Evaluation of an outpatient protocol in the treatment of canine parvoviral enteritis

Antioxidant supplementation during treatment of outpatient dogs with parvovirus enteritis ameliorates oxidative stress and attenuates intestinal injury: A randomized controlled trial

A prospective randomized controlled clinical study was conducted to determine whether antioxidant supplementation as an adjunct therapy alters hemogram, oxidative stress, serum intestinal fatty acid binding protein-2 (IFABP-2) level, fecal viral load, clinical score (CS) and survivability in outpatient canine parvovirus enteritis (CPVE) dogs. The dogs with CPVE were randomized to one of the five treatment groups: supportive treatment (ST) alone, ST with N-acetylcysteine (ST+NAC), resveratrol (ST+RES), coenzyme Q10 (ST+CoQ10) or ascorbic acid (ST+AA). The primary outcome measures were reduction of CS and fecal HA titre, and enhancement of survivability. Secondary outcome measures were reduction of oxidative stress indices and IFABP-2 level from day 0 to day 7. The mean CS and HA titre were significantly (P < 0.05) decreased from day 0 to 7 in ST and all antioxidant groups. The supplementations of NAC, RES and AA along with ST markedly (P < 0.05) reduced the concentrations of malondialdehyde, nitric oxide and IFABP-2 on day 7 as compared to ST alone. Additionally, NAC and RES supplementations markedly (P < 0.05) improved the total leukocyte count and neutrophil count in CPVE-affected dogs. NAC and RES could serve as better antioxidants for the amelioration of oxidative stress in CPVE but, the antioxidants did not confer any additional benefits in reduction of CS, fecal HA tire, or survivability when compared with ST alone.

Prognostic factors associated with survival and hospitalization time in pediatric canine patients diagnosed with presumptive acute viral gastroenteritis

Background and Aim:

Acute viral gastroenteritis is one of the main causes of hospitalization in dogs during the 1^st year of life. This retrospective study aimed to describe a pediatric canine population presumptively diagnosed with acute viral gastroenteritis and to identify potential prognostic factors that influence hospitalization time (HT) and mortality.

Materials and Methods:

Canine patients up to 12 months of age diagnosed with presumptive acute viral gastroenteritis were searched retrospectively from two veterinary hospitals during a 5-year period (2015–2020). Information regarding patient signalment, prophylactic care, clinical signs, blood test results, presence of systemic inflammatory response syndrome, and additional treatments were recorded to analyze their association with HT and mortality. Only dogs with a complete medical record until death or discharge were included in the study.

Results:

Ninety-four dogs were identified: 76 dogs (80.9%) survived with a median HT of 5 days (range: 2–16 days) and 18 dogs (19.1%) died with a median HT of 3½ days (range: 1–8 days) after admission. The presence of fever and fresh frozen plasma (FFP) administration was significantly associated with a lower survival rate (p = 0.021 and p = 0.037) in the multivariate analysis. Among survivors, incomplete primo-vaccination, the presence of hematochezia, and FFP administration were considered independent predictors of time to clinical recovery (p = 0.026, p = 0.047, and p = 0.026, respectively), being associated with higher HT.

Conclusion:

The presence of fever and FFP administration was significantly associated with a lower survival rate. An inadequate primo-vaccination status prior to admission, hematochezia, and FFP administration was associated with longer HT in surviving patients. Further studies are needed to confirm the present results.

Experimental study of tropism of cultivated canine parvovirus in the immunogenesis organs of puppies

The immune system unites the organs and the tissues that protect the organism against genetically alien cells or substances entering the organism from the environment. Canine parvovirus is an etiologic agent of hemorrhagic gastroenteritis and causes a significant problem for veterinary medicine due to high level of morbidity and mortality, mostly among dogs, because of fast progression without immune-complement response. In this study, based on the results of our clinical, virological, histological, histochemical and morphological assays, we determined the pathogenetic role of parvovirus in sick dogs experimentally infected per os, specifically with isolated canine parvovirus (Antaeus) with titer of infectious activity equaling 3.80 ± 0.008 lg TCID50/cm, cultivated on heterological cell cultures. This allowed us to clarify, add to and generalize the data on the pathogenesis of the disease and determine pathohistological and histochemical changes in the immunogenesis, since the studied virus expresses immune-suppressive properties, leading to ruination of the locomotor ability of the organism and fast lethal outcome. The study of pathomorphological changes was carried out using pathoanatomical and histologic methods. Pathoanatomical material from the autopsy of puppies aged 45 days was fixed in 10% aqueous solution of neutral formaline and embedded in paraffin. Having parvoviral infection, dogs experience pathomorphologic changes in immune-complement organs, indicating inhibition of the immunogenesis function during an infectious disease of viral etiology. In the immunogenesis organs of puppies with the experimental reconstruction of parvoviral enteritis, we microscopically determined the following: edema of the cortex and medulla, disorganization of thymic corpuscules, and impairment of processes of differentiation of lymphocytes in the cortex and medulla of the thymic lobules; edema and large areas of accumulation of hemosiderin in the spleen as a result of breakdown of large amount of erythrocytes; acute inflammatory hyperemia of the parenchyma, swelling of sinuses, serous and serous-hemorrhagic lymphadenitis in lymph nodes. The complex of histologic changes in the immune protection organs, which we found in the conditions of experimental reconstruction of parvoviral infection, can be considered a distinct criterion for pathomorphologic differentiation diagnostics of parvoviral enteritis in dogs.

