No One Talks About HGE in Dogs! But We Will Today!

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What is HGE in Dogs? 

Hemorrhagic gastroenteritis (HGE) or Acute Hemorrhagic Diarrhea Syndrome (AHDS) occurs when a dog has bloody diarrhea and sudden vomiting. HGE in dogs has an acute onset.

Healthy dogs lose their appetite, start vomiting, and produce large quantities of bloody diarrhea. The stools resemble strawberry jelly as seen with undigested blood or dark brown with a foul smell with digested blood.

White labrador lying on the floor

What Causes HGE in Dogs?

The exact cause of HGE is unknown, but researchers’ theories include speculation about allergies, food sensitivities or dietary indiscretions, toxins, pancreatitis, parasites, and dysbacteriosis. 

Small breed dogs are highly susceptible to HGE, but the condition occurs in all breeds, with no specific gender or age predispositions.  Dogs prone to anxiety and hyperactivity have a higher risk of developing HGE. 

Some breeds that often suffer from HGE are listed below: 

  • Yorkshire Terriers.
  • Miniature Poodles.
  • Miniature Schnauzers.
  • Daschunds.
  • Maltese Poodles.
  • Pekingese.
  • Shetland Sheepdogs.
  • Cavalier King Charles Spaniel.

Bloody diarrhea in dogs occurs if the gastrointestinal mucosal lining becomes damaged. This damage results in blood entering the GI tract. 

Upper GI bleeding involves the mouth, esophagus, stomach, and small intestine. An upper GI bleed will result in the blood traveling through the digestive tract, where it undergoes digestion. The color can be seen as dark black stools or smears of rust on tissue paper when picked up.

Lower GI bleeding occurs in the large intestine. The result is usually a bright red-colored stool mixed with mucous. It can look like strawberry jam or appear as bright red streaks on the stool.   

Possible causes of gastrointestinal bleeding include:

  • Gastric or intestinal ulcers.
  • Trauma from bite wounds or a blunt force. 
  • Gastrointestinal neoplasia, or growths that cause an obstruction.
  • Foreign bodies.
  • Infectious diseases such as canine parvovirus.
  • Coagulation disorders or rodenticide toxicity.
  • Intestinal parasites such as giardia.
  • Intestinal microbe imbalances cause gut dysbacteriosis.

Clinicians do not consider HGE a primary inflammatory disease. The gastrointestinal tract has an altered mucosal permeability and hypersecretion. 

Some patients have Clostridium perfringens overproliferation, but there is still no evidence that the organism or its toxins cause HGE. 

HGE in Dogs’ Symptoms

HGE happens very quickly, so it is essential to note the symptoms. Some the signs of HGE can include:

  • Sudden loss of appetite.
  • Depression.
  • Vomiting.
  • Profuse, bloody diarrhea with a fetid odor.
  • Abdominal pain or discomfort. The patient’s belly will be firm or taught, and they will groan when owners palpate the abdomen.
  • Dehydration.

Shock can develop very quickly if the mucosal permeability of the GI tract becomes significantly altered. The combination of dehydration, haemoconcentration, and endotoxemia can be fatal.   

What to Do if Your Dog Has HGE Signs?

The rapid onset and severe nature of HGE make it a potentially life-threatening condition. Pets require veterinary care if their condition deteriorates rapidly and they exhibit severe clinical symptoms.

Diligently monitor your pet’s appetite and stools daily to detect any early signs. 

If your pet becomes lethargic, vomits multiple times in a short period, and has large bowel movements containing blood, they need to see the vet as soon as possible. 

HGE can lead to hemoconcentration, hypoglycemia, and hypovolemic shock if left untreated. 

How is Canine HGE Diagnosed?

Despite the condition describing blood and inflammation in the gastrointestinal tract, HGE is a diagnosis of exclusion. Clinicians must establish if there are potentially other causes for blood in the stool.

A veterinarian considers a patient’s complete clinical history and acute onset of symptoms and performs a physical exam when a dog presents with bloody stools. Some tests requested may include a complete blood count, biochemistry, radiography, endoscopy, or an ultrasound. 

The most dependable finding in HGE is extreme hemoconcentration. An average hematocrit concentration is between 35 to 40 % in healthy dogs. 

Haemoconcentration occurs when the packed cell volume (measurement of red blood cells compared to the fluid volume of blood) is greater than 60%. Some cases may reach between 70 to 80%. A high PCV and fetid bloody diarrhea are very common in HGE patients. 

HGE causes a dramatic water loss, and electrolytes like potassium, sodium, and chloride become very low. Total proteins may also be low or normal in HGE dogs.

HGE patients will not usually have a fever, and their laboratory results are typically unremarkable. If the patient is leukopenic, unvaccinated, or a puppy, testing for parvoviral enteritis must occur to exclude it as a potential differential diagnosis.  

