What are the symptoms?

A puppy with hypoglycemia will lack energy. Glucose (sugar) is the fuel the body burns for energy; without it the puppy is listless. In severe instances, the puppy may even seizure, since glucose is necessary for the brain tissue and muscles to function. These hypoglycemic episodes will cause the puppy to fall over and appear weak or comatose.

What are the risks?

The risks depend on the severity or extent of the lack of blood sugar. If it is due to lack of food or excessive exercise it can be easily corrected. If however, the underlying cause is more serious, such as liver disease preventing the storage of glucose as glycogen, or intestinal disease preventing the proper digestion and/or absorption of food, then hypoglycemia may be chronic and life threatening.

What is the management?

If a puppy is listless due to low blood sugar, it is imperative to immediately provide sugar. Karo syrup and honey are excellent sugar sources and should be fed to the puppy. If the puppy fails to respond to sugar, or the hypoglycemic episodes are frequent, then a thorough exam by a veterinarian is in order. It must be determined if the low blood sugar is simply the result of inadequate nutrition or a more severe underlying disease.

At or about the time of birthing (whelping), the blood vessels within the fetus, which allowed blood to bypass the developing fetal liver, must close. Once these vessels close, the puppy's blood is forced to pass through the puppy's now developed liver. If these fetal vessels fail to close, then blood is allowed to abnormally be shunted around the liver, hence the name liver shunt. When blood is shunted around the liver rather than to and through it, the liver is not able to filter all of the blood, and therefore, toxic metabolic wastes such as ammonia are not adequately removed from the bloodstream. The degree to which blood is shunted around the liver is dependent on the extent to which shunting vessels persist. Liver shunts may be large allowing much blood to bypass the liver, or they may be partially closed allowing only small amounts of blood to shunt around the liver. The extent of blood shunting varies with every dog.

What are the symptoms?

The symptoms of liver shunts vary and are directly related to the extent of blood shunting. If the liver is receiving and processing 95 percent of the puppy's blood, the symptoms may be few, if any. More severe shunts are life threatening with many symptoms. Symptoms may be evident in these puppies at only a few weeks of age and may include low growth rates, vomiting, diarrhea, constipation, salivation, increased urination, seizures, and death. Dogs with less severe liver shunts may not exhibit any clinical signs until the puppy is much older, even up to a year of age.

What are the risks?

All liver shunts, whether mild or severe, are considered serious and life threatening. Even mild liver shunts generally exhibit greater symptoms as the puppy increases in body size. The larger the puppy the more metabolic wastes produced, and therefore, the more the liver is needed. Most affected dogs will not live a normal life expectancy unless the abnormality is corrected.

What is the management?

Management techniques for liver shunts have improved. The best and preferred treatment is to identify the abnormal blood vessels and surgically close them, eliminating the shunt. This will require sophisticated testing and may include radiographs (x-rays), laboratory blood analysis, ultrasound, and intravenous dye studies. The expense and results are variable depending on the degree of shunting, age, and symptoms. In addition to surgery, alterations in diet, and administration of medications are often beneficial. Restricted protein diets help reduce the production of the toxic waste, ammonia, and will therefore help lessen the need for liver detoxification. Owners and veterinarians should thoroughly discuss the seriousness, expense, and expected outcome associated with the management of all individuals suspected of having a liver shunt.

The name threadworm comes from the fact that although it is long in parasite standards (2 mm), it is only 0.035 mm wide – a thread. It is unusual in several respects. It has two forms: a parasitic form, and a form that is called 'free-living,' meaning it can live and reproduce just fine outside of a host. Another unique aspect of Strongyloides is that the parasitic worms are only females. Have we piqued your curiosity?

What is the extraordinary life cycle of the intestinal threadworm?

