Presented at the American Pets Alive No-Kill Conference 2014.

1. Giving Parvo + DOGS a 2nd Chance at Life
By: Nipuni Ratnayaka & Kristen Kjellberg, DVM

2. * *How to start saving immediately
*How to expand your program
*Complications

3. W H A T I S P A R V O ?
• Viral disease
• Incredibly hardy
• fecal-oral route
• Takes 1-5 days to cause infection
• Clinical Symptoms last 5-10 days
• 24-48 hours after cessation of symptoms

4. W H A T I S P A R V O ?
• Attacks intestinal lining
• Symptoms:
• Diarrhea, often bloody
• vomiting
• lethargy
• Causes of death:
1. Dehydration
2. Sepsis
• In severe cases, death can be
caused by hypoglycemia or
hypoprotenemia

5. PREVENTING OUTBREAKS
• CPV can be spread
Isolate the puppy
• CPV can be carried
Follow decontamination protocols
• CPV can survive
Disinfect the area

6. A P A ’ S P a r v o
P r o g r a m
85%• Volunteers Treat
• Doctors prescribe

7. This is all you need -
1. Minimal medical Supplies
2. Foster w/ Spare Bathroom
3. Doctor for Rx and assessments
4. Decontamination protocols
*

8. *
*Designated – parvo only
*AM & PM treatments
*Multiple fosters for different
stages
*No med. experience required
*Hands-on training for SQ
*Care instructions/manual
*On-Call phone number

9. D E C O N T A M I N A T I O N
P R O T O C O L S
• Isolation
• Designated scrubs & shoes*
• Toilet
• Proper Hand Washing
• Washer & Dry Separately
• Tub for Baths
*designated shoes more effective than footbath

10. Protocol found @ wiki.apaparvo.org
S C R U B B I N G I N & O U T
a strict protocol for entering and exiting the icu

11. Wash up to wrists

12. T R E A T M E N T S H E E T
1. Doctors prescribe
2. Volunteers treat
Document Everything
• Physical exam
• Medications
• Consumption and
Excretion

13. M e d i c a l
S u p p l i e s
1. Antibiotics
• Polyflex
• Baytril
2. Reglan (nausea)
3. Fluid bags
4. Needles and Syringes

14. T R E A T M E N T E S S E N T I A L S
*Cost estimate for 10lb dog
Parvo SNAP Tests (IDEXX)
• $20 for 1*
• non-essential to test-out
Baytril 100mg/mL
• $165 per 250cc bottle
• 1cc X 6 days
• 6cc - $4
• 40 dogs per bottle
Polyflex
• $40 per 150cc bottle
• $1.60
Reglan
• $6 per 30cc bottle
• $1.20
Fluids
• $20 per 12 bag case
• $2.50*
Syringes & Needles
• $5
Medicine cost =
~ $16-36 per dog
*depends on shelter protocols

15. *

16. T O U R O U R P I C U !

17. T O U R O U R P I C U !

18. T O U R O U R P I C U !

19. E N T R A N C E
• Clean side:
• Lockers
• Sink
• street clothes
• Dividing line
• Contaminated side
• Scrubs
• shoes

20. B U I L D I N G A T E A M
1. Licensed Veterinarian
• order & prescribe medications, looks over
patient cases
• Ask your local vet!
2. Team Manager
• recruit volunteers, schedule, program
improvements
3. Dedicated volunteers
• quality over quantity
4. Veterinary Technicians
• place catheters, intake, off-shift tasks

21. *
• Recruiting –
• Email
• Medical Groups
• Students
• Reg Volunteer group
• Professionalism
• Strict Requirements
• Training
• Curriculum
• Empowering = knowledge
• How vs. Why & When
• Do vs. Understand

22. How Volunteers Handle Death
• Protocols, prepared in advanced, part of training
• Facebook page
• Memorial garden
• Its not their fault
• will lose 15% no matter what

23. E S S E N T I A L I T E M S
General
Cleaning
Medical

24. G E N E R A L :
DOG CARE SUPPLIES
Designated for parvo patients only
• Fridge
• Toilet
• Bowls
• Toys
• Sweaters
• Heating pads
• Microwave
• Thermometer
General
My legs
are too
long…

25. V A R I E T Y O F F O O D
• nausea-association
• Turn around in 5-6 days
• high in protein
• stimulate appetite
• Pizza crust
• Goal = solid stools
• Chicken and Rice
General
ZZzzzZZZZ…

26. C L E A N I N G S U P P L I E S
• Sharps Container
• Parvocidal Disinfectant
• Bleach
• Laundry detergent
• Hand soap
• Washer/Dryer
• Broom/Mop
• Toilet paper
• Trash bags
Cleaning

27. M E D I C A L S U P P L I E S
*OK to began with only subcutaneous treatment
1.Treatment supplies
• Needles
• Syringes
• IV Fluid Line
• Catheters*
• Fluid pump*

