VETTECH U 2024 / HOUSTON, TX
SURVIVING PARVO: VETERINARY NURSING STRATEGIES FOR PUPPIES IN CRISIS WALTER L. BROWN, RVTg VTS (ECC)
Sponsored by
SATURDAY PM • SEPTEMBER 21 4:15 – 5:15 PM
BRIANNE MORROW, LVT, VTS (NUTRITION)
INTRODUCTION Canine parvovirus (CPV-2) has historically been associated with significant outbreaks among dogs, particularly the young ones. Vaccination has played a key role in mitigating its impact by conferring immunity to most adult dogs. Unvaccinated adults may experience asymptomatic infection. Puppies aged 6 to 20 weeks are particularly susceptible as they depend on maternal antibodies, the levels of which decrease over time, rendering them more susceptible to infection. CPV-2 primarily affects the immune system and gastrointestinal tract, with rare cases causing severe symptoms, including shock and organ dysfunction. Clinical signs typically begin with lethargy, vomiting, diarrhea, which may lead to dehydration and shock. Polymerase Chain Reaction (PCR) is the gold standard for diagnosis, while enzyme-linked immunosorbent assay (ELISA) tests offer a rapid and cost-effective option, but with varying sensitivity. Additional testing is recommended for negative ELISA results in suspected cases. False positives from vaccination are unlikely due to the test's high specificity. Dogs that have recovered from CPV-2 can shed the virus for up to 54 days post-infection. The virus is highly resilient in the environment, persisting for up to a year, therefore, to effectively manage contamination, thorough cleaning to remove organic material must precede disinfection. If there is any doubt about the effectiveness of environmental disinfection, it is advisable to cease breeding activities and allow only vaccinated dogs with confirmed CPV-2 titers on the premises for at least one year following an outbreak. The cleaning products recommended for CPV-2 disinfection include sodium hypochlorite (household bleach), potassium peroxymonosulfate (e.g., Trifectant® or VirkonTM), and accelerated hydrogen peroxide (e.g., Accel®, Rescue®). While sodium hypochlorite is less effective in the presence of organic material and requires extended contact times, both potassium peroxymonosulfate and accelerated hydrogen peroxide maintain
efficacy even with organic material present. It is worth noting that despite claims on product labels, independent studies have shown that quaternary ammonium compounds (e.g., Triple Two, Roccal) do not consistently demonstrate viricidal activity against parvovirus. MEDICAL MANAGEMENT It's important to rapidly correct hypovolemia for cardiovascular resuscitation in critically ill dogs with CPV-2 enteritis using balanced crystalloid solutions. Vasopressors can be considered if hypotension persists. Synthetic colloids are controversial due to potential complications, and plasma may be used if significant crystalloid volumes have been administered. After cardiovascular stabilization, it's crucial to address dehydration. Antimicrobial therapy should be reserved for dogs showing signs of bacterial infection or those at high risk of bacterial translocation or sepsis. Broad-spectrum antibiotics should be used in neutropenic dogs until neutrophil levels normalize, and antibiotics should target gram-positive, gram-negative, and anaerobic organisms if sepsis is suspected. Maropitant, metoclopramide, ondansetron, and dolasetron are effective for managing nausea and vomiting, but caution is advised with maropitant in puppies. The efficacy of gastroprotectants in dogs with gastrointestinal disease remains unproven. CPV-2 hospitalization can be costly, especially in low-income areas. For stable dogs, outpatient treatment may be an option if hospitalization expenses are too high. Studies show similar survival rates for inpatient and outpatient treatments. One study reported an 80% survival rate for outpatient care in a veterinary hospital, while another found a 75% survival rate for dogs treated at home. Outpatient care requires commitment from veterinary staff, with daily progress reports and regular reassessments. If a dog's condition worsens with outpatient care, hospitalization should be reconsidered.
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SEPTEMBER 20-22, 2024 | PROCEEDINGS | VETGIRLONTHERUN.COM
VETTECH U
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