The female worm lives in the intestine of the host where it lays eggs. Remarkably, the eggs can develop even though they have not been fertilized by a male. In fact, there are no adult male worms. The eggs hatch into larvae in the intestine and are passed out in the feces. These larvae can either develop into infective parasitic larvae or into free-living worms of either sex. The parasitic larvae enter a new host by penetrating the skin. They then migrate to the lungs, travel up the trachea and are swallowed. The free-living larvae mate, but do not produce more free-living larvae, only infective larvae that must enter a host to survive.

What determines whether the larvae passed in the feces develop into parasitic or free-living forms?

It is believed that the severity and length of infection, the species, age of the host, and the status of the host's immune system affect the development of the larvae.

Some migrating larvae may remain in the tissues of a dog. In a bitch, these larvae can make their way to the mammary glands, and infection can be passed directly to her puppies through her milk. This is one reason why puppies can have severe infections at such a young age.

Do the intestinal threadworms cause disease in animals?

Most infections in dogs are inapparent or cause only mild diarrhea. Infections in young puppies can become extremely serious and ultimately fatal. This can be of major importance in pet stores and kennels. In severe infections, dogs may show diarrhea, loss of appetite, loss of weight, weakness, and dehydration. Younger animals can be especially affected. Infections are more common during the summer with its high temperature and humidity.

S. tumefaciens generally does not result in disease in cats, but in some individuals, small white nodules can develop in the colon. If this occurs, chronic diarrhea may develop.

What are the signs and symptoms of Strongyloides infestations in humans?

An inflammation of the skin may develop where the larvae entered. A cough or other respiratory difficulties may occur when the larvae migrate through the lungs.

The intestinal illness caused by Strongyloides infections in humans can range from very mild to fatal. Most cases do not show any signs, but in persons whose immune systems are not functioning adequately, severe illness can result. Usually, the disease is chronic and causes abdominal pain, diarrhea, nausea, vomiting, weight loss, weakness, and sometimes constipation. Sometimes bacterial infections can take hold because of the intestinal damage.

In some humans, especially those with suppressed immune systems, the larvae that hatch from the eggs in the intestine may stay there and develop into adults. This can greatly increase the number of worms in the person and the severity of disease. In children and others who may have poor hygiene, persons may re-infect themselves if their hands become contaminated with their own fecal material, and they in turn contaminate their food or place their fingers in their mouths. The methods of infection are called 'autoinfection,' which means the person is the source of their continued infection. Because of autoinfection, some persons have been known to remain infected for up to 35 years.

How is an infestation with intestinal threadworms diagnosed?

A diagnosis can be made when the eggs, or more commonly, the larvae are found in the feces through microscopic examination. Often, the moving larvae are best seen by just smearing a small amount of feces on a microscope slide and examining it. The solutions used for a routine fecal examination will deform the larvae and make them indistinguishable. A special procedure can be performed on a stool sample to concentrate the larvae and make them easier to find. This is called the Baermann technique.

In the Baermann technique, a funnel is fitted with rubber tubing at the bottom, and the tubing is clamped off. The funnel is filled with water, and a fecal sample wrapped in a loosely woven cloth is placed in the water. The larvae will migrate from the sample, through the cloth, and into the water. After several hours, because of gravity, the larvae will sink, and can be found in the water right above the clamp. The clamp is gently released and the first drop of fluid is placed on a microscope slide and examined.

How are intestinal threadworm infections treated?

Until recently, thiabendazole was the most common drug used to treat infections with Strongyloides, although it is not FDA approved in cats. Fenbendazole and ivermectin are now recommended treatments, although, they too, are not FDA approved.

It has also been suggested that ivermectin (Ivomec 1% solution) could be given at an oral dose of 0.8 mg/kg (four times the usual dose). This treatment may need to be repeated. Ivermectin has not been approved for this use in dogs or cats.

In general, these medications are not very useful for eliminating the larvae that may be encysted in the tissues.

What control methods are effective against Strongyloides?

Strongyloides larvae are killed by cold temperatures and in dry environments. It is imperative that animals be kept in dry and clean environments. As with other parasites spread by feces, the yard and litter boxes should be kept clean. Good hygiene measures (use of gloves and handwashing) should be used by persons who may have contact with feces. Cats should not be allowed to use a sandbox or garden as their toilet area.