28. M E D I C A L S U P P L I E S
2. Medications
• Antibiotics
• Baytril (Enrofloxacin)
• Polyflex
• Ampicillin or
Cefazolin*
• Fluids
• Lactated Ringers
• Hetastarch*
• Antiemetics
• Reglan
• Dewormers
• Strongid

29. T R E A T M E N T A D D - O N S
Medications
• Cerenia or Anzemet
• Famotidine or Zantac
• Doxycycline or
Oxytetracycline
• Panacur or Strongid
• Dextrose or Karosyrup
• Metronidazole
• **Med Charts in Manual**
Equipment
• IV Pump
• Catheters
• Hair clippers

30. • Donations
• Amazon Wishlist
• Meds from Hospitals
• Recycling syringes for orals
• Hand towels
• Rely on & empower volunteers
• One parvo test per litter, up to 3
• Protocols to reduce DVM time
• Higher adoption fee for post-parvos
• Supportive care
• constant force feeding slowly
(baby food, pedialyte, chicken
broth) incredibly small amounts
• keep warm
• Reglan, fluids every 8 hours
S A V I N G M O N E Y
4,200 volunteer man hours worked in 2013

31. O V E R A L L E S T I M A T E D C O S T
Minor
$20.52 Moderate
$68.77
Severe
$133.16
Average ~ $75 per dog
20%
20%
60%

32. I N T A K E
1. Verify a positive test
2. vaccinate – DHPP and Bordatella
3. Physical assessment
4. Treatment
5. Wash hands between patients

33. ASSESSSMENT & PHYSICAL EXAM
• Assessments noted every 12 hours by volunteers
• Medical treatments prescribed every 24 hours by doctor
1. Attitude
• BAR, QAR, lethargic, semi-
comatose
2. Gum color:
• pink – healthy
• pale pink – poor circulation
• White - anemic
• Grey/pale – shock
(severe dehydration, sepsis)
3. Temperature
• Paws
• Rectal

34. M I N O R T R E A T M E N T
Assessment:
• Dog is BAR/QAR
• Decreased or no appetite
• Some vomiting and/or
diarrhea
• Moderate dehydration
Subcutaneous Treatment
• Baytril (diluted), Polyflex,
Reglan and fluids
• +/- on pump

35. M O D E R A T E T R E A T M E N T
Assessment:
• Dog is QAR/lethargic
• No appetite
• Moderate vomiting and
diarrhea
• Pink gums
Intravenous Treatment
• Baytril SQ & Ampicillin IV
• IV Fluid bolus or on pump

36. S E V E R E T R E A T M E N T
Assessment:
• lethargic
• Excessive v/bd
Intravenous Treatment
• Baytril IV diluted, vet
supervision
• Ampicillin IV
• IV fluid pump with dextrose,
reglan, kcl
• Hetastarch – blood volume
infuser (pressure
increaser), protein
• Hypoglycemia & Toy
breeds
• Force feeding

37. D I S C H A R G I N G
Testing Out:
• Two Solid Stools
• Special Circumstances: In ICU for
>10-12 days

38. D I S C H A R G I N G
Bathing – be extremely thorough
1. Clip nails
2. Remove all traces of feces
3. Two baths
4. Clean rectum, under tail, & paws very well

39. *

40. • Vaccinate immediately at intake
• Before even taking out of cage
• No harm, possible benefit
• Immediately separate litters/puppies
showing URI symptoms
• put in crate and cover
• Wash hands **properly**
*

41. Treating a dying puppy
• What are we treating?
• Dehydration
• Temperature
• Hypoglycemia
1. Act fast – no diagnostics
2. Warmth
3. Hetastarch & Dextrose IV
4. Reassess
• Temp – rectal + paws
• Gum color
• Lift head
5. LRS bolus until out-of-shock
****Have hard copies of protocols readily available****
*

42. *
• Worms, Mange
• Decontamination protocols
• Strongid given regardless to all
• For severe mange, be aggressive with
treatment
• Hookworm anemia
• URI/Distemper
• Quarantine Protocols
• Additional Medications
• Baytril
• Azithromycin
• Oxytetracycline/Doxycycline
• Nebulizing

43. • Abscesses
• How?
• blown vein – swelling above IVC
• baytril site
• Treatment
• Baytril or Clavamox ideal
• Warm compresses
• Honey Bandage
• Can’t place a catheter
• Try jugular catheter
• Call DVM or vet tech
• Intussusception
• DVM diagnose
• abdomen palpations
• excessive vomiting
• Abdominal palpations
• No diarrhea or purpleish diarrhea
*

44. • Walking on wrists/hawks
• bones and ligaments growing at
different rate
• straightens out in a week
• not to worry
• Post parvo arthritis
• Potential Causes
• Parvovirus localizing in the
joints?
• related to baytril?
• Most likely sepsis.
Supportive tx??? no surgery
necessary
• Treatment
• Tramadol & NSAIDs
• Antibiotics may not be
necessary – DVM discretion
• Temporary problem
*

45. Q U E S T I O N S / C O M M E N T S ?
nipuni.ratnayaka@austinpetsalive.org
w i k i . a p a p a r v o . o r g
Kerbey, Parvo survivor