Treatment of severe parvoviral enteritis (Proceedings) - Veterinary Healthcare


Treatment of severe parvoviral enteritis (Proceedings)



Dogs with severe CPV enteritis may have a prolonged course of hospitalization and may require nutritional support to prevent catabolism and immune dysfunction associated with negative nitrogen balance.

Partial parenteral nutrition (PPN) does not supply all of the patient's nutrient needs but can provide short term support for animals that are expected to recover soon. The advantage of PPN solutions is that they can be delivered through a peripheral vein rather than through a large central vein. PPN solutions are usually given at a maintenance dose (60 ml/kg/day) and additional fluid needs are met with crystalloid solutions as described earlier. Procalamine (McGaw, Inc.) is a commercial product which contains 3% amino acids, 3% glycerol, and electrolytes. A "homemade" PPN solution can be made by adding 300 ml of 8.5% amino acid solution (Travenol, Baxter, Inc.) to 700 ml lactated Ringer's solution with 5% dextrose. The addition of lipid emulsions is controversial. Although lipids are rich in caloric content, they have been associated with immunosuppression through impairment of reticuloendothelial function and reduction in white blood cell phagocytosis.

A common complication of PPN solutions is catheter phlebitis because the solutions are hypertonic. Catheters must be placed aseptically and the site monitored carefully for redness, swelling or pain. Solutions containing dextrose should be tapered off gradually to prevent rebound hypoglycemia.

Most practitioners offer water after vomiting has been absent for 12 - 24 hours. Early enteral nutrition is important to promote intestinal regeneration. A liquid diet (Clinicare) can be offered initially, or a gruel can be made with an easily digestible high carbohydrate, low fat diet. The addition of glutamine powder (0.5 g/kg divided q 12 hours) to drinking water may promote GI healing in dogs recovering from CPV enteritis. Various veterinary recovery diets are available for post hospital care. The puppy may have temporary intestinal malabsorption and protein-losing enteropathy until intestinal villi are repaired. Initial feeding should consist of small amounts of an easily digestible low fat diet fed frequently. The normal diet is gradually re-introduced after appetite and stool have returned to normal. Following recovery, immunity to parvo virus infection lasts at least 2 years, and may even be lifelong.


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