AbstractParvoviruses (PV) can cause outbreaks with high morbidity and mortality in dogs and cats. Even if typical cases exist in puppies and kittens, PV infection (PVI) can have many different clinical presentations, making the laboratory support necessary. The aim of this work was to evaluate retrospectively the frequency of misdiagnoses, particularly missed diagnoses, of PVI in 144 suspected cases (88 clinical cases and 56 necropsies) involving 96 dogs and 48 cats. A nested PCR test was chosen as the gold standard. An index of diagnostic suspicion (IDS) for PVI, based on parameters reported upon submittal of the samples, was introduced to classify the initial diagnoses issued by veterinarians. The agreement between the IDS of PVI and PCR results was calculated. The effect of species, age and clinical versus necroscopic presentation was evaluated by logistic regression. In 63.6% of the cases, the IDS was confirmed by the PCR, whereas in 36.4% there was a missed diagnosis or a diagnosis wrongly attributed to PVI. More accurate results were obtained for dogs, animals aged < 1 year, and necropsies. Parvovirus infection should be better investigated in patients with atypical or few clinical signs, in particular in cats and animals over 1 year old.
Buonavoglia C., Martella V., Pratelli A., Tempesta M., Cavalli A., Buonavoglia D., Bozzo G., Elia G., Decaro N. & Carmichael L. 2001. Evidence for evolution of canine parvovirus type 2 in Italy. J Gen Virol, 82 (12), 3021-3025.
Day M.J., Horzinek M., Schultz R.D. & Squires R.A. Vaccination Guidelines Group (VGG) of the World Small Animal Veterinary Association (WSAVA). 2016. WSAVA Guidelines for the vaccination of dogs and cats. J Small Anim Pract, 57 (1), E1-E45.
Decaro N., Campolo M., Desario C., Elia G., Martella V., Lorusso E. & Buonavoglia C. 2005. Maternally-derived antibodies in pups and protection from canine parvovirus infection. Biologicals, 33 (4), 59–265.
Decaro N., Elia G., Desario C., Roperto S., Martella V., Campolo M., Lorusso A., Cavalli A. &, Buonavoglia C. 2006a A minor groove binder probe real-time PCR assay for discrimination between type 2-based vaccines and field strains of canine parvovirus. J Virol Methods, 136 (1-2), 65–70.
Decaro N., Elia G., Martella V., Campolo M., Desario C., Camero M., Cirone F., Lorusso E., Lucente MS., Narcisi D., Scalia P. &, Buonavoglia C. 2006b. Characterisation of the canine parvovirus type 2 variants using minor groove binder probe technology. J Virol Methods, 133 (1), 92–99.
Decaro N., Desario C., Elia G., Campolo M., Lorusso A., Mari V., Martella V. & Buonavoglia C. 2007a. Occurrence of severe gastroenteritis in pups after canine parvovirus vaccine administration: a clinical and laboratory diagnostic dilemma. Vaccine, 25 (7), 1161-1166.
Decaro N., Campolo M., Elia G., Buonavoglia D., Colaianni ML., Lorusso A., Mari V. & Buonavoglia C. 2007b. Infectious canine hepatitis: an "old" disease reemerging in Italy. Res Vet Sci, 83 (2), 269-273.
Decaro N. & Buonavoglia C. 2012. Canine parvovirus--a review of epidemiological and diagnostic aspects, with emphasis on type 2c. Vet Microbiol, 155 (1), 1-12.
Decaro N., Desario C., Amorisco F., Losurdo M., Elia G., Parisi A., Ventrella G., Martella V. & Buonavoglia C. 2013a. Detection of a canine parvovirus type 2c with a non-coding mutation and its implications for molecular characterisation. Vet J, 196 (3), 555-557.
Decaro N., Desario C., Billi M., Lorusso E., Colaianni ML., Colao V., Elia G., Ventrella G., Kusi I., Bo S. & Buonavoglia C. 2013b. Evaluation of an in-clinic assay for the diagnosis of canine parvovirus. Vet J , 198 (2), 504-507.
