Clinical Factors, Service Type, and Clinical Outcomes associated with Canine Parvovirus in Dogs presented at the KNUST Veterinary Teaching Hospital in Kumasi, Ghana

Clinical Factors, Service Type, and Clinical Outcomes associated with Canine Parvovirus in Dogs presented at the KNUST Veterinary Teaching Hospital in Kumasi, Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical Factors, Service Type, and Clinical Outcomes associated with Canine Parvovirus in Dogs presented at the KNUST Veterinary Teaching Hospital in Kumasi, Ghana Jemima Dzigbordi Agbota, Raphael Deladem Folitse, Emmanuel Darko Opoku, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8561957/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Canine parvovirus (CPV) continues to be a predominant cause of morbidity and mortality among dogs, particularly affecting puppies and dogs with incomplete vaccination status or those that are unvaccinated. In Ghana, there is a paucity of evidence concerning the clinical predictors, service type, and clinical outcomes in dogs afflicted by CPV. This cross-sectional study was undertaken at the KNUST Veterinary Teaching Hospital, Kumasi, Ghana, to assess the clinical factors associated with CPV diagnosis, types of service delivery and clinical outcomes in dogs presented to the facility. Diagnosis was based on compatible clinical signs and positive results from a Vcheck CPV antigen test kit (Bionote Inc., Korea) and V200 analyser (Bionote Inc., Korea). Demographics, clinical signs, service type (inpatient or outpatient) and outcome data were recorded via a standardised data collection form. Odds ratios were reported with 95% confidence intervals, and a significance threshold of p < 0.05 was applied for all regression and chi-square analyses. Results A total of 129 CPV-positive dogs were diagnosed, with an overall mortality rate of 26.4% (34/129). Haemorrhagic diarrhoea (OR = 2.60), vomiting (OR = 2.67), lower body weight (OR = 0.95 per kg), the presence of diarrhoea (OR = 2.26), and complete loss of appetite (OR = 2.51) were strong independent clinical predictors of positive canine parvovirus cases. CPV-positive dogs were significantly more likely to receive inpatient care than CPV-negative dogs (OR = 7.57, p < 0.001). Among CPV-positive dogs that received treatment, 32/123 (26.0%) CPV-positive dogs died, whereas 7/82 (8.5%) CPV-negative dogs died. Conclusions This study highlights the significant impact of CPV on dog morbidity and mortality in Ghana. Classic gastrointestinal signs remain reliable predictors of CPV in practice. The strong association between CPV positivity and the need for inpatient treatment underscores the severity of the infection. These results emphasise the need for improved vaccination strategies, prompt diagnosis, and clinical management practices to reduce CPV-related mortality in affected populations. canine parvovirus dogs gastroenteritis clinical outcome KNUST Veterinary Teaching Hospital Ghana Background In veterinary practice, dogs are not only patients but also integral to the emotional and social fabric of their owners’ lives, creating a unique veterinarian–client–patient bond that influences daily clinical interactions (Behera et al., 2015 ; González-Ramírez, 2019 ). The survival or loss of a canine patient often results in deep emotional weight for both families and clinicians, and infectious diseases that cause sudden, severe illness can strain this interconnected bond (Shima et al., 2014 ; Nortey Botchway et al., 2022 ; Okwee-Acai et al., 2024 ). Among these diseases, canine parvoviral enteritis (CPE) stands out as a particularly devastating threat. Its rapid progression, high mortality in untreated cases, and frequent presentation in young or cherished dogs make it one of the most distressing conditions for veterinarians to manage (Perley et al., 2020 ; Ogbu et al., 2021 ; Larson et al., 2024 ). Canine parvovirus type 2 (CPV-2), a member of the family Parvoviridae and genus Protoparvovirus , is a highly contagious virus that causes CPE in dogs (Cotmore et al., 2019 ). Its small, nonenveloped DNA structure confers exceptional environmental stability, rendering it resistant to many disinfectants and facilitating persistent transmission in canine populations (Umar et al., 2015 ; Tuteja et al., 2022 ). Clinically, CPE infection manifests predominantly as an enteric syndrome characterised by vomiting, diarrhoea (mucoid to profuse haemorrhagic), anorexia, fever, abdominal pain, depression and, in severe cases, dehydration, electrolyte disturbances, sepsis, and endotoxemia (Barr, 2020 ). In young puppies, especially those under three months of age, a less common but often fatal cardiac form may occur, causing sudden death or long-term pathological sequelae (Nandi et al., 2013 ; Ford et al., 2017 ). The disease course is further influenced by host-related factors, including age, breed predisposition, seasonality, and settlement type (Kalli et al., 2010 ; Miranda et al., 2015 ; Zourkas et al., 2015 ). Mortality rates can reach as high as 91% in puppies affected without treatment (Prittie, 2004 ), although outcomes improve significantly with timely intervention. Aggressive supportive care is typically used to manage infection, with reported mortality rates ranging from 4% to 53% (Sarpong et al., 2017 ). Tertiary care hospitals have reported better survival rates for canine parvovirus (CPV) patients (Prittie, 2004 ; Kalli et al., 2010 ). However, the current gold standard treatment for CPV, which involves aggressive supportive therapy and hospitalisation, can be quite expensive, with costs ranging from $ 3000 to $ 5000 in high-income regions (Perley et al., 2020 ). Compared with inpatient care, outpatient therapy, which is associated with increased mortality, can incur expenses ranging from approximately $ 300 to $ 400 for diagnosis and treatment (Sarpong et al., 2017 ). These costs can be a significant financial burden for pet owners, with some even opting for euthanasia for their affected pets at times, highlighting the need to control the spread of the disease (Markovich et al., 2012 ; Kelman et al., 2019 ). Recently, monoclonal antibody therapy has shown significant promise in improving survival in CPV-infected dogs (Larson et al., 2024 ); however, this therapeutic option remains unavailable or unaffordable in many countries. This study was therefore conducted to determine the clinical factors, service type (inpatient/outpatient), and clinical outcomes associated with canine parvovirus infection in dogs that presented at the KNUST Veterinary Teaching Hospital in Kumasi, Ghana. Methods Study Area This study was conducted at the Kwame Nkrumah University of Science and Technology (KNUST) Veterinary Teaching Hospital (VTH) in Kumasi, Ghana, from August 2023 to August 2024. The hospital functions as both a referral facility and primary care facility for small animals, serving Kumasi and surrounding municipalities. Study Design This cross-sectional study formed part of a broader prospective cohort study on CPV in dogs presented at the VTH, for which the prevalence and vaccination-related findings have been reported (Agbota et al ., 2025). This study focused on the clinical factors, service type, and clinical outcomes of CPV patients diagnosed during the study period. Study Population and Case Confirmation All dogs that presented at the KNUST VTH during this period with clinical signs suggesting CPV infection were considered eligible for testing. A total of 211 dogs met these inclusion criteria during the study period. The diagnosis was confirmed via a Vcheck CPV antigen test kit (Bionote Inc., Korea) in conjunction with a V200 analyser (Bionote Inc., Korea), following the manufacturer’s instructions and protocols described by Agbota et al . (2025). Data collection For each enrolled dog, demographic and clinical information was recorded at presentation via a standardised data collection form, and outcome information was later added following treatment or follow-up. The data included age, sex, breed, clinical signs, type of service received (inpatient or outpatient), and clinical outcome (recovered, died, no treatment, or lost to follow-up). Inpatient and outpatient care definitions : In this study, inpatient care referred to cases where dogs were admitted and remained in the hospital for continuous observation and treatment, typically receiving at least two treatment sessions per day. Unlike short-stay observation patients, these patients were not discharged after 12 hours but remained hospitalised until they were clinically stable at discharge. Outpatient care referred to dogs that received a single in-clinic treatment session per day at the facility and were discharged home after each visit, with follow-up care such as oral antibiotics or rehydration solutions administered by the owner under veterinary guidance. These dogs were returned on consecutive days for additional treatment sessions as required until recovery. The decision between inpatient and outpatient management was made jointly by the attending clinician and the owner on the basis of disease severity, owner preference, logistical factors, and financial considerations. Treatment Protocol: The treatment regimen was broadly standardised but adapted to individual case severity. Supportive care primarily consisted of fluid therapy, using intravenous Ringer’s lactate, dextrose saline (DNS), 0.9% normal saline, dextrose fluids (5% or 10%) or combinations thereof, adjusted according to hydration status and electrolyte requirements. The antibiotics used in treated cases or commonly prescribed during the study period included amoxicillin–clavulanic acid or penicillin–streptomycin, which are typically administered in combination with metronidazole, with ceftriaxone, ceftiofur or gentamicin reserved for selected cases. Antiemetic support was mainly provided with metoclopramide, whereas ondansetron was used when indicated. Adjunct therapies included antispasmodics (hyoscine butylbromide), gastric protectants (omeprazole), injectable high-potency vitamins (B-complex and multivitamins), oral rehydration solutions, and nutritional supplementation. Treatment intensity and frequency were greater in inpatients, who typically received multiple daily interventions, than in outpatients, who received single-session therapy with home care instructions. Outcome assessment : Clinical outcomes were classified at discharge. Recovery was defined as the resolution of primary clinical signs, cessation of vomiting and diarrhoea, return of appetite, and rehydration. Death was recorded if the dog died during hospitalisation or if the owner reported death at home during the course of illness. Dogs that died before treatment initiation, were lost to follow-up, or received no treatment were also categorised. Statistical analysis The data were entered into Microsoft Excel and analysed via IBM SPSS version 29.0. Descriptive and inferential statistics were used to summarise demographic and clinical signs, service type, and outcome variables into graphs and tables. Inferential statistics: Logistic regression analysis was conducted in two stages. First, univariable analysis was performed to screen for potential clinical predictors of CPV positivity and service type predisposition. For potential clinical predictors of CPV positivity, variables with a p-value less than 0.20 in the univariable analysis were retained for multivariable modelling to avoid premature exclusion of variables that may become important in the