Parvovirus enteritis and other risk factors associated with persistent gastrointestinal signs in dogs later in life: a retrospective cohort study

Abstract

Background: Parvoviral enteritis (PE) is a viral gastrointestinal (GI) infection of dogs. Recovery from PE has been associated with persistent GI signs later in life. The objectives of this study were: (i) To determine whether dogs that have recovered from PE (post-parvo dogs) had an increased risk of persistent GI signs compared to uninfected control dogs. (ii) To investigate the lifestyle and clinicopathologic factors that are associated with persistent GI signs in post-parvo dogs.

Methods: A total of 86 post-parvo dogs and 52 age-matched control dogs were enrolled in this retrospective cohort study. Many years after hospitalization for PE, the owners were interviewed about the health and habits of their dogs using a questionnaire. We used generalized linear mixed effects models to test whether parvovirus enteritis and other risk factors are associated with owner-recognized general health problems in all dogs and with owner-recognized persistent GI signs in post-parvo dogs.

Results: The prevalence of persistent GI signs was significantly higher in post-parvo dogs compared to control dogs (57% vs 25%, P < 0.001). Markers of disease severity at the time of hospital admission such as neutropenia, low body temperature (BT), and treatment with an antiemetic medication (metoclopramide) were significant risk factors for persistent GI signs in post-parvo dogs. For example, PE-affected dogs that were hypothermic at hospital admission (BT of 37.2 °C) were 16.6 × more likely to have GI signs later in life compared to hyperthermic dogs (BT of 40.4 °C). The presence of persistent GI signs in post-parvo dogs was a risk factor for health problems in other organ systems.

Conclusions: Parvovirus enteritis is a significant risk factor for persistent GI signs in dogs highlighting the importance of prevention. The risk factors identified in the present study may guide future investigations on the mechanisms that link parvovirus enteritis to chronic health problems in dogs.

Keywords: Antimicrobials; Canine; Diarrhea; Gastrointestinal system; Immunology; Metoclopramide; Parvovirus; Vomiting.

Fig. 1

Risk factors for persistent health problems for control and post-parvo dogs. Effects of 6 explanatory variables on the probability that the dogs have signs in the 6 organ systems at the time of follow up. The 6 explanatory variables are as follows: (a) parvovirus infection history (Control, Post-parvo), (b) organ system (Ear, GI, Orthopedic, Respiratory, Skin, Urinary), (c) time of follow up with owners (days), (d) purebred (Mixed, Purebred), (e) medical history (No, Yes), and (f) lifestyle (Outdoor, Indoor and Outdoor, Indoor). The sample size included 52 control dogs and 86 post-parvo dogs (total of 138 dogs). The y-axis shows the probability that the dogs will develop signs in the 6 organ systems at the time of follow up. Shown are the estimated marginal means (EMMs) and their 95% confidence intervals (CIs). To facilitate interpretation, the continuous variables are shown on the x-axis in their original units rather than in units of standard deviation

Fig. 2

Risk factors for persistent GI signs in post-parvo dogs. Effects of 8 explanatory variables on the probability that the post-parvo dogs had persistent GI symptoms at follow up (FU). The 8 explanatory variables are as follows: (a) purebred (Mixed, Purebred), (b) medical history (No, Yes), (c) metoclopramide treatment (No, Yes), (d) time of follow up with owners (days), (e) body temperature at admission (°C), (f) white blood cell count (10^9 cells per litre of blood), (g) segmented neutrophil count (10^9 cells per litre of blood), and (h) banded neutrophil count (10^9 cells per litre of blood). The sample size included 31 and 29 post-parvo dogs with and without persistent GI signs, respectively (total of 60 post-parvo dogs). The y-axis shows the probability that the post-parvo dogs will develop persistent GI signs at follow up (FU). Shown are the EMMs and their 95% CIs . To facilitate interpretation, the continuous variables are shown on the x-axis in their original units rather than in units of standard deviation

Fig. 3

Post-parvo dogs with persistent GI signs have other health problems. Post-parvo dogs with persistent GI symptoms (n = 44) have more symptoms in the other 5 organ systems compared to post-parvo dogs with no persistent GI symptoms (n = 35). The 5 organ systems include ear, orthopedic, respiratory, skin, and urinary system. The y-axis shows the number of organ systems with signs at the time of follow up. The boxplots show the median (black line), 25th and 75th percentiles (edges of the box), and minimum and maximum values (whiskers). The individual data points (black dots) were jiggered for each dog to visualize their distribution