Ancylostoma caninum: severe anaemia in a suckling puppy
3-week-old crossbred puppy from a litter raised on a farm with an earth floor. It is weak, with very pale mucous membranes and black, tarry faeces. Faecal flotation is negative.
| Parameter | Result | Reference |
|---|---|---|
| Haematocrit | 12% | 3-week puppy: 25–35% |
| Total protein | 3.6 g/dL | 4.0–5.5 g/dL |
| Faecal flotation | Negative | Negative |
What is the most appropriate management?
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A. Rule out hookworm disease because the flotation is negative and look for another cause of anaemia
Larvae received in the milk can cause severe anaemia before the worms start laying eggs: a negative faecal test does not rule out hookworm disease in a suckling puppy.
B. Give oral iron and recheck in two weeks
Iron does not stop the blood loss caused by the worms and will not correct in time an anaemia that can be fatal in such a small puppy.
C. Treat only the affected puppy, because the dam is healthy
The source is the dam's dormant larvae, which keep passing into the milk: the whole litter and the dam must be treated.
D. Treat the whole litter and the dam with an effective anthelmintic, and stabilise the puppy (transfusion if the anaemia is severe)
Correct. This is acute neonatal hookworm disease from transmammary transmission. It requires an immediate anthelmintic for all, supportive care (warmth, nutrition) and transfusion if the haematocrit is very low.
lightbulb Key takeaway
Ancylostoma caninum is blood-feeding and in suckling puppies it can kill before eggs appear in the faeces. In a 2–4-week-old puppy with anaemia and melaena, treat the litter and the dam empirically and improve floor hygiene (larvae also penetrate the skin).
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.