presence of other predictors or act as confounders (Hosmer et al ., 2013). The final multivariable model was selected using backwards stepwise elimination, and its fit was assessed using the Hosmer–Lemeshow goodness-of-fit test and Nagelkerke R². In addition, two alternative models were compared, one including “smell of faeces” and the other including “diarrhoea status”. The latter was retained due to its stronger clinical relevance for CPV, significant association, and slightly better Hosmer–Lemeshow performance, although the predictive potential of the former was noted. Additionally, a chi-square analysis was performed to assess the associations between predisposing factors and services provided to positive CPV patients. A p-value of less than 0.05 was considered statistically significant for all inferential analyses. Results Clinical factors associated with canine parvovirus infection Univariable logistic regression analysis revealed that appetite status, vomiting, the nature of faeces, the smell of faeces, diarrhoea status, diarrhoea type, and body weight were significantly associated with increased odds of CPV diagnosis (p<0.05). The body temperature of CPV-positive dogs ranged from 36.7°C to 41.2°C (mean = 38.9°C), while their body weight ranged from 0.8 kg to 37.0 kg (mean = 8.2 kg). Lethargy and body temperature were not significantly associated with CPV diagnosis in this population (Table 1). Table 1: Clinical signs and measurements associated with CPV diagnosis in dogs that presented to the facility (n=211). Variable CPV+ CPV- Total p-value Odds ratio 95%CI Lethargy No a 17 16 33 Yes 112 66 178 0.220 1.60 0.76-3.37 Appetite status Normal a 4 9 13 <0.001 Ref Completely Off-feed 86 26 112 0.002 7.44 2.12–26.15 Reduced appetite 39 47 86 0.330 1.87 0.53–6.53 Vomiting status No a 25 37 62 Yes 104 45 149 <0.001 3.42 1.85-6.34 Consistency of faeces Solid a 15 30 45 <0.001 Ref Watery 94 31 125 <0.001 6.07 2.89-12.72 Semi-solid 20 21 41 0.150 1.91 0.80-4.55 Smell of faeces Normal a 31 51 82 Foul smell 98 31 129 <0.001 5.20 2.85-9.50 Diarrhoea status No a 30 48 78 Yes 99 34 133 <0.001 4.66 2.56-8.49 Diarrhoea type Non-Haemorrhagic a 72 70 142 Haemorrhagic 57 12 69 <0.001 4.62 2.28-9.34 Weight in kg N 129 82 0.030 0.96 0.92-1.00 Minimum 0.8 1.1 Maximum 37.0 35.5 Mean 8.2 10.5 Body Temperature N 129 82 0.650 0.92 0.65-1.30 Minimum 36.7 36.9 Maximum 41.2 41.5 Mean 38.9 39.0 CI = confidence interval; REF/a=reference variable In the multivariable model, haemorrhagic diarrhoea, vomiting, lower body weight, the presence of diarrhoea, and complete loss of appetite were independently associated with increased odds of CPV diagnosis. Dogs with haemorrhagic diarrhoea had 2.60 times higher odds of CPV diagnosis than those with non-haemorrhagic diarrhoea (p = 0.03). Vomiting was associated with 2.67-fold higher odds (p = 0.01), whereas each kilogram increase in body weight was associated with a 5% reduction in the odds of CPV diagnosis (OR = 0.95; p = 0.02). Dogs with diarrhoea had over twice the odds of CPV compared to those without diarrhoea (p = 0.03). The appetite status was also significant (p = 0.003), with dogs that were completely off-feed having 2.51 times higher odds of CPV compared to those with normal appetite (p = 0.04), whereas a reduced appetite did not reach statistical significance (OR = 1.46; p = 0.59). The final model demonstrated acceptable fit (Hosmer–Lemeshow p = 0.49) and explained 33.6% of the variation in CPV diagnosis (Nagelkerke R² = 0.336) (Table 2). Table 2: Multivariable logistic regression analysis of clinical signs and measurements associated with canine parvovirus diagnosis in dogs (n=211) Variables in the Equation p-value Odds Ratio 95% CI Diarrhoea Type a 0.03 2.60 1.10 – 6.12 Vomiting a 0.01 2.67 1.32 – 5.40 Weight (kg) 0.02 0.95 0.91 – 0.99 Diarrhoea Status a 0.03 2.26 1.08 – 4.72 Appetite Status Normal a Reduced Appetite Completely Off Feed 0.003 0.59 0.04 REF 1.46 2.51 0.38 – 5.61 1.08 – 16.49 Model fit: Nagelkerke R 2 =0.336; Hosmer–Lemeshow p value = 0.49 ᵃ Reference categories: non-haemorrhagic diarrhoea (for diarrhoea type), no vomiting (for vomiting), no diarrhoea (for diarrhoea status), and normal appetite (for appetite status). Reference categories were retained from the univariable regression for the multivariable regression analysis. Association between the Type of Service Rendered to Positive CPV cases by Breed As shown in Table 3, 13 different breeds were diagnosed with canine parvovirus and received treatment. Inpatient care predominated across nearly all breeds, constituting 76.6% (95/124) of CPV-positive cases. Outpatient management was less frequent (23.4%, 28/124), and for some breeds, including Bullmastiff, Caucasian Shepherd, Maltese, Shih Tzu, Alsatian Shepherd, and American Bully, all cases were managed as inpatients. The proportion of outpatient care was highest in local breeds (32.4%) and crossbreeds (33.3%). However, there was no statistically significant difference among breeds regarding the type of service they received. A single outpatient (local dog) with an incomplete treatment regimen was retained in this analysis as the service was rendered; however, dogs that received no treatment or were deceased before treatment were excluded from the comparison. Table 3: Association between breed and type of service rendered for canine parvovirus-positive cases (n=206; excluding dogs that received no treatment and death before treatment ) Service Rendered Predisposing factor Inpatient (%) Outpatient (%) p-value Breed Local Breed 22 12 0.209 Boerboel 7 4 Bullmastiff 11 0 German Shepherd 13 2 Caucasian Shepherd 8 0 Crossbreed 16 8 Poodle 5 1 Rottweiller 7 1 Maltese 2 0 Shitzu 1 0 Alsatian Shepherd 1 0 American Bully 1 0 Belgium Malinois 1 1 Total 95 29 Association between Type of Service Rendered to Positive CPV Cases by Sex and Age Group Overall, inpatient management was more common than outpatient care across sex and age categories. Although a higher proportion of female dogs (84.3%) received inpatient care compared to males, this difference was not significant (p=0.064). Similarly, age group was not significantly associated with the type of service rendered (p=0.287). Most affected dogs were younger than 24 weeks of age, with 78.8% of those aged ≤12 weeks and 77.8% of those aged 13-24 weeks receiving inpatient care (Table 4). Table 4: Association between sex, age group, and type of service rendered in canine parvovirus-positive cases (n=124; excluding dogs that received no treatment and death before treatment ) Service Rendered Predisposing factor Inpatient (%) Outpatient (%) p-value Sex Female 43 (84.3%) 8 (15.7%) 0.064 Male 51 (69.9%) 22 (30.1%) Age Group Less than or equal to 12 weeks 41 (78.8%) 11 (21.7%) 0.287 13 to 24 weeks 42 (77.8%) 12 (22.2%) More than 24 weeks 11 (61.1%) 7 (38.9%) Risk analysis on the basis of CPV diagnosis and service rendered Compared with CPV-negative dogs, CPV-positive dogs were 7.57 times more likely to be managed as inpatients (p < 0.001), and this association was statistically significant. (Table 5). Table 5: Univariate logistic regression analysis of services rendered in relation to canine parvovirus diagnosis (n=206; excluding dogs that received no treatment and death before treatment ) Variable Positive Negative Total Prevalence% p-value Odds ratio Lower 95%CI Upper 95%CI Service Rendered (Inpatient/Outpatient) Outpatient a 30 58 88 34.1% <0.001 7.57 4.04 14.20 Inpatient 94 24 118 79.7% Total 124 82 206 CI = confidence interval; a = reference variable Overall treatment outcome by CPV status Among the 211 dogs tested for canine parvovirus, 129 (61.14%) were positive, and 82 (38.86%) were negative. Across the entire cohort, most dogs received treatment and recovered (n = 166, 78.67%). Among the dogs that tested positive for CPV and received treatment (n = 129), 91 (73.98%) recovered, whereas 32 (26.02%) did not survive. In contrast, recovery rates were higher among CPV-negative dogs, with 75 out of 82 (91.46%) surviving and 7 (8.54%) not surviving despite treatment. Two dogs died before treatment could be administered at the facility, three did not receive any treatment at the facility, and one dog was lost to follow-up, leading to an incomplete treatment regimen, all of which were positive canine parvovirus cases ( Table 6 ). Table 6: Distribution of canine parvovirus diagnoses by treatment type and clinical outcome (n=211) Treatment Outcome CPV+ CPV- Total Treated and Recovered 91 (54.81%) 75 (45.18%) 166 (78.67%) Treated and Deceased 32 (82.05%) 7 (17.95%) 39 (18.48%) Incomplete Treatment Regimen 1 (100%) 0 (0%) 1 (0.47%) Deceased Before Treatment 2 (100%) 0 (0%) 2 (0.95%) No Treatment 3 (100%) 0 (0%) 3 (1.42%) Total 129 (61.14%) 82 (38.86%) 211 (100%) Discussion Canine parvovirus remains a significant clinical challenge in small animal practice worldwide (Adeyemo et al., 2024 ; Jyothi et al., 2024 ; Larson et al., 2024 ). This study contributes valuable insights by identifying key clinical predictors of CPV diagnosis, service-rendered dynamics, and outcomes in affected dogs. Classic signs such as vomiting, haemorrhagic diarrhoea, complete anorexia, and diarrhoea of any form were strongly associated with CPV positivity, which is consistent with the established enteric syndrome of the virus (Kalli et al., 2010 ; Mylonakis et al., 2016 ; Folitse et al., 2018 ; Mazzaferro, 2020 ). Vomiting showed the strongest independent association with canine parvovirus diagnosis (OR = 2.67, p = 0.01) among the predictors retained in the multivariable model, closely followed by haemorrhagic diarrhoea (OR = 2.60, p = 0.03) and complete loss of appetite (OR = 2.51, p = 0.04). These findings potentially highlight the diagnostic importance of these clinical signs in routine case assessment, particularly among unvaccinated or high-risk dogs. Early recognition of such signs can facilitate prompt supportive management, enhance prognostic evaluation, and guide timely isolation measures to limit disease transmission within hospital and community settings. Conversely, a substantial proportion of confirmed cases did not exhibit these hallmark signs at presentation: 55.8% lacked haemorrhagic diarrhoea, 19.4% showed no vomiting, 33.3% were not completely off-feed, and 23.3% had no diarrhoea. These findings, which are consistent with reports in other areas, highlight that the absence of individual signs does not exclude CPV, necessitating a thorough assessment of suspected cases (Kalli et al., 2010 ; Mylonakis et al., 2016 ; Chalifoux et al., 2021 ). Similar patterns were observed in Ghana by Folitse et al. ( 2018 ) and in Egypt by Sayed-Ahmed et al. ( 2020 ), where a significant proportion of dogs with non-bloody diarrhoea tested positive. Clinicians should therefore consider CPE as a strong differential in young dogs presenting with diarrhoea, as the haemorrhagic nature typically emerges with disease progression and severity, while earlier stages may involve non-bloody diarrhoea of variable colour and consistency (Nandi et al., 2019 ; Barr, 2020 ). Body weight also emerged as a significant predictor, reflecting the heightened susceptibility of puppies and young dogs, which generally weigh less than adults do (Miranda et al., 2015 ). Although the final multivariable model excluded foul-smelling diarrhoea, this sign remains clinically relevant, having been observed in a substantial number of cases and reflecting the severe mucosal damage characteristic of CPV enteritis (Nandi & Kumar, 2010 ). The temperature at