Hepatic Encephalopathy in Cats
Encephalopathy is the medical term for any disorder of the brain, and hepatic refers to the liver. Hepatic encephalopathy is a metabolic disorder that affects the central nervous system. It develops secondary to liver disease (known as hepatopathy). Hepatic encephalopathy is caused by an accumulation of ammonia in the system due to the liver's inability to rid the body of the substance.
The liver is the largest gland in the body, performing a number of essential functions, including the production of bile (a fluid substance involved in the digestion of fats), production of albumin (a protein in the plasma of the blood), and detoxification of drugs and other chemicals (such as ammonia) in the body.
A portosystemic shunt or portosystemic vascular anomaly is a condition in which blood vessels allow blood to flow abnormally between the portal vein (the vein that normally carries blood from the digestive organs to the liver) and into the body's blood circulation without first being filtered through the liver. This condition can be congenital (present at birth) or acquired (a condition that develops sometime later in life).
Congenital portosystemic shunt or portosystemic vascular anomaly is genetically inherited in some breeds and will generally present at a young age. With acquired forms of this disease, symptoms can occur at any age.
Symptoms and Types
- Circling, running into walls and acting confused after meals
- Learning disabilities (difficult to train)
- Sluggishness (lethargy) and/or drowsiness or sleepiness
- Aimless wandering
- Compulsive pacing
- Head pressing
- Blindness related to brain abnormality
- Seizures
- Coma
- Sudden aggression
- Vocalizing
- Lack of appetite
- Increased urination or lack of urination
- Frequent voiding of small volumes
- Orange-brown urine
- Increased thirst
- Excessive salivation
- Vomiting
- Diarrhea
- Stunted growth
- Prolonged recovery from sedation or anesthesia
- Dramatic temporary resolution of signs may occur with antibiotic or lactulose (synthetic sugar) therapy
Causes
- Congenital (genetically acquired)
- Acquired portosystemic shunt occurs with diseases that can lead to high blood pressure in the vein carrying blood from the digestive organs to the liver – such as occurs with progressive damage and scarring of the liver (cirrhosis)
- Sudden (acute) liver failure can be induced by drugs, toxins, or infection
- Alkalosis (high blood alkaline levels)
- Low blood potassium
- Certain anesthetics and sedatives
- Methionine, tetracycline and antihistamines
- Bleeding into the intestine
- Transfusion predisposes
- Infections
- Constipation
- Muscle wasting
Diagnosis
You will need to give a thorough history of your cat's health, onset of symptoms, and any background information you have on your cat's parentage. Your veterinarian will perform a complete physical exam on your cat, with standard tests including a blood chemical profile, a complete blood count, an electrolyte panel and a urinalysis so as to rule out other causes of disease. Your veterinarian will use the bloodwork to confirm or rule out impaired kidney function.
X-ray and ultrasound imaging will allow your veterinarian to visually examine the liver. Its appearance will change in certain diseased states. If this appears to be the case your veterinarian may take a sample from the liver by aspiration or biopsy in order to reach a conclusive diagnosis.
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synthetic
Something that is artificially created
seizure
An involuntary action in which the muscles contract; caused by a problem with the brain.
systemic
Something that is related to the whole body and not just one particular part or organ
urinalysis
An in-depth examination of the properties of urine; used to determine the presence or absence of illness
voiding
The process of elimination when it comes to the bowels or the bladder
lethargy
The condition of being drowsy, listless, or weak
encephalopathy
A disease of the brain of any type
bile
The fluid created by the liver that helps food in the stomach to be digested.
albumin
A type of protein that can be dissolved in water; found in milk, egg white, certain muscle, blood, and some urine.
biopsy
The process of removing tissue to examine it, usually for medical reasons.
blood pressure
The amount of pressure applied by the blood on the arteries.
acute
Term used to imply that a situation or condition is more severe than usual; also used to refer to a disease having run a short course or come on suddenly.
hepatic
Referring to the liver
Courtesy of petmd.com Original Article