Tierarztl Prax Ausg K Kleintiere Heimtiere 2009; 37(04): 261-268
DOI: 10.1055/s-0038-1622796
Übersichtsartikel
Schattauer GmbH

Akuter blutiger Durchfall beim Hund – Ursachen und diagnostische Aufarbeitung

S. Unterer
1   Medizinische Kleintierklinik (Leitung: Prof. K. Hartmann) der Ludwig-Maximilians-Universität München
,
K. Hartmann
1   Medizinische Kleintierklinik (Leitung: Prof. K. Hartmann) der Ludwig-Maximilians-Universität München
› Author Affiliations
Further Information

Publication History

Eingegangen: 02 November 2008

Akzeptiert: 12 June 2009

Publication Date:
06 January 2018 (online)

Zusammenfassung

Akuter blutiger Durchfall tritt beim Hund sehr häufig auf. Verschiedene Ursachen kommen infrage. Zur Diagnose einer extraintestinalen Krankheit als Ursache für eine gastrointestinale Blutung helfen Anamnese (z. B. Intoxikation), klinische Untersuchung (z. B. Ikterus), hämatologische, Serum- und Urinuntersuchung (z. B. Hypoadrenokortizismus, Nieren-, Leberversagen). Bei einem Patienten mit gastrointestinalen Blutungen sollte als Erstes eine Hämostasestörung ausgeschlossen werden. Die Verdachtsdiagnose eines „hämorrhagischen GastroenteritisSyndroms” lässt sich aufgrund der typischen klinischen Befunde, einer Hämatokriterhöhung (> 50–55%) und einer schnellen klinischen Besserung auf adäquate Infusiontherapie stellen. An infektiös oder parasitär bedingten hämorrhagischen Durchfall sollte man denken, wenn junge und immuninkompetente Hunde erkrankt sind, wenn Diarrhö bei mehreren Tieren gleichzeitig auftritt oder Durchfallpatienten mit Anzeichen einer Sepsis vorgestellt werden. In diesen Fällen sollten neben einer parasitologischen Kotuntersuchung auch eine Kot- und eine Blutkultur eingeleitet werden. Eine Parvovirus-Infektion sollte bei Patienten (vor allem bei jungen und ungeimpften Tieren) mit akutem Erbrechen und blutigem Durchfall differenzialdiagnostisch Berücksichtigung finden, insbesondere bei vorliegender Leukopenie. Zur Diagnostik stehen Antigen-ELISA für Kotproben zur Verfügung, die als sensitiv und spezifisch gelten. Akuter hämorrhagischer Durchfall kann lebensbedrohlich sein. Deshalb sollte bei jedem dieser Patienten frühzeitig mit einer unterstützenden symptomatischen Therapie begonnen, ein sorgfältiges Monitoring auf Anzeichen einer systemischen Komplikation durchgeführt und spezifische Tests zur ätiologischen Diagnose eingeleitet werden. Dieser Artikel liefert dem praktischen Tierarzt einen Überblick über Ursachen, deren Pathogenese und Möglichkeiten der diagnostischen Aufarbeitung von akuten hämorrhagischen Durchfallerkrankungen beim Hund.

Summary

Dogs are commonly presented with acute haemorrhagic diarrhea. There are numerous potential causes of bloody diarrhea. Extraintestinal disorders causing acute diarrhea can be ruled out using history (e. g., intoxication), physical examination (e.g., icterus), haematology, serum chemistry profile, and urinanalysis (e. g., hypoadrenocorticism, renal and liver failure). At first, gastrointestinal bleeding due to coagulation disorders has to be ruled out. A presumptive diagnosis of a “haemorrhagic gastroenteritis syndrome” can be made on the basis of appropriate clinical findings associated with an increased packed cell volume (> 50–55%) and a rapid clinical improvement with adequate fluid therapy. Haemorrhagic diarrhea caused by infectious or parasitic agents has to be considered in young and immuncompromised dogs, in diarrhea outbreaks occurring in multiple animals, and in patients with concurrent evidence of sepsis. In these cases, faecal and blood cultures should be performed. Parvovirus infections are suspected in patients (especially in young and unvaccinated animals) with sudden onset of vo-miting and bloody diarrhea, especially in dogs with concurrent leuko penia. Faecal ELISA for parvovirus antigen is regarded as a sensitive and specific diagnostic test. Acute haemorrhagic diarrhea can be a life threatening disease. Thus, early supportive care, aggressive monitoring for systemic complications, and specific diagnostic tests are indicated in these cases. This article reviews causes, pathogenesis, and diagnostic options of acute haemorrhagic diarrhea in dogs.

 
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