Hemorrhagic gastroenteritis (HGE) is a disease of dog

Dog

The domestic dog is a domesticated form of the gray wolf, a member of the Canidae family of the order Carnivora. The term is used for both feral and pet varieties. The dog may have been the first animal to be domesticated, and has been the most widely kept working, hunting, and companion animal in...

s characterized by sudden vomiting

Vomiting

Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

 and bloody diarrhea

Diarrhea

Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

. The symptoms are usually severe, and HGE can be fatal if not treated. HGE is most common in young adult dogs of any breed, but especially small dogs such as the Toy Poodle

Poodle

The Poodle is a breed of dog. The poodle breed is found officially in toy, miniature, and standard sizes, with many coat colors. Originally bred as a type of water dog, the poodle is highly intelligent and skillful in many dog sports, including agility, obedience, tracking, and even herding...

 and Miniature Schnauzer

Miniature Schnauzer

The Miniature Schnauzer is a breed of small dog of the Schnauzer type that originated in Germany in the mid-to-late 19th century. Miniature Schnauzers developed from crosses between the Standard Schnauzer and one or more smaller breeds such as the Poodle and Affenpinscher.The breed remains one of...

. It is not contagious.

Cause

The cause is uncertain. Suspected causes include abnormal responses to bacteria

Bacteria

Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

 or bacterial endotoxin

Endotoxin

Endotoxins are toxins associated with some Gram-negative bacteria. An "endotoxin" is a toxin that is a structural molecule of the bacteria that is recognized by the immune system.-Gram negative:...

, or a hypersensitivity

Hypersensitivity

Hypersensitivity refers to undesirable reactions produced by the normal immune system, including allergies and autoimmunity. These reactions may be damaging, uncomfortable, or occasionally fatal. Hypersensitivity reactions require a pre-sensitized state of the host. The four-group classification...

 to food. Pathologically there is an increase in the permeability of the intestinal lining and a leakage of blood and proteins into the bowel. Clostridium perfringens

Clostridium perfringens

Clostridium perfringens is a Gram-positive, rod-shaped, anaerobic, spore-forming bacterium of the genus Clostridium. C. perfringens is ever present in nature and can be found as a normal component of decaying vegetation, marine sediment, the intestinal tract of humans and other vertebrates,...

has been found in large numbers in the intestines of many affected dogs.

Signs and symptoms

Profuse vomiting is usually the first symptom, followed by depression and bloody diarrhea with a foul odor. Severe hypovolemia

Hypovolemia

In physiology and medicine, hypovolemia is a state of decreased blood volume; more specifically, decrease in volume of blood plasma...

 (low blood volume) is one of the hallmarks of the disease, and severe hemoconcentration (lots of blood) is considered necessary for diagnosis. The progression of HGE is so rapid that hypovolemic shock and death can occur within 24 hours. Disseminated intravascular coagulation

Disseminated intravascular coagulation

Disseminated intravascular coagulation , also known as disseminated intravascular coagulopathy or consumptive coagulopathy, is a pathological activation of coagulation mechanisms that happens in response to a variety of diseases. DIC leads to the formation of small blood clots inside the blood...

 (DIC) is a possible sequela

Sequela

A sequela) is a pathological condition resulting from a disease, injury, or other trauma.Chronic kidney disease, for example, is sometimes a sequela of diabetes, and neck pain is a common sequela of whiplash or other trauma to the cervical vertebrae. Post-traumatic stress disorder may be a...

 of HGE.

Diagnosis

Symptoms of HGE and canine parvovirus

Canine parvovirus

Canine parvovirus type 2 is a contagious virus mainly affecting dogs. The disease is highly contagious and is spread from dog to dog by direct or indirect contact with their feces. It can be especially severe in puppies that are not protected by maternal antibodies or vaccination. It has two...

 (CPV) are similar enough that they need to be differentiated. HGE is different from CPV in that there is no fever

Fever

Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...

 or low white blood cell

White blood cell

White blood cells, or leukocytes , are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a...

 count, and that there is a high hematocrit. A negative fecal parvovirus

Parvovirus

Parvovirus, often truncated to "parvo", is both the common name in English casually applied to all the viruses in the Parvoviridae taxonomic family, and also the taxonomic name of the Parvovirus genus within the Parvoviridae family...

 test is sometimes necessary to completely rule out CPV. Other potential causes of vomiting and diarrhea, white foam from the mouth include gastrointestinal parasite

Parasitism

Parasitism is a type of symbiotic relationship between organisms of different species where one organism, the parasite, benefits at the expense of the other, the host. Traditionally parasite referred to organisms with lifestages that needed more than one host . These are now called macroparasites...

s, bacterial infections including E. coli

Escherichia coli

Escherichia coli is a Gram-negative, rod-shaped bacterium that is commonly found in the lower intestine of warm-blooded organisms . Most E. coli strains are harmless, but some serotypes can cause serious food poisoning in humans, and are occasionally responsible for product recalls...

, Campylobacter

Campylobacter

Campylobacter is a genus of bacteria that are Gram-negative, spiral, and microaerophilic. Motile, with either unipolar or bipolar flagella, the organisms have a characteristic spiral/corkscrew appearance and are oxidase-positive. Campylobacter jejuni is now recognized as one of the main causes...

, or Salmonella

Salmonella

Salmonella is a genus of rod-shaped, Gram-negative, non-spore-forming, predominantly motile enterobacteria with diameters around 0.7 to 1.5 µm, lengths from 2 to 5 µm, and flagella which grade in all directions . They are chemoorganotrophs, obtaining their energy from oxidation and reduction...

, protozoa

Protozoa

Protozoa are a diverse group of single-cells eukaryotic organisms, many of which are motile. Throughout history, protozoa have been defined as single-cell protists with animal-like behavior, e.g., movement...

l infections such as coccidiosis

Coccidia

Coccidia is a subclass of microscopic, spore-forming, single-celled obligate parasites belonging to the apicomplexan class Conoidasida. Coccidian parasites infect the intestinal tracts of animals, and are the largest group of apicomplexan protozoa....

 or giardiasis

Giardiasis

Giardiasis or beaver fever in humans is a diarrheal infection of the small intestine by a single-celled organism Giardia lamblia. Giardiasis occurs worldwide with a prevalence of 20–30% in developing countries. In the U.S., 20,000 cases are reported to the CDC annually, but the true annual...

, and gastrointestinal cancer.

Treatment

The most important aspect of treatment of HGE is intravenous fluid therapy

Intravenous therapy

Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...

 to replace lost fluid volume. The vomiting and diarrhea are treated symptomatically and will usually resolve after one to two days. Antibiotics targeting C. perfringens are also used. With prompt, aggressive treatment, the prognosis

Prognosis

Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...

is good. There is less than 10 percent mortality with treatment, but 10 to 15 percent of cases will recur.