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Parvo Program Handbook

What is parvo?
The Caninie Parvovirus infects rapidly dividing cells such as: the intestinal cells, bone marrow cells, lymph system cells, and fetal cells. The virus is also extremely hardy, and can survive in organic material (feces, soil, etc) for over a year. While the original CPV only affected dogs, since the virus can rapidly mutate there are variants that also effect Raccoons. Because of this we recommend later on in the trash section that you not leave your trash from the parvo ward out for very long. Symptoms of an infected dog as: lethargy, vomiting, diarrhea. If you notice any of these symptoms it is highly recommend you test the dog as quickly as possible so that you can isolate the dog if the results come back positive. You will also want to disinfect their kennel thoroughly. A Parvocidal cleaner (Bleach, Roccal-D, Oxivir) needs to be used to disinfect the area to prevent other dogs from getting infected.

About the Austin Pets Alive parvo ward

How we got started
The Austin Pets Alive! parvo ward started in November 2008 when Dr. Jefferson took home some very sick puppies that had parvo. She used one of the bathrooms in her house as the 'official' parvo ward, and treated over 300 dogs in it for 2 years. During that time she was able to assess the dogs and treat them around the clock. You will see a bit later in this document that her success rate increased every year. When she first started she did not vaccinate on intake of parvo dogs and as a result had some losses to distemper. Since IV pumps are costly, she started out with IV drips & also utilized IV bolus treatment, both of which are discussed later in this manual under the Advanced treatment section. In August 2010 Austin Pets Alive! found a building to rent as a dedicate place for a lot of the programs, and built a dedicated parvo ward. Shortly after that we began building up a volunteer team to treat the dogs under the supervision of our Veterinarians & Vet Techs.

Our numbers throughout the years

Tracking overall numbers can be a good measure to see how many dogs you are treating and roughly how effective you are being at saving lives, setting a goal of 80% survival rate is ideal and anything higher than that is amazing! As mentioned above, APA!s parvo ward started in Dr. Jeffersons house, so between 2008 and 2010 the dogs being treated would receive around the clock check-ups and care. As she improved her treatment methods over the months her survival rate increased quite a bit.

3 In late 2010 APA! got a dedicated building and with that we built a parvo ward. As we have built up our parvo ward team, while our survival rate is still quite high we think we will see a steady improvement over the years as our volunteers gain more knowledge and understanding of assessing and treating the dogs.
250 200 150 100 50 0 2008

Yearly Parvo data

2009 Series1

2010 Series2

2011

Date 2008 2009 2010 2011 Total:

Dogs Tested Positive Dogs Survived Treatment Survival Rate 14 10 71.43% 161 135 83.85% 224 200 89.29% 167 137 82.04% 566 482 85.16%

35 30 25 20 15 10 5 0 January

2011 Parvo data

February

March

April

May

June

July

August

Dogs Tested Positive

Dogs Survived Treatment

Date January February March April May June July August Total:

Dogs Tested Positive Dogs Survived Treatment Survival Rate 31 26 83.87% 22 19 86.36% 13 10 76.92% 21 16 76.19% 30 22 73.33% 31 29 93.55% 13 11 84.62% 6 4 66.67% 167 137 82.04%

Cost breakdown
Minor Treatment # of day s 3 3 3 3 3 3 Price of Containe r $4.44 $51.42 $163.00 $19.24 $5.60 $66.62 Amount in Containe r 100 600 250 12000 30 250 Price for 15lb dog $0.27 $1.54 $2.93 $1.44 $1.12 $0.80

Supply 18ga needles 3cc syringe w/needle Baytril Injectable Lactated Ringers Solution Metochlopramide Metronidazole tablets 250mg

Quantity 1 3 1.5cc 150.0cc 1.0cc 1

Frequenc y per day 2 2 1 2 2 1

Total Used 6 18 4.5cc 900.0c c 6.0cc 3

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Polyflex Fluid administration drip set Canned Puppy Food 1.0cc 1 1 2 1 2 3 1 3 6.0cc 1 6 $35.64 $1.99 $1.50 Total Moderate Treatment # of day s 1 1 1 3 3 6 3 3 3 6 1 1 3 3 6 6 6 3 1 6 6 6 Price of Containe r $0.83 $12.35 $30.13 $13.09 $3.00 $35.64 $46.05 $33.33 $19.24 $19.24 $0.65 $2.82 $1.65 $24.96 $4.44 $163.00 $5.60 $66.62 $1.99 $17.53 $51.42 $1.50 Total Severe Treatment # of day s 1 1 1 Price of Containe r $0.83 $12.35 $30.13 Amount in Containe r 1 12 36 Price for 15lb dog $2.49 $0.02 $0.42 Amount in Containe r 1 12 36 10 10 150 5 40 12000 12000 1 1 50 500 100 250 30 250 1 100 600 1 Price for 15lb dog $2.49 $0.02 $0.42 $0.08 $1.62 $2.85 $3.87 $0.75 $2.16 $2.89 $0.85 $3.67 $0.99 $2.25 $0.53 $5.87 $3.36 $0.80 $5.97 $4.21 $5.14 $18.00 $68.77 150 1 1 $1.43 $1.99 $9.00 $20.52

