Hepatic encephalopathy in dogs and cats

Lidbury, Jonathan A.; Cook, Audrey K.; Steiner, Jörg M.

doi:10.1111/vec.12473

Cited by 49 publications

(64 citation statements)

References 141 publications

(295 reference statements)

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“…The complications associated with CH in dogs are listed in Supporting Information Table S5 and include PH, ascites, HE, coagulation disorders, infection, and gastroduodenal ulceration . Additional complications reported in humans with CH include hepatopulmonary syndrome, hepatorenal syndrome, spontaneous bacterial peritonitis, and hypersplenism.…”

Section: Complicationsmentioning

confidence: 99%

“…Hyperammonemia aids in the diagnosis of HE, but normal blood ammonia concentration does not eliminate the presence of HE. Evidence supports that HE is a pro‐inflammatory, pro‐oxidant, and hypercoagulable state . Treatment of HE consists of dietary protein modulation, lactulose, and antibiotics, and is summarized in Supporting Information Table S5.…”

Section: Complicationsmentioning

confidence: 99%

“…Treatment of HE consists of dietary protein modulation, lactulose, and antibiotics, and is summarized in Supporting Information Table S5. Recent reviews can be consulted . Investigation, recognition, and elimination of factors that precipitate HE, such as metabolic alkalosis, infection, increased protein load (eg, gastrointestinal bleeding, high protein meals), and synergistic neuroinhibition with sedative and analgesics is essential.…”

Section: Complicationsmentioning

confidence: 99%

“…The diagnosis of HE is based on the presence of neurologic signs such as lethargy, ataxia, behavioral changes, changes in mentation (eg, stupor, obtundation, and coma), head pressing, blindness, circling, shaking, twitching, and ptyalism. 205,343,344 Clinical signs of mild HE can be nonspecific (lethargy) and can easily be attributed to many other conditions. Hyperammonemia aids in the diagnosis of HE, but normal blood ammonia concentration does not eliminate the presence of HE.…”

Section: Hepatic Encephalopathymentioning

confidence: 99%

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ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

Webster

Cullen

Penninck

et al. 2019

Veterinary Internal Medicne

198

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This consensus statement on chronic hepatitis (CH) in dogs is based on the expert opinion of 7 specialists with extensive experience in diagnosing, treating, and conducting clinical research in hepatology in dogs. It was generated from expert opinion and information gathered from searching of PubMed for manuscripts on CH, the Veterinary Information Network for abstracts and conference proceeding from annual meetings of the American College of Veterinary Medicine and the European College of Veterinary Medicine, and selected manuscripts from the human literature on CH. The panel recognizes that the diagnosis and treatment of CH in the dog is a complex process that requires integration of clinical presentation with clinical pathology, diagnostic imaging, and hepatic biopsy. Essential to this process is an index of suspicion for CH, knowledge of how to best collect tissue samples, access to a pathologist with experience in assessing hepatic histopathology, knowledge of reasonable medical interventions, and a strategy for monitoring treatment response and complications.

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Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Section: Hepatic Encephalopathymentioning

confidence: 99%

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ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

Webster

Cullen

Penninck

et al. 2019

Veterinary Internal Medicne

198

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“…Ascites has been shown to be a negative prognostic indicator in dogs with CH . Portosystemic shunting often results in hepatic encephalopathy, where abnormal ammonia metabolism acts synergistically with a variety of other factors, such as neurosteroids and inflammatory mediators, to cause astrocyte swelling and neurological dysfunction . Type C hepatic encephalopathy (as a complication of CH) was the second most common category of hepatic encephalopathy in dogs.…”

Section: Consequences Of Hepatic Fibrosismentioning

confidence: 99%

Hepatic Fibrosis in Dogs

Eulenberg

Lidbury

2017

Veterinary Internal Medicne

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Hepatic fibrosis is commonly diagnosed in dogs, often as a sequela to chronic hepatitis (CH). The development of fibrosis is a crucial event in the progression of hepatic disease that is of prognostic value. The pathophysiology of hepatic fibrosis in human patients and rodent models has been studied extensively. Although less is known about this process in dogs, evidence suggests that fibrogenic mechanisms are similar between species and that activation of hepatic stellate cells is a key step. Diagnosis and staging of hepatic fibrosis in dogs requires histopathological examination of a liver biopsy specimen. However, performing a liver biopsy is invasive and assessment of fibrotic stage is complicated by the absence of a universally accepted staging scheme in veterinary medicine. Serum biomarkers that can discriminate among different fibrosis stages are used in human patients, but such markers must be more completely evaluated in dogs before clinical use. When successful treatment of its underlying cause is feasible, reversal of hepatic fibrosis has been shown to be possible in rodent models and human patients. Reversal of fibrosis has not been well documented in dogs, but successful treatment of CH is possible. In human medicine, better understanding of the pathomechanisms of hepatic fibrosis is leading to the development of novel treatment strategies. In time, these may be applied to dogs. This article comparatively reviews the pathogenesis of hepatic fibrosis, its diagnosis, and its treatment in dogs.

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