OUTPATIENT PARVOVIRUS: DOES IT WORK? DR. JUSTINE A. LEE, DVM, DACVECC, DABT
In the VETgirl Real-Life Rounds webinar, Outpatient parvovirus: Does it work?, Dr. Justine A. Lee, DVM, DACVECC, DABT reviewed outpatient parvovirus (OPP). Does it work and will puppies survive this?
KEY HIGHLIGHTS
4 DIAGNOSTIC TESTING Depending on the financial limitations of pet owners, the ideal “gold” standard for the parvovirus patient includes: Gold or Cadillac™ Standard: • Parvoviral fecal antigen test • Complete blood count + blood smear • Biochemistry panel • Venous blood gas (e.g., acid-base status, electrolytes) • Fecal float/smear • PCV/TS/BG/AZO • Blood pressure • PCR if negative fecal antigen test and still suspicious • Abdominal radiographs • Colloid oncotic pressure (COP) • + abdominal ultrasound (if intussusception is suspected) Silver or Honda™ Standard: • Parvoviral fecal antigen test • CBC with smear evaluation • Biochemistry panel or venous blood gas • Fecal float • Blood pressure Bronze or Yugo™ Standard: • Parvoviral fecal antigen • Blood smear + PCV/TS/BG/AZO • Venous blood gas with electrolytes (continued)
2 CLINICAL SIGNS Clinical signs seen with parvovirus include: • Anorexia • Lethargy/Listlessness • Malaise • Hypersalivation (e.g., secondary to nausea) • Vomiting • Abdominal pain • Diarrhea* • Hematochezia 3 PHYSICAL EXAMINATION FINDINGS Classic physical examination findings for the parvovirus patient include: • Dehydration (e.g., prolonged skin tenting, sunken eyes, etc.) • Cachexia • Hypothermia • Fever
Canine parvovirus (CPV), which was originally discovered in 1967, 1 is a common pathogen affecting young dogs that are unvaccinated, under- vaccinated, or immunosuppressed. Without treatment, CPV can be life threatening due to severe fluid losses and electrolyte derangements secondary to anorexia, vomiting, and diarrhea. In order to ensure the best outcome, treatment should be aimed towards symptomatic supportive care, aggressive fluid therapy, anti-emetics, antibiotic therapy, and nutritional support. This lecture will review the use of outpatient therapy compared to in-hospital treatment, and discuss the recent findings of the “CSU protocol.” 1 RISK FACTORS/SIGNALMENT Parvovirus is often seen in more urban environments with affected pups coming from poor husbandry backgrounds. As a result, pet owners may also have financial limitations. Dogs affected typically are < 6 months of age, between 6 to 20 weeks of age. 2 Typically, there is no gender predilection, although one study reported that in dogs > 6 months of age, intact, male dogs were overrepresented. 3 Certain breeds are thought to be at increased risk, including the American Pit Bull terrier, Rottweiler, German shepherd, and Doberman pinchscer. 4
• Tachycardia • Tachypnea • Pallor • Prolonged capillary refill time (CRT) • Hypersalivation
• Poor pulse quality • Hypovolemic shock
• Fluid filled loops of intestine • Malodorous diarrhea staining • Dyspnea • Death
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