Page 104 - WSAVA2018
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 25-28 September, 2018 | Singapore
less than 8 weeks can lead to myocarditis and result in sudden death or congestive heart failure. Depending on the presence of prior immunity, some dogs or cats may have subclinical infections.
Dogs or cats under two years of age with acute
bloody diarrhea should be considered at high risk
for parvoviruses, particularly if the vaccine history is incomplete. Another differential diagnosis with similar clinical signs is salmonellosis; this should be considered in dogs or cats that look clinically like parvovirus, but are well vaccinated. The clinical diagnosis is usually supported by documenting parvovirus antigen in feces by ELISA or PCR assays which are commonly part of diagnostic PCR panels in the United States.
Treatments. Greater than 90% of dogs with CPV-
2 enteritis will survive if administered supportive
care shortly after clinical signs develop. Feline panleukopenia often has a higher fatality rate. Fluid replacement, electrolyte balance (particularly potassium), control of hypoglycemia, control of oncotic pressure (hypoalbuminemia can develop), treatment of bacteremia and sepsis (antibiotics), control of nausea and vomiting, and “feeding the gut” as early as possible are paramount to success.
Fluid therapy should be designed to correct losses, hyponatremia and hypokalemia. Oncotic pressure should be maintained with plasma transfusions, hetastarch, or related compounds. Broad spectrum antibiotics with
like a first generation cephalosporins are often used
in routine cases with therapy escalated to include
drugs with a better gram negative spectrum in pets showing signs of sepsis. Injectable enrofloxacin or amikacin can be added to the protocol to enhance
the gram negative spectrum. Many clinics use second generation cephalosporins like cefoxitin as their primary antibiotic as this drug has an enhanced gram negative spectrum compared to first generation cephalosporin. Recently it has been shown that maropitant can be used successfully as an antiemetic agent, but also lessens abdominal pain. It is important to “feed the gut” early in cases with enteritis and so at Colorado State University, nasoesophageal or nasogastric tubes are often used
to start to deliver elemental diets as soon as possible. Highly digestible diets with or without probiotics are often used in the recovery phase.
A new gastrointestinal recuperation diet, Rebound Recuperation (Virbac) was found to be palatable, as determined by acceptance and preference testing, in healthy dogs during the preoperative and postoperative phases of routine sterilization (Forbes et al, 2015). In
a followup study, Rebound Recuperation.was used successfully in a CPV clinical trial performed at Colorado State University (Tenne et al, 2016).
Many different adjunctive therapies like passive immune
therapy (hyperimmune serum infections), granulocyte colony stimulating factors, oseltamivir (Tamiflu) are used to attempt to improve survival but has not been shown to be effective in controlled studies. Interferon omega has been beneficial in some puppies. Prognosis is variable. Intussusception may occur as a sequel to severe enteritis and so all dogs or cats should be palpated daily. Not
all clients can afford hospitalization and intensive care. Thus, researchers at Colorado State University evaluated an out-patient protocol in dogs with CPV that had an 80% success rate (Venn et al, 2017).
Prevention and public health considerations. Extreme care should be taken to prevent spread to other animals by disinfection with bleach, separation from other hospitalized animals, and vaccination of other dogs in the household. No zoonotic potential is recognized; the parvoviruses of humans are species specific. Vaccination is very effective for both CPV and FPV. Modified live parenteral products are likely to break through maternal antibody interference and should be used for the puppy and kitten series. Vaccines should be administered
until at least 16 weeks of age and one more booster
after that time could be considered in high risk animals. After a 1 year booster, 3 year intervals for CPV and
FPV vaccination is adequate for most animals. Use of serologic test results can be used after the 1 year booster to determine CPV and FPV vaccine need; positive animals do not need to be vaccinated if a validated test is used.

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