As a Labrador breeder for over 20 years, I have encountered what we refer to as "swimmers". It is a puppy that cannot get up on his feet and start walking at the appropriate age, usually around 2 weeks.
I'm not going to go into all the possible reasons for this (as there's a lot of information and speculation on the internet) but in almost all cases is due to a newborn puppy lying flat on his belly, with arms and legs sprawled out, rather than on his side. Some think there's a correlation to the puppy's position in the uterus. I think it's simply the result of a newborn puppy choosing to lie on his belly in the first couple days of life. In many cases the chest will become flattened very quickly.
I had a puppy years ago that became flat on the chest by 3 days of age. Once that happens, the puppy is not comfortable on his side ... he tends to roll over on his belly again, or even onto his back. If the chest cavity flattens, it is of real concern, as it compresses and heart and lungs. This sometimes results in a puppy that is not thriving like the rest of the litter. If left too long, it could result in some permanent damage.
Thus, many vets recommend that a "swimmer puppy" be euthanized. I disagree.
Swimmer Puppy Photos
These before and after Here are a couple pictures of a puppy that I worked with. He was flat on the chest and had issues with both front and rear legs. (Left: 4 weeks) He turned out completely normal ... and beautiful. (Right: 8 weeks)
The common practice of euthanizing swimmers is outrageous to me, as it is to most of the dedicated, established breeders I know. I put this information together to help novice people who have a swimmer puppy and have no idea of what to do. If it saves only one puppy from being euthanized, it's well worth the effort.
I have had swimmer puppies with chests as flat as a pancake, some affected in both front and rear legs, and I have saved every one of them. It took a lot of work and time and trying many different techniques. To save a swimmer, one needs to intervene at a very early stage, from Day 1 until the puppies are up and mobile.
When a puppy is always on his chest-belly take action
If the puppy is usually on flat on his belly, his chest and/or his hips can start spreading out. Start propping the puppy on a pillow, fluffy blanket, rolled up soft towels or put big stuffed animals around him to prevent him from rolling onto his stomach. The purpose is to position him comfortably on his side, get him back to sleep, and hope that he isn't readily able to roll onto his belly again.
Photos of a swimmer puppy before and 1 week after therapy!
By 2 weeks puppies should be trying to get up onto their feet. A swimmer puppy simply can't. And the bigger and heavier they get, the more challenging it becomes. I'm not going to go into details of some techniques to try at this stage but here are a few that have been tried with various levels of success:
1. Make the bedding soft so a flat chest isn't resting on a hard surface when you're not watching. Put pillows, big stuffed toys and fluffy blankets in the whelping box so the puppy can climb up on them and pad his body. Follow the above actions to get the puppy to sleep on his side.
2. Note that the temperature in the room may be significant. In the first two weeks, you need to keep the whelping area warm as newborns cannot maintain their own body temperature. If it's too hot, the puppies don't pile up; they spread out, often sleeping flat. Ideally, you want to see the puppies piling up on each other for warmth. This helps keep them from going flat.)
3. Bind the puppies affected legs with a first aid tape. You need to try to pull the legs together at the right point, making a figure-8 in-between the legs. The goal is to make it impossible for the puppy to lay on his belly with his legs sprawled out to the sides; and to hold them in, under him, as he starts trying to get up and walk. I've done this numerous times with various degrees of success. It's difficult to get the bindings precisely at the right place and they tend to come loose but it is definitely worth the effort.
4. Try the "sock" technique, cutting holes for the legs in an old sock, padding the sock with soft stuffing under the flattened chest. I have tried this and found it virtually impossible to fit the sock to the point that it accomplishes anything, but there are examples/pictures on the internet.
5. Put a big piece of egg-carton foam in the whelping box. Goal is to give good footing but I found the puppy just tripped over the lumps ... and, of course, it got saturated with urine, etc.
6. Physical therapy. Yes, definitely worth the effort! I have no experience in therapy but it's just common sense. I have held puppies on my lap and done therapy exercises 2 or 3 times a day. If the chest is flat, I gently squeeze in from the shoulders; at the same time I pull one front leg straight out (as it should be if he were standing), then back in, then back out. Then do the other front leg.
