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Hemorrhagic Gastroenteritis or HGE: A Dangerous Canine Intestinal Disease

My dog survived hemorrhagic gastroenteritis. I hope other pet owners find our story useful.

Do you know what Hemorrhagic Gastroenteritis is in dogs? Read on to find out so you can get immediate treatment for your canine companion.

Do you know what Hemorrhagic Gastroenteritis is in dogs? Read on to find out so you can get immediate treatment for your canine companion.

The Night of the HGE Diagnosis

In mid-July, 2013, my eight-year-old Miniature Schnauzer suddenly became very ill and was diagnosed with hemorrhagic gastroenteritis (HGE). This intestinal disease can be quickly fatal to dogs unless it is promptly and aggressively treated. Yet, most people with dogs have never heard of the disease. Its exact cause has not been proven, and there is no preventive. Recognizing the symptoms and getting fast emergency vet care in the event of HGE may save your dog's life. That is why I am sharing this story.

My dog, fondly called Puppy Girl, had recently lost her vision and was awaiting an appointment with a veterinary ophthalmologist. Meanwhile, I was studying the book, Living With a Blind Dog, by Caroline D. Levin, RN, so I could help her adjust to her sightless condition. She had the symptoms of canine depression, and my own state of mind was a bit shaky because of the situation.

Puppy Girl before she got sick

Puppy Girl before she got sick

Signs, Symptoms, and Behavior of HGE in Dogs

Restlessness or Unease

On the evening of July 13, I tried to relax on the den sofa watching a movie. Puppy Girl lay in the nearby recliner. By the time the movie ended at 10:30 p.m., she’d moved off the chair, walked around, gotten back in the chair, jumped down and back up several times. I put her restlessness down to nervousness because she couldn’t see. At that point, I was blaming everything she did on her blindness.

By 11:00 p.m., the real reason for her unease became clear. She walked quickly toward the back door and barked twice, her “potty” signal. I grabbed a flashlight and a couple of baby wipes, attached her leash and took her outdoors. I made a mental note to have the patio motion light reset so it would remain on longer.

Her Stool Changed Consistency

When she pooped, it was looser than is normal for her. We’d barely negotiated the back steps—so daunting to her now that she couldn’t see them—when she turned around and practically threw herself headlong down them onto the patio. She rushed to the grass where she passed another loose stool. I was puzzled because I feed her high-quality homemade food made with organic ingredients, including thoroughly washed vegetables. I also add powdered probiotics and enzymes to each serving. This was the first tummy upset she’d experienced in the two-plus years she'd been on this regimen, and there seemed no reason for it.

Her Diet and Health Is Closely Regulated

Time out while I explain that I’m a bit OCD about Puppy Girl’s care. I monitor every bite she puts in her mouth and always take her outdoors on leash. Since her loss of vision, she stayed near me more than ever and was rarely out of my sight for more than a few minutes inside the house. There simply was no way she’d eaten anything I hadn’t fed her or watched her eat. What could be affecting her digestion?

Signs of Incontinence and Accidents

By 1:15 a.m., we were going outside every few minutes, and she’d had an “accident” inside the house when she couldn't find the back door. Her behavior was extremely restless and erratic. Was she in pain? The problem by then had changed to diarrhea with watery stools. I’d clean her up and take her indoors, then—a few minutes later—we were back outside. I was now worried that she would become dehydrated from losing fluids.

Since her food is wet rather than dry, she doesn’t drink a lot of water and won't drink from her water bowl on command. For that reason, I thoroughly washed and rinsed my hands, dipped my finger in water over and over and put drops on her tongue. She swallowed a few times before turning her head away.

After five or six more trips outside between 1:30 and 3:00 a.m., she made a groaning noise as she evacuated and—fortunately, the motion light was still on. I saw the bright red that gushed out and realized it was blood. My dog appeared to be pooping pure blood. I was horrified!

Bloody Poop (and Managing the Mess)

I found a half pack of large puppy pee pads on a shelf and cut some of them in half. Grabbing a roll of paper tape, I laid her on her back (she didn’t struggle, but just lay there) and taped a makeshift diaper on her. We couldn’t keep running back and forth from the house to the back yard. The next time she started to walk away from me, I told her, “Poop in the diaper.” And she did just that.

Several years previously her anal glands had to be surgically removed due to chronic inflammation and impaction. After the surgery, the vet gave her a stool softener, so she wore diapers for a week. At that time, I used Huggies for human infants, not the overly expensive diapers made for dogs. Her tail is cropped very short, so the baby diapers fit her just fine. It had taken only a couple of times back then for her to respond to my command, "Just use the diaper. Poop in the diaper.”