Control and elimination of Strongyloides from a breeding facility is very difficult because the larvae can be transmitted to the young in utero and through nursing. It is helpful to routinely test very young puppies for Strongyloides, since if they are infected, we know their mother is too. Repeated treatment of the young during nursing and for several weeks after will help to prevent them from having threadworm larvae encyst in their tissues. If breeding females can not be cured of their infestation, it may be necessary to remove them from the breeding colony if a total elimination of Strongyloides from the facility is to be accomplished.

Pets, especially puppies and kittens, tend to explore their world by putting everything in their mouth. This may help them learn about their environment, but it can also be harmful. Many plants are dangerous. Some may cause vomiting or diarrhea while others may cause organ failure and death. Pet owners should seriously take the responsibility of keeping pets away from dangerous plants.

Below, we have provided a list of some of the more common poisonous plants. This is not an all-inclusive list. The same plant may also have different common names depending on the area of the country in which one resides. Every pet owner should know what plants are in and around his/her house.

If you think your pet has chewed on or eaten one of these plants, please contact your veterinarian, animal emergency clinic, or the poison control center for advice. The ASPCA National Animal Poison Control Center hotline numbers are as follows:

• 1-900-443-0000 ($55.00 per case). The charge is billed directly to the caller's phone.

• 1-888-4ANI-HELP or 1-888-426-4435 ($55.00 per case). The charge is billed to caller's credit card only.

Puppies have a tremendous amount of energy and natural curiosity, and they love to explore the world around them. This is part of what makes them so much fun, but it can also lead them into harmful situations. Before you bring your new puppy home, make sure you survey your home for potential dangers. In many ways, making your home safe for a puppy is similar to making your home safe for a toddler. The following tips are designed to help you keep your puppy safe. Many of the following warnings apply for adult dogs as well:

Indoor hazards

• Know which plants are toxic (see our article, Plants Which Are Potentially Poisonous) and place them out of reach, or replace them with nontoxic plants. Toxic plants commonly found indoors include dieffenbachia, azalea, Calla lily, and philodendron.

• Keep all medications, including any dog supplements, in a safe area the puppy cannot access. Do not leave vitamins or other pills out on the kitchen counter or table. A determined chewer can make short work of a plastic container. Puppies are surprisingly quick at pulling things off of end tables or other low surfaces.

• Put bathroom trash cans up high where your dog cannot get into them. Sanitary supplies and used razors are only two of the hazards here.

• Full sinks, bathtubs, or toilets with open lids can be a drowning hazard. Avoid automatic toilet bowl cleaners if you cannot keep your puppy from drinking out of the toilet.

• Keep cleaning supplies in high cupboards or use childproof latches to secure lower cupboards. Remove the puppy from the area when you are using liquid or spray cleaners. They can get into the eyes of a curious puppy, and the vapors can be harmful to lungs and eyes.

• Be careful of your puppy around furniture. A rocking chair can harm a puppy's tail or leg, and a curious puppy may crawl under an open recliner or sofa bed.

• Electrical cords are a big danger to puppies, who often chew on them while playing. This can cause burns in the mouth, electrical shock, or death by electrocution. Tie up loose electrical cords and keep them out of sight. Run cords through purchased spiral cable wrap, cord concealers, or even PVC pipe to keep them safe from your puppy.

• Any type of fire can be dangerous. Screen off fireplaces and wood stoves. Never leave your puppy unattended in a room with an open flame or space heater.

• Cords for drapery and blinds can cause strangulation. Either tie up the excess cords, or cut the loop in the cord.

• Swallowed clothing may cause a dangerous intestinal blockage. Keep socks, nylons, underwear, and other clothing put away. Keep laundry baskets off the floor.