Supply IV Catheter Zonas Tape roll for cath Vet Wrap for cath Heparin (to flush catheter) 0.01ccs Clear IV Ampicillin 0.6cc Polyflex SQ Anzemet 0.14cc Zantac 0.3cc Lactated Ringers Solution Boluses Lactated Ringers Solution SQ Potassium Chloride Vitamin B Dextrose 50% Solution Hetastarch 18ga needles Baytril Injectable Metochlopramide Metronidazole tablets 250mg Fluid administration drip set 1cc syringe w/needle 3cc syringe w/needle Canned Puppy Food

Quantit y 3 0.02 0.5 0.02cc 0.6cc 1.0cc 0.14cc 0.3cc 150cc 150cc 1.3 bottle 1.3 bottle 5cc 15cc 1 1.5cc 1.0cc 1 3 2 5 1

Frequenc y per day 1 1 1 1 3 2 1 1 3 2 1 1 2 1 2 1 3 1 1 2 2 2

Total Used 3 0.02 0.5 0.06cc 5.4cc 12.0cc 0.42cc 0.9cc 1350cc 1800cc 1.3 bottle 1.3 bottle 30cc 45cc 12 9.0cc 18.0cc 3 3 24 60 12

Supply IV Catheter Zonas Tape roll for cath Vet Wrap for cath

Quantit y 3 0.02 0.5

Frequenc y per day 1 1 1

Total Used 3 0.02 0.5

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Heparin (to flush catheter) 0.01ccs Clear IV Ampicillin 0.6cc Polyflex Anzemet 0.14cc Zantac 0.3cc Lactated Ringers Solution Boluses IV Lactated Ringers Solution SQ Dextrose 50% Solution Potassium Chloride Vitamin B Hetastarch 18ga needles Baytril Injectable Metochlopramide Metronidazole tablets 250mg Fluid administration drip set 1cc syringe w/needle 3cc syringe w/needle Nutrical Take Home Oral Baytril 22.7mg tabs Panacur Oral Canned Puppy Food

0.02cc 0.6cc 1.0cc 0.14cc 0.3cc 150cc 150.0cc 5cc 2.7 bottle 2.7 bottle 15cc 1 1.5cc 1.0cc 1 5 2 5 1 1.5 3 1

1 3 2 1 1 3 2 2 1 1 1 2 1 3 1 1 2 2 1 1 1 2

6 6 10 6 6 6 10 3 1 1 6 10 10 10 3 1 10 10 1 10 3 10

0.12cc 10.8cc 20.0cc 0.84cc 1.8cc 2700cc 3000cc 30cc 2.7 bottle 2.7 bottle 90 20 15.0cc 30.0cc 3 5 40 100 1 15 9 20

$13.09 $3.00 $35.64 $46.05 $33.33 $19.24 $19.24 $1.65 $0.65 $2.82 $24.96 $4.44 $163.00 $5.60 $66.62 $1.99 $17.53 $51.42 $5.00 $0.69 $100.53 $1.50

10 10 150 5 40 12000 12000 50 1 1 500 100 250 30 250 1 100 600 1 1 1000 1 Total

$0.16 $3.24 $4.75 $7.74 $1.50 $4.33 $4.81 $0.99 $1.76 $7.61 $4.49 $0.89 $9.78 $5.60 $0.80 $9.95 $7.01 $8.57 $5.00 $10.35 $0.90 $30.00 $133.1 6

Parvosal Cleaner Bleach Laundry Soap Paper Towels Sharps container Parvo Test Hand Soap Rawhides Dog Shampoo

Every dog gets the following no matter severity of treatment 0.2 1 1 0.2 $7.35 0.2 1 1 0.2 $0.99 0.2 1 1 0.2 $2.99 1 1 1 1 $0.99 0.01 1 1 0.01 $9.61 2 1 1 2 $57.60 0.2 1 1 0.2 $1.99 1 1 3 3 $7.99 0.1 1 1 0.1 $3.99 Total

1 1 1 1 1 5 1 30 1

$1.47 $0.20 $0.60 $0.99 $0.10 $23.04 $0.40 $0.80 $0.40 $27.99

Average Total

$100.80

Why we know you can be successful

Austin Pets Alive!s parvo ward is operated by a medium sized volunteer team that comes from various backgrounds. We have a few people that are in college and are working toward being in the medical field, but we also have a few people that also have no previous medical background are just as effective at treating the dogs in our care. While Austin Pets Alive! is lucky to have two great veterinarians on staff, you should be able to find a veterinarian and/or vet tech that can come and recommend treatments and help you with some of the more advanced treatments such as IV catheters. We highly recommend having a veterinarian or vet tech oversight for your parvo program. You will also want to check your local laws on what is required when treating animals, for example in Texas pets are property and the owner of said property can do whatever they want to it as long as its not cruel.

Preparing to open a parvo ward

Required items for a parvo ward
Before you start you parvo ward and save your first puppy there are a few essential items you will need to get started, including: cleaning supplies to help contain the parvo virus to your designated parvo ward area and also to help prevent the spread of other diseases between patients, general dog care supplies to take care of the dogs while they are fighting the parvo virus, and then medical supplies to treat the dog patients with. All these supplies should be restricted to the parvo ward to help prevent the spread of the parvo virus to other areas. General supplies General supplies you need for the parvo ward.