Her memory of the previous stint in diapers now served her (and me) well. I tried to get her to lie down and rest, but she couldn’t stay still longer than a minute. I instinctively knew she was in pain, nauseated or both.

The Animal ER Hospital: A 15-minute Drive Away

The Animal ER Hospital: A 15-minute Drive Away

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When I Realized I Needed to Take Her to Emergency

Looking back, I should have taken her straight to the Animal ER and Referral Center, only 15 minutes away, when I saw that blood. Instead, I waited until daylight—shortly before 6:00 a.m.—before leaving home. Just before I put her in the car, she vomited for the first time. It was pink and foamy. Her breed is predisposed to pancreatitis, and she'd had it before. That's the reason I feed her an organic and very low-fat diet. The vet said she might get it again, no matter how careful I was with her food. When I saw the foam, I assumed she had a reoccurrence of pancreatitis.

Transporting My Dog to Emergency

Placing Puppy Girl on an old towel in the backseat of the car (wearing one of her DIY diapers), I quickly drove to the animal ER hospital, terrified she might die. Fortunately, there was almost no traffic so early on a Saturday morning, including cars equipped with blue lights. We arrived within fifteen minutes, but it seemed longer because I was so worried.

It wasn’t easy carrying her from the parking lot into the hospital. I had trouble holding her in my arms while simultaneously trying to open the non-automatic hospital door. Fortunately, someone rushed forward to open and hold it for me.

I hurried to the desk and told the receptionist it was an emergency—my dog needed to be seen by a vet immediately. I'm sure I looked as distraught as I felt. Fortunately, the on-duty vet appeared very soon. I described the previous night’s events and my dog’s history of pancreatitis. While we were talking, she threw up again, more pink foam. He would see evidence of the bloody diarrhea in her “diaper." As a veterinary tech gathered up my dog and took her to an exam room, the vet told me they would take good care of her. I should try not to worry.

Ruling Out Causes of Bloody Diarrhea

Don’t worry? He may as well have told me not to think. I am a natural-born worrier at the best of times, and emergencies make me frantic. During a crisis, my normal level of worry morphs into full-blown anxiety, shallow breathing and, at times, hyperventilation. Don’t bother telling a major worrier not to worry—just hand her or him a paper bag.

Within an hour, another vet (actually the hospital’s chief of staff and—I later learned—an adjunct professor at Mississippi State College of Veterinary Medicine, with which the hospital is affiliated) came out to the waiting room to tell me my dog had been examined and was already being given IV fluids, plus meds for nausea, pain, diarrhea and intestinal inflammation. Tests had ruled out pancreatitis and the contagious canine disease, parvo, leaving a tentative diagnosis of Hemorrhagic Gastroenteritis, or HGE.

He asked me what I fed her, and when I told him, he laughed and remarked, “She eats better than I do.” Then he asked, “Did she get into the garbage yesterday?” The answer to that was an unqualified “no.” I have a tall, covered kitchen trash bin, and she’s never attempted to turn it over, not even as a puppy. After she pilfered a used tissue from an open bathroom wastebasket two years ago (the subject of another article), I replaced all the bathroom bins with covered ones. She's never bothered them, either.

He explained that it’s impossible to pinpoint what causes canine HGE. Although there are numerous theories—retail food or people food scraps (especially when scrounged from a trashcan), a bacterial infection, virus, reaction to an intestinal parasite, etc., none of these is proven. The vet told me stress may even play a role in HGE development, but, with no causal evidence, this is a “mystery disease.”

How Is HGE Diagnosed?

HGE is diagnosed primarily by ruling out other possible causes of the symptoms. When a previously healthy dog suddenly sickens with bloody diarrhea and a high packed cell volume (PCV), a vet usually suspects HGE.

Puppy Girl stayed in ICU for two days, where she was aggressively treated for HGE. Back home alone, I searched the Internet to learn what I could about this disease. The information I found was not encouraging.

What Causes HGE?

Smaller dogs (toys and miniatures, such as schnauzers and poodles) are more likely to contract HGE, but it can affect any breed or either gender. Deadly complications may develop quickly without prompt treatment, including dehydration, low blood pressure, an elevated red blood count, shock, kidney failure and disseminated intravascular coagulation (DIC). DIC is a potentially fatal clotting disorder that occurs when the blood thickens or slows. Once it begins, it is often irreversible. This is why it is crucial to get a dog to an emergency vet right after seeing the bloody diarrhea and/or vomitus.

