1. Hand-rearing a litter is a time-consuming exercise, and it can be very stressful. However, under some circumstances it may be essential; for example, if the bitch has died, is too unwell to nurse her puppies or has rejected the litter. Some of this guidance also applies to supplemental feeding (which may be required if the bitch does not have sufficent milk for a large litter, or if smaller puppies require extra nutrition if they are being pushed aside constantly by stronger, larger pups).

As the process is very demanding, and a bitch can generally rear a litter better than any person, one thing to consider is the possibility of finding a foster bitch. Do be aware that your search may be unsuccesful, because you need to find a bitch who has puppies of a similar age to your own litter. One big advantage of a foster bitch is that she can teach the puppies things that are very difficult for a human to do; e.g. learning bite inhibition and when enough’s enough at play time.

You can try looking for a foster bitch through your vet (who may know of a client who owns a bitch who has whelped recently), pet forums and breed clubs. Make sure any financial arrangements are made beforehand if applicable. Although the situation is often a beggars can’t be choosers one, do make sure the owner is responsible and suitable, and if you are in any doubt, it is better to rear the litter yourself.

2. Colostrum is a highly concentrated mixture of antibodies, water, vitamins, electrolytes and other nutrients that is present in the first milk that the bitch produces during the first 24 hours after she has given birth. Most hand-reared litters are brought on after this time so will have received colostrum, but in the event that they have not, oral or injectable doses of blood serum or plasma from a healthy dog may compensate for the lack of colostrum (and those vital antibodies). Puppies who have not received colostrum will always be much more vulnerable to infection and illness.

3. A bitch will stimulate her very young puppies to urinate and defecate, so in her absence this will become your job. You’ll need a large supply of cotton pads and some luke-warm water. Use this to gently massage the anus and urinal orifice after every feed, although don’t be concerned if urination or defecation doesn’t happen every time. Keep an eye on stool colour and consistency. The faeces of very young puppies is normally quite sticky, but if the stools are loose then do seek prompt veterinary advice as young pups can very quickly become dehydrated and lose electrolytes if they suffer from diarrhoea. After the pups are about 3 weeks old, they should be urinating and defecating by themselves, but they may still need help cleaning themselves up afterwards.

4. Formula milk especially for puppies is the best option, and it makes life much easier as you simply add water to reconstitute it rather than having to blend different ingredients if you are making your own bitch milk substitute. The milk should be warmed to body temperature and fed using a special bottle with a teat for the pup to suckle from. This is safer than syringe feeding because aspiration pneumonia (a dangerous condition where milk is inhaled into the lungs rather than going down the normal digestive tract channel) is more of a risk when using a syringe. The puppies should be fed when they are stomach side down rather than upright or upside down, and the head must not be over-extended. Make sure you are feeding suitable volumes according to the instructions for the puppies’ age and weight, and don’t be tempted to over-feed them, as again this can result in aspiration pneumonia (or cause diarrhoea). Not all puppies stop drinking when they are full, so it’s important to be very aware of when they have had enough. If the belly feels very taut or is more than gently rounded, then it’s a sign of too much milk. Feeds are usually every 2 hours until the pups are a week old (although if the pups are not underweight, they can take a break between midnight and 4am). The second week, providing all is well, the feeds can be reduced to 4 hourly. From week 3, 6 hourly feeds are generally fine. Much will depend on the litter though, and some pups may need more frequent feeds if they are not taking enough milk when offered. Equipment should be kept very clean, and milk should be made up daily and kept in the fridge (ready to warm for each feed).

At 4 weeks, 4 feeds per day are usually acceptable unless there are any late developers or poor feeders. At 3-4 weeks, liquidised solid food can start to be gradually introduced, and the pups can be encouraged to lap on their own.

5. One of the most beneficial things for someone taking care of a hand-reared litter is a supply of willing helpers. The intensive feeding schedule is tiring enough in itself, but the constant cleaning up and monitoring of the litter are also time-consuming. Helpers can make a big difference between sanity and profanity! Little hand reared babies need burping, bathing, drying, parasite control (worming from 2 weeks of age) and constant monitoring (see 8) in addition to the feeding and husbandry already described, and this all increases the amount of time needed when hand-rearing.

6. Just like a “normal” litter, the puppies will need safe, warm and secure accommodation. This should be situated in a quiet area away from any other pets in the household. They’ll need a sleeping area lined with safe, disposable bedding (or easily cleaned bedding such as fleece). Make sure that any fabric bedding has no snags or loose thread that the pups can get caught up in or ingest. A heat pad should be placed at one side, and there should be sufficient space for the pups to move away from the heat if they are becoming too hot. Any sources of heat should be puppy-safe and there must be no accessible electrical cables. A toy stuffed dog can be a very welcome addition, and provides something furry for the puppies to snuggle up to as well as each other.

7. Puppies are unable to properly regulate their temperature until they are 2 weeks old. Prior to this they cannot generate enough heat to keep themselves warm, and they will not yet have developed a shivering reflex. If your puppies get too cold, warm them up slowly so as not to shock them. The initial temperature of their accommodation should be in the region of 29-30 degrees C. The temperature can gradually be brought down as the litter get older, and by the time they are 4 weeks old, normal room temperature is fine. Humidity should be at about 55 to 65%. An atmosphere which is too dry can contribute to dehydration.

8. Like a “normal” litter, hand reared puppies need regular monitoring. They should be weighed daily, have their mucous membrane colour and hydration status checked several times per day. Knowing what is normal and what’s not can be a great help. The rectal temperature at birth is 35.6 to 36.1°C, increasing gradually to 37.8° by 1 week of age.

During the first day of a puppy's life, the respiratory rate can range from 8 to 18 breaths per minute, depending on the breed size (smaller breeds have a faster metabolic rate so faster respiratory and heart rates). At day 2, the respiratory rate increases to 15 to 35 breaths per minute up. By 2 weeks of age, 12-35 breaths per minute is the normal range. The heart rate of a new born puppy can range from 120-180+ beats per minute.