Clothes
You should get a couple sets of scrubs & old shoes that can be used in the parvo ward. Instead of scrubs you could use old shirts and pajama pants.

Toilet paper
Used to pick-up poop from the dogs and then flush down the toilet.

Mini-fridge
Some medications need to be stored cold, so you will need something to keep them in. Cleaning Supplies This is a list of cleaning supplies you will want to get for the parvo ward. These are important to ensure you dont spread the parvo virus outside the ward and that you dont spread other diseases between dogs if you are taking care of multiple patients.

Parvocidal Cleaner
Disinfectant that kills multiple bacteria and viruses (including the parvovirus). Roccal-D or Oxivir are both great as they kill parvo and other bacteria . This is used to disinfect yourself between dogs and before leaving the parvo ward, along with cleaning up rooms after the dogs.

Bleach
A general household cleaner that can kill the parvovirus. It is used when washing the laundry in the parvo ward. It can also be used in a spray bottle, diluted with water (1 part bleach, 32 parts water) to clean rooms after the dogs.

Laundry Detergent
Any type of detergent is fine, you just need something to be able to clean the laundry used in the parvo ward.

Hand soap
You will want an anti-bacterial hand soap so you can wash your hands between dogs to prevent spreading other germs and diseases.

Dish soap
Any type of dish soap so you can wash the dishes the dogs use for water & food. General supplies for dog care While you probably have a lot of this already, these will be used solely for the parvo ward. Its best not to take items out of the parvo ward once they have been used to prevent the spread of the virus to other areas of your shelter.

Bedding (towels, sheets)

Old sheets and towlels work great for dog bedding. You can normally find some inexpensive items at Goodwill or any other thrift store.

Bowls
To give water & food to the dogs.

Food (dry & wet)

You will want a few different types of food so that you can try out a variety of foods when trying to get the dog to eat. The reason you want a few different varieties, is that if a dog is eating and still vomiting with a certain type of food we have noticed they are less prone to continue eating if we keep giving them the same type of food since they are associating the sickness to that food smell/taste.

Toys
Things to keep the dogs occupied when they are feeling better but not quite free of the parvo virus yet.

Dog Shampoo
Needed for cleaning the dog after the are parvo free.

Nail Clipper
Needed for clipping their nails after they are parvo free

ToothBrush
Used to scrub their nails and paws after they are parvo free to remove any dirt, fecal matter, etc.

Warmth
A lot of the dogs will need things to provide extra warmth. Sweaters for smaller dogs are a good thing to have on hand since smaller dogs tend to need the extra warmth the most. Heating pads are also a good thing (always make sure you put a towel on top of the pad so it doesnt get too hot for the dog). Also fleece blankets are another good thing to have on hand to wrap up the dogs with if they are cool. Medical supplies

Thermometer
To take the dogs temperatures.

Lubricant
To make taking the dogs temperature & also doing the parvo tests less uncomfortable for them.

SNAP parvo testing kits

Testing kits used for checking dogs for the parvo virus when they are showing symptoms at your shelter, and also when you think they are cured from your wards treatment. These are stored cold.

Syringes
1cc, 3cc, and 10cc syringes.

18 Gauge needles
Used for giving subcutaneous (SQ) injections of Lactated Ringers.

Plain Lactated Ringer bags

Solutions used for giving dogs fluids: Plain Lactated Ringer Solutions (LRS) or .9% Sodium Chloride Solution.

IV Lines
Lines used to connect to the Lactated Ringer bags.

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DHLPP vaccines
Used to provide in-take vaccinations to the puppies. A series of vaccinations to project against Distemper, Hepatitis, Leptospirosis, Parvo, and Parainfluenza.

Frontline
A medication used on in-take to fight fleas and ticks. You can choose another flea/tick medication for this if you choose.

Bordatella
A vaccination used on in-take to fight against Kennel cough.

Sterile Water
Used to reconstitute dry-filled medication vials such as Polyflex and Ampicilin.

Baytril
An antibiotic that is clear (somewhat yellow) in color. It is one of the main medications used during treatment.

Polyflex
An antibiotic that is white, viscous, and opaque. It needs to be stored cold. It is another one of the main medications used during treatment

Metoclopromide (Reglan)
A anti-emetic (reduces vomiting) that is clear in color. It is one of the main medications used for our parvo treatment.

Strongid
A de-wormer that is yellow, viscous, and opaque.

Metronidazole
An anti-infective that comes in pill form 250mg and 500mg.

Where and how to purchase medical supplies

Online purchases MWI Veterinary Supply: https://www.mwivet.com Through a vet office You can go to a local Veterinarian to order medical supplies as well.

Saving your first parvo puppy

Now that you have all your supplies you are ready to start saving lives!

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Pre-Treatment
In-Take

Containment
If a dog came from your program you will want to make sure to thoroughly clean the area they were in using a parvocidal cleaner. Roccal-D needs to sit 10 minutes to be fully effective. Oxivir also needs to sit if you are using that. We will generally do a spray down and wipe up everything that can be, followed by another spray down that you let air dry. If dogs come in crates from another shelter, before taking the crate out of the parvo ward you will want to thoroughly clean that. Any laundry that is inside the parvo ward should not leave unless you have cleaned it three times with soap/bleach (as outlined in the laundry section).

Testing
You should verify there was a test done on the dog and it came back positive before you bring them into the parvo ward.

