Hepatic encephalopathy (HE) is a neurobehavioral syndrome that develops when blood from the gut is not cleared by the liver, either because of liver failure or because portal blood bypasses the liver. Ammonia is a key player, but other toxins and inflammation contribute. In cats it is mostly caused by congenital portosystemic shunts, and fast recognition and correct supportive care determine the outcome.
Key facts
Hepatic encephalopathy at a glance- Species and system: cat; liver, brain, portal circulation.
- Types: A (acute liver failure), B (portosystemic shunt) and C (cirrhosis with shunting and reduced liver mass).
- Classic presentation: young cat with episodic neurologic signs, often after a meal, with ptyalism.
- First-line medical therapy: lactulose, with antibiotics and a balanced diet.
- Avoid: benzodiazepines and alfaxalone, which act on GABA receptors.
- Zoonotic: no.
What's inside
12 sections in the full guide- Key facts
- How the NAVLE tests this
- Cause and pathophysiology
- Clinical signs
- Diagnosis
- Differential diagnoses
- Treatment and management
- HE outside congenital shunts
- Prognosis
- Quick review
- Test yourself
- References
The full guide also has 5 tables, 1 figure, 3 self-test questions and 3 references, available to NAVLE members.
Read the full study guide
The full guide is part of every NAVLE plan, with diagnosis and treatment tables, figures, a quick review and self-test questions. Start a free trial to try the question bank, or log in if you are already a member.