Is your puppy an underachiever on the growth scale?

Analysis by Dr. Karen Shaw Becker

puppy not growing properly

Story at-a-glance -

  • Lack of weight gain in puppies is a problem that demands quick resolution
  • Sometimes it’s what or how much a puppy is fed that’s the problem, but more often there’s an underlying condition that must be addressed
  • Healthy puppies thrive on a nutritionally balanced, species-appropriate, fresh diet with calories sufficient to support the normal growth and development of a lean pup
  • Intestinal parasites, gastrointestinal disorders, a liver shunt and even dental problems can contribute to a puppy’s lack of growth and weight gain
  • Your puppy is much more vulnerable to serious illness than an adult dog, so it’s important to address any potential health issue as soon as you’re aware of it

I've posted several articles here at Mercola Healthy Pets about the dangers of overfeeding puppies — especially large and giant breeds — but today I want to discuss the opposite problem: lack of weight gain in pups.

Obviously, if a puppy isn't eating for some reason, she won't gain weight. But what if your pup is licking her bowl clean at each meal but remains underweight? Of course, puppies grow at different rates depending on a number of factors, but if yours is below average for her age and breed, it's crucially important to find out why with the help of your veterinarian.

It's possible the diet you're feeding doesn't contain adequate calories or the essential nutrients young dogs require for optimal growth, so let's take a look at that issue first.

The best diet for puppies

One of the common mistakes new puppy parents make is guessing what diet is best, and how much and how often to feed their new furry family member. Unfortunately, many puppies are overfed, and this can lead to a variety of orthopedic diseases, especially in large and giant breeds. Large breed puppies require a diet that promotes slow but steady growth, while smaller breeds often need energy-dense diets. Like adult dogs, healthy puppies thrive on a nutritionally balanced, species-appropriate, fresh food diet.

You can feed a meticulously balanced homemade diet1 or an excellent-quality commercial diet that is nutritionally balanced for all life stages, or even better, for growth (a targeted puppy formula). If you decide to make your puppy's food yourself, I can't stress enough the importance of either consulting a nutrition-savvy veterinarian on how to best balance the nutrients in the diet, or follow recipes created by experts in puppy nutrition.2

There are several factors involved in determining the amount to feed your puppy, including age, current weight, anticipated adult weight, breed, environment and activity level. Puppies eat much more for their weight than adult dogs, and young puppies eat more than older puppies. Very young puppies should be fed three to four times a day; older puppies often do well with twice-daily feedings.

Feeding information on dog food packages gives guidelines on portions to feed but remember, those are only general guidelines. There's no one-size-fits-all amount that every puppy should be fed, and it certainly depends on what type of food you choose.

Raw-fed puppies often need a larger volume of food than kibble-fed puppies, because most well-formulated raw food contains less fat and calories per ounce. Another common feeding guideline is to allow your pup to eat at her own pace for about 10 minutes three times a day. However, again, there's no one-size-fits-all plan for every puppy.

I recommend feeding your pup the amount of food required to keep her lean, but not underweight. You should be able to easily feel her ribs, spine and other bones; see an obvious waist when viewed from above; and an abdominal tuck.

Work with your integrative veterinarian to determine how many calories your puppy needs at each stage of her development. As a general rule, puppies can be moved to adult foods between 6 and 10 months of age, depending on breed, size and current physical development.

Potential underlying conditions that can prevent your puppy from gaining weight

It's actually more often an underlying health issue than diet that causes failure to thrive in puppies, so now let's take a closer look at a few potential underlying causes for lack of growth and weight gain in pups.

Intestinal parasites — The most common reason for lack of weight gain in puppies today is the presence of intestinal parasites — typically hookworms or roundworms.

Hookworms attach to the intestinal wall and suck the blood of the host. They're primarily transmitted fecal-orally to animals, meaning your pup may have sampled contaminated feces or dirt, or he walked through contaminated soil, then licked his paws and ingested the eggs. Puppies can also acquire hookworm from an infected mother's milk.

