by Jenny Drastura
HGE is a life-threatening disease that can occur in small and medium-sized
breeds but with accurate diagnosis and prompt treatment, hemorrhagic
gastroenteritis it has an excellent cure rate. Seeing our dogs with bloody diarrhea can give us a real scare. It can be
a sign of a small nuisance like a minor gastrointestinal upset or the dog swallowing bits of a hard toy. It can also signal a more serious illness.
One of these illnesses is hemorrhagic gastroenteritis. This type of diarrhea must be distinguished from other types as soon as possible as the
disease can be fatal within 24 to 48 hours. Before you become too alarmed,
the treatment success rate is excellent if the disease is caught early and
HGE vs. Parvovirus
Parvovirus is usually the first disease that comes to mind when your dog has an acute onset of bloody diarrhea. These patients also usually show
severe vomiting and dehydration. Parvo is most commonly seen in dogs 3 to 6
months of age. The diagnosis is confirmed by identifying the presence of the
virus in the feces in the early stages. The in-office ELISA test is also used. In later stages, there is a change in the white blood count.
Parvo is transmitted by exposure to the feces of an infected dog. Vaccination protocols have been established and are generally effective in
preventing the disease. Vaccine failures, of course, can occur.
HGE is not contagious. It primarily affects younger dogs, but may be
seen in all ages. Toy and medium-sized dogs appear to be at increased risk.
The disease is characterized by a sudden onset of vomiting, dehydration and
profuse bloody diarrhea. As the condition progresses, the dog will eventually go into a state of circulatory collapse that is, the veins
will collapse due to dehydration and loss of fluid from the intestinal tract.
If the disease is untreated, death will come from dehydration, hypothermia
Besides contagion, there are three things that distinguish HGE from
parvo. First, the dog often does not appear to be particularly sick in the
early stages of the disease, while the parvo dog will be obviously ill. Secondly, there is a large increase in red blood cells due to the
decrease in fluid content of the blood as dehydration progresses. In laboratory terms, the dogıs pack cell volume (PCV) will be high. A PCV of
more than 55 is an indication that the blood has thickened. Greater than 70
is a sign of serious illness. The white blood count (WBC) can be high, low
or normal. Thirdly, in HGE the diarrhea appears more clotted due to the high
presence of red blood cells. It is described in veterinary books as being malodorous and looking ³similar to strawberry jam.² (Sorry readers.)
Treatment for Hemorrhagic Gastroenteritis
Once HGE is diagnosed, aggressive supportive therapy with normal saline or lactated Ringerıs solution is started intravenously to treat the
circulatory shock. An antibiotic is prescribed as well. Food is withheld for
12 to 24 hours, allowing the intestines to rest. Bland food such as chicken
and rice or a commercial diet is introduced in small amounts. There is a gradual change to the regular diet unless that diet is thought to be a
factor in the HGE. Other tests may be given during the course of treatment to monitor
electrolytes, renal function, etc.
The exact cause of HGE is not known. It most closely resembles acute
hemorrhagic enteritis in humans, a disease caused by a strain of the E.
coli. Or it may be caused by a toxin produced by the bacteria Clostridium
perfringens. Another theory is that it is the bodyıs anaphylactic reaction
to undetermined toxins. Fortunately, even in the most seemingly hopeless cases, rapid recovery
can occur with the proper treatment. Residual effects are rare. There is sometimes a recurrence in HGE, although subsequent cases are not
necessarily more serious. As long as you are informed about this insidious disease, your dog will
do fine if it develops.
My interest in HGE stems from the fact that two of my dogs have had this disease. The dogs are not closely related, and there were
10 years between the cases. To show you how the symptoms can vary, the first dog vomited undigested
food twice in a period of three hours and otherwise seemed fine and bouncy.
A few hours later there was a small amount of the clotted diarrhea stuck to
her hair, and she was still acting fine. She slowly began to weaken on the
way to the vetıs office. Her PCV was 60. The second dog had a huge amount of diarrhea first and one episode of
vomiting. She was quiet but not necessarily weak. There were several very bad cases of bloody diarrhea while she was in the hospital. Her recovery
was a little slower than the first dogıs, though her PCV was lower. Both were hospitalized for two nights and recovered very nicely. They
are small dogs but were slightly older than the usual profile of HGE, 6
years old at the time.
Golden, Dennis L., DVM ³Acute Diarrhea in the Dog.² Pedigree
Breeder Forum Magazine, 1994.
Tams, Todd R., DVM. Handbook of Small Animal Gastroenterology.
Philadelphia: W.B. Saunders Company, 1996.
Published through the courtesy of the author and The Maltese Magazine
(copy and paste URL into a browser window) http://www.fix.net/~dogmag/maltese/maltese-home.html
Editor's note: While it
is hard to predict the onset of HGE and therefore
difficult to prevent, the use of concentrated raspberry juice
(reduced sugar if possible) has been reported as helpful.
Dr. Cavanagh from the school of biomedical sciences Australia,
observes that "a dash of concentrated juice kills E.Coli,
and staphylococci among other bugs." He noted that cattle
and pig farmers "routinely used raspberry cordial with at least
25% juice" and it worked very well to treat livestock.
Raspberry tea leaves have long
been used to insure easy delivery and quick clean-out in
pregnant bitches and may have some benefit related to increased
milk supply. The leaves however, seem to have no effect on
HGE, only the juice. Cranberry juice might work as it is
frequently reported to resolve bladder infections, particularly
in estrus bitches.
Some dogs are avid scavengers
and preventing them from ingesting spoiled or toxic foods may
also help prevent a reoccurrence of hemorrhagic gastroenteritis.
Do not allow a previously affected dog free rein as regards
The vet will have done a
diagnostic blood panel as part of diagnosis and checked the dog
for parasites which are known to cause HGE in susceptible dogs.
When a dog has suffered the classic bloody diarrhea, vomiting,
and drop in blood pressure, it seems to predispose the dog to
another reoccurrence but that could in fact be due to
environmental rather than a weakened or compromised immune
Gastroenteritis is common in
babies (who put everything into their mouths) and in young
children who also chew on toys and dirty objects. It is
not possible to stop dogs from licking but keeping the dog in as
clean an environment as possible and regularly disinfecting toys
and chew bones may help. Keeping the coat in long-haired
dogs clean or clipped, particularly around the genitals, anus,
and mouth (as in dogs with whiskers or beard) will help prevent
bacterial infections which are known to precipitate bouts of
diarrhea potentially escalating into hemorrhagic
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