Hemorrhagic Gastroenteritis (A case of sudden bloody diarrhea)

Heidi, a three-year-old female spayed, miniature schnauzer, presented with sudden onset of very bloody diarrhea. Heidi came in about 5 p.m. She was last checked at noon time by her owner and was fine at that time. When the owner came home at 4 p.m., the owner found “raspberry jam” looking diarrhea. When Heidi was presented her gums were slightly pale, temperature was slightly low at 99.8 F (normal is 101-102.5). She was trembling; her belly was slightly painful, with fluid in the intestines. When she came in she vomited twice clear foam. Her stool was very watery blood tinged fluid.

Heidi was immediately started on IV fluids. Blood work showed a high Packed Cell Volume (total number of red blood cells to fluid in the blood). Fecal test showed abnormal bacteria and lots of red blood cells. After the results were obtained Heidi was diagnosed with a condition known as Hemorrhagic Gastroenteritis and started on metronidazole (an antibiotic for diarrhea). Because of the time of day (the office closed at 6 p.m.), Heidi was transferred to the local emergency clinic for overnight care. Heidi was continued on IV fluids over night, and anti-ulcer medication, and pain medicine.

Heidi was transferred back to her regular vet the next morning for continued care. The owner had taken her home until the office opened and gave her a prescription dog food for intestinal problems, which she ate readily. Heidi was 100 percent better. After keeping Heidi for the day, the IV catheter was removed, and she is now back to her normal self.

Hemorrhagic Gastroenteritis is characterized by the sudden onset of severe bloody diarrhea, (sometimes explosive), vomiting, low blood volume due to fluid and electrolytes moving into the intestines. Patients may go into septic shock due to bacteria moving from the intestines into the blood stream. The exact cause of this condition is unknown. This can occur in any dog, but the breeds most affected are miniature schnauzer, dachshund, Yorkshire terriers and miniature poodles. This condition occurs in adult dogs with the average age of five years. Most patients affected with this condition have been healthy with no historical environmental changes. Signs usually start with sudden vomiting, not eating, and depression followed by bloody diarrhea. Signs progress rapidly within 8-12 hours which result in dehydration and shock. There are other conditions that can cause the same signs including Parvo virus, Salmonella infection, intestinal obstruction, and pancreatitis to name a few.

Blood work is performed to confirm the condition which is a high packed cell volume (usually over 60%). Treatment is a high rate of IV fluids, no food, injectable antibiotics, in some cases steroids are given for shock, and in rarer cased blood transfusions. Most patients improve within 24-48 hours with aggressive therapy. Of those who recover 10% will be affected again sometime in their life.

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