Difference between revisions of "Gastroenteritis, Haemorrhagic"

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(Redirected page to Haemorrhagic Gastroenteritis)
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#redirect[[Haemorrhagic Gastroenteritis]]
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{{unfinished}}
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{| cellpadding="10" cellspacing="0" border="1"
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| Also known as:
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| '''HGE'''
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|-
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|}
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==Description==
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'''Haemorrhagic gastroenteritis''' is characterised by acute [[Vomiting|vomiting]] and [[Diarrhoea|diarrhoea]].  Gastrointestinal integrity is loss, 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 garbage, chemical or foreign body ingestion.
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==Signalment==
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Middle-aged, small-breed dogs such as:
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<gallery>
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Image:Miniature_Poodle.jpg|''Miniature Poodle''<p> Berlinda 2005, WikiMedia Commons
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Image:Toy_poodle1.jpg|''Toy Poodle''<p> Manuel González Olaechea y Franco 2006, WikiMedia Commons
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Image:Miniature_schnauzer.jpg|''Miniature Schnauzer'' <p> MagnusK 2006, WikiMedia Commons
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Image:Yorkshire_Terrier.jpg|''Yorkshire Terrier'' <p> Jlcerso 2007, WikiMedia Commons
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Image:Standard_Dachshund_(Short-haired).jpg|''Dachshund (Standard Short-haired)'' <p> Igor Bredikhin 2006, WikiMedia Commons
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</gallery>
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==Diagnosis==
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===Clinical Signs===
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*Acute and progressive haematoemesis and/or haematochezia, with [[Vomiting|vomiting]] preceding [[Diarrhoea|diarrhoea]]
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*Critically ill or moribund patient in severe cases
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*Depression and anorexia
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*Abdominal pain
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*Dehydration and  [[Shock#Hypovolaemic shock|hypovolaemic shock]] occurs over a period of 8 - 12 hours.
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*Pyrexia (rare)
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*Thrombocytopaenia (severe cases)
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*Pre-renal or renal azotaemia (severe cases)
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 +
 
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===Laboratory Tests===
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====Haematology====
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*Haemoconcentration with PCV > 60%
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*Normal or increased total protein concentrations, but proportionately lower than would be expected from the corresponding increase in PCV due to loss of protein through the intestines.
 +
 
 +
====Other Tests====
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*Faecal cytology may reveal red blood cells, occasional white blood cells, ''[[:Category:Enteropathogenic and Enterotoxaemic Clostridia|Clostridium perfringens]]'' spores or enterotoxin.  ''[[:Category:Enteropathogenic and Enterotoxaemic Clostridia|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===
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====Radiography====
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Abdominal radiograph may reveal fluid and gas filled small and large intestines.
 +
 
 +
==Treatment==
 +
*Start treatment prior to a full diagnostic investigations.
 +
*Aggressive intravenous fluid therapy is important for the treatment and prevention of shock.
 +
**[[Colloids|Colloidal]] 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.
 +
*A broad spectrum antimicrobials such as [[Penicillins|ampicillin]] combined with [[Fluoroquinolones|fluoroquinolone]] are appropriate against ''[[:Category:Enteropathogenic and Enterotoxaemic Clostridia|Clostridium perfringens]]''.  This is recommended to be given empirically.
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*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.
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 +
 
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==Prognosis==
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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 complication such as hypoproteinaemia or sepsis.  However, recurrence is possible.
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 +
 
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==References==
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*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''.
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*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''.
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*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
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[[Category:Stomach_and_Abomasum_-_Inflammatory_Pathology]][[Category:Intestine_-_Inflammatory_Pathology_by_Type]][[Category:To_Do_-_Caz]]
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[[

Revision as of 11:30, 11 August 2010


 This article is still under construction.


Also known as: HGE

Description

Haemorrhagic gastroenteritis is characterised by acute vomiting and diarrhoea. Gastrointestinal integrity is loss, resulting in a rapid movement of blood, fluid and electrolytes into the intestinal lumen. The aetiology is unknown but it may relate to Clostridium perfringens enterotoxicosis or an immune-mediated reaction. There is usually no history of garbage, chemical or foreign body ingestion.

Signalment

Middle-aged, small-breed dogs such as:

  • Miniature Poodle

    Berlinda 2005, WikiMedia Commons

  • Toy Poodle

    Manuel González Olaechea y Franco 2006, WikiMedia Commons

  • Miniature Schnauzer

    MagnusK 2006, WikiMedia Commons

  • Yorkshire Terrier

    Jlcerso 2007, WikiMedia Commons

  • Dachshund (Standard Short-haired)

    Igor Bredikhin 2006, WikiMedia Commons



Diagnosis

Clinical Signs

  • Acute and progressive haematoemesis and/or haematochezia, with vomiting preceding diarrhoea
  • Critically ill or moribund patient in severe cases
  • Depression and anorexia
  • Abdominal pain
  • Dehydration and hypovolaemic shock occurs over a period of 8 - 12 hours.
  • Pyrexia (rare)
  • Thrombocytopaenia (severe cases)
  • Pre-renal or renal azotaemia (severe cases)


Laboratory Tests

Haematology

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

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.


Diagnostic Imaging

Radiography

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

Treatment

  • Start treatment prior to a full diagnostic investigations.
  • 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.
    • 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 ampicillin combined with fluoroquinolone are appropriate against Clostridium perfringens. 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.


Prognosis

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 complication such as hypoproteinaemia or sepsis. However, recurrence is possible.


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.
  • 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.

[[

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