Truffle is Home

I am home!

After several days at the veterinarian, you wouldn’t believe that I was the same dog. I am feisty and curious (and famished.)



We are pleased to have Truffle back at home with us. She battled her way through the blitz of parvo and kept her chin up; a very indomitable dog. The Good Doctor vaccinated the other dogs today (bringing them all in at the same time was an adventure in itself.) Truffle is on medications and de-wormer (tapeworm.)

The pet place covered every last penny of her bill. We are tremendously satisfied with their level of customer service. My heart worries about the other exposed pups but they have a very good chance given the dedication of the business owner.

Truffle had a “first” today: she made her way up the concrete steps in the back yard. She is feisty and her determined attitude is most likely what brought about her triumph over this illness. She is also a bit demanding (especially where food is concerned) but she will be quite a lady after a little bit of training.

Thank you to all my dear Readers who kept us in prayer and best wishes these past few days. You made this challenge easier via your compassion.
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Shoo

C. Clymer, shoo. There is nothing for you here.
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Canine Parvo Virus (CPV): what is it and how can it be treated?

I have had several requests for information regarding parvovirus. Most of my knowledge of it was out of date as I have not worked in veterinary medicine in over ten years. I found the links below to be informative.

If you suspect that your dog or puppy may have parvovirus, I urge you to seek veterinary care immediately. Do not delay receiving a proper diagnosis. You may have gathered that we waiting a day prior to seeking medical attention. To begin with, we live very rural and after hours emergency care is not an option. Further, I was able to rely upon my experience and knowledge to give our puppy supportive therapy until she could be seen by a qualified veterinarian.

The following is from http://nd.essortment.com/symptomscanine_rhnu.htm.

Canine parvovirus (CPV) is a serious and highly contagious disease that is a major killer of puppies as well as unprotected older dogs.

Canine parvovirus (CPV) is the most dangerous and contagious virus that affects unprotected dogs. When it was first discovered in 1978, most of the puppies under five months old and 2% to 3% of older dogs died from CPV. But subsequently a parvo vaccine has helped control its spread, and CPV infection is now considered most threatening to puppies between the time of weaning and six months of age. Adult dogs can also contract the virus, although it's relatively uncommon. All breeds of dog can be infected, but Rottweilers and Doberman Pinschers are more susceptible and have less chance of recovering.

CPV affects only dogs, and cannot be transmitted to humans or other species. However, other animals and humans can carry it to dogs. Dogs who become infected have a 50-50 chance of survival. If they survive the first four days, they will usually recover rapidly, and become immune to the virus for life. Most puppies will die without medical treatment.

The source of CPV infection is fecal waste from infected dogs. It has been diagnosed anywhere groups of dogs are found: dog shows, obedience trials, breeding and boarding kennels, pet shops, animal shelters, parks, and playgrounds. Dogs that spend their time confined to a house or yard and are not in contact with other dogs have much less chance of exposure to CPV. It's easily transmitted via the hair or feet of infected dogs, and also by contaminated objects such as cages or shoes. CPV is hardy and can remain in feces-contaminated ground for five months or more if conditions are favorable. Although most disinfectants cannot kill it, chlorine bleach is quite effective. There may be other means of transmission of CPV, but they are not known at this time.

Two forms of CPV have been identified: diarrhea syndrome and cardiac syndrome. Diarrhea syndrome, or enteritis, has an incubation period of five to fourteen days. Dogs with enteritis act like they are in extreme pain. Early symptoms are depression, loss of appetite, vomiting, high fever, and severe diarrhea. Feces can be either grayish or fluid and bloody. Rapid dehydration is a danger, and dogs may continue to vomit and have diarrhea until they die, usually three days after onset of symptoms. Others may recover without complications and have no long-term problems. Puppies can die suddenly of shock as early as two days into the illness.

The second form of CPV is cardiac syndrome, or myocarditis, which can affect puppies under three months old. There is no diarrhea because the virus multiplies rapidly in muscle cells of the immature heart. Puppies may stop suckling and then collapse and die within minutes or days. No effective treatment is available for cardiac syndrome, and surviving puppies may have permanently damaged hearts.

