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What Is HGE (Hemorrhagic Gastroenteritis) in Dogs?

Hemorrhagic gastroenteritis or HGE in dogs is an emergency health situation that all dog parents should know about. So, what are the symptoms of HGE and how is it diagnosed and treated?

Stephanie Osmanski  |  Jul 18th 2018


Being a pet parent isn’t all cuddles and playing catch (although we all wish it was!). Sometimes, emergency health issues arise and dog parents need to know how to identify and circumvent such aforementioned situations. Hemorrhagic gastroenteritis in dogs (or HGE in dogs) is one such emergency situation.

First, what is hemorrhagic gastroenteritis (or HGE)?

A sick dog lying on the floor looking sad.

What exactly is hemorrhagic gastroenteritis in dogs and what do you need to know about it? Photography ©Lightguard | E+ / Getty Images.

Hemorrhagic gastroenteritis in dogs (or HGE in dogs) is a disorder marked by vomiting and bloody diarrhea. While loss of blood is not usually an issue for dogs suffering from HGE, it is often a main concern for dog parents. One of the main medical issues with HGE is the dog’s risk of dehydration.

“Hemorrhagic gastroenteritis — renamed acute hemorrhagic diarrhea syndrome (ADHS) — is characterized by the acute onset of bloody diarrhea and vomiting due to the superficial necrosis of the mucosa in the intestines,” explains Dr. Brooke Schampers, an Animal Emergency Service veterinarian.

What causes HGE?

Not much is understood about the causes of hemorrhagic gastroenteritis in dogs but veterinarians and experts within the field agree: the onset of HGE is quick and by no means subtle.

“The cause of HGE is still unclear so there is no way to prevent the condition,” says Dr. Katja Lang, a veterinarian at Heart of Chelsea Animal Hospital in New York, New York. “Small, young, purebred dogs are more prone to HGE but it can affect any size or breed.”

Hemorrhagic gastroenteritis in dogs remains mysterious and idiopathic (meaning the exact cause of it is unknown) but veterinarians do have some insight into a few factors that might exacerbate or induce the condition. According to vcahospitals.com, stress, anxiety and hyperactivity are thought to contribute to the onset of HGE. Other factors may include the ingestion of non-food items or toxins, pancreatitis, allergic reactions, bacteria or intestinal parasites.

Symptoms of HGE in dogs

The symptoms of hemorrhagic gastroenteritis in dogs come on fast. Symptoms include vomiting and bloody diarrhea, but can also include more generic things like loss of appetite and exhaustion.

“Other clinical signs include a painful abdomen, decreased appetite, lethargy and fever,” says Dr. Schampers. “The exact cause is unknown but studies have demonstrated that Clostridium perfringens is involved.”

Diagnosis of HGE in dogs

Think of the diagnosis process for hemorrhagic gastroenteritis in dogs as trial and error. As Dr. Lang explains, “it is a diagnosis of exclusion, meaning we have to rule out other causes of bloody diarrhea like a parasite, clotting disorder, Addison’s disease, etc.”

“We presume it is HGE if the red blood cell count is elevated and we have ruled out other conditions that can present with similar symptoms,” Dr. Lang adds.

The diagnosis of HGE is one of exclusion because, as Dr. Adelman explains, there is no definitive test for the disorder.

“A presumptive diagnosis is typically made based on appropriate clinical signs in combination with characteristic lab work findings of high-packed cell volume, which measures the concentration of red blood cells in the blood stream,” Dr. Adelman says.

She continues, “A normal PCV in dogs is 35-55%, whereas dogs with AHDS typically have a PCV greater than 60%. The measured amount of protein in the blood (total protein) is often normal or lower than expected relative to the PCV due to loss of plasma through the intestines. Images of the abdomen (x-rays, ultrasound) can help rule out other causes of hemorrhagic diarrhea and vomiting.”

Treatment of HGE in dogs

Now that you know a little bit more about hemorrhagic gastroenteritis in dogs, what its symptoms are, and how veterinarians work to diagnosis the disorder, let’s examine HGE treatment. Most of the treatment for HGE in dogs is considered supportive care.

“The treatment is supportive care but depends on the severity of the case,” says Dr. Lang. “In severe cases, this involves hospitalization for close monitoring, administering intravenous fluids, anti-nausea medications and antibiotics to prevent the spread of bacteria into the bloodstream.”

Dr. Alderman concurs — intravenous fluids are crucial to offsetting a dog’s risk of dehydration.

“Treatment of ADHS involves aggressive intravenous fluid therapy and supportive care with anti-diarrhea and anti-nausea/anti-emetic medications as indicated,” Dr. Alderman explains. “In some patients whose protein levels become very low, plasma transfusions are needed.”

And now, for the golden question every pet owner wants to know: Will your dog need to go on antibiotics?

“There is no consensus regarding the use of antibiotics for treatment of AHDS,” Dr. Aldeman says. “However, they are sometimes used due to the possible role of clostridial infection and risk of sepsis from bacteria crossing into the blood through a compromised gastrointestinal barrier. However, antibiotics may not be necessary in all cases. Other treatments such as probiotic therapy can be used.”

Prevention of HGE in dogs

How can responsible dog owners seek to prevent HGE? Unfortunately, veterinarians warn, there is not much you can do. And unfortunately, dogs that experience HGE once are more likely to experience an onset again.

Because HGE is idiopathic, there is not much owners can do in the way of prevention. What we can do is know how to expertly identify the symptoms, understand the diagnosis and treatment process, and have a solid understanding of how to make those processes go smoothly.

“Reasonable recommendations are to feed a high-quality cooked diet, avoid extra food or treats your dog may not be used to, use regular parasite prevention, and provide a low-stress environment,” Dr. Alderman encourages. “Veterinary attention should be sought immediately if signs of AHDS occur.

As a general reminder, Dr. Lang says, “Dehydration happens quickly in these cases and needs to be treated aggressively.”

So, if you notice your dog is vomiting and has blood in her diarrhea, contact your veterinarian immediately.

Tell us: Has your dog ever suffered from HGE?

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