Hookworms (Ancylostoma) are blood-sucking parasites of the small intestine in dogs. They can also cause disease in humans (cutaneous larval migrans is caused by larvae penetrating the skin). Eggs are passed in the feces and hatch into infective larvae (especially during the warm season). Pups can become infected through the uterus, through the milk, by ingestion, and by larvae penetrating the skin. The clinical signs include anemia (pale gums), diarrhea, and skin irritation (larval penetration). Anemia, due to blood loss, is the most significant effect and can be fatal. Multiple dewormings (every 2 weeks) are necessary in pups, and most dewormers (Pyrantel, Panacur) are effective. Deworming the female before and after whelping will help reduce infections in puppies.