You should have the mother and her puppies examined by a veterinarian within 48 hours of birth. This first check catches life-threatening problems early, when newborn puppies can decline in hours. After that initial visit, the schedule stays busy: deworming starts at two weeks old, vaccinations begin between six and eight weeks, and follow-up visits continue every few weeks until the puppies are at least 16 weeks old.
The First 48 Hours Are Critical
VCA Animal Hospitals recommends bringing the entire litter and the mother in for an exam within 48 hours of delivery. Many breeders build a veterinary examination within the first three days into their contracts. This visit isn’t optional or ceremonial. The vet will check each puppy for congenital problems that aren’t obvious to untrained eyes: cleft palates (which interfere with nursing), heart murmurs, spinal abnormalities, and hernias. Some of these conditions are immediately dangerous, while others simply need monitoring as the puppies grow.
The mother gets evaluated too. Your vet will confirm she delivered all the puppies and placentas, check for signs of infection in the uterus, and make sure she’s producing milk normally. A retained puppy or placenta can cause a serious uterine infection that worsens fast without treatment.
Weight Tracking Between Vet Visits
Between that first exam and the next scheduled visit, daily weigh-ins at home are the single best tool you have. Healthy puppies should gain 5 to 10% of their body weight every day during the first three weeks, regardless of breed. A typical puppy doubles its birth weight by about day six. The daily growth rate starts around 13% on day one and gradually decreases to about 6% by day 21.
Some weight loss in the first 48 hours can be normal, but losing 4% or more of birth weight during that window significantly raises the risk of death before three weeks of age. Puppies that lose more than 10% of their birth weight in those first two days are in serious trouble. If you see a puppy’s weight stall or drop, that’s your cue to call the vet immediately rather than wait for the next scheduled appointment. A simple kitchen scale accurate to the gram is all you need.
Deworming Starts at Two Weeks
Puppies can be born with intestinal worms passed from their mother, so deworming begins earlier than most new breeders expect. The standard schedule calls for deworming at 2, 4, 6, and 8 weeks of age. Your vet will typically prescribe the dewormer at that first 48-hour visit or shortly after, so you can administer the doses at home on schedule. If a breeder hasn’t started this protocol before the puppies go to new homes, the receiving owner’s vet will recommend deworming every two weeks for a total of four treatments.
Vaccinations Begin at Six to Eight Weeks
The first round of vaccines is given between six and eight weeks of age. The core combination vaccine protects against distemper, hepatitis, and parvovirus in a single injection. This shot is repeated every three to four weeks until the puppy is at least 16 weeks old, for a total of three rounds. Each visit also includes a wellness exam where the vet rechecks the puppy’s development, heart, and overall condition.
The reason for multiple rounds is that antibodies from the mother’s milk interfere with the vaccine’s ability to build the puppy’s own immunity. No one knows exactly when maternal antibodies fade for a given puppy, so the repeated doses ensure the vaccine eventually “takes” once that window opens. Skipping a round or stretching the interval leaves a gap where the puppy is vulnerable to deadly infections like parvo.
Warning Signs That Need an Immediate Visit
Newborn puppies can deteriorate in hours, not days. Fading puppy syndrome is a general term for newborns that fail to thrive, and the signs include refusing to nurse, persistent restless crying that isn’t soothed by nursing, failure to gain weight, and body temperature that’s too high or too low. A healthy newborn puppy feels warm to the touch and spends most of its time sleeping or nursing. A puppy that feels cool, lies away from the litter, or cries constantly needs veterinary attention right away.
Temperature regulation is a real vulnerability. Newborn puppies cannot maintain their own body temperature for the first week or two of life. The area where they’re kept should stay between 85°F and 90°F for the first four days. A chilled puppy stops nursing, which leads to low blood sugar, which leads to further decline. If you find a cold, limp puppy, warm it gradually and get to the vet.
Watch the Mother Too
The mother’s health directly affects the litter’s survival, and two postpartum conditions in particular warrant an emergency visit. Eclampsia, a dangerous drop in blood calcium, typically strikes during peak nursing demand in the first few weeks after birth. Early signs are panting, restlessness, and pacing. As it progresses, you’ll see muscle tremors, stiffness, a stiff or wobbly gait, whining, aggression, and hypersensitivity to sounds or touch. Without treatment, eclampsia leads to seizures, coma, and death. Small-breed dogs nursing large litters are most at risk. The good news is that treatment with intravenous calcium usually brings improvement within 15 minutes, but only if you get to the vet in time.
Metritis, an infection of the uterus, is the other major concern. Signs include foul-smelling vaginal discharge, fever, lethargy, and loss of interest in the puppies. Some vaginal discharge after birth is normal (it’s typically dark red or greenish-black and decreasing over days), but discharge that smells bad or increases rather than decreases signals infection.
Getting Newborns to the Vet Safely
Transporting very young puppies requires some preparation because of their inability to regulate body temperature. Line a sturdy box or carrier with soft towels and place a warm (not hot) water bottle or microwavable heat pad underneath, covered by a layer of fabric so the puppies don’t contact it directly. Keep the car warm and the trip short. Bring the mother along if possible, both for her own exam and because separation stress can disrupt nursing. If you’re transporting a single sick puppy, tuck it against your body inside your jacket for warmth during the drive.