Canis ISSN: 2398-2942

Acute hemorrhagic diarrhea syndrome (AHDS)

Synonym(s): Hemorrhagic gastroenteritis (HGE)

Contributor(s): James Simpson, Ken Harkin, Daniel Batchelor

Introduction

  • Cause: most likely a toxin produced by Clostridium perfringens.
  • Signs: peracute onset of bloody diarrhea and vomiting.
  • Diagnosis: compatible clinical signs, and exclusion of other causes.
  • Treatment: needs to be aggressive and is primarily symptomatic/supportive (fluids, antiemetics).
  • Prognosis: usually good if animals receive prompt treatment.

Pathogenesis

Etiology

  • Unknown for certain.
  • Enterotoxins are the most logical explanation for the mucosal destruction reported.
  • A primary pathogenic role for Clostridium perfringens Clostridium perfringens , or its toxins, is suspected Clostridial enterotoxicosis.
  • Large numbers of rod shaped bacteria to the necrotic mucosal surfaces of dogs with AHDS have been reported.
  • These bacteria have been identified as Clostridium perfringens.
  • In 2015, a novel pre-forming toxin named net Fwas discovered in an isolate of C. perfringens from a dog that died of AHDS. The authors then found a highly significant association between the presence of C. perfringens type A strains carrying the gene for this toxin and cases of canine AHDS.
  • They also found a similar association for the similar disease in horses (foal necrotizing enterocolitis).

Predisposing factors

General

  • None known. The disease affects previously healthy dogs.
  • The syndrome is more likely to occur during the winter months.

Pathophysiology

  • Rapid loss of fluid and protein into the GI tract.
  • Rapid development of dehydration, collapse, possible acute kidney injury Kidney: acute kidney injury (AKI) and DIC.

Timecourse

  • Can progress within hours.

Epidemiology

  • Unknown.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Mortier F, Strohmeyer K, Hartmann K, Unterer S (2015) Acute haemorrhagic diarrhoea syndrome in dogs: 108 cases. Vet Rec 176 (24), 627 PubMed.
  • Busch K, Sucoldolski J S, Kuhner K A, Minamoto Y, Steiner J M, Mueller R S, Hartmann K, Unterer S (2015) Clostridium perfringens enterotoxin and Clostridium difficile toxin A/B do not play a role in acute haemorrhagic diarrhoea syndrome in dogs. Vet Rec 176 (10), 253 PubMed.
  • Gohari I M, Parreira V R, Nowell V J, Nicholson V M, Oliphant K, Prescott J F (2015) A novel pore-forming toxin in Type A Clostridium perfringens is associated with both fatal canine hemorrhagic gastroenteritis and Fatal Foal Necrotizing Entercolitis. PLoS One 10 (4) PubMed.
  • Unterer S, Lechner E, Mueller R S, Wolf G, Straubinger R K, Schulz B S, Hartmann K (2015) Prospective study of bacteraemia in acute haemorrhagic diarrhoea syndrome in dogs. Vet Rec 176 (12), 309 PubMed.
  • Marks S L, Rankin S C, Bryne B A, Weese J S (2011) Enteropathogenic bacteria in dogs and cats: diagnosis, epidemiology, treatment, and control. JVIM 25 (6), 1195-1208 PubMed.
  • Unterer S, Strohmeyer K, Kruse B D, Sauter-Louis C, Hartmann K (2011) Treatment of aseptic dogs with hemorrhagic gastroenteritis with amoxicillin/clavulanic acid: a prospective blinded study. JVIM 25 (5), 973-979 PubMed.

Other sources of information

  • Mortier F, Yoo T-E, Strohmeyer K, Hartmann K, Unterer S (2013) Idiopathic acute haemorrhagic diarrhoea syndrome in dogs: 108 cases. Abstract, Proceedings of ECVIM Congress, Liverpool, UK.


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