Ultra-tiny dogs are undeniably cute, but I just don’t have the heart to recommend them.

I’m a veterinary technician with over 20 years of clinical experience. I’ve seen many teacup dogs come in for illnesses and injuries related to their diminutive size. I also have serious concerns about the way they are bred and raised. Here’s what you need to know before you purchase a teacup dog, plus some alternatives to consider.

What Is a Teacup Dog?
There’s technically no such thing as a teacup dog. The term “teacup” is a marketing phrase used to promote extra-small purebred dogs that typically weigh less than five pounds. No official standard exists for these breeds and no organizations recognize them as a breed or group. The closest category is the toy group, and many teacup dogs come from these breeds, including Chihuahuas, poodles, and Yorkies.

What’s Wrong With Teacup Dogs?
I think teacup dogs are awfully cute—who wouldn’t? But there are a few details about teacup dogs that prevent me from recommending them to others.

Breeding Practices
Some breeders will mate the runts of litters to produce the smallest dogs possible. The problem with this is that runts are typically the least healthy members of the litter. They are often born with hereditary health conditions that can be passed on to their offspring. Repeatedly breeding the offspring of runts can concentrate the undesired traits, increasing the chances of passing the genes to future litters. Super-small dogs may also have difficult pregnancies and complications in giving birth.

Responsible breeders choose to breed the healthiest dogs possible so that future generations are more likely to thrive. Unscrupulous breeders prioritize size and appearance over health.

Growth and Development
Some unethical breeders deliberately malnourish puppies to stunt their growth. They may also underfeed pregnant mothers to produce smaller pups. If this sounds appalling to you, that’s because it is. Poor development can lead to numerous health issues. More so, making an innocent dog suffer is plain inhumane.

Health Concerns
Not all teacup dogs are unhealthy, but most are prone to several specific conditions. Between poor breeding practices and inadequate development, many teacup dogs face health challenges throughout their lives. Their size makes storing energy difficult, so they must be fed more often to manage their blood sugar. Also, because teacups are so small, they can easily be stepped on or tripped over, causing potentially serious injuries or even death.

The following are some of the more common health problems seen in teacup dogs:

Hydrocephalus
Hypoglycemia (low blood sugar)
Heart disease or respiratory problems, sometimes caused by birth defects
Collapsing trachea
Seizures
Liver shunt (a birth defect that keeps the liver from flushing out toxins)
Luxating patella
Frail bones that are easily broken

Should You Get a Teacup Dog?
With all this information in mind, I hope you will pause before shopping for teacup dogs. Their popularity increases demand, which may encourage unethical people to breed more of them. Any dog labeled a teacup will have a hefty price tag, and consistent demand further drives up prices.

Fortunately, you can probably find a tiny dog that is healthy. It comes down to where you choose to buy or adopt.

Alternatives
If your heart is set on a tiny dog, you don’t need to fall for the marketing ploys of teacups. Search for reputable breeders with expertise in the dog breed you want and ask about their smallest dogs. If they use the term “teacup,” it’s a red flag. Ask about breeding practices, health testing of parents, and how the pups are raised. Be sure to meet the parent dogs and ask about their health.

Many litters produce runts that are still healthy. The runts are not typically appropriate for breeding, but they can still find loving homes. It’s important to spay or neuter these dogs when they’re old enough; the breeder may add this as a requirement in the contract.

You may even find a tiny dog up for adoption from a local animal shelter or rescue group. Veterinarians examine these dogs before they’re put up for adoption, so you can learn about existing health issues before you adopt. Best of all, you’ll give that dog a second chance at a happy life.