A young puppy has very little in reserve: it can go from a bit quiet in the morning to seriously ill by the evening, so it pays to know in advance which signs mean “call now”, which mean “call today”, and who you will call at two in the morning.
The most important first
- Call your veterinarian or an emergency clinic now if your puppy collapses, has trouble breathing, has a seizure, has pale or unusually colored gums, bleeds heavily, cannot stand, or may have eaten something poisonous or swallowed an object.
- Vomiting or diarrhea in a puppy is never something to sit on for days. Call the same day, and call at once if there is blood, if it keeps happening, or if the puppy is also flat and not eating. Parvovirus, which is most common in unvaccinated or not yet fully vaccinated puppies, starts exactly like this.
- Very small puppies can drop their blood sugar if they go too long without food, get cold or are stressed by the move. Weakness, trembling, wobbliness or unusual sleepiness in a toy-breed puppy is a reason to call straight away.
- Treat eye problems as urgent, and do not try home remedies for anything on this page while you wait.
- Before your puppy comes home, save your veterinarian’s number, the nearest 24-hour emergency clinic and a pet poison hotline in your phone, and know how you would get there.
Why puppies need a lower threshold
An adult dog with a mild stomach upset often recovers on its own. A puppy has less body fat, a smaller store of energy in its liver and a less mature immune system, so the same upset can lead to dehydration or low blood sugar much faster. The American Kennel Club’s guidance on low blood sugar notes that very young, small puppies are most at risk, especially when they go too long between meals, are cold or stressed, or carry intestinal parasites — all of which can happen in the first days in a new home. That is why the advice on this page is cautious on purpose. Calling and being told “keep an eye on it” costs you a few minutes. Waiting too long can cost far more.
Call now: signs that cannot wait
The ASPCA and the American Veterinary Medical Association list the same core emergencies for dogs of any age, and they apply even more to puppies. Phone your veterinarian, or an emergency clinic if your own practice is closed, and say you are on your way if your puppy has any of these:
- Collapse, or cannot stand, extreme weakness, or unusual floppiness or wobbling.
- Trouble breathing: fast, labored or noisy breathing, breathing with the mouth open while resting, or blue-tinged gums.
- Pale, white, gray or unusually colored gums, or a body that feels cold to the touch.
- A seizure, or loss of consciousness.
- Heavy bleeding, or any injury from a fall, a car, being stepped on or another dog.
- Possible poisoning: chocolate, grapes or raisins, xylitol (in some gum, sweets and peanut butters), human medicines, rat or slug bait, or anything you are not sure about. Do not make the puppy vomit unless a veterinarian or poison line tells you to.
- Possible swallowed object, gagging, choking, repeated retching or a swollen, painful belly — see puppies and swallowed objects.
- Signs of overheating: heavy panting, drooling, weakness or confusion after time in a warm car, room or yard.
- An eye injury, a suddenly cloudy eye, or a puppy that keeps one eye shut.
If your puppy is choking or bleeding, the AVMA advises basic first aid on the way, such as firm pressure on a bleeding wound, but is clear that first aid is not a substitute for veterinary care. Ask someone else to phone ahead while you drive, so the clinic is ready when you arrive.
Call today: signs that need a vet the same day
Some signs are not an emergency on their own but should not wait until next week. Call your practice the same day if your puppy:
- Vomits more than once, or has diarrhea, especially if it is not eating, seems quiet or has any blood in either.
- Has not eaten for a whole day, or a toy-breed puppy that skips more than a meal or two.
- Seems lethargic: sleeping more than usual and not interested in play or exploring when awake.
- Has a cough, nasal discharge or sticky eyes, or squints or paws at an eye.
- Strains to pass urine or stool, or has not passed stool for a day.
- Limps, cries when picked up, or will not use a leg.
- Is losing weight, or its belly looks swollen while the rest of it looks thin.