presentation varied widely, ranging from marked hyperthermia (41.2°C) to hypothermia (36.7°C), with a mean of 38.9°C. While fever is often associated with acute CPV, temperature was not statistically significant in this study, likely reflecting the heterogeneous stages of disease at presentation. Early hyperthermia may transition to hypothermia as vomiting and diarrhoea progress, driven by dehydration and circulatory compromise (Nandi et al., 2019 ). Similar to our findings, Godsall et al. ( 2010 ) and Miranda et al. ( 2015 ) reported that most CPV cases as normothermic at presentation, corroborating the limited predictive value of body temperature. Collectively, these findings emphasise the heterogeneity of CPV clinical presentation, which may vary with disease stage, viral strain, vaccination status, age, and breed predisposition (Decaro et al., 2009 ; Miranda & Thompson, 2016 ; Alves et al., 2020 ; Larson et al., 2024 ). Nevertheless, the high odds ratios for these signs in the cases assessed suggest that even in CPV cases with variable presentation patterns, these symptoms remain clinically useful for guiding presumptive diagnosis while awaiting confirmatory antigen testing. Further reflecting the severity of CPV presentations, our analysis revealed that CPV-positive dogs were almost eight times more likely to require hospitalisation than were CPV-negative dogs, highlighting the condition’s intensity and greater need for inpatient care (Kalli et al., 2010 ; Perley et al., 2020 ; Chalifoux et al., 2021 ). The breed distribution among the inpatient and outpatient groups varied; local breeds and crossbreeds accounted for more than 60% of the outpatient cases, whereas other pure breeds, such as Rottweilers, Bullmastiffs, German Shepherds, and Caucasian Shepherds, were mostly treated as inpatients. Additionally, females and dogs under 24 weeks of age received the most inpatient care. The fact that most dogs under 24 weeks of age require inpatient care may be due to the severe nature of the infection in this particular age group (Prittie, 2004 ). This pattern of service type among various predisposing factors may influence treatment pathways, as some of these pure breeds or age groups may have more severe symptomatic case presentation and progression (Mylonakis et al., 2016 ; Nandi et al., 2019 ; Alves et al., 2020 ; Okwee-Acai et al., 2024 ). The overall mortality rate among CPV-positive dogs in this study was 26.4%, including the two dogs that died before treatment, underscoring the substantial risk CPV poses to the canine population in clinical settings. Without treatment, mortality can reach as high as 91% in puppies, highlighting the lifesaving importance of early recognition and timely intervention (Nandi & Kumar, 2010 ). The rate reported in this study is lower than that reported in Nigeria (72% by Ukwueze et al. ( 2018 ) and 80.6% by Ogbu et al. ( 2021 )) and Cameroon, where Mebanga et al. ( 2024 ) reported 58.9%, but it is comparable to that reported by Godsall et al. ( 2010 ) in the United Kingdom (30.2%). In contrast, it is higher than that reported by Chalifoux et al. ( 2021 ) in the United States (9%) and Miranda et al . (2016) in Portugal (16.3%). These differences may be due to variations in disease severity at presentation, tertiary-level care, diagnostic and therapeutic capacities, demographic characteristics, vaccination, and the prevalence of regional comorbid conditions (Prittie, 2004 ; Duijvestijn et al., 2016 ; Zhao et al., 2016 ; Alves et al., 2020 ; Perley et al., 2020 ). Notably, all three dogs that received no treatment were CPV positive, and one was subsequently lost to follow-up, leading to an incomplete treatment regimen, likely reflecting the financial or logistical constraints this disease imposes on dog owners (Kelman et al., 2019 ; 2020 ). This finding emphasises how such barriers can critically affect outcomes and points to the broader socioeconomic consequences of CPV (Sarpong et al., 2017 ). For CPV-negative patients, the mortality rate was relatively low, at approximately 8.5%, demonstrating the considerably greater risk associated with CPV than with the other conditions examined, which is consistent with other studies (Okwee-Acai et al., 2024 ; Godsall et al., 2010 ). Limitations Limitations should be considered when interpreting the findings of this study. Firstly, the aggregate CPV-negative cases for which CPV-positive cases were compared could have been due to several possible causes, which limited the comparison. Additionally, recall bias could have affected the accuracy of some clinical data, as information on clinical signs at presentation partly relied on owner recall. Although multivariable analyses adjusted for various confounders, residual bias may still exist, including clinician-driven treatment decisions or financial limitations of dog owners. Inpatient management at the study facility was based on 12-hour hospitalisation without continuous 24-hour care, which may partly explain outcome differences compared to hospitals in high-income countries. Survival time analyses and related factors were beyond the scope of this current study and will be addressed in subsequent work. Lastly, the allocation of inpatient versus outpatient care was not performed within a randomised controlled setting, complicating direct causal comparisons between service types. Conclusion The findings of this study reaffirm that canine parvovirus is a preventable yet persistent threat to unvaccinated or incompletely vaccinated puppies. Classic signs, including haemorrhagic diarrhoea, vomiting, diarrhoea presence, complete anorexia and lower body weight, were independently predictive of positive CPV cases. Compared with CPV-negative dogs, CPV-positive dogs were markedly more likely to require hospitalisation and had higher mortality. Strengthening vaccination coverage, client education, and access to supportive care are crucial to reducing CPV-related deaths and improving canine health outcomes in Ghana. Abbreviations CPV – Canine Parvovirus CPV-2 – Canine Parvovirus type 2 CPE – Canine Parvoviral Enteritis KNUST – Kwame Nkrumah University of Science and Technology VTH – Veterinary Teaching Hospital KNUST-VTH – Kwame Nkrumah University of Science and Technology Veterinary Teaching Hospital OR – Odds Ratio CI – Confidence Interval DNS – Dextrose Normal Saline SPSS – Statistical Package for the Social Sciences IBM SPSS – International Business Machines Statistical Package for the Social Sciences Declarations Ethical approval and consent to participate: This study was a hospital-based observational study conducted using data obtained from routine clinical management of dogs presented to the KNUST Veterinary Teaching Hospital, Kumasi, Ghana. No experimental procedures or interventions were performed for the purpose of this research. Ethical permission to access and use clinical records for research purposes was granted by the management of the KNUST Veterinary Teaching Hospital. Informed consent for examination, diagnostic testing, and treatment was obtained from dog owners as part of routine clinical practice. All procedures were conducted in accordance with institutional guidelines and accepted standards of veterinary clinical care. Consent for publication Not applicable. No identifiable individual animal or owner data are included in this manuscript. Availability of data and materials The datasets generated and/or analysed during the study are not publicly available due to institutional and confidentiality restrictions but are available from the corresponding author on reasonable request. Competing Interests: The authors declare that they have no competing interests. Funding: This study received no external funding Author contributions: Jemima Dzigbordi Agbota and Raphael Deladem Folitse conceptualised the study, developed the study design and methodology, collected data, performed data analysis, and drafted the initial manuscript. Emmanuel Darko Opoku contributed to data analysis, interpretation of findings, and revision of the manuscript. William Tasiame, Dorcas Oyueley Kodie, and Benjamin Obukowho Emikpe contributed to data interpretation and critically reviewed and edited the manuscript. All authors read and approved the final version of the manuscript. Acknowledgements: The authors gratefully acknowledge the clinical and laboratory staff of the KNUST Veterinary Teaching Hospital for their assistance during the study period. References Adeyemo, A. A., Aiki-Raji, C. O., Akinniyi, O. O., & Fagbohun, O. A. (2024). Molecular Epidemiology of Canine Parvovirus in Nigeria. Afr. J. Biomed. Res , 27 , 217–224. https://doi.org/10.4314/ajbr.v27i2.5 Agbota, J. D., Folitse, R. D., Darko, E. O., Kodie, D. O., Tasiame, W., & Emikpe, B. O. (2025). Prevalence of canine parvovirus, vaccine-related, and other factors associated with the infection in dogs presented at the veterinary teaching hospital in Kumasi, Ghana. 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Animals , 9 (9), 674. https://doi.org/10.3390/ani9090674 Hosmer, D. W. Jr., Lemeshow, S., & Sturdivant, R. X. (2013). Model-Building Strategies and Methods for Logistic Regression. In D. W. Jr. Hosmer, S. Lemeshow, & R. X. Sturdivant (Eds.), Applied Logistic Regression (pp. 89–151). https://doi.org/https://doi.org/10.1002/9781118548387.ch4 Jyothi, P. V., Bhaskaran, M. S., & Gundi, V. A. K. B. (2024). Epidemiology, molecular prevalence and prevention on canine parvovirus in India: A review. Bioinformation , 20 (5), 536–546. https://doi.org/10.6026/973206300200536 Kalli, I., Leontides, L. S., Mylonakis, M. E., Adamama-Moraitou, K., Rallis, T., & Koutinas, A. F. (2010). Factors affecting the occurrence, duration of hospitalisation and final outcome in canine parvovirus infection. Research in Veterinary Science , 89 (2), 174–178. https://doi.org/10.1016/j.rvsc.2010.02.013 Kelman, M., Barrs, V. R., Norris, J. M., & Ward, M. P. (2020). Canine parvovirus prevention—What influence do socioeconomics, remoteness, caseload and demographics have on veterinarians’ perceptions and behaviors? Preventive Veterinary Medicine , 181 , 105065. https://doi.org/10.1016/j.prevetmed.2020.105065 Kelman, M., Ward, M. P., Barrs, V. R., & Norris, J. M. (2019). The geographic distribution and financial impact of canine parvovirus in Australia. Transboundary and Emerging Diseases , 66 (1), 299–311. https://doi.org/10.1111/tbed.13022 Larson, L., Miller, L., Margiasso, M., Piontkowski, M., Tremblay, D., Dykstra, S., Miller, J., Slagter, B. J., Champ, D., Keil, D., Patel, M., & Wasmoen, T. (2024). Early administration of canine parvovirus monoclonal antibody prevented mortality after experimental challenge. Journal of the American Veterinary Medical Association , 262 (4), 506–512. https://doi.org/10.2460/javma.23.09.0541 Markovich, J. E., Stucker, K. M., Carr, A. H., Harbison, C. E., Scarlett, J. M., & Parrish, C. R. (2012). Effects of canine parvovirus strain variations on diagnostic test results and clinical management of enteritis in dogs. Journal of the American Veterinary Medical Association , 241 (1), 66–72. https://doi.org/10.2460/javma.241.1.66 Mazzaferro, E. M. (2020). Update on Canine Parvoviral Enteritis. In Veterinary Clinics of North America - Small Animal Practice (Vol. 50, Issue 6, pp. 1307–1325). W.B. Saunders. https://doi.org/10.1016/j.cvsm.2020.07.008 Mebanga, A. S., Ebede, F. G. E., Moussa, M., & Kouamo, J. (2024). Prevalence and risk factors of canine parvovirus infection in the city of Yaoundé, Cameroon. International