Comparison
Canine parvovirus vs Acute hemorrhagic diarrhea syndrome in Dogs: How to Tell Them Apart
Canine parvoviral enteritis is a highly contagious acute GI viral disease that commonly affects young, unvaccinated dogs, whereas acute hemorrhagic diarrhea syndrome (AHDS) is an acute condition characterized by vomiting and hemorrhagic diarrhea and is often of unknown cause.[1][11] CPV is typically confirmed with fecal viral antigen testing or PCR and commonly causes leukopenia, while AHDS is typically diagnosed from acute hemorrhagic diarrhea with hemoconcentration, with PCV often > 60% and normal to slightly decreased total plasma protein concentration.[1][8] Both conditions require supportive care, but AHDS literature notes rapid clinical improvement in most cases without antibiotics, and a prospective study found amoxicillin-clavulanic acid did not improve outcome in dogs without clinical indices of sepsis.[1][2][8]
At a glance
| Feature | Canine parvovirus | Acute hemorrhagic diarrhea syndrome |
|---|---|---|
| Usual patient | Young, unvaccinated, or incompletely vaccinated dogs; suspicion is especially high in dogs living in or newly acquired from a shelter or breeding kennel.[1] | Typically young to middle-age, small-breed dogs, but it can strike any dog at any age of any breed.[11][10] |
| Cause | A highly contagious viral disease; CPV-2 targets rapidly dividing cells, including bone marrow and intestinal crypt epithelial cells.[1][4] | An acute condition often without a known cause; current information suggests overgrowth by Clostridium perfringens type A strains associated with release of NetF toxins is very likely responsible for the necrotic enterocolitis in dogs with AHDS.[11][2] |
| Onset and key signs | Clinical signs generally develop within 5–7 days after infection but can appear from 2 to 14 days after infection; initial lethargy, anorexia, and fever may progress to vomiting and hemorrhagic small bowel diarrhea within 24–48 hours.[1] | Sudden or acute onset of hemorrhagic, watery diarrhea, often with vomiting, anorexia, and lethargy; signs may rapidly progress to explosive and voluminous hematochezia.[2][10] |
| Hallmark diagnostic findings | Diagnosis is based on signalment, history, clinical signs, and fecal viral antigen testing or viral PCR assay.[1] | Diagnosis is typically based on acute onset of clinical signs with hemoconcentration, with PCV often > 60% and normal to slightly decreased total plasma protein concentration.[8] |
| Typical CBC pattern | Most dogs develop moderate to severe leukopenia characterized by lymphopenia and neutropenia.[1] | CBC abnormalities are usually limited to hemoconcentration and neutrophilic leukocytosis.[8] |
| Treatment emphasis | Treatment is largely supportive; key components listed by Merck are fluids, antiemetics, antimicrobials, and nutritional support.[1] | Prompt IV fluid therapy is the main treatment; treatment primarily involves fluid therapy, analgesics, and antiemetics.[8][2] |
| Prognosis | Prognosis is reasonable if presented early in the course of disease.[4] | With treatment, the prognosis is good, and recovery is often rapid and complete with appropriate symptomatic treatment.[10][11] |
Causes & risk factors
- Canine parvovirus: Parvoviral enteritis is a highly contagious viral disease that commonly affects young, unvaccinated dogs.[1] CPV-2 targets rapidly dividing cells, including bone marrow and intestinal crypt epithelial cells.[4] Canine parvoviral enteritis should be suspected in young, unvaccinated, or incompletely vaccinated dogs, especially those living in or newly acquired from a shelter or breeding kennel.[1]
- Acute hemorrhagic diarrhea syndrome: AHDS is often without a known cause.[10][11] Based on a summary of current information, overgrowth by C perfringens type A strains associated with the release of NetF toxins, possibly in combination with other toxins, seems very likely to be responsible for the necrotic enterocolitis in dogs with AHDS.[2] AHDS typically affects young to middle-age, small-breed dogs, although it can strike any dog at any age of any breed.[11][10]
Clinical signs
- Canine parvovirus: Clinical signs generally develop within 5–7 days after infection but can appear from 2 to 14 days after infection.[1] Initial clinical signs may be nonspecific, including lethargy, anorexia, and fever, with progression to vomiting and hemorrhagic small bowel diarrhea within 24–48 hours.[1] Approximately 25% of dogs may have nonhemorrhagic diarrhea.[1] Physical examination findings can include depression, fever, dehydration, and intestinal loops that are dilated and fluid filled.[1] Abdominal pain warrants further investigation to exclude the potential complication of intussusception.[1] Severely affected animals may present with signs potentially consistent with septic shock, including collapse with prolonged capillary refill time, poor pulse quality, tachycardia, and hypothermia.[1]
