Re: Hemorrhagic gastroenteritis.

Dear Dr. Barchas, I wonder if you have thoughts on how a dog can avoid developing Hemorrhagic gastroenteritis? I take it from both my er & regular vet that this is not yet understood, so I am gathering opinions. My er vet did say it was in his experience more common in urban dogs but didn’t know why. My dog’s diaria did start the night I brought my other dog home from having knee surgery, so worry, or maybe sensing my prolonged worry on how keep my still frisky dog confined, was likely a factor.

But what else?? Thank you.

Ann
San Francisco

Hemorrhagic gastroenteritis, also known as HGE, is one of the least subtle syndromes in veterinary medicine. It occurs in dogs and it comes on fast. It is characterized by explosive, markedly bloody (and very malodorous) diarrhea. Vomiting sometimes also occurs. Dogs with HGE usually feel terrible. Owners of dogs with HGE often worry that their dog may bleed to death. In fact, most cases of HGE does not involve significant blood loss–a little bit of blood goes a long way in diarrhea. However, many dogs with HGE do suffer from life-threatening dehydration. HGE is a serious problem.

HGE is more of a description than a diagnosis–it describes the condition of any dog with dehydration and diarrhea typical of HGE. The cause of most cases of HGE is never determined. In my experience stress definitely contributes to HGE, but so does anything that can cause diarrhea. Such triggers include dietary indiscretion, intestinal parasites, acute allergic reactions (such as vaccine reactions), and intestinal infections. Small dogs may be predisposed to the syndrome, but HGE can occur in any breed. I have not noticed a difference in incidence between urban and rural dogs, but I don’t treat many rural dogs.

Treatment for HGE includes administration of intravenous fluids, antibiotics, and gastrointestinal protectants. Most dogs afflicted with the syndrome require at least 24 hours of hospitalization. Most dogs make full recoveries if they are treated, but some sources indicate that recovered dogs may be predisposed to further episodes of the syndrome in the future. This probably reflects the individual’s initial susceptibility to the syndrome rather than a sensitization that occurs during an episode of HGE.

I strongly suspect that stress played a role in the development of HGE in your dog. I recommend that you do your best to provide a stable, stress-free environment for him. I realize that this could be harder than it sounds, but I recommend that you try your best.