# HGE



## dwerten (Oct 6, 2007)

Hemorraghic Gastroenteritis (HGE)

By Jenny Drastura

HGE is a life-threatening disease that can occur in small and medium-sized breeds, and 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 hemorraghic 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 treated aggressively.

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 and shock.

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 dog¹s 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
Once HGE is diagnosed, aggressive supportive therapy with normal saline or lactated Ringer¹s 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 hemorraghic 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 body¹s 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.

Note:
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 vet¹s 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 dog¹s, 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 were 6 years old at the time.

Sources
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
http://www.fix.net/~dogmag/maltese/maltese-home.html

E-mail: [email protected]


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## theboyz (Jan 10, 2007)

Thanks for posting this.

Chase has Colitis and had the very same symptoms. Strawberry jam diarrhea and throwing up. We got him to the Vet asap and also pm'd Dr. Jaimie for support.
It took awhile but the diagnosis was "right on" and now with a special diet he is just fine.
It is a very scary thing to go through and see your baby so sick.

We are very careful what all 3 boys eat and watch all diets closely.


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## dwerten (Oct 6, 2007)

yep just went to vet today after the whole metacam fiasco and had blood in stool this am so ironic i posted this and now mine had blood in stool  her digestive tract has been all messed up since metacam - I was feeding chick and rice bland diet to stop vomitting then she got diarhea now this  so putting her back on hydrolized diet she was on before chick and rice -- it is a nightmare 

QUOTE (theboyz @ Mar 16 2009, 04:31 AM) index.php?act=findpost&pid=746080


> Thanks for posting this.
> 
> Chase has Colitis and had the very same symptoms. Strawberry jam diarrhea and throwing up. We got him to the Vet asap and also pm'd Dr. Jaimie for support.
> It took awhile but the diagnosis was "right on" and now with a special diet he is just fine.
> ...


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## Lil Sweet Pea (Jan 7, 2009)

Sweet Pea had bloody diarrhea about a month and a half ago - but not vomiting. I hadn't had her very long and it freaked me out! I took her to the emergency clinic in the middle of the night... and in the middle of an ice storm! He gave her an anti-biotic and then a day or two later I took her to her normal vet and he put her on an additional anti-biotic and suggested I feed her baby food - which she loved by the way.

I can't remember what he called it, but it was just a little bacteria and all cleared up after about a week. I was thankful for no more runs!

Hope your furbaby gets to feeling better! I understand, it just breaks your heart!


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## k/c mom (Oct 9, 2004)

QUOTE (theboyz @ Mar 16 2009, 05:31 AM) index.php?act=findpost&pid=746080


> Thanks for posting this.
> 
> Chase has Colitis and had the very same symptoms. Strawberry jam diarrhea and throwing up. We got him to the Vet asap and also pm'd Dr. Jaimie for support.
> It took awhile but the diagnosis was "right on" and now with a special diet he is just fine.
> ...


My first Malt, Rosebud, had the same symptoms, too. She threw up and had no appetite and I took her to the vet and they couldn't find anything. Then that night she had diarrhea that was sort of like jam or really more like Jello with lots of blood. It ended up being Giardia. I'll never forgot that whole situation even though it was probably 10 years ago... it was just so horrible.


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## Ladysmom (Oct 19, 2004)

Lady had HGE three times in four months last year. :crying: 

It's a horrible condition that can kill your dog in a matter of hours if you don't get veterinary attention immediately.


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## Lacie's Mom (Oct 11, 2006)

Tilly had HGE about 1 1/2 years ago. On Thursday morning at 6:30 a.m. she was playing and romping and being her normal energizer bunny. At 7:00 a.m. when I was leaving for the office she was hunched over like her tummy hurt.

I told Jerry to watch her. By 9:30 a.m. she had diarehha but Jerry didn't realize that it had blood in it. By 1:00 p.m. Tilly couldn't stand up and Jerry rushed her to our Vet and she was given blood tests and IV because she was so dyhadrated, our Vet contacted the Emergency Clinic as she knew that Tilly had HGE and would need to be at the clinic overnight.

Jerry arrived with her about 4:30 p.m. and I met him there as the ER Clinic is close to my office. Tilly was on death's doorsteps and I truly didn't think she would survive the night. On Friday, I stopped to see her on my way to work and when again at lunch time. She was better, but not her normal self. We were able to take her home at 8:00 p.m. Friday night. Saturday she seemed OK but tired. By Sunday you would never have known that anything had been wrong with her.

I really knew nothing about HGE until this happened and then, of course, read everything I could find on the subject. Thank goodness that Dr. Jaimie pmd me to let me know that she had seen many, many cases of HGE and that all of the furbabies had survived.

The one thing that amazed and surprised me was how terribly quickly Tilly went downhill. I often wonder if Jerry had not been at home and I had not gotten home until around 6:00 p.m. if Tilly would have still been alive.

Thanks for bringing this article to everyone's attention as it is a very dangerous illness with no known cause and really no concrete treatment.

Scary -- and it only seems to happen in toy breeds.


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