Changes

==Treatment==

==Treatment==

The aims of treatment are mainly to support liver function until hepatic compromise can occur. 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. In order to reduce the severity of neurological signs, the protein should be high in branched-chain amino acids; corn and molasses are often used to achieve this. If the horse is anorexic, a naso-gastric tube can be passed and high energy foods given directly into the stomach.

The aims of treatment are mainly to support liver function until hepatic compromise can occur. 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. Stressful situations such as moving the horse or separating it from field mates should be avoided.

If the horse is still able to eat, a low protein, high carbohydrate diet should be fed. In order to reduce the severity of neurological signs, the protein should be high in branched-chain amino acids; corn and molasses are often used to achieve this. If the horse is anorexic, a naso-gastric tube can be passed and high energy foods given directly into the stomach.

==Prognosis==

==Prognosis==

The prognosis for horses with signs of hepatic encephalopathy is extremely poor with a mortality rate approaching 88%. Horses that survive for a week after the onset of clinical signs may recover. A fall in SDH is associated with a better prognosis.  

The prognosis for horses with signs of hepatic encephalopathy is extremely poor with a mortality rate approaching 88%. Horses that survive for a week after the onset of clinical signs may recover. A fall in SDH is associated with a better prognosis.  

==References==

==References==