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Hemorrhagic Gastroenteritis in Dogs

Pay attention to the symptoms of hemorrhagic gastroenteritis in dogs, especially vomiting and diarrhea (either at once or alternating consistently).

If you see blood in your dog’s stool or vomit, don’t wait. Take your dog to veterinarian immediately.

If you live in an area known to have HGE outbreaks, be especially vigilant.

Do what you can to keep your dog’s immune system strong. It can’t hurt and might help.

The signs of hemorrhagic gastroenteritis come fast and furious. One day your dog may be healthy and the next day they can be vomiting mucus all over the house.

Then vomit turned red with blood and then came matching diarrhea. this is hemorrhagic gastroenteritis (HGE).

Hemorrhagic gastroenteritis is a mystery disease. No one knows what causes hemorrhagic gastroenteritis in dogs and there is no recommended prevention. It does not seem to be contagious from one dog to another, although dogs living together sometimes develop HGE at the same time, and some parts of the country have reported outbreaks of several cases. It’s most dangerous for small dogs, and although some veterinarians consider toy and miniature breeds between the ages of two and four the most typical HGE patients, males and females of all breeds and ages have been affected.

There are few, if any, hemorrhagic gastroenteritis warning signs. It is not usually accompanied by a fever. Diarrhea containing bright or dark red blood is the illness’s signature symptom. Vomiting, which usually accompanies diarrhea, typically begins as mucus or bile and then becomes bloody. Affected dogs may eat grass and vomit that as well.

Because HGE in dogs can be fatal, prompt veterinary care is essential. Patients are not usually dehydrated when first examined, but dehydration can develop quickly, leading to hypotension (low blood pressure), an elevated red blood cell count, shock, blood clotting problems, or kidney failure.

Confirming Your Dog Has HGE

Hemorrhagic gastroenteritis is usually diagnosed by a process of elimination since there are several other disorders that produce bloody vomiting and diarrhea.

Puppies and young dogs may develop these symptoms after eating slippers, leashes, or other foreign objects. Dogs of all ages can bleed from trauma injuries; the ingestion of toxic substances or contaminated food; gastrointestinal ulcers; colitis; infectious diseases such as parvovirus and coronavirus; infections from Campylobacter, Salmonella, Clostridium, Escherichia coli, and Leptosperosis bacteria; parasites such as whipworms, hookworms, cocciodiosis, and giardia; warfarin (rat poison); coagulation disorders; gastrointestinal cancer; and Addison’s disease (hypoadrenocorticism).

Because a comprehensive examination with complete blood count (CBC), biochemical profile, urinalysis, fecal examination, and bacterial cultures is both expensive and time-consuming, unless a specific cause can be quickly identified, such as a swallowed foreign object or parvovirus, the diagnosis is likely to be HGE. In addition to producing diarrhea that looks like raspberry jam, canine HGE patients appear tired and weak. Many have an elevated pulse and labored breathing.

HGE Treatment for Dogs

The treatment of HGE may or may not involve hospitalization, but it often includes the administration of fluids to prevent dehydration. Without sufficient fluids, the blood thickens and its flow through blood vessels may be impeded.

For patients treated early, subcutaneous fluids or even plain drinking water may be sufficient, but intravenous fluids are recommended to prevent “disseminated intravascular coagulation,” or DIC, a potentially fatal clotting disorder that occurs when the blood thickens and slows. Once DIC has begun, it is often irreversible.

Although HGE has not been shown to be caused by bacterial infections, parasites, fungal infections, viruses, or any other specific pathogens, many veterinarians prescribe medications that address these agents. In addition, patients may be given medications that treat ulcers, soothe the gastrointestinal tract, or prevent nausea, vomiting, or pain.

HGE recovery time for dogs is variable. The patient’s veterinarian may recommend that no food or water be given by mouth for one to four days to let the digestive system rest or that water be given in small amounts every few hours the first day and then in larger amounts as long as it doesn’t contribute to nausea and vomiting. Food is reintroduced slowly. A veterinarian may recommend that a new or different type of protein is fed to the dog in case the problem was related to the dog’s previous diet. Alternatively, prescription pet food may be used until the acute phase of HGE has passed.

Is Hemorrhagic Gastroenteritis Seasonal or Regional?

According to Dr. Wampler, dogs in the Helena Valley present these symptoms in spring and fall, when the ground is damp from snow melt or rain. She and her colleagues have tested affected dogs for the bacterial, viral, and parasitic infections listed above, and when dogs in multiple-pet households developed symptoms at the same time, as two dogs in a five-dog household did recently, they tested soil and water samples.

“But no matter what we test for,” says Dr. Wampler, “we can’t find a cause.”Hemorrhagic gastroenteritis is common in the spring in the Northeast, . I have treated five dogs in the past two months. There is usually no known cause, and we give supportive care with subcutaneous or IV fluids and medications like metronidazole, which works well against anaerobic bacteria and parasites such as giardia, just in case they’re involved.”

