Vet’s 2025 Guide to Canine Physalopterosis 🩺 Chronic Vomiting, Diagnosis, Treatment & Home Care

By Dr. Duncan Houston BVSc

💡 What is Physalopterosis?

Physalopterosis is a parasitic infection of the stomach caused by nematodes of the genus Physaloptera. Often referred to as "stomach worms," adult worms attach to the gastric mucosa and can cause chronic gastritis, vomiting, and occasional bleeding. Even a single worm can be enough to trigger clinical signs

🧬 Life Cycle & Transmission

• 🐛 Eggs with larvae pass in feces; infect insect intermediate hosts (beetles, cockroaches, crickets)
• 🕷️ Paratenic hosts like rodents, reptiles, and amphibians ingest infected insects, carrying larvae in tissues
• 🐶 Dogs become infected by eating insects or paratenic hosts; larvae mature to adults (3–6 cm) in stomach within 2–5 months

👀 Who Is Affected?

• 🐕 Any breed, age, or gender—but outdoor, hunting, or insect-eating dogs at increased risk
• 🐢 Wild carnivores (e.g., coyotes, foxes) act as natural reservoirs
• ⚠️ Due to low egg output and heavy eggs, infection is often missed on fecal detection

🧠 Clinical Signs

• 🤮 Chronic or intermittent vomiting is most common—may notice worms in vomit
• 😔 Variable signs: anorexia, weight loss, melena or dark/black stools, anemia in heavy infections
• ✅ Many dogs remain asymptomatic but still carry infection

🔍 Diagnosis

1. Endoscopy/Gastroscopy: Best method—visualizes and allows extraction of worms
2. Vomitus examination: Adult worms occasionally vomited and were visible
3. Fecal exam: Direct smear or sedimentation preferred—flotation often misses eggs
4. Clinical suspicion: Chronic vomiting with negative results for other GI issues warrants evaluation for physaloptera

⚙️ Treatment Protocols

• ✂️ Endoscopic removal of adult worms—immediate relief if all are removed
• 💊 Pyrantel pamoate (20 mg/kg PO every 2 weeks for ≥3 doses) is recommended by CAPC
• 🚫 Fenbendazole (50 mg/kg daily × 3 days) and ivermectin can be alternatives
• 🔄 Repeat treatment as needed and monitor for persistent signs—multiple courses often required
• 🛡️ In severe gastritis, short-term corticosteroids may be prescribed alongside anthelmintics
• 📅 Monthly deworming (with pyrantel or broad-spectrum products) reduces reinfection risk

🏡 Prevention & Control

• 🛑 Prevent ingestion of insects and paratenic hosts—manage cockroaches, crickets, wildlife contact
• 🐕 Keep dogs indoors or supervised outdoors to reduce hunting behavior
• 💉 Use monthly heartworm/interparasitic preventatives that include pyrantel
• 📋 Regular fecal exams with direct smear/sediment every 6 months for high‑risk dogs

📈 Prognosis & Outcomes

• 🟢 Excellent with removal and appropriate anthelmintic therapy—even single-worm infections respond quickly
• 🟡 Relapses are possible if reinfection occurs or worms were missed
• 🔴 Persistent infection can cause gastric ulceration, bleeding, malnutrition, anemia

📲 Ask A Vet App Home‑Monitoring Tools

• 🗓️ Schedule treatments and reminders for deworming & check‑ups.
• 📊 Track vomiting episodes, appetite, weight changes, and stool color.
• 📷 Upload photos of vomit or visible worms for vet review.
• 🔔 Symptom alerts if vomiting persists or blood appears.
• 📚 In‑app guides: "Parasite prevention", "Endoscopy overview", "Gastritis caretips".

🔑 Key Takeaways 🧠✅

• Physalopterosis is a stomach worm infection causing chronic vomiting and gastritis.
• Diagnosis via endoscopy, vomitus recovery, or direct fecal sediment exam.
• Treatment includes endoscopic removal + pyrantel pamoate (repeated doses).
• Prevention focuses on avoid insect/host ingestion and monthly deworming.
• The prognosis is excellent with timely diagnosis and treatment.
• Ask A Vet tools aid home monitoring, treatment compliance, and vet collaboration.

🩺 Final Thoughts ❤️

In 2025, management of stomach‑worm infection in dogs relies on accurate diagnosis, thorough treatment, and proactive prevention. With advanced endoscopic removal, repeated anthelmintics, and strategically placed prevention, most dogs recover fully. The Ask A Vet app empowers owners to log symptoms, track treatments, and collaborate seamlessly with their veterinary team for timely intervention and optimal outcomes 🐾✨.

Visit AskAVet.com and download the Ask A Vet app to schedule meds, log vomit, set deworm reminders, upload imagery, get alerts, and stay connected with your vet throughout treatment and recovery. 📲🐶