- Acute hemorrhagic diarrhea syndrome: AHDS is characterized by both acute vomiting and diarrhea.[8] Dogs commonly present with sudden onset of hemorrhagic, watery diarrhea, often accompanied by vomiting, anorexia, and lethargy.[2] Signs may rapidly progress to explosive and voluminous hematochezia.[10] AHDS can lead to cardiovascular collapse and death without early aggressive therapy.[11]
Diagnosis: how to tell them apart
- Canine parvovirus: Diagnosis is typically based on history, physical examination findings, and fecal antigen testing, and Merck lists confirmation by fecal parvoviral antigen testing or viral PCR assay.[1] Clinical presentation may resemble hemorrhagic gastroenteritis and other acute gastroenteric disturbances, so confirmation relies on virus detection in feces.[6] Most dogs develop moderate to severe leukopenia characterized by lymphopenia and neutropenia.[1]
- Canine parvovirus test caveats: Point-of-care ELISA tests that detect virus in feces generally have specificity >90%, but sensitivity varies.[6] Both ELISA and PCR can detect vaccinal virus in 4 to 10 days of vaccination.[6] False-negative ELISA results can occur because of low viral load and/or high neutralizing antibody levels, and dogs suspected of having parvovirus that test negative via ELISA should be tested by fecal PCR if necessary.[6]
- Acute hemorrhagic diarrhea syndrome: Diagnosis is typically based on signalment and acute onset of clinical signs with hemoconcentration, with PCV often > 60% and normal to slightly decreased total plasma protein concentration.[8] Presence of anemia is not expected or typical.[8] CBC abnormalities are usually limited to hemoconcentration and neutrophilic leukocytosis.[8] If neutropenia is present, sepsis and/or parvovirus enteritis may be a concern.[8]
- When differentiating other causes of acute hemorrhagic diarrhea: In one AHDS study, all dogs underwent CBC, serum biochemistry profile, abdominal ultrasound, and fecal examination, and basal cortisol was measured in 13 dogs.[2] In acute diarrhea, additional diagnostics may include a complete blood count, serum biochemistry profile, urinalysis, baseline cortisol, SNAP Parvo Test, and survey abdominal radiographs to look for abdominal mass, dilated loop of bowel, ileocolic intussusception, foreign body obstruction, or linear foreign body requiring surgical intervention.[5]
Treatment
- Canine parvovirus: Treatment is largely supportive on an inpatient or outpatient basis because specific therapies are not available.[1] Merck key points list supportive care with fluids, antiemetics, antimicrobials, and nutritional support.[1]
- Acute hemorrhagic diarrhea syndrome: Prompt IV fluid therapy is the main treatment, and the primary treatment is prompt IV fluid therapy, rehydration, and supportive therapy.[8] Treatment primarily involves fluid therapy, analgesics, and antiemetics.[2] Depending on serum potassium concentration, maintenance fluids should be supplemented with potassium chloride (20–40 mEq/L) to prevent development of hypokalemia, and hypoglycemic dogs require dextrose supplementation (2.5–5%).[8] Additional supportive care includes antiemetic therapy and dietary management.[8]
- Antibiotics in AHDS: Rapid clinical improvement is observed in most cases without the need for antibiotics.[2] In a prospective study of dogs with AHDS and no clinical indices of sepsis, treatment with amoxicillin-clavulanic acid did not affect mortality rate, duration of hospitalization, or severity of clinical signs.[8] Consensus recommendations are against antibiotic use in AHDS without signs of bacterial translocation with subsequent sepsis, although parenteral antimicrobials may be considered in severe cases when there is concern for sepsis, neutropenia, or marked neutrophilia.[3][8]
Prognosis
- Canine parvovirus: Prognosis is reasonable if presented early in the course of disease.[4] Leukopenia, lymphopenia, and the absence of a band neutrophil response within 24 hours of starting treatment has been associated with a poor prognosis.[1]
- Acute hemorrhagic diarrhea syndrome: With treatment, the prognosis is good.[10] Recovery is often rapid and complete with appropriate symptomatic treatment.[11] Without early aggressive therapy, AHDS can lead to cardiovascular collapse and death.[11]
Key points
- In a young, unvaccinated, or incompletely vaccinated dog with vomiting and hemorrhagic diarrhea, canine parvoviral enteritis should be suspected and confirmed with fecal viral antigen testing or viral PCR assay.[1]
- In a dog with acute hemorrhagic diarrhea and hemoconcentration, with PCV often > 60% and normal to slightly decreased total plasma protein concentration, AHDS is the typical syndromic diagnosis.[8]
- CBC patterns can help separate the two conditions: CPV commonly causes leukopenia with lymphopenia and neutropenia, whereas AHDS usually shows hemoconcentration and neutrophilic leukocytosis.[1][8]
- Both diseases are managed supportively, but AHDS evidence does not show benefit from routine antibiotics in dogs without clinical indices of sepsis.[1][2][8]
Frequently asked questions
How do CBC findings help distinguish canine parvovirus from AHDS in dogs?