7. If the hips are spread out and rear legs affected, I gently squeeze the hips inward; then pull a hind leg straight forward and back in a bicycle motion, making sure to allow a bending at the hock (as would happen if taking a step forward). I normally hold the leg near the hock but if a foot is twisted in or out, you need to correct that positioning at the same time. You do need to be careful, make sure you're not manually stretching something too far for the condition of the puppy's muscles and tendons.
If a puppy seems to have had enough of the exercises, I often have simply massaged the shoulders inward and the hips inward. Occasionally a puppy starts to "fight" the rear leg exercise; then, with his rear pads in my hand, I let him push a few moments in his struggle; I think that's beneficial as he's really using those leg muscles in a positive, correct manner.
I firmly believe that these daily exercises have given my swimmer puppies a tremendous advantage in overcoming the problem.
Swimming. Although I haven't tried this technique, I believe it would be a very constructive exercise. You can use a towel as a sling under the puppy's belly and carefully lower him into water. He instinctively should start to do a dog-paddle, thus using those muscles in a correct manner. I think this could help but it's not putting any weight on the muscles ... may not give results as fast as if you could get him walking on his feet. Lukewarm water in the bathtub or big sink should work but...
Traction. Give the puppy good traction under his feet. This is essential for allowing the puppy to build the muscles that will let him start to walk properly. We have used all sorts of things. I've spent days searching for carpet scraps that might provide good footing, others have used rubber-backed carpets or rugs turned rubber side-up ... which must result in a mess of pee and poop in the whelping box! But this essential need is the inspiration for my new idea (below) to give a puppy the traction he needs to develop his muscles and basically correct himself.
My Idea On A "Traction Mat" for Swimmer Pups
I came up with this idea when I had a big puppy, one of only two, who couldn't get up on his feet by 3 weeks of age. The front hadn't gone flat but his rear legs were twisted, one knee stuck out; all he could do was push his rear. I had been constantly turning him on his side, propping him up on a blanket, and doing some physical therapy already. I tried binding his rear legs but it just didn't accomplish anything.
I had a scrap of the rubber mesh material used for lining kitchen and tool box drawers; I laid it on the floor, put him on his feet on it and his traction was amazing! Of course, it moved around, wrinkled and he tripped over the wrinkles. But I knew I was on to something and that could be remedied.
I looked in the garage and found a piece of pressed board about 3' x 5'. (Smooth plywood would be better but the pressed board was all I could find quickly.) I spray painted it with a waterproof paint on the top side, left it to dry. I wanted it waterproof so I could clean it, particularly if I needed to leave it inside the whelping box.
I ran to the Dollar General store and bought a couple rolls of the rubber drawer lining, 18" wide was the widest I could find. I stretched the material across the board, stapled on the back side, then down the seam on the front, hammering the staples down so they'd be completely flush with the board.
I put the mat down on the whelping room floor and set the puppy down, positioning his feet as best I could. It was immediately amazing! This puppy really wanted to walk, and he started trying ... with more success than I expected. He had such good traction, and it was solid and unmoving under him. I'd call him to the opposite end of the mat, then praise him like crazy. He seemed so proud of himself!
The photo to the left, shows a swimmer puppy walking and hopping around almost normal within a week of using the traction matl!
I worked with the puppy on the mat two or three times a day. Within 2 days, the improvement was dramatic. Within 4 days, his body was correcting itself ... his twisted foot rarely twisted on him and the knee didn't stick out nearly as much.
It's been an amazing experience. I continued doing physical therapy with his legs for about the first 3-4 days, then realized that he didn't need that anymore.
Advantages are: (1) the drawer-lining rubber matt provides outstanding, stable traction, (2) it can be cleaned/sterilized and saved and re-used, and (3) it is inexpensive and easy to make. As long as you paint both sides and edges of the board, you can spray it with disinfectant, hose it off and dry it in the sun. It even could be put inside the whelping box if you don't think you can spend enough time with the puppy on the mat outside the box.