Most puppies that need resuscitation are newborns that fail to breathe on their own immediately after birth. The steps you take in the first 60 seconds can determine whether that puppy survives. A healthy newborn puppy has a heart rate of 200 to 250 beats per minute and begins breathing within moments of delivery. When that doesn’t happen, you need to act fast with a clear sequence: clear the airway, stimulate breathing, keep the puppy warm, and provide rescue breaths if needed.
Newborn Puppy: The First 60 Seconds
The moment a puppy is delivered and isn’t moving or breathing, three things need to happen almost simultaneously: clear its airway, dry it off, and keep it warm. These aren’t separate steps you do one at a time. You accomplish all three by vigorously rubbing the puppy with a clean, warm towel.
Start by using the towel to wipe away the amniotic sac if it hasn’t already broken. Then rub the puppy’s body briskly, focusing on the chest and back. This friction does double duty: it dries the coat (which prevents dangerous heat loss) and provides tactile stimulation that triggers the puppy’s first breath. While rubbing, use a corner of the towel to gently clear any fluid from around the nostrils and mouth.
Most puppies that appear limp at birth will respond to this stimulation alone. You don’t need to actively suction the throat or deep nasal passages in most cases, even if the amniotic fluid looks discolored. A clean cloth wiped around the nose and mouth is sufficient. If you have a small bulb syringe available, you can use it to gently clear the nostrils: squeeze the bulb first to push the air out, place the tip just inside a nostril, then release to draw mucus into the bulb. Keep the suction gentle and brief.
Do Not Swing the Puppy
An older technique involved holding the puppy in both hands and swinging it in a downward arc to force fluid out of the lungs. This practice is dangerous and can cause fatal brain trauma. A published veterinary case documented significant intracranial injury in a puppy that was swung by an experienced birth attendant, even though the puppy’s head was stabilized during the motion. The forces generated are simply too much for a newborn skull. Use towel rubbing and gentle suctioning instead.
Keeping the Puppy Warm
Temperature control is not optional during resuscitation. It’s as critical as getting the puppy breathing. A normal newborn rectal temperature falls between 95°F and 99°F (35°C to 37.2°C). Wet newborns lose heat rapidly, and when a puppy becomes chilled, its heart rate can drop dramatically. A puppy whose body temperature falls to 70°F will have a heart rate of only 40 beats per minute, down from the normal 200 to 250.
Place the puppy on a dry, warm surface after the initial rubbing. Warm towels work well. If you have a heating pad, set it to low and place a towel between the pad and the puppy to prevent burns. A heat lamp positioned overhead can also reduce heat loss. The goal is steady, gentle warmth. If the puppy is cold at birth, rewarm it gradually over one to two hours. Avoid overheating, which can cause respiratory distress in newborns.
For ongoing warmth after resuscitation, an incubator or enclosed warm space set to 84°F to 89°F (29°C to 32°C) provides a stable environment. A simple setup using a box lined with warm towels and a covered heating pad can substitute in a home setting.
Rescue Breaths for a Newborn
If vigorous rubbing and airway clearing don’t produce spontaneous breathing within about 15 to 20 seconds, the puppy needs rescue breaths. Cover both the puppy’s nose and mouth with your mouth (or use a small piece of thin cloth as a barrier). Deliver very small, gentle puffs of air. You are inflating lungs the size of grapes. Forceful breaths can rupture delicate lung tissue.
Give two to three small puffs, then pause to check for any response: chest movement, a gasp, body tension, or a change in color. The puppy’s gums and tongue should gradually turn from blue or gray to pink as oxygen reaches the blood. If the puppy remains limp and blue, continue giving gentle breaths every two to three seconds while maintaining warmth.
CPR for Older Puppies
If you’re dealing with a puppy (not a newborn) that has collapsed and isn’t breathing or has no pulse, the approach shifts to standard small-animal CPR. The recommended protocol follows a 30:2 pattern: 30 chest compressions followed by 2 rescue breaths, then repeat without delay.
For a small puppy, lay it on its right side on a firm surface. Place your thumb and fingers on either side of the chest, just behind the front elbows, and compress the ribcage by about one-third to one-half of its width. For very tiny puppies, you can wrap one hand around the chest and squeeze rhythmically with your thumb and fingers. Aim for a fast, steady rhythm of about 100 to 120 compressions per minute.
After 30 compressions, tilt the puppy’s head back slightly to straighten the airway, close its mouth, and deliver two quick breaths into its nose. Each breath should be just enough to make the chest visibly rise. Then return immediately to compressions. Continue this cycle until the puppy begins breathing on its own, you can get to a veterinarian, or you’ve been performing CPR for an extended period without any response.
Assessing Whether It’s Working
Veterinarians use an adapted version of the Apgar score to evaluate newborn puppies. You can use the same five observations at home to gauge whether your efforts are having an effect:
- Color: Gums and tongue should be pink, not blue, white, or gray.
- Heart rate: You should feel a rapid heartbeat when placing a finger on the chest behind the left elbow. In a healthy newborn, this will be very fast, around 200 beats per minute or more.
- Reflexes: Gently pinch a paw or rub the belly. A responsive puppy will flinch, pull away, or cry.
- Movement: Look for any voluntary muscle activity, squirming, leg movement, or attempts to right itself.
- Breathing: The chest should rise and fall rhythmically. Newborn puppies breathe slowly in their first week, around 10 to 18 breaths per minute.
Each of these factors tells you something about how well the brain and body are recovering. A puppy that scores poorly on reflexes and movement may have neurological compromise, even if breathing has resumed. These puppies need close monitoring and veterinary evaluation.
Signs That May Fool You
One important caution: a newborn puppy that is cold and oxygen-deprived may have a heart rate that looks normal for an adult dog, somewhere around 60 to 100 beats per minute. This can be misleading. For a newborn, that rate is dangerously low. Normal is 200 to 250 bpm. If the heartbeat feels similar to what you’d expect from an adult dog, the puppy is in serious trouble and needs continued resuscitation and rewarming.
Similarly, a puppy that begins breathing but remains cold will not sustain its recovery. Warmth and breathing go hand in hand. Prioritize both throughout the process, and get the puppy to a veterinarian as soon as its condition allows transport.