Notes on Fitz and HGE (hemorrhagic gastroenteritis)

A couple weeks ago our Schnauzer puppy Fitzwilliam started having diarrhea (wow, this post is already off to a stellar start). Within a day blood was showing in the diarrhea. It started on a Friday I think, and by Saturday night I was waking up to his frantic back-and-forth parading as he tried to get outside. By that time he was literally shooting (with force, in a stream) a brown and red sauce.

He actually seemed to recover after we gave him some Imodium, but that took some time and was frought with some amount of peril. I advise seeking your veterinarian's opinion before administering medicine; we knew the correct dosage for Buzzle, who was a couple pounds heavier than Fitz, but Fitz really seemed to get worse on the medicine. It did stop the diarrhea that night though.

By Sunday Fitz seemed to be back to his normal self, and his recovery extended into the week. I still saw some traces of blood but I figured that was to be expected as the lining of his intestines continued to heal.

We went to the dog park the following Saturday and he drank from a communal dish that had some mud in it. Not sure if that was to blame for what occurred later that day, but I suspect it might have been.

By Saturday night he was experiencing diarrhea again. Every 2-4 hours he needed to go out, and each time the situation worsened. The hemorrhaging was accelerating and his stool became redder. He threw up at some point and it was also tinged with blood. The consistency of what was coming out of his mouth and rear was interesting, but also scary. It was full of mucous, whitish, and bloody.

I took him to the emergency clinic in Atlanta and he was diagnosed with hemorrhagic gastroenteritis, or HGE, a condition characterized by a sudden onset of bloody diarrhea. Mortality rates are high if left untreated. Dehydration from the rapid fluid loss and lack of appetite and depression is a serious concern.

Fitz produced a sample in situ while we waited. It was the worst yet; the smell was uncharacteristically strong and if one didn't know better they'd swear they were seeing traces of actual intestinal tissue within the puddle.

The vet performed a blood test that showed he had an elevated packed cell volume (PCV), a common indicator of HGE. She advised he stay overnight (possibly longer) to receive an IV drip. The cost was prohibitive so I opted for a one-hour IV infusion, antibiotic injection, kaopectate, and barium. Our regular vet opened in the morning and I planned to go when they opened.

The kaopectate (active ingredient is loperamide, same thing found in Imodium) stopped him up that night. The liquid form (and perhaps some of the other things he was given) seem to be very effective.

He was also prescribed metronidazole (Flagyl) to help with possible secondary infections within the intestines. Metronidazole is effective against many anaerobic bacteria and some parasites such as giardia which are found in the small intestine. While the exact cause of HGE is unknown, some evidence suggest these parasites can often bring on a case.

Fitz was doing well the next morning. He didn't wake us up to go outside and I don't think he needed to go that day either. He wasn't allowed to eat or drink for 12 hours after our appointment, and even after that he had to start on very small amounts of water the first few hours, and then some plain food after that.

I purchased some Pedialyte and shot 10mL of it slowly into his mouth every 30min-1hr using an oral syringe given to us by the vet.

His urine went from a very dark (think Georgia Brown, unless you like to drink) color to nearly clear within the day. He seemed to be getting more than enough fluids.

He eventually pooped a white, solid, rubber-like mass later that day. Apparently it was the kaopectate.

He recovered within another day, the condition gone nearly as fast as it had come.

Keep in mind if you're seeing similar symptoms that it could be Parvo, a very serious disease.

In any case, HGE is easily fatal if left untreated. It's not simply a matter of providing oral hydration; often times the dog is unable to absorb the water due to the condition of the intestines. It's best to get IV fluids. A dog with HGE can become extremely dehydrated within 24 hours so don't hesitate taking them to the veterinarian.