Features July 2009 Issue

Hemorrhagic Gastroenteritis in Dogs

Hemorrhagic gastroenteritis is scary, but responds to fast treatment.

The symptoms came on fast and furious. One day Chloe was a healthy, tail-wagging Labrador Retriever and the next day she was vomiting mucus all over the house. Then her vomit turned red with blood and then came matching diarrhea. Chloe had hemorrhagic gastroenteritis, or HGE.

Hemorrhagic gastroenteritis is a mystery disease. No one knows what causes it and there is no recommended prevention. It does not seem to be contagious from one dog to another, although dogs living together sometimes develop HGE at the same time, and some parts of the country have reported outbreaks of several cases. It’s most dangerous for small dogs, and although some veterinarians consider toy and miniature breeds between the ages of two and four the most typical HGE patients, males and females of all breeds and ages have been affected.

Chloe, a five-year-old companion of article author CJ Puotinen, survived a recent and scary bout of HGE. Her previous good health, CJ’s quick action, and aggressive veterinary care helped her recover quickly. Debilitated dogs don’t fare so well.

There are few, if any, HGE warning signs. It is not usually accompanied by a fever. Diarrhea containing bright or dark red blood is the illness’s signature symptom. Vomiting, which usually accompanies the diarrhea, typically begins as mucus or bile and then becomes bloody. Affected dogs may eat grass and vomit that as well.

Because HGE can be fatal, prompt veterinary care is essential. Patients are not usually dehydrated when first examined, but dehydration can develop quickly, leading to hypotension (low blood pressure), an elevated red blood cell count, shock, blood clotting problems, or kidney failure.

Confirming the diagnosis
Hemorrhagic gastroenteritis is usually diagnosed by a process of elimination, since there are several other disorders that produce bloody vomiting and diarrhea.

Puppies and young dogs may develop these symptoms after eating slippers, leashes, or other foreign objects. Dogs of all ages can bleed from trauma injuries; the ingestion of toxic substances or contaminated food; gastrointestinal ulcers; colitis; infectious diseases such as parvovirus and coronavirus; infections from Campylobacter, Salmonella, Clostridium, Escherichia coli, and Leptosperosis bacteria; parasites such as whipworms, hookworms, cocciodiosis, and giardia; warfarin (rat poison); coagulation disorders; gastrointestinal cancer; and Addison’s disease (hypoadrenocorticism).

Because a comprehensive examination with complete blood count (CBC), biochemical profile, urinalysis, fecal examination, and bacterial cultures is both expensive and time-consuming, unless a specific cause can be quickly identified, such as a swallowed foreign object or parvovirus, the diagnosis is likely to be HGE. In addition to producing diarrhea that looks like raspberry jam, canine patients appear tired and weak. Many have an elevated pulse and labored breathing.

Treatment
The treatment of HGE may or may not involve hospitalization, but it often includes the administration of fluids to prevent dehydration. Without sufficient fluids, the blood thickens and its flow through blood vessels may be impeded.

For patients treated early, subcutaneous fluids or even plain drinking water may be sufficient, but intravenous fluids are recommended to prevent “disseminated intravascular coagulation,” or DIC, a potentially fatal clotting disorder that occurs when the blood thickens and slows. Once DIC has begun, it is often irreversible.

Although HGE has not been shown to be caused by bacterial infections, parasites, fungal infections, viruses, or any other specific pathogens, many veterinarians prescribe medications that address these agents. In addition, patients may be given medications that treat ulcers, soothe the gastrointestinal tract, or prevent nausea, vomiting, or pain.

The patient’s veterinarian may recommend that no food or water be given by mouth for one to four days to let the digestive system rest or that water be given in small amounts every few hours the first day and then in larger amounts as long as it doesn’t contribute to nausea and vomiting. Food is reintroduced slowly. A veterinarian may recommend that a new or different type of protein is fed to the dog in case the problem was related to the dog’s previous diet. Alternatively, a prescription pet food may be used until the acute phase of HGE has passed.

Seasonal and regional?
Two weeks before Chloe’s symptoms began, she and I moved from New York to Helena, Montana. At 7 p.m. on a Monday in May, she vomited blood, and I drove her to the first veterinarian listed in the phone book who could see us. I used a plastic bag to gather a sample some of the bloody mucus that she vomited to show to the vet.

Heidi Wampler, DVM, took one look at Chloe and the bag of mucus and said, “This looks familiar.” Chloe’s pulse was fast but her temperature was normal, and when Dr. Wampler removed the thermometer, a pool of bright red diarrhea came with it.

According to Dr. Wampler, dogs in the Helena Valley present these symptoms in spring and fall, when the ground is damp from snow melt or rain. She and her colleagues have tested affected dogs for the bacterial, viral, and parasitic infections listed above, and when dogs in multiple-pet households developed symptoms at the same time, as two dogs in a five-dog household did recently, they tested soil and water samples.

“But no matter what we test for,” says Dr. Wampler, “we can’t find a cause.”

When I spoke with Chloe’s previous veterinarian, Stacey Hershman, DVM, in Hastings-on-Hudson, New York, she said, “Hemorrhagic gastroenteritis is common in the spring in the Northeast, too. I have treated five dogs in the past two months. There is usually no known cause, and we give supportive care with subcutaneous or IV fluids and medications like metronidazole, which works well against anaerobic bacteria and parasites such as giardia, just in case they’re involved.”