Most dogs with canine parvoviral enteritis develop moderate to severe leukopenia characterized by lymphopenia and neutropenia.[1] In AHDS, CBC abnormalities are usually limited to hemoconcentration and neutrophilic leukocytosis, and if neutropenia is present, sepsis and/or parvovirus enteritis may be a concern.[8]
When should I run PCR after a negative fecal parvo ELISA?
Can recent vaccination affect canine parvovirus test results?
Do antibiotics help dogs with AHDS?
Rapid clinical improvement is observed in most cases without the need for antibiotics.[2] In a prospective study of dogs with AHDS and no clinical indices of sepsis, treatment with amoxicillin-clavulanic acid did not affect mortality rate, duration of hospitalization, or severity of clinical signs.[8] Consensus recommendations are against antibiotic use in AHDS without signs of bacterial translocation with subsequent sepsis.[3]
What findings support a diagnosis of AHDS?
AHDS is typically diagnosed from acute onset of hemorrhagic diarrhea with hemoconcentration, with PCV often > 60% and normal to slightly decreased total plasma protein concentration.[8] Presence of anemia is not expected or typical, and the serum biochemical profile may be unremarkable or show mild panhypoproteinemia, hypoglycemia, and electrolyte abnormalities consistent with GI loss and decreased intake.[8]
How soon do clinical signs of canine parvovirus appear after infection?
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Veterinarian · Reviewed 25 Oct 2026
References
- Canine Parvovirus Infection (Parvoviral Enteritis in Dogs)
Passage read from this source
Full Review: Jun 2025 ByAlex Gallagher, DVM, MS, DACVIM-SAIM, Columbia Veterinary Emergency Triage and Specialty | Peer reviewed byJoyce Carnevale, DVM, DABVP, College of Veterinary Medicine, Iowa State University Last updated: Jun 2025 v3266271 View the Pet Owner Version Parvoviral enteritis is a highly contagious viral disease that commonly affects young, unvaccinated dogs. Clinical signs include anorexia, lethargy, vomiting, and diarrhea, which is often hemorrhagic. Diagnosis is typically based on history, physical examination findings, and fecal antigen testing. Treatment is largely supportive on an inpatient or outpatient basis because specific therapies are not available. - Etiology and Pathophysiology| - Epidemiology| - Clinical Findings| - Diagnosis| - Treatment and Prognosis| - Prevention and Control| - Key Points| - For More Information|…
Clinical signs of parvoviral enteritis in dogs generally develop within 5–7 days after infection but can appear from 2 to 14 days after infection. Initial clinical signs may be nonspecific (eg, lethargy, anorexia, fever) with progression to vomiting and hemorrhagic small bowel diarrhea within 24–48 hours. Approximately 25% of dogs may have nonhemorrhagic diarrhea. Physical examination findings can include depression, fever, dehydration, and intestinal loops that are dilated and fluid filled. Abdominal pain warrants further investigation to exclude the potential complication of intussusception. At the time of initial evaluation, severely affected animals may have clinical signs potentially consistent with septic shock (collapsed with prolonged capillary refill time, poor pulse quality, tachycardia, and hypothermia).
