Ask VETbytes: Acute Haemorrhagic Diarrhoea Syndrome

This week we were asked if antibiotics are indicated in cases of canine acute haemorrhagic diarrhoea syndrome (AHDS)? Our team of vets had the following advice:

  • Routine use of antibiotics is not recommended
  • Treatment of dogs with aseptic haemorrhagic gastroenteritis with co-amoxiclav does not reduce the time to resolution of clinical signs
  • Evidence suggests that the addition of metronidazole is not beneficial
  • Broad-spectrum i/v antibiotics are indicated in immunocompromised or neutropenic patients and in those with suspected sepsis
  • Stop antibiotics as soon as the patient is clinically well


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[3] Unterer, S., Strohmeyer, K., Kruse, B.D. et al. (2011)
Treatment of Aseptic Dogs with Hemorrhagic Gastroenteritis with Amoxicillin /Clavulanic Acid: A Prospective Blinded Study

Journal of Veterinary Internal Medicine;25(5) 973-979
Full text available

[6] Unterer, S., Lechner, E., Mueller, R.S. et al  (2015)
Prospective study of bacteraemia in acute haemorrhagic diarrhoea syndrome in dogs 

Veterinary Record;176(12) 309

[16] Dunowska, M. (2017)
What is causing acute haemorrhagic diarrhoea syndrome in dogs?
Veterinary Record;180(22) 539 – 541
No Abstract available

[17] Ortiz, V., Klein, L., Channell, S. et al. (2018)
Evaluating the effect of metronidazole plus amoxicillin‐clavulanate versus amoxicillin‐clavulanate alone in canine haemorrhagic diarrhoea: a randomised controlled trial in primary care practice
Journal of Small Animal Practice59(7) 398-403

[18] Ziese, A.L., Suchodolski, J.S., Hartmann, K. et al. (2018)
Effect of probiotic treatment on the clinical course, intestinal microbiome, and toxigenic Clostridium perfringens in dogs with acute hemorrhagic diarrhea
PLOS One13(9) e0204691
Full text available

[25] Dean, R. and Perry, R. (2017)
Use of antibiotics in dogs with aseptic haemorrhagic gastroenteritis
In [clinically well dogs with haemorrhagic gastroenteritis] does [systemic antibiotics compared to no antibiotics] [decrease the time to resolution of clinical signs]?
BESTbets for Vets, University of Nottingham
Full text available

[28] Unterer, S. (2017)
Acute hemorrhagic diarrhea syndrome – an update
An urban experience, 42nd World Small Animal Veterinary Association Congress and FECAVA 23rd Eurocongress pp 242-243

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