Hemorrhagic gastroenteritis (HGE) in dogs

Hemorrhagic gastroenteritis (HGE), also known as acute hemorrhagic diarrhea syndrome (AHDS), is the acute onset of bloody diarrhea and vomiting in an otherwise healthy dog. Although the exact cause is unknown, veterinarians know how to treat this sudden illness with a high success rate. HGE is known to commonly affect small dogs and toy breed dogs like the poodle, miniature schnauzer, miniature pinscher, Cavalier King Charles spaniel, and the Yorkshire terrier.

As with all things that affect their dogs, pet parents want to know the underlying causes of HGE. Unfortunately at this time, vets only know possible causes of HGE.

Unknown causes

The exact cause of HGE is unknown, however, more research is being conducted to pinpoint the cause. Research has found that the bacteria Clostridium perfringens Trusted Source PubMed Central Archive of biomedical and life sciences journal literature. Go to source , also known as E.coli, is frequently found in HGE cases, but it is not present in all cases.

Possible triggers for HGE

There are many possible triggers for HGE outside of the bacteria. The wide range of recognized triggers makes diagnosing and researching difficult. Some of the possible contributing factors include:

• Dietary indiscretion (eating non-food items or new food)
• Stress and anxiety
• Diseases including immune-mediated and infectious diseases
• Intestinal parasites or bacteria
• Gastrointestinal tumors or obstructions

Because of the seriousness of this condition, it is a good idea to be familiar with the signs and symptoms of HGE. If you see these symptoms, seek veterinary care as soon as possible.

Early warning signs of HGE

HGE is an acute disorder meaning that it is very sudden in onset. As of now, there are no early warning signs of HGE. If your dog has a sudden onset of vomiting or bloody, watery diarrhea, get them in to see their vet as soon as possible.

Advanced symptoms of HGE

If you notice your dog’s gums are pale and sticky, contact your emergency vet to find out how to bring your pup in. Pale gums are a sign of dehydration which is the leading complication of HGE. You may also see your dog is very lethargic and will avoid food.

Because of the severity of the disorder, it is crucial for vets to diagnose HGE as soon as possible. Early treatment greatly reduces the risk associated with HGE. Vets are looking for two things: high red blood cell count with low plasma count, called hemoconcentration, and bloody diarrhea.

Physical examination and history

To determine the cause of the vomiting and diarrhea, vets will do a physical examination along with asking about your dog’s history. During the physical exam, they will press on the abdomen to check for any abnormalities and abdominal pain. This can sometimes cause some diarrhea to be pressed out during the examination.

For your pup’s history, include any past incidents of HGE if this is not the first time your dog has had it. You’ll also want to include everything that you know your dog has eaten in 24 hours before the vomiting or diarrhea started. This includes things that your dog doesn’t normally eat, as well as what they do.

Lab tests for HGE

In addition to the physical exam, your vet will do various lab tests to determine if it’s HGE. Although this is not an exhaustive list, most will conduct the following:

• Blood tests. Because of the high amount of liquids your pup is losing, they will get a complete blood count. They are looking at the levels of red blood cells, white blood cells, and plasma.
• Stool tests. They use these to test for intestinal parasites and bacteria.
• X-rays. Although HGE doesn’t normally show on an X-ray, your vet may opt to do them to rule out a blockage.

Because HGE causes the intestinal lining to become extremely permeable, fluids are leaking into the gastrointestinal tract. To combat HGE and prevent sepsis from setting in, aggressive treatment is necessary. The quick onset of symptoms makes it a high-risk condition.

Immediate treatment

Depending on how soon your vet starts treatment and what has caused this case of HGE determines the treatment needed.