Companionship
If dogs come in the same litter, we normally keep them in the same room to give each other some company. You can also do this with nonlitter mates. There are a few things you need to be careful with though. If there is a chance a dog has distemper dont put them in a room with other dogs. Also you dont want to room dogs with each other if they are on an IV drip/pump so that you dont get IV lines tangled up. Vaccinations Some shelters vaccinate on in-take so you will want to check what vaccinations the dog has received recently. Make sure they are updated on the following vaccinations:

DHLPP
It comes with 2 vials: a sterile diluent and dry powder vial. You mix the sterile diluent into the dry vial. Then draw the well mixed medication into your syringe and administer SQ into the right shoulder.

Bordatella
It comes with 2 vials: a sterile diluent and dry powder vial. You mix the sterile diluent into the dry vial. Pull the mixed solution into your syringe and remove the needle. Apply a nasal applicator to the syringe and administer to both nostrils.

Frontline
This medication dose depends on the dogs weight, they receive 0.3cc for every 10lbs of body weight. It is applied to the neck skin.

12 Filling out patient chart information See (Parvo Intake Paperwork) and (Parvo Dog Treatment Sheet). You will want to make sure you note the date of any vaccinations you did on the Intake Paperwork and all other relevant information.

Treatment
Each time you go to treat the parvo dogs you will want to look through all the patients and see if there are any that need to be taken care of sooner than others based on their appearance, the amount & type of feces & vomit present in their room. ALWAYS wash your hands between patients. This section will only discuss SQ treatment, later on we have a section that will discuss IV treatment and the medications associated with that. Checking patients status Before medicating any dogs you will want to assess how they are doing & note all observed information on their Treatment Sheet:

Weight
You dont have to weigh the dogs every time. You should weigh them upon in-take, and if they are doing very poorly you may weigh them occasionally to determine exactly how much weight they are losing.

Temperature
It is not necessary to take their exact temperature every time, though we do on the very sick dogs. Another method of determining their approximate temperature is feeling their paws to see if they are cool or warm. This doesnt always work if they have been standing on cool tile floors their paws will be cool.

Circulation
Check the color of their gums, they should be pink. If they are gray or white their circulation is really low. You can also do a capillary refill test by pressing your finger again their gum for a second and lift off to see how quickly color returns. Color should return immediately for healthy circulation, if it doesnt that means they are very dehydrated

Attitude
We generally measure lethargy by a few states: Semi-comatose, Lethargic, Quite and Reactive(QAR), & Bright and Reactive(BAR). This is done just by observing the dog and their reaction to you entering their room.

Feces & vomit

Look for feces and vomit, and note what they look like. Feces of concern are: runny, bloody, dark. Vomit is never good, but be on the lookout for: syrupy vomit. See the below sections on types of feces and vomit for more information.

13 Signs to watch out for & how to react

Types of Feces
Bloody This is normal for dogs with parvo, generally you want to look at how much is there during assessment. Between the feces, vomit and urine you can get a good idea of how many fluids have left the dog since you last saw them. You react through normal treatment. Serumy (looks like Karol Syrup) - This means their intestines are leaking proteins. You react to this by giving hetastarch (discussed below in the advanced treatment section). Black This is digested blood, and you will normally see this when the dog is getting over parvo and their system is cleaning out.

Types of vomit
Bloody This means there are ulcerations in their stomach. You should give them some sort of antacid, such as Pepcid or zantac. Bright yellow/green This means there is too much acid in their stomach. Again you can give them an antacid, such as Pepcid or zantac. Watery/clear This means you are letting them drink too much water. While it may seem like drinking water is a good thing to rehydrate them, the dog doesnt know how much water is enough so will over drink and vomit. Instead of giving plain water, mix with wet or dry food and then the dog wont drink as much plus they will be getting some nutrients from the food.

Abscess
Caused by Baytril not being absorbed and or diluted enough. If you see this, you will want to make sure you are giving Baytril with Plain Lactated Ringers and also changing up the locations that you are giving other medications. If you see an Abscess forming, do not administer more Baytril to the same location, change to somewhere else. Preparing & administering medications Generally speaking, dogs will receive Baytril, Polyflex and Metoclopromide until they are starting to eat a good amount again. Once they are eating, we swap them over to Metronidazole. If the dogs are very sick they will get more and that is discussed in the advanced treatment section.

Plain Lactated Ringer

Dosage amount 100cc for every 10lbs of body weight, 2 to 3 times per day.

14 Administering First check that the dog is absorbing fluids from previous treatments. If they are not, you will want to lower the amount of fluids given or skip fluids for one treatment. To check that, you look for a sack of fluids that is under their skin. Connect a clean 18 gauge needle to the end of the line on the LRS bag. If you are giving the dog Baytril with other medications you will want to bring a second clean needle to change out between the Baytril injection and the others. Note how much fluid is in the bag currently, and where it will be at once you give the correct amount of fluids, it can be helpful to make a line with a permanent marker. Then you will lift up a tent of skin, basically scruff the dog, between the shoulder blades and push the needle into the skin. Open up the line so and check that the bag is flowing, you may need to move the needle around a bit to get a good flow. If you need to give Baytril and other medications, then youd do the Baytril first then close off the line after at least 20cc of LRS and replace the needle with a new clean one. Make a tent of skin in a different location and inject under the skin, open the line again until the desired amount of fluids has been given. When you are giving SQ medications (Baytril, Polyflex, etc) you can inject them into the LRS line so that they go in with the LRS. See below for recommendations on when to give the various medications with the LRS.

