HGE In Dogs: Symptoms, Causes & Treatment

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You spend lots of time with your dog and know everything about them. For example, when you pick up their poop on walks, you likely look at it to ensure it's healthy. You know when your dog has an upset stomach or when they're not drinking enough water because of the consistency and color of their stool. However, many pet parents don't realize that their pet's stool can be more alarming than soft diarrhea; their dog could have bloody diarrhea. 

You may be wondering "Why does my dog have diarrhea with blood? Or "Why is my dog vomiting?" Bloody diarrhea and vomiting can occur in dogs for many reasons, ranging from colitis and stress to something more severe like hemorrhagic gastroenteritis (HGE). If your dog experiences bloody diarrhea with clots, you should take them to the vet immediately since HGE can be fatal if not treated in time. Luckily, dogs with HGE that have treatment have a good prognosis if there are no complications. 

What Is HGE In Dogs?

HGE, also known as ADHS, is a sudden disorder in dogs that results in vomiting and bloody diarrhea

Hemorrhagic gastroenteritis (HGE) is also known as acute hemorrhagic diarrhea syndrome (AHDS). Because the stomach isn't involved in the condition, many experts believe AHDS is a more accurate term.1 However, vets still use both to describe the sudden disorder that results in dog vomiting food or bile and bloody diarrhea.2 HGE causes inflammation of the intestinal lining, which sheds, and chunks can be seen in the dog's stool. Many people describe HGE diarrhea as looking like clots of tissue in watery stool, and the amount of blood may vary. 

Unfortunately, the cause of HGE in dogs is unclear and often comes with hemoconcentration, an increase in the concentration of cells and solids in the blood that result from loss of fluids in the tissues.3

Many experts believe the disorder could be caused by bacteria.2 HGE Is more common in dogs under the age of 5 and small breeds such as the Yorkshire Terrier, Miniature Pinscher, Miniature Schnauzer, Miniature Poodle, and Maltese.2 However, this condition can affect any breed, no matter its age, size, or gender. Unfortunately, HGE in dogs could be fatal if left untreated due to life-threatening dehydration.4  

Signs Of Hemorrhagic Gastroenteritis In Dogs

Symptoms of HGE in dogs

HGE in dogs is characterized by diarrhea with a jelly-like consistency and large amounts of blood in the dog's stool.5 Hemorrhagic gastroenteritis in dogs appears as clots of tissue in watery stool, which may be red or reddish brown in color. 

However, this condition progresses quickly, and you may notice the following HGE symptoms in dogs: 

  • Acute vomiting (often before diarrhea starts)
  • Acute diarrhea with blood
  • Anorexia
  • Lethargy
  • Abdominal pain
  • Very acute fluid loss
  • Hypovolemic shock due to blood and fluid loss6

Fluid loss from vomiting and diarrhea can lead to severe dehydration in dogs, especially because they might not drink if they're experiencing abdominal pain. Dogs will also have lesions in the small and large intestines.2 If left untreated, the condition can lead to sepsis or death. 

What Causes Hemorrhagic Gastroenteritis In Dogs?

HGE can be the result of clostridial overgrowth, bacterial endotoxins, hypersensitivity to food, or autoimmune reactions

Unfortunately, the cause of hemorrhagic gastroenteritis in dogs is unknown, but many speculate that it's the result of infection with or hypersensitivity to Clostridium perfringens, a bacteria that's found in the small intestines of dogs with HGE.2 This suggests clostridial overgrowth, which can come from raw or improperly cooked meat, meat left out for too long, or living with other dogs at a shelter or kennel.7 However, in general, hemorrhagic gastroenteritis in dogs is not contagious. Other possible causes of HGE in dogs include: 

  • Toxins
  • Immune-mediated diseases
  • Stress and anxiety
  • Trauma
  • Foreign bodies
  • Intestinal parasites and bacteria
  • Blood disorders
  • Ulcers5

Diagnosing HGE In Dogs

To diagnose HGE in dogs, vets often rule out other potential causes of bloody stool and GI issues. They will also perform a packed cell volume (PCV) blood test and other diagnostic tests to rule out pancreatitis and parvovirus, which can have similar symptoms. A PVC of 60% or higher, normal to slightly decreased total plasma protein concentration, severe hemoconcentration, and neutrophilic leukocytosis (high total white blood cell count) indicate hemorrhagic gastroenteritis in dogs.2

