Unsolved Illness...

[Guest Beaubelle]

Dear Greyfriends!

We, my Spanish galga Leah and I, are new to you.

You can find us here http://www.flickr.com/photos/beaubelle/218...in/photostream/

 

I registered because a concerned friend, Z-stream on Flickr, , advised me to.

She is sure I will get a lot of good help and information here.

So, here is the story.

 

2 weeks ago Leah vomitted blood on the kitchenfloor, early in the morning.

Not a little bit, but a very big big splash, like 80x40 cm.!!! There was dark, thin and very bloody diarrhoea too.

Drifting in the vomit blood there was something that looked like pieces of white jelly.

There was no warning, except she had been restless for an hour or so before this happened.

 

I took her to the vet, together with samples of the vomit and the diarrhoea. Also I took pictures of the vomit etc. to show the quantity of it all to the vet.

Rontgen pictures were taken, bloodtests too. She had no fever.

The pics did not show any strange objects, only her spleen was a little bit too big.

 

The vet diagnosed sudden and enormous gastro-enteritis, cause unknown.

The medication every day: Zitac 2 x 100mg.Ulcogant suspense 4x 2,5 ml.Salazosulfa 500 3x

 

She is much better now. Lost some weight but is eating good, so that will be alright in a short time.

Only, as long as I don't know what possibly caused it, I am afraid it can happen again.

And it was no fun....

 

My question to you:

anybody experienced something like this too?

If yes, what was the cause?

 

All suggestions and good advises are very welcome!

 

Thank you!

[Burpdog]

I have no experience with HGE (thank goodness!). I am curious as to why the sulfa drug?

 

Sending lots of prayers.

 

How long have you had Leah?

 

edited to add: I see her spleen was too big. Are you in Spain? Do you have ticks there?

Edited January 12, 2008 by Burpdog

[Guest grey_dreams]

Hi Beaubelle! This is Z. So glad to see you registered. Hopefully someone here will be able to give you good advice!

 

 

edited to add: I see her spleen was too big. Are you in Spain? Do you have ticks there?

 

Hi, I was really hoping you could help . Leah is from Spain but now lives in Netherlands (not sure how long). There are ticks here too. Do you think maybe it could be from a TBD?

[Guest grey_dreams]

Here is an article I found on HGE at the International Greyhound Research Forum.

 

 

Hemorrhagic Gastroenteritis (HGE) Date posted: 2007-04-04 21:18:30

 

Hemorrhagic gastroenteritis (HGE) is a disease syndrome seen in dogs, characterized by the acute (sudden) onset of bloody diarrhea, usually explosive, accompanied by high packed cell volumes (red blood cells).

 

 

Causes

 

The true cause of HGE is unknown but there are some suspected causes.

 

Endotoxic shock, or poisons produced from bacteria causing shock

Immune mediated destruction of the intestinal lining

Infectious agents, possibly Clostridium

Predisposing Factors

 

This is a syndrome seen in dogs only. All breeds can be affected, although the incidence is greater in small breed dogs. Schnauzers, Dachshund, Yorkshire terriers, and miniature poodles are the most commonly affected.

 

HGE usually occurs in adult dogs, with the mean age of 5 years, and there is no sex predilection. HGE is most often seen in city dogs, or dogs housed in urban areas.

 

What to Watch For

Acute vomiting

Anorexia

Depression

Bloody diarrhea

Clinical signs are variable in both the course and severity of the disease. The onset of HGE is usually very quick/immediate, with no previous warning signs or health problems reported in the affected individuals. Signs progress rapidly and become severe within a few hours. Signs of shock, collapse, and sudden death have been reported.

 

Diagnosis

Complete blood count (CBC)

Biochemical profile

Urinalysis

Fecal examination

Elisa for parvovirus

Bacteria cultures and cytology of the stool

Coagulogram, or clotting profile

Abdominal radiographs (X-rays) should be obtained to eliminate a foreign body or other disease process

Treatment

 

Patients suspected of having HGE should be hospitalized and treated aggressively because clinical deterioration is often rapid and can be fatal. Treatment includes:

Aggressive fluid therapy is the mainstay of therapy.