Canine parvovirus-2: An Emerging Threat to Young Pets

Canine parvovirus-2 (CPV-2) is a highly contagious and key enteropathogen affecting the canine population around the globe by causing canine parvoviral enteritis (CPVE) and vomition. CPVE is one of the the leading causes of morbidity and mortality in puppies and young dogs. Over the years, five distinct antigenic variants of CPV-2, namely CPV-2a, CPV-2b, new CPV-2a, new CPV-2b, and CPV-2c, have emerged throughout the world. CPV-2 infects a diverse range of wild animals, and the newer variants of CPV-2 have expanded their host range to include felines. Despite the availability of highly specific diagnostics and efficacious vaccines, CPV-2 outbreaks have been reported globally due to the emergence of newer antigenic variants, expansion of the viral host range, and vaccination failures. The present chapter describes the latest information pertaining to virus properties and replication, disease manifestations in animals, and an additional recent updates on diagnostic, prevention and control strategies of CPV-2.

Parvovirus enteritis and other risk factors associated with persistent gastrointestinal signs in dogs later in life: a retrospective cohort study

Background

Parvoviral enteritis (PE) is a viral gastrointestinal (GI) infection of dogs. Recovery from PE has been associated with persistent GI signs later in life. The objectives of this study were: (i) To determine whether dogs that have recovered from PE (post-parvo dogs) had an increased risk of persistent GI signs compared to uninfected control dogs. (ii) To investigate the lifestyle and clinicopathologic factors that are associated with persistent GI signs in post-parvo dogs.

Methods

A total of 86 post-parvo dogs and 52 age-matched control dogs were enrolled in this retrospective cohort study. Many years after hospitalization for PE, the owners were interviewed about the health and habits of their dogs using a questionnaire. We used generalized linear mixed effects models to test whether parvovirus enteritis and other risk factors are associated with owner-recognized general health problems in all dogs and with owner-recognized persistent GI signs in post-parvo dogs.

Results

The prevalence of persistent GI signs was significantly higher in post-parvo dogs compared to control dogs (57% vs 25%, P < 0.001). Markers of disease severity at the time of hospital admission such as neutropenia, low body temperature (BT), and treatment with an antiemetic medication (metoclopramide) were significant risk factors for persistent GI signs in post-parvo dogs. For example, PE-affected dogs that were hypothermic at hospital admission (BT of 37.2 °C) were 16.6 × more likely to have GI signs later in life compared to hyperthermic dogs (BT of 40.4 °C). The presence of persistent GI signs in post-parvo dogs was a risk factor for health problems in other organ systems.

Conclusions

Parvovirus enteritis is a significant risk factor for persistent GI signs in dogs highlighting the importance of prevention. The risk factors identified in the present study may guide future investigations on the mechanisms that link parvovirus enteritis to chronic health problems in dogs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12917-022-03187-7.

Antimicrobial Resistance (AMR) of Bacteria Isolated from Dogs with Canine Parvovirus (CPV) Infection: The Need for a Rational Use of Antibiotics in Companion Animal Health

Canine parvovirus type 2 (CPV-2) represents a major viral threat to dogs. Considering the potential effects of pets on antimicrobial resistance, information on the CPV and associated bacterial co-infections is limited. The aim of this study was to analyze the antimicrobial susceptibility and multidrug-resistance profiles of bacterial species from tissue samples of dogs with canine parvovirus infection. A set of PCR assays and sequence analyses was used for the detection and the molecular characterization of the CPV strains and other enteric viruses. Bacterial isolation, the determination of antimicrobial susceptibility via the disk diffusion method, and the determination of the minimum inhibitory concentration were performed. The detection of β-lactamase genes and toxin genes for specific bacteria was also carried out. CPV infection was confirmed in 23 dogs. Forty-three bacterial strains were isolated and all showed phenotypic resistance. Seventeen multidrug-resistant bacteria and bacteria with high resistance to third- and fourth-generation cephalosporins and metronidazole were detected. Almost 50% of the isolated Enterobacteriaceae were positive for at least one β-lactamase gene, with the majority carrying more genes as well. The evidence for multi-resistant bacteria with the potential for intra- or cross-species transmission should be further considered in a One Health approach.