• Keep small objects (coins, jewelry, needles and thread, straight pins, yarn, dental floss, rubber bands, paper clips, toys, etc.) out of your puppy's reach. Jewelry and coins are easily swallowed and can contain metals that are toxic. Keep costly items and those of sentimental value put away until your puppy is older and less likely to chew.

• Keep fishing line, hooks, and lures stored out of reach.

• Be careful about closing doors as you walk through – your puppy may be right behind you and get caught.

• Keep doors and windows closed. Keep screens on windows and sliding glass doors securely fastened and in good repair, to keep your puppy from falling through or escaping.

• Close off stairwells with a baby gate.

• Many dogs will eat cat feces from the litter box if given the chance. In addition to being a disgusting (at least to us!) habit, this can be a dangerous health hazard. Cat litter can cause an intestinal obstruction, and in addition, any intestinal worms the cat has may be passed on to the dog. One solution may be to put the litter box behind a baby gate, either in a separate room or in a closet with the gate across the doorway. The gate can be raised up from the floor to allow the cat to go under it, unless the dog is able to go under it also. If the cat cannot jump over the gate easily, a stepstool beside the gate can help.

• Many human foods can cause problems for pets. Chocolate, onions, alcohol, and foods high in fat, sugar, or salt can be very harmful. Chocolate, coffee, and tea all contain dangerous components called "xanthines," which cause nervous system or urinary system damage and heart muscle stimulation. Problems from ingestion of chocolate range from diarrhea to seizures and death. All chocolate, fudge, and other candy should be placed out of your dog's reach. Grapes and raisins contain an unknown toxin, which can damage the kidneys.

• Tobacco products, including nicotine gum and patches, contain substances that can be toxic or fatal to dogs.

• Chicken bones, plastic food wrap, coffee grounds, meat trimmings, the string from a roast – all pose a potential hazard. Scraps from ham or other foods high in fat can cause vomiting and diarrhea, or pancreatitis. To be safe, put food away immediately, dog-proof your garbage, and do not feed table scraps to your dog. Uncooked meat, fish, and poultry can contain disease-causing bacteria, such as E. coli, and parasites, such as Toxoplasma gondii. These uncooked foods should not be given to your dog. For your own health, as well as your pet's, wash utensils that have been in contact with raw meat, and cook meat thoroughly.

• The holidays can bring extra hazards for dogs. For a review of holiday precautions, see "Keeping the Holidays Happy and Safe."

Outdoor hazards

• Do not leave your puppy outside unsupervised. To prevent your puppy from wandering, you will need to either build an outdoor kennel or provide secure fencing that your puppy cannot jump over or dig under.

• Provide your puppy a separate area of your yard to use as his bathroom area. Use fencing, or other means, to keep him out of areas where children may play, especially sand boxes.

• Some outdoor plants and trees can be toxic to dogs. Common ones include potato (all green parts), morning glory, foxglove, lily of the valley, and oak (buds and acorns). Many bulb plants, such as daffodils, are also poisonous. Cocoa bean mulch can be toxic to dogs. Some dogs chew and swallow landscaping stone, which can cause dangerous intestinal blockage.

• Make sure all gasoline, oil, paint, lawn fertilizers, insecticides, and auto supplies are placed into secure containers, out of reach. Be especially careful with antifreeze and rat poison, both of which taste good to dogs and both of which can be deadly if ingested.

• Pools, ponds, and hot tubs should be covered or fenced off. Drainpipes can also pose problems.

• Fire rings, barbecues, and other heat or fire sources pose the potential of causing burns.

• Keep all food and other garbage in securely closed containers. Used coffee grounds can contain harmful amounts of caffeine, and decomposing food may contain toxic molds. Keep compost in a secure bin.

• Walk around your property and look for other areas or items that could be a hazard to your puppy, such as broken glass, exposed nails, or other sharp objects. Plan how you will restrict your puppy's access to these areas.

Bringing home a new puppy is a time of fun and excitement. Following these tips will help you keep your new friend safe, so that the two of you can enjoy each other's company for years to come.