Photo by Rick Steele

Photo by Rick Steele

Helios, a Silken Windhound, was just a year and a half old when he developed HGE. The racing and coursing champion recovered after spending a week in a vet hospital.

In the winters of 2004, 2005, and 2006, outbreaks of mild to moderately severe bloody diarrhea in dogs were reported to the Los Angeles County (California) Veterinary Public Health office. Because so many cases occurred near each other within a short time, researchers suspected that a contagious infection or food contamination caused the illness. However, extensive diagnostic tests conducted during each outbreak failed to reveal a connection.

In January 2009, the L.A. County Veterinary Public Health department reported a much higher than normal incidence of canine diarrhea and hemorrhagic gastroenteritis in the San Fernando Valley. They began collecting information about the diet and lifestyle of affected animals as well as the results of their physical exams, laboratory tests, and treatment protocols.

The department’s report explained, “If parvovirus is considered a possibility, a rapid in-clinic test on feces may be done first to make sure that is not the problem. Fecal tests for parasites are often performed. Blood tests often show that the dog has a very high red blood cell count and low protein levels as protein and fluid are lost into the gut. Sometimes additional tests such as fecal cultures are done, or radiographs of the abdomen are taken to check whether the dog has swallowed any unusual objects.”

Between January 1 and February 12, 2009, veterinarians at 13 Los Angeles County clinics reported 99 cases of bloody or watery diarrhea in dogs. Most of the patients (82) also had vomiting. Half recovered within five days and half took longer to recover or had a waxing and waning disease course. At least 29 cases required intravenous fluid treatment, while others required less intensive care. Most cases were treated with antibiotics and anti-nausea or anti-vomiting drugs.

No evidence links this disease outbreak to January’s recall of peanut butter products contaminated with Salmonella. Of the 12 Los Angeles County dogs with HGE who were checked for Salmonella, all tested negative. Tests for several other infectious agents were also performed but none were conclusive. There is no evidence that any food contamination played a role, because the affected dogs ate a wide variety of foods.

In almost 90 percent of cases reported, no other pet in the house had the same illness. HGE does not appear to spread easily from dog to dog, and it does not appear to spread from dogs to people. Whether HGE is a regional or seasonal illness remains speculative, but there does seem to be a connection in at least some parts of the country between HGE and certain times of the year.

In general, HGE strikes anywhere at any time. In most parts of the United States, it is a random rather than seasonal disorder. And it’s rare. If you’ve never heard of hemorrhagic gastroenteritis, you’re not alone. Even at its peak, the Los Angeles County outbreak affected less than a fraction of one percent of the county’s 1.9 million canines. But if your dog is one of its victims, HGE is an enormous problem.

Canine patients
Janet Tobiassen Crosby, DVM, has treated only one dog for HGE, and that was during her first year of veterinary practice. However, dozens of dog lovers across the country have described their pets’ bouts with HGE at her Veterinary Medicine Blog and online forums.

The patients’ breeds include Jack Russell Terrier, Beagle, Pembroke Welsh Corgi, Labrador Retriever, Pit Bull, Toy Fox Terrier, Miniature Dachshund, Golden Retriever, English Bulldog, Miniature Poodle, Miniature American Eskimo, Yorkshire Terrier, English Springer Spaniel, Maltese, Miniature Schnauzer, Bichon Frise, Shih Tzu, Chihuahua, Silken Windhound, and several mixed breeds.

Their stories illustrate the frustration, confusion, fear, and loss that HGE produces, for many of these dogs were desperately ill and some of them died. If the reports share a common message, it’s a plea for fast action.

“Time is of the essence,” agrees Dr. Crosby. “Because there are so many possible causes of vomiting or diarrhea, the best thing you can do is call your veterinarian immediately. HGE has a high survival rate when patients receive aggressive support therapy, and a pet that has observant caretakers (the situation just happened and they responded right away) has a much better chance than pets that have been sick for days. It also helps if the dog is in good health to begin with and at a good weight. Age can be a factor, too, with young to middle-aged dogs bouncing back faster. Like other illnesses, HGE is hardest on pets that are in poor shape to begin with.”

One HGE survivor whose story appears on Dr. Crosby’s forum is Helios (Ch. Talisman’s Light of Helios SRC IC), a Silken Windhound with racing and coursing titles who lives in Walnut Creek, California, with Joyce Chin. In May 2008, when he was one and a half years old, Helios became lethargic and vomited bloody foam.

“He wasn’t interested that morning in playing with the pups,” says Chin, “and he’s always playing with the pups. Since he’s always so happy and on the go, it was a dramatic change. He developed bloody diarrhea and was in the vet clinic on IV fluids and IV antibiotics for almost a week. He’s better now and has regained the weight he lost, but he really could have died. I’m so glad we were around to catch it. It would have been very hard to lose him, he’s such a happy part of the family here. When he was in the hospital, all the hounds were looking for him.”

Hospital stays can be expensive. Just ask Heidi Hansen, who lives in San Anselmo, California, with her eight-year-old, 100-pound yellow Lab, Herbie.