Assessing the Impact of a Virtual Shelter Medicine Rotation on Veterinary Students' Knowledge, Skills, and Attitudes Regarding Access to Veterinary Care

Strong bonds commonly form between companion animals and people of all socio-demographic backgrounds, yet many pet owners face numerous barriers to accessing veterinary care for their companion animals. For example, they may have difficulties paying for care; they may lack veterinary practices in their community; and they may experience language barriers that impede their ability to utilize veterinary services. Various strategies exist that can help veterinarians address the diverse needs of pet owners in their communities, but these techniques are not commonly covered in the veterinary school curriculum. This study explored how including in-depth, purposefully curated information about access to veterinary care issues within a required shelter medicine rotation impacted fourth-year veterinary students' knowledge, skills, and attitudes regarding the problems clients commonly face when seeking access to veterinary care. Students participated either in a control group of a virtual, four-week rotation delivered via Zoom meetings and self-study, or in an experimental group that additionally completed an interactive online learning module. The online module heavily featured issues surrounding access to veterinary care. Irrespective of which version of the rotation students enrolled, their opinions grew more favorable from pretest to post-test regarding the role of not-for-profit veterinary clinics in communities, as did their expectations that veterinarians should provide affordable treatment options. Additionally, students in the experimental group demonstrated from pretest to post-test increased awareness of the potential for implicit bias toward pet owners within veterinary practice and showed a reduction in their tendency to be judgmental of veterinary clients. By the end of the study, students in the experimental group also expressed greater confidence in their ability to offer incremental care treatment options to veterinary clients. These findings suggest that providing content that focuses on increasing access to veterinary care enhances students' awareness of the need to offer a variety of treatment and payment options to clients. Findings from this study can inform curriculum design in veterinary schools and continuing education programs for veterinary professionals.

Measuring Changes in Perceptions of Access to Pet Support Care in Underserved Communities

Understanding social, economic, and structural barriers to accessing pet care services is important for improving the health and welfare of companion animals in underserved communities in the U.S. From May 2018-December 2019, six questions from the validated One Health Community Assessment were used to measure perceptions of access to pet care in two urban and two rural zip codes. One urban and one rural community received services from a pet support outreach program (Pets for Life), while the other served as a comparison community. After propensity score matching was performed to eliminate demographic bias in the sample (Urban = 512 participants, Rural = 234 participants), Generalized Estimating Equations were employed to compare the six measures of access to pet care between the intervention and comparison communities. The urban community with the Pets for Life intervention was associated with a higher overall measure of access to pet care compared to the urban site that did not have the Pets for Life intervention. When assessing each of the six measures of access to care, the urban community with the Pets for Life intervention was associated with higher access to affordable pet care options and higher access to pet care service providers who offer payment options than the community without the Pets for Life intervention. Further analyses with a subset of Pets for Life clients comparing pre-intervention and post-intervention survey responses revealed statistically significant positive trends in perceptions of two of the six measures of access to pet care. This study provides evidence that community-based animal welfare programming has the potential to increase perceptions of access to pet support services.

Increased survival in puppies affected by Canine Parvovirus type II using an immunomodulator as a therapeutic aid

