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Friday, February 27, 2009
Solution for case 17

Tentative Diagnosis: Parvovirus infection


Differentials: 

  • Coronavirus infection
  • Bacterial gastroenteritis
  • Foreign body
  • Hemorrhagic gastroenteritis
  • Intussusceptions
  • Intestinal parasites
  • Toxins
Further diagnostic tests: 

  • ELISA for Parvovirus
  • Fecal exam
  • Radiograph
ELISA was positive for this patient and as this patient had no recent history of Parvo-vaccination the test was a true positive. 
ELISA can have false negatives and false positives for Parvo. False positives are because of recent vaccination which was not in this case. Supporting the diagnosis of Parvo is the leukopenia which is very commonly seen in Parvo generally due to a neutropenia. It is often common to have an azotemia (increased BUN and Creatine) with Parvo. Icterus can also be associated with Parvo but not commonly.

Parvo is a highly contagious disease and positive dogs should be kept in isolation.

Complications to be aware of are sepsis, shock, disseminated intravascular coagulopathy, intussusception, and acute respiratory distress syndrome. Sepsis prevented by administering antibiotics. Shock and DIC are prevented by fluid therapy. Intussusceptions must be monitored for by doing abdominal palpation and possibly radiographs. These puppies are at a high risk of this because of the hypermotility of the gut.

Treatment and management: There is no cure for Parvo only palliative treatment. 

Lactated Ringers solution and antibiotics (Ampicillin and Enrofloxacin) were administered to the patient. Hetastarch was also added to the fluids because of the decrease of Total Protein to compensate for the decrease in oncotic pressure. Metaclopramide was also given to stop vomiting. Nothing per os was prescribed for 24 hr. Once infected and recovered, animals will be immune for life. 

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posted by Dr Banga's Websites @ 12:00 AM  
3 Comments:
  • At February 27, 2009 at 1:43 PM, Blogger Paola Lazaretti Lott said…

    Why isnt Leptospirosis one of your differentials?

     
  • At March 1, 2009 at 1:32 PM, Blogger Dr Banga's Websites said…

    Yes Paola, you are right. Lepto will also be one of the differential for this case. Usually we see renal, hepatic and digestive system signs as well depending on the serovar of lepto. Other bacterial causes of gastroenteritis like salmonella, E coli etc. are also on our differentials list.

     
  • At May 8, 2010 at 10:43 AM, Blogger Dr Swarupmay Majumdar said…

    Dr Rajesh, the puppy was just six weeks. Using enrofloxacin at this small age seems not a good idea. although can be used for a few days. What about AmiKacin. I learnt that it is very good on Parvo.

    I have also seen many suspected cases are benefitted by using simultaneous Levamisole injections as an immunostimulator.

     
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