“Herbie’s HGE symptoms started at about 5 a.m. on a Sunday last April,” she says, “and by 9 a.m. he was in the hospital. He stayed there for three days and needed albumin transfusions. The total bill came to $5,620.”

Fortunately, Herbie survived his ordeal. “He’s better now,” says Hansen, “but he’s slower than before. This took a lot out of him. He had blood loss once before, so he has had a tough time.”

Looking for culprits
So far, the cause of hemorrhagic gastroenteritis has eluded everyone, but the search goes on.

Enterotoxigenic Clostridium perfringens is the most commonly suspected agent in HGE cases because specific strains of Clostridium have been associated with hemorrhagic gastroenteritis in both dogs and cats. This common inhabitant of soil, air, dust, and manure is found in the water of lakes, streams, and rivers, and it is a contaminant in many types of commercially prepared foods.

Toxins associated with Clostridium bind to the intestinal epithelial cells of infected animals, increasing membrane permeability. However, since Clostridium is a normal inhabitant of the intestinal tract, no one knows whether it’s involved. Some veterinarians suspect that allergies may play a role, but no one has been able to find a specific allergen that has caused HGE in any patient.

Is diet a factor? Some veterinarians and Internet resources blame raw food, home-prepared diets, and “people food” for HGE, but the evidence doesn’t support those claims, either. Most HGE patients have eaten commercial pet food all their lives. This doesn’t mean that diet isn’t a factor, but it’s one that hasn’t been proven. “One common contributing factor,” says Dr. Crosby, “may be stress or hyperactivity. I wonder if this might help explain why smaller dogs are over-represented.”

The stress theory makes sense to me. For a month before we moved, Chloe lived with packing boxes and confusion. Her morning routine was interrupted when I tripped on a log while hiking and broke my right wrist. Thanks to friends, the packing got done, but I wasn’t able to drive, take Chloe for hikes, or prepare her usual dinners. We switched to a dehydrated food for convenience, and she did well on it as she has in the past while traveling or staying with friends.

After the moving van departed, my fiancé, Stephen, drove us 2,300 miles with Chloe and Pumpkin (a red tabby cat) on my car’s back seat. Waiting for us in Helena was our new roommate, a Cairn Terrier. Seamus is a sweet dog but he guards food and toys. While Chloe gets along with everyone, settling into her new home made May a stressful month.

Herbie is an eight-year-old Labrador who needed blood transfusions to recover from HGE. The vet bill came to almost $6,000.

And while HGE doesn’t seem related to pathogens, I can’t help but notice a coincidence of timing. For most of her life, Chloe has consumed one or two tablespoons of coconut oil every day, a supplement whose medium-chain fatty acids help destroy viruses, harmful bacteria, parasites, yeast, and fungi. She also received probiotics, which are the body’s first line of defense against many agents of infection, along with supplements that improve digestion and the assimilation of nutrients. But during and immediately after our move, I forgot or was at best inconsistent. When Chloe’s immune system most needed a boost, it wasn’t getting one.

Because a small number of dogs develop HGE more than once, one of my goals is to protect Chloe from future episodes. Even though the HGE experts say there is no way to do this, anything that strengthens her immune system sounds like a good idea! Stress relief is another strategy we’ll employ to keep her healthy. The passage of time and a comfortable daily routine are already helping to reduce Chloe’s stress.

Home support
Not all HGE patients are hospitalized and not all of them need IV or subcutaneous fluids. Dr. Wampler sent Chloe home with medication and instructions to call during the night if she continued to vomit or if her symptoms grew worse. In her favor, Chloe was five years old, athletic, and otherwise healthy.

Dr. Wampler warned us that Chloe would probably have diarrhea without realizing it and that we might want to confine her to keep things tidy. I put layers of towels in Chloe’s crate and changed them twice during the night when they became soaked. Owners who describe how they discovered their dogs in what looked like a slaughterhouse or excecution scene aren’t exaggerating. HGE can be a huge and malodorous mess.

That night we gave Chloe small amounts of water but no food. According to Small Animal Clinical Nutrition, a veterinary textbook edited by Michael S. Hand, et al, the best foods for patients with acute vomiting and diarrhea are those that do not produce “excess dietary acid load.” Foods that normally produce alkaline urine are less likely to be associated with acidosis than foods that produce acid urine. Grains are alkalizing foods, while meat is acidifying. As a result, according to this theory, foods that are high in grain may be more comfortable than meat-based diets for dogs with gastrointestinal distress.

Another theory is that high-fiber foods, such as canned foods prescribed for dogs with diabetes, may be helpful during the acute phase of HGE. Dr. Wampler give us four cans of a high-fiber prescription food to help Chloe make a comfortable transition back to solid food.

Her appetite came back the next morning but she vomited the small amount she swallowed and lost interest in food for the rest of the day. The towels in her crate didn’t need to be changed, but she released alarmingly red diarrhea in the backyard. The one encouraging sign was her thirst, for she drank increasingly large amounts of water that stayed down.

By Wednesday, 48 hours after her first symptoms, Chloe’s appetite was back and she was on the mend. By Friday, she was her tail-wagging self again, producing normal bowel movements and ready for hiking. She was delighted to resume her regular diet and has been thriving ever since.

