Veterinary Clinical Medicine-I (General and Systemic)

HEPATIC ENCEPHALOPATHY

• A metabolic disorder affecting the CNS and
• Developing secondary to advanced hepatic disease

Causes

• PSVA (dogs)—usually single large intrahepatic or extrahepatic vessels
• Acquired portosystemic shunting—occurs with diseases that induce portal hypertension (cirrhosis; intrahepatic arteriovenous fistula; fibrosis;
• Acute hepatic failure—induced by drugs, toxins, or infection

Risk factors

• Alkalosis
• Hypokalemia
• Certain anesthetics and sedatives
• Gastrointestinal bleeding—most common precipitating cause
• Transfusion of stored blood products containing high concentrations of ammonia
• Infections
• Constipation
• Methionine