So, you have an abnormally small dog that is predisposed to health problems due to the genetic faults that it took to get such a small dog. This health-crisis-waiting-to-happen is displaying signs that could be a fatal virus, a fatal intestinal perforation by a foreign object, or a fatal physical abnormality. You allow the dog to suffer for two days and now you wonder what it might be? Have you thought about taking him in to see his vet before he drops dead?
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