In the winters of 2004, 2005, and 2006, outbreaks of mild to moderately severe bloody diarrhea in dogs were reported to the Los Angeles County (California) Veterinary Public Health office. Because so many cases occurred near each other within a short time, researchers suspected that a contagious infection or food contamination caused the illness. However, extensive diagnostic tests conducted during each outbreak failed to reveal a connection.

In January 2009, the L.A. County Veterinary Public Health department reported a much higher than normal incidence of canine hemorrhagic gastroenteritis in the San Fernando Valley. They began collecting information about the diet and lifestyle of affected animals as well as the results of their physical exams, laboratory tests, and treatment protocols.

The department’s report explained, “If parvovirus is considered a possibility, a rapid in-clinic test on feces may be done first to make sure that is not the problem. Fecal tests for parasites are often performed. Blood tests often show that the dog has a very high red blood cell count and low protein levels as protein and fluid are lost into the gut. Sometimes additional tests such as fecal cultures are done, or radiographs of the abdomen are taken to check whether the dog has swallowed any unusual objects.”

Between January 1 and February 12, 2009, veterinarians at 13 Los Angeles County clinics reported 99 cases of bloody or watery diarrhea in dogs. Most of the patients (82) also had vomiting. Half recovered within five days and a half took longer to recover or had a waxing and waning disease course. At least 29 cases required intravenous fluid treatment, while others required less intensive care. Most cases were treated with antibiotics and anti-nausea or anti-vomiting drugs.

No evidence links this disease outbreak to January’s recall of peanut butter products contaminated with Salmonella. Of the 12 Los Angeles County dogs with HGE who were checked for Salmonella, all tested negative. Tests for several other infectious agents were also performed but none were conclusive. There is no evidence that any food contamination played a role because the affected dogs ate a wide variety of foods.

In almost 90 percent of cases reported, no other pet in the house had the same illness. HGE does not appear to spread easily from dog to dog, and it does not appear to spread from dogs to people. Whether HGE is a regional or seasonal illness remains speculative, but there does seem to be a connection in at least some parts of the country between HGE and certain times of the year.

In general, HGE strikes anywhere at any time. In most parts of the United States, it is a random rather than seasonal disorder. And it’s rare. If you’ve never heard of hemorrhagic gastroenteritis, you’re not alone.

What Causes HGE?

So far, the cause of hemorrhagic gastroenteritis has eluded everyone, but the search goes on.

Enterotoxigenic Clostridium perfringens is the most commonly suspected agent in HGE cases because specific strains of Clostridium have been associated with hemorrhagic gastroenteritis in both dogs and cats. This common inhabitant of soil, air, dust, and manure is found in the water of lakes, streams, and rivers, and it is a contaminant in many types of commercially prepared foods.

Toxins associated with Clostridium bind to the intestinal epithelial cells of infected animals, increasing membrane permeability. However, since Clostridium in dogs is a normal inhabitant of the intestinal tract, no one knows whether it’s involved. Some veterinarians suspect that allergies may play a role, but no one has been able to find a specific allergen that has caused HGE in any patient.

Is diet a factor? Some veterinarians and Internet resources blame raw food, home-prepared diets, and “people food” for HGE, but the evidence doesn’t support those claims, either. Most HGE patients have eaten commercial pet food all their lives. This doesn’t mean that diet isn’t a factor, but it’s one that hasn’t been proven. “One common contributing factor,” says Dr. Crosby, “may be stress or hyperactivity. I wonder if this might help explain why smaller dogs are over-represented.”

Hemorrhagic Gastroenteritis Home Treatment for Dogs

Not all HGE patients are hospitalized and not all of them need IV or subcutaneous fluids.

According to Small Animal Clinical Nutrition, a veterinary textbook edited by Michael S. Hand, et al, the best foods for patients with acute vomiting and diarrhea are those that do not produce “excess dietary acid load.” Foods that normally produce alkaline urine are less likely to be associated with acidosis than foods that produce acid urine. Grains are alkalizing foods, while meat is acidifying. As a result, according to this theory, foods that are high in grain may be more comfortable than meat-based diets for dogs with gastrointestinal distress.

Another theory is that high-fiber foods, such as canned foods prescribed for dogs with diabetes, may be helpful during the acute phase of HGE.

Keeping HGE in Perspective

Hemorrhagic gastroenteritis is a serious illness, but most dogs will never develop its symptoms. Still, because it progresses so quickly and is potentially dangerous, being able to recognize those symptoms and act on them can prevent another dog from HGE death. If your dog – or any dog – is bleeding from both ends, don’t wait. Get immediate help. With rapid treatment, the story will have a happy ending.

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