The initial diagnosis of CPV can usually be made by a veterinarian after observing the dog’s symptoms; however, vomiting and diarrhea can be caused by a number of diseases. The rapid spread of illness in a group of dogs is another indication that CPV may be the culprit. A more definitive diagnosis of CPV can be made by testing feces for the virus, either at the veterinarian's office or through an outside laboratory.

Treatment for CPV should be started immediately. Hospitalization is necessary, except in relatively mild cases. Dogs must be kept warm. Dehydration is treated by replacing electrolytes and fluids and controlling vomiting and diarrhea. Antibiotics are used to prevent secondary infections. No drug is yet available that will kill the virus.

The easiest way to prevent CPV in adult dogs has been through annual vaccinations, although increasingly, veterinarians are recommending that vaccinations be administered every three years. Puppies need a series of booster shots, because of uncertainty about when maternal immunity wanes and the time the vaccine can provide puppies with their own immunity. This may be as early as six weeks of age or as late as fourteen weeks of age. If there is still a high level of maternal antibody present in the puppy, it will interfere with a vaccination. Veterinarians recommend that puppies get boosters every three weeks until they are sixteen weeks old, and they should be kept separate from unvaccinated dogs. Vaccinations given to puppies as well as adults also protect against other serious canine diseases like distemper, infectious hepatitis, leptospirosis, parainfluenza, and coronavirus.

Parvo vaccinations are usually required for participation in puppy obedience classes and for boarding your dog at kennels. A vaccination does not guarantee that your puppy will be safe from the virus, but it's good protective insurance.

A parvo-infected dog can shed the virus in his feces, which makes him extremely contagious to other dogs. The following precautions will help prevent the spread of this disease.

· Keep the dog isolated from all other dogs for at least a month after recovery.

· Pick up all the dog's stools in your yard.

· Use chlorine bleach and water to clean food and water bowls. Wash the dog's bedding in bleach and hot water. Disinfect all areas that the dog has been in, including linoleum floors, crates, etc.

· If you have any other dogs who are two years old or younger, or who have not had parvo vaccinations, take them to your veterinarian immediately for a booster shot.

· Feed your dog a bland diet until he recovers. Reintroduce regular food slowly.

A healthy puppy or adult dog should never be allowed contact with the feces of other dogs when walking or playing in public. Dispose of waste material properly and try to keep lawns, sidewalks, and street gutters clear of feces from neighborhood dogs.

Treatment
Treatment for canine parvovirus is supportive and the goals are to relieve symptoms and prevent complications. Because the disease progresses so quickly, it is important to begin treatment as soon as possible.


In most cases, hospitalization is required. Treatment usually involves intravenous (IV) fluids, anti-nausea medications, and antibiotics to prevent secondary infections. Infected dogs should be kept warm and away from other dogs and activity should be restricted.

Treatment for CPV is not always successful, even when it is started promptly. In dogs that recover from infection, improvement may be seen in 2 or 3 days.

Prognosis

Puppies that are infected with CPV have a guarded prognosis (expected outcome). For dogs that receive prompt medical treatment and survive acute infection, the prognosis usually is good. Severe infection often has a poor outcome. Mortality is high in cardiac CPV and is about 10% in the more common, intestinal CPV. Following CPV infection, dogs may be contagious for up to 2 months.

For those who would say "I can't afford treatment, so I'll take my dog home."

There are a few holistic web sites that offer tips. I suggest Healing Parvo Puppies - Home or Vet Treatment or (http://wolfcreekranch1.tripod.com/heal_parvo.html#VO)

I would strongly urge you to not take your dog or puppy "home to die" without thinking of his or her comfort. The actual death itself, unsupported by medications to relieve pain or chronic suffering, is horrorific to watch.


A final note to breeders and "do it yourself-ers": all vaccines MUST be kept cool. Follow the directions on the package to determine the correct storage methods, including proper refrigeration temperatures. Do now allow the loaded syringes or the phial itself to sit out on a counter while you slowly work your way through a litter of puppies.

This information is only provided as a jumping off place for your own fact finding.


Followup 19 May 2009: I had an image featured above that was originally sent to me in pamphlet form via a friend in the veterinary field. I am pleased to say that the image it is actually the work of Jean-Yves Sgro. It originally from this scientist's website at the University of Wisconsin-Madison and derived from PDB Xray data by others (PDB ID 4DPV). The original and highly detailed image can be found at: http://www.virology.wisc.edu/virusworld/images/cpvweb.jpg. Please see the comments section for more information.