• Intravenous fluid therapy. All cases of HGE get aggressive fluid therapy Trusted Source University of Illinois College of Veterinary Medicine Veterinary school. Go to source . This replaces the fluids lost in diarrhea and vomiting to stop dehydration from getting worse. The vet will also add in the appropriate mix of electrolytes and vitamins that have been lost. The leading cause of complications from HGE stems from dehydration.
• Subcutaneous fluid therapy. This is a more conservative treatment that some vets use to get fluids into the body. This is used in severe dehydration cases because it may be difficult to place an IV. It is also used when the owners may not be able to afford IV fluid therapy.
• Medications. Depending on the determined cause of HGE, vets may prescribe different antibiotics. This is to help with the infection that has already set in, or to keep an infection from occurring. They may also prescribe different medications to help with the vomiting and diarrhea.
• Plasma. If the blood’s protein levels have fallen below the normal range, vets may give plasma during fluid therapy as well. If too much plasma is lost, it could lead to blood clotting issues.

The good news is that with proper treatment, your pup can make a full recovery from HGE. Many dogs make a full recovery with no lasting effects of HGE. It has been noted that dogs that have had HGE are more likely to develop the life-threatening condition again than dogs who have never had it.

While your dog is recovering, most vets will prescribe a bland diet for the first few days. This keeps the GI tract from overworking itself after the trauma that HGE can cause. Although most cases of HGE cause dehydration, there aren’t any lasting effects because the treatment for HGE includes treatment for dehydration. Keep an eye on your dog’s activity level and make sure they have easy access to fresh water.

Because vets can’t pinpoint one specific cause for HGE, it’s difficult to make a plan to prevent it. There are a few helpful tips to lower the risk of your dog developing it.

Watch what they eat  — Make sure they aren’t getting into anything that is rotting or decaying. Also, make sure they don’t swallow any non-food items.

Lower their stress — Stress and anxiety have been linked to some cases of HGE. Keeping their stress levels down will make sure their bodies aren’t too worn down or tired to handle an infection.

Stay up to date on their vaccines — Parvovirus infections have  been linked with causing susceptibility to developing HGE.

Stay regular with heartworm prevention treatment — Heartworms are parasites found in the heart. Staying up to date on treatment lowers the chances of parasites getting into the GI tract.

HGE causes the lining of the large and small intestine to become very permeable, allowing liquids and blood to seep through and out. The imbalance this causes in the body can lead to serious conditions that have to be treated.

• Dehydration. Any case of vomiting and diarrhea can lead to dehydration because of the large amounts of fluids lost. Because blood loss can also lead to dehydration, HGE causes rapid dehydration. Severe dehydration can lead to death if not treated because the organs begin to shut down.
• Hypovolemic shock. Hypovolemic shock is when the heart can’t pump blood through the body because of the severe drop in fluid and blood levels in the body. This can happen when symptoms are seen separately such as in gastroenteritis or with vomiting and diarrhea.
• Kidney problems. Kidneys are the first in line to clean toxins from the blood. When the blood thickens and can’t flow, the toxins can set in and even create an infection in the kidneys. In extreme cases, this can lead to kidney disease or kidney failure.
• Blood clotting disorders. Blood clotting is controlled by the platelets found in the plasma. During HGE, the plasma levels drop, causing issues where the blood clots irregularly. It’s been seen not clotting at all or clotting in the vessels.
• Sepsis. Sepsis Trusted Source Centers for Disease Control and Prevention (CDC) Federal agency. Go to source is where the immune system is hypervigilant against infections which causes inflammation and can lead to blood clots and weak blood vessels. This greatly reduces the flow of blood throughout the body and can lead to organ failure in severe cases.

Although there is a high survival rate for dogs with HGE, it’s not guaranteed. HGE can be a very rapid condition and, in severe cases, may only last a few hours before we lose our canine friend. Losing a family member is never easy. It’s natural and normal to feel grief and loneliness. Reach out for support from family and friends, or make an appointment with a grief counselor.

Although there is no known prevention of HGE, there are steps that you can take to ensure your pup has a healthy lifestyle. Make sure to take them to their regular vet visits. If you think your dog may have an infection, don’t hesitate to take them. There is pet insurance available that can help with exam and medication costs. Loving our pets is the first way we can take care of them. Let’s make sure we can love them as long as we can.