Parvo puppy

I come downstairs to get something, I can't remember what. J my nurse is crouched over a puppy lying on the floor.

I work with J regularly on a Saturday. She's a top nurse who is currently undertaking a critical care course. She genuinely cares for the animals and takes initiative, especially when critical care cases come in. She's very capable of dripping, bleeding and xraying. This means I am happy to trust her looking after these cases. On a busy Saturday, when both vets are booked out, this is essential.

"I'm not happy with this puppy" she says, "She's really flat and has a temperature of 40 and a heart rate of 240"

"What puppy is this?" I say, there were no puppies in hospital this morning and I've not admitted any.

"She's a stray, just come in" says J, crouching over a prostrate blonde puppy lying on her side. She looks like a labrador, or a staffy, about 12 weeks old and ever so cute. Or she would be, if she didn't look so ill.

I take one look at the puppy, grab a glove and stick a finger up its bum. The rectum feels hot and my finger quests around a large cavern instead of a tightish passage. Sure enough the rectum is chockful of liquid. The puppy barely notices but does manage to sit up and then let fly an enormous stream of bloody diarrhoea.

"It's parvo" I say, surer of this than anything else I've seen that day. "We need a faecal parvo test done right now. This entire area needs to be triple bleached, now!" I yell out to the vet student to grab a towel, the lethal cocktail of diarrhoea and virus is spreading around the hospital floor. Parvo can be very stable in the environment and a serious risk in a veterinary hospital.

"Puppy in isolation straight away, parvo test then I'll have to call the boss"

Parvo is bad news. It's a very serious virus which causes severe vomiting and bloody diarrhoea in puppies. It is often fatal and there isn't much we can do beyond supporting the puppies with intravenous fluids, pain relief and some antibiotics for secondary infections. More heroics, like plasma transfusions, help a lot, but are very expensive. Even a mild case of parvo without these would be $500+. We want to help this puppy, and as a stray, we are obliged to give first aid, but the definition of first aid is blurry. In this case, it definitely could include euthanasia. Parvo is dangerous for the hospital and expensive for us to treat gratis, given we don't know whether this puppy will even be rehomed.

The irony here is that a vaccination or two in this puppy's life would most probably have avoided the problem. It is almost certain, in my mind, that the unvaccinated puppy started to get ill and so was turfed out on the street. People who won't even pay for a series of puppy vaccinations, won't pay for any treatment. Fortunately for her, someone found her and brought her in promptly. I worry about the rest of the litter, this could be the first of a whole batch.

The parvo test is positive. I speak to my boss on the phone who gives me permission to begin basic treatment - drips and antibiotics. One of the other nurses has rung the council. The pound will not take the puppy, even if we manage to pull her through as she is an infection risk to other dogs. I can understand this, even if it is hard. This then makes it an almost impossible situation - puppy may end up being euthanased on Monday when the pound opens anyway unless the practice decides to keep her and rehome her themselves. Although we rehome kittens, puppies are much more work, and need much more attention, so are rarely rehomed through the clinic. Fortunately one of the rangers has said he might take her, although he is worried about the cost. I decide to ignore this, I'm just working on today, I can't worry about Monday until later. And she is a stray, so her treatment is our responsibility, not his.

I manage to get away from the maelstrom upstairs and set up the medication and drip lines for the pup. I have to get everything ready because we will be working in isolation with barrier nursing. This means we have to wear special aprons, disposable gloves, use dedicated equipment and foot bath whenever we enter the area. We don't want to be walking back and forth between this area and the main hospital.

I grab half-used bags of fluids which other animals no longer need. At least puppy can have these without costing the hospital anything.

J and I get the puppy out to set up her drip. She is curled up on a half-towel in the isolation cage looking miserable. Fortunately her blood pressure is not too bad and I manage to get a catheter into her vein. We check her haematocrit and blood protein which are both markedly elevated indicating her severe dehydration. Her paws are starting to go cold as she goes into shock.

I set the fluid rate high to treat this, give her antibiotics and pain relief and leave her to it. We disinfect ourselves the best we can, spraying our arms and legs. I am now the "no puppies" vet for the day. I won't be seeing or treating any littlies for the rest of the day, only this one.

Later in the evening I set up all the medications before going in to check her again. I've left her until last as I want to leave the hospital straight away without looking at any other dogs to decrease infection risk. We have one very large 50 kg dog crammed into a tiny cage in the main hospital to keep him further away from this area. He has an unknown vaccination history, and when I called the owner to clarify, he wasn't sure if he'd ever received his "shots". This owner is not wealthy and we've only ever seen the dog to trim his nails, so it is possible he hasn't even had a course as a puppy meaning he is at risk of parvo, even as a four year old.

Puppy has vomitted and there is a large pool of something - probably very liquid diarrhoea in the cage. She is lying partially in it, but does seem brighter and manages to wag her tail when I talk to her. I adjust her medication to put her onto a constant rate infusion of antivomiting medication. I stroke her and speak softly. She is just a baby. I'm rewarded with a few weary tail flaps. Then I repeat her pain relief, clean her cage out, give her another 1/2 towel and leave her to it. We've done our best, she is getting "first aid" of the same standard as a paying client (I've slipped in a few extras, like pain relief, antinausea meds and potassium in the drip. The boss didn't ok these but won't be upset, she's a good boss). Now it's up to puppy - she will live or die in this first battle, even before she's found someone to really love and look after her.

**update**
I rang today. Puppy is better, no vomiting, diarrhoea only. The ranger looks like he might take her. I knew that if she was alive and better Monday, she wouldn't be euthanased. She is just too cute. Perhaps, getting parvo and being thrown on the street was the best thing for her in the end.

**update on the update**
Puppy did go to the pound in the end, but has been recruited from there to become a working dog – assistance, or sniffer dog or something similar. She was picked out as being exceptionally bright compared with the others and was recruited. This means she will get top-notch training, exceptional veterinary care and will have a great interactive life. Eventually when she can’t work anymore, she will be retired, usually with her handler. A dog couldn’t ask for a better life.

By Jo Griffith; Illustration by Quintin Lau