Dorothy Joan Kendall
This article is written to offer my experience with Parvo Virus as a help to anyone in similar circumstances. Canine Parvo Virus (CPV) is a killer of young dogs, and we were exposed taking an older dog to a Veterinarian for teeth cleaning. Since symptoms appear 3 or 4 days after infection, we unknowingly exposed all of our dogs during this initial period ... of course, as soon as the tests were run confirming CPV, we gave everyone booster shots - even the older dogs; but by then, it was too late. From the time of exposure, Dec. 5, to Dec. 18th, we were taking dogs to our Vet Clinic - the youngest died, but we saved two that were older puppies. All had the same shots, so we can only think that some had stronger immune responses than others.
Dottie was the last to exhibit symptoms on the 18th, when she was rushed to the Clinic and put on IV (intravenous) care immediately. Dottie at 7 months of age weighed about 13 pounds, was in excellent health and condition at the time she went to the Vet. Our Vets are very good, one of the few hospitals where there is 24 hour care, either from one of the 5 doctors, or U of P students.
What I want to talk about here is Intensive Care Nursing. First, once the CPV ravages the gastrointestinal tract, the dog must be on IV fluids to fight dehydration, shock and lack of food. Nine to five nursing care just wont do it; it must be on a round the clock 24 hour a day schedule, and 90% of our Veterinarians just are not prepared to deal with this. Costs are prohibitive, and skilled technicians hard to find ... we arent blaming our Vets for not running an ICU (intensive care unit) like this; I just wish they had told us immediately how critical this was, and either encouraged us to take over Dottie to a place that was equipped, or take on this care at home, where we could be equipped to deal with the problem ourselves.
I realize not all people would even want to do this themselves, nor would a sane Veterinarian even recommend this to everyone ... but to keep a dog like Dottie, and not use strenuous support, was condemning her to a sure death. I was not satisfied with what I saw of their nursing care, and told them so; eliciting a very defensive response. It was only then that they told us she was probably going to die, and we could take her someplace else with better nursing care if we werent satisfied. As a result, we lost many precious hours that could have effected an earlier recovery.
Human medicine is further advanced than Veterinarian teaching, and the average Vet cant begin to avail himself of the all the new and very expensive equipment needed for specialized cases; but just good nursing is something we all can do. Another very important point is the psychology of the sick dog ...they need to be in familiar surroundings, with people they know and trust to stimulate the will to live. Having knowledgeable friends is also something we all dont have access to, but the information is out there if we want to learn and equip ourselves to take on home care nursing.
We brought Dottie home on Christmas Eve, knowing that she would probably die. Our Vet had put in a very good IV line on Dottie (this is very tricky, and should be done only by a professional, where a small, plastic tube is inserted into the main vein on the front leg to admit fluids and medication), well taped and hard for her to get at. Very sick dogs wont bother this, believe me. When we told the Vet we wanted to take Dottie home, she provided the medication she had been using, and instructions on how to use it. But that wasnt enough! Since it obviously wasnt working, we knew something else had to be changed, so we called a friend (Medical Doctor versed in emergency room medicine). She was horrified that the fluids and medications (see article on fluid and electrolyte treatment) being used were not consistent with what she knew of canine physiology. Ann, being an Operating Room Nurse was inclined to trust the Vets, but bowed to the Doctors advice.
The Vets were treating this problem much too conservatively, with plain lactated Ringers solution (comes in a 1,000 ml plastic bag with a hanger on the top), and no potassium. This was changed! We used a liter of 5% dextrose and Ringers Lactate solution, with 20 milli equivilents of potassium chloride added. Veterinarians are hesitant to use potassium for fear of side effects, but this was a real emergency. Ann was knowledgeable about administering fluids, so she showed me how the IV worked.
Next, I had to be instructed on how to check on the dogs condition; this involved taking the pulse (inside of the thigh muscle next to the bone) and keeping a written record ... should have been about 90 beats per minute on older dogs, up to 120 bpm for puppies. Dotties was 168! This meant the fluid was being administered too slowly from the IV (faster pulse rate means less fluid circulating in the body), so that had to be adjusted, and a constant monitoring of the pulse and IV was necessary to correct any significant changes. I also had to keep a record of oral fluid intake, vomiting or diarrhea every hour during the day, and every two hours through the night. Respiration (breathing) was also watched to see if it were excessively fast or slow.
Potassium infusion rate was reduced day by day as pulse rate dropped, and fluid intake slowed accordingly. We had to know how the kidneys were working, so any urination was also closely watched - for amount, color and frequency. During this time, the bedroom had to kept draft free and warm, with a heating pad in one side of the sick bed (2 x 3 playpen, with floor elevated to mid-level, and draped with a sheet), underpads covering the rest with a soft bed of towels or small blankets for her to lay on. Lay she did, hardly moving, still having some diarrhea ... this had to be gently sponged off as necessary.
This went on for two days, with barely perceptible improvement, a step backward, two steps forward - not knowing from one day to the next if she would live. On the day after Christmas, Dottie woke me up whining to tell me her bed was dirty and wet - she was sitting up, and wagged her tail when she saw me. Even though she was still critically ill, I now had hope that she might pull through! She began taking a little chicken broth by mouth, and I offered her this every couple of hours, coaxing her to drink. Her pulse was now down to 134, so the fluids were slowed down accordingly. She got a partial bath in a small basin, and was dried with the hair dryer on low - she didnt usually want to be on the heating pad, but she went to it after the bath as she was still probably slightly damp.
The next day she had her first solid food, finely chopped chicken breast with more broth, and seemed to be hungry. Although she vomited some of this, most of it stayed down; wed fixed a big Ham for Christmas, and she would eat small amounts of this, even though it was definitely not recommended. I gave her whatever she would eat, chopped egg yolk, chicken, broth and finally raw ground sirloin the next day.
What an ordeal for all of us, but I can say without reservation that Dottie would have died at the Vets if we hadnt brought her home. She would have died without the professional human medical knowledge necessary to resolve the electrolyte imbalance. She would have died without the nursing, record keeping, and loving handling during her critical care time. The lesson here is to expect certain standards of care from your Vet, and to ask intelligent questions about what will be done to help your dog. Time is of the essense in critical care, so if youre not sure about the course of treatment, get help from someone who does know - and dont be afraid to tackle the problem of home nursing yourself. It can mean the difference between life and death. We owe so much to so many who helped and prayed for us and Dottie - and if we can be of similar help, just ask!Dorothy Joan Kendall
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