HEMORRHAGIC GASTROENTERITIS
Hemorrhagic gastroenteritis (HGE) is a disorder of dogs which is usually fairly
abrupt in onset. The significant signs of HGE are vomiting and/or diarrhea
containing variable amounts of blood. The blood may be bright red (fresh blood)
or dark (digested blood).
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 signs resolve. More details on this are given
below.
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.
The exact cause of HGE remains unknown.
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 death.
Additional therapy may include antibiotics and anti-ulcer medication
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Updated 20-06-05