The image is copyright protected (and not public domain, as was erroneously implied in the pamphlet) thus I have removed it. If you would like to see the face of parvovirus, please stop by here. My apologies to Sgro. Delaney, you might want to double-check the pamphlet's sources.
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Truffle Update

We heard from the sellers. They were quite concerned and told us that they would cover all veterinary costs. This is a huge burden off my shoulders.

We do not have an update from the vet (they shut down their front office at 5 PM on Tuesdays.)
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Truffle Update

Update (combination of several calls to the vet throughout the day):

Truffle survived the night. The Good Doctor reported that she was alert this morning and placed her paws on his chest in order to lick his face. She vomited a little of her water earlier today, and had kept her lunch down (as of 5 PM.) She is still resting on a hot water bottle.

Visits are not allowed as she is in the ICU. She is receiving antibiotics and subcutaneous fluids throughout the day. Her prognosis is still guarded and her percentages are still low. My poor girl.

We have not heard back from the sellers as of yet. Better Half intends to place himself on their doorstep at 10 am tomorrow. I shall have to work hard at keeping him temper in check. His anger is not simply due to the financial damages (which increase by the hour!) but he is also upset that our hearts have gone through so much hell.

As silly as this sounds, this puppy shattered the thick mantle of depression that had been pressing me into the ground. Her intelligent eyes and her total dependency upon me for her needs drew me from my shell. When one is depressed, one simply does not wish to participate in life. I found myself daydreaming of little training sessions, of playing with toys and of grooming. I taught her to fetch on Saturday and we were working on "sit"; she was already mastering housebreaking.

Sunday was hell. Parvo can devastate a puppy. She spent most of Sunday conserving what little strength she had. I remained awake with her all of Sunday night and into Monday morning. When the Good Doctor decided to hospitalize her, I began to cry. I kissed her and handed her to him and I felt wretched for not being able to "mother" her into good health personally (or professionally, as I do not work in the field any more.) As we drove from the parking lot, I sobbed and Better Half comforted me.

We spent Monday waiting for "the dreaded phone call" telling us that she had passed away. My emotions were (and still are) at a raw state. Tuesday has been spent in status; will she live or will she die? We watch our older dogs for symptoms. I pray. I try to distract myself with the television or my Facebook account.

My parents' anniversary is today. I had scribbled a little message in the daily bible devotions book that I gave my mother last year, which tickled my Mum. Their card will arrive late as I did not mail it in time.

The rains have let up and I can go back to pretending the leak in the roof is nothing but a figment of my imagination. Truly what else can I do at this point? We haven't the money to get the cricket fixed. We shall probably have to skimp on our regular bills just to cover the veterinary costs.

Please pardon my bland writing style. Dear Readers, I can honestly admit that I really don't give a damn about expressing myself with any panache.
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Evening Truffle Update

Latest news around 5:00 PM. She was alert and showed some interest in the vet tech. She was curled around a blanket and hot water bottle.

In other news, the damned leak in my office is back. We have had rain for most of the day and tiny drip paths of water are trickling around the Dread Pillar.

My coping skills are at an all-time low. The depression that has been present since last year has gnawed most bitterly at me today. I am at the point of apathy towards the leak (let the house fall in.)

We have wiped down surfaces in the house and have done several (bleached) loads of laundry. We have only to wash our bedding and the clothing we wore over the last few days (and the throw rugs in the kitchen) before calling that task "done". I will begin the carpets a little later on tonight.
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Truffle Update: grave news

Truffle Update

We brought Truffle in to Crestview at 10:30 this morning. Her vet, who we absolutely adore for his positive outlook and good humor, was shocked at her level of lethargy. As he stated in regard to her apathetic response, “this is not a puppy.” She had no energy. He asked us to leave her in order for him to run tests and take x-rays.

The Good Doctor phoned twenty minutes ago: prognosis very guarded. Truffle’s Parvovirus score lit up before the control registered. What this means is that she “tested very positive for Parvo.” I had hoped in my heart that my intuition last night was incorrect. I am emotionally devastated. Our little 2.2-pound pup has frightening mortality rate. The Good Doctor will do his best with subcutaneous fluids and some antibiotics.

