Changes

==Description==

==Description==

Hepatic encephalopathy is characterised 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]] (PSS), although a marked reduction in functional mass of hepatic tissue can also lead to hepatic encephalopathy.  In rare cases, when severe acquired shunt due to hepatobiliary disease and congenital PSS have been ruled out, congenital urea enzyme cycle deficiencies and organic acidaemias, where there is lack of ability to degrade ammonia to urea, can be considered.

'''Hepatic encephalopathy''' is characterised 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]] (PSS), although a marked reduction in functional mass of hepatic tissue can also lead to hepatic encephalopathy.  In rare cases, when severe acquired shunt due to hepatobiliary disease and congenital PSS have been ruled out, congenital urea enzyme cycle deficiencies and organic acidaemias, where there is lack of ability to degrade ammonia to urea, can be considered.

*the catabolic metabolism of glutamine as an energy source by small intestinal enterocytes.

*the catabolic metabolism of glutamine as an energy source by small intestinal enterocytes.

*endogenous hepatic protein metabolism by excess dietary protein intake, breakdown of lean body mass and gastrointestinal bleeding.

*endogenous hepatic protein metabolism by excess dietary protein intake, breakdown of lean body mass and gastrointestinal bleeding.

==Diagnosis==

==Diagnosis==