Successful management of clinical signs associated with hepatic encephalopathy with manual therapeutic plasma exchange in a dog.
ammonia
critical care
extracorporeal therapy
liver disease
plasmapheresis
portosystemic shunt
Journal
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
ISSN: 1476-4431
Titre abrégé: J Vet Emerg Crit Care (San Antonio)
Pays: United States
ID NLM: 101152804
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
23
02
2018
revised:
03
08
2018
accepted:
14
08
2018
pubmed:
23
2
2020
medline:
6
10
2020
entrez:
21
2
2020
Statut:
ppublish
Résumé
To describe the use of manual therapeutic plasma exchange (TPE) to manage hepatic encephalopathy (HE) in a dog. A 9-year-old neutered female Dachshund presented for HE secondary to a previously diagnosed portosystemic shunt. The hyperammonemia and severe clinical signs of HE persisted despite extensive medical management. Therapeutic plasma exchange was performed for stabilization prior to surgical shunt ligation. A total of 1 plasma volume was processed during a single manual TPE session. The ammonia immediately prior to TPE was 235 μmol/L (reference interval, 10-30 μmol/L) and decreased to 117 μmol/L by the end of the session. The dog showed significant improvement in clinical signs shortly after the session and remained stable thereafter. Shunt ligation was performed 5 days later with no complications observed with TPE or postoperatively. The dog was discharged 3 days after surgery with no neurological signs and was doing well 100 days after surgery. To the authors' knowledge, this is the first published report of manual TPE to manage HE in veterinary medicine. Therapeutic plasma exchange should be further investigated as a possible strategy to manage clinical signs of HE in patients that are refractory to medical management. Achieving this with manual TPE may be considered in patients that are too small for conventional TPE due to extracorporeal volume or in situations where conventional TPE is not available.
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
312-317Informations de copyright
© Veterinary Emergency and Critical Care Society 2020.
Références
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