Difference between revisions of "Hepatic Encephalopathy - Horse"
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===Laboratory Tests=== | ===Laboratory Tests=== | ||
| − | Haemotology and Biochemistry results will be consistent with hepatic disease | + | Haemotology and Biochemistry results will be consistent with hepatic disease; including increased GGT and SDH, hypoalbuminaemia and elevated bile acids. |
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===Biopsy=== | ===Biopsy=== | ||
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==Treatment== | ==Treatment== | ||
| − | 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 in acute cases likely to make a recovery. |
'''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. | ||
==Prognosis== | ==Prognosis== | ||
Revision as of 12:37, 19 August 2010
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This article is still under construction. |
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 mechanisms is probably responsible for the syndrome.
Signalment
No age, sex or breed predisposions.
There are many hepatic disorders which can lead to hepatic encephalopathy including, Hepatitis, Ragwort Toxicity, Tyzzer's Disease and Hyperlipaemia
Diagnosis
Clinical Signs
Clinical signs vary depending on the severity of hepatic dysfunction, early signs are often subtle and may be missed. Clinical signs may be associated with feeding.
- Depression
- Lethargy
- Head pressing
- Dysphagia
- Ataxia
- Behavioural changes
- Seizures
- Coma
- Death
Clinical signs associated with hepatic disease
- Weight loos
- Diarrhoea
- Icterus
Laboratory Tests
Haemotology and Biochemistry results will be consistent with hepatic disease; including increased GGT and SDH, hypoalbuminaemia and elevated bile acids.
Biopsy
A liver biopsy can provide a definitive diagnosis of liver disease, a clotting profile should be carried out before taking an ultrasound-guided biopsy.
Ultrasound
Transabodimal ultrasound can be used to assess the structure of the liver and degree of damage.
Pathology
See Hepatic Encephalopathy Pathology
Treatment
With supportive therapy horses may recover from hepatic encephalopathy after 4-21 days. Treatment is only warranted in acute cases likely to make a recovery.
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.
Prognosis
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.
References
- Bertone, J. (2006) Equine Geriactric Medicine and Surgery, Elsevier
- Knottenbelt, D.C. A Handbook of Equine Medicine for Final Year Students University of Liverpool
- Merck & Co (2008) The Merck Veterinary Manual (Eighth Edition) Merial
- Rose, R. J. and Hodgson, D. R. (2000) Manual of Equine Practice (Second Edition) Sauders.