A puppy with hookworms can become lethargic, weak, malnourished and anemic. Left untreated, the infestation can turn into a life-threatening emergency. Pups typically acquire roundworms by eating infected feces. The infection can also be passed from a female to her unborn litter across the placenta. The pups develop their own infection while still in the uterus and are born positive for roundworm.

Puppies with roundworm often have potbellies and poor growth. If not treated quickly, a severe infestation can block the intestines and cause death. That's why I recommend checking fecal samples at 6, 8, 10 and 12 weeks of age. I do not recommend giving deworming drugs without knowing what parasite you are deworming for, as these drugs alter the microbiome and should only be used if absolutely necessary.

An undiagnosed giardia infection is another common reason puppies may fail to thrive, and often sets the stage for IBS at an early age.

Irritable bowel syndrome/inflammatory bowel disease — The term irritable bowel syndrome (IBS) is often used interchangeably with inflammatory bowel disease (IBD), but they are actually different conditions. However, left untreated, I believe IBS can progress to full-blown IBD in dogs.

In IBD, there is chronic inflammation of the bowels. However, puppies with IBS usually have what I call "consistently intermittent" inflammation, meaning it comes and goes, but does so dependably. IBS — also often called "sensitive stomach" — is actually less common in dogs than other gastrointestinal (GI) diseases, but it may not seem so, because when a dog's digestive issues aren't accurately or thoroughly diagnosed, they're often assumed to be IBS.

IBS is a diagnosis of exclusion, meaning it's the diagnosis we arrive at after other conditions with similar symptoms are ruled out. Most GI disorders share a long list of symptoms, so there's a lot to rule out before deciding on a diagnosis of puppy IBS. Some of the conditions that may need to be crossed off the list include intestinal worms or parasites (ask specifically for a Giardia test), inflammatory colitis, a bacterial, fungal or other type of infection, or abnormal turning of the intestine (cecal inversion).

It's important to realize that lack of healthy digestion is a common cause of secondary infections. Since over half your puppy's immune function is located in his GI tract, compromised intestines lead to a compromised immune system. Nutritional deficiencies are also a significant risk because GI inflammation greatly interferes with your pup's ability to process and absorb nutrients from his diet.

If your puppy has repeated GI disturbances I suggest you test his microbiome and consider microbiome restorative therapy as a first line of treatment, before your vet resorts to repeated rounds of unnecessary antibiotics, which can set the stage for dysbiosis down the road.

Liver shunt — The liver's job is to distribute protein so a puppy can grow, and also to detoxify the blood. A sign of the presence of a liver shunt is failure to thrive. A puppy that isn't thriving will have lack of physical growth, poor muscle tone, a tendency to sleep a lot and will generally appear lethargic and underdeveloped.

A liver shunt compromises the flow of blood to and through the liver. A liver shunt called the ductus venosus is actually a natural development while a puppy is growing inside the mother's uterus. During gestation, puppies' livers aren't functional. The mother's liver carries the detoxification burden for her body and her litter while in utero.

Toward the end of gestation, the ductus venosus is designed to close, ensuring the puppy's liver is functional at birth. If the shunt doesn't seal itself off before birth, the puppy is born with an open shunt called the patent ductus venosus which is an intrahepatic (inside the liver) shunt.

An extrahepatic (outside the liver) shunt is a genetic anomaly in which the blood flow to the liver is rerouted by an abnormal blood vessel outside the organ. This type of shunt also develops in utero. Even though the ductus venosus closes as it should prior to birth, the shunt outside the liver remains open, compromising blood flow to and through the puppy's liver.

Other potential underlying disorders that can cause failure to thrive in puppies include protein losing enteropathy (any condition of the digestive tract that results in loss of protein), exocrine pancreatic insufficiency (EPI), hypoglycemia and problems with the teeth or gums that make eating difficult or painful.

Again, if you're confident you're offering your puppy an optimal diet but he's not eating enough to gain weight or has a good appetite but isn't gaining weight, it's extremely important to make an appointment with your veterinarian to have the situation evaluated. There's very little margin for error when it comes to the well-being of puppies. Things can go bad very quickly, so it's critically important to address any and all potential health issues as soon as they become apparent.