Clinical signs
  • Vaginitis, metritis, vulvar discharge, and polyuria-polydipsia in the bitch.
  • Painful teats (one or several).
  • Anatomical anomaly of galactophorous teat canals (following recurrent mastitis).
  • Purplish "cauliflower anus" in puppies.
  • Continuous whining of puppies.


Before weaning, diarrhoea in puppies is generally attributed to suckling disorders. 

Toxic milk syndrome is an infection or bacterial poisoning of one or more puppies during feeding. Puppies are particularly exposed to food-borne diseases associated with bacterial contamination of maternal milk since micro-organisms or their toxins cannot be neutralised because of insufficient gastric acid in young puppies (gastric pH of 3 approximately versus less than 2 in adults).


- Ascending infection or haematogenous infection of milk or teats. 

- Clinical (usually acute streptococcal mastitis) or subclinical (usually streptococcal or colibacillary chronic mastitis) mastitis. However, milk does not appear to play any role in the transmission of beta-haemolytic Streptococcus which can often still be found in the mother's vaginal flora.

- Toxic milk syndrome is not always attributable to an ascending bacterial contamination of milk and may sometimes be related to the presence of toxins that have entered the milk through the blood (very often associated with post-partum mastitis in the mother). In the event of recurrent mastitis of the same mammary gland, it is necessary to examine the gland for an anomaly in the conformation of the galactophorous canals.


- It is sometimes difficult to detect diarrhoea in young puppies since the mother naturally licks the perineal region of puppies, often evoked by breeders as "puppies with a damp tail". 

- The faeces of suckling puppies are usually straw yellow in colour and have a sour odour. 

- Green-coloured diarrhoea reveals increased biliary secretion and accelerated bowel movements. An acidic pH shows lactase maldigestion whereas a putrid smell and high pH indicate protein maldigestion or necrotic diarrhoea. 

- Vaginal smears allow th detection of mastitis or vaginitis associated with toxic milk syndrome during haematogenous poisoning. 

- Bacteriological tests on milk are often deceptive for the following reasons: 

• Milk samples must be collected in sterile conditions by teat puncture, 

• Some bacteriologically sterile samples may however contain bacterial toxins which are undetectable but dangerous for puppies. 

• It is not possible to wait for the antibiogram results before treatment start.

Differential diagnosis 

- Toxic milk syndrome must be differentiated from osmotic and overconsumption diarrhoeas. 

- In the event of galactorrhoea (spontaneous flow of milk from teat), mere overconsumption diarrhoea may be observed in puppies, especially in dominant puppies suckling the posterior (and most productive) teats. Puppies then show "sourish" diarrhoea (acidic pH) linked to the saturation of the intestinal lactasic capacity. Unlike toxic milk syndrome or fading puppy syndrome, puppies suffering from overconsumption diarrhoea do not usually whine or cry because of abdominal pain.

- During simple overconsumption diarrhoea, puppies suckle normally, which is not the case during food-borne diseases (toxic milk syndrome). Protusion of a purplish anus tends to support the diagnosis of toxic milk syndrome. 

- In the event of overconsumption diarrhoeas, the micrographic examination of faeces (by rectal collection or swabbing) shows numerous fat drops after staining with Sudan III. 

- Neonatal campylobacteriosis (look for poultry droppings or carcasses of uncooked poultry in the vicinity). 

- Cryptosporidiosis (rare in dog breeding facilities).


- Reduce suckling time in case of overconsumption diarrhoea (separate mother and litter every 3 hours). 

- Premature drying-off of the mother and artificial feeding of puppies. 

- Antibiotic treatment of mother using an antibiotic with good mammary diffusion (spiramycin) while awaiting antibiogram results.


- Cull breeding bitches suffering from recurrent mastitis, generally linked to teat canal malformation enhancing ascending infections from the bedding. 

- Blunt puppy claws in case of mammary gland trauma attributable to scratches. 


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