FEEDING STRATEGIES FOR PARVO VIRUS RECOVERED DOGS

June 4, 2022

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A puppy recovering from canine parvovirus will require special care to help facilitate a complete and successful recovery. Upon returning home, your puppy will be finishing up a course of antibiotics and may also be on some medication for nausea or diarrhea. It is very important that you give your puppy the medication prescribed for the full amount of time it has been prescribed; even if he seems fine.

Your puppy is recovering from some extensive damage to his/her intestinal tract. It is typical for stools to be a little loose at first or for no stool to be produced for a few days as the intestinal tract recovers. The stool should gradually firm up over the first 3-5 days at home and your puppy should be active, and exhibiting his normal demeanor and behavior. If the diarrhea persists, if vomiting occurs or if your puppy seems depressed, please contact your veterinarian at once for instructions on any additional treament that may be necessary.

Dog Parvovirus or “Parvo” is a contagious viral disease causing gastrointestinal worry and depression in young dogs. Zones of quickly dividing cells, such as those in the small intestine are highly easily able to be harmed or influenced by the virus, causing vomiting and diarrhea.

The virus also depends on hematopoietic ancestor cells in the small areas in the body that fight disease and blood marrow, increasing the chance of infection. You can protect your dog from this killer by making sure shes up to date on her vaccinations, and a full series of booster vaccines treatments given.

Parvo is the everyday speech name for dog parvovirus, young dogs are at the highest risk, those who are partially or completely unvaccinated. If these diseases like, dehydration, septic shock and stress are not treated quickly and effectively there may be chances of an animal’s heart attack. Immediately consult a veterinarian if parvovirus is suspected, and 80% of animals die if untreated.

Signs of Parvovirus in Dogs:

Fever
Feelings of being tired
Refusal of food
Vomiting
Diarrhea
Fluid swelling/stretching out of intestines
Weak pulse
Too-fast heartbeat
Dangerously low body temperature

Types:

Intestinal
Cardiac

Feeding a Parvo Puppy

The caring puppy who is suffering from Parvo is difficult. Especially, if the puppy cannot eat and continues to get worse. Consult your vet and try to find out what food should be given to him that will help him to fight off the virus and gain strength. Sometimes you may need to try several foods strategies before finding one that works.

Treatment of a puppy with parvovirus can be done by providing supportive care, as the dog fights off the virus. Good and enough nutrition is an important part of this care. It is often difficult to achieve as Parvo puppies suffer from vomiting and nausea.

The veterinarian suggests using a syringe to feed the puppy at home if they can keep food down.
Another method of feeding puppies is sitting with them and hand-feeding.
Feed the puppy small meals regularly after a certain interval of time rather than fewer large meals, as this makes it easier for them to digest the meal and control vomiting.
As the puppy gets better, they want to eat more, but it’s important to give them small meals during the recovery period to prevent (stomach aches, cramps, diarrhea etc.)
Never try to force-feed your puppy. This could cause food particles to travel down the trachea into the lungs instead of the stomach, this could lead to aspiration pneumonia.
Do not free feed the puppy and don’t give him full freedom to eat. As you need to know when and how much he is eating.

High-Calorie Supplements

The veterinarian may suggest providing the puppy with a high-calorie supplement. These nutritional supplements come in a tasty gel form and provide pets with added calories and vitamins.

Baby Food

It is advised to give soft food to sick puppies to eat. It’s easy and they have to put less effort to eat. It’s also highly digestible. Before feeding check, the ingredient label to secure there is nothing harmful in the baby food, such as onion powder or garlic.

Home Food options for Parvo include:

Boiled chicken, with the skin and bones, removed, chopped or shredded into small pieces
Bone broth or low-sodium chicken broth
Cooked white rice
Feeding egg yolks can help a puppy with Parvo
Apple cider vinegar and always water down it in a large amount of water

The Traditional Nutritional Approach: NPO

Traditionally, interventions used in parvoviral enteritis patients include the practice of placing the patient on NPO, or nil per os (“nothing by mouth”), treatment for 24 to 72 hours, preventing any food from entering the gastrointestinal tract.⁵ While the application of NPO treatment is common, growing evidence indicates that early implementation of enteral nutrition is beneficial for patients with a variety of gastrointestinal diseases, including canine parvoviral enteritis.