- Suspected based on signalment, history, and clinical signs - Confirmation by fecal parvoviral antigen testing or viral PCR assay Canine parvoviral enteritis should be suspected in any young, unvaccinated, or incompletely vaccinated dog with relevant clinical signs, especially those living in or newly acquired from a shelter or breeding kennel. During the course of the illness, most dogs develop moderate to severe leukopenia characterized by lymphopenia and neutropenia. Leukopenia, lymphopenia, and the absence of a band neutrophil response within 24 hours of starting treatment has been associated with a poor prognosis.
- Parvoviral enteritis is a highly contagious acute GI disease in young, unvaccinated dogs. - Diagnosis is based on signalment, history, clinical signs, and fecal viral antigen testing or viral PCR assay. - Treatment requires supportive care with fluids, antiemetics, antimicrobials, and nutritional support.
- Comparing treatment effects on dogs with acute ...
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Acute hemorrhagic diarrhea syndrome (AHDS) in dogs presents with sudden onset of hemorrhagic, watery diarrhea, often accompanied by vomiting, anorexia, and lethargy.1–3 Treatment primarily involves fluid therapy, analgesics, and antiemetics.1,3,4 Rapid clinical improvement is observed in most cases without the need for antibiotics.1,3 Histopathological examinations have revealed necrotizing enterocolitis and layers of *Clostridium perfringens* strains adherent to the necrotic surface,5 and fecal real-time PCR (qPCR) analysis has been found to show an increase in the abundances of *C perfringens* in dogs with AHDS compared to healthy dogs.6 Based on a summary of all current information, it seems very likely that overgrowth by *C perfringens* type A strains associated with the release of NetF toxins, possibly in combination with other toxins,…
Dogs of any breed, both sexes, and over 1 year of age were included in the study if the hemorrhagic diarrhea lasted < 3 days. Dogs receiving mucosal irritants (such as NSAIDs, doxycycline, and/or corticosteroids) within 1 week prior to diagnosis or dogs with an underlying disease that could also cause acute hemorrhagic diarrhea (such as acute pancreatitis, exocrine pancreatic insufficiency, acute renal and/or liver failure, mechanical obstruction, focal intestinal disorder, or hypoadrenocorticism) were excluded. Therefore, a CBC, serum biochemistry profile, abdominal ultrasound, and fecal examination (flotation and SNAP *Giardia* Test; Idexx Laboratories Inc) were consequently performed in all dogs and basal cortisol in 13 dogs.
Figure 1Comparison of the acute hemorrhagic diarrhea syndrome (AHDS) index between the different treatment groups. The AHDS index of each dog is shown as an individual dot. The horizontal lines show the mean values. The gray dots represent the symptomatic treatment (ST) group. The black dots represent the fecal microbiota transplantation treatment (FMTT) group. The red dots represent the antibiotic treatment (AT) group. No significant differences between the treatment groups at any time point were found except on day 2; on this day, the AHDS index was significantly higher in the AT group than in the FMTT group (*P* = .046). Citation: Journal of the American Veterinary Medical Association 262, 12; 10.2460/javma.24.03.0153
- Acute canine diarrhea: is it time to rethink our treatment ...
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Despite sparse historical evidence that metronidazole may reduce the time it takes for acute diarrhea to resolve in dogs, even the authors of these studies note that most cases of canine diarrhea resolve in a few days “regardless of treatment.” Caution should be raised when owners say, “it worked before, just give me another week,” especially if “only one dose” was needed to resolve the signs, as this temporal association could be simply coincidental.
