Parvovirus Treatment with Canine Parvovirus Monoclonal Antibody

Sponsored by Elanco

Although canine parvovirus (CPV) is largely preventable, it poses a significant threat to unvaccinated dogs and puppies. Survival rates vary, depending on the level of care provided, but can be as low as 9% in untreated patients.¹

CPV treatment has traditionally focused on supportive care, allowing time for the immune system to mount an effective response. However, a novel, conditionally approved treatment option, Canine Parvovirus Monoclonal Antibody (CPMA), is now available.

Rascal’s Case

Rascal, a 12-week-old intact male crossbreed dog, was presented for vomiting and lethargy of 12 hours’ duration, accompanied by several episodes of diarrhea. Rascal’s owner was unaware of any known toxin or foreign body ingestion since obtaining him from a neighbor 3 weeks earlier. Rascal was dewormed at 8 weeks of age but had received no other preventive care.

On physical examination, Rascal’s temperature was 103.2°F (39.5°C). Heart rate was 160 bpm, and respiratory rate was 36 breaths per minute. Mucous membranes were pale pink, with a capillary refill time of 3 seconds, and hypersalivation was observed. Rascal’s abdomen was tense on palpation, with fluid-filled intestinal loops.

Testing for intestinal parasites, including Giardia spp, and CPV was recommended. No ova were seen on fecal flotation. Giardia spp results were negative, but CPV results were positive. CBC revealed lymphopenia, further supporting a CPV diagnosis.

The veterinarian spoke with Rascal’s owner and recommended hospitalization at the local emergency clinic, explaining that intensive care over the next several days would be recommended. Before sending Rascal to the emergency clinic, the veterinarian recommended administering Canine Parvovirus Monoclonal Antibody (CPMA), a new treatment for parvovirus.

CPMA is conditionally approved by the USDA and is supported by efficacy and safety studies.^2,3 CPMA binds to CPV and prevents it from entering cells. In a study of 28 dogs laboratory-infected with CPV, including 21 dogs receiving CPMA only and 7 dogs receiving a placebo control, all CPMA-treated dogs survived infection as compared with just 43% of dogs receiving placebo.⁴ Treatment with CPMA was also associated with faster resolution of vomiting, lethargy, and inappetence.⁵ A field safety study of 147 client-owned dogs as young as 6 weeks of age also showed that adverse events were rare and mild and included mild diarrhea, pruritus, and localized reactions.²

Rascal’s owner approved this treatment and the veterinary team placed an IV catheter and administered CPMA (0.2 mL/kg IV).

At the emergency clinic, IV fluids were recommended, including an initial bolus and fluids for maintenance and ongoing losses. Maropitant was recommended to control vomiting, although metoclopramide or ondansetron could be equally effective.⁶ Cefovecin was recommended to address potential bacterial translocation, and buprenorphine was recommended to manage abdominal pain.⁷

Rascal’s owner authorized treatment and was informed that his discharge date would depend on his response to therapy. Rascal’s signs began to improve within 24 hours. By day 3, Rascal was barking loudly in his cage and attempting to remove his e-collar and catheter. Although his appetite had not fully returned to normal, it had improved significantly. Rascal was discharged due to his dramatic improvement in attitude.

Two days later, Rascal’s owner reported that his appetite had completely returned and he was eating readily. No further vomiting or diarrhea was noted, and Rascal’s owner was pleased with his treatment outcome.

Conclusion

Elanco’s CPMA is the first and only USDA conditionally approved monoclonal antibody that binds CPV.^4,5 Not only can CPMA lead to faster resolution of clinical signs associated with parvovirus, it also markedly decreases the risk for death.⁴ These clinical benefits are accompanied by a low risk for adverse events, with most side effects being mild in nature.² New data is also showing evidence of reduced viral shedding in patients that receive CPMA, which can have benefits in communities and shelter environments.⁴ In one study, dogs treated with CPMA had significantly lower amounts of CPV shed in their feces two days after CPMA treatment as compared to dogs not receiving CPMA treatment.⁴

CPMA treatment is not intended to replace hospitalization or supportive care. Affected dogs still need IV fluid therapy for rehydration, antiemetics to control vomiting, antibiotics to address potential sepsis, and analgesics for abdominal pain. However, CPMA may shorten the duration of hospitalization, potentially reducing costs to the client while also improving patient outcomes.

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