A number of longstanding reasons advocate for an NPO strategy in a patient that is exhibiting gastroenteritis with signs of vomiting and diarrhea:

It has been thought that the presence of food in the gastrointestinal tract can delay recovery by stimulating intestinal contractions and increasing frequency of defecation, thereby increasing patient discomfort, and that fasting allows the bowel to rest.
The introduction of food is thought to stimulate further vomiting in animals with gastroenteritis, which can lead to higher chances of aspiration.
Undigested food in the gastrointestinal lumen is thought to serve as nutrition for bacteria, leading to further proliferation of detrimental microbes.
The presence of food in the gastrointestinal lumen can draw exudate into the lumen through osmosis and exacerbate diarrhea.
Offering food to a patient that is nauseated and feeling ill can lead to food aversion, delaying the return of appetite when the patient is ready to eat.

While these reasons seem sound, evidence points toward various benefits of feeding and supports arguments against an NPO strategy.

Reasons to Feed

Fasting Causes Contractions and Pain

While the common belief is that fasting allows the bowel to rest, it seems to increase the degree of intestinal contractions instead. The lack of nutrients in the gastrointestinal lumen leads to vigorous contractions from the pylorus to the ileum, causing sensations described as “hunger pains.”These contractions are observed to be inhibited by the presence of food. The presence of luminal nutrients also seems to promote contractions of normal intensity sooner, preventing the persistence of ileus related to gastroenteritis. Introducing food early thus prevents pain, promotes normal contractions, and shortens recovery time from impaired gastrointestinal motility.

Feeding Shortens Duration of Nausea

Feeding animals with gastroenteritis is thought to stimulate vomiting. One study that evaluated the effect of early enteral nutrition on patients with hemorrhagic gastroenteritis observed that the chances of vomiting did increase, although the frequency subsided starting on the second day.Similarly, another study evaluating dogs with parvoviral enteritis observed a shorter time to vomiting cessation in the group that was fed starting 12 hours after admission compared with the group that was fasted.

The presence of luminal nutrition is thought to help maintain the integrity of the gastrointestinal mucosa and promote healthier motility, leading to less vomiting. However, food containing high amounts of fat or poorly digestible starches causes maldigestion and gastrointestinal distention and promotes vomiting through afferent stimulation of the vomiting center in the medulla oblongata. When feeding is instituted, small, frequent meals of highly digestible foods are recommended to prevent excessive secretion of gastric acids and minimize gastric distention, which can stimulate emesis.

Feeding Reduces Bacterial Proliferation and Translocation

While the presence of undigested food might lead to the proliferation of some species of microbes, the presence and production of volatile fatty acids such as proprionic acid and butyric acid acidify the environment and suppress pH-sensitive pathogens such as Campylobacter and Clostridium spp. In addition, fasting seems to increase the chances of bacterial translocation and bacterial adherence, as seen in several experimental studies,⁵ leading to worse consequences such as bacteremia and sepsis. Providing nutrition leads to a healthier mucosal barrier.⁵

Feeding Maintains Digestive Function and Structure

Changes are seen in the gastrointestinal system when an animal is fasted, even when the animal is healthy. First, fasting promotes negative changes in the intestinal mucosa, such as decreased villus height and crypt depth, decreased antioxidants within enterocytes, and increased enterocyte apoptosis. These changes lead to increased permeability of the mucosal barrier and higher chances of bacterial translocation. Negative changes such as small intestinal villous atrophy and infiltration of the lamina propria with white blood cells have been observed even in animals that were provided parenteral nutrition in the absence of oral nutrition, indicating that the presence of food in the gastrointestinal tract has beneficial effects beyond nutritional content in the blood.

