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Gastroenteritis, Haemorrhagic (view source)
Revision as of 16:53, 11 August 2009
, 16:53, 11 August 2009no edit summary
{{dog}}
{{dog}}
==Signalment==
==Signalment==
Middle-aged, small-breed dogs such as:
*Toy and Miniature Poodles
*Toy and Miniature Poodles
*Miniature Schnauzers
*Miniature Schnauzers
*Yorkshire Terrier
*Dachshunds
==Description==
==Description==
Haemorrhagic gastroenteritis is characterised by acute vomiting and diarrhoea. This is accompanied by a marked haemoconcentration. The aetiology is not yet known but it may relate to ''Clostridium perfringes'' enterotoxicosis or an allergic reaction.
Haemorrhagic gastroenteritis is characterised by acute vomiting and diarrhoea. Gastrointestinal integrity is loss, resulting in a rapid movement of blood, fluid and electriolytes into the intestinal lumen. The aetiology is unknown but it may relate to ''Clostridium perfringes'' enterotoxicosis or an immune-mediated reaction. There is usually no history of garbage, chemical or foreign body ingestion.
==Diagnosis==
==Diagnosis==
===Clinical Signs===
===Clinical Signs===
*Acute and progressive haemorrhagic vomiting and diarrhoea, with vomiting preceding diarrhoea
*Acute and progressive haematoemesis and/or haematochezia, with vomiting preceding diarrhoea
*Depression
*Critically ill or moribund patient in severe cases
*Depression and anorexia
*Abdominal pain
*Abdominal pain
*Dehydration and hypovolaemic shock occurs over a period of 8 - 12 hours.
*Pyrexia (rare)
*Pyrexia (rare)
*Dehydration may not be obvious
*Thrombocytopaenia (severe cases)
*Prerenal or renal azotaemia (severe cases)
====Other Tests====
====Other Tests====
*Faecal analysis rarely reveals ''C. perfringes'' spores or enterotoxin. Both of these can be found in a normal dog, therefore care has to be taken not to overinterprete this.
*Faecal cytology may reveal red blood cells, occasional white blood cells, ''C. perfringes'' spores or enterotoxin. ''C. perfringes'' spores or enterotoxin can be found in a normal dog, therefore care has to be taken not to overinterprete this.
===Diagnostic Imaging===
===Diagnostic Imaging===
*Radiology is unremarkable.
*Abdominal radiograph may reveal fluid and gas filled small and large intestines.
==Treatment==
==Treatment==
*Start treatment prior to a full diagnostic investigations.
*Start treatment prior to a full diagnostic investigations.
*Aggressive intravenous fluid therapy is vital.
*Aggressive intravenous fluid therapy is important for the treatment and prevention of shock.
**Colloidal or plasma are recommended to replace the intravascular deficit due to loss of protein, followed by crystalloids to complete rehydration.
**Colloidal or plasma are recommended to replace the intravascular deficit due to loss of protein, followed by crystalloids to complete rehydration.
**Clinical improvements should be noted within a few hours but resolution of clinical signs may take a few days.
**Clinical improvements should be noted within a few hours but resolution of clinical signs may take a few days.
*Antimicrobials such as ampicillin is appropriate against C. perfringes but a broad spectrum may be required to prevent sepsis.
*A broad spectrum antimicrobials such as ampicillin combined with fluoroquinole are appropriate against C. perfringes. This is recommended to be given empirically.
*Initially, nil per os should be implemented. Once vomiting has stopped, a bland and highly digestible diet such as chicken and rice can be introduced.
*Initially, nil per os should be implemented. Once vomiting has stopped, a bland and highly digestible diet such as chicken and rice can be introduced.
==Prognosis==
==Prognosis==
Good. Complete recovery in most cases provided there is no compication such as hypoproteinaemia or sepsis. There is a chance of recurrence.
Good if presented in a timely fashion. The duration of the disease is normally between 24-72 hours. Complete recovery in most cases provided there is no compication such as hypoproteinaemia or sepsis. Howevern, recurrence is possible.
==References==
==References==
*Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition) ''W.B. Saunders Company''.
*Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition) ''W.B. Saunders Company''.
*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''
*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''.
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.