I contacted the place where we procured Truffle; they are normally closed until Wednesday. Better Half had already left a message earlier, after we came home from the vet. I left a rather terse message at 1:45, explaining the test results and recommending that they contact the owners of pups that might have been sold recently to include Truffle’s littermates. I am beyond angry.

Of course, our own dogs are at risk. Our two elderly dogs do not do well with the 5-way, and so they have not been vaccinated in a few years (they are 14 years of age.) Nutmeg never, to our knowledge, had her puppy series, as she was already a “stray” rescue at six months of age. Zephry and Sammi have been vaccinated fully.

Better Half is at the store buying gallons of bleach. We will need to bleach out the couch covers and all blankets and clothing that came in contact with Truffle. I will also need to shampoo (and possibly bleach!) my rugs. I shall bleach the kitchen floor and bathroom floor. Truffle’s toys are getting a soak in bleach.

What the fuck is wrong with the breeder? Surely she vaccinated the litter prior to releasing them for sale! The bitch (meaning Truffle’s mother) should have full vaccinations and the antibodies would have been present in the milk. We were told that Truffle’s dam was AKC and shown, ergo her vaccinations would be up to date.

The place where we acquired Truffle was kept very clean, with paper changes done immediately after soiling. The two women who ran the business were knowledgeable. It is possible that exposure to the virus occurred after they had received the litter, however. Parvo is an evil bastard to fight. It can take four to ten days for symptoms to appear in an animal, but the animal can actually begin shedding the virus only four days after being infected. As Truffle was already showing symptoms on Friday (what I mistook as carsickness) it stands to reason that she picked up the Parvo either from the “pet place” or from the breeder.

Dear Readers, please say a prayer for us today. It’s Christmas, and we stand to lose companions (six if we include Truffle), two of which we have had since Better Half and I first married.
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Truffle

My level of frustration is at an all-time high tonight. Truffle has been unable to keep any food down since we took ownership, and perhaps the problem was prevalent before we even picked her up. I do not know. I do know that she threw up during the car ride home, which I attributed to motion sickness. She seemed to do all right yesterday but threw up this morning, and again this evening.

I am not one to panic under normal circumstances. I did work as a veterinary technician nearly a decade ago. I do know the signs and symptoms of parvovirus and I am pleased to say that Truffles does not seem to have them (visually, not counting the vomiting itself.)

This leads me to wonder what could cause vomiting. She may have chewed up something and ingested a large enough part to cause an obstruction between the stomach and intestine. She would have had to chance upon this prior to our receiving her, as I do not keep toys about that can be easily chewed (as we have large dogs that could choke on a small toy or who might shred anything not made of industrial grade rubber.) We have no gravel that she could have eaten, or any rocks at all in our turnout area (which is actually an asphalt driveway with a little mud patch to the side.)

Coupled with this concern is the fact that she seems weaned on boiled poultry and does not eagerly eat kibble or boiled rice.

I combed out her undercoat and discovered that she is on the thin side, which may indicate that the problem has lasted for over a week. She has been lethargic all day today (an indication that she needs nourishment!)

I simply do not have answers and we do not have emergency vet services in this tiny town. I can only wait until tomorrow when our local vet opens his doors.

In the meantime, I have been worrying myself sick. I am not too proud to admit that I actually fell back on faith and laid hands on the sweet pup, begging God to give her strength and to allow us to find answers in time. Truffle rests in Zephyr’s bed, on the corner of my desk. Her breathing is even but my imagination tells me “it’s labored and she looks pathetically weak.” She is not at a pathetically weak stage, of course, but she does lack energy.

I am feeling intense anger at the moment. Why would anyone offer pups that may have medical complications? Why would anyone put an owner through this?

My disquiet stems from the years that I did work in the veterinary field. It also stems from past experiences with my own beloved pets. I know that diagnostics and treatment can run into the thousands. I also know that we do not have thousands (or even hundreds.) I am willing to try, however, if our vet is willing to let us make payments. She is too sweet a dog; she deserves a chance.

Thus begins my overnight vigil. I will remain awake to tend to her until we can get her in for an emergency exam. My challenge will not lie in remaining awake but in controlling my imagination.

Please excuse my complete lack of flair in this post. I am stressed out.
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