I've done tons of research on HGE and the etiology is unknown. However, a few couple theories are bacterial infection, or bacterial toxins. The possible bacteria is Clostridium perfringens.
Predisposing factors are toy/teacup breed dogs (especially yorkies and poodles), between the ages of 2-4, and urban living dogs. Martini is 3 1/2yrs old and we live downtown, in the city. I had read on one website that diet could also be a cause so I'm changing her food. I want to give her the best food possible. I'm still looking into Innova, unless I read about another brand that is better!