Cookie the Pitbull mix puppy was only 8 weeks old when she got sick. Still small enough to fit in the cupped palms of two open hands, she started showing symptoms no pet parent wants to see: lethargy, lack of appetite vomiting, diarrhea.

Her owners promptly brought her to see the clinicians from The Fix Project, a non-profit clinic specializing in parvovirus as part of Fix Long Beach Pets’ facility in Long Beach, California.

There, a test confirmed a diagnosis dreaded by owners, vets and animal welfare activists alike: Cookie had contracted parvovirus.

She was immediately admitted to the clinic, looking weak, sick and facing a prognosis that, historically, is less than stellar. Little did Cookie know when she walked in that day, she would make a little bit of history.

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Canine parvovirus' deadly history

Canine parvovirus is one of the most deadly and contagious viruses impacting dogs. It is especially prevalent in young puppies who are not yet old enough to receive their full round of preventive vaccines. The mortality rate for canine parvovirus is as high as 91% if left untreated and an estimated 900 cases are diagnosed a day in the U.S., totaling 330,000 cases annually.

The progression of the virus is unpleasant to witness, to put it lightly. Distressed owners often watch their beloved companion suffer with symptoms including lethargy, GI bleeding, bloody diarrhea, vomiting, dehydration, shock and sepsis.

And even with intervention, survival is not guaranteed, as all treatment up to this point have merely been supportive, meaning they aim to alleviate symptoms but cannot fight or cure the virus itself.

In fact, many owners in the three decades since parvo first appeared in Europe have faced unbelievably tough decisions after arriving at the vet, where they grapple with a low survival prognosis and the extremely high price tag of the round-the-clock care required to stabilize a dog suffering with parvo.

Often, these cases ended up in euthanasia or death from progression of the disease.

Vets, rescues, shelters, activists and animal welfare organizations have contended with the unpredictable, complicated and difficult-to-tame disease for years, fighting to keep it from spreading in shelter settings or simply fighting to keep their patients alive.

Despite the best efforts of so many, the lack of a targeted treatment left caregivers often feeling helpless – until a recent development blew the thing wide open.

Elanco announces first-ever targeted parvo treatment

Elanco Animal Health Incorporated, a pharmaceutical company producing medicine and vaccines for animals, made the long-awaited announcement earlier this year that it had developed the first-ever targeted treatment for canine parvovirus.

The Canine Parvovirus Monoclonal Antibody treatment by Elanco is the first and only USDA conditionally approved therapy of its kind that directly targets canine parvovirus. In clinical trials, zero dogs treated with the Elanco's Monoclonal Antibody died, the company told USA TODAY. The treatment has also been found to shorten the course of the disease, resolving some of the worst symptoms more quickly, limiting hospitalizations and increasing survivability.

The treatment is administered intravenously in a single dose and works by binding to the virus directly, blocking entry into host cells. By resolving symptoms faster, patients are able to feel and get better sooner and go home to their families after a much shorter (and hopefully cheaper) vet stay.

"In the past, we've only had symptomatic and supportive care to help these puppies," Dr. Jennifer Miller, Elanco's in-house veterinarian told USA TODAY. "Now, we have something that will fight the virus directly and stop it in its tracks, so that way it doesn't get into the host cells and cause destruction in these puppys' guts."

The company expects full USDA approval to come in 2024, said Miller, but vets are able to access the medicine in the meantime. With a recent Elanco study finding only 44% of total dog owners actually know what parvo is and 20% have no idea, she feels it is important to raise awareness about parvo and its seriousness, as well as the new treatment options available.

"Parvovirus really affects all segments of veterinary medicine. Shelter, general practice, ER, rescue, everything. All puppies are susceptible to parvo," she said. "Right now, even with the conditional approval, any veterinarian that wants to order it can."

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Treatment in action at The Fix Project clinic

Luckily for Cookie and other dogs cared for by The Fix Project, it became one of the first clinics to use Elanco's Monoclonal Antibody in practice. According to Dr. Alex Cabrera, veterinarian and medical director at The Fix Project, seeing the new treatment in action has had an impact not only on the puppies and their owners, but also the teams caring for them as well.

"Lately, especially during COVID, treating these puppies was tough," he told USA TODAY, "I was giving out bills of $5,000 for three to four days of hospitalization. I don't mind giving a big bill like that if we're saving the pet but when we're losing them and it's not the first day, not the second day, it's usually three days into treatment, of holding onto them and caring for them ... that sucks."

Cabrera said that the clinic has recently incorporated the new medication into protocol at the parvo ICU and that their treatment success rate has increased, especially in smaller and more vulnerable patients.

"It made a big difference," he said. "And we've also noticed that they're getting out of our treatment ward faster and they're spending less time in."

This is great for the animals and the people who love them, of course, but also for the mental health of his team, who are able to enjoy more positive outcomes and have less of their time consumed by intensive care that may or may not work.

Cabrera said that the clinic has been able to essentially cut treatment length in half and change what it looks like while puppies and dogs are in their care.

Traditionally, dogs would come to the clinic presenting symptoms of vomiting, loss of appetite and maybe lethargy or diarrhea. Clinicians would test the animal and immediately admit them if the results turned up positive. Patients would be put on intravenous fluids, have a catheter placed and receive antibiotics and supplements to support their body's attempts to fight the virus off.

After that, caregivers could only encourage the dogs to eat and monitor them, overall relying on symptom alleviation. Things look different now, said Cabrera.

"Once we see that parvo test, that positive, we use (the medicine) immediately," he said. "With our original treatment protocol, we were probably getting these dogs out at seven, six days, around that timeframe. And now, we're getting them out around the four-to-five-day mark. So, we've saved some time off the back end and increased our success rate."

More happy endings

The first puppy to receive Elanco's Monoclonal Antibody was considered high-risk due to her young age and small size. She was brought in on a Friday and tested positive in the parking lot, then immediately admitted. The treatment was administered the same day and by Saturday, her energy began to return.

Like any young, energetic puppy, she was wiggling around and trying to chew through her lines. By Saturday night, she was already eating again.

By Monday morning, she was tested once more, and results came back negative: she was parvo free. After just a weekend stay, she was able to go home to her family.

And that puppy, of course, was Cookie.

"To actually see it (used) on a client-owned puppy....to see the, the change," said Miller. "It was just such a contrast to what I've seen living in a parvo endemic area. It was amazing to see that come to life."