Hemorrhagic Gastroenteritis (HGE) in Dogs

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Overview of Canine Hemorrhagic Gastroenteritis 

Hemorrhagic gastroenteritis, commonly referred by the letters “HGE”, is a disease syndrome seen in dogs, characterized by the acute (sudden) onset of bloody diarrhea, usually explosive, accompanied by high packed cell volumes (red blood cells).

Below is an overview on HGE followed by detailed information about Hemorrhagic Gastroenteritis in dogs. 

Causes of HGE in Dogs

The true cause of HGE is unknown but there are some suspected causes.

  • Endotoxic shock, or poisons produced from bacteria causing shock
  • Immune mediated destruction of the intestinal lining
  • Infectious agents, possibly Clostridium
  • Predisposing Factors for HGE

    This is a syndrome seen in dogs only. All breeds can be affected, although the incidence is greater in small breed dogs. Schnauzers, Dachshund, Yorkshire terriers, and miniature poodles are the most commonly affected.

    HGE usually occurs in adult dogs, with the mean age of 5 years, and there is no sex predilection. HGE is most often seen in city dogs, or dogs housed in urban areas.

    What to Watch For

  • Acute vomiting
  • Anorexia
  • Depression
  • Bloody diarrhea

    Clinical signs are variable in both the course and severity of the disease. The onset of HGE is usually very quick/immediate, with no previous warning signs or health problems reported in the affected individuals. Signs progress rapidly and become severe within a few hours. Signs of shock, collapse, and sudden death have been reported.

  • Diagnosis of Canine Hemorrhagic Gastroenteritis 

  • Complete blood count (CBC)
  • Biochemical profile
  • Urinalysis
  • Fecal examination
  • Elisa for parvovirus
  • Bacteria cultures and cytology of the stool
  • Coagulogram, or clotting profile
  • Abdominal radiographs (X-rays) should be obtained to eliminate a foreign body or other disease process
  • Treatment of Canine Hemorrhagic Gastroenteritis 

    Patients suspected of having HGE should be hospitalized and treated aggressively because clinical deterioration is often rapid and can be fatal. Treatment includes:

  • Aggressive fluid therapy is the mainstay of therapy.
  • Antibiotics are recommended in most cases.
  • The patient should be kept off food and water until signs are clearly resolving, and the PCV is within normal range. A bland, easy to digest diet should be given for several days, and then your pet can be weaned back to a regular diet if his condition has improved.
  • Home Care and Prevention

    The prognosis for patients with HGE is excellent if it is caught early and treated aggressively. If you suspect your pet may have HGE, seek veterinary attention immediately. Administer all medication and recommended diet as directed by your veterinarian.

    Because there is no known cause of the syndrome, there are no preventative measures that can be recommended in these patients.

    In-Depth Information on Hemorrhagic Gastroenteritis (HGE) in Dogs

    Many conditions result in hemorrhagic diarrhea, although the hemorrhagic gastroenteritis (HGE) syndrome of dogs appears to have unique clinical features that distinguish it as an entity separate from other causes. Although HGE can affect any breed of dog, it is seen most commonly in small breeds.

    HGE is considered a common clinical condition, especially in dogs that live in urban settings. There is no way to prevent the syndrome, as we do not know with certainty what causes it. Most affected animals have been previously healthy, have no concurrent illness, and receive the best of care. Clinical findings are variable in both the course and severity of the disease.

    The most common sign seen is an acute onset of bloody, often projectile diarrhea. The bloody stools have been likened to dark raspberry jam. The prognosis for patients with HGE is generally excellent if caught early and treated aggressively. Most often hospitalization with intensive fluid therapy and support is necessary.

    There are many other diseases/disorders that can appear similar to HGE. These include:

  • Parvovirus is a contagious virus that can affect any age or breed of dog, although it is most common in the young, unvaccinated pup. The most common signs associated with parvo are vomiting, diarrhea (often with blood), and loss of appetite.
  • Bacterial enteritis, which is inflammation/infection of the intestinal tract with salmonella, clostridia, is commonly associated with signs that may mimic HGE.
  • Conditions resulting in endotoxic or hypovolemic shock, often associated with the movement of certain bacteria or toxins, or other overwhelming systemic infections, need to be ruled out.
  • Intestinal obstruction or intussusception, which is the telescoping of one part of the bowel into another, secondary to foreign bodies, tumors, or parasites can cause similar gastrointestinal signs.
  • Hypoadrenocorticism (Addison’s disease) is an endocrine disorder in which there is a hormonal deficiency, most often corticosteroids and mineralocorticoids, due to a problem with the adrenal glands. These individuals often present with signs extremely similar to HGE.
  • Uremia is when toxins or poisons are not excreted from the body associated with kidney failure. It is not uncommon for these patients to present with gastrointestinal ulceration, vomiting, and bloody diarrhea.
  • Pancreatitis, an inflammation of the pancreas, often presents for some combination of vomiting, inappetence, and/or bloody diarrhea.
  • Coagulopathies, or bleeding disorders, including thrombocytopenia (decreased platelets), warfarin ingestion, disseminated vascular coagulation (DIC), and bleeding secondary to liver disorders may present with bloody diarrhea.
  • Toxins including arsenic, thallium, Amanita mushrooms, and certain household cleaning products cause bloody diarrhea.
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