Second, a fasted animal experiences reduced secretion of digestive enzymes. Lower levels of digestive enzymes impair an animal’s ability to digest food, leading to less efficient use of nutrients when food is reintroduced. Basal and histamine-stimulated gastric acid levels and secretion of pancreatic exocrine enzymes (lipase, trypsin, and amylase) decrease when an animal is fasted, potentially contributing to diarrhea. The presence of food is therefore important to both structural and functional soundness of the gastrointestinal tract.

Feeding Reduces Inflammation

The number of neutrophils primed for activation through the expression of adhesion molecules increases when an animal is fasted. The adhesion molecules enable neutrophil sequestration in the microvasculature of the intestinal tract, where the neutrophils cause oxidative and enzymatic damage upon activation and degranulation. Fasting also leads to impairment in the interaction of T and B lymphocytes and, subsequently, reduced production of immunoglobulin A and cytokines, which are important in immunologic function and regulation of inflammation. This dysfunction is seen even when total parenteral nutrition is provided, further supporting the importance of enteral nutrition.

Enteral Nutrition Literally Feeds the Gut

Normally, enterocytes of the small intestine are passively exposed to nutrients in ingested material and use them to their benefit. Glutamine, an amino acid derived in the intestinal lumen, serves as an antioxidant as well as the carbon skeleton and amino acid for DNA synthesis during enterocyte turnover. Mucosal cells normally expire every few days; therefore, healthy mucosal turnover is vital to maintaining a functional gastrointestinal barrier. Deficiency in other nutrients, such as essential fatty acids, folate, zinc, vitamin A, and vitamin B₁₂, decreases mucosal turnover. The presence of nutrients in the intestinal lumen allows enterocytes to directly acquire these nutrients.

Summary of Benefits

Providing enteral nutrition early in the course of parvovirus treatment instead of applying an NPO strategy has significant benefits, including the following:

Alleviating pain through promotion of normal peristaltic activities
Shortening the duration of the vomiting period and limiting aspiration
Thwarting microbial proliferation and reducing bacterial translocation
Promoting the return to healthy enterocyte and mucosal turnover
Limiting inflammation and improving immune function

For these reasons, providing enteral nutrition as soon as fluid deficits are replenished and adequate perfusion of the gastrointestinal tract is reestablished is recommended. Adequate perfusion is indicated when mentation, heart rate, pulse quality, mucous membrane color, capillary refill time, and core-to-extremity temperature gradient return to normal. Many negative effects of feeding can be alleviated through providing smaller amounts (25% of resting energy requirement, or RER) of a highly digestible, low-fat diet, preferably consisting of a novel protein source.

Methods of Feeding

Methods of providing enteral nutrition include voluntary eating, hand or syringe feeding, and feeding through orogastric, nasoenteric, esophagostomy, gastrostomy, or jejunostomy tubes. In parvoviral enteritis and other gastroenteritis patients, less invasive methods of feeding that are appropriate to short-term hospitalization are desirable. The best method is for the patient to eat voluntarily, indicating the limited presence of nausea. Hand or syringe feeding an inappetent patient can lead to food aversion caused by the patient’s association of food with nausea and procedures performed during hospitalization. A reasonable in-hospital method of enteral feeding is through a nasoenteric tube, alleviating this effect.

Feeding Puppies With Parvovirus

The first step in feeding a puppy with parvovirus is determining the best way to get the puppy to eat.

In some cases where your puppy is very dehydrated or experiences profuse vomiting, your veterinarian may recommend hospitalization. Supportive care with IV fluids, anti-nausea medication, and possible tube-feedings will help them get back on their feet before returning home for continued care.
Your veterinarian may suggest using a syringe to feed your puppy at home if they can keep food down.
Another method of coaxing a puppy to eat is sitting with them and hand-feeding.
Feed the puppy small meals several times a day rather than fewer, larger meals, as this makes it easier for them to digest the meal and control vomiting. As the puppy gets better, they will want to eat more, yet it’s important to keep meals small and feed your puppy frequently during the recovery period to prevent gastrointestinal upset.
Never try to force-feed a puppy, as this could cause food particles to travel down the trachea into the lungs rather than the stomach, which can lead to aspiration pneumonia.
Do not “free feed” your puppy — or provide unrestricted access to food — as you need to know when and how much they are eating.