Changes

==Signalment==

==Signalment==

ESH occurs predominantly in older horses. Cases (both individual cases and outbreaks) occur relatively frequently during the autumn months in north western USA. Some parts of the world have no reported cases.

ESH occurs predominantly in older horses. Cases (both individual cases and outbreaks) occur relatively frequently during the autumn months in north western USA, however some parts of the world have no reported cases. Some reports suggest that lactating broodmares given tetanus antitoxin after parturition are particularly prone to Theiler's disease.

* Hypoglycaemia

* Hypoglycaemia

* Reduced urea

* Reduced urea

* Bilirubinuria

 

Bilirubinuria may also be present.

In several studies, biopsy is considered as the ‘gold standard’ technique for hepatic disease diagnosis. Biopsy is usually performed on the right hand side, between the twelth and fourteenth intercostal spaces. A coagulation profile is often performed prior to performing the procedure.  

In several studies, biopsy is considered as the ‘gold standard’ technique for hepatic disease diagnosis. Biopsy is usually performed on the right hand side, between the twelth and fourteenth intercostal spaces. A coagulation profile is often performed prior to performing the procedure.  

==Treatment==

==Treatment==

Affected horses should be housed in a quiet, darkened stable in order to minimise stimulation. Sedation may be required if signs of hepatic encephalopathy are present. If the horse is still able to eat, a low protein, high carbohydrate diet should be fed. The protein should be high in branched-chain amino acids.

Affected horses should be housed in a quiet, darkened stable in order to minimise stimulation. Sedation may be required if signs of hepatic encephalopathy are present. If the horse is still able to eat, a low protein, high carbohydrate diet should be fed. The protein should be high in branched-chain amino acids, and corn and molasses are often used to achieve this.

==Prognosis==

==Prognosis==