Other diagnostic tests your vet might use to diagnose HGE include:

  • Blood tests: Blood tests can help evaluate your dog's red blood cell count to diagnose HGE. 
  • Radiographs: Radiographs, also known as X-rays, can help rule out other possible causes of bloody diarrhea and vomiting, including blockages.
  • Parvovirus testing: Since HGE symptoms in dogs resemble parvovirus, your vet will want to rule out parvo as the cause. 
  • Fecal testing: Your vet may test your dog's feces to look for parasites or bacteria to determine whether they have an infection or infestation causing diarrhea and vomiting. 

Treating HGE In Dogs

Treating your dog's diarrhea is crucial because it can cause dehydration. HGE treatment requires dogs to spend at least a day getting supportive care at the veterinary center because they need their fluids monitored to prevent or treat severe dehydration.5 The main treatment of hemorrhagic gastroenteritis in dogs is immediate IV fluid therapy to prevent worsening dehydration. Vets may also prescribe parenteral antibiotics if there are signs of sepsis or low white blood cell count.2 Additional medication may also be used to prevent vomiting, protect the stomach lining, and reduce pain and discomfort associated with the illness. 

Throughout your dog's time at the hospital, they'll have their PCV and electrolyte levels monitored to ensure they're improving.5 If HGE worsens, dogs can develop disseminated intravascular coagulation, a clotting disorder that occurs when the blood thickens, slowing its flow. This disorder can be fatal, so it's important to get your dog treated as soon as possible. 

Symptoms of HGE only last for a few days, and dogs can make a quick recovery as long as they get the early treatment they need. Most dogs that receive treatment for HGE can make a full recovery within a few days but typically improve within the first day.8 Unfortunately, there's a chance the condition will recur in dogs who have already had HGE. Additionally, young dogs or immunocompromised dogs have worse outlooks. Therefore, if your puppy is throwing up, they should be taken to the vet as soon as possible because their immune systems are still developing and may not be able to fight the infection, as well as a healthy adult dog. 

Since the cause of HGE in dogs is unknown, you may think you can't take measures to prevent it. However, since there are so many potential causes of this illness, you can ensure your dog is living a healthy lifestyle with a premium, well-balanced diet, plenty of exercise, parasite prevention, and a low-stress environment. Ultimately, taking proper care of your dog may help prevent HGE, so there's no reason not to ensure your dog is healthy. 

HGE In Dogs: FAQs

Are dogs with HGE in pain?

Hemorrhagic gastroenteritis in dogs can cause pain because it makes the dog vomit and experience bloody diarrhea. Some dogs experience a plethora of symptoms, including decreased appetite, lethargy, fever, and stomach pain. Since HGE can occur suddenly and without warning, if your dog starts acting strange or experiencing bloody diarrhea, you should take them to the vet immediately because it indicates a serious health condition that could prove fatal. 

Symptoms of HGE in dogs can begin before they experience bloody diarrhea. Therefore, it's important to know the warning signs that indicate your dog isn't feeling well and have access to a vet if you start to notice changes in their behavior, such as not wanting you to touch their stomachs or sides. 

How long can dogs live with HGE?

Dogs can live with HGE as long as they get proper treatment early. Since complications can be fatal, dogs should get IV fluid therapy as soon as possible to prevent dehydration and help the body expel the illness. Most dogs make a full recovery in a few days, but dogs can have hypovolemic shock and sepsis with a poor prognosis. Of course, the earlier your dog gets treatment, the better their outlook. Any time your dog has bloody diarrhea with clots (or bloody diarrhea of any kind) you should take them to the vet immediately, especially if they don't have a diagnosed underlying illness. 

Is HGE in dogs contagious?

HGE in dogs is not contagious to other dogs, pets, or humans.2 It cannot be transmitted from one dog to another. However, since the underlying cause of HGE is unknown, what causes the illness could be contagious, so it's best to separate dogs when one has been diagnosed. In addition, if one of your dogs is diagnosed with HGE, you should monitor all your pets since the unknown cause could be contagious. 

