In an ideal world, no puppy would ever contract and get sick with parvovirus. Or, if a puppy did get sick with parvovirus, the cost and commitment to treat a puppy with parvovirus would be treatment that is accessible to everyone who requests care.

But we live in a world where costs and the number of affected pups that may become ill make access to gold standard treatment for canine parvovirus unattainable to all puppy owners.

How to Treat Puppies for Parvovirus

1. IV catheter for IV Fluid therapy with a loading dose of fluids to initiate treatment. After the initial hours in the hospital for a loading dose, Lactated Ringers should be administered subcutaneously at a dose of 40ml/kg every eight hours to provide maintenance fluid and account for ongoing losses. Over the first 24 hours, dehydration should be managed by administering the calculated fluid deficit in addition to maintenance fluids.
2. Anti-vomiting medication (Cerenia/maropitant or ondansteron) starting with an injection, followed by tablets if the puppy is not vomiting.
3. Antibiotics – can be a long-acting injection of Convenia (cefovecin). Although parvovirus is a viral disease, antibiotics providing gram negative and anaerobic coverage are recommended to treat bacteria in the bloodstream resulting from bacteria crossing from the damaged intestinal cells. Appropriate antibiotic coverage can be accomplished by using an amoxicillin-clavulanate, combination therapy with a fluoroquinolone (if the pup is not a large breed puppy) and metronidazole. Given the intolerance of oral antibiotics in nauseous animals, Convenia was used in the referenced outpatient protocol due to its convenience (requiring only one dose that lasts two weeks) and reasonable coverage against anaerobes and gram-negative bacteria.
4. CBC (complete blood count) and blood glucose/kidney values/electrolytes to assess the pup’s prognosis and specific needs. This test needs to be performed at a vet clinic.
5. Glucose and potassium supplements. Glucose and potassium supplementation should be considered in the form of oral corn syrup (for glucose) and Tumil-K (for potassium), respectively.
6. Anti-diarrheal medication including Kaolin-Pectin. Avoid human Keopectate and Pepto Bismol.
7. Nutritional support. Food and water should be withheld until vomiting has ceased for at least six to 12 hours. Calorie dense food, such as Hill’s or Royal Canin Starter Mousse Dog Food should then be syringe-fed at a dose of 1ml/kg every six hours
8. Supportive care (e.g., including temperature monitoring and support, keeping the puppy clean, comfortable and dry).
9. Pain management. If the patient is painful subcutaneous buprenorphine can be considered. This is a prescription drug.
10. Plasma IV or SQ. There are anecdotal reports of what improvements can be seen.

It is essential that Venn et al’s protocol for outpatient care was only initiated AFTER the pups received a fluid bolus to restore circulation and have been treated for low blood sugar and electrolyte imbalances.

Puppies receiving outpatient care should return to the veterinarian once daily for evaluation. Any puppy experiencing persistent diarrhea and/or vomiting, developing a fever >104°F, or declining in physical condition or alertness should be transitioned to inpatient care. Thus, this protocol is more conservative than many inpatient protocols, but is not entirely an “outpatient” protocol and yet requires significant dedication and modest financial commitment on the puppy owner’s part.

In preparing an outpatient protocol for canine parvovirus patients, owners need to understand the indications and limitations.

Hospitalization is the gold standard recommendation for all patients with canine parvovirus. However, for financially-constrained clients, outpatient care can be considered. Only puppies mildly to moderately affected should be considered candidates for outpatient care. Any puppy with severe dehydration, evidence of shock, or a reduced level of alertness or consciousness should be hospitalized.

If hospitalization is not feasible, humane euthanasia should be considered. For those mildly affected, an outpatient protocol can be attempted if the owner is amenable to a significant time commitment and comfortable administering subcutaneous injections.

Parvovirus Treatment in a Kennel Environment

If you have a litter with one or more sick puppies here are some additional tips to keep in mind to help prevent the spread of the disease to more puppies in the kennel.

1. Isolate-– If you have an area to isolate a sick puppy, do so. If not, do not move healthy animals around the kennels or to another kennel. You will just spread the disease. Try to isolate to just the area/building where it started. In addition, always isolate incoming breeding stock or returning puppies for three weeks.
2. Care for Healthy Puppies First-– When tending to the puppies care for the healthy ones before going to those that are sick. Do not go back to the healthy puppies without strict disinfection that includes changing clothes. Remove coveralls after care and wash your hands to help stop the spread of the disease. Hand disinfectants aren’t always instant, so don’t rely on just them.
3. Give Electrolytes-– You want to keep all puppies hydrated whether they are sick or not. Breeder’s Edge^®Puppy Lyte ™ is a great electrolyte to keep on hand in your kennel to use when needed.
4. Disinfect-– Be sure you’re using a penetrating disinfectant to kill parvovirus. Bleach isn’t enough in an outbreak. Bleach will sterilize the surface, but will not go through smeared feces or fat to get the virus underneath. Virkon^® and Oxine^® (with citric acid) are penetrating disinfectants. They are safe around young puppies. Use Virkon for a spray and a shoe bath. Bleach and quaternary ammonias are absorbed through the thin skin of puppies and are a cause of Fading Puppy Syndrome.

Parvo Research Continues

As parvo research continues, protocols and treatment recommendations evolve so it’s important to continue to stay informed of the latest research findings. There are protocols that have been developed, instituted and shared by prominent veterinary schools and institutions that show great promise in saving the lives of many sick puppies, while being affordable enough for many owners to pursue treatment. Some refer to the protocol developed and published at Colorado State University Veterinary School referenced here. This has also been recommended by Justine Lee, University of Wisconsin Shelter Medicine Program, Maddie’s Fund, and many others.

These parvo treatment protocols also lighten the load on veterinary care facilities, allowing them the opportunity to provide a promising level of care without burdening an already overwhelmed veterinary team.

If you have more questions on how to treat puppies with parvo or the parvo vaccine, call us at 800.786.4751.

Original article written by Donald Bramlage, DVM