"Please, not the pink stuff." (Photo Credit: West Hills Animal Hospital)
Last night, about 5:30pm, my receptionist said a new client (someone we’d never seen before) called because her puppy was just diagnosed with parvo and she wanted to have it euthanized. Would I be willing to do it? I said yes, and agreed to stay late, for the puppy would be arriving about a half hour past closing time.
I dreaded her arrival and doing what I had already agreed to do. But when the owner arrived, things went quite differently than I had expected. She was upset, understandably, and during her hour-long drive to come see us, she started thinking about alternatives to euthanasia. She was especially upset because the vet who provided the diagnosis gave her no information and no options for treatment. “Is there anything I can do for her?” she asked.
It’s not exactly something to be proud of, but our hospital does have a lot of experience treating parvo, and we have (what I feel is) a pretty good protocol in place. We even have a 3-day “initial treatment of parvo” treatment plan already made up in our computer system. I reviewed this with her, along with key information all owners should know about parvo:
- It’s a highly contagious virus, and puppies and unvaccinated dogs are at greatest risk
- The virus attacks the neutrophils, the type of white blood cells responsible for fighting infections
- It also causes breakdown of the lining of the intestines (I don’t see value in explaining the important role of the villi and how they’re destroyed, even though I find it interesting and relevant–there’s just not enough time to cover all that), leading to severe diarrhea and absorption of “bad” bacteria into the bloodstream, eventually leading to sepsis
- Dogs/puppies with parvo tend to shed the virus for about 7-10 days, so patients are often treated for a full week
- We usually know within the first 3 days whether or not the patient is going to survive
The puppy’s presenting complaint at the other vet was related to an episode of bloody diarrhea. She had just bought the puppy on Sunday, and the puppy had diarrhea on a Monday. The other vet performed (I assume) a parvo snap test using a swab of fecal matter. Naturally, the owner wondered if it’s possible to have a false positive, and I said yes, it’s possible. “When was she last vaccinated for parvo?” I asked. Apparently, the breeder had given the vaccines herself, “shortly before” the puppy came home. (We don’t know if that means hours before or days before.)
Normally, I place an IV catheter and get started on fluids and antibiotics right away for these puppies, but “normally”, parvo puppies don’t have much appetite and this puppy wolfed down some Critical Care food I set out for her. (Thankfully, she didn’t throw it up either, which I would have expected a sick puppy to do!) When my initial blood work revealed a normal CBC and no significant changes in the chemistries, and my recheck parvo test was negative (admittedly it didn’t have a lot of stool sample on it, so I couldn’t get too excited yet), I started to doubt whether she was truly sick.
But when I checked on her the next morning, and she was clearly feeling very good (especially those strong vocal cords!), I tried retesting her parvo test again, with a better sample. Weakly positive.
We continued to monitor her throughout the day (and had her on prophylactic metronidazole and clavamox) in our isolation ward, but when she passed a very normal-looking stool in the afternoon, and a recheck CBC was still normal, I pronounced her as normal, with a false-positive parvo test.
And to think, we came soooo close to euthanizing this perfectly healthy baby! Thank God the owner trusted her gut that euthanasia was not the right answer, and was willing to spend $1000+ to treat (the final total was far less than that, of course, but my initial treatment plan was in that ballpark, and we had no idea how things were going to play out). She thanked me again today, as I sent the puppy home, for providing me with the information and options that the other vet had not delivered.