The Effect of Canine Parvovirus Monoclonal Antibody on Length of Treatment, Cost of Treatment, and Mortality in a Shelter Setting [Abstract]

Abstract

The full article is published.

Introduction

Since its emergence in 1978, canine parvovirus (CPV-2) has been a leading cause of morbidity and mortality in dogs. The most susceptible dogs are generally less than 6 months of age, although older dogs may be at risk if unvaccinated. Treatment for parvovirus mainly consists of supportive care including fluid therapy, antibiotics, antiemetics, gastroprotectants, and analgesics. Recently, there has been the development of a monoclonal antibody (CPMA) that binds to CPV giving passive immunity and thus acting as a direct treatment for parvovirus infection.  In a shelter setting, much as with private owners, finances are a limiting factor in being able to treat parvovirus. Length of treatment is the biggest factor contributing to cost of treatment, thus decreasing length of treatment may warrant a more expensive treatment such as CPMA to increase overall cost efficiency. Decreasing length of treatment would also decrease length of stay which is important in a shelter setting, as decreasing length of stay has positive impacts on behavior and health. The goal of this study was to look at the length of treatment, mortality rate, and cost of treatment between dogs treated with supportive care versus supportive care and CPMA in order to discover if the addition of CPMA to classic parvovirus treatment was worthwhile in a shelter setting from the stand point of length of treatment, cost, and mortality.

Methods

This retrospective study involved a total of 94 cases of parvovirus treated in a shelter setting. Diagnosis of parvovirus was based on one positive IDEXX enzyme-linked immunosorbent assay (ELISA) SNAP test elected due to clinical presentation of the patient. Out of the 94 cases, 51 dogs received CPMA intravenously as part of their treatment plan and 43 cases did not. All CPMA treated dogs received a dose of CPMA within 48 hours of diagnosis. All dogs in both groups were treated with fluid therapy (either subcutaneous or intravenous fluids), at least one antibiotic, and at least one antiemetic. The length of treatment was then determined by the number of days from date of diagnosis to date of clinical resolution. The median length of treatment and mortality was then determined. Cost of treatment was determined by calculating the cost of individual treatments using the median weight of all 94 dogs.

Results

A total of 43 cases were reviewed for the non CPMA treated group and a total of 51 cases were reviewed for the CPMA treated group. The majority of dogs in both the non CPMA and CPMA treated groups were less than 5 months of age, had a clinical score of 3, and were either unvaccinated or had an unknown vaccine history. While the majority of dogs in the CPMA treated group were still less than 5 months old, there was a spike in dogs greater than 5 months due to a large group of dogs being surrendered to the shelter from one source. The median length of treatment for the CPMA treated group was significantly shorter than for the non CPMA treated group with a p value <0.001. The median length of treatment for dogs treated with CPMA was 3 days and the median length of treatment for dogs not treated with CPMA was 6.5 days. The overall cost of treatment for dogs treated with CPMA was significantly lower than the cost of treatment for dogs not treated with CPMA with a p value <0.001. The average cost of treatment for the dogs treated with CPMA was $962 and for the dogs not treated with CPMA was $1447. The overall mortality rate of dogs treated with CPMA was lower than dogs not treated with CPMA, but ultimately found not to be significant. The CPMA treated group mortality rate was 6% with 48 dogs who survived, 1 dog with an unassisted death, and 2 dogs who were euthanized. The non CPMA treated group mortality rate was 12% with  38 dogs who survived treatment and 5 dogs who were euthanized. All dogs who survived treatment either went on to be adopted or were redeemed to their previous owners. 

Conclusion

The addition of CPMA to established treatment plans within an individual shelter led to a decreased length of treatment and overall treatment cost, thus indicating that using a costly treatment such as CPMA is justified when considering length and financial cost of treatment. While fewer dogs died with the addition of CPMA, it did not appear to have a significant effect on mortality when added to established treatment plans. Overall, it appears that the use of CPMA in addition to other treatments within a shelter setting is significant on length of treatment and cost of treatment, but not significant on mortality.