Journal of Biological and Chemical Sciences , 17 (6), 2347–2358. https://doi.org/10.4314/ijbcs.v17i6.17 Miranda, C., Carvalheira, J., Parrish, C. R., & Thompson, G. (2015). Factors affecting the occurrence of canine parvovirus in dogs. Veterinary Microbiology , 180 (1–2), 59–64. https://doi.org/10.1016/j.vetmic.2015.08.002 Miranda, C., & Thompson, G. (2016). Canine parvovirus in vaccinated dogs: a field study. Veterinary Record , 178 (16), 397–397. https://doi.org/10.1136/vr.103508 Mylonakis, M., Kalli, I., & Rallis, T. (2016). Canine parvoviral enteritis: an update on the clinical diagnosis, treatment, and prevention. Veterinary Medicine: Research and Reports , Volume 7 , 91–100. https://doi.org/10.2147/vmrr.s80971 Nandi, S., & Kumar, M. (2010). Canine Parvovirus: Current Perspective. Indian Journal of Virology , 21 (1), 31–44. https://doi.org/10.1007/s13337-010-0007-y Nandi, S., Kumar, M., Mohapatra, T. K., & Ravishankar, C. (2013). Emergence of canine parvovirus - 2 variants and its impact on vaccination. World Applied Sciences Journal , 23 (10), 1366–1376. https://doi.org/10.5829/idosi.wasj.2013.23.10.1823 Nandi, S., Sharma, G. K., Gupta, V., & Gupta, V. (2019). Global Scenario of Canine Parvovirus Mutants: Epidemiology, Diagnostics and Immunoprophylactic Agents . https://www.researchgate.net/publication/372860405 Nortey Botchway, L. A., Asare, D. A., Emikpe, A. O., Omoniyi, M. M., Essel-Cobbinah, D., Adankwah, F., & Emikpe, B. O. (2022). Pet Bereavement Among Pet Owners in Ghana. Anthrozoös , 36 (3), 323–332. https://doi.org/10.1080/08927936.2022.2141505 Ogbu, K. I., Chukwudi, I. C., Mira, F., Eze, U. U., Di Bella, S., Olaolu, O. S., Tion, M. T., Purpari, G., Cannella, V., Nwosuh, I. C., Guercio, A., & Anene, B. M. (2021). Current status and risk factors of canine parvovirus type 2 in North Central Nigeria. Comparative Immunology, Microbiology and Infectious Diseases , 74 , 101578. https://doi.org/10.1016/j.cimid.2020.101578 Okwee-Acai, J., Agwai, B., Mawadri, P., Kesiime, C., Tubihemukama, M., Kungu, J., & Odur, B. (2024). Prevalence of common conditions and associated mortalities of dogs treated at the small animal clinic, Makerere University, Kampala, Uganda. BMC Veterinary Research , 20 (1), 590. https://doi.org/10.1186/s12917-024-04432-x Perley, K., Burns, C. C., Maguire, C., Shen, V., Joffe, E. R., Stefanovski, D., Redding, L., Germanis, L., Drobatz, K. J., & Watson, B. (2020). Retrospective evaluation of outpatient canine parvovirus treatment in a shelter-based low-cost urban clinic. Journal of Veterinary Emergency and Critical Care , 30 (2), 202–208. https://doi.org/10.1111/vec.12941 Prittie, J. (2004). Canine parvoviral enteritis: A review of diagnosis, management, and prevention. In Journal of Veterinary Emergency and Critical Care (Vol. 14, Issue 3, pp. 167–176). Blackwell Publishing Ltd. https://doi.org/10.1111/j.1534-6935.2004.04020.x Sarpong, K. J., Lukowski, J. M., & Knapp, C. G. (2017). Evaluation of mortality rate and predictors of outcome in dogs receiving outpatient treatment for parvoviral enteritis. Journal of the American Veterinary Medical Association , 251 (9), 1035–1041. https://doi.org/10.2460/javma.251.9.1035 Sayed-Ahmed, M. Z., Elbaz, E., Younis, E., & Khodier, M. (2020). Canine Parvovirus Infection in Dogs: Prevalence and Associated Risk Factors in Egypt. World’s Veterinary Journal , 571–577. https://doi.org/10.54203/scil.2020.wvj68 Shima, F., Mosugu, J., & Apaa, T. (2014). Causes of mortality in dogs in and around Effurun/Warri Municipality of Delta State, Nigeria. African Journals Online , 62 (4), 387–396. Tuteja, D., Banu, K., & Mondal, B. (2022). Canine parvovirology – A brief updated review on structural biology, occurrence, pathogenesis, clinical diagnosis, treatment and prevention. Comparative Immunology, Microbiology and Infectious Diseases , 82 , 101765. https://doi.org/10.1016/j.cimid.2022.101765 Ukwueze, C. S., Anene, B. M., Ezeokonkwo, R. C., & Nwosuh, C. I. (2018). Prevalence of canine parvovirus infection in South Eastern region, Nigeria. Bangl. J. Vet. Med , 16 (2), 153–161. https://doi.org/10.33109/bjvmjd1804 Umar, S., Ali, A., Younus, M., Maan, M. K., Ali, S., Khan, W. A., & Irfan, M. (2015). Prevalence of Canine Parvovirus Infection at Different Pet Clinics in Lahore, Pakistan. In Pakistan J. Zool, 47 (3), 657-663. Zhao, Z., Liu, H., Ding, K., Peng, C., Xue, Q., Yu, Z., & Xue, Y. (2016). Occurrence of canine parvovirus in dogs from Henan province of China in 2009–2014. BMC Veterinary Research , 12 (1), 138. https://doi.org/10.1186/s12917-016-0753-1 Zourkas, E., Ward, M. P., & Kelman, M. (2015). Canine parvovirus in Australia: A comparative study of reported rural and urban cases. Veterinary Microbiology , 181 (3–4), 198–203. https://doi.org/10.1016/j.vetmic.2015.10.009 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8561957","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":582304814,"identity":"afc10a53-d987-4bf9-a9f3-4e5edfedb94d","order_by":0,"name":"Jemima Dzigbordi Agbota","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Jemima","middleName":"Dzigbordi","lastName":"Agbota","suffix":""},{"id":582304818,"identity":"b0d88844-6266-4404-b18f-80228f9efc95","order_by":1,"name":"Raphael Deladem Folitse","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Raphael","middleName":"Deladem","lastName":"Folitse","suffix":""},{"id":582304819,"identity":"56e689c9-cfa2-452f-b749-eae37d6b1b3b","order_by":2,"name":"Emmanuel Darko Opoku","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA00lEQVRIiWNgGAWjYLACHgYGAwb2BiDLwIIULTwHQFokSNEikQBiEqGFX+x04oM3NfeM+SWfX93wo0CCgb+9OwGvFsnZuZsN5xwrNpOcnVN2swfoMIkzZzfg1WJwO3ebNA9bgo3B7Zy0GzxALQYSufi12IO1/ANquXkm7eYfYrQYSAO18LYlmBncYD92myhbJG4D/TK3L8FYsieH7baMgQQPQb/wz87d+ODNtwTDfvbjz26++WMjx9/ei18LEuAxAJPEKgcB9gekqB4Fo2AUjIIRBACwk0W2X6PabAAAAABJRU5ErkJggg==","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":true,"prefix":"","firstName":"Emmanuel","middleName":"Darko","lastName":"Opoku","suffix":""},{"id":582304820,"identity":"4011df96-a726-4af9-8a33-09dc94dbacea","order_by":3,"name":"Dorcas Oyueley Kodie","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Dorcas","middleName":"Oyueley","lastName":"Kodie","suffix":""},{"id":582304821,"identity":"7bfcbdc2-2584-4d18-84f3-9c0eaedec59e","order_by":4,"name":"William Tasiame","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"William","middleName":"","lastName":"Tasiame","suffix":""},{"id":582304822,"identity":"2f11fafd-937c-4bee-9270-6a9e9d450d5a","order_by":5,"name":"Benjamin Obukowho Emikpe","email":"","orcid":"","institution":"Kwame Nkrumah University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Benjamin","middleName":"Obukowho","lastName":"Emikpe","suffix":""}],"badges":[],"createdAt":"2026-01-09 14:24:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8561957/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8561957/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105566453,"identity":"fbeb4c9f-cd02-497c-87dc-b1824327a3d8","added_by":"auto","created_at":"2026-03-27 12:56:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1732555,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8561957/v1/5466fd31-d4bc-4a32-b901-0b3497e7608b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical Factors, Service Type, and Clinical Outcomes associated with Canine Parvovirus in Dogs presented at the KNUST Veterinary Teaching Hospital in Kumasi, Ghana","fulltext":[{"header":"Background","content":"\u003cp\u003eIn veterinary practice, dogs are not only patients but also integral to the emotional and social fabric of their owners\u0026rsquo; lives, creating a unique veterinarian\u0026ndash;client\u0026ndash;patient bond that influences daily clinical interactions (Behera et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Gonz\u0026aacute;lez-Ram\u0026iacute;rez, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). The survival or loss of a canine patient often results in deep emotional weight for both families and clinicians, and infectious diseases that cause sudden, severe illness can strain this interconnected bond (Shima et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Nortey Botchway et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Okwee-Acai et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Among these diseases, canine parvoviral enteritis (CPE) stands out as a particularly devastating threat. Its rapid progression, high mortality in untreated cases, and frequent presentation in young or cherished dogs make it one of the most distressing conditions for veterinarians to manage (Perley et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Ogbu et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Larson et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCanine parvovirus type 2 (CPV-2), a member of the family \u003cem\u003eParvoviridae\u003c/em\u003e and genus \u003cem\u003eProtoparvovirus\u003c/em\u003e, is a highly contagious virus that causes CPE in dogs (Cotmore et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Its small, nonenveloped DNA structure confers exceptional environmental stability, rendering it resistant to many disinfectants and facilitating persistent transmission in canine populations (Umar et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Tuteja et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Clinically, CPE infection manifests predominantly as an enteric syndrome characterised by vomiting, diarrhoea (mucoid to profuse haemorrhagic), anorexia, fever, abdominal pain, depression and, in severe cases, dehydration, electrolyte disturbances, sepsis, and endotoxemia (Barr, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In young puppies, especially those under three months of age, a less common but often fatal cardiac form may occur, causing sudden death or long-term pathological sequelae (Nandi et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Ford et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The disease course is further influenced by host-related factors, including age, breed predisposition, seasonality, and settlement type (Kalli et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Miranda et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Zourkas et al., \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Mortality rates can reach as high as 91% in puppies affected without treatment (Prittie, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2004\u003c/span\u003e), although outcomes improve significantly with timely intervention.\u003c/p\u003e \u003cp\u003eAggressive supportive care is typically used to manage infection, with reported mortality rates ranging from 4% to 53% (Sarpong et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Tertiary care hospitals have reported better survival rates for canine parvovirus (CPV) patients (Prittie, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Kalli et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). However, the current gold standard treatment for CPV, which involves aggressive supportive therapy and hospitalisation, can be quite expensive, with costs ranging from \u003cspan\u003e$\u003c/span\u003e3000 to \u003cspan\u003e$\u003c/span\u003e5000 in high-income regions (Perley et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Compared with inpatient care, outpatient therapy, which is associated with increased mortality, can incur expenses ranging from approximately \u003cspan\u003e$\u003c/span\u003e300 to \u003cspan\u003e$\u003c/span\u003e400 for diagnosis and treatment (Sarpong et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). These costs can be a significant financial burden for pet owners, with some even opting for euthanasia for their affected pets at times, highlighting the need to control the spread of the disease (Markovich et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Kelman et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Recently, monoclonal antibody therapy has shown significant promise in improving survival in CPV-infected dogs (Larson et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2024\u003c/span\u003e); however, this therapeutic option remains unavailable or unaffordable in many countries.