If the above methods don't work, or your puppy is displaying the following signs, you should bring them in for veterinary evaluation. (preventivevet.com)
If you see these behaviors and they do not resolve in a couple of hours, I recommend veterinary evaluation. (dogsora.com)
Instead, vaccines need not, and should not be the primary focus of a discussion about the importance and value of routine veterinary evaluations. (preventivevet.com)