Gastroenteritis, Haemorrhagic

Signalment

Small breed dogs such as:

• Toy and Miniature Poodles
• Miniature Schnauzers

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.

Diagnosis

Clinical Signs

• Acute and progressive haemorrhagic vomiting and diarrhoea, with vomiting preceding diarrhoea
• Depression
• Abdominal pain
• Pyrexia (rare)
• Dehydration may not be obvious

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 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.

Diagnostic Imaging

• Radiology is unremarkable.

Treatment

• Start treatment prior to a full diagnostic investigations.
• Aggressive intravenous fluid therapy is vital.
  • 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.
• Antimicrobials such as ampicillin is appropriate against C. perfringes but a broad spectrum may be required to prevent sepsis.
• 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. Complete recovery in most cases provided there is no compication such as hypoproteinaemia or sepsis. There is a chance of recurrence.

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.