Acute haemorrhagic diarrhoea syndrome in dogs: treatment
4-year-old Yorkshire Terrier with vomiting and profuse bloody diarrhoea ('raspberry jam') for 10 hours. Temperature 38.6 °C, pink mucous membranes, mild tachycardia and acceptable pulse quality.
| Parameter | Result | Reference |
|---|---|---|
| Haematocrit | 64% | 37–55% |
| Total protein | 5.4 g/dL | 5.5–7.5 g/dL |
| White blood cells | 11,200/µL | 6,000–17,000/µL |
| Lactate | 3.1 mmol/L | < 2.5 mmol/L |
What is the most appropriate treatment?
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A. Broad-spectrum IV antibiotics, because blood in the faeces indicates bacterial translocation
Studies in dogs with acute haemorrhagic diarrhoea without sepsis show no benefit of antibiotics on recovery or survival. Blood in the faeces does not equal bacteraemia.
B. Strict fasting until 48 hours after the diarrhoea stops
Early refeeding, as soon as vomiting is controlled, supports mucosal recovery. Prolonged fasting offers no benefit.
C. Synthetic colloids (hydroxyethyl starch) as first-choice fluid because of the low protein
Isotonic crystalloids are first choice. Starches are associated with kidney injury and coagulation disorders, and the hypoproteinaemia is usually mild and transient.
D. IV crystalloid fluid therapy, antiemetic, analgesia and early refeeding, without antibiotics
Correct. Fluid loss into the gut lumen causes haemoconcentration and hypovolaemia; restoring volume is what saves the dog. Without fever, neutropenia or other signs of sepsis, antibiotics are not needed.
lightbulb Key takeaway
The syndrome mainly affects small dogs (Yorkshire Terrier, Miniature Schnauzer, toy breeds) and is associated with Clostridium perfringens toxins. A very high haematocrit with normal or low protein is the typical pattern. Add antibiotics only if there is sepsis: fever or hypothermia, neutropenia or left shift, or unresponsive hypotension.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.