\u003c/p\u003e \u003cp\u003eThis study was therefore conducted to determine the clinical factors, service type (inpatient/outpatient), and clinical outcomes associated with canine parvovirus infection in dogs that presented at the KNUST Veterinary Teaching Hospital in Kumasi, Ghana.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Area\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted at the Kwame Nkrumah University of Science and Technology (KNUST) Veterinary Teaching Hospital (VTH) in Kumasi, Ghana, from August 2023 to August 2024. The hospital functions as both a referral facility and primary care facility for small animals, serving Kumasi and surrounding municipalities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study formed part of a broader prospective cohort study on CPV in dogs presented at the VTH, for which the prevalence and vaccination-related findings have been reported (Agbota \u003cem\u003eet al\u003c/em\u003e., 2025). This study focused on the clinical factors, service type, and clinical outcomes of CPV patients diagnosed during the study period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Population and Case Confirmation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll dogs that presented at the KNUST VTH during this period with clinical signs suggesting CPV infection were considered eligible for testing. A total of 211 dogs met these inclusion criteria during the study period. The diagnosis was confirmed via a Vcheck CPV antigen test kit (Bionote Inc., Korea) in conjunction with a V200 analyser (Bionote Inc., Korea), following the manufacturer\u0026rsquo;s instructions and protocols described by Agbota \u003cem\u003eet al\u003c/em\u003e. (2025).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ecollection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor each enrolled dog, demographic and clinical information was recorded at presentation via a standardised data collection form, and outcome information was later added following treatment or follow-up. The data included age, sex, breed, clinical signs, type of service received (inpatient or outpatient), and clinical outcome (recovered, died, no treatment, or lost to follow-up).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInpatient and\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eoutpatient care definitions\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e In this study, inpatient care referred to cases where dogs were admitted and remained in the hospital for continuous observation and treatment, typically receiving at least two treatment sessions per day. Unlike short-stay observation patients, these patients were not discharged after 12 hours but remained hospitalised until they were clinically stable at discharge. Outpatient care referred to dogs that received a single in-clinic treatment session per day at the facility and were discharged home after each visit, with follow-up care such as oral antibiotics or rehydration solutions administered by the owner under veterinary guidance. These dogs were returned on consecutive days for additional treatment sessions as required until recovery. The decision between inpatient and outpatient management was made jointly by the attending clinician and the owner on the basis of disease severity, owner preference, logistical factors, and financial considerations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTreatment Protocol:\u003c/strong\u003e The treatment regimen was broadly standardised but adapted to individual case severity. Supportive care primarily consisted of fluid therapy, using intravenous Ringer\u0026rsquo;s lactate, dextrose saline (DNS), 0.9% normal saline, dextrose fluids (5% or 10%) or combinations thereof, adjusted according to hydration status and electrolyte requirements. The antibiotics used in treated cases or commonly prescribed during the study period included amoxicillin\u0026ndash;clavulanic acid or penicillin\u0026ndash;streptomycin, which are typically administered in combination with metronidazole, with ceftriaxone, ceftiofur or gentamicin reserved for selected cases. Antiemetic support was mainly provided with metoclopramide, whereas ondansetron was used when indicated. Adjunct therapies included antispasmodics (hyoscine butylbromide), gastric protectants (omeprazole), injectable high-potency vitamins (B-complex and multivitamins), oral rehydration solutions, and nutritional supplementation. Treatment intensity and frequency were greater in inpatients, who typically received multiple daily interventions, than in outpatients, who received single-session therapy with home care instructions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eassessment\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Clinical outcomes were classified at discharge. Recovery was defined as the resolution of primary clinical signs, cessation of vomiting and diarrhoea, return of appetite, and rehydration. Death was recorded if the dog died during hospitalisation or if the owner reported death at home during the course of illness. Dogs that died before treatment initiation, were lost to follow-up, or received no treatment were also categorised.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eanalysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were entered into Microsoft Excel and analysed via IBM SPSS version 29.0. Descriptive and inferential statistics were used to summarise demographic and clinical signs, service type, and outcome variables into graphs and tables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInferential statistics:\u003c/strong\u003e Logistic regression analysis was conducted in two stages. First, univariable analysis was performed to screen for potential clinical predictors of CPV positivity and service type predisposition. For potential clinical predictors of CPV positivity, variables with a p-value less than 0.20 in the univariable analysis were retained for multivariable modelling to avoid premature exclusion of variables that may become important in the presence of other predictors or act as confounders (Hosmer \u003cem\u003eet al\u003c/em\u003e., 2013). The final multivariable model was selected using backwards stepwise elimination, and its fit was assessed using the Hosmer\u0026ndash;Lemeshow goodness-of-fit test and Nagelkerke R\u0026sup2;. In addition, two alternative models were compared, one including \u0026ldquo;smell of faeces\u0026rdquo; and the other including \u0026ldquo;diarrhoea status\u0026rdquo;. The latter was retained due to its stronger clinical relevance for CPV, significant association, and slightly better Hosmer\u0026ndash;Lemeshow performance, although the predictive potential of the former was noted. Additionally, a chi-square analysis was performed to assess the associations between predisposing factors and services provided to positive CPV patients.\u003c/p\u003e\n\u003cp\u003eA p-value of less than 0.05 was considered statistically significant for all inferential analyses.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003efactors associated with canine parvovirus infection\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnivariable logistic regression analysis revealed that appetite status, vomiting, the nature of faeces, the smell of faeces, diarrhoea status, diarrhoea type, and body weight were significantly associated with increased odds of CPV diagnosis (p\u0026lt;0.05). The body temperature of CPV-positive dogs ranged from 36.7\u0026deg;C to 41.2\u0026deg;C (mean = 38.9\u0026deg;C), while their body weight ranged from 0.8 kg to 37.0 kg (mean = 8.2 kg). Lethargy and body temperature were not significantly associated with CPV diagnosis in this population (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Clinical signs and measurements associated with CPV diagnosis in dogs\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ethat\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003epresented to the facility (n=211).\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"683\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCPV+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCPV-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOdds ratio\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; 95%CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 45.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eLethargy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e1.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e0.76-3.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 45.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAppetite status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCompletely\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOff-feed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e7.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e2.12\u0026ndash;26.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReduced appetite\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e0.330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e0.53\u0026ndash;6.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 45.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eVomiting status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e3.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e1.85-6.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 45.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsistency of faeces\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSolid\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWatery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e6.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e2.89-12.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSemi-solid\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e0.80-4.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 45.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSmell of faeces\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFoul smell\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e5.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e2.85-9.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 45.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDiarrhoea status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e4.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e2.56-8.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"top\" style=\"width: 45.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eDiarrhoea type\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-Haemorrhagic\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHaemorrhagic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e4.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e2.28-9.