Keeping HGE in perspective
Hemorrhagic gastroenteritis is a serious illness, but most dogs will never develop its symptoms. Still, because it progresses so quickly and is potentially dangerous, being able to recognize those symptoms and act on them can mean the difference between life and death. If your dog – or any dog – is bleeding from both ends, don’t wait. Get immediate help. With rapid treatment the story should, like Chloe’s, have a happy ending.

CJ Puotinen is a freelance writer and a longtime contributor to WDJ. She is also author of many books on holistic health, including Natural Remedies for Dogs and Cats. She recently moved to Helena, Montana from New York. For contact and book purchasing information, see “Resources,” page 24.

Comments (21)

I hope your dog never gets HGE! Our 10 month old lab is home after spending the night and full day at emergency vet hospital. On Thursday afternoon he was diagnosed with giardia and was sent home with meds which we gave him around 5 pm. Around six he started throwing up. When the 5th was red tinged it was time to have him checked out. While there he started having bloody blowouts from the other end, was dehydrated and in pain. We left him there on IV drip and meds. The next morning he refused food and fell asleep with his head in his water bowl. Went up to see him around 11 and he was up, ate and I walked him out to pee. He was doing so well we were able to bring him home at 8 pm. He is not perfect but much more himself. He was text book!

Posted by: Judyadz | August 24, 2014 10:51 AM    Report this comment

My youngest chihuahua, Precious, is just recovering from an episode of HGE. She has had one other mild episode in the past but this one was a bit worse. She only required subq fluids as opposed to a hospital stay thankfully. I wish I knew what caused it. She was so miserable and so weak from it. She is on Hill's i/d low fat prescription diet which is what my older chihuahua is on for her pancreatitis. I wonder if I should just keep her on it or switch her off. I know, nutritionally, it isn't the best food on the market but it keeps my Angel out of the hospital for pancreatitis attacks so we stick with it.

I am very curious about Ankhorite's comment and mention of cancer being a possible trigger. My chihuahua had a mass cell tumor removed a couple of years ago so I wonder now if there is more to be concerned about? Going to have to do much more research about this.

Posted by: iluvmychis | August 11, 2014 3:20 PM    Report this comment

My 13 year old Jack Russell Terrier has alot of these symptoms at least once a week. I have been told he has pancreaititis however he has had the pancreatic specific lipay blood tests several times and the majority have come back as ok. He also had cancer surgery in 2011 to remove a large sarcoma from his back as well as several mast cell tumours between 2011-2013. he developed quite severe oesophogitus and pancreaititis after a seven hour surgerywhich was successful. I am curious to know whether the other dogs written about below are ok now or hace reoccurring bouts of the same problem. I have tried chicken and Hills I/D kibble, turkey, venison and steak all fat free options and no real treats for my Sam and he still gets sick. He is on losec daily and metamide for nausea but nothing seems that helpful anymore. He vomits alot of white foam and feels miserable. I have codeine tablets for him but he turns into skitzo dog when I try and give him one so I usually leave it so he doesnt get anymore stressed than he already is. It is a very frustrating and repetitive cycle because when he is not having one of these episodes he is full of life running around like a two year old chasing and playing with my other dog who is a six year old foxie and Sam is happy and eating well. Any advice would be appreciated from New Zealand thank you.

Posted by: Sarznz | July 7, 2014 8:51 PM    Report this comment

My little Pom, Pumpkin, just went thru a serious bout of HGE. She had had squishy poops about five before hand, but when I gave her a different food, then she really had just awful diarrhea and vomiting. When the bloody stool came, that's when I rushed her to the vets. She's been then there three nights, and is coming home tonight. I'm so glad I could get her in to the vets fast, and they recognized what this was...

Posted by: Pumpkin's Mom | May 30, 2014 1:26 PM    Report this comment

Gastroenteritis - Hemorrhagic. My male baby 15 months mini schnauzer was vomiting since yesterday and had stopped eating. Last night, the symptoms got worse and turned to bloody vomits & diarrhea. It was so scary. I took my baby to vet office this early morning; the vet admitted him to hospital right away for immediate treatments for IV antibiotic, IV fluid & stop vomiting/bleeding med. Since I reacted early, vet said I could pick him up tomorrow night to continue treatment at home. I suspect he ate a poisoned rat from neighborhood. He could run so fast that sometimes I could not keep up with what he picked up from the ground. Blessings to all dogs & dogs lovers.

