Equine Hepatic Encephalopathy

Anaesthesia and analgesia considerations for foals with confirmed or suspected portosystemic shunt

“…While the foal in the current case report had never shown seizure activity, the foal had shown signs of hepatic encephalopathy (HE) upon presentation to the hospital. The pathophysiology of HE is complex and likely involves several gut‐derived neurotoxins, cerebral and systemic inflammation, cerebral vascular dysfunction and neuroendocrine abnormalities (Divers 2015). The signs of HE had resolved in the current case, but it is likely that at the time of presentation, the inflammation and ammonia‐induced free radical production in the brain in the presence of HE may also cause vasogenic oedema (Divers 2015) and may therefore have caused an elevation in ICP.…”

“…The pathophysiology of HE is complex and likely involves several gut‐derived neurotoxins, cerebral and systemic inflammation, cerebral vascular dysfunction and neuroendocrine abnormalities (Divers 2015). The signs of HE had resolved in the current case, but it is likely that at the time of presentation, the inflammation and ammonia‐induced free radical production in the brain in the presence of HE may also cause vasogenic oedema (Divers 2015) and may therefore have caused an elevation in ICP. It would therefore be advisable to avoid induction agents which precipitate an elevation in ICP in animals with seizure activity or evidence of HE.…”