Recently we’ve had quite a few cases of hemorrhagic gastroenteritis (HGE) at Greenbrier Emergency Animal Hospital. The good news with HGE is that, seeing blood in their dog’s stool, many owners will bring them in immediately, allowing us to start treatment right away, greatly improving the survival rate and minimizing hospitalization time. HGE sometimes can be mistaken for colitis, an inflammation of the colon that presents with mucousy, blood-tinged stool. Patients with colitis — which we also see a lot of at Greenbrier — usually are bright and alert and can be treated as outpatients. Dogs with HGE, however, usually present with lethargy and very bloody, watery or mucoid diarrhea, and in severe cases can present in shock from dehydration. The diarrhea in cases of HGE has often been described as “strawberry jam-like”. Occasionally HGE causes vomiting as well.
The etiology or cause of hemorrhagic gastroenteritis is unknown but is thought to involve any one of the following: allergy, stress, parasites, or bacteria. Small breed dogs are affected most often, but any dog can get HGE. It is believed that when the condition is present, the permeability of the GI tract is increased, allowing protein and plasma to leak into the bowels and causing the dog to become severely dehydrated. The diagnosis usually is made based on the description of the diarrhea and a simple blood test that looks at the levels of protein and red blood cells. A very high level of red blood cells, low levels of protein and very bloody diarrhea is diagnostic for hemorrhagic gastroenteritis.
We treat HGE with high levels of IV fluids. Occasionally, dogs with low protein will need an additional type of IV fluid to boost the protein level. Other treatments might include antibiotics (since one theory holds that hemorrhagic gastroenteritis is caused by Clostridium, a form of bacteria), GI protectants, and antiemetics or antinausea medication. If untreated, HGE can be a life-threatening disease. Once placed on IV fluids, most dogs will need to be hospitalized for 1-3 days and then will be fine. But it is extremely important to seek veterinary care immediately if your dog has a bloody stool.
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