Difference between revisions of "Hepatic Encephalopathy"
Jump to navigation
Jump to search
| Line 15: | Line 15: | ||
==Diagnosis== | ==Diagnosis== | ||
===Clinical Signs=== | ===Clinical Signs=== | ||
| − | Typical signs include | + | ====Dog==== |
| + | Typical signs include: | ||
*depression and lethargy | *depression and lethargy | ||
*aimless wandering | *aimless wandering | ||
| Line 22: | Line 23: | ||
*pacing | *pacing | ||
*coma | *coma | ||
| + | *poor growth rate | ||
| + | *anorexia | ||
| + | *gastrointestinal signs such as vomiting | ||
| + | |||
| + | Other signs include: | ||
| + | *temporary resolution of clinical signs with antimicrobial therapy | ||
| + | *prolonged recovery from sedation or anaesthesia | ||
| + | *polyuria and polydipsia in a third of cases | ||
| + | |||
| + | ====Cat==== | ||
| + | Typical signs include: | ||
| + | *well grown and in good body condition which in contrast to dogs | ||
| + | *Hypersalivation or ptyalism is the most commonly reported clinical feature, but rarely in dogs | ||
| + | |||
===Laboratory Tests=== | ===Laboratory Tests=== | ||
Revision as of 22:10, 7 August 2009
 |
This article is still under construction. |
Signalment
Description
Hepatic encephalopathy is charaterised by a complex of neurological abnormalities that may occur in the presence of advanced liver disease. By far the most common cause in dog and cat is Portosystemic Shunt.
Diagnosis
Clinical Signs
Dog
Typical signs include:
- depression and lethargy
- aimless wandering
- head pressing
- blindness
- pacing
- coma
- poor growth rate
- anorexia
- gastrointestinal signs such as vomiting
Other signs include:
- temporary resolution of clinical signs with antimicrobial therapy
- prolonged recovery from sedation or anaesthesia
- polyuria and polydipsia in a third of cases
Cat
Typical signs include:
- well grown and in good body condition which in contrast to dogs
- Hypersalivation or ptyalism is the most commonly reported clinical feature, but rarely in dogs
Laboratory Tests
Haematology
Biochemistry
Other Tests
Diagnostic Imaging
Treatment
- Enemas to decrease the amount of bacteria in the colon
- Ampicillin PO to reduce the amount of bacteria in intestines and hence decrease the production of ammonia
- Lactulose PO
- This is metabolised by colonic bacteria are responsible for producing acids, thereby decreasing the pH in the colon. Ammonia is converted into ammonium ions which cannot be absorbed and is therefore lost in the faeces. Lactulose also causes water to be drawn into the colonic lumen, causing diarrhoea, thereby more faeces and bacteria are washed out.
- High carbohydrate, low protein (2g/kg/day) and low fat diet is recommended.
Prognosis
References
- Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company.
- Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier.