Hepatic Encephalopathy

Hepatic Encephalopathy affects the nervous system mainly. It is caused by a dysfunction of the liver not being able to remove toxic products from the blood.

Exact which toxins is the main one is not known. One important candidate could be ammonia from the protein breakdown. Main reasons for Encephalopathy is as follows.

1. Congenital Porto systemic shunts
2. Liver disease
3. Acquired Shunts

1. Congenital Porto Systemic Shunts

These are often seen in young animals.

In the fetus blood can normally bypass the liver. That's totally normal. After birth these special connections should get closed. When they don't, you have a congenital shunt.

Congenital liver shunts are not common. I have only seen one.

Breeds such as Shih Tzus, Schnauzers and Yorkshire Terriers do often have extra hepatic shunts. Some shunts can be lying inside the liver and therefore more difficult to repair surgically

2. Liver disease

If the liver cells are compromised in any way they can be work overloaded. Not being able to do the work to clear blood from toxins. The result could be Hepatic Enchephalopaty.

3. Acquired Shunt

The blood flow is like a water flow. It finds new ways if the normal flow is disrupted.

If the liver is becoming more difficult to pass through, shunts will find other ways. This will bypass the liver. These liver shunts are often found in older dogs with severe liver fibrosis.

Treatment of Hepatic Encephalopathy

At first try to solve the primary reason. This makes good sense. But if that's not possible you ca do a lot by proper liver diet to dogs with hepatic Encephalopathy

Give restricted volume of protein of high biological value. This will sustain the nutrition needed to maintain the body and reduce the production of ammonia. Liver diets are often low protein, but of high quality. You need to control both volume and type of protein. To givecanine low protein is not enough. If the body not gets it's essential amino acids break down the muscles instead. Production of ammonia will increase.

General between 12-16% of the energy should be from protein.

Feeding small, but frequent meals could be helpfull as well

Antibiotics and oral Lactulose used in some situations. This will decrease the absorbing from the gut of ammonia

Soubel fibes can do the same. Fibers in the food will have a acidifying function and bind some of the ammonia in the gut.

Symptoms of Hepatic Encephalophathy

Congenital shunts are found in young dogs.

Related to CNS and growth. You will see tremors, cramps, seizures, head pressing (headache probably), lack of growth and vomiting.

Some of these symptoms are not seen all the time. Cramps and seizures can be seen only after feeding when toxin production is at its highest.