All the Hidden Dangers of Having a Tiny Dog

On its own, the name is adorable. “Teacup.” Among certain dog breeders and aficionados, this label describes dogs bred to be extraordinarily small — so small, in fact, that they’d fit inside a… well, you know. 

These pint-sized pups might command sky-high prices among certain dog lovers, but over the years, they’ve also courted plenty of controversy. At this moment, several animal-rights groups in the Netherlands have launched a campaign to ban the breeding and sale of dogs under a certain weight. They argue that these dogs are prone to numerous health problems and often suffer in silence, which makes their very existence unethical. 

But what’s the cutoff between an appropriately small toy breed and a dangerously tiny “teacup” pup, and how severe are the risks these dogs face? And, perhaps more importantly, what can those who’ve already brought a tiny dog into their home do to protect their health and comfort as much as possible?

How small is too small?

According to the Dutch animal rights nonprofit Dier&Recht, dogs under three kilograms, or six pounds, are at the most risk.

“That's the red zone you should stay away from, in our opinion,” says Kelly Kessen, a veterinarian and campaigner for the organization. “And orange, like in a traffic light system, is between three kilos and five. Above five, you’re safe.” (For those reading this in the United States, five kilograms comes out to just above 11 pounds.)

It’s worth noting that the American Kennel Club (AKC) does not recognize teacup breeds and recommends that anyone looking to buy a dog ask questions of any breeder who is “actively marketing puppies that differ from the breed standard.” 

According to the AKC, these pups “can be susceptible to a variety of health problems” — which brings us to why they’ve become so controversial.

What health risks do smaller dogs face?

According to Dier & Recht, tiny dogs can suffer from numerous health issues, including:

• Extreme headaches caused by hydrocephalus (build-up of cerebrospinal fluid in the brain's ventricles)

• Chiari malformation (herniation of the cerebellum through the back of the skull) 

• Syringomyelia (cavity formation in the spinal cord)

• Eye disorders

• Knee problems like luxating patellas

• Collapsing tracheas (windpipes)

Beyond these issues, Kessen argues, these dogs “are so small that they are very fragile, so their bones are like really thin sticks, and they break easily.” That can make it difficult and even dangerous for tiny dogs to interact with their normal-sized kin. 

Dr. Mondrian Contreras, a Pumpkin Pet Insurance veterinary expert who is not affiliated with Dier&Recht, says that miniature dogs “can be more prone to certain congenital health problems,” and that small breeds in general are often more susceptible to conditions like patellar luxation, dental problems, hypoglycemia, and certain heart diseases.

Many of these issues can come down to breeding practices. “I’m sorry to say, I see more puppy-mill breeding with small dogs,” Dr. Contreras says. 

At the same time, Dr. Contreras adds, “it’s worth mentioning that while I do notice many issues in these tiny dogs, larger breeds also have their fair share of health concerns, especially since they make up a bigger chunk of the dog population.” For example, he says, the AKC reports that larger breeds “are often prone to conditions like hip dysplasia and obesity-related problems.” 

When asked if tiny dogs tend to experience more pain, particularly as they age, Dr. Contreras says the answer hinges on the specific health issues they face. Because smaller dogs weigh less, conditions like medial patellar luxation might not impact their mobility or quality of life as much as they would for larger dogs. At the same time, smaller breeds could suffer more acutely from conditions like hypoglycemia and respiratory due to their size. Heart disease and dental issues, meanwhile, would likely cause similar kinds of pain, regardless of breed.

Dr. Contreras says the risk factors for dogs big and small all demonstrate “the importance of breed-specific veterinary care.”

Taylor Powell, a 20-year-old college student who has a two-year-old Teacup Yorkie named Bella, learned about the health issues these breeds face only after she’d already brought her pup home. Her family has always had Yorkies, and as someone with dog allergies, she appreciates that Yorkies are less allergenic than other breeds. 

“She’s an ESA, and she’s very good at her job,” Powell says. “I think she can sense whenever I’m not feeling the best, and she just kind of comes and lays on my chest, or just touches me in some way. She brings a lot of joy to my life, and to my family’s life as well.”

Bella’s kneecaps pop in and out of their sockets when she runs, Powell says, but “other than that, she’s been pretty healthy — although she does have a sensitive stomach. We just kind of have to watch that.” Powell uses a slow-feeding bowl to make sure Bella doesn’t eat too fast.

“It was about a year and a half ago that I really learned it was just small dogs that have that kind of stuff,” she says. If she gets another dog while in school, Powell says she “might go for a bigger dog, just because of all of the health issues and stuff that come with the smaller dogs. But in the future, whenever I actually have a career, I might think about getting a smaller kind of dog again,” assuming she has the money to “give it a good life.”

Per Dr. Contreras, it’s up to both breeders and pet parents to protect their animals’ wellbeing.

“While I completely support responsible pet ownership and understand that not everyone is suited for a larger dog, potential owners must be well-informed about the specific health risks tied to these tiny breeds,” he says. “Many teacup and mini dogs are susceptible to congenital issues due to the extreme selective breeding practices used to achieve their small size. This can lead to a variety of health problems, which can create both emotional and financial stress for their owners.”

Because of all this, Dr. Contreras says, it’s crucial that anyone considering bringing home a tiny dog “be aware of these potential challenges before making a commitment.” At the same time, he says, breeders should “aim to produce dogs that are not just small, but also healthy.”

Kessen and Dier&Recht go a step further. The Dutch organization aims to prohibit the breeding of dogs under three kilograms in the Netherlands, which has already banned the breeding of pets with excessively short muzzles and folded ears.

How to protect your tiny dog’s health

If you already own a teacup breed, it’s important to look after their wellbeing. That means being proactive and seeking as much information as possible about their health.

Keep up with your vet visits.

More than anything, Dr. Contreras emphasizes the importance of regular veterinary care. “Early detection and management of health problems can greatly improve the quality of life for these dogs and can help mitigate the financial burden on owners,” he says. 

That means:

• Regular check-ups

• Keeping up with vaccinations

• Ongoing dental care

Give them the lifestyle they deserve.

Remember, your tiny dog is still a dog, which means they want to engage in the usual doggie activities. “Despite their small size,” Dr. Contreras says, these dogs “need sufficient exercise, mental stimulation, and social interaction to thrive.”

Kessen’s advice? “Let them play as much as possible in a safe zone every day so they can be dogs.”

Adopt when possible.

If you do not already have a dog but want a miniature, Dr. Contreras recommends adopting from a rescue organization or shelter that specializes in miniature breeds. 

“While reputable breeders can also be an option, it's essential for owners to know how to find and properly vet one,” Dr. Contreras says. “By making thoughtful choices and prioritizing the health and welfare of these animals, we can help create a better future for them.”

Consider ordering an MRI.

It might sound extreme, but Kessen advises that all pet parents with tiny dogs get an MRI to ensure that neurological issues are not causing them to have extreme headaches, which they can often suffer in silence. 

“If they are in pain,” Kessen says, “you need to know and you need to treat it.” She also recommends asking your vet to check on your pup’s teeth for dental disease and their eyes for dryness, for the same reason.

In other words, proactive care will deliver the best health results possible for your dog regardless of size. Check with your vet early, and stay in touch often.