Pet Case: Patience the Puppy and the Case of the Bloody Diarrhea

Patient is a canine (dog) female, not spayed, 12-week-old mixed breed dog. The owner brought the puppy in because she had not been eating, was vomiting, and had bloody diarrhea.

What are some important questions to ask about the patient’s history?

Has this puppy been vaccinated?
Has this puppy been dewormed?
How long has this been going on?

The owner explained that they had not had a chance to do any vaccines or deworm their puppy. Patience had been sick for the past two days.

Exam

I examine Patience and note that she is very depressed, weak and lying quietly on the exam table. Not typical behavior for a 12-week-old puppy.

Patience’s temperature is 102 Fahrenheit. A dog’s temperature should be between 99.5 and 103.5. Her mucous membranes (gums) were slightly pale and tacky. Meaning, she was slightly anemic and dehydrated. The rest of her physical exam was normal.

With these clinical signs in mind, I start thinking of differentials:

Parvovirus
Parasites
Gastritis (stomachache)
Foreign body (sometimes dogs eat things they are should not)

Diagnostics

In order to properly diagnose Patience, I thought it was best to run a few tests. I started with a fecal sample. Basically, taking a sample of Patience’s poop, mixing it in a sugar solution and let it sit for about 10 minutes. I can then look at this sample under the microscope and look for parasite eggs. I did find a few hookworms (a parasite), which can cause patients to lose blood, causing the anemia.

The next test to perform was a parvo test. This test, also using a lovely poop sample, will test for Parvovirus. In this case, the test came back positive. Due to the patient’s history, clinical signs and a positive parvo test I diagnosed Patience with parvovirus.

Treatment

Every veterinarian has his or her own protocols for treating/managing parvovirus. Sadly, there is not a medication that will TREAT parvovirus, but instead we must give supportive care until the patient’s immune system is strong enough to fight off the virus.

Antibiotics are used to help fight of secondary infections.
Anti-inflammatories are used to help decrease the inflammation in the gut and keep the patient comfortable.
Fluids, containing electrolytes/proteins are the most important part of the treatment protocol. When a patient is losing fluid due to vomiting and diarrhea, those have to be replaced. Oral fluids alone are not sufficient in replacing this loss. An intravenous (IV) catheter must be placed in the patient so fluids can be given continually.
Anti-nausea medications are used to help prevent vomiting.
Anti-parasitics are used to deworm the patient.

Recovery

Patience did make a full recovery and she is now basking in the warm sun! She stayed in the hospital for five days before returning home. Sadly, I don’t always have a happy ending like Patience. It is important to follow appropriate measures to protect your sweet little puppy.

Prevention

Parvovirus is HIGHLY contagious. It is spread through the feces (poop) of dogs. Here are some tips to help prevent parvovirus in your dog:

Vaccinate your puppy! Check with your veterinarian to see when they recommend you start vaccines. It is important to booster this vaccine every three weeks until they are 16 weeks of age. Remember your puppy is not fully vaccinated until 3 weeks after their last vaccination.
Older dogs can get parvovirus too! Booster your dog’s vaccines every year.
Use extreme caution when taking your puppy out and about. Especially if it is a location where puppies have previously been.
Even with proper vaccination puppies can still get parvovirus. Early treatment is always best.

To find out more about parvovirus and prevention, visit https://www.avma.org/public/PetCare/Pages/canine-parvovirus.aspx