Although distressing to owners and clinicians alike, despite the presence of hematochezia, the consensus recommendations are against antibiotic use as no evidence corroborates benefit in cases of acute hemorrhagic diarrhea syndrome (AHDS) without signs of bacterial translocation with subsequent sepsis.12 On the contrary, it has been demonstrated that administration of antibiotics in dogs presenting with AHDS did not significantly improve severity of clinical signs, fecal consistency, and duration of hospitalization when compared to placebo.9 In truth, multiple canine and feline studies have demonstrated broad spectrum antibiotics markedly derange the fecal metabolome and reduce its diversity, with modifications persisting up to 4 years reported in human medicine.11,22-26
Kaolin/pectin formulations (such as Pro-Pectalin) have gained popularity for symptomatic therapy of diarrhea. Kaolin, an aluminum silicate, and pectin, a carbohydrate extracted from the rind of citrus fruits, act synergistically as a demulcent and an adsorbent in the treatment of diarrhea by binding bacterial toxins (endotoxins and enterotoxins) within the GI tract. In placebo-controlled clinical trials, treatment with ADPP was associated with significantly shorter duration of diarrhea (ADPP: median, 32 hours; 95% confidence interval [CI], 2-118; n = 51; placebo: median, 47 hours; 95% CI, 4-167; n = 58; P=.008) and a more rapid rate of resolution of diarrhea (1.60 times faster), and it required fewer additional medical interventions for non-improvement or worsening clinical signs (3.5% and 14.8% of dogs,…
- Parvovirus disease associated with CPV-2
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- 2 parvoviruses affect dogs: - CPV-1 (first recognized in 1967). - CPV-2 (first recognized in 1978). - Highly resistant nonenveloped viruses. - CPV-2 targets rapidly dividing cells, eg bone marrow, intestinal crypt epithelial cells, myocardium/young puppies. - **Signs**: vomiting, profuse hemorrhagic diarrhea and profound depression. - **Diagnosis**: clinical signs, vaccination, history, antigen detection or PCR from feces. Serology and virus isolation are not practical for use in clinics. - **Treatment**: symptomatic, interferon, fecal matter transplant. - **Prognosis**: reasonable if presented early in course of disease. - **Prevention**: vaccination, isolation of infected dogs. - **Zoonotic potential**: some strains of CPV (CPV-2a, 2c) may cause enteric disease in cats.Print out owner factsheetParvovirus disease in your dogto give to your client.
- GI Intervention: Approach to Diagnosis & Therapy of the ...
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Signalment and history often contain the information necessary to make a tentative diagnosis or help rank differential diagnoses (**Tables 1 and 2**). Puppies and kittens, especially from shelters, are prone to viral diseases and GI parasites. Physical examination may detect: * Abdominal masses * Dilated loops of bowel * Foreign bodies * Intussusception * Abdominal pain. When patient size permits, routinely performing digital rectal palpation aids recovery of feces for observation of the presence of blood (digested [melena] or fresh) and/or mucus.
The most important initial step in evaluating animals with acute diarrhea is to determine if they have a self-limiting or potentially life-threatening problem (**Table 2**). This distinction is crucial as it guides the level of diagnostics and therapy indicated, and should be based on a thorough history, careful physical examination, clinical experience and judgment, and a sound understanding of the differential diagnoses for acute diarrhea.
* If dietary indiscretion has occurred, removal of the incriminating factors and/or feeding a highly digestible diet for 3 to 5 days usually helps resolve diarrhea. * If parasites are detected, diarrhea should improve 2 to 3 days after appropriate treatment * If an etiology is not found, a presumptive diagnosis of acute idiopathic self-limiting diarrhea may be made. Symptomatic therapy usually relieves clinical signs in 1 to 3 days. If diarrhea persists or other clinical signs develop or intensify, a more serious problem may exist, requiring thorough evaluation and more intensive therapy. **A patient may have a potentially LIFE-THREATENING PROBLEM** if some of the following are present:
**Laboratory Analysis.** Laboratory evaluation helps rank differential diagnoses as well as assess severity of dehydration and electrolyte disorders; it may include: * Complete blood count * Serum biochemistry profile * Urinalysis * Baseline cortisol (to exclude hypoadrenocorticism) * SNAP Parvo Test (idexx.com). In chronic or recurrent cases of diarrhea, serum concentrations of cobalamin and folate and canine or feline trypsin-like immunoreactivity (cTLI or fTLI) can be measured. Depending on clinical signs, patients may be evaluated for hyperthyroidism (cats) and pancreatitis. **Radiography.** Survey abdominal radiographs may demonstrate an abdominal mass, dilated loop of bowel, ileocolic intussusception, foreign body obstruction, or linear foreign body requiring surgical intervention.
