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Description
Hepatic encephalopathy is neurological disfunction caused by hepatic disease, 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
- Ataxia
- Behavioural changes
- Seizures
- Coma
- Death
Clinical signs associated with hepatic disease
- Weight loos
- Diarrhoea
- Icterus
Laboratory Tests
Biopsy
Ultrasound
Pathology
See also Hepatic Encephalopathy Pathology
Treatment
With supportive therapy horses may recover from hepatic encephalopathy after 4-21 days.
Prognosis
Prognosis depends 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.