Prolific vomiting in dogs

In 2020, the Small Animal Veterinary Surveillance Network (SAVSNET) investigated reports of acute onset prolific vomiting in dogs in various parts of the UK.

Prolific vomiting is defined as five or more episodes in a 12-hour period, where a foreign body or pancreatitis is considered unlikely. We investigated this outbreak with Liverpool veterinary practitioner Dr Danielle Greenberg, who had seen a recent increase in suspect cases.

Based on statistical analysis by colleagues at the University of Lancaster, it was clear the current pattern of gastroenteric disease in dogs was outside normal parameters and therefore we were able to call it an outbreak. Our analysis of data suggests that this outbreak ended in April 2020. Thank you to everyone who participated in this research.

Please note, information on this page relates to the vomiting outbreak identified in 2020 and is not current.

Outbreak

• Several vets across the country reported an increase in vomiting in dogs. Affected cases seemed to vomit more frequently than is typical for canine gastroenteritis, and sometimes had diarrhoea and prolonged lethargy
• Based on SAVSNET data, we confirmed that there was an outbreak of gastroenteric disease affecting dogs in most areas of the UK. About half of the practices seemed to have experienced a similar increase in vomiting in dogs; this rise in cases lasted for approximately 4-6 weeks
• Real-time data from collaborating laboratories strongly suggested existing pathogens like parvovirus and salmonella were not involved.
• Dogs usually made a full recovery with routine symptomatic veterinary therapy. There is no known risk to people
• There was some anecdotal evidence that affected dogs could transmit the disease
• Both vaccinated and unvaccinated dogs were affected.

Symptoms

The information below about the classic presentation of affected dogs is based on a question and answer session with Dr Danielle Greenberg.

• Vomiting - this was unusual in the multiplicity and relentlessness of vomiting, roughly every 10 minutes and the forcefulness of the vomit. Typically the dog vomited 4-8 times. Sometimes the vomiting stopped, such as overnight, and then started again. Often dogs vomited after taking water at this time. The frequency of vomiting was the feature that Dr Greenberg first noted as being unusual
• Anorexia or pica - dogs were reluctant to take food for 2-5 days. This marked and repeatable clinical sign was unusual in its persistence after vomiting has ceased
• Lethargy - some dogs were lethargic (dull) for about 2-3 days after the onset of vomiting
• Diarrhoea - most but not all dogs had diarrhoea which could be described as ‘gravy-like’
• Other clinical signs: Surprisingly, dogs had not been drooling. They were normothermic on assessment of rectal temperature. However, temperatures were perhaps towards the cooler end of the normal range. Many dogs had a slow capillary refill time but pink mucous membranes. Heart rate and respiratory rate remained normal for individual dogs based on previous clinical exams. Relaxed abdomen, no tensing. On rectal exam, faeces were scant, and pasty light brown or normal in colour. There was no blood.

Treatment

The majority of cases responded to symptomatic therapy. Dr Greenberg used maropitant, gastrointestinal binding agents, a bland diet (home-cooked or bland gastro-type tinned food), and Buscopan if the dog had diarrhoea. Dogs were encouraged to take fluids. The most severe cases had intravenous fluid therapy.

All Dr Greenberg’s cases were asked to come in for a follow-up the next day. Only a small minority of dogs continued to vomit through maropitant. Interestingly, most owners reported that their dog was still not eating normally 1-3 days later, with full recovery often taking 5-10 days. This prolonged recovery seemed unusual compared to more typical cases of vomiting in dogs.