Changes

{{unfinished}}

{{unfinished}}

==Description==  

==Description==  

Hepatic encephalopathy is neurological disfunction caused by any acute or severe hepatic insult; 60-80% of hepatic function must be lost before clinical signs develop. A combination of mechanisms is probably responsible for the syndrome.   

'''Hepatic encephalopathy''' is neurological disfunction caused by any acute or severe hepatic damage; 60-80% of hepatic function must be lost before clinical signs develop. A combination of mechanisms is probably responsible for the syndrome.   

==Signalment==

==Signalment==

No age, sex or breed predisposions.

No age, sex or breed predisposions.

There are many hepatic disorders which can lead to hepatic encephalopathy including, [[Hepatitis, Equine Serum|Hepatitis]], [[Ragwort Toxicity]], [[Tyzzer's Disease]] and [[Hyperlipaemia - Horse|Hyperlipaemia]]

There are many hepatic disorders which can lead to hepatic encephalopathy including, '''[[Hepatitis, Equine Serum|Hepatitis]], [[Ragwort Toxicity]], [[Tyzzer's Disease]]''' and '''[[Hyperlipaemia - Horse|Hyperlipaemia]]'''

==Diagnosis==

==Diagnosis==

===Laboratory Tests===

===Laboratory Tests===

Haemotology and Biochemistry blood results will be consistent with hepatic disease,

Haemotology and Biochemistry results will be consistent with hepatic disease,

Increased GGT, SDH

Increased GGT, SDH

Hypoalbuminaemia

Hypoalbuminaemia

With supportive therapy horses may recover from hepatic encephalopathy after 4-21 days. Treatment is only warranted   

With supportive therapy horses may recover from hepatic encephalopathy after 4-21 days. Treatment is only warranted   

Sedation is often necessary in cases of hepatic encephalopathy; An alpha 2 agonist at a low dose is usually effective. If the neurological signs are so severe that the horse is a danger to itself and others then immediste euthansia is indicated.   

'''Sedation''' is often necessary in cases of hepatic encephalopathy; An alpha 2 agonist at a low dose is usually effective. If the neurological signs are so severe that the horse is a danger to itself and others then immediate '''euthansia''' is indicated.   

    

    

==Prognosis==

==Prognosis==

Prognosis is poor to severe but depend on the underlying disease; signs are potentially reversible if the initiating course can be corrected.  

Prognosis is '''poor''' to severe but depend on the underlying disease; signs are potentially reversible if the initiating course can be corrected.  

Horses with hepatic disease showing neurological signs have a poorer prognosis than those showing only signs af hepatic dysfunction. However with appropriate supportive therapy 40% of horses survive for at least 6 months. Recovery may be incomplete and temporary.

Horses with hepatic disease showing neurological signs have a poorer prognosis than those showing only signs af hepatic dysfunction. However with appropriate supportive therapy 40% of horses survive for at least 6 months. Recovery may be incomplete and temporary.