How Is It Treated?

Fluids are administered intravenously with medications added to treat diarrhea, nausea, pain, and intestinal ulcers. Sadly, even with treatment, some dogs don’t survive HGE. Among those that recover, the disorder reoccurs in 30%—a frightening statistic, especially since there is no method of prevention. (When scientists don't know what causes a disease, a vaccine can't be developed to immunize against it.)

Although HGE is not contagious, there are records of widely-scattered geographical outbreaks. I later learned the animal ER hospital in my area had eight cases of HGE that weekend! This fact lent credence to the viral or bacterial theories of HGE's source.

I tried not to phone the animal hospital too frequently to check on Puppy Girl, but I was undoubtedly a nuisance to the receptionist. However, she was always courteous, as were the vets and techs. My girl’s condition was stable and began to improve.

How I Cared for Puppy Girl After Recovery

When she was released from the hospital, Puppy Girl still had a very slight amount of diarrhea, but it was expected to end very soon. The vet instructed me to reintroduce food slowly with small amounts of bland ingredients, such as boiled low-fat chicken and rice. Pumpkin, which is good for dogs with tummy problems, was also recommended. She could resume her regular diet a week after there were no further symptoms.

The post-hospitalization medication tray

The post-hospitalization medication tray

What Medications Are Used to Treat HGE?

There was a “take-home” bag containing three prescription meds—Metronidazole, Sucralfate, and Sulfasalazine. Over-the-counter children’s Imodium was advised until the diarrhea completely stopped. Only one dose of the latter was needed.

I’d bought a package of Huggies diapers to keep on hand “just in case," so I put one on her when we got home. She didn’t seem to mind wearing a diaper, but I added a strip of tape to the front tabs for extra security. That was before I learned that putting the diaper on backward and taping it in the back worked better.

Huggies work for dogs, too.

Huggies work for dogs, too.

HGE Is a Dangerous Canine Disease

To say I was nervous about a relapse of the HGE is an understatement. I watched Puppy Girl almost continuously, barely letting her out of my sight. She was lethargic for a couple of days before her appetite and strength returned, so she didn’t follow me every time I left the room. Giving her multiple medicines was a challenge, but I managed to get her to swallow every dose.

For a full week, her blindness took second place to a deadly disease that could have claimed her life. I’m so grateful to the vets and staff of Animal Emergency and Referral Hospital for their excellent care of her. One thing I know for certain. If I ever see that bloody signal of HGE, we’ll head straight to the pet ER hospital right then.

I caution all dog owners reading this to be aware of the urgency if your pet develops bloody diarrhea and/or vomiting. These symptoms could mean HGE, which requires fast emergency veterinary care. Don’t delay, or it might be too late to save your dog's life.

My sweet girl, recuperating from HGE

My sweet girl, recuperating from HGE

This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

© 2013 Jaye Denman


Jaye Denman (author) from Deep South, USA on December 29, 2019:

I am so thankful that Millie survived the dangers of HGE and glad that our story was helpful. You did the right thing by getting her to emergency care quickly. Now that Millie has eaten (added to IV fluids), her chances of full recovery are much greater. Best wishes to Millie as well as you and your family who have all gone through an ordeal.

Andreas Pack of 4 on December 28, 2019:

Hi Jaye, I'm happy your Puppy Girl was able to survive this and you were able to get her the help she needed. My 11 year old Jack Russel Millie was diagnosed with HGE the day after Christmas and she almost died in my brothers arms while bleeding. You are correct when you say every hour is crucial as everything happens so fast. I noticed a dark stool Christmas Day and noticed her appetite was non existent. The next day my brother woke up to bloody stools that progressively got worse within hours, she lost strength in her back legs and couldn't even control her bowel movements. My brother found her outback laying in a hole she always digs at ready to give up and die while my other dog Coco sat beside her. We brought her to the vet and they felt there was not much that could be done in that facility and sent her to a 24 hour care facility. She stayed overnight but refused to eat (she has extreme separation anxiety and Deaf, and I was worried she was stressed not knowing where I was and plotting her escape). I picked her up next day as I could not afford another $2000 stay. They sent me home with medications, but Millie would still not eat. I called my local vet and asked them if they can give her a bag of IV fluids to sustain her for the night and luckily the obliged. I've been reading articles all day, some with positive out comes and unfortunate to find out what my true chances were. We asked the vet realistically how long a dog can survive without food and he said 3-5 days. We were on our 3rd day and absolutely desperate to get her to eat. We blended boiled chicken breast and rice and using a syringe force fed her 3 tablespoons. Luckily she was able to keep her food down. It's now 4am in NY and thankfully she woke up hungry enough to eat on her own. I am so happy but I know there is more recovering that needs to be done. Thank you for sharing your story, it truly has helped me knowing I am not alone in this experience and gave me hope for Millie.