Posted by: panda888999 | March 12, 2014 5:41 PM    Report this comment

i just got my 4 years old pom throwing up a lot of bloody liquid. at first she was vomiting her own food, then 20 minutes after, she start to throwed up again. this time a lot of bloody liquid. i was really scared to death. it was last night at 8.30 pm. i live in Indonesia jakarta, where there's no ER vet CARE. on top of that these weeks is a holiday weeks to celebrating Idul fitri, where most of the clinics already closed for a holiday. devastated and scared, i have had to wait until the next morning to took her to the clinic. i cant slept, and really scared. the first time in my life i seen her throwing up that bloody liquid. all night long she was throwing up foamy white mucus. i try to give her rantinidine, but she throwing it out again. on the way to the vet, she also throwing out a lot of white foamy liquid-mucusy like. as soon as we got into the clinics, i start to shout help my pom to the vet. the vet then put my girl on IV, gave her a shot of ranitidine and a Bio ATP Bcomplex vitamin. and i ask for a complete blood test. when the vet drawn her blood it was really thick and wasnt able to flow. my girl is still "lively" and doesnt look like she was sick at all. im really confused this things already happened many many time. it's been 5 months. it was start in march, where she got a sudden vomited. then diarrhea is appear. it was black and tarry like. brought her to the vet, just to be sent home w/ranitidine and pimperan. the next 2 days, we got an explosive diarrhea. again, black and tarry. brought her again to the other vet, tested for feces parasyte, came out negative. sent home w/sulcrafate and rantinidine. got better for 1 weeks but then it happened again. a strawberry jam like-stools. brought her to the other clinics. test for xrays and CBC n biochem. it came out she has a thickened gastro's wall, cbc n biochem was all good. sent home w/ sulcrafate, famotidine, and flagyl. for 3 weeks. she did well, until the 4th weks, it came back again. took her to her previous vet, asking for another prologing drugs, sent home for another 3 weeks on sulcrafate, famotidine and flagyl. did well for 1 months, but then on the 6th week, my pom start to vomiting agin and has a bloody loose stools. i took her to test for ultrasound, it was nothing new, but her gastro's wall was thickening (like her xrays examination told us before)and the vet said, there's a "hills"-like on her gastro walls. the vet didnt want to said it was a polip, but he said let's put her on rantine and sulcrafate for 6-8 weeks. and now, it hasnt been on her 8 weks, my girl already throwing up bloody liquid on her 6 weeks. she did well on her last 6 weeks. which is then it's confusing me. anyone who knows and has the same problem like me, please do emailed me for an advice. aden_santi_lutchu01@yahoo.com. please do.

Posted by: adensanti | July 31, 2013 2:34 AM    Report this comment

We lost our 6 year old beagle yesterday. Three weeks ago he was totally off his food for 2 days and then he was fine again. But last week he stopped eating again, we took him to the vet after 2 days, blood tests came back clear, x-rays clear, they said he had a bad stomach virus as he was constantly vomiting and had diahorrea, he was on a drip and had various antibiotics and surgery but unfortunately he just continued to go downhill. After a week at the vets whatever it was attacked him so much and he was in a terrible state that we had to do the humane thing and put him down. I don't think he would have lived another night. This is the hardest thing I have had to do in my life, I felt so helpless and now so empty. He was such a happy, healthy dog, its hard to understand why this happened. I believe he might have been suffering from HGE. :(

Posted by: Michele.Smith | December 4, 2012 10:55 PM    Report this comment

My dog is currently on her 2nd day in the veterinary hospital, suffering HGE. I'm really worried about his health. I hope she will be that fortunate like the other dogs in the story. We want her to survive and be home soon! :) This article gives me hope that my dog will be okay soon. THANK YOU SO MUCH!

Posted by: IloveChassy | November 28, 2012 3:56 AM    Report this comment

Thank you for sharing. My dog had this issue about 4 weeks ago. She is a chocolate lab. In the last 6 months she lost my older lab to cancer and that definitely contributed. My dog was hospitalized for 2 days. She is 4 years old. The cost was $2800 but my baby is still alive and healthy. I also changed her food in the past year and may to food with grains. It was scary.

Posted by: Unknown | November 11, 2012 7:28 AM    Report this comment

My purebred Yorkie is 6 years old and recently went to the 24hr emergency vet hospital. He started having diarrhea on Tuesday night which I was not too concerned of. I thought it must of been something he ate. He showed no signs of depression or discomfort. As time went on (now Wednesday morning about 2am) My yorkie started vomiting up his food but then quickly went back into his crate to sleep. So I didn't think much about it. Around 4am he had explosive diarrhea in his crate and started vomiting clear mucus. I cleaned it all up and got him to drink some water thinking it would clear out his system. About ten minutes later he was vomiting again but this time it was bloody mucus and the more he barfed the more bloody it got. I started to panic. I have never seen my dog vomit out blood before and quickly looked up the number for the hospital and let them know I was coming. My yorkie ended up vomiting twice in the car but there was no sign of blood this time, just clear thick mucus. He was very still during the ride and only moved when he needed to vomit. Shortly after arriving to the hospital, the veterinarian took his temperature from behind and she said he was perfectly fine. No sign of a fever. I felt relieved hearing that, but a minute later explosive blood came out. It smelt foul and very strong of blood. The veterinarian ended up taking a sample and sent it out checking if my yorkie had parvo or parasites. He was connected to an intravenous right away and ended up staying the night there. In the evening, I was able to go visit the little guy and he was full of life but looked stressed. One of the caretakers asked if I was able to feed him because he hadn't eaten all day. I was given a plate with 3 different types of wet food. 1. Heinz Chicken and Broth baby food, 2. Hill's I/D gastrointestinal wet food and 3. another type of wet food. My yorkie ended up eating 3 spoons of the baby food and although he barely ate anything, I was happy. As I was preparing to leave, I could tell he wanted to go home as well. He never stayed overnight anywhere without me so it was pretty hard leaving. The next day I got a phone call saying he was stable enough to go back home. I got at the hospital shortly after and was given a few items to bring back home. 1. Metronidazole 2. Sulcrate Suspension 3. Panacur Dog Dewormer 4. Hill's I/D gastrointestinal wet food. It's quite a job nursing your dog back to health when they had hemorrhagic gastroenteritis. He is currently on a tight schedule with meals and medication. His diet currently consists of baby food, Hill's I/D wet food and white rice with boiled ground beef. It's been close to 5 days now since the incident and my yorkie is showing signs of his normal self again. I received a call saying his feces sample came in negative. What a relief. As I look back, I would not have him laying here right next to me right now if I hadn't brought him to the hospital that early morning. I really believe that the intravenous fluids saved my yorkie's life. I was told that there is a small chance of him relapsing, I just hope for the best and that my yorkie has a speedy recovery. Best of luck with everyone who's going through the same scare.

