Puppies: Tube Feeding

Everybody who has ever come across artificial feeding of newborn puppies remembers in detail this time-consuming and exhausting crazy continuous round of events. In a situation like this, little time is left to sleep or just to have a rest – puppies must be fed in the daytime and at night; moreover, the time when the last puppy is fed is very close to the moment when the first puppy must be fed again. And it is like that several weeks running. Things are easier when the litter is not very big, when the puppies are not weak and suck actively.
There are several conditions when artificial feeding becomes necessary:
1) a big litter while the puppies’ mother does not have enough milk;
2) the bitch has no milk due to an illness (including suppurative mastitis) or due to other reasons;
3) hypertrophy of nipples (sometime a bitch may have too big nipples for the puppies to take);
4) mother’s milk intolerance;
5) orphaned puppies.
In all abovementioned cases, artificial feeding is the only way out. There are a lot of methods of artificial feeding, each of them having its advantages and drawbacks. The most widespread and, at the same time, the most laborious one is using a feeding bottle. Unfortunately, this method has a number of serious drawbacks. The minor drawback is that while eating, a puppy swallows quite a lot of air, which fills a part of the puppy’s stomach and provokes colic – abrupt pain in stomach and intestines. The puppies become restless, they often cry and whine. Moreover, puppies often choke while trying to quickly suck in as much milk formula as possible, hence the risk of aspiration pneumonia. Or, on the contrary, a puppy may not receive the milk formula while sucking violently, as air access to the bottle may be restricted and, consequently, the puppy receives no milk. It is very difficult to make the correct opening in the teat, especially if puppies in the litter are of different sizes.
One can try to feed puppies using a syringe without the needle. In this case the milk formula is dosed with the help of the plunger, but this feeding method demands definite skills, so it is rather risky and quite laborious.
I would call dropper feeding the worst of the classical methods of artificial feeding. It demands great patience and excellent skills in working with the ‘instrument’. (However, I must say that this very method helped me to save my own baby – due to some reasons, I had to apply dropper feeding).
The following method, in my view, is the simplest, the fastest and the most optimal one. It is tube feeding. No doubt, definite skills are necessary to apply it; on the other hand, it has a lot of advantages. Firstly, it allows giving the puppy the right amount of milk formula during each feeding time. Secondly, it is easy, when necessary, to give the puppy any medicine or food supplement. Thirdly, there is almost no air swallowing, and less feeding time is needed (for a litter of seven – eight puppies it makes about 15–20 minutes). There is also no food aspiration.
For tube feeding, a flexible tube of scalp vein set is used, or a nasogastric tube which is used in premature newborns.

Having chosen the tube, you need to make marking to know how deep to insert it. The necessary length is from the puppy’s lips to its last rib. It is important for the puppy not to shrink, but to lie in full length when you measure it. If you measure a shrunken puppy, the length of the tube measured by you to insert will be shorter than it must be. It is easier if the tube is factory-marked – then you just write down or memorize the length in centimeters necessary for each puppy. If the difference in puppies’ sizes is small, as well as the difference in length, you may use the average value. If the tube is not factory-marked, mark it with adhesive plaster or a non-toxic waterproof marker. Take into account that the puppies’ measurements will change as they grow, and you will have to insert the tube further down. So it is necessary to make new measurements from time to time, or to trust your experience and rationality, measuring the tube by eye.
According to all rules, for each puppy there must be a personal tube and a personal syringe. In practice, there are usually two or one for the whole litter, so the instruments must be washed in boiling water after each puppy. The tube and the syringe must be washed thoroughly after each feeding, and they must be stored in a sterilizer (if you have one) or in a clean ironed piece of cloth.
Before feeding, place everything so that you could reach what you need easily. You will need a bowl with the milk formula, a cup with the liquid to lubricate the tube (you can use linseed decoction, or vegetable oil, or neither of these – you can just put the end of the tube into the milk formula) and syringes.

When everything is ready, put the puppy on the table, or, what is more convenient, on your lap. Holding the puppy with your left hand forefinger and thumb, take the muzzle so that the puppy would open its mouth a little. Then, with your right hand, put the lubricated tube into the puppy’s mouth, on the root of tongue, and carefully guiding it, insert it into the throat.

