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My 10 week puppy is currently in the care of our vet. He is…

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My 10 week puppy is...
My 10 week puppy is currently in the care of our vet. He is being treated for Parvo—waiting for test results to confirm he's positive for it. However, I'm finding dog toy stuffing around the room he was in and my husband said he noticed a hole in the toy the puppy was playing with prior to falling ill. Is there a chance that the vomiting, lethargic, diarrhea and loss of appetite could be from an obstruction in his intestines? His white blood cells dropped between Thursday and Sunday. They were normal to high on Thursday at the onset of the illness. Or does the white blood cell drop confirm that we're most likely dealing with Parvo?
Submitted: 5 months ago.Category: Dog Veterinary
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Answered in 5 minutes by:
11/20/2017
Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago
Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,984
Experience: Veterinarian at Kingsland Blvd Animal Clinic
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Hi I am Dr. Denney. I am currently reviewing your post now. Please give me a few minutes to type my response. Thank you for trusting us with your question. This service is used for general information only and is no substitute for a veterinarian patient relationship by examination.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

I am so sorry your pup is ill. It is so hard when the young ones get sick.

Unfortunately it is very classic for Parvo to cause an abrupt drop in white blood cell count ( in some cases it goes to zero) during the course of disease because the virus attacks the lining of the gut and the bone marrow

White blood cell counts/complete blood counts
One of the first acts of the parvovirus is to shut down the bone marrow production of immunologic cells (the white blood cells). White blood cell counts are often monitored as the infection is followed. The white blood cell count bottoms out at the height of the viral infection and recovers as the patient’s immune system gains the upper hand. Following the white blood cell count is helpful in determining the patient's ability to recover.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Parvo: the Physical Illness and its Treatment

Treatment for parvoviral infection centers on supportive care. This means that the clinical problems that come up during the infection are addressed with the goal of keeping the patient alive long enough for an immune response to generate. We do not have reliable antiviral drugs and must rely on the patient’s immune system for cure.

BE PREPARED FOR A 5-7 DAY HOSPITAL STAY AND SUBSTANTIAL EXPENSE.
INTENSIVE CARE IS NEEDED TO TREAT THIS INFECTION.

There are certain basic treatment principles that can be viewed as "must haves" in addressing the parvo puppy.

Beyond these basics are some added pluses that may or may not contribute to the chance for survival. In order to achieve the usual survival rate of approximately 75-80%, the basics must be delivered. If an owner is less concerned about expense and simply wants to maximize survival chances, some of the optional treatments may be employed.

The Basics

Fluid Therapy

One of the ways parvo can kill is via the metabolic derangements that occur with extreme dehydration. It is crucial to replace the vast fluid losses (from vomiting and diarrhea) with intravenous fluids. Fluids are given as a steady drip rather than simply under the skin so that absorption into the circulation is direct. Potassium is usually added to the fluids in order to maintain electrolyte balance. Dextrose (sugar) is also frequently added as the stress of the disease may lower blood sugar, especially in a small puppy.

Antibiotics
The important thing is that antibiotics are given directly intravenously so as to avoid issues with attempting to absorb medication from the diseased intestinal tract or from poorly perfused peripheral tissues. Intravenous antibiotics are taken directly to the battlefield of the infection in the intestine where bacteria are attempting to invade. Since the patient's white blood cell count is typically drastically reduced during the height of the parvo infection, we are relying on antibiotics to keep the bacteria out.

Control of Nausea
Patient comfort is an important part of treatment for any disease but is especially important for parvo treatment as these puppies feel extremely nauseated. Again, the GI tract is too damaged for oral medication so medications are given as injections. There are several popular medications for nausea control:

Metoclopramide: (best given as a continuous drip in the IV fluid set up.) If used as separate injections, relief tends to be short lasting and does not provide around the clock control. If a continuous drip is used, nausea control lasts as long as the drip is running.

Chlorpromazine: a strong nausea control medication that lasts 6 to 8 hours per injection and has the added benefit of a drowsiness side effect (so patients can sleep through most of this uncomfortable time).

Ondansetron and dolasetron: These injectables are especially strong anti-nausea medications. In the past, expense has made these medications uncommon but recent generics have made them readily available. Ondansetron is typically given two to three times daily while dolasetron is given only once daily.

Maropitant (brand name: Cerenia®): This powerful anti-nausea has not been adequately tested in puppies under 16 weeks of age. For older puppies, this should be an excellent choice to improve patient comfort. It is given once daily.

The vomiting typical of parvo infection is not only uncomfortable but can ulcerate the esophagus. The disease itself ulcerates the stomach and small intestine. Medications called gastroprotectants help heal ulcers and help minimize their formation. These medications include the injectable antacids (cimetidine, ranitidine, or famotidine) as well as sucralfate, which forms webbing over ulcers to facilitate healing.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Good luck with your puppy. If you can afford to do so and your veterinarian has it an infusion of fresh frozen plasma can really help speed recovery in these puppies.

If this was helpful I would be most appreciative if you could take the time to rate my assistance so the site will credit me with helping you

Without a rating (the stars at the top) the site will not compensate me for helping you.

I am also here for additional questions you may have just reach out to me here and I will be more than happy to assist you.

Kind regards,

Dr. Meghan Denney

This Content is not intended to be a substitute for a professional veterinary exam, diagnostics, diagnosis, or treatment. Always seek the advice of your attending veterinarian with any questions you may have regarding a medical condition of a pet.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

Did this answer your question?

Have you heard back about the Parvo test on your little pup yet?

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago

How is your puppy doing?

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Customer reply replied 5 months ago
Lab results came back and the puppy is negative for Parvo. His blood work is showing signs of improvement—his white blood cell count has increased—but he continues to have diarrhea and vomiting. His current treatment is supportive care with IV fluids and antibiotics. I'm at a loss as to what the underlying cause could be. No other puppies from his litter are sick. Not sure if it could be Giardia or Coccidia. He had three days of Panacur before we adopted him on 11/11 and multiple workings before that so hookworms or anything else should have been cleared out. I'm at a loss as to what else we should be asking our vet about or having him do.
Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 5 months ago
He may just have developed severe gastroenteritis (inflammation along the lining in his intestines) this can happen from a number of causes ranging from bacterial flora imbalances, inflammatory bowel disease, food sensitivities etc. Unfortunately in most cases we don’t ever find a true cause which is really frustrating for both owner and veterinarian because we all want to know why. I am glad he is getting supportive care and so glad this is not parvo.
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