Hepatic Encephalopathy In Dogs

Hepatic encephalopathy is a serious condition that can impact dogs with advanced liver disease.

Though liver disease is a life changing diagnosis in itself, there are a few complications that can come along with its presence.

In this article we will discuss the details behind hepatic encephalopathy in dogs, and help you understand what this diagnosis means for your canine companion.

What is Hepatic Encephalopathy In Dogs?

Hepatic encephalopathy is a degenerative brain disease that is caused by a buildup of ammonia in the body.

Since a healthy liver in dogs helps to filter the blood and rid the body of excess toxins such as ammonia, a damaged liver struggles to get the job done.

Because of this, ammonia will begin to build up in the blood, eventually affecting the central nervous system.

Once the central nervous system is impacted by this excess amount of ammonia in the body, the concerning symptoms of hepatic encephalopathy begin to develop.

Hepatic Encephalopathy in Dogs

What Causes Hepatic Encephalopathy In Dogs?

This disease is a result of the liver failing to remove toxins from the bloodstream, any condition that affects the liver can lead to hepatic encephalopathy.

Some of the most common causes of this disease in dogs includes:

  • Chronic liver failure
  • Infectious disease that damages the liver
  • Toxicity that affects the liver
  • Portosystemic shunt (liver defect)
  • Acute liver injury
  • Hypoglycemia
  • Severe dehydration
  • Gastrointestinal bleeding
  • High protein diets
  • Prolonged use of certain medications

As you can see, multiple liver conditions can lead to the development of hepatic encephalopathy.

Due to this, it’s extremely important to stay on top of the above conditions and follow your veterinarian’s orders for proper care.

What Are The Symptoms Of Hepatic Encephalopathy?

The symptoms of hepatic encephalopathy are part of what makes this condition so scary for pet owners.

This degenerative condition can bring with it a number of alarming symptoms, all of which cause great concern among dog owners.

The most common symptoms of hepatic encephalopathy in dogs include:

  • Disorientation
  • Circling or running into objects
  • Change in behavior
  • Unsteady on their feet
  • Pacing
  • Head pressing
  • Tremors
  • Change in vision or evidence of vision loss
  • Abnormal vocalization, barking more than usual
  • Appearing confused or in a daze
  • Lethargic
  • Extreme thirst
  • Vomiting
  • Diarrhea
  • Seizures

How To Test For Hepatic Encephalopathy

When it comes to diagnosing hepatic encephalopathy in dogs, your veterinarian will often order a few different tests.

Each of these tests help to offer a full picture of what is happening inside of your dog’s body, and help to determine how serious your dog’s case is.

Complete Blood Count (CBC)

A CBC can show evidence of liver damage in your canine friend.

A high white blood cell count is often present in cases of infectious disease, and some of these infections can impact the function of your dog’s liver. 

Chemistry Panel

A chemistry panel in dogs is the tool that will measure your dog’s liver enzymes.

The levels in this test can help your veterinarian determine your dog’s liver function, as well as how severe your dog’s illness may be.

Blood Ammonia Levels

Since hepatic encephalopathy is a result of toxins built up in the bloodstream, a high ammonia level in the blood can help to lean toward a positive diagnosis of hepatic encephalopathy. 

Coagulation Tests

Since the liver also aids in the clotting of blood, hepatic encephalopathy can cause clotting problems that can be evident on a coagulation test. 


Due to a high concentration of ammonia in the bloodstream, some dogs with hepatic encephalopathy will begin to form crystals in their urine.

Not only can you search for crystals in this diagnostic, but you can also search for any severe urinary tract infections as well.

Abdominal Ultrasound

An abdominal ultrasound is an incredible way to take a look at the current state of the liver.

Ultrasounds can show enlargement of organs, masses on organs, and any other abnormalities.

Hepatic encephalopathy in dogs is a serious diagnosis that often requires multiple diagnostics.

The more tests that your vet is able to run, the more chance they have of creating a full picture and accurate treatment plan for your dog.

Hepatic Encephalopathy Treatment In Dogs

Ideally, each dog that is diagnosed with hepatic encephalopathy should stay in the hospital to be stabilized.

Since this condition can cause serious neurological symptoms, it’s always best to have them monitored closely as they begin their treatment.

Here are some of the most effective forms of treatment for HE in our canine friends.


Hospitalizing your dog on IV fluids can help to offer the liver additional support, as well as around the clock monitoring while your dog begins their treatment plan.

This is the safest option for a dog with a liver condition that is serious enough to cause hepatic encephalopathy.

Identifying a cause

If there is an underlying condition behind your dog’s liver damage, it’s important to get to the bottom of it.

For example, if your dog is suffering from an infectious disease, their HE will not resolve until the infection is cleared.


Antibiotics are a common therapy in hepatic encephalopathy due to the possibility of bacteria in the GI tract.

Since bacteria in the intestinal tract can release ammonia, it’s important to remove any possible cause of excess ammonia in the bloodstream.


Lactulose is an oral medication that helps to trap ammonia in the colon.

By doing this, the excess toxins are unable to absorb into the bloodstream and cause additional neurological symptoms.

Your dog will often continue this medication until your veterinarian instructs otherwise.

Diet change

Diet is one of the most important tools of long term hepatic encephalopathy management.

Since high protein can be a cause for HE symptoms, a liver disease diet will offer a safe amount of protein for your dog.

Life Expectancy in Dogs With Hepatic Encephalopathy

When a dog with hepatic encephalopathy receives treatment from the moment their symptoms begin, their prognosis is generally good.

Though they have often suffered irreversible liver damage in many cases, their HE can be managed with proper medical care.

As long as the dog owner is dedicated to following the veterinarians instructions, offering their daily medications religiously, and keeping up with follow up diagnostics; these dogs have the ability to live full lives.

Because of this, their life expectancy can be anywhere from 6 months to 2 years.

Just be sure to keep a close eye on your dog, and notify your vet of any decline in their health throughout the process.

Hepatic encephalopathy in dogs is a serious condition that can cause our dog great distress.

Be sure to review the information we discussed above, and you will better understand this disease going forward.

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