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Tamiflu To Treat Parvo~

the concept of treating Parvoenteritis in dogs with a neuraminidase inhibitor such as Tamiflu on the Veterinary Information Network’s Infectious Disease Board. Since it’s introduction, Tamiflu has been used successfully by veterinarians, shelter workers and rescue groups to treat Parvoenteritis in thousands of dogs, cats and raccoons throughout the world. In order to understand the how and why this treatment has been so universally successful, there are several terms and concepts that have to be discussed:

Tamiflu: is a commercially available source of a neuraminidase inhibitor that has been used successfully in these cases.

Neuraminidase: An enzyme that is produced by both bacteria and viruses. It is considered a virulence factor in viral and bacterial infections that require neuraminidase to remove biological barriers that protect the host from these pathogens.

Super infections: Any infection that requires both a virus and bacteria to produce an infection that is more pathogenic than either can produce alone. Veterinary examples: canine and feline parvo, canine kennel cough and influenza, feline URI, parvoenteritis in raccoons, and bloody scowls in deer.

The use of Tamiflu in canine, feline, and raccoon parvoenteritis: The success of using a neuraminidase inhibitor in treating canine and feline parvo is due to the suppression the production of bacterial neuraminidase, and has no effect on the Parvovirus’ ability to replicate. Puppies can still develop myocarditis and CHF…kittens can still develop cerebellar hypoplasia…the patient’s feces will still contain the viral antigen even while the animal is recovering.

Tamiflu does not interfere with the replication of the Parvovirus,as a result, no mutant or resistant strains of the Parvovirus will be created from the use of Tamiflu in the treatment of Parvoenteritis.

Tamiflu should never be used to treat any animal that does not test (+) using the fecal antigen test prior to starting Tamiflu. All of the guidelines for using Tamiflu have been developed in cases that have had a (+) fecal Parvo test.

Dose: 1mg/lb that dose given every 12 hours for 10 consecutive treatments…requires a (+) fecal antigen test…. should be given w/in 48 hrs of onset of clinical signs…if no response after the first dose…double to 2mg/lb for the second, third dose…

Specific Breeds of Dogs: Dobes, Rotties, Retrievers, Pit Bulldogs, and Alaskan slead dogs…all require at least 2mg/lb as the starting dose as these breeds respond poorly to Parvo infections…

As a preventive: One can give animals have been exposed, but are not currently showing any clinical signs one dose of 1mg/lb once a day for 5 days…if these animals develop one or more clinical signs (vomiting/bloody diarrhea/anorexia)…they should be given 1mg/lb every 12 hr for a total of 10 treatments.

Animals requiring IV support: Animals sick enough to require IV support (fluids/antibiotics/antiemetics) respond poorly to Tamiflu as their clinical condition suggest that their GI tract has already been damaged beyond the ability of Tamiflu’s ability to protect the patient. These animals should be started at 2mg/lb and the dose adjusted according to response every 12 hours.

Animals that vomit after being given oral Tamiflu: These patients can be given the same dose as an enema. You can also divide the contents of a 75mg capsule into lines and mix the appropriate amount into pancake syrup or honey and place under the tongue or in the lip fold.

Tamiflu Products: Suspension that you add 23 cc of water to get 25cc of 12mg/cc and 75mg capsules…. a flat of 10 capsules…. a 6 lb pup would get 0.5cc of the 12mg/cc suspension q. 12 hr x 10 Tx.

To treat a 5 lb puppy: Mix the contents of 1 capsule into 10 cc of Canine Rebound…get 10 cc @ 7.5mg/cc….Refrigerate and shake well and give 1cc q. 12 hrs x 10 treatments…. do not mix capsules with water as this water suspension is .very bitter and will cause the patient to vomit.. One can also use liquid VAL or a similar vitamin prep.

Tamiflu and FDA: On March 20, 2006, the FDA banned the use of Tamiflu and other neuraminidase inhibitors in treating chickens, ducks, turkeys and other birds…goes into effect in June 2006…. you can still use Tamiflu in dogs, cats, and raccoons.

In the emergency clinics or private clinics that are presented with cases whose disease course is unknown or have exceeded the 48 hrs time-frame: The professional staff should make the client aware of the poor response to Tamiflu due to the high levels of bacterial neuraminidase currently present in the patient’s GI tract, and the presence of GI pathology created prior to presentation. Tamiflu will only prevent future pathology, and can not reverse any pathology created prior to treatment.

Treating Parvo requires the same mental process used in treating Diabetes Mellitus….The DVM begins with a standard initial dose of Tamiflu or insulin and then uses professional judgment to adjust the following doses required to get a clinical response.

In an uncomplicated case, presented within 48 hrs. of the onset of clinical signs, one should see no vomiting after the first dose…no diarrhea after the 2nd…and alert/eating after the 3rd dose. If there is no clinical response after the 3rd dose…you have either started using Tamiflu too late, have a secondary medical problem that needs to be addressed, or have the wrong diagnosis.

In summary, the introduction of the concept of using a neuraminidase inhibitor to treat canine, feline and raccoon Parvoenteritis, has open many new doors into the understanding of the pathobiology and treatment of this disease. Prior to April 24, 2004, Parvovirus was thought of a viral enteritis. Based on this concept, vaccines were developed to help prevent or reduce the severity of the clinical disease.

Once the disease was diagnosed, treatment protocols were all designed to address the various end-products produced during the disease. The presence of vomiting usually dictated that most drugs were given intravenously. Animals that were hospitalized usually remained 3-7 days with unpredictable prognosis.

This is because none of the treatments were addressing the core problem of excessive GI bacterial neuraminidase. They were being given to address all of the various end-reactions such as: vomiting, endotoxic shock, pain, bacterial septicemia, GI mucosal ulcerations and general organ failure. This approach required many drugs and many man hours to treat the multiple pathological processes associated with viral Parvoenteritis.

With the introduction of using a neuraminidase inhibitor (Tamiflu), we established that Parvoenteritis is not a viral enteritis, but a super infection that requires the presence of bacterial neuraminidase. When a neuraminidase inhibitor is used under the strict guidelines developed since April 24, 2004, the disease is not allowed to develop into the clinical disease currently known as viral Parvoenteritis. The commensal bacteria do not transform into pathologic bacteria, and the patient’s disease is not allowed to progress as described in the veterinary literature. In order to achieve this reversal, there has to be a definitive diagnosis and the neuraminidase has to be given according to established guidelines.

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