GastroEnteritis in Dogs

Hemorrhagic GastroEnteritis (HGE) in dogs is a sudden-onset episode of diarrhea, often very bloody in nature. Some dogs may vomit. The exact cause is unknown, but there are many theories. Stress may play a role in the development of HGE. This disease may affect any breed, gender, and age.

What does HGE stand for?

HGE (at least in terms of veterinary medicine) stands for Hemorrhagic GastroEnteritis, and it is a disease of dogs. In human medicine, HGE commonly stands for Human Granulocytic Ehrlichia(HGE). 

What are the signs seen with HGE in dogs?

The most notable sign seen with HGE is a very sudden onset of bloody diarrhea in a previously healthy dog. Vomiting, not eating (anorexia), and listlessness are also seen. Dehydration is not usually clinically seen on initial presentation, but shock can develop quickly without treatment.

What causes HGE?

At this time, the exact cause of this disease is unknown. There are many theories - diet, a bacterial infection or bacterial toxin, virus, reaction to an intestinal parasite, etc. - but nothing has been proven. Stress may play a role in the development of HGE. Dogs that have an episode of HGE may be prone to another occurrence. Many dogs never experience HGE.

What breeds/ages/gender of dog are more susceptible?

Toy and miniature breeds of dogs, ages 2 to 4, are the types of dogs most commonly seen, but HGE can affect any breed, gender, and age. There is no gender predilection (HGE occurs equally in males and females).

How is HGE diagnosed?

HGE is diagnosed primarily by ruling out other causes of bloody diarrhea. The sudden appearance of bloody diarrhea and a high packed cell volume (PCV) in a previously healthy dog rule in favor of the HGE diagnosis. Other causes of gastrointestinal bleeding that must be considered as possibilities and subsequently ruled out include:

• Gastrointestinal ulcers
• Colitis
• Parvovirus
• Coronavirus
• Campylobacter sp (bacteria)
• Salmonella sp (bacteria)
• Clostridium sp (bacteria)
• Escherichia coli (bacteria)
• Leptospirosis
• Whipworms
• Hookworms
• Coccidiosis
• Giardiasis
• Warfarin (rat poison) toxicity
• Thromobocytopenia (low platelets)
• Gastrointestinal cancer
• Hypoadrenocorticism

This sounds serious - is it a fatal disease?

Left untreated, this can be a deadly disease. However, with prompt veterinary care, most dogs respond to treatment and recover.

How is HGE treated?

The mainstay of treatment is aggressive supportive care -- no food or water by mouth for 1-4 days (while on IV fluid therapy), and intravenous (IV) fluid therapy with Potassium added to the fluids. Antibiotics are also recommended (IV, subcutaneous). Food should be reintroduced slowly and, in the event that the HGE is food related, a new (novel) protein should be given that the dog doesn't usually eat, i.e. chicken, lamb or cottage cheese.

What is the success rate? Do dogs recover from this?

With aggressive supportive care, most dogs recover within a few days. Some dogs can have repeated episodes of HGE.

What should I do if I see vomiting or diarrhea in my pet? Is it an emergency?

This is a hard question to answer, because there are so many causes for vomiting and / or diarrhea. As for any situation that is "not normal" for your pet, it is always recommended that you call your veterinarian and discuss what is going on. Your veterinarian will be able to advise you if it is a situation that can wait or if it sounds like an emergency.