Hypoglycemia (low blood sugar level) is a common and serious condition that can commonly occur in young puppies (especially small breeds). The maintenance of proper blood sugar levels is vital due to the brain being entirely dependent on blood sugar as a source of energy. This condition is typically caused by a puppy being unable to adapt to fasting during the post-weaning period. Young puppies cannot tolerate fasting for more than a few hours. Thus, puppies should have food available at all times and be monitored for consumption. Many factors can contribute to a puppy not eating as it should. These include any type of stress such as infections, vaccinations, physical exertion, weaning, poor nutrition, hypothermia, gastric upset, etc… Clinical signs include depression, hypothermia, confusion, seizures and coma. Treatment should begin by contacting your veterinarian. A warm, humid environment (85 degrees, 85% humidity) is very important. Oral sugar supplementation (dextrose, honey, sugar water) should be given if the puppy can swallow- 1cc/# hourly. Moist food and water should then be offered/forced while slowly weaning off the sugar. Your veterinarian may start an intravenous line if the condition warrants it.