Baytril
Dosage amount 1cc for every 10lbs of body weight, once per day. Administering Baytril is always given SQ (NEVER IV) and must be accompanied by at least 20cc of plain LRS or it will cause an abscess. If there are other SQ medications, the Baytril must be injected in a different location than the others. We generally give Baytril first and then set the SQ line to a different location. Draw up the proper amount of Baytril into a syringe and inject into the IV line when giving at least 20cc of LRS.

Metoclopromide (Reglan)
Dosage amount 0.5cc for every 10lbs of body weight, 2 to 3 times per day depending on amount of vomit.

15 Administering Draw up the proper amount of Metoclopromide and when giving LRS, inject into the IV line. You can give this as quickly as you want when giving with LRS.

Polyflex
Dosage amount 0.5cc for every 10lbs of body weight, 2 to 3 times per day depending on how sick they are. Administering Polyflex is always given SQ (NEVER IV)! Prior to drawing up the Polyflex, you will want to shake the bottle vigorously to ensure it is well mixed. Polyflex also stings, so we recommend this is one of the last medications you give to the dog. Draw up the proper amount of Polyflex and when giving the LRS inject into the IV line.

Strongid
Dosage amount 1.0cc for every 10lbs of body weight, once after they are eating again. Administering Without a needle on a syringe, draw up the proper amount of Strongid and give to the dog orally. It is best to give it in smaller amounts, 1-2cc at a time, if they are getting a larger dose so they have time to swallow it.

Metronidazole
Dosage amount 125mg for every 10lbs of body weight, once per day for 3 days after they are eating again. Administering If required break the pill in half or forth so that it is the right amount of medication for the dogs size. If the dog isnt too squirmy you can pinch your forefinger and thumb on either side of the dogs mouth to get them to open and then drop the pill into the back of their throat. Hold the dogs mouth shut, with their nose in the air and massage the dogs throat. You can also gently blow on the dogs nose. Wait to see that the dog swallows. You can also put the pill into a treat or wet food and get the dog to eat it that way. Cleaning up their room Youll want to make sure to pickup any solid poop with toilet paper and flush it down the toilet. Using a towel and a parvocidal cleaner to wipe up any diarrhea from the floor and wipe up any diarrhea from the sheets. Replace all their dirty sheets with fresh ones. If they have any toys that are dirty you will want to replace those too. Place all their dirty laundry & toys in the washer (or dirty laundry hamper to wash later).

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Post-Treatment
When to test & testing When a dog has been active and responsive for treatments, eating solid food, drinking water, has had solid formed feces, and no vomit for two consecutive shifts then the dog is ok to test. The SNAP tests have instructions on them so you should review them in case they change between when this document was written and when you are testing. Cleaning the puppy and their room After your dog is parvo free you are ready to remove them from the parvo ward and get them ready to be adopted. When removing a dog from the parvo ward you have to be very mindful of not contaminating areas outside. Our washtub for the dogs is outside of our parvo ward so we follow a few procedures that can be helpful depending on how your area is setup: Setup a clean crate with some bedding/towels (non-parvo ward ones) inside. Get a clean towel (non-parvo ward one) to dry the dog after he is bathed. Also get a clean hospital gown (non-parvo ward one). Roll up scrub pants to your knees so they are not dragging on the ground and take off parvo shoes. Have a tub filled with a parvocidal cleaner to disinfect your feet. Have the shampoo, nailclippers, and toothbrush ready at the wash tub, and make sure the water is warm. Remove any collar from the dog o You can soak it in a bowl of 30parts water: 1part bleach if it is not too dirty while you bathe the dog. o I the collar is soiled, place in the parvo dirty laundry. (make sure to keep any tags that belong to the dog with their paperwork) Pickup the puppy from the parvo ward and carry him/her to the washtub. Make sure to step completely into the footbath on your way outside of the ward. Set the puppy in the washtub. We have a leash in the tub that we put around them to prevent them from jumping out. Thoroughly wash the dog with shampoo from head to toe including anal area, ear tips, mouth, and feet. Use toe clipper to clip off the very tips of the toe nails Use toothbrush to scrub the pads, tops of each nail, and underneath each nail. Rinse and re-wash the dog from head to toe again with shampoo. Put on the clean hospital gown so that when you pickup the puppy he/she isnt touching your parvo clothes. Dry off the puppy with the clean towel you have set aside.

17 Place them in their crate after they are dried off, you may need to give them extra towels to keep them warm if they are particularly small or young. Spray off all their paperwork & any collar tags that were removed from dirty collar with a parvocidal cleaner and place on top of crate. Your puppy is now ready to be picked up and processed into your adoption program!

Next is cleaning up their room so it is ready for your next patient: Much like you do during your regular treatment days, you will pick up all solid poop with a paper towel and flush in the toilet. Wipe up all liquids with a towel and place the towel in the wash. Sweep up all food, lint, hair, etc into a dustpan and place in trash. Fill a bucket/sink with 1in of warm water and soap, and use a mop to put soapy water all over the floor in the room. Mop up sections at a time and squeeze into the sink. Caked on poop you will need a scrapper to scrape it off (clean the scrapper afterward). Once everything has been cleaned, spray Rocall on every surface and let it sit & air dry. Use 409 on windows inside/out.

