Neurologic disorders: Hepatic Encephalopathy

Question 1

The most frequent cause of hepatic encephalopathy in small animals are -?

Answer 1

Congenital extrahepatic or intrahepatic portal-to-systemic venous communications

Question 2

True or False: Clinical signs associated with hepatic encephalopathy are often overt and pathognomonic.

Answer 2

False, they are often subtle and episodic

Question 3

In dogs presenting with hepatic encephalopathy, what clinical signs would you expect to see?

Answer 3

Disorientation, personality change, stupor, pacing, head pressing, stargazing, coma, and occasionally seizures; PU/PD, also GI and urinary signs as well

Clinical signs associated with CNS depression often predominate in patients with hepatic encephalopathy

Question 4

Diagnosis of hepatic encephalopathy includes -?

Answer 4

Serum biochemistry panel and liver function tests (ammonia, SBA, BSP dye tests) for signs of moderate to severe liver disease

Question 5

Treatment of hepatic encephalopathy includes -?

Answer 5

Diazepam, propofol, or bromide for seizures or as needed for sedation, glucose and potassium supplementation, colloid fluid therapy (PLT, plasma, or packed RBC), lactulose (PO or enema), GI protectants, and antimicrobials