Decaro N., Crescenzo G., Desario C., Cavalli A., Losurdo M., Colaianni ML., Ventrella G., Rizzi S., Aulicino S., Lucente M.S. & Buonavoglia C. 2014a. Long-term viremia and fecal shedding in pups after modified-live canine parvovirus vaccination. Vaccine, 32 (30), 3850-3853.
Decaro N., Martella V., Desario C., Lanave G., Circella E., Cavalli A., Elia G., Camero M. & Buonavoglia C. 2014b. Genomic characterization of a circovirus associated with fatal hemorrhagic enteritis in dog, Italy. PLoS One, 9 (8), e105909.
Desario C., Decaro N., Campolo M., Cavalli A., Cirone F., Elia G., Martella V., Lorusso E., Camero M. & Buonavoglia C. 2005. Canine parvovirus infection: Which diagnostic test for virus? J Virol Methods, 126 (1-2), 179–185.
Demeter Z., Palade E.A., Soós T., Farsang A., Jakab C. & Rusvai M. 2010. Misleading results of the MboII-based identification of type 2a canine parvovirus strains from Hungary reacting as type 2c strains. Virus Genes, 41 (1), 37-42.
Diez M., Picavet P., Ricci R., Dequenne M., Renard M., Bongartz A. & Farnir F. 2015. Health screening to identify opportunities to improve preventive medicine in cats and dogs. J Small Anim Pract, 56 (7), 463-469.
Eleni C., Scholl F. & Scaramozzino P. 2014. Causes of death in dogs in the province of Rome (Italy). Vet Ital, 50 (2), 137-143.
Faz M., Martínez J.S., Quijano-Hernández I. & Fajardo R. 2017. Reliability of clinical diagnosis and laboratory testing techniques currently used for identification of canine parvovirus enteritis in clinical settings. J Vet Med Sci, 79 (1), 213-217.
Houston D.M., Ribble C.S. & Head L.L. 1996. Risk factors associated with parvovirus enteritis in dogs: 283 cases (1982-1991). J Am Vet Med Assoc, 208 (4), 542-546.
Kruse B.D., Unterer S., Horlacher K., Sauter-Louis C. & Hartmann K. 2010. Prognostic factors in cats with feline panleukopenia. J Vet Intern Med, 24 (6), 1271-1276.
Landis J.R. & Koch G.G. 1977. The measurement of observer agreement for categorical data. Biometrics, 33 (1), 159-174.
Maxie G. 2015. Alimentary system, Infectious and Parasatic Diseases of the Alimentary tract. In: Jubb, Kennedy & Palmer's Pathology of Domestic Animals, 6th Edition, Elsevier Health Sciences, Vol 2, 135-279.
Merck Veterinary Manual 2016. (http://www.merckvetmanual.com/mvm/digestive_system/diseases_of_the_stomach_and_intestines_in_small_animals/hemorrhagic_gastroenteritis_in_small_animals.html. Accessed on 9 December 2016]
Miranda C., Carvalheira J., Parrish C.R. & Thompson G. 2015. Factors affecting the occurrence of canine parvovirus in dogs. Vet Microbiol, 180 (1-2), 59-64.
Pedersen N.C. 2014. An update on feline infectious peritonitis: Diagnostics and therapeutics. Vet J, 201 (2), 133–141.
Proksch A.L., Unterer S., Speck S., Truyen U. & Hartmann K. 2015. Influence of clinical and laboratory variables on faecal antigen ELISA results in dogs with canine parvovirus infection. Vet J, 204 (3), 304-308.
Schoeman J.P., Goddard A. & Leisewitz A.L. 2013. Biomarkers in canine parvovirus enteritis. N Z Vet J, 61 (4), 217-222.
World Organisation for Animal Health 2016. chapter 3.6.5. Statistical approaches to validation. (http://www.oie.int/fileadmin/Home/eng/Health_standards/tahm/3.6.05_STATISTICAL_VALIDATION.pdf. Accessed on 1 December 2016]
Zappulli V., Caliari D., Cavicchioli L., Tinelli A. & Castagnaro M. 2008. Systemic fatal type II coronavirus infection in a dog: pathological findings and immunohistochemistry. Res Vet Sci, 84 (2),278-282.