Posted by: MaiNguyen | September 24, 2012 12:26 AM    Report this comment

I feel for every dog and owner that has gone through this terrible disease. I never heard of it until my yellow lab, Sundance was diagnosed on Friday night. We visited her in the hospital Saturday night, and she was happy and wanted to play....she even ate canned dog food. Because she ate and looked so good...all her blood tests were normal, she came home. Mathis morning, she does not want to eat or drink. Should we be concerned??

Posted by: Les H | September 9, 2012 8:03 AM    Report this comment

My German Shepherd/Cattle Dog mix is currently in the vet hospital with HGE. He had soft stools over the weekend, and almost watery this morning. He vomited on Saturday in the car, but I didn't think anything of it. We had just spent 45 minutes witha dog trainer (his first day) and it was hot in the car, too. Then, this morning, while I was walking him he pooped on his first walk of the day (he never does this) and then kept trying to go after that, and most of what came out was thin and bloody. Came back into the house and he wanted to eat breakfast. I gave him his breakfast and he ate all but maybe a 1/4 cup. Then, when he wanted to go out again, nothing but blood. Scared me half to death. On the way to the vet, he threw up again in the car (my car will smell great when I go home tonight) and they did a parvo test right away which was negative. His weight was good, he was running all over sniffing everything and was sweet as pie to the vet and the techs. His "pack cells" (not sure if that is spelled right) should be 37, they were 60. He is being kept overnight, should be able to come home tomorrow. he is on iv fluids, sleeping comfortably. Poor baby. After I put him in the kennel at teh vet, he jumped up on his hind legs and barked at me as I left. I almost cried. Going to visit him tonight.

Posted by: lagbfn | August 20, 2012 4:00 PM    Report this comment

-Illinois I have a Chihuahua/Miniature Pincher named Rio who is 1 year old and just got home from the hospital for this. I'm still confused as to how he got this problem. His condition deteriorated in a matter of hours. He was fine before I let him outside and then horrible when I let him in. He was obviously depressed because he went straight to his kennel, giving me that "what did I do to deserve this pain look." There was clear foam (most likely vomit) on his chin, and he was uncoordinated. Reo came out to drink some water, then a few moments later he went to our bathroom and left a bloody puddle on the floor. I called my vet and came right in. I told the receptionists that I may have a possible parvo case. But once I saw the doctor, we ruled out parvo with the rapid test. He had a temp of 99 degrees F and a hematocrit of 76% which is really high. So the doctor was pretty sure it was this condition and proceeded with fluids and a variety of medications that were administered during his stay. I was able to pick him up after 2 days. He's still having diarrhea but it is far less bloody. Reo seems to be on the way to being ok again. He's been eating Hill's I/d gastrointestinal health little by little throughout today. I'm so glad to hear others have made it through this like my Reo has.

Posted by: duey237 | June 28, 2012 5:37 PM    Report this comment

We just got back from the vet and an overnight hospital stay with my 2 year old Chow/Golden Retriever/Boxer mix. They are convinced it was HGE. He had vomiting with bloody diarrhea for over 48 hours before I took him to the doctor. I thought he had a virus and was bleeding b/c of the amount of vomiting and diarrhea. The doctor had me start meds b/c I didn't have the money to bring him in. Well, it got worse. So, we upped our credit card limit and brought him in. She wanted to keep him another 24 hours, but I decided to bring him home since he was stable and had perked up some. She felt it was safe as long as I didn't leave his side. He is resting comfortably next to me. He has so far held down some prescription canned food, in small amounts and some water. If he has any more episodes, back to the vet we go. So far, it has cost a little over $1,000. This is my baby, so the money is worth it. It's just coming up with it is the hard part. I'm sure all of you understand that. We just cancelled his health insurance a few months ago b/c we never used it. Big mistake! Anyway, from reading this article, we're lucky he even survived those 2 days. He was severely dehydrated. It was pretty bad. The other concern is that his liver enzymes were so high that he may have permanent liver damage. Has anyone else had this experience? Feel free to email me at melswanson502@yahoo.com

Posted by: mswanson502 | March 21, 2012 11:21 AM    Report this comment

I have a 2 1/2 year old chiweenie. in november he started throwing up blood and the bloody diarrhea followed. when he got to the vet he was in shock. he had lost so much blood the vet did not think he would make it. she informed me that he had HGE. he was put on IV fluids for 4 days due to the thickening of his blood and he made a great recovery. just today i woke to him once again throwing up and having diarrhea. it had not yet been bloody but once we got to the vet he started throwing up the blood and having the bloody diarrhea. his vet is suprised to see the he once again has HGE. This time his odds are much better. if your dog starts having these signs please take your pet to the vet.