Parvovirus is the reason vomiting and diarrhea matter so much in puppies. The Merck Veterinary Manual describes it as most common in puppies from about six weeks to six months that are unvaccinated or not yet fully vaccinated. The first signs are often vague — tiredness, poor appetite and fever — followed within a day or two by vomiting and diarrhea, often bloody. With prompt hospital care, most puppies survive, but without care young puppies can die. Tell the clinic when you call that you have a young puppy with vomiting or diarrhea, so they can keep it away from other dogs on arrival.
Low blood sugar in small puppies
Toy and very small breeds are most at risk of hypoglycemia, a drop in blood sugar. AKC Chief Veterinarian Dr. Jerry Klein describes affected puppies as often extremely lethargic, uncoordinated, trembling, or even unconscious or seizing. Prevention is mostly routine: keep feeding times regular, do not let a small puppy go long without food, keep it warm, and let it rest after travel and play. If your breeder sends a written feeding plan, follow it closely for the first weeks. Ask your veterinarian at the first visit what you should keep at home for an episode and how to use it, and remember that any home measure only buys time on the way to the clinic. A puppy that has had an episode needs to be seen.
In practice
A family collects a nine-week-old toy-breed puppy on a Saturday. It is too excited to eat much that evening, plays hard on Sunday morning, then sleeps through lunch and wobbles when it stands up. They remember the breeder’s note about small puppies and blood sugar, call the emergency clinic saved in their phone and are seen within the hour. The puppy recovers, and the breeder adds a line to every puppy pack: three or four small meals a day for the first weeks, on a fixed schedule, even on busy days.
(Illustrative, composite scenario.)
Be ready before you need it
- Book a check with your own veterinarian within the first few days, and ask how the practice handles emergencies out of hours.
- Save three numbers in your phone: your veterinarian, the nearest 24-hour emergency clinic, and a pet poison hotline. In the US, the ASPCA Animal Poison Control Center (888-426-4435) and the Pet Poison Helpline (855-764-7661) both answer around the clock and may charge a fee.
- Keep a copy of your puppy’s records from the breeder — vaccination and worming dates, microchip number — where you can grab it.
- Have a carrier or box you can lift the puppy into, and know the route to the emergency clinic.
- Ask your breeder what is normal for this puppy: how much it eats, how often it sleeps, what its stools have been like. Knowing normal makes abnormal easier to spot.
Your breeder is a good person to tell, and often knows the litter better than anyone. But the breeder is not your puppy’s veterinarian. When something on this page happens, call the clinic first and the breeder after.
Work on it
A few minutes here will teach you more than re-reading the article.
Ask yourself
- If my puppy collapsed tonight, do I know exactly where I would drive?
- Do I know what my puppy’s normal appetite, energy and stools look like?
- Is there anything in my home, bag or yard that would be on the poison list above?
Find out & check
- Call your veterinary practice and ask what they do out of hours, and which emergency clinic they recommend.
Do one thing
- Save your veterinarian, the nearest 24-hour clinic and a pet poison line in your phone today, and put the same numbers on the fridge.
Was this article helpful?
Anonymous. We do not store your name, email or IP address.
Sources & further reading
- ASPCA — Emergency Care for Your Pet. aspca.org
- American Veterinary Medical Association — Pet First Aid (client brochure, 2025). avma.org
- American Kennel Club (Dr. Jeff Grognet, DVM) — What Constitutes a Veterinary Emergency?. akc.org
- American Kennel Club (Caroline Coile, PhD, with Dr. Jerry Klein, DVM) — Hypoglycemia in Dogs. akc.org
- Merck Veterinary Manual — Canine Parvovirus. merckvetmanual.com
- Animal Health Centre, Government of British Columbia — Canine Parvovirus (fact sheet, 2024). gov.bc.ca
- ASPCA Animal Poison Control — People Foods to Avoid Feeding Your Pets. aspca.org
Where evidence is limited, recommendations rest on established practice and expert judgment, and may be updated as knowledge develops. This page helps you decide when to seek help; it cannot tell you what is wrong with your puppy. If you are unsure, call your veterinarian. This is general information and does not replace advice from your veterinarian.