Acute hemorrhagic diarrhea syndrome
The Acute Hemorrhagic Diarrhoesyndrom (ADHD) is a disease in domestic dogs , which is characterized by acute onset of bloody diarrhea, vomiting and dehydration. In the older literature, the term acute hemorrhagic gastroenteritis is also used, but neither the stomach is involved, nor does an inflammation of the intestinal mucosa occur. The cause of the disease has not yet been clarified. Treatment is purely symptomatic by compensating for the loss of fluid and interrupting the vomiting with medication.
Cause and development of the disease
The cause of acute hemorrhagic diarrhea syndrome is not yet known. Clostridia , mostly Clostridium perfringens , can be detected in the intestinal mucosa of affected dogs . However, it is possible that this colonization with clostridia takes place only secondary and that hypersensitivity reactions of the intestinal mucosa or endotoxins cause the primary damage. As a rule, bacteria do not enter the bloodstream. In addition to Clostridium difficile and Clostridium perfringens endotoxins also be detected in some dogs that have no diarrhea. Another opinion is that it is an idiopathic disease. It occurs preferentially in winter and mainly affects small dog breeds such as Yorkshire Terriers , Miniature Pinschers , Miniature Schnauzers or Maltese , but in principle all dog breeds are susceptible.
The disease results in acute necrosis of the intestinal mucosa and infiltration with neutrophils .
Clinical picture
Acute Hemorrhagic Diarrhea Syndrome is characterized by sudden bloody diarrhea, bloody vomiting, and fluid loss. Sometimes an acute loss of fluid in the small intestine can lead to shock symptoms even before diarrhea and vomiting occur. The disease usually heals within two days, but severe or even fatal courses of the disease with sepsis , DIC and multiple organ failure are also possible.
Differential diagnosis
The diagnosis is made by excluding other diseases. Foreign bodies and infectious causes ( parvovirus , giardiosis and some nematode infections ) in particular can cause bloody diarrhea. In addition, pancreatitis , drug side effects ( NSAID , glucocorticoids ), adrenal insufficiency , IBD , liver diseases, acute or chronic kidney failure , coagulopathies (e.g. due to coumarin in rat poison), tumors of the gastrointestinal tract or intestinal invaginations must be excluded.
treatment
The most important treatment measure is to compensate for the loss of fluid, with severe dehydration by infusion , in milder cases by oral administration. Maropitant , metoclopramide or ondansetron are also used to prevent vomiting . The use of antibiotics is normally not indicated, as sepsis is extremely rare and antibiotics have no influence on recovery and the outcome of the disease. If there are signs of sepsis such as fever, leukocytosis or leukopenia , amoxicillin and clavulanic acid are usually administered.
Individual evidence
- ↑ a b c d e Frauke Rödler: Acute hemorrhagic diarrhea syndrome . In: Leipziger Blaue Hefte . tape 1 , 2016, p. 112-114 .
- ↑ a b S. Unterer, K. Busch, M. Leipzig, W. Hermanns, G. Wolf, RK Straubinger, RS Mueller, K. Hartmann: Endoscopically visualized lesions, histologic findings, and bacterial invasion in the gastrointestinal mucosa of dogs with acute hemorrhagic diarrhea syndrome. In: Journal of veterinary internal medicine / American College of Veterinary Internal Medicine. Volume 28, Number 1, 2014 Jan-Feb, pp. 52-58, doi: 10.1111 / jvim.12236 , PMID 24205886 .
- ^ S. Unterer, E. Lechner, RS Mueller, G. Wolf, RK Straubinger, BS Schulz, K. Hartmann: Prospective study of bacteraemia in acute haemorrhagic diarrhea syndrome in dogs. In: The Veterinary Record. Volume 176, number 12, March 2015, p. 309, doi: 10.1136 / vr.102521 , PMID 25568184 .
- ^ A b F. Mortier, K. Strohmeyer, K. Hartmann, S. Unterer: Acute haemorrhagic diarrhea syndrome in dogs: 108 cases. In: The Veterinary Record. Volume 176, number 24, June 2015, p. 627, doi: 10.1136 / vr.103090 , PMID 26023146 .