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Name
Hemorrhagic Gastroenteritis, Canine
Short Description
Hemorrhagic gastroenteritis
Affected Animals: Dogs of all ages and breeds can be affected by
hemorrhagic gastroenteritis. Young adult dogs of toy and miniature
breeds, especially schnauzers and poodles, may be affected more
frequently.
Overview: There are many causes for bloody diarrhea and
vomiting in dogs. Hemorrhagic gastroenteritis, or HGE, refers to a
specific syndrome usually seen in young adult dogs of the toy and
miniature breeds. In HGE, fever is usually not present, and the main
laboratory abnormality is a marked elevation of the hematocrit
(concentration of blood cells) due to fluid shifts and intestinal
fluid loss. There is no diagnostic test that confirms the presence
of HGE. Its diagnosis is made mainly on clinical grounds.
Just as there is no unique diagnostic test for HGE, there is no
established cause for the illness. Treatment is similar as that for
other causes of vomiting and bloody diarrhea in dogs. However,
relatively large amounts of fluid are usually needed to replace the
fluid lost into the intestinal tract, and to reverse shock, if
present. Antibiotics are also given because bacteria may play a role
in causing HGE. Although the signs are sudden and severe, and some
dogs do not survive, most animals with HGE recover fully with prompt
treatment. Recurrences are possible in an individual dog, but they
are not common. Prompt veterinary attention is vital for any dog
with severe gastrointestinal signs and depression, whether due to
HGE or other causes.
Clinical Signs: The clinical signs of hemorrhagic gastroenteritis
include vomiting, bloody diarrhea, depression, and collapse, or
shock.
Symptoms:
See Clinical Signs.
Description: Canine hemorrhagic gastroenteritis, or HGE, is a
syndrome characterized by the sudden onset of vomiting, bloody
diarrhea, depression, and an elevated hematocrit on bloodwork. The
etiology, or cause, of HGE is not known. Changes in the mucosa, or
lining tissue, of the intestine result in fluid shifts from the
vascular system and changes in fluid secretion into the intestinal
tract. These changes appear to cause the symptoms of HGE. Animals
can become extremely ill in a very short period of time. Small and
toy breed dogs from two to four years of age are affected most
commonly. There is no specific diagnostic test for HGE, but the
occurrence of severe bloody diarrhea in a dog with an elevated
hematocrit, a normal white blood cell count, and no fever, strongly
suggests its presence.
Treatment requires prompt and aggressive fluid administration, and
shock-level doses are usually needed at first. Food and water are
withheld until the vomiting and diarrhea resolve. Steroids are given
to animals that are in shock, and dogs with severe blood loss may
require blood transfusion. Antibiotics are also given as part of the
supportive treatment for HGE. Most dogs recover with appropriate
treatment, although some may have additional bouts of the same signs
after the initial episode resolves.
Diagnosis: The diagnosis of hemorrhagic gastroenteritis
usually rests on the presence of severe diarrhea in a dog with an
elevated hematocrit. The elevated hematocrit results from fluid
shifts out of the blood vessels, and excessive fluid loss through
the intestinal tract. Additional bloodwork and x-rays are helpful
for excluding other causes of bloody diarrhea, as is testing of the
feces for the presence of parvovirus.
Prognosis: With prompt and aggressive treatment, most dogs
with HGE recover completely. Occasionally, some dogs will have
recurrent episodes.
Transmission or Cause: The cause of hemorrhagic gastroenteritis is
unknown. A bacterium called Clostridium perfringens has been
isolated from cultures of intestinal contents in dogs with HGE, but
its exact role in the syndrome has not been identified.
Treatment:
The main aspect of treatment for HGE is intravenous fluid
replacement. Large doses of fluids are usually required for initial
therapy. Fluids are continued for one to two days, as long as the
diarrhea persists. Antibiotics are also used because of the
potential role of bacteria in the development of HGE. Steroids may
be administered if the affected dog is in shock. Blood transfusions
may be needed if blood loss is severe. Food and water are withheld
until vomiting and diarrhea subside. These treatments are similar to
those for almost any cause of acute, severe diarrhea in dogs. HGE
symptoms should improve within 24 to 48 hours. If the affected dog
fails to improve after 48 hours, other causes of the symptoms should
be considered.
Prevention: Since the cause of HGE is not completely
understood, at present no known preventive measures exist.
