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?

A sick dog lying in bed with full stomach.
A sick dog lying in bed with full stomach. Photography ©beer5020 | iStock / Getty Images.

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?

Read more about dog health and care on Dogster.com:

21 thoughts on “What Is HGE (Hemorrhagic Gastroenteritis) in Dogs?”

  1. Pingback: What to Do About Dog Stomach Gurgling – Best Dog Care Info

  2. Thank you for the information, about 2 weeks ago my dog was pooping pure blood and I rushed to the ER they found out a combination of gastritis and pancreatitis, I am trying to educated myself about these 2 deceased since my dog has very good days but also bad days such loss of appetite and gurgling stomach that seems that cause pain on him. He’s been under medication and now just probiotics abs b12 injections, I need to constantly monitor my dog and my concern when he loss appetite if that can affect even worse his condition, we tried appetite stimulators and seems like they are no longer working for him ☹️ Any advise will be appreciated

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  4. Pingback: Dog Anxiety Probiotics – Dog Anxiety Symptoms

  5. Samantha Piotrowski

    We just went through this on Sunday with our 1 yr old weimaraner. She had a severe case and required not only IV fluids but plasma as well. I’ve had dogs my whole life (44 years) and I’ve never heard of this until 2 days ago. Its absolutely terrifying and with how unexpectedly it comes on, with no warning and how rapidly your loved one can decline. I wish there was so much more awareness around this condition. Luckly, our baby pulled through wonderfully but we acted quickly and the vet was aggressive, had this not occurred I hate to think what might have happened!

  6. Pingback: Dog Anxiety Vomiting – Dog Anxiety Symptoms

  7. I have 2 Portuguese Water dogs, a 12 yr. old male and 4 yr. old female. Both were just diagnosed with HGE. Came on suddenly with vomiting, every 2 hours. Couldn’t get in to the vet til 5pm the next day. Never saw signs of bloody diarrhea but noticed a pink tinge in the vomit after 4 hours. Bloody diarrhea was evidenced by vet. Male had to spend night with IV fluids, antibiotics and anti nausea. He was totally lethargic. Female got anti nausea, antibiotics and subcutaneous fluids. She was able to come home with us. Never had HGE before in any pet (and I’ve had dogs for 50 years.) Curious that both should succumb within hours of each other. They both eat dry food with fat content of no more than 9% to 12%. Nothing’s changed in their diets. They aren’t allowed off leash to eat random things. Where did it come from? How did they get it? What are the chances they will get it again?

  8. My 2 year old husky female was just diagnosed with this last night. I will say she is what I call a high strung dog. Within 4 hours she went from fine to vomiting and hemorrhaging blood from her rectum. She is the happiest dog I have ever encountered and she was lethargic and depressed. I have never been so scared about one of my animals as I was yesterday. She was put on two medications and given fluid injections and she was able to come home with me. Her PCV was 46% so luckily I caught this early. I have no idea how to keep stress from a high strung dog.

    1. May I ask what they put your Husky on? I have a 2 yr old shepherd that I’ve put a lot of money into that has been battling the same for the last 2 weeks. My house looks like the exorcist invaded. Same vets office 2 different vets and 2 different opinions. Everything from a basic thought and given meds to the other 1 saying it was EPI and cancelling out the meds and when the blood test showed no now he thinks its a food allergy . I woke to our little dog starting now. I think I’m as stressed as the dogs are.

  9. Pingback: Dog Anxiety And Vomiting – Dog Anxiety Symptoms

  10. My Lexie has had this four times since January. Always stays one to two days at Vet’s and given IV. This is getting so expensive to treat. We’re at our wits end. She is seven years old. It started every two months and now it’s only been one month. Should I keep putting her through this.

  11. I just got back from the vet and my mini-Aussie mix was diagnosed with HGE today. She is staying overnight on IV fluids due to severe dehydration. She is also on anti-biotics and anti-nausea medication tonight. The vet is going to give her pain meds later after she is more hydrated. Thankfully, I left work early to check on her because she didn’t eat her breakfast this morning which is unusual. She was also shivering and was noticeably lethargic. I had never heard of it but HGE is an emergency situation. It comes on very quickly and the dog can die if not treated right away. So thankful my vet could see her on short notice!

  12. Interesting that it is stated that reasonable recommendations are to feed a high-quality cooked diet… Seems a raw diet is gaining more popularity and is healthier, thoughts?

  13. My Labrador/Retriever
    Came out of vets after spending 1 week in there. From start of normal diarrhoea to pure blood from both ends within 3 hours! We nearly lost him. Drip, antibiotics via drip. Now home chicken rice diet, medication, and daily visit back to vet for next few days. But he is on road to recovery.

  14. We believe our Shepard boxer mix has this and he is unfortunately having a bout today and why I am on here. He hasn’t had an episode in months ever since we started feeding him exactly the same thing every day at the same time. We have to feed him every few hours and if we wait to long, or stray from the same food it always comes back. I fear that someone gave him pizza crust last night (guests who didn’t know better because most our friends know) that had tomato sauce on it because we know the acidity is an issue. We hate to take him to the ER because we have been through so many times and know he will work through it and each time it’s $500 or more with the probiotic prescription and he has made it through without the prescriptions previously. Tough call when he continues to drink water just fine but his stomach makes so much noise!! Good luck all.

  15. My dachshund/Basenji mix became sick after eating a Purina busy bone. We brought her to emergency after she kept having diarrhea. Otherwise she was acting ok. She was diagnosed with HGE and had to stay the night in the hospital. After 24 hours of fluids and meds, she came home, along with the remainder of her meds (all 4 of them!) Luckily she’s been doing well since then.

  16. Pingback: What Is HGE (Hemorrhagic Gastroenteritis) in Dogs? | Viral Top Feeds

  17. My last dog, a rough collie rescued from a hoarder, had a horrible case. I woke up early one morning and there was horrible bloody diarrhea all over the floor of the bathroom and hallway. I immediately took him to my emergency doctor who – like the article said – was evaluated for several problems and ended at HGE. He stayed in hospital for several days getting IV fluid. It was a horrible experience but he came through.

  18. Margaret Sullivan

    Hi Louanne Hull, I recently purchased a little female Cavalier King Charles Spaniel pup who had very loose motions [jelly like with blood]. I suspected she had coilitis. My suspicions were confirmed after a trip to the vet. He gave her an injection and antibiotics. As she was only 8 weeks I was concerned about her. He also said it could recur, thankfully she is ok so far. He gave her Canigest [which helps with the digestive system]. He recommended Farrado dry nuts [grain free]. It took a week or more for her to get back to normal. Thankfully she has put on weight and is thriving on Farrado. Hope this will help you and your little Chihuahua

  19. My little Chihuahua had a bout similar to this but has been diagnosed as IBS. After reading this article I’m beginning to wonder. She is on a prescription dog food and treats of any kind are out of the question. Her condition is a recurring one. I’m going to talk to my vet about this article. Thank you very much.

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