Evaluation of an outpatient protocol in the treatment of canine parvoviral enteritis

• Published in: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000) Tex. : 2000), 2017-01, Vol.27 (1), p.52-65
• Main Authors: Venn, Emilee C., Preisner, Karolina, Boscan, Pedro L., Twedt, David C., Sullivan, Lauren A.
• Format: Article
• Language: English
• Subjects: Ambulatory Care; Animals; Antiemetics - administration & dosage; Antiemetics - therapeutic use; Antiviral Agents - administration & dosage; Antiviral Agents - therapeutic use; cefovecin; Clinical Protocols; Dog Diseases - drug therapy; Dogs; Enteritis - drug therapy; Enteritis - veterinary; Female; Fluid Therapy - veterinary; Hospitalization; Infusions, Intravenous - veterinary; Male; maropitant; outpatient; Parvoviridae Infections - drug therapy; Parvoviridae Infections - veterinary; Parvovirus, Canine - isolation & purification; Prospective Studies; Treatment Outcome; Triage
• ISSN: 1479-3261; 1476-4431
• DOI: 10.1111/vec.12561

Objective To compare 2 treatment protocols (standard in‐hospital versus modified outpatient) in affecting the duration of treatment or survival of dogs with parvoviral enteritis. Design Prospective, randomized study. Setting University teaching hospital. Animals Client‐owned dogs with naturally acquired parvovirus were randomized to receive either an inpatient (n = 20) or outpatient (n = 20) treatment protocol. Interventions Both groups received intravenous (IV) fluid resuscitation and correction of hypoglycemia at hospital admission. Following stabilization, basic inpatient interventions included administration of IV fluids, administration of cefoxitin (22 mg/kg IV q 8 h), and maropitant (1 mg/kg IV q 24 h). Basic outpatient interventions (provided in‐hospital) included administration of subcutaneous (SC) fluid (30 mL/kg q 6 h), administration of maropitant (1 mg/kg SC q 24 h) and cefovecin (8 mg/kg SC once). Using daily electrolyte and glucose evaluations, dextrose and potassium supplementation was provided intravenously (inpatients) or orally (outpatients) as indicated. Rescue criteria were used in both groups for analgesia and nausea. All dogs were syringe fed a commercial canine convalescence diet (1 mL/kg PO q 6 h) until voluntary appetite returned. Measurements and Main Results Protocol success, defined as survival to hospital discharge, was 90% (18/20) for the inpatient group compared to 80% (16/20) for the outpatient group (P = 0.66). There was no difference detected in duration of hospitalization for inpatient dogs (4.6 ± 2 days) versus outpatient dogs (3.8 ± 1.8 days, P = 0.20). Metabolic disturbances were frequent in the outpatient group, with 50% of dogs requiring dextrose supplementation and 60% of dogs requiring potassium supplementation. Conclusions An outpatient protocol may be a reasonable alternative for dogs that cannot receive standard in‐hospital treatment for parvoviral enteritis. Diligent supportive care and monitoring are still required to optimize treatment of dogs with parvoviral enteritis in an outpatient setting.