How long do dogs take to recover from hemorrhagic gastroenteritis?

With proper treatment by a vet, dogs with HGE can recover in as little as two to three days, and many will start to feel better after 24 hours. However, the prognosis in dogs with HGE depends on how fast they get treatment. Since there are complications associated with the illness, early diagnosis is key to preventing the condition from becoming fatal. 

Owner comforting dog in pain laying on top of rubber hot water bottle

Final Notes

HGE will not go away on its own, so if your dog experiences bloody diarrhea for more than a day, you shouldn't wait any longer to take them to the vet. Unfortunately, there are many causes of bloody diarrhea in dogs, so HGE isn't always obvious to pet parents. However, if your dog is experiencing blood in their diarrhea, it's never something you should wait to have diagnosed. Bloody diarrhea is almost always a sign of a more serious condition, ranging from HGE, parasites, and infections to toxin ingestion and trauma or obstruction, so you should talk to a vet as soon as possible. 

Consult a Dutch vet if your dog is showing signs of HGE, including bloody diarrhea with clots or jelly-like substances. With treatment, your dog can fully recover in a few days, but without fast and aggressive treatment, HGE can cause severe hydration and lead to illness, potentially becoming fatal the longer you wait to get your dog the care they need. Wondering what your dog's poop is trying to tell you? Try Dutch today. 

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References

  1. Leipig-Rudolph, Miriam, et al. "Intestinal Lesions in Dogs with Acute Hemorrhagic Diarrhea Syndrome Associated with Netf-Positive Clostridium Perfringens Type A." Journal of Veterinary Diagnostic Investigation : Official Publication of the American Association of Veterinary Laboratory Diagnosticians, Inc, SAGE Publications, July 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505910/.

  2. Gallagher, Alex. "Acute Hemorrhagic Diarrhea Syndrome in Dogs - Digestive System." Merck Veterinary Manual, 18 Oct. 2022, https://www.merckvetmanual.com/digestive-system/diseases-of-the-stomach-and-intestines-in-small-animals/acute-hemorrhagic-diarrhea-syndrome-in-dogs.

  3. "Hemoconcentration Definition & Meaning." Merriam-Webster, https://www.merriam-webster.com/medical/hemoconcentration.

  4. K, Unterer "Acute Hemorrhagic Diarrhea Syndrome in Dogs." The Veterinary Clinics of North America. Small Animal Practice, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/33131918/.

  5. "Hemorrhagic Gastroenteritis (HGE) in Dogs: Symptoms and Treatment." WebMD, https://pets.webmd.com/dogs/what-is-hemorrhagic-gastroenteritis-dogs.

  6. Hypovolemic Shock - Statpearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK513297/.

  7. "Diarrhea Due to Clostridium Perfringens in Dogs." PetMD, https://www.petmd.com/dog/conditions/digestive/c_dg_clostridial_enterotoxicosis.

  8. "Haemorrhagic Gastroenteritis (HGE) in Dogs." PDSA, https://www.pdsa.org.uk/pet-help-and-advice/pet-health-hub/conditions/haemorrhagic-gastroenteritis-hge-in-dogs.

Frequently Asked Questions

Who is Dutch?

Dutch is an online veterinary pet telehealth service, created by pet parents and board-certified veterinary specialists. We use a science-backed approach to provide pets relief for their everyday physical and behavioral health issues. Dutch connects you with licensed veterinarians over video chat and messaging to help you get care for your dog or cat quickly wherever you are — without the stress or expense of a vet visit. We also partner with pharmacies who can deliver prescription medication (in applicable states only) and over-the-counter treatments directly to your door. Dutch isn’t a veterinary practice or pharmacy, but a company that helps facilitate these services for pet parents to make veterinary care more accessible to all.

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During your video call, one of our licensed veterinarians will talk to you about the symptoms your pet is experiencing, ask you questions, review your pet’s medical history if you’ve provided it, and answer any questions you have. The vet will ask to see your pet and their environment. And they may ask you to perform some simple checks on them if needed.

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In addition to the base membership plan, our veterinarians may also recommend additional medication (Rx and/or OTC) that you will have the option of adding to your plan at an additional cost.