Hepatische Enzephalopathie bei einer Stute

Summary

In this study we describe a ten-year old pre-bred English mare. Anorexia, weight loss and intermittent abdominal pain were described in the anamnesis. Several approaches to treat the patient remained without success. A physical examination performed later, yielded neurological symptoms like ataxy. A hepatic encephalopathy was diagnosed based on the results of clinical and biochemical examinations. Material und Methods: The patient was characterized clinically and with using biochemical assays. Later, an autopsia was performed. An analysis of serum yielded increased concentrations of the enzymes AST and GGT, as well as an increased concentration of ammonia. An autopsy after the patients' death confirmed cirrhosis of the liver. Furthermore, cerebral edemas were found. The hepatic encephalopathy of the patient described in this study with high probability is resulting from the cirrhosis of the liver and the hyperammonemia. This report including its clinical and biochemical data is supposed to help to diagnose a hepatopathy prior to the onset of a hepatic encephalopathy. After the onset of hepatic encephalopathy the prognosis is known to be substantially worse.

Key words

equine - cirrhosis of the liver - hyperammonemia

Literatur

• 1 Barton M H, Morris D D. Doenças do fígado.. In: Reed S M, Bayly W M Medicina Interna Eqüina.. Rio de Janeiro: Guanabara Koogan; 2000
• 2 Durham A E, Newton J R, Smith K C, Hillyer L L, Smith M R W, Marr C M. Retrospective analysis of historical, clinical ultrasonographic, serum biochemical and haematological data in prognostic evaluation of equine liver disease.  Equine Vet J. 2003;  35 542-547
• 3 Durham A E, Smith K C, Newton J R. An evaluation of diagnostic data in comparison to the results of liver biopsies in mature horses.  Equine Vet J. 2003;  35 554-559
• 4 Frye M A, Johnson J S, Traub-Dargatz J L, Savage C J, Fettman M J, Gould D H. Putative uremic encephalopathy in horses: five cases (1978–1998).  J Am Vet Med Assoc. 2001;  15: 218 560-566
• 5 Hasel K M, Summers B A, DeLahunta A. Encephalopathy with idiopathic hyperammonaemia and Alzheimer type II astrocytes in Equidae.  Equine Vet J. 1999;  31 478-482
• 6 Johns I C, Piero F, Wilkins P A. Hepatic encephalopathy in a pregnant mare: identification of histopathological changes in the brain of a mare and fetus.  Austr Vet J. 2007;  85 337-340
• 7 Maddison J E. Hepatic encephalopathy.  J Vet Int Med. 1992;  6 341-353
• 8 Mair T S. Ammonia and encephalopathy in the horse.  Equine Vet J. 1997;  29 1-2
• 9 McGorum B C, Murphy D, Love S, Milne E M. Clinicopathological features of equine primary hepatic disease: a review of 50 cases.  Vet Rec. 1999;  145 134-139
• 10 Messer N T, Johnson P J. Serum hepatitis in two brood mares.  J Am Vet Med Assoc. 1994;  204 1790-1792
• 11 Morris D D, Henry M M. Hepatic encephalopathy.  Comp Cont Educ. 1991;  13 1153-1161
• 12 Nobre V M T, Riet-Correa F, Barbarosa, Filho J M, Dantas A F M, Tabosa I M, Vasconcelos J S. Intoxicação por Crotalaria retusa (Fabaceae) em eqüídeos no semi-árido da Paraíba.  Pesq Vet Bras. 2004;  24 132-143
• 13 Peek S F, Divers T J, Jackson C J. Hyperammonaemia associated with encephalopathy and abdominal pain without evidence of liver disease in four mature horses.  Equine Vet J. 1997;  29 70-74
• 14 Seahorn J. Liver disease in a 9-year-old Arabian stallion.  Vet Clin Eq Pract. 2006;  22 117-126
• 15 Sharkley L C, DeWitt L C, Stockman C. Neurologic signs and hyperammonemia in a horse with colic.  Vet Clin Pathol. 2006;  35 254-258
• 16 West H J. Clinical and pathological studies in horses with hepatic disease.  Equine Vet J. 1996;  28 146-156
• 17 Zientara S, Trap D, Fontaine J J, Gicquel B, Sailleau C, Plateau E. Survey of equine hepatic encephalopathy in France in 1992.  Vet Rec. 1994;  134 18-19