Hepatic Encephalopathy

Vet Clin North Am Small Anim Pract. 2017 May;47(3):585-599. doi: 10.1016/j.cvsm.2016.11.008. Epub 2017 Jan 6.

Abstract

This article reviews hepatic encephalopathy (HE) in companion animals. Clinical signs and categories of hepatic disease likely to cause HE are discussed. Ammonia has a key role in pathogenesis and current concepts in body ammonia metabolism are reviewed. Inflammation and manganese accumulation are also thought to be important in pathogenesis. Treatment of HE in acute and chronic cases is discussed along with the rationale for current treatment recommendations. Potential avenues for new treatments and human treatments, which may be transferable to companion animals, are reviewed.

Keywords: Ammonia; Inflammation; Manganese; Neurotransmitter; Portosystemic shunting.

Publication types

  • Review

MeSH terms

  • Ammonia* / adverse effects
  • Ammonia* / blood
  • Ammonia* / metabolism
  • Animals
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Cat Diseases* / diagnosis
  • Cat Diseases* / etiology
  • Cat Diseases* / therapy
  • Cats
  • Dog Diseases* / diagnosis
  • Dog Diseases* / etiology
  • Dog Diseases* / therapy
  • Dogs
  • Hepatic Encephalopathy / complications
  • Hepatic Encephalopathy / diagnosis
  • Hepatic Encephalopathy / therapy
  • Hepatic Encephalopathy / veterinary*
  • Humans
  • Inflammation / complications
  • Inflammation / veterinary
  • Liver Diseases / complications
  • Liver Diseases / veterinary
  • Manganese / adverse effects
  • Rats
  • Severity of Illness Index

Substances

  • Anti-Bacterial Agents
  • Manganese
  • Ammonia