Small Animal Emergency and Critical Care Medicine: Self-Assessment Color Review, Second Edition, Q&A 15

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Student tip: This case is an overview of a common condition and the basic first line treatment.

A 3-month-old female intact 123 Pitbull puppy presents for 2 days of anorexia, lethargy, vomiting clear fluid, and watery, fetid diarrhea. Radiographs were reported as normal. The puppy has received 3 of her puppy vaccination series. T = 39.6°C (103.3°F); HR = 165 bpm; RR = 25 bpm; CRT = 3 sec; MM pale and dry; femoral pulses bounding; perfusion hyperdynamic; 10% dehydration based on skin turgor and dry MM/corneas. Shortly after presentation the dog passed a large amount of liquid bloody stool (see image).

Question	Answer		Article
A parvovirus CITE (Snap) test is positive. What additional diagnostics are recommended for a patient with parvovirus?	Should include emergency data base (venous blood gas, electrolyte panel, PCV, TS, glucose, BUN), CBC and serum biochemistries, and a routine fecal examination. Abdominal radiographs and/or ultrasound are examined if there is suspicion for intussusception.		Link to Article
PCV equals 0.6 l/l (60%); TS equals 21 g/l (2.1 g/dl); glucose equals 2.28 mmol/l (41 mg/dl). Interpret these results for this dog.	The dog is markedly dehydrated (elevated PCV) and likely has some significant protein losses (primarily GI loss). Albumin is likely low due to decreased production (an acute-phase protein), decreased intake, and loss due to capillary leakage (SIRS). Hypoglycemia is from decreased intake with poor glycogen reserves and increased metabolic rate, possibly due to SIRS and sepsis.		Link to Article
Discuss the treatment recommendations for an in-hospital dog with parvovirus infection.	The dog is immediately placed in isolation and all exposed surfaces disinfected. Personnel must wear gowns, gloves, and shoe covers when handling this dog. An IVC is placed; emergency database collected and blood drawn for CBC, biochemistries; IV isotonic balanced buffered crystalloids and HES using large-volume technique to high end end-points; reassess perfusion and correct hydration over 4–6 hours with crystalloids, continuing to account for dehydration, maintenance, and ongoing losses; CRI of HES at 0.5–2 ml/kg/hr to supplement COP; IV antibiotics effective against gram-positive/gram-negative organisms as well as anaerobes are recommended; anti-emetics; motility modifier such as metoclopramide or cisapride; and gastroprotectants (H2-blockers or proton pump inhibitors, sucralfate); nasogastric tube gastric decompression and trickle enteral feeding. Many dogs require dextrose and potassium supplementation.		Link to Article

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