Antibiotics are recommended in most cases.

The patient should be kept off food and water until signs are clearly resolving, and the PCV is within normal range. A bland, easy to digest diet should be given for several days, and then your pet can be weaned back to a regular diet if his condition has improved.

Home Care and Prevention

 

The prognosis for patients with HGE is excellent if it is caught early and treated aggressively. If you suspect your pet may have HGE, seek veterinary attention immediately. Administer all medication and recommended diet as directed by your veterinarian.

 

Because there is no known cause of the syndrome, there are no preventative measures that can be recommended in these patients.

 

Information In-depth

 

Many conditions result in hemorrhagic diarrhea, although the hemorrhagic gastroenteritis (HGE) syndrome of dogs appears to have unique clinical features that distinguish it as an entity separate from other causes. Although HGE can affect any breed of dog, it is seen most commonly in small breeds.

 

HGE is considered a common clinical condition, especially in dogs that live in urban settings. There is no way to prevent the syndrome, as we do not know with certainty what causes it. Most affected animals have been previously healthy, have no concurrent illness, and receive the best of care. Clinical findings are variable in both the course and severity of the disease.

 

The most common sign seen is an acute onset of bloody, often projectile diarrhea. The bloody stools have been likened to dark raspberry jam. The prognosis for patients with HGE is generally excellent if caught early and treated aggressively. Most often hospitalization with intensive fluid therapy and support is necessary.

 

There are many other diseases/disorders that can appear similar to HGE. These include:

Parvovirus is a contagious virus that can affect any age or breed of dog, although it is most common in the young, unvaccinated pup. The most common signs associated with parvo are vomiting, diarrhea (often with blood), and loss of appetite.

Bacterial enteritis, which is inflammation/infection of the intestinal tract with salmonella, clostridia, is commonly associated with signs that may mimic HGE.

Conditions resulting in endotoxic or hypovolemic shock, often associated with the movement of certain bacteria or toxins, or other overwhelming systemic infections, need to be ruled out.

Intestinal obstruction or intussusception, which is the telescoping of one part of the bowel into another, secondary to foreign bodies, tumors, or parasites can cause similar gastrointestinal signs.

Hypoadrenocorticism (Addison's disease) is an endocrine disorder in which there is a hormonal deficiency, most often corticosteroids and mineralocorticoids, due to a problem with the adrenal glands. These individuals often present with signs extremely similar to HGE.

Uremia is when toxins or poisons are not excreted from the body associated with kidney failure. It is not uncommon for these patients to present with gastrointestinal ulceration, vomiting, and bloody diarrhea.

Pancreatitis, an inflammation of the pancreas, often presents for some combination of vomiting, inappetence, and/or bloody diarrhea.

Coagulopathies, or bleeding disorders, including thrombocytopenia (decreased platelets), warfarin ingestion, disseminated vascular coagulation (DIC), and bleeding secondary to liver disorders may present with bloody diarrhea.

Toxins including arsenic, thallium, Amanita mushrooms, and certain household cleaning products cause bloody diarrhea.

Veterinary Care In-depth

 

Diagnosis In-depth

 

Certain diagnostic tests must be performed to diagnose HGE and exclude other disease processes that may cause similar symptoms. Obtaining a complete history, description of clinical signs, and thorough physical examination are all an important part of obtaining a diagnosis. In addition, the following tests are recommended to confirm a diagnosis:

A complete blood count (CBC) most often reveals profound hemoconcentration with a PCV of greater than 60 percent, and sometimes as high as 75 percent. There is most often an elevation in white blood cell count consistent with a stress response.

A biochemical profile is usually within normal limits, although it may reveal elevations in kidney and/or liver enzymes, and/or electrolyte abnormalities that may suggest other disease processes.

A urinalysis helps assess the kidneys and level of hydration of the patient.

Abdominal radiographs (X-rays) are usually within normal limits, although they may reveal fluid and gas in the intestinal tract. They also help rule out other causes of bloody diarrhea, such as tumors, foreign bodies, and changes in the liver, for example.

