Parvoviral Enteritis

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Parvoviral Enteritis (Parvo)

By: Dr. Debra Primovic

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Section: Veterinary Care In-depth

Treatment In-depth

Treatments for parvovirus may include one or more of the following:

Serious cases require hospitalization during which IV fluid therapy, antibiotics and anti-vomiting drugs may be administered. Severe cases may require referral to a 24-hour hospital.

Milder cases may require outpatient treatment consisting of subcutaneous fluid therapy, antibiotics and anti-vomiting drugs.

Daily physical examination by your veterinarian to assess your pet's progress is vital.

Fluid therapy is necessary if your pet is dehydrated, actively vomiting or has diarrhea. Severe cases will most likely require IV fluid therapy consisting of an electrolyte solution supplemented with potassium. If necessary, a bicarbonate supplementation may be required, which is determined after lab testing. In more severe cases where pets have become hypoglycemic (low blood sugar), dextrose (sugar) may be added to the fluid therapy.

Milder cases may be treated with subcutaneous fluid therapy, which is administered in the loose skin over the back and more slowly absorbed. Pets with severe cases will almost always require IV therapy for survival.

Nutrition. There are different thoughts on feeding dogs with parvovirus. Many veterinarians recommend giving no food or water until vomiting or diarrhea has stopped completely for 12 to 24 hours. Only then will water be offered in small amounts along with small frequent feedings of a bland diet, including such foods as Hill's Prescription Diet i/d®, Iams Recovery Diet®, Purina EN Diet® or Waltham Low Fat Diet®. Your pet may also be given a bland homemade meal of carbohydrates (boiled rice or potatoes) and protein (lean hamburger, skinless chicken or low-fat cottage cheese) in small amounts. The return to regular dog food must be gradual over a 3 to 4 day period. Other veterinarians recommend feeding despite vomiting. High-protein and high calorie foods such as Hills Science Diet A/D or Eukanuba Max Calorie may be offered as soon as possible.

Antibiotic therapy is often used to control secondary bacterial infection. Antibiotics (such as gentamicin or amikacin) must only be given after dehydration is corrected with the proper fluid therapy. Commonly used antibiotics are: cefazolin or ampicillin combined with enrofloxacin, gentamicin or amikacin. Gentamicin and amikacin are administered to your pet especially when there is indication of a very low white blood cell count (neutropenia).

Antiemetic drugs may be administered to your pet to control vomiting. Common drugs include: metoclopramide (Reglan®) given SQ or as continuous IV; chlorpromazine (Thorazine®); prochlorperazine (Compazine®), or ondansetron (Zofran®) by injection.

Gastrointestinal protectants are sometimes prescribed. Common drugs include: famotidine (Pepcid®), cimetidine (Tagament®) and sucralfate (Carafate®), prescribed only after vomiting is controlled.

Parenteral nutrition (such as PPN) may be suggested in very weak puppies with persistent vomiting and diarrhea. This is a special food that is placed in an IV type catheter; parenteral nutrition requires hospitalization.

Anti-diarrheal drugs, which help reduce bowel movements, are only prescribed for unresponsive diarrhea. These include: loperamide, oral opiods and diphenoxylate.

Pepto-Bismol® (Bismuth subsalicylate) is sometimes administered when vomiting has stopped.

Pain medications may also be indicated. Commonly used pain medications include Buprenorphine (Bupernex) and Butorphanol (Torbugesic).

Blood products (packed red blood cells or plasma) may be administered with severe blood loss, protein loss, or anemia.

Isolating your dog from other dogs is very important throughout treatment of parvovirus.

Nursing and caring for your pet is vital throughout treatment. Your pet must be kept clean and dry, and debilitated dogs must be turned frequently. Rectal temperature must be monitored frequently.

Worm infestation is treated once your pet is able to eat and drink. The common drug administered is fenbendazole (Panacur®), given orally for three consecutive days or Ivermectin by injection.

Prognosis

Approximately 80 to 90 percent of affected dogs will survive and lead normal lives if disease is detected early and proper treatment and hospitalization is sought and administered. Prognosis is worse for high-risk breeds.

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