How to deal with deceased dogs This will be one of the toughest parts of having a parvo ward. Losing a puppy is never pleasant, but unfortunately it will happen. The one piece of advice we can give you is that while you may lose some, your parvo ward is saving a lot of lives and giving so many dogs a second chance. Our protocol for deceased dogs is the following: Ensure the dog is deceased. Get a clean towel and place the dog on it. With clean hands get a clean bag (we normally have a few of those thicker black garbage bags), place the dog in the bag being careful not to let the outside of the bag touch any poopy areas on the floor. Seal the bag and place the bag in a cleaner area of the parvo ward (we use our kitchen area) With clean hands get a second bag, bring the dog in the first bag to a clean area and place inside the second bag. Wash hands and seal second bag Spray outside of bag with parvocidal cleaner and set bag outside of parvo ward in a tub or in a crate. Label the bag with any sort of shelter identification number and its name. Write died on patient paperwork, and put paperwork in whichever bin you use for processing dogs into your pet database.

18 We drop our deceased dogs to the local city shelter and let the know their shelter#, and make sure they are aware the dog was parvo positive so they are extra careful to not contaminate their shelter.

General Parvo ward best practices

This section is best practices to use on a daily basis to avoid spreading parvo outside of your designated ward area. You should ready through all of these and incorporate them in your own ward, along with putting up any friendly reminder signs for your parvo team to remember. Clean room for entering & exiting the ward Our parvo ward has an entrance with a footwash tub that we keep filled with about an inch of parvocidal cleaner, along with some clothes hooks to hang our street clothes up when changing into scrubs. Entrance: o Step inside door and no further. o Take off street clothes including socks. o Step across tape line and put on scrub top and bottom. o Put on clogs/parvo shoes. o Do not step near door/sink again in these clothes. Exit: o Remove scrub tops and bottoms and shoes BEFORE crossing tape line into door/sink area. o Step into door/sink area and wash hands in sink by door. o Put on street clothes. o Use bottle of disinfectant to pour a little in the foot bath then walk out through foot bath o Make sure both feet step firmly in foot bath disinfectant then lock door and leave.

Parvo ward specific clothes & shoes It is recommended you have clothes that stay in your parvo ward to be used in there. We have a lot of scrubs in ours which can be purchased at thrift stores for not very much. We also have a couple pairs of shoes. We find the rubber clogs (like crocs) are good as they clean easily if they end up getting messy. You will want to wash these fairly regularly, or if they get visible poop on them you should also wash them. Washing hands between patients Always wash your hands thoroughly between each patient. This will prevent other diseases from passing between patients. If you have any ringworm or mange pups it is also a good idea to spray off your clothes with Roccal or Oxivir after handling those dogs.

19 Daily inventory Depending on if you have a medical clinic you may or may not have access to additional medications. At Austin Pets Alive we keep a majority of our medications in our medical clinic and when we run low on certain medications in the parvo ward we let the clinic know. We take an inventory of all our medications every shift (twice a day) to make sure the following shift will have enough medications to treat all the patients, it also lets us know when we are getting low on certain medications and can let the medical clinic know. If they end up needing to order meds to restore our stock, the daily inventory helps them know in advance. Laundry Keeping on top of laundry is very important in the parvo ward. Since a lot of the sheets and towels are soiled with fecal matter you want to make sure those gets washed ASAP to attracting flys. Unless we have very critical patients, we try to start a load of laundry at the begging of each shift. We also make sure the dryer and washer are off before leaving to avoid any fires. Here are our washing and drying check lists: Washer: o Do not overload washing machine o Make sure towels are evenly distributed to avoid washer stopping. o Use cup detergent and cup bleach o Set cycle to 4 minutes. Dryer: o Clean lint filter each time o Push on to start and open door to stop o Dryer will not stop on its own so make sure stopped before leaving for the shift.

General Cleaning

Dishes
Youll want to keep dishes clean between dogs. Wash them well with a sponge and liquid soap. If a dogs dish has poop or pee on it you should wash it off.

Hallways & kitchen area

It is a good idea to clean the common area where you prepare medications, do laundry, wash dishes, etc on a regular basis (once per week). We do the following: Sweep and collect in dustbin then put in trash. Mop with warm soapy water to decrease spread of virus starting near door and working inward towards dryer then into kitchen/storage area (start in cleanest area first and move to dirtiest). Spray all floor surfaces with a parvocidal cleaner and let dry. Spray the dryer, fridge, washer, and toilet with a parvocidal cleaner (in that order) and wipe with rag, then wash rag used to clean these surfaces in washer.

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Trash & Recycling

Youll inevitably get a lot of trash and recycling inside your parvo ward. You will always want to be extra careful when removing both from the parvo ward to avoid contaminating any outside areas. Here are our disposal procedures: Trash: o When bag is full, remove from can and set on clean floor area. Continue to fill bag until truly full. Replace bag in can (if out, there are more in other bathroom). o Tie up full bag of trash and spray entire outside with a parvocidal cleaner including bottom of bag and ties. Then set in clean area of entrance. o When finished with parvo care, take bag to trash can being careful not to set down on any surfaces or rub up against things on way out. Trash should be taken out right before trash pickup to prevent raccoons from getting into the trash. (reminder: some forms of the canine parvovirus can infect raccoons). Recycling: o When box is full, spray outside of box with a parvocidal cleaner and set near entrance so it can be put out in recycling area on Wednesday night for pick up on Thursday (our recycling pickup day).

