What is acute hemorrhagic diarrhea syndrome? Acute hemorrhagic diarrhea syndrome (AHDS) (also known as hemorrhagic gastroenteritis [HGE]) is an acute (emergent) disease in dogs characterized by vomiting and bloody diarrhea.
Most cases occur without warning in healthy dogs. The main and most disturbing clinical sign is profuse bloody diarrhea, most often bright red.
Some dogs may have stomach pain, decreased appetite, lethargy (fatigue), or a fever. AHDS can affect dogs of any breed, age, size, or gender, but is more common in small and toy dogs. Young Miniature Poodles, Miniature Schnauzers, and Yorkshire Terriers are most commonly affected. Other commonly affected breeds include Pekingese, Dachshunds, Maltese, Cavalier King Charles Spaniels, Shetland Sheepdogs, and Poodles. The exact cause of AHDS remains unknown (idiopathic).
This may be due to poor dietary habits (consumption of non-food items or various foods), immune-mediated diseases, toxins, or pancreatitis. In many cases, stress, anxiety, and hyperactivity are thought to be possible contributing factors. Recent studies suggest that AHDS may be an allergic reaction (food or inhalation).
Dogs with AHDS may be more likely to develop AHDS in the future. Diagnosis of AHDS can be difficult, and in persistent cases, a bowel biopsy may be required. Because there are so many possible causes of AHDS, evaluation usually requires a complete blood count (CBC), blood chemistry tests, urinalysis, x-rays (X-rays), blood clotting or clotting tests, stool evaluation, and ultrasound. gastrointestinal tract.
Compressed cell volume (PCV) or hematocrit (HCT), a measure of the proportion of red blood cells in the blood, is often over 60% in dogs with AHDS. The normal HCT for most dogs is between 37% and 55%. High HCT combined with low or normal total protein is an important indicator that a dog may have AHDS. Blood bicarbonate levels, blood pH, and serum chemicals are also indicators of possible AHDS.
Diagnosis is usually a process of eliminating bloody stools and other causes of gastrointestinal distress. Dogs with AHDS appear very sick and can die if left untreated. In most cases, the disease resolves within a few days if the dog receives adequate supportive care.
Intravenous fluid therapy with potassium and electrolyte supplementation provides the basis for the treatment of AHDS. Subcutaneous fluids (fluids injected under the skin) are generally considered insufficient to meet the large fluid needs of most dogs with AHDS. Most dogs are not fed for the first 24 hours of treatment, and antibiotics such as ampicillin, enrofloxacin, or metronidazole (brand name Flagyl®) are often used to combat potential secondary intestinal infections. Adjunctive therapy for AHDS may include gastrointestinal protectants (eg, sucralfate, marketed as Carafate® and Sulcrate®) and antiemetics (eg, maropitant, marketed as Cerenia®). In severe cases, plasma or colloids may be required to correct severely low blood protein levels.
Without intravenous fluid therapy, a dog's red blood cell count will continue to rise due to dehydration. In this condition, dogs are at risk for a life-threatening bleeding disorder called disseminated intravascular coagulation (DIC). Once DIC begins, it is usually irreversible and can lead to death. For unknown reasons, it is difficult to give preventive advice. However, sound advice is to feed your dog high-quality commercial food, avoid other foods or treats your dog is not accustomed to, use preventive parasite medications as directed by your veterinarian, and generally provide a low-stress environment.