Because the normal intestinal lining is also compromised, blood and protein leak into the intestines, leading to anemia and loss of protein, and endotoxins escape into the bloodstream, causing endotoxemia. Secondary infections occur as a result of the weakened immune system. Diarrhea and vomiting result in dehydration that upsets the electrolyte balance and this may affect the dog critically. Secondary signs are loss of weight and appetite or diarrhea followed by vomiting. Generally, the first sign of CPV is lethargy. The signs may include lethargy, vomiting, fever, and diarrhea (usually bloody). Dogs that develop the disease show signs of the illness within three to ten days.
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