Fading Puppy Syndrome (Failure to thrive) in Dogs

Key Takeaways

Fading puppy syndrome, sometimes called failure to thrive, refers to the death of apparently normal puppies within the first two weeks of life.

• The syndrome has many potential causes, but often the cause of the demise is unknown

• Congenital abnormalities are the cause of nearly half of all neonatal deaths and may not be immediately apparent

• Other potential causes include maternal issues, infectious causes, and environmental causes

• Symptoms vary widely, and may be subtle

• In general, fading puppies are cold to the touch, weak, and may not be able to suckle properly

• Diagnosis is usually postmortem and most often by necropsy (autopsy)

• Puppies often die before any specific treatment can be initiated

• If symptoms are noticed in time, supportive care such as hydration, rewarming, bottle feeding, and antibiotics may be effective

A Closer Look: What is Failure to Thrive in Dogs?

Failure to thrive occurs when a puppy does not meet basic development milestones in the earliest days of life. Most often, this occurs so rapidly, there is no time to initiate medical treatment before the puppy dies. It is not always possible to determine the reason why an individual puppy succumbed to fading puppy syndrome, but in general cases can be categorized as related to maternal issues, environmental factors, congenital abnormalities (aka birth defects), or infectious causes.

Fading puppies may be described as showing:

• Excessive crying compared to littermates

• Staying separated from littermates

• Low body temperature

• Limpness when picked up

Other symptoms stem from common conditions associated with puppies with failure to thrive, particularly dehydration and hypoglycemia (low blood sugar).

Risk Factors

Fading puppy syndrome is fairly common, and generally has a poor prognosis, especially in puppies within their first week of life. Whenever any puppy seems sick, prompt veterinary care is ideal. If a puppy dies, necropsy (autopsy) findings may help to prevent other puppies from dying of the same underlying cause.

Possible Causes

Causes associated with maternal issues include:

• Lack of adequate care from the mother

• Lack of milk production or poor-quality milk

• Malnutrition/improper nutrition: homemade raw diets in particular have been associated with higher rates of failure to thrive and neonatal sepsis

• Age of mother (too young or too old)

• Cannibalism

Mastitis (infection of the mammary glands)

• Poor maternal health, including underlying illness

• Parasites 

• Injuries during pregnancy

Dystocia (difficulty giving birth)

Causes associated with environmental factors include:

• Unsanitary conditions • Extreme temperatures

Congenital abnormalities (may not be immediately apparent) that may lead to failure to thrive include:

Cleft palate • Hydrocephalus

Kidney defects • Heart defects

Infectious causes include:

Parvovirus • Distemper • Canine adenovirus

• Heavy worm burden • Bacterial infections • Fungal diseases

Giardia parasitesCoccidia parasites

Main Symptoms

Signs and their severity vary depending on the underlying cause. Examples of specific symptoms outside of obvious weakness, coldness, and inability to breastfeed may include:

• Abdominal distension • DiarrheaDifficulty breathing

Cyanosis (bluish mucous membranes)Rapid breathing

• Red or spotted gums • Jaundice (yellow skin and gums)

Blood in the urineEye dischargeNasal discharge

Sneezing • Poor weight gain/thin body condition

• Enlarged, round head (from hydrocephalus)

• Physical defect in the lip, nose, soft and/or hard palate (from the presence of congenital abnormality cleft palate)

Testing and Diagnosis

If a puppy is presented for treatment with suspected failure to thrive, supportive therapy is initiated immediately, prior to any diagnostics. If there is an identifiable underlying cause, this may be determined by bloodwork, urinalysis, and diagnostic imaging once the puppy is stabilized.

Steps to Recovery

Treatment is supportive (such as warming, hydrating, supplemental feeding, and ensuring a clean environment) or may be more specific (such as antibiotics, antiparasitic medications, or in the case of some congenital defects, humane euthanasia) if an underlying cause is identified.

If an underlying cause can be identified and treated in time, puppies may make a full recovery, though some may have lifelong health problems. Often, puppies die before an underlying cause is identified, and/or before treatment is initiated. The outcome is highly dependent on the underlying cause and response to treatment. The prognosis is poor, and grave in puppies less than a week of age.


Many puppies with failure to thrive have underlying congenital conditions. Screening breeding animals for genetic conditions is an important preventive measure. 

Fading puppy syndrome can also be caused by contagious or infectious diseases. Transmission may be prevented by appropriate vaccination, regular vet care including deworming, and good hygiene practices for breeding animals. Monitoring maternal health and fitness for and during pregnancy also helps maximize outcomes.

Is Failure to Thrive Common in Dogs?

Fading puppy syndrome is common in dogs.

Typical Treatment

• None

• Rewarming

• Rehydration

• Supplemental feeding

• Addressing environmental or hygiene issues

• Antibiotics

• Dewormers

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