Canine parvovirus type II (CPV-2) infection induces canine parvoviral enteritis (CPE), which in turn promotes sepsis and systemic inflammatory response syndrome (SIRS). Mortality in this disease is usually registered within 48-72 h post-hospitalization, the critical period of the illness. It has been recently described that the use of an immunomodulator, whose major component is monomeric ubiquitin (mUb) without the last two glycine residues (Ub∆GG), in pediatric human patients with sepsis augments survival. It is known that CXCR4 is the cell receptor of extracellular ubiquitin in humans. This work aimed to explore the effect of one immunomodulator (human Dialyzable Leukocyte Extract-hDLE) as a therapeutic auxiliary in puppies with sepsis and SIRS induced by CPE. We studied two groups of puppies with CPV-2 infection confirmed by polymerase chain reaction. The first group received conventional treatment (CT) and vehicle (V), while the second group received CT plus the immunomodulator (I). We assessed both groups' survival, clinical condition, number of erythrocytes, neutrophils, and lymphocytes during the hospitalization period. In addition, hematocrit, hemoglobin, plasma proteins and cortisol values, as well as norepinephrine/epinephrine and serotonin concentration were determined. Puppies treated with CT + I showed 81% survival, mild clinical signs, and a significant decrease in circulating neutrophils and lymphocytes in the critical period of the treatment. In contrast, the CT + V group presented a survival of 42%, severe clinical status, and no improvement of the parameters evaluated in the critical period of the disease. We determined in silico that human Ub∆GG can bind to dog CXCR4. In conclusion, the administration of a human immunomodulator (0.5 mg/day × 5 days) to puppies with CPE under six months of age reduces the severity of clinical signs, increases survival, and modulates inflammatory cell parameters. Further studies are necessary to take full advantage of these clinical findings, which might be mediated by the human Ub∆GG to canine CXCR4 interaction.

[Use of antimicrobials in acute canine diarrhea - overview of potential risks, indications and alternatives]

In Germany, antibiotics are frequently used in dogs with gastrointestinal disorders such as acute diarrhea. In line with global efforts to limit antibiotic use, this literature review aims to provide a guideline for the rational and judicious use of antibiotics in acute canine diarrhea. Antibiotics can lead to gastrointestinal side effects and may exert a negative influence on the intestinal microbiota in addition to increasing the occurrence of resistant bacteria. There is also evidence that chronic immunological diseases may be triggered by the administration of antibiotics. Therefore, these should not be administered in uncomplicated acute diarrhea without signs of sepsis or systemic inflammatory reaction. In addition, enteropathogenic bacteria usually do not play a role in the etiology of acute diarrhea. For select clinical entities such as acute hemorrhagic diarrhea syndrome, antibiotic therapy should only be recommended in cases displaying signs of bacterial translocation with subsequent sepsis. In the case of parvovirosis, on the other hand, the administration of antibiotics is unavoidable due to the immunological incompetence of the dog caused by the accompanying severe neutropenia.

Prognostic indicators at presentation for canine parvoviral enteritis: 322 cases (2001-2018)

OBJECTIVE

To evaluate clinicopathological prognostic indicators associated with survival based on hematology and serum biochemistry profile findings at presentation of dogs with canine parvoviral enteritis (CPE). Secondary objectives were to describe the signalment, history, physical examination findings, and progression of disease while in hospital and correlate them to survival.

DESIGN

Retrospective study from medical records of dogs diagnosed with CPE between 2001 and 2018.

SETTING

University teaching hospital.

ANIMALS

Three hundred twenty-two dogs diagnosed with CPE that received in-hospital treatment.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Of 322 hospitalized dogs, 294 dogs (91%) survived infection with a median hospitalization time of 79 hours. Multivariable analysis showed that glucose (P = 0.04), total magnesium (P = 0.011), and the dichotomized variable of a low HCT (P = 0.033) on presentation were significantly associated with survival. For every 1 mmol/L (18 mg/dL) decrease in glucose concentration, cases had 1.85 lower odds of survival. For every 0.1 mmol/L (0.2 mEq/L) increase in total magnesium concentration, cases had 2.50 lower odds of survival. Cases with a low HCT had 10.69 lower odds of survival. On univariable analyses, non-survivors had a lower median body weight (P = 0.006) and presented more commonly for diarrhea (P = 0.015). At least 1 episode of diarrhea (P = 0.003) and hematochezia or melena (P < 0.001) in hospital were negatively associated with outcome, in addition to the persistence of diarrhea (P = 0.026) and hyporexia (P = 0.018) in hospital for 5 to 6 days.

CONCLUSIONS

Survival rates of 91% were achieved with in-hospital treatment in this cohort of dogs. Negative biochemical prognostic indicators affecting survival include a low HCT, decreased blood glucose concentrations, and increased total serum magnesium concentrations at presentation.