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeight in kg\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e0.92-1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e37.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 10.3108%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody Temperature\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e0.650\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 4.0318%;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 6.2129%;\"\u003e\n \u003cp\u003e0.65-1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e36.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e36.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e41.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 7.2044%;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.7589%;\"\u003e\n \u003cp\u003e38.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.4945%;\"\u003e\n \u003cp\u003e39.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4.9571%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCI = confidence interval; REF/a=reference variable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the multivariable model, haemorrhagic diarrhoea, vomiting, lower body weight, the presence of diarrhoea, and complete loss of appetite were independently associated with increased odds of CPV diagnosis. Dogs with haemorrhagic diarrhoea had 2.60 times higher odds of CPV diagnosis than those with non-haemorrhagic diarrhoea (p = 0.03). Vomiting was associated with 2.67-fold higher odds (p = 0.01), whereas each kilogram increase in body weight was associated with a 5% reduction in the odds of CPV diagnosis (OR = 0.95; p = 0.02). Dogs with diarrhoea had over twice the odds of CPV compared to those without diarrhoea (p = 0.03). The appetite status was also significant (p = 0.003), with dogs that were completely off-feed having 2.51 times higher odds of CPV compared to those with normal appetite (p = 0.04), whereas a reduced appetite did not reach statistical significance (OR = 1.46; p = 0.59). The final model demonstrated acceptable fit (Hosmer\u0026ndash;Lemeshow p = 0.49) and explained 33.6% of the variation in CPV diagnosis (Nagelkerke R\u0026sup2; = 0.336) (Table 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 2:\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Multivariable logistic regression analysis of clinical signs and measurements associated with canine parvovirus diagnosis in dogs (n=211)\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables in the Equation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOdds Ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiarrhoea Type\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2.60\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e1.10 \u0026ndash; 6.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVomiting\u003csup\u003ea\u003c/sup\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2.67\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e1.32 \u0026ndash; 5.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeight (kg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0.91 \u0026ndash; 0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiarrhoea Status\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2.26\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e1.08 \u0026ndash; 4.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAppetite Status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNormal\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eReduced Appetite\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCompletely Off Feed\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eREF\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.46\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.38 \u0026ndash; 5.61\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.08 \u0026ndash; 16.49\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eModel fit: Nagelkerke R\u003csup\u003e2\u003c/sup\u003e=0.336;\u0026nbsp;\u003c/em\u003e\u003cem\u003eHosmer\u0026ndash;Lemeshow p\u0026nbsp;\u003c/em\u003e\u003cem\u003evalue = 0.49\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eᵃ Reference categories: non-haemorrhagic diarrhoea (for diarrhoea type), no vomiting (for vomiting), no diarrhoea (for diarrhoea status), and normal appetite (for appetite status). Reference categories were retained from the univariable regression for the multivariable regression analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAssociation between the Type of Service Rendered to Positive CPV cases by Breed\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs shown in Table 3, 13 different breeds were diagnosed with canine parvovirus and received treatment. Inpatient care predominated across nearly all breeds, constituting 76.6% (95/124) of CPV-positive cases. Outpatient management was less frequent (23.4%, 28/124), and for some breeds, including Bullmastiff, Caucasian Shepherd, Maltese, Shih Tzu, Alsatian Shepherd, and American Bully, all cases were managed as inpatients. The proportion of outpatient care was highest in local breeds (32.4%) and crossbreeds (33.3%). However, there was no statistically significant difference among breeds regarding the type of service they received. A single outpatient (local dog) with an incomplete treatment regimen was retained in this analysis as the service was rendered; however, dogs that received no treatment or were deceased before treatment were excluded from the comparison.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 3:\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Association between breed and type of service rendered\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003efor\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;canine parvovirus-positive cases\u0026nbsp;\u003c/strong\u003e(n=206; \u003cem\u003eexcluding dogs that received no treatment and death before treatment\u003c/em\u003e)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 64.5276%; text-align: center;\" colspan=\"3\"\u003e\u003cstrong\u003eService Rendered\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePredisposing factor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInpatient (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutpatient (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 557px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u003cem\u003e\u0026nbsp; Breed\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocal Breed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"14\" valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBoerboel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBullmastiff\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGerman Shepherd\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaucasian Shepherd\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCrossbreed\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoodle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRottweiller\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaltese\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShitzu\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlsatian Shepherd\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmerican Bully\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBelgium Malinois\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAssociation between Type of Service Rendered to Positive CPV\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eCases\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;by Sex and Age Group\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverall, inpatient management was more common than outpatient care across sex and age categories. Although a higher proportion of female dogs (84.3%) received inpatient care compared to males, this difference was not significant (p=0.064). Similarly, age group was not significantly associated with the type of service rendered (p=0.287). Most affected dogs were younger than 24 weeks of age, with 78.8% of those aged \u0026le;12 weeks and 77.8% of those aged 13-24 weeks receiving inpatient care (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 4:\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Association between sex, age group, and type of service rendered\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ein\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;canine parvovirus-positive cases\u0026nbsp;\u003c/strong\u003e(n=124; \u003cem\u003eexcluding dogs that received no treatment and death before treatment\u003c/em\u003e) \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 64.5276%; text-align: center;\" colspan=\"3\"\u003e\u003cstrong\u003eService Rendered\u003c/strong\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePredisposing factor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInpatient (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutpatient (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 557px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u003cem\u003eSex\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e43 (84.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e8 (15.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e51 (69.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e22 (30.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 557px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003cem\u003eAge Group\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLess than or equal to 12 weeks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e41 (78.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e11 (21.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e13 to 24 weeks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e42 (77.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e12 (22.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMore than 24 weeks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e11 (61.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e7 (38.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eRisk analysis on\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003ethe basis of\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eCPV diagnosis and service rendered\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCompared with CPV-negative dogs, CPV-positive dogs were 7.57 times more likely to be managed as inpatients (p \u0026lt; 0.001), and this association was statistically significant. (Table 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 5:\u003c/em\u003e\u003c/strong\u003e Univariate logistic regression analysis of services rendered in relation to canine parvovirus diagnosis (n=206; \u003cem\u003eexcluding dogs that received no treatment and death before treatment\u003c/em\u003e)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"648\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevalence%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOdds ratio\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower 95%CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper 95%CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 574px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003cstrong\u003eService Rendered\u003cem\u003e\u0026nbsp;(Inpatient/Outpatient)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eOutpatient\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;34.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e7.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 59px;\"\u003e\n \u003cp\u003e4.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e14.