- Diagnosing, Treating, and Preventing Canine Parvovirus
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Clinical presentation of CPV infection may resemble other acute gastroenteric disturbances, including intussusception; foreign body; other gastroenteric viral, bacterial, parasitic, and protozoal pathogens; and hemorrhagic gastroenteritis. Confirmation of diagnosis relies on virus detection, which is primarily accomplished through point-of-care ELISA tests that detect the virus in feces. Specificity of most point-of-care ELISA tests is high (ie, generally >90%), but sensitivity varies.11 PCR can also be used for sensitive detection of the virus. It is important to interpret results in light of vaccination history, as both tests can detect vaccinal virus in 4 to 10 days of vaccination.12,13 However, ELISA tests usually give weak positive results, and real-time PCR results will manifest a high cycle threshold value with vaccine detection. False-negative…
- Parvovirus Infection: Diagnosis - Veterinary Partner - VIN
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A puppy with bloody diarrhea could have a parasite problem, a virus other than parvovirus, stress colitis, an intestinal foreign body, or may simply have eaten something that disagreed with him. It is important to confirm the diagnosis of parvovirus before embarking on what could be the wrong treatment. Fortunately, parvovirus infection does not generally present a challenge in diagnosis. Tests that Are Especially Useful The Fecal Parvo ELISA Test
- Acute Hemorrhagic Diarrhea Syndrome in Dogs
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Full Review: Jun 2025 ByAllison Collier, DVM, DACVIM, Ontario Veterinary College, University of Guelph | Peer reviewed byJoyce Carnevale, DVM, DABVP, College of Veterinary Medicine, Iowa State University Last updated: Jun 2025 v3266639 View the Pet Owner Version Acute hemorrhagic diarrhea syndrome in dogs is characterized by both acute vomiting and diarrhea. The diagnosis is based on clinical signs and hemoconcentration. Prompt IV fluid therapy is the main treatment. Parenteral antimicrobials may be considered in severe cases, such as when there is concern for sepsis, neutropenia, or marked neutrophilia. - Etiology and Pathophysiology| - Epidemiology| - Clinical Findings and Lesions| - Diagnosis| - Treatment and Prognosis| - Key Points| - For More Information| - References|
- Acute onset of hemorrhagic diarrhea - Severe hemoconcentration (PCV often > 60%) Diagnosis of acute hemorrhagic diarrhea syndrome is typically based on signalment and acute onset of clinical signs with hemoconcentration (PCV often > 60%) and normal to slightly decreased total plasma protein concentration. Presence of anemia is not expected or typical. Abnormalities on CBC are usually limited to hemoconcentration and neutrophilic leukocytosis. If neutropenia is present, sepsis and/or parvovirus enteritis may be a concern. The serum biochemical profile may be unremarkable or show mild panhypoproteinemia, hypoglycemia (sepsis, decreased intake with limited hepatic glycogen stores), and electrolyte abnormalities consistent with GI loss and decreased intake (ie, hypokalemia, hyponatremia, hypochloremia).
In a prospective study of dogs with AHDS and no clinical indices of sepsis, treatment with amoxicillin-clavulanic acid did not affect mortality rate, duration of hospitalization, or severity of clinical signs (2). This might suggest that not all cases of AHDS are due to primary bacterial infection or that the bacteria involved may not be susceptible to amoxicillin-clavulanic acid. Depending on serum potassium concentration, maintenance fluids should be supplemented with potassium chloride (20–40 mEq/L) to prevent development of hypokalemia. Hypoglycemic dogs require dextrose supplementation (2.5–5%). Additional supportive care, including antiemetic therapy and dietary management, is as described for canine parvovirus and acute gastritis.
- Dogs with acute hemorrhagic diarrhea syndrome develop acute vomiting and acute hemorrhagic diarrhea. - Diagnosis is based on clinical presentation and evidence of hemoconcentration (PCV often > 60%). - The primary treatment is prompt IV fluid therapy, rehydration, and supportive therapy.
- Acute hemorrhagic diarrhea syndrome associated with ... - PMC
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A one-year-old male Golden Retriever presented with acute onset of vomiting and hemorrhagic diarrhea since 2 days. The dog was depressed, showing abdominal pain, 12% dehydration, tachycardia, and a bounding pulse. Diagnostic imaging showed severe dilatation and fluid retention of the entire gastrointestinal tract with decreased motility. A foreign body was found in the gastroduodenal region, but there was no obstruction or plication. The dog was tentatively diagnosed with acute hemorrhagic diarrhea syndrome and rapidly recovered after supportive treatment. However, on the morning of day 4, anorexia and vomiting recurred, and diagnostic imaging revealed intestinal plication with free peritoneal fluid, not found on the previous image. An emergency laparotomy revealed the foreign body to be two used feminine hygiene products.…
In this case report, contaminated foreign bodies were strongly suspected to induce AHDS via intestinal bacterial dysbiosis. In particular, a tampon, identified as one of the contaminated foreign bodies in the dog, is highly infectious and can stimulate toxic shock syndrome toxin 1 (TSST-1) via staphylococci bacteria in human beings [6, 14]. This report describes the clinical signs, diagnosis, treatment, and outcome of AHDS associated with heavily contaminated foreign bodies (used feminine hygiene products) in a Golden Retriever dog. To the author’s knowledge, there are currently no reports of AHDS associated with contaminated foreign bodies in small animals.
