Hemorrhagic gastroenteritis (HGE) is a cause of vomiting and bloody diarrhea in dogs. Learn why prompt diagnosis and treatment by your veterinarian is necessary to prevent potentially life-threatening complications from impacting your dog.
What Is HGE?
Hemorrhagic gastroenteritis (HGE), also called acute hemorrhagic diarrhea syndrome (AHDS), is an acute (or sudden) cause of bloody diarrhea (hematochezia) and vomiting in otherwise healthy dogs. Cats are not affected.
What Causes HGE?
The exact cause is not fully understood but it may be triggered by dietary indiscretion (eating foods or non-food items that upset the GI tract), a GI virus or toxin, concurrent gastrointestinal disease, as well as stress or anxiety. HGE is non-transmissible between dogs (meaning one dog can’t “catch” it from another), so usually only one dog per household is affected at any given time.
What Dogs Are Affected by HGE?
Any dog breed may be affected, yet cases in middle-aged Yorkshire terriers, Schnauzers, Dachshunds, or Poodles may be more prevalent. Dogs with food allergies may also be more likely to experience HGE.
What Are the Signs and Consequences of HGE?
Dogs experiencing HGE may at first look and act normally aside from their vomiting and diarrhea (which will be bright red in appearance or resemble raspberry jam and will have a very fetid odor). However, due to the amount of fluid and blood lost, affected dogs can soon appear very weak and lethargic due to severe dehydration; some may enter into hemorrhagic shock, a life-threatening condition. If not diagnosed and treated early on by a veterinarian, dogs with severe cases of HGE can develop anemia (low red blood cells) and hypoproteinemia (low blood proteins), experience hypoxia (low oxygen levels, which can cause tissue and organ damage) and cardiac arrhythmias (irregular heart beats), develop blood clots (DIC, disseminated intravascular coagulation, an often fatal condition), or develop sepsis (a life-threatening condition in which the body mounts a dangerous inflammatory response secondary to an infection; in the case of HGE, the intestinal lining becomes damaged, allowing bacteria to cross from the GI tract into the bloodstream).
How Is HGE Diagnosed?
Therefore, HGE requires prompt diagnosis by your vet, who will rule out other causes of bloody diarrhea (including canine parvovirus); your vet may also wish to perform a fecal test to rule out parasites or a bacterial infection. Abdominal X-rays or ultrasound as well as blood clotting tests may sometimes be recommended. Most commonly, bloodwork (CBC and chemistry) will be monitored to track hydration, anemia, and signs of infection. A urinalysis may also be performed. If your dog is very dehydrated, your vet will perform repeated blood samples to track PCV (packed cell volume); if PCV is very high (>60%), your vet will recommend shock doses of IV fluids to combat dehydration; if it is very low, a blood transfusion may be recommended.
How is HGE Treated?
Your vet will continue to deliver injectable fluids until your dog has stabilized; anti-nausea medication (such as Cerenia) and antibiotics to prevent secondary infection (such as ampicillin, enrofloxacin, or metronidazole) may also be administered. Once your dog has stopped vomiting, a bland diet will be given for a few days and then transitioned to your dog’s regular, well-balanced diet once HGE has run its course.
What Is the Recovery Time and Prognosis of HGE?
Most dogs recover fully within 2-3 days if veterinary treatment is initiated. If treatment is withheld, death can occur in severe cases, so always consult with your vet if your pet is experiencing vomiting or diarrhea.
Can HGE Be Prevented?
While there is no guaranteed method of preventing HGE, keeping your dog calm and stress-free, feeding a well-balanced commercial diet (plus, avoiding offering your dog treats or human foods he or she isn’t used to), and controlling GI parasites with proper preventives can help reduce your dog’s chances of developing HGE.
– Maranda Elswick, DVM
