Updates on GI disease in dogs 2022

SAVSNET is unable to provide advice on individual cases and we urge owners worried about their dog to contact their veterinary practice.

Update 2nd March 2022

Working with colleagues at Lancaster University, the latest regional graphs are now available here: GI disease regional data 02Mar22

Update 16th February 2022

A team at University of Lincoln led by Dr Simon Clegg heard about cases of vomiting and diarrhoea from local vets and dog owners around Lincolnshire (January-February 2022) who were concerned. Since January 5th, they requested samples of the faecal matter from 35 of these dogs (from different households) to have a look into potential pathogens which may be associated with the clinical signs using isolation of bacteria and molecular detection of viruses. Samples were received between 7th January and 2nd February 2022. In addition, they applied the same techniques to 60 control dogs, where there was no clinical signs and no evidence of illness a few days before or after (received between 8th January and 4th February). There were no differences in the bacteria isolated, suggesting that Salmonella and Campylobacter were not associated with these clinical signs, reducing risk of zoonotic infections. Of the gastroenteric viruses, canine parvovirus is generally considered to be the most severe, but was not found in any of the samples. Many other viruses associated with canine gastroenteritis such as canine kobuviruses, astroviruses and circoviruses were also not detected. However, 29/35 of the cases were positive for canine enteric coronavirus (CECov), and all of the control samples were negative.

Whilst this was only a small scale, very localised study, it suggests that there may be an association with CECoV and the clinical illnesses seen around Lincolnshire.

Further molecular characterisation is currently ongoing, and sequencing of the viral M gene is due shortly. Further updates will be provided when the data is known.

This work was carried out at the University of Lincoln as part of a study into dog gastroenteric health. For more information on this study, the lead scientist Dr Simon Clegg can be contacted at SClegg@Lincoln.ac.uk.

Update: 7th February 2022

SAVSNET collects data from a number of veterinary diagnostic laboratories. Using this data, we have been able to analyse testing for canine enteric coronavirus (CECoV).  The graph below confirms again the seasonality of canine enteric coronavirus in dogs, broadly paralleling that of the clinical signs seen

graph showing lab test results for canine enteric coronavirus

Update: 3rd February 2022

There have been recent concerns about an increased number of cases of vomiting and diarrhoea in dogs that first started in Yorkshire. By analysing routinely collected data from vets in practice SAVSNET has been able to show this increase is indeed of a size and duration that allows us to call it an outbreak. We are now conducting further investigations into the outbreak to ascertain case details, determine risk factors and to try and identify the cause based on questionnaire responses. Between 29th and 31st January 2022 we had details of 208 cases submitted by vets and owners.

Here is a provisional analysis of these questionnaire responses.

The most common clinical signs reported were inappetence, and vomiting and diarrhoea both without blood.  The majority (79%) of dogs had NOT visited the beach prior to becoming ill and many cases were reported inland (away from the coast.  The vast majority of cases (94%) had been vaccinated in the last three years.  The majority (56) of the 88 owners who had more than one dog reported that other dogs in the household had also shown similar signs possibly suggesting in infectious cause.  The good news is the majority of dogs seem to recover within 7-14 days, although over 60% required treatment of some form.

No underlying cause was reported and so the aetiology of this outbreak is still unknown.

To help us investigate further, we are asking more people with affected dogs to fill out our questionnaire; this is the best way we can better understand what is going on. In addition, and in order to help us try and work out the cause, if you have a case that is currently vomiting or has diarrhoea please ask your vet to submit a faecal sample from your dog. We can only accept samples from veterinary practices and are asking practices willing to submit to contact us by email to request the required forms.

Advice to owners

Acute GI disease like that being described in these cases is always unpleasant regardless of the cause, and regardless of whether it affects an individual dog or many; in severe cases, especially if left untreated, it can be life threatening. If you are an owner concerned about the health of your pet, then please contact your own veterinary surgeon who is best placed to offer advice, and treatment if necessary.

Regardless of whether the pattern of disease in your area is normal or not, if your dog does have vomit and / or diarrhoea, it makes sense to keep it away from other dogs (isolate) at least whilst it is ill and preferably a few days longer just in case it is infectious. And if your dog does defecate or vomit in a public place, then it is even more important to clear up after them, washing your own hands carefully afterwards. Close contact with affected dogs, and their vomit and diarrhoea are likely to be the main ways that GI bugs are transmitted.

 

Update: 27th January 2022

Summary

Gastrointestinal (GI) disease in dogs covers a wide range of symptoms and is generally mild. However, in a minority of cases it can be severe.

Real time data from veterinary practices collected by SAVSNET over several years suggests that such GI disease appears to be seasonal in dogs, peaking in January. In addition, there was a national outbreak of more severe GI disease affecting dogs nationally in January to May 2020 that was associated with a canine enteric coronavirus (CECoV) variant.

There are concerns from some veterinary practitioners and owners in several regions of the country starting in Yorkshire, that a similar outbreak may be occurring this January (2022).

Analysis of real-time data collected by SAVSNET from veterinary practices suggests that in Yorkshire, levels of disease have been statistically higher than we would expect for three weeks – we can therefore call this an outbreak in Yorkshire.

In other regions, the increases we have seen so far look more like normal seasonal variation. However, such signals can change quickly and we will continue to monitor the situation. Please see here for more detail: GI disease regional data 25jan22

Data from laboratories suggests that similar to previous winters, CECoV appears to be more common in samples submitted for testing at this time of year. Because of this, and our previous association of CECoV to the 2020 outbreak, it would be tempting to speculate on a role for CECoV in current cases of GI disease. However, that would be premature based on our current data.

If an owner is worried about their dog it is important they contact their vet who can give advice and treatment if necessary. In addition, we would recommend affected dogs should be isolated from other dogs to minimise the risks of onward transmission.