After excluding other possible causes of hemorrhagic diarrhea, based on clinical signs and examinations, the dog was tentatively diagnosed with AHDS, and treatment commenced accordingly. Treatment consisted of fluid therapy (lactated ringer’s solution 130 ml/kg/day constant rate infusion), antiemetic therapy (maropitant 1 mg/kg SC, q 24 hr), gastric antacids (famotidine 0.5 mg/kg IV, q 8 hr), analgesics (butorphanol 0.4 mg/kg IV, q 6 hr, to q 8 hr), and antibiotics (amoxicillin 11 mg/kg IV, q 8 hr; metronidazole 15 mg/kg IV, q 12 hr). After alleviation of vomiting, oral medications including omeprazole (1 mg/kg q 24 hr) and sucralfate (1 g, q 12 hr) and a gastrointestinal diet were added.
To diagnose AHDS, other possible causes of acute hemorrhagic diarrhea, including drug administration (non-steroidal anti-inflammatory drugs, corticosteroids, doxycycline intoxication), gastrointestinal disease (neoplasia, intussusception, foreign body), infectious disease (nematode or protozoan parasites, parvovirus infection, infection of Salmonella, Yesinia, Campylobacter species), organ dysfunction (azotemia, liver failure, pancreatitis), coagulopathy, and systemic disease (Addison’s disease, disseminated intravascular coagulation), should be excluded [9]. In this case report, clinical signs and lesions in the dog were similar to those reported in previous studies of AHDS, including acute profuse hemorrhagic diarrhea, hypovolemic shock, hemoconcentration due to severe dehydration, and intestinal fluid retention and dilatation without obstruction. All other potential causes of hemorrhagic diarrhea were excluded; we excluded the foreign body at initial presentation as it was not…
- Hemorrhagic Gastroenteritis
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HEMORRHAGIC GASTROENTERITIS Garret Pachtinger, VMD, DACVECC Megan Brashear, RVT, VTS (ECC) Hemorrhagic Gastroenteritis, renamed Acute Hemorrhagic Diarrhea Syndrome (AHDS) is a disease often without a known cause. More prevalent in young, small breed dogs, it can strike any dog at any age of any breed at any time. It is thought to possibly be caused by exposure to a novel food item or perhaps an atypical immune response to bacteria. Clostridial species of bacteria may play a role but its significance is not yet understood. Dogs suffering from AHDS are often previously healthy before acutely developing vomiting and hematochezia. Quick recognition of the problem and aggressive treatment by the veterinary team is needed, and with treatment, the prognosis for these…
History and Clinical Signs: Acute Hemorrhagic Diarrhea Syndrome is often readily recognized by the owner. The disease starts with the dog exhibiting depressed mentation and the dog may start vomiting but signs rapidly progress to explosive and voluminous hematochezia. Due to large numbers of clotted red blood cells in the diarrhea, it is often described as strawberry jam in appearance. Owners may note anorexia prior to the diarrhea. It is important to collect a complete history on these patients, as medication (such as NSAID) ingestion can lead to hematochezia as well as parasitic infection, viral infection, and systemic disease.
- Acute Hemorrhagic Diarrhea Syndrome
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ArticleLast Updated August 20185 min readPeer Reviewed Print/View PDF Acute hemorrhagic diarrhea syndrome (AHDS), formerly termed hemorrhagic gastroenteritis (HGE), is an acute condition of unknown cause characterized by severe hemorrhagic diarrhea and vomiting. AHDS typically affects young to middle-age, small-breed dogs1 and can lead to cardiovascular collapse and death without early aggressive therapy. Recovery is often rapid and complete with appropriate symptomatic treatment. Endoscopic evaluation of affected dogs reveals no macroscopic or histologic gastric pathology, despite a high incidence of vomiting and hematemesis in many patients.1,2 Severe, coagulative necrosis of the small and large intestines2 is present histologically, however, and HGE was renamed AHDS following these findings.2
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