Basics
Acute Hemorrhagic Diarrhea Syndrome (AHDS), also known as Hemorrhagic Gastroenteritis (HGE), is a condition characterized by acute, profuse vomiting with blood or diarrhea with blood. It may progress rapidly, leading to blood volume reduction, circulatory collapse, multiple organ dysfunction, and death if left untreated.
Genetics, Breed Predisposition
AHDS can occur in any breed, although small dogs may be predisposed to this condition.
History, Chief Complaint
Anorexia and lethargy initially
Acute onset of vomiting, which may be profuse and contain fresh blood
Acute onset of diarrhea that may become grossly bloody; consistency varies from watery to jelly-like.
Etiology and Pathophysiology
A novel pore-forming toxin (NetF) from type A Clostridium perfringens is the probable cause of AHDS/HGE.
Gastrointestinal (GI) permeability increases markedly, leading to the leakage of fluids, proteins, and red blood cells into the intestinal lumen.
If left untreated, hypovolemic shock and death may occur.
Prognosis
Dogs with AHDS/HGE may die if the condition is not recognized and treated quickly. Early treatment is crucial, even as diagnostics are being performed, to prevent progression to life-threatening complications.
Nutrition / Diet
Water should be withheld until vomiting is adequately controlled. Once vomiting subsides, small amounts of water can be offered every 1-2 hours.
Food should be introduced once vomiting is reduced. Easily digestible diets, such as boiled white rice with cottage cheese or low-fat turkey breast, are recommended initially due to faster gastric emptying times.
Possible Complications
The condition may progress to hypovolemic shock, organ failure, or a life-threatening bleeding disorder.
Esophageal irritation may occur with persistent vomiting.
Patients with reduced alertness are at risk of developing aspiration pneumonia.
Sepsis can result from the body’s overreaction to infection, which may become a medical emergency.
Prognosis & Outcome
HGE is an extremely serious disease in small dogs, and without treatment their prognosis is poor. With appropriate treatment, the prognosis is still uncertain in some dogs, depending on how badly dehydrated the dog was at the beginning of treatment. Even with the best intensive care, some dogs die of this disease. Dogs that survive the first 24 hours of treatment have a good prognosis.
Recurrences are possible in some dogs at a later date.Most dogs recover rapidly, within 1-2 days, though severely affected dogs may require several days of supportive therapy before their gastrointestinal function returns to normal. About 10% of affected dogs may die despite receiving therapy due to multipl eorgan dysfunction and DIC.
Client Education
Approximately 10%-15% of dogs with AHDS/HGE may experience repeated episodes of the condition. Regular veterinary checkups and prompt treatment of any future signs are essential to prevent complications and ensure a good prognosis.
Monitoring & Follow-up
After surgery or medical intervention, follow-up visits are essential to ensure recovery and prevent complications.
Monitor your dog closely after discharge. If vomiting, diarrhea, or lethargy persist, seek veterinary advice immediately.
Adhere to dietary and medication instructions from your veterinarian to promote healing and recovery.
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