A thorough fecal evaluation should be performed, as there are certain intestinal parasites (whipworms) that can cause explosive bloody diarrhea.

A platelet count and full coagulation (clotting) profile should be obtained, as thrombocytopenia and other clotting abnormalities are very often seen responsible for similar clinical signs.

Your veterinarian may recommend additional tests to exclude or diagnose concurrent conditions. These tests are not necessary in every case, although they may be of benefit in certain individuals, and are selected on a case by case basis. These include;

A fecal Elisa test for parvovirus in suspect dogs

Fecal cytology and bacterial culture in selected cases

An ACTH stimulation test should be performed in individuals suspect of having hypoadrenocorticism. It consists of a pair of blood tests that can be drawn at your local veterinary hospital.

Abdominal ultrasound may be recommended in certain cases. It is very helpful in evaluating all of the abdominal organs, including the liver, kidneys, lymph nodes and spleen. It is equally important to rule out other disorders or diseases that may initially be difficult to differentiate from HGE. Abdominal ultrasound is a noninvasive test that often needs the expertise of a specialist and/or referral hospital.

An electrocardiogram may be recommended as cardiac arrhythmias (abnormal heart rhythms) may be associated with HGE.

Colonoscopic examination (evaluation of the colon through an endoscope) is generally not necessary or even recommended in patients with HGE. The reason for it's mention is so that other disorders can be ruled out. Examples include colonic cancer, foreign bodies, etc.)

Therapy In-depth

 

Patients suspected of having HGE should be hospitalized and treated aggressively, because clinical deterioration is often rapid and can be fatal. This is a syndrome in which out patient therapy most often is not enough, and certainly may put the patient at great risk, increasing the potential for complications. Successful treatment depends on managing fluid and electrolyte abnormalities and minimizing bacterial invasion of the body. Dietary management is important during the recovery period.

Rapid volume replacement with appropriate fluid and electrolyte therapy is imperative.

The patients PCV should be monitored closely during the initial stages of treatment.

Injectable antibiotics are given due to the potential for septicemia (systemic infection).

Dogs with evidence of shock may benefit from corticosteroids. They should be used with caution, however, as they do potentiate gastrointestinal ulceration.

Affected individuals should be held completely NPO (nothing given orally) for the initial part of therapy. Once vomiting has ceased, and blood in the stool has resolved, a very bland, low in fiber and fat, easy to digest diet should gradually be offered. After 1 to 2 weeks of tolerating the bland diet, the patient can be weaned back onto their original diet.

Follow-up

 

Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your pet does not rapidly improve.

Administer all prescribed medication and diet as directed. Alert your veterinarian if you are experiencing problems treating your pet.

Most patients, especially when HGE is recognized and treated aggressively, have an excellent prognosis and a full recovery is expected. Patients whose signs are not recognized early, or whose treatment is not terribly aggressive, may have complications, some of which may be life threatening. Acute death has been seen with this syndrome.

Reoccurrence is seen in approximately 10 percent of the cases.

Legal Disclaimer

 

If your pet is showing any signs of distress or you suspect your pet is seriously ill, CONTACT YOUR VETERINARIAN immediately.

 

 

 

[Burpdog]

Can tick panels be done there? Would be good to also put it out on the tick list:

 

Tick List

[Guest artemiss]

oops.

Edited January 12, 2008 by artemiss

[Guest Beaubelle]

I have no experience with HGE (thank goodness!). I am curious as to why the sulfa drug?

How long have you had Leah?

 

Leah is going to be three in May. I have her since she was 4 months. Leah and Zoey have their own site on Flickr. Thank you.

[Guest grey_dreams]

Can tick panels be done there? Would be good to also put it out on the tick list:

 

Tick List

 

 

Thanks! I really don't know what labs they might use here for tick panel tests. It must be possible though ...

[macoduck]

Our non-grey got into some snail pellets for the garden (poison)and it gave her bloody vomit and bloody diarrhea. Nearly ruined her liver. Taught us a big lesson in safety with pesticides. The vet didn't think she'd live through it because of the damage to her liver, but she did.

[Guest Beaubelle]

Thank you Grey Dreams, Burpdog and Artemiss, your posts are very helpful.

