VETTECH U 2024 / HOUSTON, TX
SURVIVING PARVO: VETERINARY NURSING STRATEGIES FOR PUPPIES IN CRISIS (CONT.)
Sponsored by
SATURDAY PM • SEPTEMBER 21
WALTER L. BROWN, RVTg VTS (ECC) BRIANNE MORROW, LVT, VTS (NUTRITION)
Treating hospitalized CPV-2 patients requires close monitoring and management of critical parameters. Regularly check PCV and TS to assess hydration and detect anemia or low protein levels. Monitor blood glucose levels for hypoglycemia due to vomiting and anorexia. Perform a CBC to evaluate for low white blood cell count and chemistry panels to assess electrolyte imbalances and kidney function. Check coagulation profiles for signs of clotting issues. Frequent reassessment of these parameters will guide treatment adjustments to ensure optimal care. The Canine Parvovirus Monoclonal Antibody (CPMA) uses monoclonal antibodies to provide targeted protection against CPV. Unlike traditional treatment for parvovirus – which typically comprises symptomatic supportive care, CPMA delivers pre-formed antibodies that specifically neutralize CPV, offering immediate protection. Its high specificity ensures effective virus neutralization, and it can be used for treatment of affected puppies sickened by parvovirus. CPMA is NOT a vaccine and works to directly neutralize active parvoviral virus within the body. A CHANGE IN NUTRITIONAL APPROACH Historically the traditional approach to treating puppies with CPV-2 involved withholding food or implementing a "nil per os" (NPO) directive, under the belief that this would allow the GI tract to rest and recover. However, fasting may exacerbate the condition leading to this practice increasingly now being recognized as outdated. 1,2 When the GI tract is deprived of nutrients, it can lead to a series of detrimental effects, including villous atrophy, increased mucosal permeability, and a heightened risk of bacterial translocation. These conditions can compromise the immune system, increase the likelihood of sepsis, and ultimately reduce the chances of survival. 3,4
Playing a leading role in helping puppies with CPV-2 recover is enteral nutrition, which involves providing nutrients directly to the GI tract. An important callout before continuing with this discussion is that feeding should only be begin after the puppy has had its fluid deficit corrected and electrolytes balanced. Then and only then does the introduction of enteral nutrition begin. 5,6 By providing nutritional support the integrity of the mucosal lining is maintained as the mucosal cells require nutrients from the lumen to function properly. In the absence of these nutrients, the mucosal barrier can become compromised, allowing bacteria and toxins to enter the bloodstream, leading to systemic infection. 6-8 Furthermore, enteral nutrition helps to prevent the severe intestinal contractions associated with fasting, known as hunger pains, which can cause additional discomfort and exacerbate the symptoms of CPV-2. 9 The benefits of early enteral nutrition extend beyond maintaining mucosal integrity. It also supports the overall immune function of the puppy. Nutrients such as glutamine are essential for the health of enterocytes, the cells lining the intestines, which play a key role in the immune response. By providing these essential nutrients, enteral feeding helps to maintain a robust immune defense, reducing the risk of secondary infections that can complicate CPV-2 and prolong recovery. 7,8,10 The ability to reduce the severity and duration of symptoms such as vomiting and diarrhea caused by CPV-2 has been shown through feeding puppies early on, challenging previous practices that advocated withholding food. Research indicates that the early introduction of enteral nutrition can significantly improve clinical outcomes by providing essential nutrients that support gastrointestinal (GI) function and overall recovery. In a study conducted by Mohr et al. (2003), puppies with CPV that were fed a highly digestible diet experienced less severe vomiting and diarrhea compared to those that were not fed. 11 This approach stabilizes the
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SEPTEMBER 20-22, 2024 | PROCEEDINGS | VETGIRLONTHERUN.COM
VETTECH U
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