What is the reason for the concern?

There have been recent social media reports of possible increases in acute gastrointestinal (GI) disease in the North East, characterised by vomiting and diarrhoea. To date the authors are unaware of any statistical analyses of these data or any suggestion of a possible cause.

What data have we used?

SAVSNET collects data from a sentinel network of UK veterinary practices that voluntarily contribute real time consultation data, and from a network of diagnostic veterinary laboratories. We can use these data to try and identify changes in the patterns of pet animal disease. Here we have used a unique feature of SAVSNET, and reviewed consultations that participating vets have told us are primarily for GI disease - we call this the main presenting complaint (MPC).

Results from veterinary data

The first plot below shows data up to 17th January 2022. Apart from early 2020 in dogs (more on that later), this GI MPC has a gentle seasonality at a national level in dogs (blue line), lowest in the summer and almost doubling at this time of year. Similar data for cats is less seasonal (orange line) and suggests whatever is driving this seasonality in dogs does not impact cats.

 

The second plot shows that vets are also prescribing to dogs more of a drug commonly used to treat vomiting (maropitant). The orange line shows use of this drug, which very closely matches that of the GI MPC (blue line).  The y axis is percent of unwell animal consultations (i.e., excluding things like vaccine consultations).

The series of plots below are a more complex statistical analysis of the same dog data, that seeks to identify those weekly data points using red and orange dots that are significantly outwith normal ranges (shown by the grey shaded area). These plots are for different regions; at the top the national GB data again, and in the bottom panel Yorkshire.

 

How do we interpret these observations?

1. Gastrointestinal disease in dogs is appears to be seasonal, peaking each year in January.

Together, these data suggest each winter period is associated with an increase in gastrointestinal disease in dogs. We might consider 2018-19 and 2020-21 to represent “normal” winter periods. Although not much is written about the seasonality of canine GI pathogens, it seems reasonable that as in humans, some causes may be more transmissible at certain times of the year, perhaps driven by climate or behaviour changes leading to increased chances for mixing.

2. There was a national outbreak of GI disease affecting dogs in early 2020.

In 2019-20, the winter peak was statistically much higher over a period of several weeks at the national level (eight red dots spanning roughly January – May 2020), constituting a clear outbreak which, after additional studies, we thought was likely to be caused by a variant of canine enteric coronavirus. This outbreak seemed shorter lived in Yorkshire (three red dots in the same period). 

What about this winter?

This winter (2021-22), apart from a single significantly high week three weeks ago, the national pattern so far seems similar to a more normal year. However, the data set that includes owners living in Yorkshire seems at this early stage to be more similar to the outbreak year of 2020, as shown by the two red dots and one orange dot on the very right of the chart. We now feel this is strong enough evidence to call this an outbreak for the Yorkshire region. It also shows an individual significantly high week also occurred last winter.

Data from other regions of Great Britain largely point to the regular seasonality of GI disease in dogs.

Clearly, this represents a worrying trend and one that needs to be monitored both locally and more widely, especially as there are reports of similar increases from other regions of the country.

We will continue to monitor these trends at national and regional levels in the coming weeks to see whether future data follows the patterns typical of a more normal year, or whether it might follow a pattern more similar to that seen in January 2020. We will likely start collecting additional data from both owners of affected animals and their vets necessary to shed further light on what is going on – this will need help from both vets and owners so please watch this space.

What about laboratory data?

The GI outbreak of 2022 was associated with a canine enteric coronavirus variant. Using data from participating labs, we again see a seasonality to the diagnosis of CECoV that seems to broadly follow that of the GI seasonality, with the proportion of submitted samples testing positive being highest in the winter.  It will be important to test samples from cases and controls to see whether this association holds.

 

This is not the case for canine parvovirus, another pathogen that can cause severe GI signs, particularly in unvaccinated animals.

Clearly other pathogens could be involved. It will be important to test samples from cases and controls to see whether this association with CECoV holds.

Disclaimer

The data presented shows regional averages; clearly such an analysis could hide variations in this pattern specific to individual more local regions.

The MPC is broad syndrome and will likely include a range of other GI diseases for example chronic disease. SAVSNET collects data from ~10% of UK practices recruited by convenience and may therefore not necessarily be representative of the entire UK population of dogs. Data like that presented here is provided in good faith and should not be used as proof of the presence or absence of events, anomalies or outbreaks. However, they can be used to inform discussions about possible changes of disease seen in practice.

Unfortunately we will not be able to produce RDIs for every possible scenario, and the absence of an RDI should not be used to imply there is no issue.

Advice to owners

Even in the absence of a clear understanding of what, if anything, out of the ordinary is happening in these cases, there are important things that can be done now to lessen the impact of any possible infections on the population.

Severe acute GI disease like that being described in these cases is always unpleasant regardless of the cause, and regardless of whether it affects an individual dog or many; in severe cases, especially if left untreated, it can be life threatening. If you are an owner concerned about the health of your pet, then please contact your own veterinary surgeon who is best placed to offer advice, and treatment if necessary.

Regardless of whether the pattern of current disease is normal or not, if your dog does have vomit and / or diarrhoea, it makes sense to keep it away from other dogs (isolate) at least whilst it is ill and preferably a few days longer just in case it is infectious. And if your dog does defecate or vomit in a public place, then it is even more important to clear up after them, washing your own hands carefully afterwards. Close contact with affected dogs, and their vomit and diarrhoea are likely to be the main ways that GI bugs are transmitted.

Acknowledgments

SAVSNET is incredibly grateful to the vets (both independent and CVS group using Robovet and Teleos software) and labs (Idexx, Biobest, Battlab, NWL and VPG) who submit their data to us, and without whom such insights would not be possible.