Case Study – Miss Hoover

Miss. Hoover was a young Boston terrier who was brought into the clinic presenting with diarrhea that had been ongoing for 2 days. Vaccine history was incomplete. Due to her age, she had only received the first in a series of DA2PP vaccines.

Upon arrival, Miss Hoovers’ feces were tested using a commercial ELISA snap test. She tested positive for canine parvovirus.

img1

img2

Canine parvovirus is a highly contagious and serious disease.

The virus does not have a cure and in order for survival aggressive supportive care is required – IV fluid therapy, controlling vomiting and diarrhea, and preventing secondary infections. In untreated dogs, mortality rate can exceed 90%.

Once the virus enters blood stream, it causes damage to the intestinal tract, heart muscle, lymphoid tissue, and bone marrow. This results in a low WBC count, breakdown of the intestinal tract lining allowing pathogens to invade the intestinal tract and enter into the blood stream.

Whether an individual dog gets infected or not depends on the number of viral particles the dog is exposed to, what kind of immune experience the dog has had with the virus before (vaccinated? previously infected? how much past exposure?), and how strong the individual dog is (stress factors, diet etc.)

The viruses are small and hardy in the environment and many household disinfectants are not capable of killing this virus.

The parvovirus can survive over winter in the ground despite freezing temperatures. It is readily carried on shoes or clothing to new areas.

The incubation period is 3-7 days.

Infected dogs shed huge amounts of virus in their feces, saliva and vomit; thus the need  to isolate infected dogs from other dogs.

In surviving dogs, the virus may be shed for 2-3 weeks post infection.

Miss Hoover’s clinical signs after physical exam:

  • Vomiting
  • Diarrhea with blood
  • Lethargic
  • Little appetite
  • Painful abdomen
  • 10% dehydration (extreme)
  • Muddy mucous membranes, cold ears and paws – signs of shock
  • Coughing- aspiration pneumonia due to persistent vomiting

On presentation, Miss. Hoover was immediately hooked up to IV fluids and antibiotics to correct dehydration, to treat secondary bacterial infections, and to rehabilitate shock.  The use of continuously delivered IV therapies was needed to control severe pain, nausea and vomiting.   This supportive care was monitored hourly, and provided as symptoms presented themselves.

Intensive care was continued at Dr. Judy’s home for over 7 days with little improvement. Finally, the bloody diarrhea subsided but vomiting continued to happen after each attempt to feed. She was also profoundly anemic because of the blood loss from diarrhea and vomiting blood over a prolonged period. She had a low amount of proteins in her blood from the chronic disease and anorexia.

It was determined that Miss. Hoover was in need of a blood transfusion to regain antibodies, red blood cells and proteins. Luckily, Johnny, one of our technicians dog, was up for the task!

img3

On day 7, due to persistent vomiting and anorexia prevailing, an abdominal ultrasound was preformed to check for intussusceptions. Intussusceptions are when part of the intestine telescopes onto another piece of intestine causing a blockage.  Ultrasound showed a signs of an obstruction, so an emergency exploratory surgery was needed. During the exploratory, Miss. Hoover’s cecum was impacted with blood clots and lining of the GI tract and colon were completely compromised.

During the days following surgery, Miss. Hoover was still unable to eat without vomiting, because of the effects that the virus had on the intestinal motion and function.  As a last chance to avoid euthanasia, a nasogastric tube was inserted in through the nose and advanced into the stomach to allow for drainage and small amounts of liquid food to be fed every half hour.

img4

img5

img6

It was a full two weeks before Miss. Hoover finally turned the corner and has made a full recovery!!!

She is now a very bouncy, energetic, ball of fun that will give you love, kisses and smiles!

img7

img8