Hepatic encephalopathy

Abstract

This chapter presents information on etiology/pathophysiology, signalment/history, clinical features, differential diagnosis, diagnostics and therapeutics of hepatic encephalopathy (HE) in dogs and cats. Clinical signs in the early course of HE are often nonspecific, subtle, and episodic, and are frequently undetected by owners and/or clinicians. Many animals have minimal and nonspecific clinical signs throughout their lives that are not detected by owners and/or clinicians. In other cases, clinical signs progress in intensity and frequency. Imaging is crucial and almost always necessary for the definitive diagnosis of portosystemic shunts (PSS). Ultrasonography is used for detection of possible underlying disorder, portal vasculature evaluation, visualization of single or multiple PSS. Computed tomography (CT) is used for liver size determination; visualization of PSS; and visualization and quantification of cerebral edema. CT angiography is commonly used for the detection of congenital PSS. Dietary protein restriction is the mainstay of medical management. © 2019 John Wiley & Sons, Inc.