In the ongoing blog series about the history of no kill in Austin, Dr. Ellen Jefferson recalls the creation of a Parvo ward – http://bit.ly/2cjsCj8. After reading about the incredibly journey to saving lives, below is an article about the program, why it is important and how it is managed crafted by one of our own APA! medical volunteers, Jessica Marsh
APA! Parvo Puppy ICU: Saving Lives, One Puppy at a Time
By: Jessica Marsh
In shelters around the country, a diagnosis of parvovirus is a death sentence for a puppy. Due to the highly contagious nature of the disease, that death sentence often extends to the puppy’s littermates, kennelmates, and other puppies housed in the same area or suspected to have been exposed to the puppy with parvovirus. But not in Austin. Austin Pets Alive! developed a groundbreaking Parvo Puppy ICU to take in puppies with parvovirus and safely quarantine those puppies while treating their symptoms.
What is Parvo?
Parvovirus, frequently referred to as parvo, is a virus that affects the lymph nodes, bloodstream and small intestines of dogs. The virus rapidly infects the dividing cells in the patient’s body, most severely in the intestinal tract. Through the infection, bacteria can enter the puppy’s bloodstream, causing widespread infection while the virus inhibits the body’s ability to create new white blood cells to fight the infection. Parvo is life-threatening and causes symptoms including lethargy, loss of appetite, severe vomiting, fever, and severe diarrhea which is frequently bloody. These symptoms often lead to dehydration which can result in death if not quickly and aggressively treated.
Who is at risk?
Parvo mostly affects puppies under four months of age that are not fully vaccinated but can affect older dogs and puppies as well if they have not been fully vaccinated. Parvo can be prevented through a 5-in-1 or 4-in-1 vaccine given in a series until the puppy is four months of age, or a series of two vaccines for dogs over four months of age.
Why is Parvo such a big deal?
Parvo is an incredibly contagious virus that spreads easily from dog to dog through the fecal-oral route. The virus enters a puppy or dog’s body through the mouth when the dog licks something, cleans itself, or eats something. Even the smallest amount of infected fecal material can contaminate the environment lead the spreading of the disease. Dogs can spread the virus by walking through an environment with contaminated soil and later licking their paw or spreading the contamination into their living areas. Humans can spread the virus on their shoes, on their hands, or their clothing if they have come into contact with infected fecal material. The virus is incredibly strong and can live in the environment for a long time even through long, hot summers or cold winters. This ease of spreading and virility is what makes parvo such a death sentence in almost all shelter environments – the shelters simply do not have the space or ability to quarantine infected or possibly infected puppies and the cost of treatment can be extreme.
The APA! Parvo Puppy ICU
Many years ago, APA recognized that some of the most highly adoptable animals were being euthanized as a result of being diagnosed with parvo, being exposed to parvo, or being suspected of having or being exposed to parvo. These puppies, if they were able to survive the illness, would be highly adoptable and very easy to place in loving forever families. Saving these puppies, however, is intensive and can be expensive. In a private hospital, quarantine and hospitalization is cost-prohibitive for most pet owners and nearly all animal shelters. Recognizing that a gap existed between existing services available for these puppies and the ability for these pups to represent a highly adoptable population following treatment, APA! created a Parvo Puppy ICU. The Parvo ICU is the first program of its kind in the United States and works to save these highly adoptable puppies while containing costs to the best extent possible. The protocols and programs that APA! has developed allow the parvo team to treat parvovirus at approximately 10% of the cost of treatment at a private veterinary clinic.
The Parvo Puppy ICU! is largely operated by a team of highly trained volunteers under the supervision of APA!’s veterinary staff. The Parvo ICU is a quarantined area connected to the APA! Medical Clinic in which the puppies can be contained and provided hospitalization care without risking contamination to the Medical Clinic or to the Austin Pets Alive! shelter as a whole. APA! veterinarians assess each puppy on a regular, ongoing basis and develop a treatment plan for the Parvo ICU team to follow. The Parvo ICU is operated on a shift system with set shifts every morning and evening and midday shifts to provide additional support, medication, monitoring, or feeding as needed and ordered by a veterinarian.
Each volunteering shift is staffed by one or more medical team volunteers and one or more care team volunteers along with a staff team manager. The medical team completes treatments prescribed by an APA! veterinarian pursuant to a standard treatment protocol that is then individualized to the patient’s needs while the care team focuses on ensuring each puppy has clean bedding, appropriate food and water, is kept warm through the use of heating pads, and are given the love and support necessary to undergo such a fight. The medical team and care team monitor the progress of each puppy through the use of a set of metrics developed by APA! through years of experience and modified over time as additional treatments prove to be effective. The treatment is focused on combating the dehydration caused by vomiting and diarrhea by providing additional fluids and proteins, controlling vomiting and diarrhea to best extent possible through the use of antiemetic and antidiarrheal medications, and treating or preventing secondary infections with antibiotics. The care team provides nursing care by keeping puppies warm, making sure the puppies have clean bedding, food, and water.
The elimination of opportunities for cross-contamination is one of the most important roles of the Parvo ICU team. The staff and volunteers who enter the Parvo Puppy ICU must change out of their street clothes, including shoes and into specifically designated scrubs and shoes that do not leave the ICU. While in the Parvo Puppy ICU, staff and volunteers work to avoid cross-contamination in between individual patients through the use of sterile techniques, lots of hand washing, and making sure that items that have entered the ICU do not leave the ICU unless they have been appropriately decontaminated. The disposal of trash and contaminated fecal material must be done very carefully in order to ensure that the Parvo Puppy ICU is not potentially contaminating dumpsters that could be dug through by animals such as raccoons, thereby resulting in more widespread contamination. At the end of a shift, leaving the Parvo Puppy ICU requires changing back out of the specifically designated scrubs, decontaminating any skin that has been exposed to potentially contaminated materials, and thoroughly scrubbing hands prior to changing back into street clothes. Additionally, the Parvo Puppy ICU is not accessible to the public and only those staff and volunteers that have been trained on proper cross-contamination elimination protocols and have a need to go into the Parvo Puppy ICU are permitted entrance. Using these protocols that have evolved through years of experience has allowed APA! to operate the Parvo Puppy ICU onsite at our shelter while still protecting healthy puppies in our care.
When puppies have recovered to the point that they are no longer showing symptoms of parvo and have two solid stools, they are tested on a snap test to determine whether they are still shedding the virus. Asymptomatic puppies that still test positive are not permitted to leave the Parvo Puppy ICU and are regularly retested to determine status. Puppies that are asymptomatic and test negative have their nails trimmed to remove any embedded fecal material and are thoroughly bathed twice to remove all traces of contaminated fecal material prior to entering the shelter. Following bathing, puppies undergo an examination by the APA! medical clinic staff and to determine whether they are cleared for adoption or if they need additional time to get their strength back in a foster home.
Although it is a small program in both physical space and staff size, the APA! Parvo Puppy ICU has a huge impact. The treatment protocol developed by APA!’s veterinarians has been very successful. Thus far in 2016, 388 ill puppies have been admitted to the APA! Parvo Puppy ICU and APA! has saved 88% of those puppies. This high survival rate is despite taking in higher numbers critically ill puppies than in previous years. The current 88% survival rate represents a five percent increase from the 2015 survival rate of 83% for the 405 patients treated during that year. In sum, since opening the APA! Parvo Puppy ICU, more than 2,000 dogs have been pulled from euthanasia lists to be provided treatment.
Come learn how your shelter or organization can save and treat parvo puppies in your area, even with extremely limited staff and resources, at this year’s American Pets Alive! No Kill Conference (www.americanpetalive.org) .