Hemorrhagic Gastroenteritis (HGE) in Dogs

Sick puppy
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A sudden case of bloody diarrhea is often the first sign that a dog may have hemorrhagic gastroenteritis (HGE), which causes gastrointestinal bleeding. The disease may also cause vomiting along with other symptoms, and it often comes on very quickly.

If you notice blood in your dog's stool, it's important to contact your veterinarian right away. While bloody stool is a symptom of many different illnesses, HGE is serious and needs to be treated aggressively. If left untreated, it can be fatal. With prompt veterinary care, most dogs respond to treatment and recover in a few days.

Why Do Dogs Have HGE?

Bloody diarrhea is often a symptom of HGE. The exact cause of HGE is unknown, although there are a number of theories, including an adverse reaction to a change in food, a bacterial infection or virus, or a reaction to intestinal parasites. Additionally, it's thought that stress or a hyper disposition (overactive, high energy, excitable, etc.) can play a role in the development of HGE. Dogs that have an episode of HGE may be prone to another occurrence, but most dogs never experience HGE.

The most notable sign you may see if your dog has HGE is the sudden onset of bloody diarrhea in a previously healthy dog. The blood is often a bright red, and many people compare it to raspberry jam. You may also notice a foul odor with the diarrhea that's anything but normal.

Other common symptoms include vomiting, loss of appetite (anorexia), and a rapid decrease in energy (listlessness or lethargy). Without treatment, the dog can quickly go into shock and may suffer from dehydration. Some dogs may develop a fever, though this is not very common. Because there are many causes of vomiting and diarrhea in dogs, you should always your veterinarian to discuss what's going on. Only your vet can properly advise you if it's a situation that can wait or if it sounds like an emergency.


If your dog is diagnosed with HGE, it's likely that hospitalization for several days will be necessary. Aggressive supportive care is required during treatment, and it's not something that can be done at home. During this time in the hospital, it's typical for dogs to receive no food or water by mouth for one to four days. Instead, they receive intravenous (IV) fluid therapy with potassium added to the fluids. Antibiotics are also recommended, delivered either through IV or subcutaneous injection.

Food is reintroduced slowly. In the event that the HGE is thought to be food related, your vet may also recommend switching to a novel protein (such as chicken, lamb, or cottage cheese) that the dog doesn't usually eat. The good news is that with this aggressive care, most dogs recover within a few days.

How to Prevent HGE

Because the cause of HGE is unknown, it's difficult to prevent it. Preventive measures like feeding your dog high-quality food, maintaining a low-stress environment, limiting table scraps and human food, and regularly using parasite-prevention medications, as prescribed by your veterinarian, are all steps that you can take to help safeguard your dog.

Once a dog has had an HGE episode, it may continue to have repeated episodes over time. After your dog's recovery, ask your vet to recommend ways you might be able to reduce the risk of recurrence. For example, keeping your dog on same high-quality diet rather than switching it periodically may help if the vet thinks the episode may have been food related.

Diagnostic Process

HGE is diagnosed primarily by ruling out other causes of bloody stool. The sudden appearance of bloody diarrhea and high packed cell volume (PCV) in a previously healthy dog stack the odds in favor of an HGE diagnosis. A high packed cell volume refers to the concentration of red cells in the blood. When the PCV is high, it's an indication of dehydration.

Other causes of gastrointestinal bleeding that must be considered as possibilities include gastrointestinal ulcers or cancer, colitis, parvovirus, and coronavirus. Your vet will also want to rule out bacteria such as Campylobacter spp., Salmonella spp., and ​Clostridium spp., and Escherichia coli.

It's likely that your vet will also check for other health issues such as:

Risk Factors

HGE can affect any breed of dog at any age, and it's not more prevalent in males or females. The initial case may occur around 2 to 5 years of age. A higher percentage of cases may occur in toy and miniature breeds, in particular, Maltese and Yorkshire terriers and miniature pinschers, schnauzers, and poodles.

If you suspect your pet is sick, call your vet immediately. For health-related questions, always consult your veterinarian, as they have examined your pet, know the pet's health history, and can make the best recommendations for your pet.