The coroner stone of management of CPV enteritis remains supportive care. Mildly infected puppies may be treated as out patients, receiving subcutaneous fluids and dietary restriction. Puppies that fail outpatient management due to persistent or recurrent diarrhea and /or vomiting, and puppies that initially present to the veterinarian with more sever clinical signs, including severe dehydration/hypoperfusion, fever, abdominal pain, and protracted diarrhea and/or vomiting should be hospitalized immediately and managed aggressively.
Re-establishment of effective circulating blood volume inpuppies that present in hypovolemic shock and fluid replacement for losses secondary to ongoing diarrhea and vomiting is mandatory in severly affected puppies. The initial fluid of choice is a balanced electrolyte solution (i.e. LRS) with fluids deficits being replace in 1-2 hours in dogs with hypovolemic shock, while animals that are dehydrated but not in shock should be rehydrated over a period of 6-24 hours. Once perfusion has been restored and deficits corrected the IV rate is decreased to 4-10 mL/kg/hr, adjusted to account for ongoing losses.
Puppies with ongoing anorexia, vomiting, and diarrhea are prone to the development of hypokalemia, which can result in profound muscle weakness/paralysis, gastrointestinal ileus, cardiac arrhythmias and polyuria. Potasium chloride is added to the fluids as needed to prevent the development or worsening of hypokalemia, the rate should not exceed 0.5mEq/kg/hr because it may adversely affect normal cardiac function. After rehydration IV supplementation of 2.5-5% dextrose may be added to combat hypoglycemia secondary to ongoing vomiting and anorexia. A sever PLE may accompany CPV enteritis and the addition of a nonprotein colloid to the fluid plan should be added it the albumin decrease below 2g/dL, the TP decrease below 4g/dL or if the patient develops evidence of third spacing fluids. Daily COP measurements are warranted as during colloidal therapy as over-supplementation can blunt endogenous hepatic albumin production. Packed RBC’s should be administered for anemia resulting from blood loss secondary to hemorrhagic diarrhea or concurrent endoparastism, this should be based on clinical signs of anemia not on the absolute hematocrit. Plasma transfusions can be added as adjunctive treatment for CPV enteritis, for its ability to provide albumin, immunoglobulins, and serum protease inhibitors tht may help to neutralize circulating virus and diminish the accompanying systemic inflammatory response.
