Issue Description Hemorrhagic gastroenteritis is a disease of
dogs characterized by sudden vomiting and bloody diarrhea. The
symptoms are usually severe, and HGE can be fatal if not treated. HGE
is most common in young adult dogs of any breed, but especially small
dogs. It is not contagious. Other Names HGE
Causes The cause is uncertain. Suspected causes
include abnormal responses to bacteria or bacterial endotoxin, or a
hypersensitivity to food. Pathologically there is an increase in the
permeability of the intestinal lining and a leakage of blood and
proteins into the bowel. Clostridium perfringens has been found in
large numbers in the intestines of many affected dogs.
occurs in all breeds of dogs, at any age. However, it appears to occur
more frequently in small and toy breeds of dogs. Breeds that seem to
have a higher than average incidence of hemorrhagic gastroenteritis
are the Miniature Schnauzer, Dachshund, Yorkshire Terrier, and
Miniature Poodle. The average age at onset of disease is 2-4 years
old, and there is no gender predisposition.
Symptoms Profuse vomiting is usually the first symptom,
followed by depression and bloody diarrhea with a foul odor. Severe
hypovolemia (low blood volume) is one of the hallmarks of the disease,
and severe hemoconcentration (a very high hematocrit) is considered
necessary for diagnosis. The progression of HGE is so rapid that
hypovolemic shock and death can occur within 24 hours. Disseminated
intravascular coagulation (DIC) is a possible sequela of HGE.
Diagnosis The diagnosis of HGE is one of exclusion,
meaning other possible causes of bloody vomiting and/or bloody
diarrhea must first be considered. Some of these possible causes
include ulcers, trauma, gastrointestinal tumors or obstruction,
foreign bodies, infectious diseases, and coagulation disorders.
Evaluation of these other causes might require such tests as a
complete blood count, biochemical analysis of the blood, urinalysis,
x-rays, coagulation tests, fecal evaluation ultrasound or endoscopic
(fiberoptic) evaluation of the gastrointestinal tract. Because the
costs of all these tests could be significant, it is sometimes prudent
to treat the dog for a few days with supportive care to see if the
HGE is most common in small breeds of dogs.
The blood count of affected dogs is frequently characterized by an
elevated hematocrit (red blood cell count). Most normal dogs have
hematocrits of 37-55%, while dogs with HGE may have hematocrits well
above 60%. The elevated hematocrit provides the veterinarian with an
important clue that the dog may have HGE.
Treatment Dogs with HGE will appear profoundly ill and,
if left untreated, may die. In most cases, the disorder appears to run
its course in a few days if the animal is given appropriate supportive
care. Intravenous fluid therapy provides the cornerstone of therapy
for HGE. Fluids given under the skin are not considered adequate to
meet the significant fluid requirements of most dogs with HGE.
If intravenous fluid therapy is not given, the dog's red blood count
will continue to elevate due to dehydration. Eventually, the blood may
become so thick that it flows very slowly through the blood vessels.
In this situation, the dog is a prime candidate for a potentially
fatal clotting disorder called disseminated intravascular coagulation
(DIC). Once DIC has begun, it is often irreversible and may result in
Additional therapy may include antibiotics and
anti-ulcer medication. With prompt, aggressive treatment, the
prognosis is good. There is less than 10 percent mortality with
treatment, but 10 to 15 percent of cases will recur.
Prognosis Hemorrhagic gastroenteritis typically lasts
about 2-3 days. The majority of dogs recover with no complications if
they are treated early on in the disease. Dogs that are not treated
have a poor prognosis for recovery. Pet owners should always be aware
that a small percentage of dogs with HGE will suffer relapses.
Since the cause of hemorrhagic gastroenteritis is still
unknown, there is no way to prevent the disease. Thus, it is important
for owners to act quickly when their pets show signs of illness.