Leah came from Spain. Usually those dogs are tested negative for leishmania, erlichia en filaria, before they are brought to Holland, Germany or France. But Leah was only 4 months and a "last minute" put in the transport to Holland...

 

She gets all the injections she needs every year, every six months treatment against worms etc.

But I will ask the vet to do those tests concerning leishmania, erlichia en filaria next week. After all, you never know.

 

 

The vet mentioned it could be a virus, but...Zoey (my other doggie who eats almost from Leah's mouth) never got sick and a virus is contagious...and, she had no fever.

I am pretty sure (99%) that Leah had no ticks the last 8 months. She almost has no fur and is lightcolored. A tick would be very visible, even the little wound it would leave behind I would have noticed, since Leah goes through my hands every day, from tip to toe.

I really hope it is not Ehrlichiosis...

 

Macoduck, you've got a great looking bunch of dogs overthere!

Edited January 12, 2008 by Beaubelle

[Burpdog]

Our non-grey got into some snail pellets for the garden (poison)and it gave her bloody vomit and bloody diarrhea. Nearly ruined her liver. Taught us a big lesson in safety with pesticides. The vet didn't think she'd live through it because of the damage to her liver, but she did

 

You are fortunate! Not very many dogs survive snail bait

 

Hope to hear good news on Leah Is there any possibility that she got into poison? Bad food?

[Guest grey_dreams]

Leah came from Spain. Usually those dogs are tested negative for leishmania, erlichia en filaria, before they are brought to Holland, Germany or France. But Leah was only 4 months and a "last minute" put in the transport to Holland...

 

She gets all the injections she needs every year, every six months treatment against worms etc.

But I will ask the vet to do those tests concerning leishmania, erlichia en filaria next week. After all, you never know.

 

I am pretty sure (99%) that Leah had no ticks the last 8 months.

 

I really hope it is not Ehrlichiosis...

 

Beaubelle, Diane posted a good thread about tick borne diseases here. The article says there are different stages of the disease. I wonder if maybe it could be possible that the test they did before Leah left Spain might not have detected the disease? Maybe the titer wasn't high enough?

 

I do hope that you will be able to run the tick panel and have the tests run by a good lab. I hope it's not ehrlichiosis too.

 

[Guest Scouts_mom]

"I am curious as to why the sulfa drug."

 

I have had Ulcerative Colitis and am regularly take a sulfa drug, azulfidine, to keep it in remission (which it has very successfully for years). I wonder if the vet prescribed the sulfa drug because he suspected something similar in your dog. Active Ulcerative Colitis does cause very bloody diarrhea.

[Greytlady94]

Beaubelle, welcome to Greytalk.

 

I hope that your Leah's vet will know where to send blood for tick disease titers. Tick diseases can lay dormant for years.

[Guest Beaubelle]

Thank you all for your reactions.

I decided to contact Monday the vet to ask about Tick panels. I asked by email already about the sulfa (because I forgot)

As soon as I know more I'll come back to tell you about it.

After reading all this I think Leah didn't have symptoms that come with Tick Desease, leishmania, erlichia en filaria, babesiosis.

She did show though the symptoms of hemorrhagic gastroenteritis. It seems the cause is unknown. It can happen again, in 10 to 15%.

Thanks again.

Always happy with good advice!

Edited January 13, 2008 by Beaubelle

[grayladee]

Pharoah had HGE a year ago while we were visiting in Colorado. They ran all the tests and found nothing -- no cause. He's since recovered all his weight and is completely healthy and back on his regular diet

[Guest argolola]

I will pray for your sweet Leah. Please let us know how she's doing.

[Guest Beaubelle]

As promised, back with the result:

The answer I got from the vet was: the symptoms Leah had, without any other complaints, don't fit in with diseases like Leishmania, filaria etc. Especially because the medicines she's gotten, cured her.

And, animals, born in the south of Spain are less sensitive for Leishmania etc. No bloodtests advised!

 

Sulfa was to cure eventual infection of the intestines.

 

I am satisfied with this answer.

Thank you all for your support.