Veterinary Clinical Medicine-I (General and Systemic)

SPECIFIC TREATMENT

Medications - Drugs and Fluids

• Lactated Ringer's solution or 0.9% NaC with KCl (20-30 mEq/L) and B-complex vitamins (2 ml/L) added. Glucose should be added if hypoglycemia is present. 
•  For Hepatic Encephalopathy 
  • Lactulose (1 ml/kg PO q8h) 
  • Antibioticsmetronidazole (7.5 mg/kg PO q8h), ampicillin (20 mg/kg PO q8h), or neomycin (20 mg/kg PO q8h)
• For Ascites 
  • Sodium: restricted diet
  • Diuretics: spironolactone (1-2 mg/kg PO q12h) or furosemide (1-2 mg/kg PO q12h)
  • Repeated abdominocentesis in patients refractory to diet and diuretics
• For Hemorrhage
  • Fresh whole blood transfusion.
• For Fibrosis
  • Prednisone (1 mg/kg PO q24h-q48h)
  • Colchicine (0.03 mg/kg PO q24h)
  • d-penicillamine (10-15 mg/kg PO q12h)
• Altered Bile Acid Dynamics
  • Ursodiol (10-15 mg/kg PO q24h)

Contraindications

• Diuretics may worsen hepatoencephalopathy if prerenal azotemia results.
• Prednisone should not be used in animals with secondary infection.
• The following drugs should be avoided if possible: chloramphenicol , tetracycline , clindamycin , meperidine , pentazocine , aspirin , and azathioprine .

Nephrotic syndrome

• ACE inhibitor such as enalapril (0.5 mg/kg q24h)

Treatment of Edema and Ascites

• Cage rest and dietary sodium restriction
• Paracentesis and diuretics
• Dietary management