Changes in Mass Treatment of the Canine Parvovirus ICU Population in Relation to Public Policy Changes during the COVID-19 Pandemic

Previous work has indicated that canine parvovirus (CPV) prevalence in the Central Texas region may follow yearly, periodic patterns. The peak in CPV infection rates occurs during the summer months of May and June, marking a distinct “CPV season”. We hypothesized that human activity contributes to these seasonal changes in CPV infections. The COVID-19 pandemic resulted in drastic changes in human behavior which happened to synchronize with the CPV season in Central Texas, providing a unique opportunity with which to assess whether these society-level behavioral changes result in appreciable changes in CPV patient populations in the largest CPV treatment facility in Texas. In this work, we examine the population of CPV-infected patients at a large, dedicated CPV treatment clinic in Texas (having treated more than 5000 CPV-positive dogs in the last decade) and demonstrate that societal–behavioral changes due to COVID-19 were associated with a drastic reduction in CPV infections. This reduction occurred precisely when CPV season would typically begin, during the period immediately following state-wide “reopening” of business and facilities, resulting in a change in the typical CPV season when compared with previous years. These results provide evidence that changes in human activity may, in some way, contribute to changes in rates of CPV infection in the Central Texas region.

Update on Canine Parvoviral Enteritis

Canine parvoviral enteritis is one of the most common causes of morbidity and mortality in dogs worldwide. Tests can detect viral antigen in feces, and characteristic decreases in total leukocyte, neutrophil, and lymphocyte counts can increase the index of suspicion in affected cases and can be used to prognosticate morbidity and mortality. The standard of care for infected animals includes IV crystalloid and sometimes colloid fluids, antiemetics, broad-spectrum antibiotics, and early enteral nutrition. Vaccination induces protective immunity in most dogs. Vaccination, along with limiting exposure in young puppies, is the most effective means of preventing parvoviral enteritis in dogs.

Antimicrobial Prescribing Practices in Small Animal Emergency and Critical Care

Background: Antimicrobial use contributes to emergence of antimicrobial resistance. It was hypothesized that antimicrobial prescribing behavior varies between the emergency (ER) and critical care (CC) services in a veterinary teaching hospital. This study aimed to: (i) describe antimicrobial prescribing patterns in the ER and CC services; (ii) assess adherence to stewardship principles; (iii) evaluate the prevalence of multidrug resistant (MDR) bacterial isolates. Methods: Institution electronic medical records were queried for all antimicrobial prescriptions from the ER and CC services between 1/1/2017 and 12/31/2017. Prescriptions were manually reviewed, and the following data recorded: drug, dosage, duration, diagnosis, outcome, hospitalization duration, culture submission, and susceptibility results. Results: There were 5,091 ER visits, of which 3,125 were not transferred to another service. Of these emergency visits, 516 (16.5%) resulted in 613 antimicrobial drug prescriptions. The most commonly prescribed drugs for the ER were amoxicillin/clavulanate (n = 243, 39.6%), metronidazole (n = 146, 23.8%), and ampicillin/sulbactam (n = 55, 9.0%). The most common reasons for antimicrobial prescriptions were skin disease (n = 227, 37.0%), gastrointestinal disease (n = 173, 28.2%), and respiratory disease (n = 50, 8.2%). For ER patients 18 cultures were submitted, equivalent to a 3.5% submission rate. The CC service managed 311 case visits for 822 patient days. Of these, 133 case visits (42.7%) resulted in 340 prescriptions. The most commonly prescribed drugs for the CC service were ampicillin/sulbactam (n = 103, 30.3%), enrofloxacin (n = 75, 22.1%), and metronidazole (n = 59, 17.4%). The most common reasons for antimicrobial prescriptions were gastrointestinal disease (n = 106, 31.2%), respiratory disease (n = 71, 20.9%), and sepsis (n = 61, 17.9%). On the CC service, 46 patients had ≥1 culture submitted, equivalent to a 34.6% submission rate. Of patients prescribed antimicrobials, 13/38 (34%) with urinary tract disease, 2/28 (7%) with pneumonia, 1/11 (9%) with canine infectious respiratory disease complex and 2/8 (25%) with feline upper respiratory infection were compliant with published guidelines. Conclusions: Antimicrobial prescription was common in both ER and CC services and followed similar patterns. Adherence to published guidelines for urinary and respiratory infections was poor.

Retrospective evaluation of outpatient canine parvovirus treatment in a shelter-based low-cost urban clinic

OBJECTIVE

To evaluate survival and associated risk factors when utilizing an outpatient treatment protocol for treatment of canine parvovirus (CPV) performed in a shelter-based low-cost urban clinic.

DESIGN

Retrospective study.

SETTING

Pennsylvania Society for the Prevention of Cruelty to Animals.

