Hemorrhagic Gastroenteritis (HGE) in Dogs
Hemorrhagic Gastroenteritis (HGE) has, in recent years, been renamed Acute Hemorrhagic Diarrhea Syndrome (AHDS), but you will hear veterinary personnel use either term. The term hemorrhagic gastroenteritis basically means inflammation of the stomach and intestine with bleeding. HGE is a life-threatening condition that occurs when large amounts of fluid or blood seep into the gut.
Signs of HGE present as a sudden onset of vomiting and/or bloody diarrhea in an otherwise seemingly healthy dog. Extreme dehydration will quickly follow, and if not promptly treated, the dog can go into shock and die.
Prompt medical attention and diagnosis are crucial to identify HGE and rule out other serious conditions so the dog can get the correct treatment. There are no specific tests for HGE, but a blood test called a packed cell volume (PCV or hematocrit) is helpful in making the diagnosis. Most veterinary hospitals can perform this test in-house using just a few drops of blood. A PCV measures the percentage of the blood volume made up of red blood cells. A normal PCV for a healthy dog will be 37-55 percent, but a dog with HGE will have a PCV of at least 57 percent, and often greater than 60 percent. Additional tests may be performed to rule out other causes of gastrointestinal issues and blood in the stool such as parvovirus, Addison’s disease, intestinal parasites, and rat poison intoxication. These tests may include an x-ray, ultrasound, biochemistry panel, and taking urine and fecal samples.
The cause of HGE has not yet been confirmed, as there are still many unknown factors. However, it appears to begin with infection from an intestinal bacterium that produces two toxins that ulcerate the intestinal lining, making the intestinal blood vessels permeable to fluid. In this way, fluid is lost into the intestine, dehydrating the patient. Other possible contributing factors include stress, anxiety, and hyperactivity.
While HGE can be seen in dogs of all ages and breeds, it most commonly affects small and toy breed dogs such as miniature pinschers, miniature Schnauzers, miniature poodles, Maltese terriers, and Yorkshire terriers. The average age of dogs diagnosed is 5 years. Most cases occur without warning.
Treatment of HGE will begin with aggressive intravenous fluid therapy. Anti-nausea and anti-diarrhea medications may also be used along with antibiotics if there is any evidence of a bacterial infection. In severe cases, plasma may be needed to correct low blood protein levels. The dog will most likely be hospitalized for a minimum of 24 hours to remain on intravenous fluid therapy with veterinary monitoring. It is unlikely that the vet will feed the dog during the first 24 hours of treatment. After that, when their condition starts to improve, water and small bland meals may be offered.
Prognosis for HGE in dogs is generally good as long as treatment is early, appropriate, and aggressive. However, there is a chance of the condition recurring. Prevention of HGE is based mainly on common sense. Owners should try to ensure their dogs live in low-stress environments, are fed on high-quality balanced diets, and given parasite preventative medications as directed by their veterinarians.
As a rule, owners should always seek immediate veterinary care if their pet has any bloody diarrhea or vomiting, as this is always an emergency situation.