Expanding your Parvo program

Once you get the procedure of caring for parvo puppies down, you may want to look at expanding your program so you can take in and care for more parvo puppies. Expanding your program can come in a few different areas: The first of which would be getting a team together so that you always have someone that has been trained to cover all the shifts required for caring for your dogs. We also notice in Austin that there are busy seasons for parvo puppies, so having a team will help to treat more dogs during that time. If you have the space and resources, you can also look into building a parvo ward from the ground up to meet all the requirements. And finally there are some more advanced treatment methods for parvo puppies that require more medical knowledge and a vet/vettech to help with. These treatment methods will increase your survival rate greatly, especially for puppies that are very sick.

Building and training a team of volunteers

APA! has had great success with volunteers with no medical background, so do not limit yourself when you are looking to increase the size of your team. You will hopefully have a volunteer recruiting team built up (see other handbook on building a volunteer team for better details), you should utilize this to get people interested in the team.

21 Training Training should be very hands on, we recommend the embedded learning method of Watch one, Do one, Teach one. Have your new volunteer watch you perform a specific procedure on one of the dogs, be sure to explain each step that you are taking and why the step is important: Assess the dog Draw up the medications Give the medications Make relevant notes and observations on the medical chart.

On the next dog have your new volunteer perform all the procedure. If the other dog ends up requiring additional medications you should step in to show them those only. Encourage them to ask clarifying questions and try to let them figure everything out on their own, but definitely step in if you see them about to make a mistake. On their second or third training session, have the new volunteer teach the procedure to you or if you or someone else. This will help them remember not only what they are doing with each step but why each step is taken. One thing to note about the Austin Pets Alive volunteer team is that they are not required to calculate dosage amounts for the animals. All of that is done by the medical team on a daily basis and dosage amounts required are written on the chart for the volunteer to follow.

Building a dedicated parvo ward

Clean room When building out a parvo ward, the clean room is a very important part so that you can properly disinfect before leave the ward and avoid spreading the virus to other parts of your shelter. Our clean room has a door to the outside and a curtain to the ward so that people can change out of their street clothes and into the parvo scrubs in privacy. We also have a sink to wash our hands before changing back into our street clothes. And also have a foot wash tub that we put a parvocidal cleaner into, and step into the tub before leaving the ward. The clean room also has a spray bottle of parvocidal cleaner to spray off your feet, hands, etc so you can be extra careful. Another crucial part of the clean room is having a designated street clothes area and a designated parvo area. We have a line of tape on the floor that we never let parvo clothes, shoes, etc cross. Washer & Dryer Having a washer and dryer inside of the ward helps immensely with doing laundry regularly and not having to bring laundry outside of your parvo ward.

22 Separate rooms Having separate rooms with glass doors or at least windows on the doors is another good thing to consider. Windows or glass doors allow you to do a quick patient check without having to go into each room. The separate rooms also allow you to prevent the spread of other various diseases between the dogs. Sink & Toilet A sink with a garbage disposal is nice when washing dishes and will help prevent the sink from getting clogged by food, not to mention a sink also lets you wash your hands between each patient using anti-bacterial soap. A toilet is good to dispose of toilet paper that you use to pick up feces with to prevent spreading the virus outside of the ward area.

Advanced treatment methods

For pretty much every one of the advanced treatments you will need someone (a vet or vet tech) that has been trained in putting in and monitoring IV catheters. IV catheters IV catheters are fragile, so when disconnecting the IV line to administer any medications via IV you will want to be very careful not to pull on the catheter when disconnecting the line. This can cause the catheter to come out of the vein and then all medications would be going under the skin (sq) instead. When administering IV medications always keep an eye on the catheter area for swelling. If swelling occurs, stop IV medications and contact your trained professional to come look at the catheter and possibly set it again. IV Medications

Heparin
This is an anticoagulant (blood thinner) that prevents the formation of blood clots. It is used to flush the IV catheters when there is a clot formed and the pump or IV drip is no longer flowing properly. Dosage amount Never inject straight Heparin into a dog! To create a flush, get a 3cc syringe and pull in about 0.5cc of Heparin from the vial. With the syringe needle pointing upward push all the air and heparin back into the medicine vial. You only need the amount of Heparin that is left in the tip of the syringe. After that you fill the syringe with plain Lactated Ringer solution (we normally have a bag hanging above the sink that is labeled For Flush only to create flushes for the dogs) Administering To un-clot an IV, get your 3cc flush syringe and connect it to the IV catheter. See if you can push the liquid in, if that works then reconnect the IV line and see if the drip/pump starts flowing again. If simply pushing liquid into the catheter doesnt work you can try plunging which is attempting to push liquid in and also pulling liquid out. You may see some blood come into the syringe with this. That generally means the clot is gone and you should be

23 able to push liquid in easily. Try connecting the IV drip/pump again. We also use the flush between each IV medication to ensure it doesnt drip out of the catheter between medications.

