The health of puppies begins with the health of the parents and the grandparents and so on. Excellent nutrition of the mothers while pregnant ensures puppies are born without organ defects and strong immune systems. Imagine the sorry state of health that puppymills contribute to the puppies born to them, who become sickly adults suffering from degenerative diseases while quite young. Health, or lack of it, starts while puppies are fetuses. Mothers living under horrible conditions will be unhappy and stressed and her body constantly bombarded with the stress hormone"cortisol". Puppy fetuses are delicate and yet they too are bombarded with the stress hormones from their mother. On top of this comes the lack of proper nutrients. Such puppies born are not only physically weak but have serious personality disorders from lack of essential nutrients during prenatal care and while raised with a stessed & unhappy mother