The association between serial point-of-care test results and hospitalization time in canine parvovirus infection (2003-2015)

Abstract

The objectives of this study were to describe serial point-of-care test results in dogs infected with canine parvovirus (CPV), highlight clinicopathologic abnormalities at various timepoints, and investigate their association with the duration of hospitalization. Two-hundred and four dogs positive for CPV at the Western College of Veterinary Medicine between 2003 and 2015 were included. Data were recorded pertaining to emergency panel and venous blood gas tests at presentation, and every 12 hours thereafter (+/- 4 hours) for the first 72 hours of hospitalization. Common persistent abnormalities included hypoproteinemia, acidosis, hyponatremia, hypochloremia, hyperkalemia, and hyperbicarbonatemia. Ionized hypocalcemia was associated with a longer duration of hospitalization and mild hyperkalemia was associated with a shorter duration of hospitalization (P < 0.05). This study suggests that the use of point-of-care tests for in-hospital monitoring may provide insight into CPV case complexity and predict total hospitalization times.

Figure 1

Serial median PCV (packed cell volume) and TP (total protein) over the first 3 days of hospitalization in dogs that survived canine parvovirus infection, categorized by age. A — ≤ 8 wk [PCV reference interval (RI): 20% to 41%, TP RI: 14 to 50 g/L]; B — 8.1 to 16 wk (PCV RI: 20% to 69%, TP RI: 16 to 35 g/L); C — 16.1 wk to 1 y (PCV RI: 32% to 54%, TP RI: 19 to 57 g/L); D — > 1 y (PCV RI: 38% to 56%, TP RI: 22 to 50 g/L). Time categories on the x-axis include data +/− 4 h from the respective timepoint. Reference intervals established by Harper et al (12). Error bars display +/− 1 standard deviation.

Figure 2

Serial median venous blood gas results over the first 3 days of hospitalization in dogs that survived canine parvovirus infection. Time categories on the x-axis include data +/− 4 h from the respective timepoint. A — pH [reference interval (RI): 7.395 to 7.4812, K (potassium, RI: 3.4 to 4.3 mmol/L), iCa (ionized calcium, RI: 1.31 to 1.40 mmol/L), Cl (chloride, RI: 113 to 121 mmol/L)]. B — HCO₃ (bicarbonate, RI: 17.3 to 24.8 mmol/L), glucose (RI: 4.8 to 6.6 mmol/L), lactate (RI: 0.45 to 2.33 mmol/L), and Na (sodium, RI: 143.1 to 149.2 mmol/L). Reference intervals established at Prairie Diagnostic Services from arterial samples of 34 healthy adult dogs. Error bars display +/− 1 standard deviation.

Figure 3

Box plot of the duration of hospitalization of dogs that survived canine parvovirus infection that had a low ionized calcium (L iCa) at 12 (P = 0.551), 24 (P = 0.018), 36 (P = 0.195), and 48 h (P = 0.035) (+/− 4 h) into hospitalization compared with dogs that did not have this abnormality (N/H iCa, normal or high ionized calcium) on venous blood gas. The box plot displays the first quartile, median, and third quartile durations of hospitalization. Whiskers display the minimum and maximum durations of hospitalization that do not exceed 1.5 times the interquartile range (IQR), represented by the vertical axis of the box plot. Points plotted beyond the maximum whisker value represent single durations of hospitalization that exceeded 1.5 times the IQR.

Figure 4

Box plot of the duration of hospitalization of dogs that survived canine parvovirus infection that had a high potassium (H K) at 12 (P = 0.034), 24 (P = 0.005), 36 (P = 0.047), and 48 h (P = 0.696) (+/− 4 h) into hospitalization compared to dogs that did not have this abnormality (N/H K, normal or high potassium) on venous blood gas. The box plot displays the first quartile, median, and third quartile durations of hospitalization. Whiskers display the minimum and maximum durations of hospitalization that do not exceed 1.5 times the interquartile range (IQR), represented by the vertical axis of the box plot. Points plotted beyond the maximum whisker value represent single durations of hospitalization that exceeded 1.5 times the IQR.