The potbelly appearance is due to the large number of adult roundworms in your dog’s belly.

Puppies that are four to six months old and have heavy roundworm infections may vomit large worms that are still alive, which could be very distressing to you. The roundworms will be an off white color. With early diagnosis and proper treatment, it is unlikely for your puppy to have such a severe infection. The vomiting is due to the adult roundworms irritating the lining of your dog’s stomach. Call your veterinarian if you see live worms and are unsure how to dispose of them. The chronic diarrhea may cause your dog to eliminate more often in the house, which would leave worm eggs in your home and potentially expose other pets, or re-expose him, to infection. With the digestive upset, your dog will eat less.

Signs of pneumonia include difficulty breathing, a deep cough, and lethargy. [6] X Research source

If you see adult worms, you may want to place a small sample in a tightly sealed plastic bag and take it with you when you take your dog to the veterinarian. Wear gloves when you collect the sample and wash your hands thoroughly afterwards. Roundworms are usually found in the feces. [8] X Research source

If your dog defecates outside of your veterinarian’s office, pick up and discard the feces immediately to prevent infecting other dogs.

Although unpleasant, you may see dead or dying roundworms in your puppy’s feces. If you have the puppy’s mom at home, she will need to be treated at the same time as the puppy. This will kill any larvae that may migrate to her milk and cause the puppy to be re-infected. Follow the prescribing instructions carefully to ensure effective treatment.

Even with a monthly preventative, you should have your dog screened for roundworms once or twice a year after his first year of life.

Roundworm eggs become infective after one to three weeks of being in the environment.

Wash your own hands frequently and properly as well since you are most likely the one who is picking up your dog’s feces.