Jaye Denman (author) from Deep South, USA on October 10, 2019:

Hi, samlucy44 - I'm assuming that you sent your vet my HubPage articles (two parts) about our experiences with keratoconjunctivitis sicca (KCS), or "dry eye" in dogs since your Bichon Yorkie was diagnosed with dry eye. I hope the vet's treatments will be successful. KCS, if it proves to be ongoing rather than temporary, can definitely be a challenging problem. Best wishes to you and your furbabies. Jaye

samlucy44 on October 07, 2019:

Hi Jaye

I just read your stories and I am so sorry you are going through this ..I too have a Schnauzer Boy who I love to the moon and back who has Mitral Valve ..I also have a Bichon Yorkie who I also love to the moon and back who was diagnosed with dry eye this morning and was given the drug to put in her eyes ..I immediately copy and pasted your article and sent it to my vet and told him to please read your story in as much as I know it was long for an email to him ....I am hesitant to use it to be honest I will wait and see if he responds ...In the meantime please kiss and hug Puppy Girl and tell her she has a huge fan club

Jaye Denman (author) from Deep South, USA on June 04, 2019:

I'm so sorry your dog had to go through this illness, but glad you were finally able to get the right treatment. I hope he is now healing and feeling alright.

Amy Buddys Mom on May 27, 2019:

This has been our life since early Thursday morning. Thank you for this article. People need to share! My dog had colitis several months ago and it was easily treated. This was was a whole different bear! Symptoms started in the morning. After working til 9 I decided to take him to the ER. Thought antibiotics again or they can see if he swallowed something obstructing. He was sent home with tablet antibiotics ( but he wouldn’t even look at food so how was he to take these ?) and he received fluids while there. I took him to our vet the next morning. Then again the following morning. He received 4 rounds of fluids and IV antibiotics.. it was now Saturday, and my poor guy didn’t even look like he knew who I was. I was told to take him to the ER if he didn’t show improvement by evening. At 3 I took him he was admitted. He had to stay two nights to even remotely be able to go home. He is exhausted not totally out of the woods but comfortable... Prayers to those doggies going through this and their owners. Especially those who don’t make it through, or who can’t afford the treatment. ❤️

In Teddys Memory on October 23, 2018:

PLEASE READ & SHARE...your dog's life may be saved by it.

My 3.5-lb rescue yorkie, Teddy, had thrown up on Thursday, nothing too out of the norm (or so we thought) since he was still drinking water even if he wasn't that interested in food that day. On Friday, he ate his breakfast of kibble and rice, and things appeared like they were improving. But later that night was when the bloody diarrhea started. We called the vet's office on Saturday morning when they opened and spoke to the woman who answered the phone (who I later found out was the receptionist and not a vet tech/vet). She said the same things that we had already been thinking - that it was gastritis or colitis - which we think Teddy has had in the past. She told us to continue to monitor him - it's just something that has to pass his system - and if he didn't get better by a day or two, to bring him in. Teddy got weaker and weaker that night as the bloody diarrhea continued...and if I could do it over again, this is where I would go back in time every single time. I would give anything to have this moment back. We thought he needed to rest and we would take him to the vet Sunday morning...but he never made it to the morning.

Like you, HGE (hemorrhagic gastroenteritis) is something that I have NEVER heard of before. It comes on quickly to a perfectly healthy dog with symptoms similar to "stomach issues"/colitis/gastritis, and if left untreated can be fatal. Symptoms include vomiting, bloody diarrhea, dehydration, lethargy, and possible abdominal pain. I say possible because I checked Teddy for abdominal pain, and he didn't flinch.

They don't know what causes it, and the ONLY way to detect that it's HGE (fatal) vs. colitis/gastritis (non-fatal) is with a PCV blood test in order to rule everything else out. Though not contagious, ANY dog can get it regardless of breed or size. A bitter realization for me is that HGE is highly treatable if you get your dog to the vet quickly. Do NOT wait - Teddy's deterioration was less than 24 hours - a life depends on it!