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eInpatient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 79.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCI = confidence interval; a = reference variable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eOverall\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003etreatment outcome\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;by CPV\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003estatus\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 211 dogs tested for canine parvovirus, 129 (61.14%) were positive, and 82 (38.86%) were negative. Across the entire cohort, most dogs received treatment and recovered (n = 166, 78.67%). Among the dogs that tested positive for CPV and received treatment (n = 129), 91 (73.98%) recovered, whereas 32 (26.02%) did not survive. In contrast, recovery rates were higher among CPV-negative dogs, with 75 out of 82 (91.46%) surviving and 7 (8.54%) not surviving despite treatment. Two dogs died before treatment could be administered at the facility, three did not receive any treatment at the facility, and one dog was lost to follow-up, leading to an incomplete treatment regimen, all of which were positive canine parvovirus cases (\u003cstrong\u003eTable 6\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eTable 6:\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eDistribution of canine parvovirus diagnoses by treatment type and clinical outcome (n=211)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment Outcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCPV+\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCPV-\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreated and Recovered\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003cp\u003e(54.81%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003cp\u003e(45.18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003cp\u003e(78.67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreated and Deceased\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e(82.05%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e(17.95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e(18.48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncomplete Treatment Regimen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e(0.47%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDeceased Before Treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e(0.95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo Treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e(1.42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003cp\u003e(61.14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003cp\u003e(38.86%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e211\u003c/p\u003e\n \u003cp\u003e(100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eCanine parvovirus remains a significant clinical challenge in small animal practice worldwide (Adeyemo et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Jyothi et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Larson et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This study contributes valuable insights by identifying key clinical predictors of CPV diagnosis, service-rendered dynamics, and outcomes in affected dogs. Classic signs such as vomiting, haemorrhagic diarrhoea, complete anorexia, and diarrhoea of any form were strongly associated with CPV positivity, which is consistent with the established enteric syndrome of the virus (Kalli et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Mylonakis et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Folitse et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Mazzaferro, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Vomiting showed the strongest independent association with canine parvovirus diagnosis (OR\u0026thinsp;=\u0026thinsp;2.67, p\u0026thinsp;=\u0026thinsp;0.01) among the predictors retained in the multivariable model, closely followed by haemorrhagic diarrhoea (OR\u0026thinsp;=\u0026thinsp;2.60, p\u0026thinsp;=\u0026thinsp;0.03) and complete loss of appetite (OR\u0026thinsp;=\u0026thinsp;2.51, p\u0026thinsp;=\u0026thinsp;0.04). These findings potentially highlight the diagnostic importance of these clinical signs in routine case assessment, particularly among unvaccinated or high-risk dogs. Early recognition of such signs can facilitate prompt supportive management, enhance prognostic evaluation, and guide timely isolation measures to limit disease transmission within hospital and community settings. Conversely, a substantial proportion of confirmed cases did not exhibit these hallmark signs at presentation: 55.8% lacked haemorrhagic diarrhoea, 19.4% showed no vomiting, 33.3% were not completely off-feed, and 23.3% had no diarrhoea. These findings, which are consistent with reports in other areas, highlight that the absence of individual signs does not exclude CPV, necessitating a thorough assessment of suspected cases (Kalli et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Mylonakis et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Chalifoux et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Similar patterns were observed in Ghana by Folitse et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) and in Egypt by Sayed-Ahmed et al. (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), where a significant proportion of dogs with non-bloody diarrhoea tested positive. Clinicians should therefore consider CPE as a strong differential in young dogs presenting with diarrhoea, as the haemorrhagic nature typically emerges with disease progression and severity, while earlier stages may involve non-bloody diarrhoea of variable colour and consistency (Nandi et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Barr, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Body weight also emerged as a significant predictor, reflecting the heightened susceptibility of puppies and young dogs, which generally weigh less than adults do (Miranda et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Although the final multivariable model excluded foul-smelling diarrhoea, this sign remains clinically relevant, having been observed in a substantial number of cases and reflecting the severe mucosal damage characteristic of CPV enteritis (Nandi \u0026amp; Kumar, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The temperature at presentation varied widely, ranging from marked hyperthermia (41.2\u0026deg;C) to hypothermia (36.7\u0026deg;C), with a mean of 38.9\u0026deg;C. While fever is often associated with acute CPV, temperature was not statistically significant in this study, likely reflecting the heterogeneous stages of disease at presentation. Early hyperthermia may transition to hypothermia as vomiting and diarrhoea progress, driven by dehydration and circulatory compromise (Nandi et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Similar to our findings, Godsall et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) and Miranda et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) reported that most CPV cases as normothermic at presentation, corroborating the limited predictive value of body temperature. Collectively, these findings emphasise the heterogeneity of CPV clinical presentation, which may vary with disease stage, viral strain, vaccination status, age, and breed predisposition (Decaro et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Miranda \u0026amp; Thompson, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Alves et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Larson et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Nevertheless, the high odds ratios for these signs in the cases assessed suggest that even in CPV cases with variable presentation patterns, these symptoms remain clinically useful for guiding presumptive diagnosis while awaiting confirmatory antigen testing.\u003c/p\u003e \u003cp\u003eFurther reflecting the severity of CPV presentations, our analysis revealed that CPV-positive dogs were almost eight times more likely to require hospitalisation than were CPV-negative dogs, highlighting the condition\u0026rsquo;s intensity and greater need for inpatient care (Kalli et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Perley et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Chalifoux et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The breed distribution among the inpatient and outpatient groups varied; local breeds and crossbreeds accounted for more than 60% of the outpatient cases, whereas other pure breeds, such as Rottweilers, Bullmastiffs, German Shepherds, and Caucasian Shepherds, were mostly treated as inpatients. Additionally, females and dogs under 24 weeks of age received the most inpatient care. The fact that most dogs under 24 weeks of age require inpatient care may be due to the severe nature of the infection in this particular age group (Prittie, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). This pattern of service type among various predisposing factors may influence treatment pathways, as some of these pure breeds or age groups may have more severe symptomatic case presentation and progression (Mylonakis et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Nandi et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Alves et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Okwee-Acai et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe overall mortality rate among CPV-positive dogs in this study was 26.4%, including the two dogs that died before treatment, underscoring the substantial risk CPV poses to the canine population in clinical settings. Without treatment, mortality can reach as high as 91% in puppies, highlighting the lifesaving importance of early recognition and timely intervention (Nandi \u0026amp; Kumar, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The rate reported in this study is lower than that reported in Nigeria (72% by Ukwueze et al. (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) and 80.6% by Ogbu et al. (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e)) and Cameroon, where Mebanga et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) reported 58.9%, but it is comparable to that reported by Godsall et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2010\u003c/span\u003e) in the United Kingdom (30.2%). In contrast, it is higher than that reported by Chalifoux et al. (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) in the United States (9%) and Miranda \u003cem\u003eet al\u003c/em\u003e. (2016) in Portugal (16.3%). These differences may be due to variations in disease severity at presentation, tertiary-level care, diagnostic and therapeutic capacities, demographic characteristics, vaccination, and the prevalence of regional comorbid conditions (Prittie, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Duijvestijn et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Zhao et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Alves et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Perley et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNotably, all three dogs that received no treatment were CPV positive, and one was subsequently lost to follow-up, leading to an incomplete treatment regimen, likely reflecting the financial or logistical constraints this disease imposes on dog owners (Kelman et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This finding emphasises how such barriers can critically affect outcomes and points to the broader socioeconomic consequences of CPV (Sarpong et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). For CPV-negative patients, the mortality rate was relatively low, at approximately 8.5%, demonstrating the considerably greater risk associated with CPV than with the other conditions examined, which is consistent with other studies (Okwee-Acai et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Godsall et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eLimitations should be considered when interpreting the findings of this study. Firstly, the aggregate CPV-negative cases for which CPV-positive cases were compared could have been due to several possible causes, which limited the comparison. Additionally, recall bias could have affected the accuracy of some clinical data, as information on clinical signs at presentation partly relied on owner recall. Although multivariable analyses adjusted for various confounders, residual bias may still exist, including clinician-driven treatment decisions or financial limitations of dog owners. Inpatient management at the study facility was based on 12-hour hospitalisation without continuous 24-hour care, which may partly explain outcome differences compared to hospitals in high-income countries. Survival time analyses and related factors were beyond the scope of this current study and will be addressed in subsequent work. Lastly, the allocation of inpatient versus outpatient care was not performed within a randomised controlled setting, complicating direct causal comparisons between service types.