Changes

{{unfinished}}

{{review}}

Also known as: '''''HGE

| Also known as:

| '''HGE'''

==Description==

==Introduction==

'''Haemorrhagic gastroenteritis''' is characterised by acute [[Vomiting|vomiting]] and [[Diarrhoea|diarrhoea]]. Gastrointestinal integrity is lost, resulting in a rapid movement of blood, fluid and electrolytes into the intestinal lumen. The aetiology is unknown but it may relate to ''[[:Category:Enteropathogenic and Enterotoxaemic Clostridia|Clostridium perfringens]]'' enterotoxicosis or an immune-mediated reaction. There is usually no history of rubbish, chemical or foreign body ingestion.

'''Haemorrhagic gastroenteritis''' is characterised by acute [[Vomiting|vomiting]] and [[Diarrhoea|diarrhoea]]. Gastrointestinal integrity is lost, resulting in a rapid movement of blood, fluid and electrolytes into the intestinal lumen. The aetiology is unknown but it may relate to ''[[:Category:Enteropathogenic and Enterotoxaemic Clostridia|Clostridium perfringens]]'' enterotoxicosis or an immune-mediated reaction. There is usually no history of rubbish, chemical or foreign body ingestion.

==Signalment==

==Signalment==

Middle-aged, small-breed dogs such as:

Middle-aged, small-breed dogs such as: Miniature Poodle, Toy Poodle, Miniature Schnauzer, Yorkshire Terrier, Dachshund.

==Clinical Signs==

 

 

 

===Clinical Signs===

Include acute and progressive haematoemesis and/or haematochezia, with vomiting preceding diarrhoea.

Include acute and progressive haematoemesis and/or haematochezia, with vomiting preceding diarrhoea.

Other signs include depression, anorexia, abdominal pain, dehydration and  [[Shock#Hypovolaemic shock|hypovolaemic shock]] occurs over a period of 8 - 12 hours. Pyrexia can occur but is rare.

Other signs include depression, anorexia, abdominal pain, dehydration and  [[Shock#Hypovolaemic shock|hypovolaemic shock]] occurs over a period of 8 - 12 hours. Pyrexia can occur but is rare.

In severe cases patients may be critically ill or moribund.

In severe cases, patients may be critically ill or moribund.

===Laboratory Tests===

==Laboratory Tests==

====Haematology and Biochemistry====

===Haematology and Biochemistry===

Reveals haemoconcentration with PCV > 60%. Normal or increased total protein concentrations will be present, but proportionately lower than would be expected from the corresponding increase in PCV due to loss of protein through the intestines.

Reveals haemoconcentration with PCV > 60%. Normal or increased total protein concentrations will be present, but proportionately lower than would be expected from the corresponding increase in PCV due to loss of protein through the intestines.

In severe cases a thrombocytopaenia and a Pre-renal or renal [[Azotaemia|azotaemia]] may occur.

In severe cases a thrombocytopaenia and a pre-renal or renal [[Azotaemia|azotaemia]] may occur.

====Other Tests====

===Other Tests===

Faecal cytology may reveal red blood cells, occasional white blood cells, ''Clostridium perfringens'' spores or enterotoxin. Clostridium perfringens spores or enterotoxin can be found in a normal dog, therefore care has to be taken not to over-interpret this.

Faecal cytology may reveal red blood cells, occasional white blood cells, ''Clostridium perfringens'' spores or enterotoxin. ''Clostridium perfringens'' spores or enterotoxin can be found in a normal dog, therefore care has to be taken not to over-interpret this.

===Diagnostic Imaging===

==Diagnostic Imaging==

====Radiography====

===Radiography===

Abdominal radiograph may reveal fluid and gas filled small and large intestines.

Abdominal radiograph may reveal fluid and gas filled small and large intestines.

Aggressive intravenous [[Principles of Fluid Therapy|fluid therapy]] is important for the treatment and prevention of shock.

Aggressive intravenous [[Principles of Fluid Therapy|fluid therapy]] is important for the treatment and prevention of shock.

[[Colloids|Colloids]] or plasma are recommended to replace the intravascular deficit due to loss of protein, followed by [[Crystalloids|crystalloids]] to complete rehydration.

[[Colloids|Colloids]] or plasma are recommended to replace the intravascular deficit due to loss of protein, followed by [[Crystalloids|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.

A broad spectrum antimicrobials such as [[Penicillins|ampicillin]] combined with [[Fluoroquinolones|fluoroquinolone]] are appropriate against  ''Clostridium perfringens''.  

Broad spectrum antimicrobials such as [[Penicillins|ampicillin]] combined with [[Fluoroquinolones|fluoroquinolone]] are appropriate against  ''Clostridium perfringens''.  

Initially, food should be withheld. Once vomiting has stopped a bland and highly digestible diet such as chicken and rice can be introduced.

 

Initially, food should be withheld. Once vomiting has stopped a bland and highly digestible diet such as chicken and rice can be introduced.

==Prognosis==

==Prognosis==

Complete recovery in most cases provided there is no complication such as hypoproteinaemia or sepsis. However, recurrence is possible.

Complete recovery in most cases provided there is no complication such as hypoproteinaemia or sepsis. However, recurrence is possible.

 

 

==References==

==References==

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''.

[[Category:Stomach_and_Abomasum_-_Inflammatory_Pathology]][[Category:Intestine_-_Inflammatory_Pathology_by_Type]][[Category:To_Do_-_Caz]]

[[Category:Stomach_and_Abomasum_-_Inflammatory_Pathology]][[Category:Intestine_-_Inflammatory_Pathology_by_Type]][[Category:To_Do_-_Caz]][[Category:Dog]]

[[Category:To_Do_-_Review]]

[[Category:Expert_Review]]