Posted by: nurse81 | February 2, 2012 6:21 PM    Report this comment

My yorkie/poodle mix is a little over 2 yrs old. Today he was taken to the vet for very bloody diarrhea, a little vomiting, weakness, lack of appetite (especially not wanting his daily wet food). He is now sleeping beside me as I type this. I finally got a little tail wag a few hours ago, first of the day. A simple but very beautiful sign. It was scary to see the amount of blood he passed, it really did look like a slaughter house, I feared the worst. All tests came back normal, like they had the 2 previous time he has been to the vet for these symptoms within the past year. Yes, 2 other times. Although it is rare that it occurs more than once, my little guy has the horrible luck of being in that 10-15%. With nothing showing any hint of what it may be, the vet stated that he probably has HGE. I now find myself learning and not learning what exactly it is. Fritz does have high anxiety and can get wound up pretty quickly, he does not get alot of human food due to him having an already sensitive stomach. It seems as though there may be a correlation bewteen stress an HGE, at least for my situation. Praying he has a speedy recovery, and no more occurances. A wonderful companion deserves a wonderful life. Great speed in finding out more about HGE, our companions need it.

Posted by: Fritz E Boy | January 27, 2012 10:50 PM    Report this comment

(Continued from my previous post.....)

Another thing that can help both people and dogs that have had bowel problems like this is Slippery Elm, which I have seen described as "a band-aid for the intestines". Since losing much of the mucosal lining during an HGE episode adds to digestive difficulties, Slippery Elm could literally be a lifesaver by helping seal the intestinal wall until the dog's own system replaces the lining.

Common precursors as noted in numerous articles are stress and/or hyperactivity. I really suspect that the main common trigger is HEAT. My observation of my own dog is that she gets hot VERY easily. Her stools are hotter than those of my other dogs (I live where I have to pick up after them, lol, so that's how I know). She does not tolerate heat that my other dogs seem to. And stress - even emotional stress - causes most dogs to overheat. One of the commenters above experienced a heat wave before her dog's HGE incident. I believe that HEAT kills off some of the digestive bacteria (not all types) and there is then some kind of imbalance that is NOT good for these dogs, so probiotics are absolutely needed if they are prone to this. Obviously most dogs can get hot and not lose too many of the necessary digestive bacteria, but I am convinced that those that are susceptible need the help of GOOD probiotics and attentive owners to stop these bouts of HGE before they become fatal. When I see my dog start to have an odd BM (some mucous in it is how it starts), she gets 2 doses of kaolin pectin (1 in morning and 1 at dinner) to coat her insides and slow down the irritation process. That usually heads off a major incident, and she has had only TWO episodes with blood in her stool in 6 years, but before probiotics she had one or two a month for a year or so. I consider what I learned to be the main reason she is alive. I hope this helps some others.

Posted by: D Tucker | January 20, 2012 9:26 PM    Report this comment

I am not a vet. I am an observant and curious dog owner with a rescue dog (Bichon) I adopted that developed what was called colitis. Two vets could not help her, and she went up and down for about a year with sudden and unpredictable bouts of feeling terrible and having mucoussy, then bloody, diarrhea (not a lot of vomiting). Vets gave her stuff to settle her bowels/stomach, and once she had fluids under her skin, but I was not content that there did not seem to be an answer for this recurring and serious problem. She might be fine for just days, or it could be weeks, then have a sudden incident. It was very troubling, and the problem was obviously not 'fixed'.

When reading up about colitis, Crohn's (in people) and some other things, I came across a few possibilities. One is that after being sick even a little with diarrhea/vomiting, some of the intestinal lining and many 'good' bacteria can be lost, leaving an ineffective mucosal lining and an imbalance of digestive bacteria. I strongly felt that this was what my dog was experiencing, so I got some probiotics for her. Not just the dry stuff with one type of digestive bacteria; I first used Wysong (for animals) and then finally tried Udo's Choice Infant (for people). Both have at least 5-6 types of digestive bacteria, and both have done well for her. Neither vet recommended them, but the second vet - when I asked if there was a way to check for an imbalance in the intestines - sold me the Wysong probiotics, saying 'try this'. (I'm sure it had been in his clinic for a while and he was glad to sell me the last bottle, as I could not get any from him again, lol, he didn't carry it anymore!) My dog went from near death (seriously - muscle tremors, no enjoyment, obviously in pain and distress) to HAPPY and JOYOUS by the 3rd day, and has never looked back! I now know that this was the most important part of her problem. (I have a main theory as to what is a trigger for this that I discuss in the last section of my comments.)

