Based on her professional experience, Dr. Medora Pashmakova DVM conveys some very important advices to the professionals, of the subject based on a four-point strategy to save the life of a parvovirus infected puppy.
Before mentioning these four basic points, we would like to share with you a fact of interest:
“If you help the puppies to survive the first three to four days of infection, they usually have a quick recovery.”
The stages of therapy are as follows:
First, treat the patient for shock. Dr. Pashmakova says the crystalloids are the best choice for puppies. She recommends liquid cakes of 30 ml / kg. The pattern is to: administer the bolus, reassess the patient, repeat the bolus, and reevaluate the patient. You have to be evaluating the progress of the patients response after the bolus are administrated. The bolus must be completely consumed in 10 minutes to effectively replenish the volume and treat the shock.
Second, rehydrate the puppy. It is difficult to detect dehydration in pediatric patients compared to adults because of many factors, says Dr. Pashmakova. To rehydrate the puppy, Dr. Pashmakova says that you should be sure to use an intravenous (IV) route, not a subcutaneous route (SQ) since SQ is not systemic and will take longer to circulate. It also recommends using a weight scale to measure whether the patient is adequately rehydrated. For example, if you think the patient is dehydrated about 5 percent and weighs 10 kg, with the correct hydration, it should weigh about 10.5 kg. She recommends making this measurement scale as part of the treatment sheet, and measuring the patient’s weight frequently, especially when gastrointestinal losses are deep. The scale can help you measure losses as well as rehydration goals. Waiting for it in 12 to 24 hours until the next body weighing can cause you to decrease the dose of rehydration. Measuring body weight every four hours is a reasonable starting point to help correct fluid therapy.
If you decide to place a nasogastric or naso-esophageal feeding tube, be sure to get the X-ray confirmation, note the length of the placement, and resume the X-ray if you have concerns about your location. Advice to ensure correct placement:
A. Measure the tube to the last rib (for nasogastric placement) or the ninth intercostal space (for naso-esophageal placement).
B. After placement, obtain a right lateral radiograph that includes the neck, chest, and stomach to confirm placement and visualize that there are no loops or twists in the tube.
Third, replenish those worrying gastrointestinal losses. Dr. Pashmakova says that Veterinarians do pretty well in the first couple of steps of the treatment to keep the puppy away from suffering Parvovirus. It is in this third phase that mortality often results. “Gastrointestinal losses are where we are often left behind because we are not keeping up with the losses.”
The key here is to find a way to quantify the loss of diarrhea and vomiting. Dr. Pashmakova says she is likely to need more than two to three times the maintenance rate. She recommends measuring how much the patient has lost every two to three hours (“Calculate Fluid Rate.”) A calculated fluid rate in a Parvo case may actually be 6-7 times the normal “maintenance” dose, So that she advocates the use of objective metrics rather than thinking of these patients with exact mathematical figures. Taking an example of a 10 kg patient and using the Fluid Calculation Table should be delivering 75 ml / hour, but if Metabolic needs are added this figure reaches 133 ml / hour, which is almost twice as initially calculated in the table.
Dr. Pashmakova says, once again, that crystalloids are the mainstay of therapy in these patients. (Crystalloid solutions provide water and sodium to maintain the positive osmotic gradient between the extracellular and intracellular space.) Synthetic starches have been used for decades to help hypo-proteinemic patients, but we are learning that the vascular system in sick (septic) patients does not retain Starches within it in the way it does in healthy patients. Human Medicine has documented significant morbidity associated with synthetic starches, especially in patients with sepsis, and acute renal injury. For this reason, the pendulum in Veterinary Medical Care has changed greatly to stepping away from using Starches on a routine basis.
Fourth advice, provide metabolic maintenance. Early enteral nutrition with specialty products has been shown to make a difference in patients with Parvovirus, says Dr. Pashmakova. One study¹, showed that shorter hospital stay in one day. Although patients probably vomit some of what they are feeding, if even half are still there, that is something. “Nutrition should be part of their medical management for these patients,” says Dr. Pashmakova.
Dr. Pashmakova is an admirer of tube feeding, but may not be appropriate in this case, she says, since placing a tube in a vomiting patient in an isolation room and not supervised is risky.
BioAdvance offers you our EWEGURT® product, which you can supply dry alone or mixed with a hypoallergenic balanced food at doses of 5 grams per 10 kilograms live weight or reconstituted in water (1: 1) at a dose of 10 ml per 10 Kilograms of weight, has proved to be an excellent support to provide the minimum nutrients that help the puppy’s Immune System to fight with the viral challenge.
If you want to know more information to prevent your furry friends from suffering this disease, you can read the full article at: http://veterinarynews.dvm360.com/life-saving-pointers-parvo-puppies, Or contact us by email: info @ Bioadvance.life, and we will advise you with our quality products!
Mohr AJ, Leisewitz AL, Jacobson LS, et al. Effect of early enteral nutrition on intestinal permeability, intestinal protein loss, and outcome in dogs with severe parvoviral enteritis. J Vet Intern Med 2003; 17: 791-798.