ANIMALS

Ninety-five CPV positive dogs presented between June 1 and July 31, 2016. Owners elected for outpatient care when inpatient care was not financially feasible and the dog was considered medically stable for outpatient care.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Of the 95 CPV positive dogs, 79 (83%) survived treatment. Logistic regression indicated that an increasing number of days with clinical signs prior to treatment and an increase in percent body weight during treatment were significantly associated with survival (odds ratio [OR], 3.15, P = 0.020; and OR, 1.29, P = 0.027, respectively). Hypothermia upon presentation (T < 37℃) was negatively associated with survival (OR, 0.002; P = 0.002).

CONCLUSIONS AND CLINICAL RELEVANCE

The survival rate of this clinic suggests that an outpatient program may be a potential alternative treatment to inpatient care. Longer duration of clinical signs prior to treatment and an increase in percent body weight during treatment appear to be associated with increased survival outcomes, while hypothermia on presentation appears to be associated with decreased survival outcomes.

Serum D-lactate concentrations in dogs with parvoviral enteritis

BACKGROUND

Dogs infected with canine parvovirus (CPV) have compromised intestinal epithelial barrier integrity. Production of D-lactate by enteric bacteria may directly reflect disease severity or contribute to metabolic acid-base status in these dogs.

HYPOTHESIS

Serum D-lactate concentration will be increased in CPV dogs compared to healthy controls and correlate with markers of disease severity and acid-base status.

ANIMALS

Dogs with CPV undergoing treatment (n = 40) and healthy control dogs (n = 9).

METHODS

Prospective observational study. Dogs with CPV had a baseline and daily CBC, venous blood gas with serum electrolyte concentrations, composite clinical severity score, and serum D-lactate concentration performed. A single serum D-lactate measurement was obtained from healthy control dogs.

RESULTS

The CPV dogs had a higher D-lactate concentration (mean ± SD) of 469 ± 173 μM compared to controls, 306 ± 45 μM (P < .001). There was no difference in baseline D-lactate concentrations for CPV survivors (474 ± 28 μM), versus nonsurvivors (424 ± 116 μM; P = .70). D-lactate concentration decreased over the first 4 days of treatment (-9.6 μM/d; P = .46). Dogs hospitalized for <4 days had lower baseline D-lactate concentrations compared to those hospitalized ≥4 days (400 ± 178 μM versus 520 ± 152 μM; P = .03). No sustained correlation over time between serum D-lactate concentration and clinical severity score or recorded acid-base results.

CONCLUSIONS AND CLINICAL IMPORTANCE

Serum D-lactate concentrations are higher in dogs with CPV compared to healthy controls but do not appear to be clinically relevant. No relationship identified between serum D-lactate concentrations and markers of CPV disease severity, acid-base status, or outcome.

Pathophysiology and aetiology of hypoglycaemic crises

Hypoglycaemia is a common, life-threatening complication that occurs as a component of a wide variety of disease processes. Despite its frequent occurrence, information concerning the aetiology, characteristics and outcomes of hypoglycaemic crises in veterinary medicine is limited. This review summarises the current understanding of the pathophysiology of hypoglycaemia, the body's counter-regulatory response, underlying aetiologies, diagnosis and treatment. Disease mechanisms are discussed and published evidence in veterinary literature regarding prognostic indicators, prevalence, diagnosis and treatment is examined for hypoglycaemia-related disease processes including insulinoma, glucose-lowering toxins and medications.

Clostridium perfringens and C. difficile in parvovirus-positive dogs

The aim of this study was to investigate Clostridium difficile and Clostridium perfringens in 82 diarrheic dogs positive for canine parvovirus type 2 (CPV). Enterotoxigenic C. perfringens type A was isolated from three (3.6%) dogs. One (1.2%) strain was also positive for NetE- and NetF-encoding genes, which are commonly associated with diarrhea in dogs. Toxigenic C. difficile was isolated from one animal (1.2%), which was also positive for A/B toxins. The present study identified C. difficile and C. perfringens infection in CPV-positive dogs. Further studies are necessary to clarify if clostridial infections may predispose or potentiate CPV-infection in dogs or vice versa.

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The co-infection of canine parvovirus (CPV) and toxigenic clostridia is still poorly understood.

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82 CPV-positive dogs were tested for C. perfringens netF+ and C. difficile infection (CDI).

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C. perfringens type A positive for NetF-encoding gene (netF) was recovered from an adult dog (1.2%).

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C. difficile was isolated from ten 12.2% (10/82) dogs, but in only one CDI was confirmed.

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To our knowledge, this is the first study that report C. perfringen netF positive in CPV-positive dogs.