Recently I had a chat
with Vet 1 regarding the importance of evidence-based
medicine in the diagnosis of vomiting and diarrhoea in
puppies. There was presented a case of a puppy with
vomiting and diarrhoea vaccinated 5 days ago. Vet 1 did
not think it was parvovirus since the puppy had been
vaccinated and the recent vaccination was 5 days ago.
Vet 1 showed me two comments about parvovirus infections
in a short paragraph in veterinary medicine text book
edited by US vets. These comments are:
1. Parvoviral tests will provide false positive if the
puppy has been vaccinated from 5 - 10 days ago.
2. Most puppies with parvoviral infections survive when
given supportive treatment.
POINT NO. 1
Apparently one Singapore vet had remarked to Vet 1 that
parvovirus test will show a false positive when the
puppy had been vaccinated 5 days ago. Therefore, Vet 1
showed me the book which stated the same. I said: "Will
Vet 1 put in writing that he or she finds that a
positive parvoviral test is a false positive? I doubt
it. The puppy may have got vaccinated 5 days ago but it
could be incubating the parvoviral infections before
that and shows positive on the test. So, it can also be
a true positive."
In any case, I got this puppy which was vaccinated 5
days ago but suffering from vomiting and diarrhoea
tested for parvovirus. It was positive.
POINT NO. 2
"From my experience in working with the professional dog
breeders in Pasir Ris for around 2-3 years, covering
almost all the breeders, I know that parvovirus kills
puppies despite supportive treatment," I said. "This
observation has had been reported by various breeders
and vets in countries like Australia.
"Much depends on the immune status and age of the
puppies, the number of vaccinations, whether the dams
have had been regularly vaccinated to produce maternal
antibodies, the environmental load of parvoviruses and
the strains. The author of the book cannot be trusted as
he wrote a generalised statement. Young puppies with one
or no vaccinations rarely survive even with supportive
treatment because they are very young and their immune
system is not developed. Breeders sometimes miss out
regular vaccinations of their dams and it is extremely
difficult for breeders to isolate infected puppies owing
to their management system of cleaning crates with the
SHOWS A CASE OF PARVOVIRUS WHERE THE PUPPY WAS
VACCINATED 5 DAYS AGO AND SOLD. A DIAGNOSIS OF
PARVOVIRUS ON EVIDENCE-BASED MEDICINE NEEDS A BLOOD
TEST, PARVOVIRAL TEST TO CONFIRM THE CLINICAL SIGNS OF
VOMITING AND DIARRHOEA.
In rare cases, expensive supportive treatment like blood
transfusion, intensive care, IV drips, antibodies, long
hospitalisations may save the odd puppy. But how many
owners are willing to pay for such treatments which are
not guaranteed to save the puppy? The puppy costs $500 -
$1,000. Do you really expect the owner to shell out much
more to save it without a guarantee of success? There
will be owners but not many.
Two years ago, one pet shop girl told me that her staff
spent $20,000 to treat her puppy with vomiting
and diarrhoea at a veterinary practice when I tested it
to be positive for parvovirus. The staff took the puppy
to another practice for treatment since I gave a poor
prognosis. I had no reason to doubt her story although
it does sound incredible.
In the past years, I used to go to pet shops to
vaccinate puppies even if there were only 2-3 puppies
and got to know more about the practices of the pet
shops and breeders. But I have stopped doing it nowadays
as I need to spend more time with my private patients to
build up the practice rather than being "not around"
when I went to the pet shops and breeders.
Despite advances of the world's technologies,
parvoviruses still kill puppies in 2011 and in some
cases, young dogs that have not been vaccinated properly
or not vaccinated.