Teddy was one week away from his 12th birthday/adoption day on 10/22. He was and always will be my person, my little shadow, my first baby, and truly changed me by making me a better person. I can't really describe the connection that he and I had, but I know that we are bonded together forever even beyond this physical world. There are so many "what if's" that play out in my mind on a daily basis - what if he didn't eat on Friday, we wouldn't have thought he was getting better; what if the receptionist had just told us to come in and didn't give blanket advice out over the phone; what if she had looked at his file to see that he was only 3.5 lbs and didn't have the fluid/blood reserves to make it to morning like a normal sized dog; why didn't common sense kick in for me or my husband as we were watching this unfold in front of us? I can't get past the guilt from this day and Teddy's passing, and I'm not sure I ever will. I just miss his energy SO much - he was such a big personality in a little body! Until we meet again, sweet boy...

Jaye Denman (author) from Deep South, USA on October 28, 2017:

Knotts - I'm sorry that I just saw your comments and questions. (I've been packing to move and haven't checked my responses this week.) I hope your schnauzer girl has recovered by now. I worried that my schnauzer would get it again, but she didn't. However, the vet cautioned that it can reoccur with some dogs, and my research confirmed that possibility.

Part of the problem may be that whatever caused it--bacteria or virus--is still in the soil where she goes to potty. It appears to be very much like parvo in that respect--that the disease pathogens can live in the soil where the sick animal's feces or vomit contaminated it--for months or even years.

I would suggest that you take your dog on-leash outdoors to potty and that you take her to a different part of the yard than she used when she was ill, if possible (if your yard is large enough), and don't let her go to the places she used when she had HGE. Keep her away from those areas altogether.

I don't know if there is any way to disinfect the soil, grass, etc. in your yard and kill the HGE disease. Oh, yes--another thing. The vet told me that people who walk on those areas can bring the pathogens that cause HGE indoors on their shoes, so that's another source of infection, because your dog may lick the floor or carpet. I got in the habit of taking my outdoor shoes off in the foyer and changing to indoor (uncontaminated) shoes to wear in the house.

My last suggestion is that you may get a second opinion about your dog's condition if she still has symptoms even though her lab work doesn't show why. If you live near a veterinary school/college program or even an emergency animal hospital, any of those may be a good source. Best wishes to you and your schnauzer girl. Please let me know how she is doing. Regards,


Knotts on October 20, 2017:

My Schnauzer had this same thing happen to her 3 months ago. I rushed her to the vet she had to be put on IV & stay over night. They sent her home with antibiotics. She seemed better couple weeks after finishing the antibiotics it happen again. She had to be put bk on IV & stay over night again. He sent her home with 2 weeks of antibiotics. A week after she's off the antibiotics it came back again. This time I request more test. He's done all blood work & all rest come back normal. She's now on antibiotics for the 3rd time, I'm so aggravated to have no answers. I'm not sure if she has this or maybe bowel syndrome. I have paid $9 hundred dollars and they still don't know. So all that to ask did your dogs come back?

Jaye Denman (author) from Deep South, USA on November 03, 2015:

Thank you, Linda. Nice to meet you also. I wrote this hub to warn pet owners about a very dangerous illness that strikes suddenly and can be fatal if not treated right away. Knowing the symptoms is the key to saving a beloved pet. Regards, Jaye

Linda Robinson from Cicero, New York on October 06, 2015:

What a terrific helpful hub for all pet lovers. Nice meeting you. Excellent writing and so much detail. I look forward to following you. Linda

Jaye Denman (author) from Deep South, USA on July 10, 2014:

Thank you, Peg. After learning how dangerous HGE is, I feared for my dog's life until I knew she was fully recovered. Then I worried about recurrences, but--so far (knock on wood!) there have been none. I felt it was my duty to spread the word about this dangerous disease which strikes suddenly and can be so quickly fatal if not treated.

I'm so glad your puppy survived and thrived. Aren't dogs wonderful?

Regards, Jaye

Peg Cole from North Dallas, Texas on July 09, 2014:

This was an incredible story. I was captivated by your every word and read straight through without interruption. Of course, I'm a dog lover and any type of animal trauma is incredibly disturbing so I had to be sure there was a happy ending to her illness. Wow.

We experienced a similar issue with our little lab mix puppy about 3 months after we adopted him from the SPCA. He had similar symptoms and ended up in the emergency care of the veterinarian with a case of intussusception. He had to have surgery but it fixed the issue and he is okay. He's four now and weighs 103 pounds.

Jaye Denman (author) from Deep South, USA on July 06, 2014:

ologsinquito - Thank you. I wrote this article because every dog owner should know about this very dangerous canine disease that can kill within hours. I'd never heard of it before my dog got so ill with it, and I am so grateful that she survived. Please pass it on to other dog lovers.

Regards, Jaye