There are other aspects - I give her kaolin pectin (not kaopectate, which I have read can be tough on animals, the K. pectin is for pets) to slow down her intestines and coat her stomach if I see any signs of trouble starting, although now it is much less frequent than before I came across probiotics. The person with the Maltese (Nemo) who posted previously mentions that he vomited frequently but they thought it was normal for dogs to do that. It isn't. I suspect his digestion was a bit 'off' and he could have used some help like probiotics, and finally his system was out of whack enough to have a severe crisis. It is so hard to know about this stuff, because it's invisible and we don't usually think of a dog's digestive bacteria, but after having the experience with my own dog and reading about others, I am convinced that this is a key element. Also, my dog's relative has problems with what was called colitis but I now feel is HGE, so somehow this is a tendency in her genetics. None of my other dogs has gone through this at all!

(I will continue this in the next post as I seem unable to post it all at once....)

Posted by: D Tucker | January 20, 2012 9:25 PM    Report this comment

I am just testing to see if this gets posted, as I have tried to add comments re HGE and colitis.

Posted by: D Tucker | January 20, 2012 9:21 PM    Report this comment

I agree that this has been the most comprehensive article I have seen on HGE. We lost our 6 year old maltese, Nemo, to HGE 3 days ago. It came so quickly and suddenly that it has been very hard for all of us to make sense of it all and to come to terms with what has happened. Nemo was always a very happy and energetic dog, and perfectly healthy. We thought he would live well past 18. Nemo started vomiting, then shortly thereafter had the bloody diarrhea around 3pm on Sunday. He was taken to the vet right away but it was already too late. He had already suffered shock and was gone by around 9:30 that night. There are 2 other small dogs in the house and they seem to by fine.

Like many other pet owners, we attributed Nemo's vomiting to having eaten something bad. Dogs vomit all the time, as did Nemo. HGE is a terrible disease, and if we had known more about it, we might have done some things differently. While I am thankful that Nemo went quickly and didn't have to suffer a long illness or the terrible things that come with old age, I miss him dearly and can't help wondering why it had to happen to Nemo and why so soon.

The last couple days have been incredibly difficult, but learning a bit more about HGE has helped me come to terms with what has happened to Nemo. While some dogs have a few days before it becomes critical, our Nemo got sick and passed in less than a day. It only took 6 1/2 hours after the first signs of blood for the disease to take our beloved Nemo. I am happy to hear that Chloe and Gem had time to get treatment, but not all dogs are so fortunate. I'm glad that there is on going research to find out more about this mysterious disease. The hardest thing for a pet owner is to be told that your perfectly healthy, young pet died of a something that sounds a lot like a catch-all when there is no other good explanation for what just happened. I hope one day I can learn what really happened to Nemo and what caused his condition. My heart goes out to all those who lost their beloved pet to this terrible disease.

Posted by: nemolove | November 30, 2011 8:09 AM    Report this comment

I have been researching HGE for the past couple of days because my 7-year-old German Shorthaired Pointer has it. This is by far the best, most comprehensive article I have found (though it doesn't mention cancer, see below).

My Gem has been hospitalized for three days and two nights so far. She's being treated with IV fluids, an anti-emetic for the vomiting, an insulin drip (she's diabetic and not eating), a painkiller, and metronidazole (an antibiotic). The expense is extraordinary.

She stopped eating Wednesday morning and would not eat again until we visited her in the hospital Friday evening. With hindsight, we realized that she had had her first bloody vomit and bloody diarrhea at least as early as Tuesday. We didn't see it before that because she has a dog door which is usually unlocked, but was locked on Tuesday. Wednesday was marked by disinterest in food; Thursday the severe diarrhea & vomiting began. Even after 48 hours of IV treatment, she still had bloody diarrhea as of late Friday night. If that stops, the hospital will allow her to come home Saturday afternoon.

As the author mentions, the house looked like an abbatoir from Gem's sudden onset of explosive bloody diarrhea and bloody vomiting. If this happens to you, get a professional carpet cleaning team in as soon as you can. They were successfully able to lift the stains even though it took me 48 hours to get around to calling them (because we were at the hospital with our poor sick dog).

Possible stressors for Gem: the sudden and permanent presence of a new spayed bitch in the household about ten days before her symptoms; possible lymphoma (cancer); and the heat wave of July 2011, which produced temperatures over 100 F in our northern Virginia home for over a week. Even with air conditioning, the heat has been oppressive.

The article mentions cancer as a possible alternative to HGE, but does not mention cancer's role as a possible trigger for HGE. The emergency hospital we are using (Southpaws in Arlington, VA) believes it is a strong possibility for her and other dogs with HGE. We will know if Gem has lymphoma when her needle biopsy results come back from a lab in Wisconsin Monday or Tuesday.

Symptoms you may want to watch for: for about two weeks (starting BEFORE the new bitch moved in), Gem would whine softly, which she had never done before. She was also waking in the night panting, which I (mistakenly? or not?) attributed to the heat and/or her diabetes instead of pain.

Recurrence: other articles I have read seem to agree that 10-15% of dogs with HGE will get a recurrence. I have not found any info on the likelihood of multiple recurrences in the same dog.

Posted by: Ankhorite | July 30, 2011 6:47 AM    Report this comment

New to Whole Dog Journal? Register for Free!

Already Registered?
Log In