Cute dog on couch

HGE in Dogs Diet Tips

The cause of HGE is unknown, so it is difficult to prevent. Here are a few tips if your dog has a sensitive stomach and is predisposed to frequent bouts of HGE.

  1. Avoid sudden diet changes – try to alter your dog’s diet gradually to avoid GI upsets. 
  2. Do not feed table scraps that are rich and high in fat.
  3. Feed high-quality food from trusted or reputable dog food brands.
  4. Do not leave treats such as raw hides or bones unattended with your pets because if they bury them or leave them in moist conditions, they can become seriously contaminated with bacteria. 
  5. Use internal parasite preventative medications.
  6. Ensure that highly strung dogs avoid high-stress environments.
  7. Use probiotics to help pets with sensitive digestive systems to help maintain a healthy gut microbe population. 

HGE in Dogs – Treatment

The sudden onset of HGE means that owners must act swiftly to prevent their pet’s symptoms from progressing to a life-threatening level. 

Dogs with HGE need supportive treatment to avoid complications associated with hemoconcentration and dehydration. Hypovolemia, electrolyte imbalances, and hypoglycemia can lead to a patient going into shock and possibly dying. 

Mortality rates are low in patients who receive treatment. Most treatments include the following steps:

  1. Administration of intravenous fluid therapy to correct hydration status, hemoconcentration, and electrolyte imbalance.
  2. Food and water restriction until vomiting has subsided. 
  3. The use of corticosteroids may be indicated in critical patients who are in shock.
  4. An antibiotic may be needed if there is a heavy overgrowth of bacteria such as C. perfrigens. Common antibiotics prescribed to combat secondary intestinal infections may include ampicillin, enrofloxacin, or metronidazole (brand name Flagyl®). 
  5. Antiemetic medication is often needed to help combat severe nausea and may include maropitant (Cerenia®) or Ondansetron
  6. Gastroprotectant medication may be necessary for some patients. 
  7. Clinicians may include probiotics and prescription foods to help the gastrointestinal tract recover from mucosal lining damage.
  8. In cases showing low blood protein levels, patients may need plasma or colloid therapy.  

During recovery, the attending vet will recommend specific prescription diets designed and formulated to help dogs who have suffered from gastroenteritis. Feeding your pet this diet for 7 to 10 days is essential to allow enough time for their gastrointestinal tract to regain its natural microbiome. 

Assess your dog’s appetite, habitus, vomiting, and the consistency of their stools daily to monitor their recovery. Gradually transition your pet to their regular food after ten days if their stools and appetite have returned to normal.

Most dogs will recover within 24 to 48 hours of therapy. Clinicians must investigate secondary complications such as ileus, intussusception, or endotoxemia if a patient is not showing improvement. 

HGE can be an emergency, often meaning pet owners may need to visit an emergency vet after hours. Hospitalization and after-hour vet treatments can be very costly. Pet insurance is always a great way to help avoid unexpected vet bills and allows clinicians the opportunity to provide the best standard of care.   

Is HGE in Dogs Contagious?

HGE in dogs is not contagious. HGE occurs without sudden diet changes, environmental contaminants, or infectious diseases. A fever with HGE is uncommon.

How Long Does HGE in Dogs Last?

Most animals show improvement within hours of treatment, and most symptoms of HGE will abate within 24 to 48 hours. The sooner the animal receives treatment, the better. Stools may remain soft and foul-smelling for several days.

Is Bloody Diarrhea in Dogs an Emergency?

HGE is a severe condition because the disease can cause circulatory failure and acute death.

Why is My Dog Not Eating After HGE?

HGE results in drastic changes in the gastrointestinal mucosal lining. The normal gut microbiome becomes disrupted, and healthy bacteria will take time to recover. 

A depressed appetite may result from food aversion from nausea and vomiting, gastric pain or irritation, and even stress from being ill. Most patients are fasted for 24 hours before being fed to allow their stomachs to settle. Most patients will eat again within 36 to 48 hours when offered water and small bland meals.

Dog waiting at home

A Final Word

Due to the frustrating fact that HGE has no defined cause, it is essential to try and support any pet with a sensitive gastrointestinal system by avoiding sudden diet changes and not feeding table scraps. 

HGE in dogs occurs rapidly and can progress to a life-threatening condition in a matter of hours. Pet owners should make it a habit to check their pet’s appetite and stool consistency at least once a day to ensure early detection of HGE. 

HGE can be fatal if left untreated. Acting quickly and avoiding HGE triggers can help to keep pets happy and healthy. Dogs predisposed to HGE should ideally have comprehensive pet insurance to avoid unforeseen vet bills.   

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Dr. Kaylee Ferreira, a South African vet from Johannesburg, excels in diverse veterinary roles. Founder of Kubuntu Veterinary Services, she's a dedicated animal lover and adventurer.