Parvo Program

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Presented at the American Pets Alive No-Kill Conference 2014.

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Parvo Program

  1. 1. Giving Parvo + DOGS a 2nd Chance at Life By: Nipuni Ratnayaka & Kristen Kjellberg, DVM
  2. 2. * *How to start saving immediately *How to expand your program *Complications
  3. 3. W H A T I S P A R V O ? • Viral disease • Incredibly hardy • fecal-oral route • Takes 1-5 days to cause infection • Clinical Symptoms last 5-10 days • 24-48 hours after cessation of symptoms
  4. 4. W H A T I S P A R V O ? • Attacks intestinal lining • Symptoms: • Diarrhea, often bloody • vomiting • lethargy • Causes of death: 1. Dehydration 2. Sepsis • In severe cases, death can be caused by hypoglycemia or hypoprotenemia
  5. 5. PREVENTING OUTBREAKS • CPV can be spread Isolate the puppy • CPV can be carried Follow decontamination protocols • CPV can survive Disinfect the area
  6. 6. A P A ’ S P a r v o P r o g r a m 85%• Volunteers Treat • Doctors prescribe
  7. 7. This is all you need - 1. Minimal medical Supplies 2. Foster w/ Spare Bathroom 3. Doctor for Rx and assessments 4. Decontamination protocols *
  8. 8. * *Designated – parvo only *AM & PM treatments *Multiple fosters for different stages *No med. experience required *Hands-on training for SQ *Care instructions/manual *On-Call phone number
  9. 9. D E C O N T A M I N A T I O N P R O T O C O L S • Isolation • Designated scrubs & shoes* • Toilet • Proper Hand Washing • Washer & Dry Separately • Tub for Baths *designated shoes more effective than footbath
  10. 10. Protocol found @ wiki.apaparvo.org S C R U B B I N G I N & O U T a strict protocol for entering and exiting the icu
  11. 11. Wash up to wrists
  12. 12. T R E A T M E N T S H E E T 1. Doctors prescribe 2. Volunteers treat Document Everything • Physical exam • Medications • Consumption and Excretion
  13. 13. M e d i c a l S u p p l i e s 1. Antibiotics • Polyflex • Baytril 2. Reglan (nausea) 3. Fluid bags 4. Needles and Syringes
  14. 14. T R E A T M E N T E S S E N T I A L S *Cost estimate for 10lb dog Parvo SNAP Tests (IDEXX) • $20 for 1* • non-essential to test-out Baytril 100mg/mL • $165 per 250cc bottle • 1cc X 6 days • 6cc - $4 • 40 dogs per bottle Polyflex • $40 per 150cc bottle • $1.60 Reglan • $6 per 30cc bottle • $1.20 Fluids • $20 per 12 bag case • $2.50* Syringes & Needles • $5 Medicine cost = ~ $16-36 per dog *depends on shelter protocols
  15. 15. *
  16. 16. T O U R O U R P I C U !
  17. 17. T O U R O U R P I C U !
  18. 18. T O U R O U R P I C U !
  19. 19. E N T R A N C E • Clean side: • Lockers • Sink • street clothes • Dividing line • Contaminated side • Scrubs • shoes
  20. 20. B U I L D I N G A T E A M 1. Licensed Veterinarian • order & prescribe medications, looks over patient cases • Ask your local vet! 2. Team Manager • recruit volunteers, schedule, program improvements 3. Dedicated volunteers • quality over quantity 4. Veterinary Technicians • place catheters, intake, off-shift tasks
  21. 21. * • Recruiting – • Email • Medical Groups • Students • Reg Volunteer group • Professionalism • Strict Requirements • Training • Curriculum • Empowering = knowledge • How vs. Why & When • Do vs. Understand
  22. 22. How Volunteers Handle Death • Protocols, prepared in advanced, part of training • Facebook page • Memorial garden • Its not their fault • will lose 15% no matter what
  23. 23. E S S E N T I A L I T E M S General Cleaning Medical
  24. 24. G E N E R A L : DOG CARE SUPPLIES Designated for parvo patients only • Fridge • Toilet • Bowls • Toys • Sweaters • Heating pads • Microwave • Thermometer General My legs are too long…
  25. 25. V A R I E T Y O F F O O D • nausea-association • Turn around in 5-6 days • high in protein • stimulate appetite • Pizza crust • Goal = solid stools • Chicken and Rice General ZZzzzZZZZ…
  26. 26. C L E A N I N G S U P P L I E S • Sharps Container • Parvocidal Disinfectant • Bleach • Laundry detergent • Hand soap • Washer/Dryer • Broom/Mop • Toilet paper • Trash bags Cleaning
  27. 27. M E D I C A L S U P P L I E S *OK to began with only subcutaneous treatment 1.Treatment supplies • Needles • Syringes • IV Fluid Line • Catheters* • Fluid pump*
