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==Description==  

==Description==  

'''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 the following mechanisms are probably responsible for the syndrome, hepatic insufficiency allows the build up of ammonia which affects neurotransmission in the CNS, toxic metabolites may act as false neurotransmitters and there can be an imblance between excitatory and inhibitory neurotransmission.     

'''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 the following mechanisms are probably responsible for the syndrome, hepatic insufficiency allows the build up of ammonia which affects neurotransmission in the CNS, toxic metabolites may act as false neurotransmitters and there can be an imblance between excitatory and inhibitory neurotransmission.     

==Signalment==

==Signalment==

* Stage II: Depressed mental state, lethargy, behavioural changes, head pressing, ataxia and dysphagia.  

* Stage II: Depressed mental state, lethargy, behavioural changes, head pressing, ataxia and dysphagia.  

* Stage III: Somnolent but rousable. Reactions may be very reduced or exagerrated.

* Stage III: Somnolent but rousable. Reactions may be very reduced or exagerrated.

* Stage IV: Coma, Seizures rae atypical but may occur in late stages of the syndrome.

* Stage IV: Coma, Seizures are rare but may occur in the late stages of the condition.

 

Additional clinical signs associated with hepatic disease:  

Additional clinical signs associated with hepatic disease:  

'''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.   

'''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.   

    

    

Fluid deficits and acid base abnormalities should be corrected as necessary and hypoglycaemic animals should be given a 5% dextrose solution IV. High carbohydrate, low protein diets should be fed in small amounts fequently.  

Fluid deficits and acid base abnormalities should be corrected as necessary and hypoglycaemic animals should be given a 5% dextrose solution IV. High carbohydrate, low protein diets should be fed in small amounts and frequently.  

==Prognosis==

==Prognosis==