HISTORY / CLINICAL SIGNS: 1 day Hx of decreased appetite, vomiting, and diarrhea. Has already received initial DHPP vaccine, administered by breeder 1 week prior (unknown storage or handling of the vaccine). No other dogs in household.
PHYSICAL EXAM FINDINGS: QAR. BCS 3/9, poor muscling. T 103.4 ยฐF (36.7 ยฐC). P 115 bpm. R 40/min. mm pale pink/tacky. CRT 2 sec. Discomfort upon abdominal palpation. Small intestinal loops distended and fluid-filled. Diarrhea with hematochezia. Poor hair quality. Otherwise, unremarkable.
What is on your differential diagnosis list? What diagnostic tests would you order? Any other questions?
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DIFFERENTIALS: Dietary indiscretion. GI foreign body. GI parasites. Parvovirus. Coronavirus. Intussusception. Small intestinal bacterial overgrowth (SIBO). Congenital intrahepatic portosystemic shunt (PSS). Eosinophilic gastroenteritis.
DIAGNOSTIC TESTS & RESULTS:
- Bloodwork: Anemia (mild, non-regenerative). Mild monocytosis. Eosinophilia. Mild hypoglycemia. Mild hypoalbuminemia. Elevated ALT & GGT. Mild low BUN. Mild hyperphosphatemia.
- Parvovirus antigen ELISA SNAP test: positive
- Fecal flotation test: roundworms
- Abdominal radiographs: unremarkable
What is your diagnosis, recommended treatment, and prognostic outlook?
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DIAGNOSIS: This patient is in the early stages of a canine PARVOVIRUS infection. Parvovirus, also called parvo, is a highly contagious and potentially fatal viral infection of dogs. It is particularly worrisome in young puppies and is transmitted via direct contact with fecal material or fomites. This virus invades GI crypt cells, damaging villi and causing necrosis of the crypt which causes malabsorptive diarrhea with PLE. Parvo can also cause panleukopenia which can lead to secondary bacterial infections and sepsis (not yet developed in this puppy due to prompt diagnosis/treatment). Common clinical signs: fever, severe vomiting, and foul-smelling bloody diarrhea leading to anorexia and dehydration. Consequences of infection include myocarditis, intussusception, and death. Treatment involves supportive care and prevention of secondary infections. Vaccination against parvo is imperative for prevention; it is included in the DHPP puppy vaccine given at 3 week intervals between the ages of 6-8 weeks & 15-18 weeks old, then annually. Maternal antibodies received by a puppy from his motherโs milk is also protective; however, this puppy was prematurely weaned and was lacking in maternal antibodies.
TREATMENT (in isolation): IV fluids + 2.5% dextrose. IV ampicillin. Cerenia. Fenbendazole. (Other considerations: fresh frozen plasma transfusion.) Once vomiting subsided: Purina EN. Plenty of โTLCโ (very important for young animals in isolation). Client education: clean with bleach, preventative medicine (routine vaccines at appropriate ages and deworming by a veterinarian rather than a breeder), responsible breeding (do not separate pups from dam prior to 6 weeks).
PROGNOSIS: Though parvo can be fatal, this patientโs Px is excellent due to good response to Tx as well as no panleukopenia (which results within 48 hours). Upon subsequent clinic visits, this puppyโs heart will be evaluated for signs of myocarditis, which can occur in puppies infected with parvo prior to 8 weeks of age.
Any other questions, comments, or suggestions?
A key point to remember is that just because a canine has been vaccinated against parvovirus, testing for parvo is still important if clinical signs are suggestive of this viral infection.
For more info on canine parvovirus, visit The Meowing Vetโs article HERE.
Unless otherwise stated, these clinical cases are real-life cases that I have managed as a veterinarian in general small animal veterinary practice or else assisted with as a student in vet school. These cases are a great real-world learning tool for vet students and other veterinary professionals. They shall be used for learning purposes and collaboration of knowledge only. These cases are not intended to diagnose or treat any disease by pet owners. – Maranda Elswick, DVM
