HGE in my yorkie

Question
I have a 6 year old rescue yorkie that has had 2 bouts with what I was told to be HGE. The first bout was a dark brownish red vomit that I did not realize to be "blood" or "old blood". I never took her to the vet because she seemed fine after and ate and drank normally. I thought she may have just eaten something that upset her stomach. Well, a few months later, she suddenly vomited a BRIGHT red bloody mucous...(no diarrhea,though). It was very scary and I immediately rushed her a nearby vet who referred me to an emergency animal care hospital. She was kept overnight on IV and meds and sent home on a bland diet and 5 days worth of continuing meds. My question is "what causes this to happen to her?" The hospital didn't really give me any answers and actually didn't seem to know. I never got a chance to talk to the doc when she was released and I am so nervous that it may happen again. I understand that it can be dangerous for her. Any suggestions on how to keep this from happening again? Is there some type of long term treatment? I would appreciate any help you could offer.

Answer
Typically, Hemorrhagic Gastroenteritis(HGE) causes severe bloody diarrhea and not bloody vomit. HGE is believed to be an infection with a bacteria called Clostridium. There is severe denuding of the cells lining the intestinal tract from toxins released by the bacteria. HGE can cause a rapid onset of dehydration and hemoconcentration(high red blood cell count) with a normal protein level. (Normally proteins are elevated in the blood when there is dehydration.) I am concerned that your little Yorkie may have something other than HGE going on. Other causes of hematemesis(bloody vomit) include a gastric ulcer, foreign body, Inflammatory Bowel Disease, Pancreatitis or Cancer. In order to further evaluate the underlying cause for the vomiting, xrays and an abdominal ultrasound should be performed. If this is negative but further episodes of vomiting continue then endoscopy with gastric biopsies should be done. I am assuming she has already had full blood work which would be an important part of the basic database to have for her.

Dr. G