Bloody diarrhea, otherwise known as hemorrhagic gastroenteritis, can be life-threatening in dogs. This syndrome, HGE, is defined as a sudden and severe diarrhea that is notably bright red with fresh blood. Most cases occur without warning in otherwise healthy dogs. The diarrhea causes large amounts of water to be lost from the body, which makes this a potentially deadly syndrome if not treated appropriately.
The cause of HGE is not well defined. Previous studies propose causes such as dietary indiscretion (ingesting nonfood items or different foods), immune-mediated disease, toxins or pancreatitis. Some studies have found that middle-age, small-breed dogs are at a higher risk, but any dog at any age could develop HGE. Clinical signs include bloody diarrhea that develops very quickly, shivering, dehydration and dark red gums.
Diagnosis of HGE may be challenging because there are so many different causes that could be causing the bloody diarrhea. Laboratory tests often used in dogs with HGE may include, but are not limited to, blood work, fecal evaluation and abdominal X-rays. Blood work examination can usually help with diagnosis because it allows us to measure the red blood cell count and serum total protein. Usually dogs that are bleeding will have a low red blood cell count. The fecal examination will help diagnose any parasites, bacteria or viral diseases that may be causing the HGE. Abdominal X-rays may be recommended to visualize the stomach and intestines to make sure there is not a foreign body present.
Treatment of HGE is often intensive because the dogs can be severely dehydrated, with sludging of the blood that can lead to failure of the kidneys, liver and heart. Most patients require hospitalization for intravenous fluid therapy to replace the water lost in the bloody diarrhea. Supportive care with antibiotics and anti-parasitic medications may also be provided at this time. In most cases, the disease will run its course in a few days if given proper supportive care.
Dogs with HGE can deteriorate very rapidly and may die within hours after the onset of clinical signs if not treated appropriately. With appropriate treatment and supportive care, the prognosis is still uncertain depending on how badly dehydrated the dog was at the beginning of treatment. Dogs that survive the first 24 hours of treatment have a good prognosis. Recurrences are possible in some dogs at a later date. If you notice that your dog develops bloody diarrhea, please consider bringing it to your veterinarian for examination immediately.