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762 Parvoviral Enteritis

hypermotility and intussusception; deter- or nasoesophageal tube and with control of • Persistent lymphopenia and elevated
mine need for prokinetics based on • Syringe feeding is an acceptable alternative C-reactive protein have been associated with
vomiting (p. 1107).
VetBooks.ir ○ Gastric acid suppressants: pantoprazole but may predispose to food aversion and PEARLS & CONSIDERATIONS
degree of regurgitation and/or absence
mortality in select studies.
of borborygmi.
aspiration pneumonia.
1 mg/kg IV q 12h or famotidine
0.5-1 mg/kg IV q 12h for hematemesis • Choose a calorically dense food; options Comments
include Hill’s Science Diet a/d (1.1 kcal/mL),
or melena. Royal Canin Recovery Support (1.0 kcal/ • False-positive ELISA is unlikely after
○ Parasite control: fenbendazole 50 mg/kg mL), or Purina ProPlan Critical Nutrition vaccination.
PO q 24h for 3-5 days or sulfadimethoxine (1.3 kcal/mL). • Immunotherapies have not been found to
50 mg/kg PO q 24h for 5-20 days as • Calculate resting energy requirement (RER) significantly influence clinical recovery or
indicated (after vomiting resolved). based on hydrated body weight (daily kilo- survival; the aforementioned cornerstones
○ Colloidal support: synthetic colloids calorie requirement = [BW kg × 30] + 70). of therapy remain integral to overall success.
10-20 mL/kg q 24h or fresh-frozen ○ Begin with one-fourth of the calculated
plasma 10 mL/kg over 4-6 hours in cases RER on day 1, dividing the daily volume Prevention
of severe hypoalbuminemia with persistent over 4-6 feedings. Puppies should be vaccinated q 3-4 weeks
cardiovascular instability. Canine albumin ○ If tolerated, increase feedings by 25% per between the ages of 6 and 16 weeks. Limit
may also be used (0.5-1 g/kg, IV), if day until full RER is attained. susceptible puppy’s potential exposure to CPV
available. • Supplements aimed at improving GI until fully protected.
○ N-acetylcysteine 70 mg/kg IV q 24h recovery (e.g., prebiotics, omega 6/3 fatty
consecutively for 5 days has been shown acids, essential amino acids) may enhance Technician Tips
to ameliorate oxidative stress and minimize voluntary appetite and caloric intake. • Central venous catheter placement is helpful
duration of hospitalization. The author’s institution has used Viyo for serial blood sampling.
○ Recently, fecal microbiota transplantation Recuperation with success (10 mL q 12h if • Evaluate the IV catheter site daily because
(p. 1105) was associated with faster resolu- body weight 0-10 kg, 15 mL q 12h if body neutropenia predisposes to secondary infec-
tion of diarrhea. weight 10-25 kg). tion and phlebitis/cellulitis is commonly
• After voluntary appetite returns, many dogs observed.
Chronic Treatment prefer dry food. Offer dry food staggered
Limited finances may dictate treating CPV with the prescribed diet during hospitaliza- Client Education
on an outpatient basis. Outpatient success tion. Free-choice water should be available • Husbandry considerations include preven-
(80% survival) is best achieved with highly at all times. tion, disinfection, and reducing the risk of
compliant owners and when the puppy is briefly transmission.
stabilized in hospital (e.g., IV fluid resuscita- Possible Complications • Properly disinfect nonporous surfaces using
tion, supplementation of dextrose and KCl). • Intestinal intussusception dilute bleach (1 part sodium hypochlorite to
Recommended outpatient protocol: • Bacterial sepsis, consumptive coagulopathy 30 parts water) or quaternary ammonium
• Cefovecin 8 mg/kg SQ once • Pneumonia (e.g., aspiration, hematogenous, disinfectants; allow ≥ 10 minutes of exposure
• Isotonic crystalloid fluids 30 mL/kg SQ q or opportunistic viral) time. Porous objects should be discarded.
6h • Phlebitis or thrombosis at IV catheter site • Although puppies that survive infection have
• Maropitant 1 mg/kg SQ q 24h a high level of immunity against CPV, they
• Syringe feed q 6h (see below) Recommended Monitoring still require wellness exams and vaccination
• 60% of outpatient dogs develop hypokalemia; • Every 24 hours: PCV/TS, venous blood gas for other preventable diseases.
50% develop hypoglycemia. If electrolytes and electrolyte panel, more frequently for
cannot be monitored on an outpatient critically ill patients SUGGESTED READING
basis, provide oral supplementation using • Every 12 hours: body weight, arterial blood Venn E, et al: Evaluation of an outpatient protocol
potassium gluconate (2 mEq/4.5 kg body pressure, more frequently for critically ill in the treatment of canine parvoviral enteritis. J
weight PO q 6-12h) and high-fructose corn patients Vet Emerg Crit Care 21(7):52-65, 2017.
syrup (1-5 mL buccally q 6h). • Every 6 hours: vital signs, pain assessment,
• Buprenorphine 0.02 mg/kg SQ prn up to more frequently for critically ill patients AUTHOR: Lauren Sullivan, DVM, MS, DACVECC
EDITOR: Benjamin M. Brainard, VMD, DACVAA,
q 6h • CBC and biochemical profile as needed DACVECC
• External warming to maintain rectal tem- during hospitalization; repeated blood sam-
perature > 37.2°C (99°F) pling can lead to anemia and hypovolemia
in small dogs
Nutrition/Diet
• Early enteral nutrition is associated with PROGNOSIS & OUTCOME
more rapid clinical improvement in CPV
dogs compared with withholding food. Begin • Prompt diagnosis, hospitalization, and
nutrition within the first 12-24 hours of aggressive supportive care result in a high
hospitalization, ideally through a nasogastric survival rate (≥90%).

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