Ampicillin
This is the IV equivalent of Polyflex (listed above in the normal treatment section). It is clear instead of the vicious white fluid of Polyflex. Just like Polyflex this comes in a vial with dry powder that you have to reconstitute with sterile water. Dosage amount 100mg (cc amount depends on the fluid amount used when reconstituting the dried powder) for every 10lbs of body weight, 2-3 times per day. Administering IV only.

Anzemet
This is a long acting anti-vomit that is used in addition to the reglan if there is lots of vomiting occurring. Dosage amount 0.15cc for every 10lbs of body weight, once per day. Administering SQ or IV.

Zantac
An antacide Dosage amount 0.5 cc for every 10lbs of body weight, once per day. Administering

Hetastarch
It is a starch derivative that is used as a plasma volume expander. Used to help circulation. Dosage amount 10 to 20mL per kg per day Administering Given IV only!

Dextrose
Sterile sugars for low blood sugar

24 Dosage amount It comes at 50% strength in the bottle. You want to dilute into IV fluids to get the dextrose to 5% strength. Administering Given via IV pump or drip.

Nutrical
A high-calorie dietary supplement that is brown and viscous. Its used to increase a dogs blood sugar and energy when they have not been eating for a while Dosage amount follow bottle instructions - used when they can hold it down & for longer parvo cases to get their blood sugar and protein levels up Administering Without a needle on a syringe, draw up the proper amount of Strongid and give to the dog orally. It is best to give it in smaller amounts, 1-2cc at a time, if they are getting a larger dose so they have time to swallow it. IV Fluid Bags We generally mix our IV bags of plain lactated ringers, 5% strength dextrose, 3cc per L of reglan, 20mEq per bag of KCL/Potassium Chloride. Normal infusion rate is 20mL per hour per 10lbs of body weight, up to 50mL per hour per 10lbs of body weight. IV Bolus Treatment This is used for very dehydrated dogs to get them extra fluids into their system. It is just plain LRS given via an IV drip over about an hour. 100mL per 10lbs of body weight. Since it is possible to over hydrate a dog, you will want to monitor this to ensure you dont give too many fluids. You can either pay close attention to the IV drip while giving the dog some extra attention/love. Or if you have to step away make sure the bag only has the amount you need to administer so no more is given if you dont return on time.

Learning from mistakes and overcoming roadblocks

Chesters story
He had jugular catheter, and the catheter came out of the vein so IV medications were going under the skin including Dextrose. This caused the skin to slough off (as pictured). While seeing this on a jugular catheter is difficult, it was a reminder that we need to pay attention when administering IV medications if there is any swelling around that area.

25 That means the catheter has come out of the vein. It was also another great reminder on why you never give Dextrose or Hetastarch SQ. Again if you observe swelling when administering IV medications, then stop treatment and contact your vet/vettech to come check out the catheter.

Tina and Peppers story

Tina was hit by parvo pretty bad and ended up passing away under our care. Her siblings were lucky to not get hit as bad by parvo and made it out fine. Pepper came into the parvo ward shortly after Tina, and she was reacting very similarly to Tina. Our team knew if we didnt act quickly we could lose her too. We were lucky to have some plasma that had been donated to APA! when a few of our dogs had heat stroke, so Pepper received 3 plasma transfusions along with Hetastarch, Dextrose, etc to make sure she had everything she needed to stay hydrated and fight off parvo. Some of our staff would stay the night to ensure her IV pump was running and getting her the medications she required.

IV pumps woes
Another lesson that has been learned, our IV pumps have had issues where they clog up overnight and the dogs were not getting their fluids. This was due to the IV lines being placed where they normally are, in the middle of the arm. Because the catheter may reach close to the elbow, when the dogs lies down to sleep it kinks the line and stops the pump. Instead we place the catheters closer to the dogs wrist area so it isnt as likely to kink when the dog bends its arm.

Forms & Documents used by Austin Pets Alive

This section shows what our typical forms look like. Look in the Parvo directory on your media CD to get easy to print versions of all of these forms.

Patient in-take form

We fill out this form on in-take so that we can enter him into our pet database (Pet Point) and once the dog comes out of the ward we update the database with all his medical information.

Daily patient medical form

Our vet staff comes in to evaluate the dogs on a daily basis, and will fill out which medications they recommend for them. The volunteer team follows these recommendations, and if they notice anything odd with the dog during the assessment portion they will notify the medical team and will sometimes be told to administer additional medications. This is noted on the chart as well under the notes section.

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IV pump log
We created this since our pumps were getting clogged overnight. Each shift writes down the rate of infusion, along with what current to be infused number is. Then if someone comes in one the next shift and the pump is clogged and not running they can determine how long the pump was running before it was clogged and how long the dog has been without additional fluids.

Inventory sheet
We fill this out after each shift to ensure that the next shift wont be missing any important supplies or medications. If anything is missing we notify the medical clinic to get stocked up, or in the case of food & cleaning supplies we can get those from outside of the parvo ward and set them near the door before we leave.

Volunteer Schedule Sheet

Our volunteer lead sends this sheet out weekly to let people know what their schedule is.

Post Parvo Hand-out

This is given to owners that come to us for treatment of their parvo dogs so that they are well informed on what they dog had and how to monitor their health and avoid spreading to other dogs.