Hepatic encephalopathy

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The term hepatic encephalopathy refers to a complex of neurological abnormalities that may occur in the presence of advanced liver disease. In the dog and cat, hepatic encephalopathy most commonly results from a single congenital vascular shunt from the portal circulation, which bypasses the hepatic circulation and allows mesenteric blood to enter directly either the caudal vena cava or the azygos vein. Acquired portosystemic shunting also occurs as a consequence of diseases that induce portal hypertension, including cirrhosis, arteriovenous (AV) fistula and hepatoportal fibrosis. This chapter covers Clinical features of dogs and cats; Differential diagnosis; Diagnosis; and Treatment.

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15.1 These Maltese dogs are littermates; the one on the right has a congenital portacaval shunt.
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15.2 An extra-hepatic shunt in a Maltese dog prior to ligation.
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15.3 An intra-hepatic shunt in an Australian Cattle Dog. The vena cava communicates directly with the portal vein within the parenchyma of the liver.

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