in human medicine called Sudden Infant Death Syndrome (SIDS). This is when there is an unexplained death of an apparently healthy baby, even after a post-mortem examination has been rigorously carried out.
In companion animal medicine (but not only), vets are confronted with a similar situation. We call it the Fading Puppy Syndrome. It occurs when the pup dies within the first 2-3 weeks of life.
Of course, the same questions are posed to vets:
• What are the signs?
• Could we have done anything to stop our pet from dying?
Q: What are the causes for this FPS?
Well, what can one say – as a valid, comforting, convincing answer – to this question? It is especially embarrassing to the vet when he/she not only knew the pup almost from birth and had seen the animal grow and flourish over the weeks post-partum (after being born).
A: “I just don’t know” is not a satisfactory answer. Research has in fact implicated:
• Viruses (e.g. Canine Parvo and Distemper Viruses);
• Intestinal parasites (e.g. Hookworms, Tapeworms, Roundworms – some of these get into the pups’ bodies even while they are well ensconced in their mother’s womb);
• Ectoparasites (e.g. blood-sucking ticks and fleas, etc. Surely, if these organisms suck blood needed for the pup’s development, one can expect that the growth/weight gain of the pup will be compromised because it will be deprived of valuable nutrients, vitamins, trace elements, etc.).
Other possible causes for the Fading Puppy Syndrome.
• We have already mentioned viruses and helminths (worms) and ectoparasites (ticks, fleas, mites, lice). But it seems that bacteria, streps and staphs (even if to a lesser degree), can insidiously create conditions in the pups’ bodies that could lead to the FPS.
• Insanitary environments may really be high on the list of causative factors (you remember us speaking of Navel Ill – September 27, 2020), and can be identified as indirect culprits causing FPS.
• Too large litters – The mother dog has a finite number of functional breasts. She may not be able to suckle all the pups equally and optimally. In fact, she may “know” instinctively that some of her pups are not going to make it, and therefore she rejects/abandons them. Or, if the nursing quarters are too small to accommodate the relatively large mother and her multiple offspring, she may (un)intentionally squeeze one or two – creating enough of a traumatic effect that can lead quickly to death.
Q: How can I as a caregiver prevent the FPS in the litter when the cause is unclear/unknown?
A: As I said above, if ecto- and endoparasites abound in and on the puppy, it is important for the caregiver and his/her veterinarian to remove at least most of the nutrient-sucking agents like hookworms and ticks/fleas from the pup. Already this undertaking will give the pup a better fighting chance. Pups can be dewormed at an early age (three weeks is recommended). Because ticks, fleas, and worms are carried by the mother dog, these (and other) parasites must be removed from the dam during pregnancy. It is amazing how many caregivers believe that they cannot deworm a pregnant bitch. I think they may be confusing this policy with vaccination. It is absolutely ill-advised to expose the mother dog to vaccination during pregnancy. However, as soon as the pups are born, one could vaccinate the dam (mother dog). That will enhance her already available immunity which can be passed on to the suckling pups – especially within the first few days of their lives. We have addressed this absolute necessity of ensuring that the newborn pups (neonates) get the “first milk” (Colostrum), even if we have to collect the mother’s “first milk” directly from her breast and feed it to her offspring via eye droppers or syringes within the first 3 days.
Let me also hasten to add that research and my own empirical observations over the decades have shown that when a pup begins to fade (for whatever reason), the mother dog may abandon/reject the pup. She may recognize this fading pup long before the caregiver does.
Of course, if there is an anatomical defect (e.g. a cleft palate) that prevents the pup from nursing optimally, then that pup does not have a great chance of surviving. Heart defects or other internal invisible abnormalities, on the other hand, may be overlooked, but yet contribute to the FPS.
Q: What are the symptoms of FPS?
A: Well, as I mentioned above, the whole episode is often so short, that by the time you recognize something is amiss, the pup is dead. If the pup manages to hang on to life for a day or two, you may witness the following:
• Reluctance to suckle.
• Listlessness; unwillingness to move around.
• Constant crying and exhibiting signs of discomfort; not trying to be with the other pups, warming each other.
Q: Are there worthy and valid considerations for commencing treatment? What will that treatment entail?
A: Of course, the caregivers together with his/her vet – should discuss the continued survival of the pup(s). Obviously, those visible areas, where veterinary intervention can be successful, must be implemented. What I am positing is simply that any chance of survival of the pup(s), will depend on discovering the underlying and precipitating causes for the malaise – if they can be immediately detected – and removing them.