  28. 28. M E D I C A L S U P P L I E S 2. Medications • Antibiotics • Baytril (Enrofloxacin) • Polyflex • Ampicillin or Cefazolin* • Fluids • Lactated Ringers • Hetastarch* • Antiemetics • Reglan • Dewormers • Strongid
  29. 29. T R E A T M E N T A D D - O N S Medications • Cerenia or Anzemet • Famotidine or Zantac • Doxycycline or Oxytetracycline • Panacur or Strongid • Dextrose or Karosyrup • Metronidazole • **Med Charts in Manual** Equipment • IV Pump • Catheters • Hair clippers
  30. 30. • Donations • Amazon Wishlist • Meds from Hospitals • Recycling syringes for orals • Hand towels • Rely on & empower volunteers • One parvo test per litter, up to 3 • Protocols to reduce DVM time • Higher adoption fee for post-parvos • Supportive care • constant force feeding slowly (baby food, pedialyte, chicken broth) incredibly small amounts • keep warm • Reglan, fluids every 8 hours S A V I N G M O N E Y 4,200 volunteer man hours worked in 2013
  31. 31. O V E R A L L E S T I M A T E D C O S T Minor $20.52 Moderate $68.77 Severe $133.16 Average ~ $75 per dog 20% 20% 60%
  32. 32. I N T A K E 1. Verify a positive test 2. vaccinate – DHPP and Bordatella 3. Physical assessment 4. Treatment 5. Wash hands between patients
  33. 33. ASSESSSMENT & PHYSICAL EXAM • Assessments noted every 12 hours by volunteers • Medical treatments prescribed every 24 hours by doctor 1. Attitude • BAR, QAR, lethargic, semi- comatose 2. Gum color: • pink – healthy • pale pink – poor circulation • White - anemic • Grey/pale – shock (severe dehydration, sepsis) 3. Temperature • Paws • Rectal
  34. 34. M I N O R T R E A T M E N T Assessment: • Dog is BAR/QAR • Decreased or no appetite • Some vomiting and/or diarrhea • Moderate dehydration Subcutaneous Treatment • Baytril (diluted), Polyflex, Reglan and fluids • +/- on pump
  35. 35. M O D E R A T E T R E A T M E N T Assessment: • Dog is QAR/lethargic • No appetite • Moderate vomiting and diarrhea • Pink gums Intravenous Treatment • Baytril SQ & Ampicillin IV • IV Fluid bolus or on pump
  36. 36. S E V E R E T R E A T M E N T Assessment: • lethargic • Excessive v/bd Intravenous Treatment • Baytril IV diluted, vet supervision • Ampicillin IV • IV fluid pump with dextrose, reglan, kcl • Hetastarch – blood volume infuser (pressure increaser), protein • Hypoglycemia & Toy breeds • Force feeding
  37. 37. D I S C H A R G I N G Testing Out: • Two Solid Stools • Special Circumstances: In ICU for >10-12 days
  38. 38. D I S C H A R G I N G Bathing – be extremely thorough 1. Clip nails 2. Remove all traces of feces 3. Two baths 4. Clean rectum, under tail, & paws very well
  39. 39. *
  40. 40. • Vaccinate immediately at intake • Before even taking out of cage • No harm, possible benefit • Immediately separate litters/puppies showing URI symptoms • put in crate and cover • Wash hands **properly** *
  41. 41. Treating a dying puppy • What are we treating? • Dehydration • Temperature • Hypoglycemia 1. Act fast – no diagnostics 2. Warmth 3. Hetastarch & Dextrose IV 4. Reassess • Temp – rectal + paws • Gum color • Lift head 5. LRS bolus until out-of-shock ****Have hard copies of protocols readily available**** *
  42. 42. * • Worms, Mange • Decontamination protocols • Strongid given regardless to all • For severe mange, be aggressive with treatment • Hookworm anemia • URI/Distemper • Quarantine Protocols • Additional Medications • Baytril • Azithromycin • Oxytetracycline/Doxycycline • Nebulizing
  43. 43. • Abscesses • How? • blown vein – swelling above IVC • baytril site • Treatment • Baytril or Clavamox ideal • Warm compresses • Honey Bandage • Can’t place a catheter • Try jugular catheter • Call DVM or vet tech • Intussusception • DVM diagnose • abdomen palpations • excessive vomiting • Abdominal palpations • No diarrhea or purpleish diarrhea *
  44. 44. • Walking on wrists/hawks • bones and ligaments growing at different rate • straightens out in a week • not to worry • Post parvo arthritis • Potential Causes • Parvovirus localizing in the joints? • related to baytril? • Most likely sepsis. Supportive tx??? no surgery necessary • Treatment • Tramadol & NSAIDs • Antibiotics may not be necessary – DVM discretion • Temporary problem *
  45. 45. Q U E S T I O N S / C O M M E N T S ? nipuni.ratnayaka@austinpetsalive.org w i k i . a p a p a r v o . o r g Kerbey, Parvo survivor

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