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Hepatic Encephalopathy HE in Yorkies
Hepatic Encephalopathy HE is a degenerative disease of the brain caused by severe hepatic insufficiency in advanced liver disease. It is characterized by abnormal mental status, an altered state of consciousness and impaired neurologic function.
The most common cause is a congenital abnormality present at birth called a Portosystemic Shunt. This is an anatomical defect that causes blood to be diverted around the liver instead of passing through the liver. The liver cannot detoxify the blood and the toxins reach the brain and cause the clinical syndrome. Patients with liver failure due to toxic or infectious causes can also exhibit signs of HE.
Hepatic Encephalopathy is a syndrome of liver disease.
There are 3 classifications:
Type A - Acute - describes Hepatic Encephalopathy associated with acute liver failure
Type B - Bypass - is caused by Portal-Systemic Shunting without associated intrinsic liver disease
Type C - Cirrhosis - occurs in patients with Cirrhosis.
The signs of HE can be mild to severe unusual behavior.
Hysteria
Staggering
Pacing
Tremors
Seizures
Coma-like state
Compulsive circling
Pressing the head against a wall
Sudden apparent blindness
Unpredictable bouts of aggression
These unusual behavior changes are often seen shortly after a meal.
Anorexia
Lethargy
Vomiting
Diarrhea
Weight loss
Drinking a lot or urinating a lot
Nausea or drooling
Treatment
Is actually treating the liver itself the same as with liver shunts disease.
Low Protein Diet
Antibiotics
Lactulose
Read more about
Liver Shunts - MVD and PSVA
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