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings of this study reaffirm that canine parvovirus is a preventable yet persistent threat to unvaccinated or incompletely vaccinated puppies. Classic signs, including haemorrhagic diarrhoea, vomiting, diarrhoea presence, complete anorexia and lower body weight, were independently predictive of positive CPV cases. Compared with CPV-negative dogs, CPV-positive dogs were markedly more likely to require hospitalisation and had higher mortality. Strengthening vaccination coverage, client education, and access to supportive care are crucial to reducing CPV-related deaths and improving canine health outcomes in Ghana.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCPV \u0026ndash; Canine Parvovirus\u003c/p\u003e\n\u003cp\u003eCPV-2 \u0026ndash; Canine Parvovirus type 2\u003c/p\u003e\n\u003cp\u003eCPE \u0026ndash; Canine Parvoviral Enteritis\u003c/p\u003e\n\u003cp\u003eKNUST \u0026ndash; Kwame Nkrumah University of Science and Technology\u003c/p\u003e\n\u003cp\u003eVTH \u0026ndash; Veterinary Teaching Hospital\u003c/p\u003e\n\u003cp\u003eKNUST-VTH \u0026ndash; Kwame Nkrumah University of Science and Technology Veterinary Teaching Hospital\u003c/p\u003e\n\u003cp\u003eOR \u0026ndash; Odds Ratio\u003c/p\u003e\n\u003cp\u003eCI \u0026ndash; Confidence Interval\u003c/p\u003e\n\u003cp\u003eDNS \u0026ndash; Dextrose Normal Saline\u003c/p\u003e\n\u003cp\u003eSPSS \u0026ndash; Statistical Package for the Social Sciences\u003c/p\u003e\n\u003cp\u003eIBM SPSS \u0026ndash; International Business Machines Statistical Package for the Social Sciences\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was a hospital-based observational study conducted using data obtained from routine clinical management of dogs presented to the KNUST Veterinary Teaching Hospital, Kumasi, Ghana. No experimental procedures or interventions were performed for the purpose of this research. Ethical permission to access and use clinical records for research purposes was granted by the management of the KNUST Veterinary Teaching Hospital. Informed consent for examination, diagnostic testing, and treatment was obtained from dog owners as part of routine clinical practice. All procedures were conducted in accordance with institutional guidelines and accepted standards of veterinary clinical care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. No identifiable individual animal or owner data are included in this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the study are not publicly available due to institutional and confidentiality restrictions but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study received no external funding\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJemima Dzigbordi Agbota and Raphael Deladem Folitse conceptualised the study, developed the study design and methodology, collected data, performed data analysis, and drafted the initial manuscript. Emmanuel Darko Opoku contributed to data analysis, interpretation of findings, and revision of the manuscript. William Tasiame, Dorcas Oyueley Kodie, and Benjamin Obukowho Emikpe contributed to data interpretation and critically reviewed and edited the manuscript. All authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors gratefully acknowledge the clinical and laboratory staff of the KNUST Veterinary Teaching Hospital for their assistance during the study period.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAdeyemo, A. A., Aiki-Raji, C. O., Akinniyi, O. O., \u0026amp; Fagbohun, O. A. (2024). Molecular Epidemiology of Canine Parvovirus in Nigeria. \u003cem\u003eAfr. J. Biomed. Res\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e, 217\u0026ndash;224. https://doi.org/10.4314/ajbr.v27i2.5 \u003c/li\u003e\n\u003cli\u003eAgbota, J. D., Folitse, R. D., Darko, E. O., Kodie, D. O., Tasiame, W., \u0026amp; Emikpe, B. O. (2025). Prevalence of canine parvovirus, vaccine-related, and other factors associated with the infection in dogs presented at the veterinary teaching hospital in Kumasi, Ghana. \u003cem\u003ePAMJ-One Health\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e. https://doi.org/10.11604/pamj-oh.2025.17.11.46310 \u003c/li\u003e\n\u003cli\u003eAlves, F., Prata, S., Nunes, T., Gomes, J., Aguiar, S., Aires da Silva, F., Tavares, L., Almeida, V., \u0026amp; Gil, S. (2020). Canine parvovirus: a predicting canine model for sepsis. \u003cem\u003eBMC Veterinary Research\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 199. https://doi.org/10.1186/s12917-020-02417-0 \u003c/li\u003e\n\u003cli\u003eBarr, M. C. (2020). Infectious Disease: Canine Viral Enteritis . 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A., Eis-Hubinger, A.-M., Hughes, J., Mietzsch, M., Modha, S., Ogliastro, M., P\u0026eacute;nzes, J. J., Pintel, D. J., Qiu, J., Soderlund-Venermo, M., Tattersall, P., \u0026amp; Tijssen, P. (2019). ICTV Virus Taxonomy Profile: Parvoviridae. \u003cem\u003eJournal of General Virology\u003c/em\u003e, \u003cem\u003e100\u003c/em\u003e(3), 367\u0026ndash;368. https://doi.org/10.1099/jgv.0.001212 \u003c/li\u003e\n\u003cli\u003eDecaro, N., Cirone, F., Desario, C., Elia, G., Lorusso, E., Colaianni, M. L., Martella, V., \u0026amp; Buonavoglia, C. (2009). Severe parvovirus in a 12‐year‐old dog that had been repeatedly vaccinated. \u003cem\u003eVeterinary Record\u003c/em\u003e, \u003cem\u003e164\u003c/em\u003e(19), 593\u0026ndash;595. https://doi.org/10.1136/vr.164.19.593 \u003c/li\u003e\n\u003cli\u003eDuijvestijn, M., Mughini-Gras, L., Schuurman, N., Schijf, W., Wagenaar, J. A., \u0026amp; Egberink, H. (2016). 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Zool,\u003c/em\u003e 47 (3), 657-663.\u003c/li\u003e\n\u003cli\u003eZhao, Z., Liu, H., Ding, K., Peng, C., Xue, Q., Yu, Z., \u0026amp; Xue, Y. (2016). Occurrence of canine parvovirus in dogs from Henan province of China in 2009\u0026ndash;2014. \u003cem\u003eBMC Veterinary Research\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(1), 138. https://doi.org/10.1186/s12917-016-0753-1 \u003c/li\u003e\n\u003cli\u003eZourkas, E., Ward, M. P., \u0026amp; Kelman, M. (2015). Canine parvovirus in Australia: A comparative study of reported rural and urban cases. \u003cem\u003eVeterinary Microbiology\u003c/em\u003e, \u003cem\u003e181\u003c/em\u003e(3\u0026ndash;4), 198\u0026ndash;203. https://doi.org/10.1016/j.vetmic.2015.10.009\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"canine parvovirus, dogs, gastroenteritis, clinical outcome, KNUST Veterinary Teaching Hospital, Ghana","lastPublishedDoi":"10.21203/rs.3.rs-8561957/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8561957/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCanine parvovirus (CPV) continues to be a predominant cause of morbidity and mortality among dogs, particularly affecting puppies and dogs with incomplete vaccination status or those that are unvaccinated. In Ghana, there is a paucity of evidence concerning the clinical predictors, service type, and clinical outcomes in dogs afflicted by CPV. This cross-sectional study was undertaken at the KNUST Veterinary Teaching Hospital, Kumasi, Ghana, to assess the clinical factors associated with CPV diagnosis, types of service delivery and clinical outcomes in dogs presented to the facility. Diagnosis was based on compatible clinical signs and positive results from a Vcheck CPV antigen test kit (Bionote Inc., Korea) and V200 analyser (Bionote Inc., Korea). Demographics, clinical signs, service type (inpatient or outpatient) and outcome data were recorded via a standardised data collection form. Odds ratios were reported with 95% confidence intervals, and a significance threshold of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was applied for all regression and chi-square analyses.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 129 CPV-positive dogs were diagnosed, with an overall mortality rate of 26.4% (34/129). Haemorrhagic diarrhoea (OR\u0026thinsp;=\u0026thinsp;2.60), vomiting (OR\u0026thinsp;=\u0026thinsp;2.67), lower body weight (OR\u0026thinsp;=\u0026thinsp;0.95 per kg), the presence of diarrhoea (OR\u0026thinsp;=\u0026thinsp;2.26), and complete loss of appetite (OR\u0026thinsp;=\u0026thinsp;2.51) were strong independent clinical predictors of positive canine parvovirus cases. CPV-positive dogs were significantly more likely to receive inpatient care than CPV-negative dogs (OR\u0026thinsp;=\u0026thinsp;7.57, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Among CPV-positive dogs that received treatment, 32/123 (26.0%) CPV-positive dogs died, whereas 7/82 (8.5%) CPV-negative dogs died.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis study highlights the significant impact of CPV on dog morbidity and mortality in Ghana. Classic gastrointestinal signs remain reliable predictors of CPV in practice. The strong association between CPV positivity and the need for inpatient treatment underscores the severity of the infection. These results emphasise the need for improved vaccination strategies, prompt diagnosis, and clinical management practices to reduce CPV-related mortality in affected populations.\u003c/p\u003e","manuscriptTitle":"Clinical Factors, Service Type, and Clinical Outcomes associated with Canine Parvovirus in Dogs presented at the KNUST Veterinary Teaching Hospital in Kumasi, Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-30 15:34:45","doi":"10.21203/rs.3.rs-8561957/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b2e0030e-500e-41a9-8972-3cc71bd7caae","owner":[],"postedDate":"January 30th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-25T19:09:18+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-30 15:34:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8561957","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8561957","identity":"rs-8561957","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}