If the puppy has a well-developed sucking reflex, it makes things easier: give him suck your finger with the tube pressed to it – the puppy will suck in the tube easily. You will only have to slowly guide the tube down the necessary depth, following the marking.

When you insert the tube, be calm and attentive. If you feel that the tube does not go down, take it out, lubricate it and try again. Almost always, the tube gets into the stomach inlet or into the stomach. However, if you put the tube into the windpipe or into the trachea (which is an extremely rare case), the puppy will start coughing, chocking and it may faint. If this happens, never worry, panic or fuss about. Take the tube out carefully, calm the puppy down and start again.
Insert the tube slowly and never force it in! After the necessary length of tube is inserted, make sure that it is in the stomach and is placed correctly. To do it, attach an empty syringe to the tube and pull the plunger slightly to make sure that it sucks out digestive juices or curdled milk. If you pull the plunger and feel any resistance, it means that the end of the tube is set against a stomach wall - so if you go on, you may provoke bleeding. Do not panic – if the end of the tube is set against a stomach wall, the resistance is felt at once, and it is impossible not to notice it. Move the tube gently, pull it a bit towards you but do not pull it all out, then pull the plunger again. If nothing changes, pull out the tube; let the puppy breathe for a while and to calm down, then start over again. In case everything works and when the plunger is pulled digestive juices or curdled milk go up, attach a syringe with the milk formula to the tube and start depressing the plunger very smoothly and slowly.
Hold the syringe almost vertically, with the end down, to avoid introduction of air. Remember that the formula must be given extremely slowly. An intense stream may cause the so-called ‘mechanical burn’, which can further lead to serious problems.
When the contents of the syringe are in the stomach, wait some 20–30 seconds to make sure that everything is all right. Then pull out the tube with one smooth and confident movement. Hold the puppy in a vertical position for some time, like you do with a baby, to let it belch the taken-in air. Do not worry if everything does not go as fast and smoothly as you would like it to. Experience comes gradually. When you do everything for the first time, let a person experienced in tube feeding control you. It can’t be that hard and every road starts with the first step.

The amount of food depends on the age and the weight of the puppy. It is usually considered that a puppy should receive as much food as possible, but I must say that the principle “the more the better” does not work in this case. If the amount of milk formula per one feeding is too large, it may pour back through the puppy’s nose and mouth before you pull out the tube or before that. It is not very dangerous but, if repeated regularly, may cause irritation of mucous membrane and a lot of other problems. Moreover, the puppy’s digestive and enzymatic systems are not fully developed yet, and they are not adapted to an excessive load, so the amount of food must be strictly dosed, optimally for the age. Overfeeding may lead to the puppy’s death; thus, during artificial feeding you must be very careful and do everything gradually, little by little, according to the principle ‘better less, but more often‘.
The volume of milk formula per one feeding of a one-day old bulldog puppy is 5–7 ml, depending on the size of the puppy. Further on, the amount of milk formula is gradually increased, but it is done very carefully. The thickness and the composition of milk formula are changed gradually, as the puppy grows; it is important to pay attention to the stool. The temperature of food depends on the puppies' age. For one to three-day old puppies it is 38–39°, which is approximately equal to mother’s body temperature. Before the end of the first week of life the temperature of food is about 30–32°, before the end of the second week – 28–30°, the third – 26–28°. As the puppy grows, the milk formula becomes colder, about 24–26°.
During the first days of life puppies must be fed 11–12 times a day, during the second week of life – 8–10 times, at the beginning of the fourth week of life – 6–7 times. The intervals between feeding times are increased, as well as the amount of food given per one feeding.

Newborn puppies can be fed with the ready-made milk formula, close to a bitch’s milk in composition. Unfortunately, having tried a lot of different ready-made milk formulas available at the market, I have chosen none of them. Some are not dissolved very well in water; some cause diarrhea or constipation; some cause allergy and the puppies are covered with pimples, like little frogs, and so on. It is not very convenient to buy and store dry milk formula beforehand – there is always a chance that this time you will not need it at all. However, it often happens that you need food urgently right at the time when all pet shops and vet stations are closed till morning or for the weekend. In this case I suggest turning to old, time-tested recipes, with little additions and changes ‘in the spirit of the times’, - but this is another topic.